• Investigative Magnetic Resonance Imaging
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• v.4 no.2
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• pp.100-106
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• 2000

Purpose : To evaluate the usefulness of cerebral blood flow measurement applied to perfusion weighted image with short-scan time single shot gradient echo-planar technique in measuring cerebral blood volume(rCBV) of normal rabbits. Materials and methods : With 2.1-3.6 kg weighted rabbits, image is acquired when they are in supine position in children positioner. Perfusion weighted image is acquired to 44 seconds per 1 second successively. After 4 seconds later, Gd-DTPA 2ml are injected into int. jugular vein with 2 ml per second and normal saline is also injected after that. Same technique is applied 2 times per 30 minites in same rabbit. After Image is obtained in two part of cerebral cortex at vertex, convexity, in one of basal ganglia with choosing about $3-5{\textrm{mm}^2}$ areas. Curve of signal intensity changes in time sequence is drawn. After this images are transmitted by PC and software IDL, regional cerebral blood volume is measured with imaging processing program made by us. Results : With 22 of 24 rabbits, satisfactory 1-2 signal intensity versus time curve is made. Cerebral blood capacity and contrast media stay time (ST) is measured in two cerebral cortex and basal ganglia refering in parietal cerebral cortex. Mean focal cerebral blood flow capacity ratio in cortex was $0.97{\pm}0.35$ and in basal ganglia, $0.99{\pm}0.37$, mean contrast media stay time in cortex was $9.83{\pm}1.63$ sec and in basal gaiglia, $9.42{\pm}1.14$ sec, but there was no statistically significant difference between two areas ($\rho$=0.05). Conclusion : In cerebral cortex and basal ganglia, there is no difference in mean focal blood volume and mean contrast stay time. Therefore, PWI is useful in cerebral blood flow and early diagnosis, prognosis of cerebral ischemic disease. Hereafter, it is helpful in analysing cerebral blood flow changes with comparison difference in rCBV between normal tissue and ischemic tissue, and that with DWI finding in infarcted patient.

• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1013-1018
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• 2003

Purpose : Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP). Methods : We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in $FEV_1(PC_{20})$ with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between $PC_{20}$ and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups. Results : Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group($273{\pm}108$ vs. $365{\pm}178/{\mu}L$; $16.3{\pm}9.4$ vs. $26.5{\pm}15.1{\mu}g/L$, both, P<0.05). $PC_{20}$ was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159). Conclusion : BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.525-531
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• 2010

Purpose : Expression levels of tumor necrosis factor (TNF)-${\alpha}$ expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-${\alpha}$ has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis of FPIES. Methods : Fifteen infants diagnosed as having FPIES using standard oral challenge test and 5 controls were included. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining was performed to identify the apoptotic cell death bodies. Immunohistochemical staining of TNF-${\alpha}$, Fas ligand (FasL) for TNF family and TNF-related apoptosis-including ligand (TRAIL) receptor 1 (DR4), TRAIL receptor 2 (DR5), and Fas for TNF-receptor family were performed to determine the apoptotic mechanisms. Results : $TUNEL^+$ was significantly more highly expressed in the duodenal mucosa of FPIES patients than in controls ($P$-0.043). TNF-${\alpha}$ ($P$=0.0001) and DR4 ($P$=0.003) were significantly more highly expressed in FPIES patients than in controls. Expression levels of FasL, Fas, and DR5 were low in both groups and were not significantly different between the 2 groups. Conclusion : These results suggest that FPIES pathogenesis is induced by apoptosis, and that TNF-${\alpha}$ expression and DR4 pathway may have an important role in apoptosis.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.77-84
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• 2019

Objectives : The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. Methods : Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. Results : 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. Conclusions : The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1205-1210
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• 2008

Purpose : The development of the corpus callosum occupies the entire period of cerebral formation. The myelination pattern on magnetic resonance imaging (MRI) is very useful to evaluate neurologic development and to predict neurologic outcome in high risk infants. The thickness of the corpus callosum is believed to depend on the myelination process. It is possible to calculate the length and thickness of the corpus callosum on MRI. Thus, we can quantitatively evaluate the development of the corpus callosum. We investigated the clinical significance of measuring various portions of the corpus callosum in neonate with neurologic disorders such as hypoxic brain damage and seizure disorder. Methods : Forty-two neonates were evaluated by brain MRI. We measured the size of the genu, body, transitional zone, splenium, and length of the corpus callosum. Each measurement was divided by the total length of the corpus callosum to obtain its corrected size. The ratio of corpus callosal length and the anteroposterior diameter of the brain was also measured. Results : There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy. Conclusion : The abnormal size of the corpus callosum showed a good correlation with periventricular leukomalacia and hypoxic ischemic encephalopathy in neonates. We can predict clinical neurological problems by estimation of the corpus callosum in the neonatal period.

• Journal of Nutrition and Health
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• v.50 no.4
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• pp.391-401
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• 2017

Purpose: The purpose of this study was to estimate the dietary flavonoid intakes of Korean adults according to socioeconomic status. Methods: Using data from the 2007~2012 Korea National Health and Nutrition Examination Survey, a total of 31,112 subjects aged over 19 years were included in this study. We estimated individuals' daily intakes of total flavonoids and seven flavonoid subclasses, including flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, proanthocyanidin, and isoflavones,by linking food consumption data with the flavonoids database for commonly consumed Korean foods. We compared intakes of flavonoids according to the levels of household income and education. Results: Average dietary flavonoid intakes of the study subjects were 321.8 mg/d in men and 308.3 mg/d in women. Daily flavonoid intakes were positively associated with household income level (p < 0.0001) and education level (p < 0.0001). The subjects in the highest household income and highest education level group (OR 0.37, 95% CI 0.30~0.45, p < 0.0001 in men, OR 0.50, 95% CI 0.41~0.60, p < 0.0001 in women) had a lower likelihood of having low total flavonoid intake (less than 25 percentile) compared to the lowest household income and lowest education level group. The food group that contributed to total flavonoid intake with the biggest difference between the lowest and highest groups for both household income level and education level was beverages. Conclusion: This study shows that socioeconomic status was positively associated with flavonoid intake in a representative Korean population. Further research is needed to analyze the association of flavonoid intake with health outcomes according to socioeconomic status such as household income and education level.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.244-249
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• 2010

Purpose: Our goal of this study was to compare the mechanism of injury and the clinical outcomes between the non-traumatic and traumatic type II SLAP lesions. Materials and Methods: From January 2007 to May 2009, the sunjects of this study were 27 patients who had undergone operations for isolated type II SLAP lesions. The lesions were classified according to Burkhart's method. The lesions that were located on the anterior-superior labrum were classified as type I, those lesions located on the posterior-superior labrum were classified as type II and those lesions located on the anterior-posterior labrum were classified as type III. The clinical outcomes were evaluated by the UCLA score and the KSS score preoperatively and postoperatively. Results: Of the 27 cases, 16 cases were traumatic and eleven cases were non-traumatic. In the traumatic group, there were 12, 2 and 2 cases of type I, type II and type III, respectively (p=0.013). In non-traumatic group, there were 2, 6 and 3 cases of type I, type II and type III (p=0.026). Anterior lesions were more frequent in the traumatic group and posterior lesions were more frequent in the non-traumatic group. For the clinical outcomes, the mean preoperative UCLA score and KSS score were 18 (range: 14~23) and 48 (range: 32~76), respectively, and the postoperative UCLA score and KSS score were 32 (range: 28~33) and 86 (range: 71~92), respectively, in the traumatic group, and the preoperative UCLA score and KSS score were 21 (18~25) and 58 (41~68), respectively, and the postoperative UCLA score and KSS score were 29 (26~31) and 81 (68~89), respectively in the non-traumatic group. There was no significant statistical difference of clinical outcomes between the two groups (p=0.317, 0.405). Conclusion: In this study, the anatomical feature of type II SLAP lesion was associated with a trauma mechanism. Therefore, a trauma mechanism must be considered when planning the surgical treatment for type II SLAP lesions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.30-35
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• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.195-202
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• 2007

Purpose : The normal flora, which was suggested to prevent infection, is acquired first from the birth canal and develops by dietary factors. Here presents a case-control study, aimed to evaluate the postnatal acquisition factors relating to the achievement of the normal flora in infants with urinary tract infection (UTI). Methods : 115 UTI infants, admitted at Ewha Womans University Mokdong Hospital from 2004 to 2005 and 116 age-matched control infants, who had visited well baby clinic, were evaluated. The suggested postnatal acquisition factors of the normal flora such as vaginal delivery, breast feeding, probiotics and yogurt intake and their relationship with UTI were evaluated. Results : The rate of vaginal delivery was 50%(58/l15) in UTI infants, which was not significantly different from 60%(69/116) in control infants(P>0.05). In the infants with UTI, the feeding pattern(breast milk 19%, mixed 26%, formula 55%) was significantly different from that(44%, 19%, 37%) in control infants(P<0.05). This significant difference was shown only in infants less than 6 months of age, but was not in infants over 6 months of age. The rate of probiotics intake in UTI infants was 4%(4/115), which was significantly lower than 27% (32/116) in control infants(P<0.05). The rate of regular intake of yogurt in UTI infants over 6 months of age was 27%(6/23), which was not significantly different from 35%(8/23) in control infants(P>0.05). The odds ratios of breast feeding and probiotics intake against UTI were significantly low as 0.30 (95% Cl 0.17-0.55)(P<0.01) and 0.03 (95% Cl 0.01-0.07)(P<0.01). Conclusion : The significantly lower rates of breast feeding and probiotics intake in UTI infants suggest that these dietary factors might have preventive effects in infants with UTI.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.239-246
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• 2007

Purpose : The progressive deterioration of renal function in children can impose a serious and lifelong impact on their lives. The ultimate goal in the management of children with chronic kidney disease(CKD) is to prolong survival, to prevent complications, and to promote growth and neurodevelopment. The aim of this study is to investigate the risk factors for the decline of renal function in pediatric CKD patients. Methods : Data from patients who met the criteria for the Kidney Disease Outcomes Quality Initiative(K/DOQI) CKD stage 2 to 4 between August 1999 and March 2007 were retrospectively analyzed. The estimated glomerular filtration rate(eGFR) was calculated by the Schwartz formula, using serum creatinine levels and height. We calculated the annual eGFR change from the difference between the baseline eGFR and the last eGFR divided by the duration(years) of the follow-up period. We analyzed the association between the annual eGFR change and factors such as age, gender, K/DOQI stage, underlying renal disease, serum calcium, and inorganic phosphorous during the follow-up period. Results : Sixty one children(44 boys & 17 girls) were enrolled. The age at entry was $7.1{\pm}4.7$ years. The annual eGFR change was $-1.2{\pm}11.9 mL/min/1.73m^2/year$. Our study showed that older age(P=0.005). hypocalcemia(P=0.012), and hypenhosphatemia(P=0.002) were significantly related to more rapid decline in renal function. Conclusion : In pediatric CKD, older age, hypocalcemia and hyperphosphatemia are related to more rapid deterioration of renal function.