Purpose : Asthma is defined as chronic inflammation of the lower small airways, and bronchial hyperreactivity (BHR) is a pathophysiologic feature of asthma. It has been proposed that although there is no direct variable capable of assessing the small airways, a forced expiratory flow of between 25 and 75 percent ($FEF_{25-75}$) might be considered a more sensitive early marker of small airway obstruction than the forced expiratory volume in 1 second ($FEV_1$). Thus, we proposed that the presence and degree of positive responses to bronchial methacholine testing were related to the difference (DFF) and ratio (RFF) between $FEV_1$ and $FEF_{25-75}$ in asthmatic children. Methods : The subjects were 583 symptomatic children, including 324 children with BHR and 259 controls. Pulmonary function tests, methacholine challenge tests, and skin prick tests were performed, and the total eosinophil count, total serum IgE, and serum eosinophil cationic protein level were measured in all subjects. From a concentration-response curve, the methacholine concentration required to produce a decrease of 20% from post-saline $FEV_1$ was calculated ($PC_{20}$). Results : The median DFF and RFF values decreased in controls compared to subjects with bronchial hyperresponsiveness, and this trend was found in groups ranked by its severity. $PC_{20}$ had a negative correlation with DFF and RFF. Cutoff values of 0.5 for DFF and 1.042 for RFF were identified, and sensitivity and specificity were calculated. Conclusion : This study revealed that DFF and RFF might be predictive of bronchial hyperresponsiveness in the context of normal $FEV_1$ in children.
Han, Dong Kyun;Cheon, Jin Sook;Choi, Young Sik;Kim, Ho Chan;Oh, Byoung Hoon
Korean Journal of Psychosomatic Medicine
/
v.24
no.2
/
pp.227-235
/
2016
Objectives : The aims of this study were to know the frequency of cognitive dysfunction among patients with autoimmune thyroid disorders, and to reveal influencing factors on it, especially to clarify association with autoimmune thyroid antibodies. Methods : From sixty-five female patients with autoimmune thyroid disorders, demographic data were obtained by structured interview. Their cognitive funtions were measured using the MMSE-K and the MoCA-K tests. Depression was evaluated by the K-HDRS. Results : 1) Among patients with autoimmune thyroid disorders, 7.69% of them were below 24 on the MMSE-K, while 10.77% were below 22 on the MoCA-K. The frequency of cognitive deficit was not significantly different according to having positivity to antimicrosomal antibodies or not. 2) The antimicrosomal antibody-positive patients had significantly higher antithyroglobulin antibody titers, antimicrosomal antibody titers, and TSH concentration, while had significantly lower free T4 levels(p<0.05, respectively). 3) The total scores of the MMSE-K and the MoCA-K had significant correlation with age, marital status, antithyroglobulin antibody titers and K-HDRS(p<0.05, respectively). 4) The regression analysis revealed that variables such as age, education, autoimmune thyroid antibodies, thyroid function and depression did not influence on cognitive function of patients with autoimmune thyroid disorders. Conclusions : Our results could not support that cognitive function of patients with autoimmune thyroid disorders had correlation with autoimmune thyroid antibodies.
Kim, Sung-Jae;Lee, Hee Jae;Lee, Kwang-Hyun;Park, Dong-Hyeok;Lee, Bong Geun
The Journal of Korean Orthopaedic Ultrasound Society
/
v.7
no.2
/
pp.77-83
/
2014
Purpose: The purpose of current study was to evaluate the validity of the existing radiological classifications as a diagnostic modality for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint. For that purpose, we determined the inter-observer reliability for evaluating diagnostic precisions of the classification and also evaluated diagnostic accuracy of predicting the toothpaste type calcific deposition. Materials and Methods: We performed retrospective study with total 26 patients surgically treated with calcific tendinitis of the shoulder joint from March 2010 to October 2013. Two independent observers reviewed preoperative radiographs of shoulder joints, and classified the characteristics of calcific depositions according to the criteria of Gartner, DePalma and Patte. Cohen's kappa were calculated for each classifications to evaluate inter-observer reliability. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were determined for type of calcific depositions with Gartner type III, DePalma type I, and Patte type II for predicting toothpaste type calcific deposition. Results: The values of Cohen's kappa were the highest in the classification of Patte, 0.62, and the values for the classifications of DePalma and Gartner were 0.56 and 0.36, respectively. The sensitivities for predicting toothpaste type calcific deposition in Gartner Type III, DePalma type I and Patte type II were 83.3%, 91.7%, and 58.3%, respectively. Specificities were 85.7% 50.0% and 64%, positive likelihood ratios were 5.833, 1.833 and 1.633, negative likelihood ratios were 0.194, 0.167 and 0.648, and diagnostic odds ratios were 30.00, 11.00 and 2.52, respectively. Conclusion: There were no radiologic classifications of calcific tendinitis which has both high precision and accuracy. Further studies with other diagnostic modalities such as ultrasonography are needed for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint.
Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.
Park, Kang-Gyun;Kim, Sang-Ha;Choi, Jong-Tae;Kim, Sunghyun;Kim, Young-Kwon;Yu, Young-Bin
Korean Journal of Clinical Laboratory Science
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v.49
no.4
/
pp.407-412
/
2017
The aim of this study was to shorten the time required for subculture and bacterial identification and obtain a simple and rapid identification method for new test methods for bloodstream infections. The following results were obtained using a mass spectrometer. In Vitek 2, 208 (81.8%) cases were well-identified and 45 isolates were not identified in blood cultures. Among 208 cases, 146 (57.5%) were Gram positive bacteria and 108 (42.5%) were Gram negative bacteria. In total, 233 were identified to the species level and 21 were identified to the genus level. The identification error was found to be Propionibacterium acnes as Clostridium bifermentans. The accuracy of Enterobacteriaceae, glucose non-fermentative bacilli (GNFB), and staphylococci were 81/83 (97.6%), 12/15 (80.0%), and 72/85 (84.7%), respectively. The concordance rate of Vitek 2 and Vitek MS by the direct method was 81.8% and 45 isolates were not identified. Most of the unidentified bacteria were Gram positive bacteria (N=37). The Gram positive bacteria were streptococci (14), coagulase-negative staphylococci (CNS) (11), enterococci (3), Staphylococcus aureus (2), Micrococcus spp. (2), Bacillus spp. (2) and Actinomyces odontolyticus, Finegoldia magna, and Peptostreptococcus spp. The results reporting time was reduced to 24~72 hours compared to the conventional method. The rate of identification of the aerobic and anaerobic cultures was similar, but the use of an anaerobic culture did not require a dissolution process, which could shorten the sample preparation time. These results suggest that the method of direct identification in blood cultures is very useful for the treatment of patients. In further studies, it might be necessary to further improve the method for identifying streptococci and CNS, which were lacking in accuracy in this study.
For the analysis of hazard factors and the development of GAP (Good Agricultural Practices) Ginseng, 10 ginseng cultural farms wished certified GAP were selected at Geumsan-gun area, a representative site of ginseng cultivation in Korea. In order to verify the safety of GAP ginseng, possible contamination of pesticide and heavy metal residues, and microbial hazard were analyzed. Soil and water around ginseng cultivation field, and ginseng were investigated. Eighty-one pesticides including carbendazim were used as typical pesticide against plant pathogens and insect pests of ginseng plant and general crops. There was no excess the maximum residue limit (MRL) in residue figure of the soil. Including the residue figure of the arsenic (0.81 ml/kg) and 7 other heavy metals was also suitable to cultivate the ginseng plant. The irrigation water and dilution water for pesticide application were also safety level for GAP. Fresh ginsengs from the farms were sampled and investigated pesticide residues and contaminations of bacteria. Among 23 pesticides tested, we didn't detect any kinds of pesticide residues, but tolclofos-methyl was frequently found in the other ginseng field. On the investigation of microorganism hazards, 2 gram negative bacteria and 1 gram positive bacterium were found in the fresh ginseng. Number of total bacteria was $1.5{\times}10^3$ cfu/ml, which was less than the other agriculture products. At these results, 10 selected ginseng farms were good cultural places for GAP ginseng production and the ginseng cultured from Geumsan-gun area were a good safe far human.
Bae, Kang Woo;Kim, Jong Ho;Kim, Youn Seup;Park, Jae Seuk;Jee, Young Koo;Lee, Kye Young
Tuberculosis and Respiratory Diseases
/
v.58
no.2
/
pp.167-173
/
2005
Background : Airborne particles during Yellow Sand phenomena are known to be associated with the respiratory disease. The purpose of this study was to evaluate the concentration and metal component properties of Yellow Sand particles and compare with airborne microbial concentration and species in non Yellow Sand and Yellow Sand phenomena. Methods : Samplings were carried out in 2002 in Seosan, during non Yellow Sand and Yellow Sand phenomena. Samples were taken using the 8-stage Cascade impactor and metallic elements were analyzed by XRF. Those were culture on the media for bacterial and fungal culture and celline for virus. Results : The concentration of total suspended particulate matter were respectively $80.2{\mu}g/m^3$, $40.3{\mu}g/m^3$ in non Yellow Sand and Yellow Sand phenomena. The concentration of metallic elements such as Ca, Fe, Cu and Zn in Yellow Sand phenomena were higher than its in non Yellow Sand. Two bacteria, Bacillus species and Staphylococcus were grown in two periods. In both periods, several fungal spores(Mucor species, Cladosporum, Alternaria, Aspergillus, Penicillium, and Alternaria species) were identified. The differences of bacteria and fungus species not observed in Yellow Sand and non Yellow Sand. Any viruses were not isolated in between both periods. Conclusions : The concentration of total suspended particulate matter and some metallic elements in Yellow Sand phenomena were higher than its in non Yellow Sand. The difference of bacteria and fungus species was not observed in non Yellow Sand and Yellow Sand phenomena.
Purpose : Hepatitis B virus (HBV) infection has been involved in several forms of immune-related glomerulopathy but the pathogenic role of HBV infection is not clear. To evaluate the clinicopathological features of HBV-associated glomerulopathy, a clinicopathological analysis and immunohistochemical stain for HBs Ag and HBe Ag were done. Methods : Clinicopathological features of HBV-associated glomerulopathy were analyzed with renal biopsies in 28 HBsAg seropositive patients from April 1990 to February 1997 at Pusan Paik Hospital, and immunohistochemical evaluation for HBsAg and HBeAg was done in renal tissues. Light microscopic, immunofluorescent and electron microscopic examination and immunohistochemical staining for HBsAg (DAKO) and HBeAg (BIONIKE) of renal tissue were performed. Result ; 1. The age distribution was 6 to 73 years old, and eight were children and 20 were adults. Male : female ratio was 3:1. Nineteen (67.9%) and 21 (75.0%) of 28 cases showed hematuria and proteinuria, respectively at the time of biopsy. Sixteen (57.2%) of them had nephrotic syndrome. 2. Liver function test was performed in 11 patients and seven (63.6%) of them showed increased AST and ALT levels. Liver biopsy was done in three patients and revealed findings of chronic active hepatitis. 3. HBV-associated glomerulopathy was membranous glomerulonephritis (MGN) in 10 (35.7%), mesangiopathy in 8 (28.6%), membranoproliferative glomerulonephritis (MPGN) in 7 (25.0%) and minimal change disease in 3 (10.7%) out of 28 cases. 4. Ultrastructurally HBV-associated MGN showed conspicuous subepithelial deposits with intramembranous, mesangial and subendothelial deposits and proliferation of mesangial cells and matrix, which were suggestive of MPGN. In HBV-associated MPGN, intramembranous and subepithelial deposits were scattered. 5. Immunohistochemical staining revealed no expression for HBsAg, but positive reaction for HBeAg along capillary wall in 8 cases (28.6%), of which 3 cases were checked for serum HBeAg, all showed positivity. Conclusion : HBV-associated glomerulopathy showed a wide morphologic spectrum and overlapping ultrastructural features in MGN and MPGN, and the activity of hepatitis B virus may be related to the development of HBV-associated glomerulopathy but further studies are recommended to confirm this relationship.
Son, Sohee;Kang, Ji-Man;Kim, Jong Min;Sung, Sein;Kim, Yi-Seoul;Lee, Haejeong;Kim, BitA Reum;Lee, Yeon Kyoung;Ko, Sun Young;Shin, Son Moon;Kim, Yae-Jean
Pediatric Infection and Vaccine
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v.24
no.3
/
pp.134-140
/
2017
Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.
Purpose: The aims of this study are to investigate the effect of the eradication of H. pylori on histological change of gastric mucosa in children with H. pylori gastritis and to determine whether the histological grading by the Sydney system is valuable in predicting the effect of treatment. Methods: 1) Histological scores by the Sydney system and the endoscopic characteristics were assessed before and at least four weeks after anti-H. pylori therapy in 42 children with H. pylori gastritis. 2) In 32 children treated with omeprazole, amoxicillin and clarithromycin (OAC), pretreatment histological scores and endoscopic findings were compared between the eradicated and the noneradicated to evaluate their predictive value for the successful eradication. Results: 1) In the eradicated (27 cases), nodular gastritis significantly decreased from 89% to 63% (p<0.05). There was an significant improvement in the mean activity score from 2.06 before treatment to 0.24 after treatment (p<0.01). The mean inflammatory score also improved from 2.61 before treatment to 1.89 after treatment (p<0.05). Lymphoid follicles significantly decreased from 48% to 15% (p<0.05). Epithelial damage improved in all 4 cases. But in the noneradicated (15 cases), there was no significant change in the frequency of nodular gastritis, the mean activity score, the mean inflammatory score and the frequency of the lymphoid follicles. 2) In 32 children treated with OAC, there was a tendency that the higher was the pretreatment score of the bacterial density, the lower was the eradication rate of H. pylori (p=0.072). Conclusion: The loss of the polymorphonuclear cell infiltration is the most prominent histological change after successful eradication. There may be negative correlation of the grade of the bacterial density with the success rate of the anti-H. pylori therapy.
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