• Clinical and Experimental Pediatrics
• /
• v.49 no.4
• /
• pp.424-430
• /
• 2006

Purpose : Juvenile rheumatoid arthritis(JRA) is one of the most common rheumatic diseases of childhood and is an important cause of short- and long-term disability. The purpose of this study was to determine the disease course and outcome in childhood patients with JRA. Methods : Fifty nine patients with JRA who were diagnosed and treated in the Department of Pediatrics, Asan Medical Center from August 1990 to November 2004 were enrolled in this study. Sex, age, type, affected joints, extra-articular manifestations, laboratory and radiologic findings, treatments, and outcomes of JRA patients were reviewed retrospectively. Results : Among JRA patients, 32.2 percent had pauciarticular type, 30.5 percent had polyarticular type and 37.3 percent had systemic type. The ratio of boys to girls was 1.7 : 1 and the mean age at onset was $9.3{\pm}3.7$(1.3-15.9) years. The most commonly affected joints were knee, ankle and wrist. The extra-articular manifestations observed were fever, rash, myalgia and lymph node enlargement, etc. The main laboratory findings observed were leukocytosis, anemia, thrombocytosis, elevated ESR, and elevated CRP. Rheumatoid factor and antinuclear antibody(ANA) were positive in 5.3 percent and 18.0 percent. Nonsteroid anti-inflammatory drugs(NSAID) were used most frequently and methotrexate with or without steroids was added in 27.1 percent of patients unresponsive to NSAID. 88.1 percent of patients were cured without functional disability and only one patient was in functional status IV. One patient, who had pulmonary involvement, died. Conclusion : Our results showed an even distribution in type of onset, male predominance, older age of onset, low incidence of iridocyclitis, and low positivity of ANA in JRA patients; this differs from occidental data. This study may suggest regional differences and variability in disease groups of JRA among different racies, but further multi-center trials and large scale epidemiological studies are needed to confirm our conclusion.

• Journal of agricultural medicine and community health
• /
• v.27 no.2
• /
• pp.107-126
• /
• 2002

Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

• Journal of agricultural medicine and community health
• /
• v.28 no.1
• /
• pp.67-77
• /
• 2003

Objectives: This study is designed to suggest the health service goals necessary for providing the more efficient services relevant to the requests of the community, through the evaluation on the operating status of the unified health subcenters. Methods: We visited total 5 unified health subcenters comprising 3 ones located in Gyeongsangbuk-do and 2 ones located in Gyeongsangnam-do from December 2000 to January 2001, and interviewed about the pre- and post-unified status related to manpower, facilities, equipment, medical service and health service quality, and the problems and improvement plans of the unified management. Results: According to the evaluation on the manpower before and after the unification of the health subcenters, the total employees increased by 2.8 persons on average from 6.8 to 9.6 persons in the investigated subjects. The numbers of doctors, dentists and nurses were almost the same as before. There were no clinical pathologic technician and radiological technician before but they were appointed to duty in 3 unified health subcenters later. The unification of the health subcenters has produced slight increases in the frequency of the medical service and dental treatment and considerable increases in that of the physical therapy and laboratory tests. In relating to the changes of the health service, the cases of visiting health care and ambulatory medical service, and the total number of health education participants were greatly increased after the unification. The number of cases undergoing the vaccination and cervical cancer screening was similar to that of the pre-unification while the patient number of the registration to hypertension or diabetes showed a tendency to increase a little. Since the unification of the health subcenters, the frequency of laboratory tests has been increased, but the quality of health service has not been improved yet. Nevertheless, the unification seems to be positive according to the result of the great improvement in visiting health care, ambulatory medical service and health education service. The problems of the unification of the health subcenters were indicated in indefiniteness of the service details between the workers; excessively large building hard to be effectively managed; insufficient medical instruments, inappropriation of working expenses, lack of professional training for the health education, etc. Conclusions: For further active functions of the unified health subcenters, the minimal allocation basis to appoint doctors, nurses and administrative workers to do the duty should be differentiated from the basis for a health subcenter, and the fundamental instruments needs to be expanded to improve the quality of the medical service and visiting health care service. Moreover, the unified health subcenter needs to have definite service details between the workers, and should improve the working efficiency through the development of service-related guidelines.

• Applied Microscopy
• /
• v.37 no.2
• /
• pp.83-91
• /
• 2007

The present study examined the epidermal changes of adhesive disks which occur during attachment in Parthenocissus tricuspidata using scanning and transmission electron microscopy. Several adhesive disks, each covered with a bract, develop from the shoot apical meristem during early development. In the initial stage, the adhesive disks are club-shaped and their upper and lower epidermis are indistinguishable. However, in the actively growing stage, they become spherical and both epidermis are clearly differentiated into the adventitious roots. Prior to wall attachment, the adhesive disks exhibit adaxial convex and abaxial concave shapes, and electron-dense substances are abundant in the vacuoles of epidermal cells. The peripheral area of the adhesive disk is adhered first to the wall surface, while the central area is drawn inward in a vacuum-like state during attachment. As the attachment progresses and the electron-dense substances continue to discharge, the upper and lower epidermis rapidly undergo deterioration and the disks shrink considerably. At this stage, structural changes of the lower epidermis occur much faster than in the upper one. The discharged substance is accumulated on the wall surface, and this aids the attachment of adhesive disks on the wall for long periods. In this manner, the shape and structure of the adhesive disk epidermis change drastically from initial growth to the mature stage. Further, the role of electron-dense substance and shrinkage of the disk during attachment has been discussed in Parthenocissus tricuspidata.

• Applied Microscopy
• /
• v.37 no.2
• /
• pp.93-102
• /
• 2007

Secretory leukocyte protease inhibitor (SLPI) was known as one of bacterial lipopolysaccharide (LPS)-induced products of macrophage. Macrophages play an important role in the development of inflammatory responses by secreting an array of cytokines and chemokines in a tissue microenvironment. To identify the function and relationship between potent growth factors and SLPI after LPS stimulation, we conducted reverse transcriptase polymerase chain reaction (RT-PCR) and Western blots for the detection of mRNA and protein expression of SLPI and growth factors such as VEGF, PDGF, bFGF after 100 ng LPS stimulation on the RAW264.7 cells. The result of RT-PCR was showed SLPI mRNA expression was increased from 60 min to 48h in RAW 264.7 cells after incubation with LPS. VEGF and PDGF mRNA was expressed highly at initial stage by LPS stimulation. The mRNA of bFGF and type I collagen was very weakly expressed after LPS stimulation. SLPI protein level was increased likely the mRNA levels in RAW 267.7 cells. Additionally, phase contrast and scanning electron microscopic observation demonstrated that the LPS induce the change of morphology of the RAW264.7 cells. From these results, it suggest that expression of SLPI by LPS treatment may associate with VEGF and PDGF expression in RAW264.7 cells.

• Journal of Preventive Medicine and Public Health
• /
• v.29 no.4 s.55
• /
• pp.801-814
• /
• 1996

Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.

• Progress in Medical Physics
• /
• v.14 no.4
• /
• pp.218-224
• /
• 2003

Purpose：By evaluating the dependence of the tray transmission factor (tray factor) on collimator setting and tray thickness, we determined the validity of the clinically used single tray factor for standard radiation field size (10${\times}$10 $\textrm{cm}^2$). Methods and Materials：For each X ray energies (6 and 10 MV), outputs were measured by using 5 steps of tray thickness (0, 6, 8, 10, 12 mm) and 7 steps of radiation field size (5${\times}$5, 10${\times}$10, 15${\times}$15, 20${\times}$20, 25${\times}$25, 30${\times}$30, 35${\times}$35 $\textrm{cm}^2$) at 10 cm phantom depth. Outputs were measured in both 'with tray' and 'without tray' conditions by using radiation with the same monitor units, and the tray factors were determined by the ratios of the two outputs. To evaluate the validity of a single tray factor obtained for standard radiation field, we analyzed the pattern of the field sizes in cases treated at our hospital in 2002. Results : In the 6 MV X-ray, the increases in the tray factor between the standard field (l0${\times}$10 $\textrm{cm}^2$) and the largest field (35${\times}$35 $\textrm{cm}^2$) were 0.517%, 0.835%, 1.058%, 1.066% in 6, 8, 10, and 12 mm thickness tray, respectively. In the 10 MV X-ray, the increases in the fray factor between the standard field (10${\times}$10 $\textrm{cm}^2$) and the largest field (35${\times}$35 $\textrm{cm}^2$) were 0.517%, 0.836%, 1.058%, 1.066% in 6, 8, 10, 12 mm thickness tray, respectively. In a major portion of clinical cases, when the field size was smaller than 20${\times}$20 $\textrm{cm}^2$, the tray factor was in good agreement with the standard tray factor. However, in cases where the field sizes were 30${\times}$30 $\textrm{cm}^2$ and 35${\times}$35 $\textrm{cm}^2$, the error could exceed 1.0%. Conclusion：The tray factor increased with increasing field size or decreasing tray thickness. The difference of tray factor between the small field and the large field increased with increasing tray thickness. Furthermore, the standard tray factor was valid in most clinical cases except for when the field size was greater than 30${\times}$30 $\textrm{cm}^2$, wherein the error could exceed 1.0%.