• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.331-338
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• 2002

Purpose : To investigate the feature of the range of measles in 2000, we studied epidemics of the measles in western Kyungnam District. Methods : Among 489 patients under 15 years of age who visited or were admitted to in our hospital from January to December in 2000, we selected 344 patients whose measles IgM antibody was positive. We investigated age, monthly incidence, clinical features, vaccination history, and measles IgG antibody. Results : Patients under 12 months of age occupied the largest proportion(36.9%). Patients firstly occurred in May and geometrically increased from October. Fever, cough and rashes were observed in all patients but conjunctivitis in 54.9%, Koplik spot in 23.8%. The first vaccination ratio was 41.8%. Compared with the number of patients and the first vaccination ratio, the first vaccination ratio was the lowest under 12 months of age. After that age group, the number of patients was decreased as the first vaccination ratio was increased. Among 152 patients sampled for measles IgG antibody, 35 patients had received the first vaccination and 6 patients had received the second vaccination. Among 35 patients who received the first vaccination, 22(62.9%) patients were negative of measles IgG antibody. Among 6 patients who received the second vaccination, 3(50%) patients were negative. Conclusions : Measles patients under 12 months still dominated. Therefore, routine vaccination of single measles vaccine, is currently done at 6 month when measles are prevalent, should be considered. High first vaccination failure suggests problems of vaccines itself, transport and storage rather than vaccination methods. Therefore a thorough investigation should be made.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.5
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• pp.249-256
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• 2006

Purpose: Although computed tomography (CT) is widely used for diagnosing liver metastasis from colorectal cancer, diagnostic accuracy of CT is not satisfactory. Magnetic resonance (MR) imaging and F-18 FDG PET has been reported to be superior to CT. However, studies on direct comparison of PET and MR are scarce. We compared the diagnostic accuracy of FDG PET and MR in detecting liver metastasis from colorectal cancer. Materials and Methods: Among 363 colorectal cancer patients who underwent F-18 FDG PET (ECAT, Siemens-CTI, Knoxville; Gemini, Philips, Milpitas, U.S.), 26 patients (M:F=17:9, age=$62{\pm}11$) underwent MR to evaluate suspicious metastatic liver lesions. Finally, 35 liver lesions detected by CT from 26 patients were enrolled for analysis. PET and MR results were compared with pathologic reports, clinical findings or follow-up results. Results: Of the 35 lesions, 18 lesions (51.4%) were diagnosed as liver metastases, while remaining 17 (48.6%) as benign. The sensitivity and the specificity of PET were 94.4% and 94.1%, respectively, compared to 100% and 82.4% for MR. MR and PET was concordant in 30 lesions (85.7%: 17 metastatic (94.4%) and 13 benign (76.5%) lesions. ROC curve analysis revealed maximal SUV of 3.1 as the optimum standard in differentiating metastatic from benign liver lesions (AUC=0.897, p<0.001, sensitivity 83.3%, specificity 94.1%). For small lesions less than 1 cm ln diameter (n=20), diagnostic accuracy of PET was comparable to that of MR. Conclusion: F-18 FDG PET showed good diagnostic performance in detecting liver metastasis from colorectal cancer, which was comparable to MR.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.28-33
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• 2001

Purpose: H. pylori infection is thought to contribute to iron-deficiency anemia, especially during puberty. The ferritin protein Pfr of H. pylori is homologous to eukaryotic and prokaryotic ferritins. The purpose of this study was to analyze the H. pylori pfr status in gastric biopsy specimens according to clinical data, including antral gastritis with or without iron-deficiency anemia. Methods: A total of 26 H. pylori-positive patients aged from ten to 18 years were categorized into subgroups based on the presence or absence of iron-deficiency anemia. All of them had antral gastritis. Sixteen patients were proved to have iron-deficiency anemia by hematological study, two of which had a duodenal ulcer. The other ten patients showed normal hematological findings. DNA isolation was performed from each of the gastric biopsy specimens. PCR amplification of the pfr gene coding was done using two sets of primers. The pfr region, 501 bp, was generated by linking the sequences of the two PCR products. The nucleotide and protein sequences were compared between the pfr regions from Korean H. pylori strains and the NCTC 11638, 26695, and J99 strain, which were obtained from the Genbank. Sequence comparisons were also performed for the pfr regions between the iron-deficiency anemia (+) and (-) groups. Results: Analysis of the complete coding region of pfr gene revealed three sites of mutation. The Ser39Ala mutation was found in 100% (26/26), Gly111Asn in 26.9% (7/26), and Gly82Ser in 11.5% (3/26). There were no significant differences in the mutations of the pfr regions between the iron deficiency anemia (+) and (-) groups. Conclusion: The mutation in the pfr gene did not relate with the clinical phenotype, iron deficiency anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate the mechanisms by which the H. pylori infection might lead to iron deficiency anemia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.1-9
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• 2003

Purpose: To investigate the relation of the gastric epithelial cell proliferation, apoptosis and genotypes of H. pylori in children. Methods: Histologic grading by updated Sydney system, PCNA immunostaining, TUNEL method and the genotypes (cagA, picB and iceA) by PCR were performed in H. pylori positive (N=20) and negative (N=20) gastric biopsy specimens. Results: PCNA index was significantly different between H. pylori positive children ($77.4{\pm}13.12$) and H. pylori negative children ($52.3{\pm}12.20$) (p=0.000). There were positive correlations between PCNA index and H. pylori density (r=0.624, p=0.000), polymorphonuclear neutrophil activity (r=0.460, p=0.005) and chronic inflammation (r=0.433, p=0.009). Apoptosis index of H. pylori positive children ($0.70{\pm}0.411$) was significantly higher than of H. pylori negative children ($0.14{\pm}0.201$) (p=0.000). Positive correlations between apoptosis index and H. pylori density (r=0.691, p=0.000), polymorphonuclear neutrophil activity (r=0.585, p=0.000) and chronic inflammation (r=0.535, p=0.001) were noted. As PCNA index increased, apoptosis index significantly increased (r=0.527, p=0.001). The positive rates of genotypes were cagA 90%, picB 75%, iceA1 60% and iceA2 15%, respectively. There were no significant correlations between the status of the genotypes and PCNA index, apoptosis index, the endoscopic findings and the histologic findings. Conclusion: PCNA index and apoptosis index in H. pylori positive children were higher than in H. pylori negative children but were not related to H. pylori genotypes. This study suggested that correlatively increased gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.480-483
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• 2003

Purpose : We evaluated clinical manifestations and laboratory findings in patients with measles according to C-reactive protein(CRP) concentration. Methods : A retrospective analysis was performed using the medical records of patients with measles at The Catholic University of Korea, Daejeon St. Mary's Hospital from October 1999 to May 2000. We divided the patients with measles into four groups according to CRP level, i.e., those with below 5 mg/L(134 patients, negative group), those with 6-19 mg/L(85 patients), those with 20-49 mg/L(27 patients), and those over 50 mg/L(7 patients). We compared clinical and laboratory characteristics among these four groups. Results : The mean CRP level of all patients was $11.1{\pm}7.5mg/L$. No statistical differences were present between the negative group and the 6-19 mg/L group or the 20-49 mg/L group in the duration of fever, hospitalization days, complications determined with longer hospitalization for more than eight days, white blood cell count, and incidence of hepatitis. Compared with the negative group, the over 50 mg/L group showed a longer duration of fever($4.7{\pm}1.7$ vs $7.2{\pm}3.9days$), duration of hospitalization($5.4{\pm}1.4$ vs $9.4{\pm}4.7days$), incidence of complications(5.2% vs 42.9%) and a higher mean level of WBC count($5,900{\pm}2,700/mm^3$ vs $12,700{\pm}6,700/mm^3$). With an increasing CRP level, there was a tendency for the duration of fever, complications and WBC count to increase. However the levels of liver enzymes(AST/ALT) were not associated with CRP level. Conclusion : A CRP level of over 50 mg/L in measles is associated with severity and complications.

• Journal of fish pathology
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• v.11 no.1
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• pp.77-81
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• 1998

By standardized method, Bacillus subtilis BGA, Bacillus cereus var. mycoides ATCC 11778, and Micrococcus luteus ATCC 9341 were seeded on the muller hinton agar (Difco) plate, and pH was adjusted to 6.0, 7.2, and 8.0. Five agar plates, B. subtilis (pH 6.0), B. cereus (pH 6.0), B. subtilis (pH 7.2), B. subtilis (pH 8.0), and M. luteus (pH 8.0), were employed as test plates of modified EEC 4-plate method. Oxytetracycline (OTC) with a diet was orally administered to flounder, Paralichthys olivaceus, at 100 mg/kg once a day. After oral administration, modified EEC 4-plate method by the three screening test using muscle-direct, extraction-disk and direct-disk methods was conducted for 3 fish at 1, 3, 5, 10, 15, 20, 25 and 30 days. Muscle-direct treatment of B. subtilis (pH 6.0) was found to be dubious positive (${\pm}$) at the 1st day after the administration; thereafter, it was found to be negative to the last day of the experiment. Extraction-disk and direct-disk treatment of B. subtilis (pH 6.0) were found to be negative from the 1st day to the last day after the administration. B. subtilis (pH 7.2), B. subtilis (pH 8.0), and M. luteus (pH 8.0) by the three screening tests, were found to be negative all the way after the administration. On the other hand, B. cereus (pH 6.0) by the three screening tests was clearly found to be positive for the first 15 days after the administration, and then muscle-direct and direct-disk treatment of B. cereus (pH 6.0) were found to be dubious positive at 20th days after the administration. However extraction-disk treatment of B. cereus (pH 6.0) was clearly found to be negative at the same stage; thereafter, the three screening tests of B. cereus (pH 6.0) were found negative to the last of the experiment. These findings showed that to have equal sensitivity to those determination for the residual detection of OTC, and also confirmed that B. cereus was effective test organism for the monitoring of OTC.

• Tuberculosis and Respiratory Diseases
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• v.61 no.1
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• pp.34-40
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• 2006

Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.6
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• pp.546-552
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• 2007

Purpose: In the breast cancer patient, lymphatic mapping and sentinel lymph node biopsy are the most important procedure for axillary lymph node staging. We aimed to compare the three radiocolloids [$^{99m}Tc$-antimony trisulfide colloid (ASC), $^{99m}Tc$-tin colloid (TC), and $^{99m}Tc$-human serum albumin (HSA)] for sentinel lymph node mapping. Subjects and Methods: Totally, 397 patients with clinically N0 stage were enrolled. $^{99m}Tc$-ASC was injected in 202 out of 397 patients, $^{99m}Tc$-TC was injected in 120 patients, and $^{99m}Tc$-HSA was injected in the remaining 75 patients. The sentinel lymph nodes were localized by lymphoscintigraphy and selected using intraoperative gamma probe. All sentinel lymph nodes were investigated by intraoperative pathologic consultation. The axillary lymph nodes which were harvested by the lymph node dissection were also investigated. Results: The patients of each group showed similar clinical characteristics. There were no significant differences (p>0.05) in the identification rate of sentinel lymph nodes (IR), false negative rate (FNR), and negative predictive value (NPV). The axillary lymphadenectomy revealed axillary lymph node metastases in those three groups (ASC-33.2%, TC-31.7%, HSA-22.7%). The IR, FNR, and NPV were not significantly different among those groups. Conclusion: Those three $^{99m}Tc$-labeled radiocolloids showed equivalent results in sentinel lymph node mapping of breast cancer.

• Journal of Life Science
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• v.16 no.6
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• pp.1006-1013
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• 2006

To High Throughput Screening (HTS), a homogeneous fluorescence polarization immunoassay (FPIA) was developed for the quantitative determination of ochratoxin A(OTA) using a $Victor^3$ (PerkinElmer). The homologous tracer, fluorescein-labelled OTA-EDF were synthesized and a specific OTA antibody has been used in the development of the method. It allowed the determination of OTA in the concentration range 0.5-200 ng/ml, with the detection limit of 0.3 ng/ml. The method developed was highly specific and reproducible. OTA spikes in unpolished rice extracts were determinable by FPIA with good recovery. For naturally contaminated unpolished rice samples some disagreement was observed between the results obtained by FPIA and HPLC, which could be related to the a little matrix effect observed for FPIA. Further research is needed to validate the procedure. On the basis of these initial results, this FPIA appears to meet the performance criteria for OTA screening of food samples without a complicated clean-up.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.186-196
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• 2004

Purpose: Autoimmune hepatitis is a chronic inflammatory liver disease with unknown cause that is characterized by liver histology, circulating autoantibodies and increased levels of immunoglobulin G. Only sporadic reports are available on autoimmune hepatitis in children. The aim of this study was to evaluate the clinical, biochemical, and histological features, and the long-term outcome of autoimmune hepatitis in Korean children. Methods: We reviewed the medical records of 14 children diagnosed as having autoimmune hepatitis at Seoul National University Children's Hospital from 1990 to 2004, and analyzed clinical, biochemical, and histological features, and clinical outcomes. Results: Mean age at diagnosis was 9 years and 11 of the 14 children were female. Six children presented with acute hepatitis-like manifestations. Jaundice and fatigue were the most common symptoms. Other autoimmune diseases accompanied in 6 children. Anti-nuclear antibody was detected in 13 patients and anti-smooth muscle antibody was positive in 8. All 14 patients were type 1 autoimmune hepatitis. The main histologic findings were interface hepatitis, rosette formation, and cirrhosis. Clinical and biochemical features were improved in six patients treated with ursodeoxycholic acid. Eight patients were treated with corticosteroid alone or in combination with azathioprine and five of them are in biochemical remission. Conclusion: Autoimmune hepatitis is an inflammatory liver disease, which has a favorable long-term outcome if it is diagnosed and treated promptly. Therefore, autoimmune hepatitis should be suspected in children with chronic hepatitis of unknown etiology, especially in female patients who show hypergammaglobulinemia or some clinical features of autoimmune disease.