• Clinical and Experimental Pediatrics
• /
• v.49 no.1
• /
• pp.29-33
• /
• 2006

Purpose : The aim of this study was to analyze the results and contributing factors of catch-up growth in very low birth weight infants(VLBWI) at the corrected age of 2 years. In addition, we looked for a relationship between the catch-up growth and the development by the bayley scales of infant development II(BSID II). Methods : A retrospective analysis by evaluating medical records was done for the 76 VLBWI whose follow-up was possible up to a corrected age of 2 years, out of the 114 who had been treated in the neonatal intensive care unit during the January of 2000 to December of 2001 at Samsung Cheil Hospital. Based on the Standard Korean Infant's Growth Curve, the catch-up growth group was defined over the 10th percentile of weight at 2 years as the corrected age and the failed catch-up growth group was defined under the 10th percentile. We investigated the clinical factors and courses of each group and compared the scores of the BSID II. Results : The catch-up growth group of the VLBWI was 51 infants and the failed catch-up growth group was 25 infants. In comparison with maternal clinical factors, use of antenatal steroids was significantly higher in the catch-up growth group. In comparisn with clinical factors and courses of VLBWI, two clinical factors were significantly different between the two groups : birth weight and intrauterine growth retardation(IUGR). Numbers of delayed development were increased in the failed catch-up growth group but statistically significant differences could not be observed. Conclusion : The catch-up growth of the VLBWI was affected by the use of antenatal steroids, birth weight and IUGR. No significant differences regarding neurodevelopmental outcome were observed between the catch-up and failed catch-up growth groups.

• Clinical and Experimental Pediatrics
• /
• v.49 no.4
• /
• pp.431-438
• /
• 2006

Purpose : Insulin-like growth factor binding protein(IGFBP)-3 has been known as a tumor suppressor gene, and its anti-tumor function was divided into insulin-like growth factor(IGF)-dependent and IGF-independent mechanism. In IGF-independent mechanism, IGFBP-3 directly interacts with a cell without binding of IGFs, becoming an interesting object in oncology. Several studies demonstrate that one of the well-known tumor suppressor genes, p53, induces directly IGFBP-3 transcription, and the increment of IGFBP-3 expression induces apoptosis of many cancer cells. Recently, the anti-tumor mechanisms of IGFBP-3 have been reported, but post-translational modification of IGFBP-3 and its anti-tumor mechanism are not well known. In this study, we examined whether p53 regulated the glycosylation of IGFBP-3, and analysed the meaning of IGFBP-3 glycosylation related to the apoptosis of cancer cell. Methods : The p53-mutated status of MDA-MB-231 human breast cancer cells was used in this experiment. The expression and glycosylation of IGFBP-3 were tested by Western blot analysis after infection of adenovirus mediated Ad/p53 and/or Ad/IGFBP-3. Results : Ad/p53 infected cells resulted in growth retardation and the induced apoptosis. p53 induced direct expression and glycosylation of IGFBP-3. The increase of glcosylated IGFBP-3 was able to promote cellular apoptosis, and the glycosylation of IGFBP-3 was more activated by the double treatment of Ad/p53 and Ad/IGFBP-3. Conclusion : From this study, the anti-tumor activity of IGFBP-3 was shown to improve the stabilization of IGFBP-3 through the increment of glycosylation of IGFBP-3 by p53. This result suggests that the combined gene therapy of p53 and IGFBP-3 may appropriate treatment of cancer.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1139-1142
• /
• 2005

Purpose : The aim of this study was to investigate the epidemiologic and clinical profiles of Kawasaki disease(KD) in children 8 years of age and older. Methods : For the epidemiologic study of KD in Korea, data of total 15,692 KD patients were collected from 1994 to 2002 on a 3 year basis, by the retrospective survey. Among them, data of 211 KD patients 8 years of age and older were analyzed and compared with those of the KD patients less than 8 years of age. Results : 211 patients 8 years of age and older(1.3% of total KD patients) with the mean age of 9.8 years, included 142 cases aged 8-10 years, 42 cases aged 10-12 years, and 27 cases aged 12 years and older. The male-to-female ratio was 1.9 : 1, the recurrence rate was 3.8%, and the prevalence of cases in sibling was zero. Coronary arterial(CA) abnormalities were detected by echocardiography in 25.4% of the cases, including 7.6% of CA aneurysm cases. There was 1 case complicated by myocardial infarction. Conclusion : Comparing with the data of the KD patients less than 8 years of age, data of 211 patients 8 years of age and older showed significantly higher incidences of CA abnormalities(25.4% : 19.8%) and CA aneurysms(7.6% : 4.0%).

• Clinical and Experimental Pediatrics
• /
• v.46 no.9
• /
• pp.854-857
• /
• 2003

Purpose : It is known that single umbilical artery is frequently associated with gastrointestinal or urogenital anomaly, however, routine renal sonography has been debated in healthy neonate with isolated single umbilical artery. This study is designed to determine the usefulness of routine renal sonography in apparently healthy infants with an isolated single umbilical artery. Methods : Thirty healthy neonates with a single umbilical artery without a major anomaly from January 1995 to July 2002 were enrolled. The authors investigated the clinical background of babies and their mothers after renal sonography after 72 hours of age. When the abnormalities were found at the first renal sonography, the severity of hydronephrosis and degree of obstruction and renal function were analyzed by follow up renal sonography, voiding cystourethrography(VCUG) and technetium-99m-dimercaptosuccinic acid(DMSA) scan or technetium-99m-mercaptoacetyl-triglycerine (MAG3) scan. Results : Among the 30 healthy patients with isolated single umbilical artery, five patients(16.7%) showed abnormalities on first renal sonography with one major(3.3%) and four(13.4%) minor renal anomaly(minimal or mild hydroneohrosis). One major renal anomaly(severe hydronephrosis) showed severe decreased renal function on MAG3 scan without reflux, and the other four minor regressed spontaneously on follow up study. Conclusion : The value of routine early renal sonograpy for detecting renal anomaly in healthy infants with an isolated single umbilical artery remained unclear because most of the anomalies would regress spontaneously in the follow up study.

• Clinical and Experimental Pediatrics
• /
• v.46 no.3
• /
• pp.277-283
• /
• 2003

Purpose : Craniopharyngiomas are often accompanied by severe endocrine disorders. Although there is universal growth hormone deficiency(GHD), the resulting growth pattern is very heterogeneous. We report the growth and endocrine outcome of 44 children with craniopharyngioma, with emphasis on initial symptoms, growth before and during growth hormone(GH) treatment and spontaneous growth in spite of GHD. Methods : We performed a retrospective study of 44 children treated at our centre between 1984 and 2002. Results : About 30% of patients had symptoms suggesting endocrine disorder at diagnosis. After surgery, multiple endocrinopathies were almost universal. Before GH therapy, height velocity was $8.00{\pm}2.71cm/yr$ in the normal growth group(n=11) and $1.79{\pm}1.10cm/yr$ in the subnormal growth group(n=7) during the first year and during the second year, $6.76{\pm}2.49cm/yr$ and $2.29{\pm}1.33cm/yr$, respectively. There was no difference of body mass index(BMI) change between before and after surgery in the two groups. Height standard deviation score(SDS) was $-1.46{\pm}0.74$ in the normal growth group and $-0.43{\pm}0.97$ in the subnormal growth group. Before GH treatment height SDS was $-1.31{\pm}1.25$ and BMI was $20.46{\pm}3.60$. During GH treatment, height SDS increased to $-0.60{\pm}1.37$ in the first, and to $-0.41{\pm}1.54$ in the second year(P<0.05), but BMI did not change significantly. Conclusion : The endocrine morbidity could develop in most children with craniopharyngioma before and after the operation and should be managed properly. Although all treated patients benefit from GH therapy, further studies are necessary to find out the possible mechanism of growth regulation in normally growing children, despite GH deficient.

• Journal of the Korean Institute of Traditional Landscape Architecture
• /
• v.31 no.1
• /
• pp.48-58
• /
• 2013

The results of this research to study forms, structure, changes, symbolic meanings of 16 Hahoe sceneries through analyses of "Hahwaesipyukgyeong" and "Hahwaenakgangsanghaildaedo" are as belows. The coherence of headword is not discovered in 16 Hahoe sceneries, but based on various variables and sense dependence, endemicity with original natural scenes, human's life and phenomena of riverside village are spread in 3km viewing areas within 200m from Gyeonamjeongsa(謙巖精舍) and Okyeonjeongsa(玉淵精舍). As the viewing points of Gyeonam and Okyeonjeongsa are symmetrically facing and separately independent, while viewing angles do not intersect at Wonjijeongsa (遠志精舍) and Binyeonjeongsa(賓淵精舍) because of Buyongdae(芙蓉臺), and crating each independent viewing area, we can see 16 Hahoe sceneries are perfect views by supplementing Gyeonam and Okyeon Jeongsa, as well as points of views from Wonji and Binyeonjeongsa. Meanwhile, as the view point of 16 Hahoe sceneries, Gyeomam, Okyeon, Binyeon, and Wonji Jeongsa are clearly described, and 12 natural sceneries, which are Hwasan(花山), Ipam(立巖), Maam(馬巖), Jando(棧道), Bangi(盤磯), Hoengju(橫舟), and Honggyo(虹橋), among landscape elements of 16 Hahoe sceneries that can be expressed on canvas in the Haoedo are realistically described, there is high possibility that Haoedo is the 'Mental Stroll about Nature(臥遊) of 16 Hahoe sceneries. The belted forest surrounding the village in the painting is assumed to be an erosion control forest, and considering row-expressed trees, the south belted forest may be a different broad-leaved forest from current Mansongjeong(萬松亭) pine forest. In 16 Hahoe sceneries, there is Neo-confucianism tendency, which connects the nature and human life, and moreover prioritize human life than the nature. Especially as seen in the 'Choljae(拙齋)', the pen name of 16 Hahoe sceneries' author park, the 16 Hahoe scenery poet suggests 'Beauty of Jolbak(拙撲美)' based on the simple life that upright classical scholars pursued as the basic emotion. The thinking system shown in the poet is interpreted as Neo-confucianism category including one's sense and emotion depended on natural features or phenomena. Ultimately, 16 Hahoe sceneries are landscape that reflects moral world views of Confucianism scholars who wanted to express ideal thoughts based on natural features and phenomena in reality at Jeongsa in Buyongdae and Hahoe Village.

• Radiation Oncology Journal
• /
• v.18 no.3
• /
• pp.182-186
• /
• 2000

Purpose : To determine treatment or이ecol for inoperable esophageal cancer patients, 껜e evaluated survival rate and prognostic factors. Materials and Methods : We evaluated esophageal cancer treated by curative or palliative am in KCCH from 1992 to 1996, retrospectively. Recurrent or underdose case below 40 Gy were excluded. The number of male and female were 35 and 5, respectively. Thirty-eight patients were squamous carcinoma and 2 patients were not biopsy proven. Ten patients were treated with radiation therapy and chemotherapy Median dose of radiation therapy was 59.4 Gy and the range was $40\~60$ Gy. Results : The median survival is 6.5 months and 1-year survival rate was $28.3\%$. Age, location, radiation dose and chemotherapy were not significant prognostic factors. Median survivals of patients with below stage III and over stage IVA were 7.6 and 6.2 months respectively, but it is not significant. Conclusions : The survival for esophageal cancer is very poor. For patients with curative aim, chemotherapy must be considered. For patients with palliative aim, short-term external beam radiation therapy and/or brachytherapy must be considered.

• Tuberculosis and Respiratory Diseases
• /
• v.65 no.3
• /
• pp.198-206
• /
• 2008

Background: Tracheobronchial suctioning using the closed suctioning system has physiological benefits for critically ill patients. Despite these benefits, there are concerns about increased colonization of tracheobronchial tree by pathogenic organisms. The cost is another hinder to the introduction of closed suction system. The aim of this study was to evaluate the incidence of colonization and ventilator associated pneumonia and the cost-effectiveness of closed suction compared with open suction. Methods: During separated one month period, patients admitted MICU were cared by multiple-use, open suction, single-use, open suction and multiple-use, closed suction method, consecutively. Costs, colonization of tracheobronchial tree by MRSA and the incidence of ventilator-associated pneumonia (VAP) were analyzed. Results: One-hundred and six patients were enrolled. Twenty patients were treated with multiple-use, open suction, while 42 and 44 patients were cared with single-use, open catheter and multiple-use, closed catheter, respectively. Colonization by MRSA and the incidence of VAP were not different among three ways of suctioning. The overall costs per patient per day for suctioning were $10.58 for multiple-use, open suction, $28.27 for single-use, open suction and $23.76 for multiple-use, closed suction. Conclusion: Multiple-use, closed suctioning, when suction catheters were changed every 48 hrs, has the similar incidence of colonization of MRSA and occurrence of VAP and is a cost-efficient way of endotracheal suction.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.3
• /
• pp.304-313
• /
• 2006

Background : Heme oxygenase-1 (HO-1) is an inducible enzyme that catalyzes the oxidative degradation of heme to form biliverdin, carbon monoxide (CO), and free iron. The current evidence has indicated a critical role of HO-1 in cytoprotection and also in other, more diverse biological functions. It is known that the high expression of HO-1 occurs in various tumors, and that HO-1 has an important role in rapid tumor growth because of its antioxidative and antiapoptotic effects. Therefore, the role of HO-1 was analyzed in human lung cancer cell lines, and especially in the A549 cell line. Material and Methods : Human lung cancer cell lines, i.e., A549, NCI-H23, NCI-H157 and NCI-H460, were used for this study. The expression of HO-1 in the untreated state was defined by Western blotting. ZnPP, which is the specific HO inhibitor we used, and the viability of cells were tested for by conducting MTT assaysy. The HO enzymatic activity, as determined via the bilirubin level, was also indirectly measured. Moreover, the generation of intracellular hydrogen peroxide (H2O2) was monitored fluorimetrically with using a scopoletin-horse radish peroxidase (HRP) assay and 2',7'-dichlorofluorescein diacetate (DCFH-DA). We have also transfected small HO-1 interfering RNA (siRNA) into A549 cells, and the apoptotic effects were evaluated by flow cytometric analysis and Western blotting. Results : The A549 cells had a greater expression of HO-1 than the other cell lines, whereas ZnPP significantly decreased the viability of the A549 cells more than the viability of the other lung cancer cells in a dose-dependant fashion. Consistent with the viability, the HO enzymatic activity also was decreased. Moreover, intracellular H2O2 generation via ZnPP was induced in a dose-dependent manner. Apoptotic events were, then induced in the HO-1 siRNA transfected A549 cells. Conclusion : HO-1 provides new important insights into the possible molecular mechanism of the antitumor therapy in lung cancer.

• Clinical and Experimental Pediatrics
• /
• v.45 no.8
• /
• pp.980-986
• /
• 2002

Purpose : Although the number of patients with measles have dramatically decreased since the introduction of measles vaccines in 1965, measles outbreaks have occurred periodically every 4-6 years during the 1990s(1989-1990 and 1993-1994). During 2000-2001, measles prevailed all over the country again. A characteristic of current epidemics is that the majority of affected population was infants and school-aged children. This study was designed to analyze the epidemic and clinical features of measles prevalence during 2000-2001 and to find ways to overcome vaccination failure. Methods : We reviewed the records of 59 patients with mealses admitted in the Pediatric Department of Pusan National University Hospital from January 2000 to October 2001 for patient's age, month of admission, history of vaccination, clinical features and complications. Antibody titers of measles-specific IgM and IgG were measured by enzyme immunoassay. Results : The epidemic show two peaks in the age distribution. Forty three patients(72.9%) were under 2-years of age and 14 patients(23.7%) were over 5-years of age. Outbreaks had high incidence in July to August, 2000 and March to April, 2001, then faded away after July, 2001. Vaccinated group comprised 30.5% and unvaccinated group comprised 69.5% and their mean age was $9.25{\pm}4.27$ years old and $0.95{\pm}0.30$ years old respectively. Positive rate of IgM was 86.7% in vaccinated group and 90.3% in unvaccinated group. This means there was primary vaccine failure; 13 cases of 15 vaccinated patients were positive in IgM antibody. During the prevalence, two patients died with mealses complication. One of them was immunocompromised. Conclusion : To prevent another prevalence of measles in the future, we must enhance revaccination at ages 4-6 and check vaccination status when children enter elementary school. These will produce over 95% of herd immunity, with catch-up MMR vaccination which has been completed already.