• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.519-528
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• 2002

Background : Steroid therapy has been shown to improve the clinical outcome in acute respiratory distress syndrome (ARDS) patients with histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. Because the histopathological features of acute interstitial pneumonia(AIP) are identical with that of ARDS, early steroid therapy was used in AIP patients who had histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. We analyzed seven years of our experience to evaluate the efficacy of early steroid therapy in AIP. Materials and Methods : A retrospective review was performed on AIP patients who received steroid therapy within 7 days of mechanical ventilatory support in Dankook university Hospital between May 1995 and May 2002. AIP was diagnosed clinically by ARDS without a known cause of the etiology and pathologically by a lung biopsy showing a fibroproliferative stage of diffuse alveolar damage. The clinical response and physiologic parameters were evaluated during steroid therapy. Results : Five AIP patients received intravenous methylprednisolone (1-2 mg/kg every 6 hours) after $0.6{\pm}1.7$ days of mechanical ventilatory support. Lung biopsies were performed after $1.8{\pm}1.4$ days of mechanical ventilatory support. Four patients(80%) survived and were extubated after $2.8{\pm}0.4$ days of steroid therapy with improvement in the $PaO_2/FiO_2$ ratio ($127.4{\pm}10.0$ at day 0 to $223.8{\pm}37.6$ at day 7) by steroid therapy. However, one patient(20%) died of respiratory failure after 15 days of steroid therapy. Conclusion : Early steroid therapy sppears to be beneficial in AIP patients without evidence of infection. However, as our study group was too small, further large scale studies to define the effectiveness of steroids are required.

• Herbal Formula Science
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• v.16 no.2
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• pp.91-100
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• 2008

Background and Objectives : There are three kinds of formulas for purging the kidney to cure its sthenic syndrome based on the types of preparation formulas : Sashintang, Sashinhwan and Sashinsan. There are 4 kinds of Sashintang, 1 kind of Sashinhwan and 1 kind of Sashinsan. Combination of herbal medicines, carried out in formulas for purging the kidney, consists of various kinds depending on medical scientists' personal experience in medical treatment without any general principles, which makes it difficult to apply it to clinical use. The objectives of this study lie in theoretical establishment of Pyeongshintang for curing the sthenic syndrome of kidney through analyzing the component medicines and combination principles of Hyeongok's Pyeongshintang, and furthermore, maximizing the clinical use of Pyeongshintang. Methods : This study analyzed the component medicines and combination principles of Hyeongok's Pyeongshintang based on the theory for properties and tastes of herbal medicines from the "Yellow Emperor's Canon of Internal Medicine", the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine, and the five elements doctrine. Hyeongok's Pyeongshintang is an odd prescription, composed of 7 kinds of ingredients : No.1 Rhizoma Alismatis (2don;7.5g), No.2 Poria (1don;3.75g), No.3 Radix Paeoniae Alba (1don), No.4 Fructus Chaenomelis (1don), No.5 Polyporus (1don), No.6 Cortex Cinnamomi (1don), and No.7 Radix Glycyrrhizae (1don) Results : There are three methods for curing the sthenic syndrome of kidney according to the five elements doctrine : purging the kidney, purging the liver and invigorating the spleen. First, if you suffer from the sthenic syndrome of the kidney, you need to purge your kidney. There are two available methods, including taste and property purgation according to the theory for properties and tastes of herbal medicines. They each imply the salty taste and the hot property purge the kidney. In the case of taste purgation, two herbal medicines with salty taste, Rhizoma Alismatis and Poria, are combined into the principal and assistant herbal medicine, respectively. For property purgation, two herbal medicines with the hot property, Polyporus and Cortex Cinnamomi, are combined into adjuvant herbal medicines. Secondly, if you suffer from the sthenic syndrome of the kidney, you need to purge your liver which is child in the mother-child relationship in inter-promotion among the five elements. There are two methods to purge the liver, including taste and property purgation according to the theory for properties and tastes of herbal medicines. They each mean the sour taste and the cool property purge the liver. Therefore, it is important to use sour herbal medicines for taste purgation and cool ones for property purgation. Both sour and cool herbal medicines, Radix Paeoniae Alba and Fructus Chaenomelis, are combined into adjuvant herbal medicines. Lastly, if you suffer from the sthenic syndrome of the kidney, you need to invigorate your spleen which is an element being surpassed in the relationship between the elements surpassed and ones not surpassed in inter-restraint among the five elements. There are two methods to invigorate the spleen, which include taste and property invigoration according to the theory for properties and tastes of herbal medicines. Taste invigoration means to invigorate the spleen with sweet taste and property invigoration to invigorate the spleen with warm property. Therefore, it is important to use sweet herbal medicines for taste invigoration and warm ones for property invigoration. Both sweet and warm herbal medicines, Polyporus and Cortex Cinnamomi, were combined to invigorate the spleen and purge the kidney. In addition, Radix Glycyrrhizae are combined as dispatcher herbal medicine, harmonizing all the herbal medicines composing the formula. Conclusions : First, to cure the sthenic syndrome of the kidney, the methods of purging the kidney and the liver, and invigorating the spleen should be used according to the five elements doctrine. Secondly, herbal medicines appropriate for those treatment methods should be chosen according to the theory for properties and tastes of herbal medicine and thirdly, the combination of those herbal medicines should be carried out according to the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine. As a good example, Hyeongok's Pyeongshintang is combined according to the above theories. In conclusion, this formula was created by applying to the theory for properties and tastes of herbal medicines.

• Clinical and Experimental Pediatrics
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• v.50 no.2
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• pp.178-181
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• 2007

Purpose : The renal manifestations of tuberous sclerosis complex (TSC) are remarkably diverse, including polycystic kidney disease, simple renal cysts, renal cell carcinomas, and angiomyolipomas. All of these occur in children as well as adults in TSC. Angiomyolipomas, which can cause spontaneous life-threatening hemorrhages, are by far the most prevalent and the greatest source of morbidity. Here, we will address our experience, adding to the literature on pediatric patients with TSC requiring evaluation and treatment for renal manifestations. Methods : A retrospective analysis was made on 19 patients in whom TSC was diagnosed between May 2001 and Oct. 2005 at Severance Hospital. All patients had clinical diagnoses of TSC as defined by the 1998 tuberous sclerosis complex consensus conference. Results : The patients consisted of 13 boys and 6 girls with a mean age of 7.3 years (range 1 to 22). The renal disease associated with TSC included angiomyolipoma in nine patients (47.4 percent), renal simple cyst in one (5.3 percent), hydronephrosis in one (5.3 percent) patient. Eight patients (42.1 percent) presented with normal kidney contours at abdominal ultrasonography. One patient underwent renal replacement therapy due to chronic renal insufficiency after nephrectomy. Hemorrhage from angiomyolipoma was not detected. Conclusion : In our review of 19 cases of TSC, renal manifestations are reported in 57.9 percent of patients. Asymptomatic angiomyolipoma associated with TSC grow gradually, although severe hemorrhages are rare. So patients with TSC should be followed up with serial computerized tomography or abdominal ultrasonography. And also, renal function should be monitored conservatively.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.649-654
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• 2007

Purpose : The objective of this study was to clarify the presentation, associated preceding illness, pathologic organisms, treatment and outcome of deep neck abscess in children according to age and location. Methods : We retrospectively reviewed the in-patient charts of children treated at our hospital for deep neck abscess. Thirty-five such patients were identified as having been treated from March 1990 to December 2005. Results : A total of 35 were enrolled in our study: 25 boys and 10 girls. Their ages ranged from 11 months to 15 years. Presenting symptoms included mass, fever, irritability, trismus and dysphagia. The most commonly known associated preceding illness was viral upper respiratory infection (53%). The most common site of infection was the submandibular space (37%). Bacteria was identified in 16 patients. The most common pathogen was Staphylococcus aureus. Thirteen (37%) children recovered from the infection with conservative treatment and twenty-four (68%) children received surgical drainage. The duration of hospitalization was longer in the group who underwent surgery than in the group who were managed with conservative treatment. No complication occurred. Conclusion : Unexplained torticollis, trismus or irritability in children were suggestive of deep neck abscess. Our results demonstrate that deep neck abscesses in children is respond well to conservative treatment if diagnosed early.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.58-65
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• 2010

Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7${\pm}$4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3${\pm}$553.2 and 766.2${\pm}$723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.185-194
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• 1998

Purpose : With the development of stereotactic immobilization systems capable of reliable serial repositioning, fractionated stereotactic radiation therapy (FSRT) offers the Potential for an improved treatment outcome by excellent dose delivery, and dose distribution characteristics with the favorable radiobiological properties of fractionated irradiation. We describe our initial experience using FSRT for the treatment of intracranial benign tumor. Materials and Methods : Between August 1995 and December 1996. 15 patients(7 males and 8 females aged 6-70 years) were treated with FSRT. The patients had the following diagnosis pituitary adenoma(10) including one patient who previously had received radiotherapy, craniopharyngioma (2), acoustic neurinoma (1), meningioma (2). Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2Gy was irradiated at 90% to 100% isodose surface of the isocenter The collimator sizes ranged from 26mm to 70mm. Results : In all patients except one follow-up lost, disease was well-controlled. Acute complication was negligible and no patient experienced cranial nerve neuropathies and radiation necrosis. In overall patient setup with scalp measurements, reproducibility was found to have mean of $1.1{\pm}0.6mm$ from the baseline reading. Conclusion : Relocatable stereotactic system for FSRT is highly reproducible and comfortable. Although the follow-up period was relatively short. FSRT is considered to be a safe and effective radiation technique as the treatment of intracranial tumor. But the fractionation schedule(fraction size, overall treatment time and total dose) still remains to be solved by further clinical trials.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.3
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• pp.591-595
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• 2007

There are eight kinds of formulas for invigorating the liver to cure its asthenic syndrome based on the types of preparation formulas Began-tang, Boganhwan, Bogansan, Bogandan, Boganeum, Boganjoo, Boganjeon and Bogango. Another formula called Bocheonghwan is to invigorate the green colour of liver. There are 22 kinds of Bogan-tang, 12 kinds of Boganhwan, 25 kinds of Bogansan, one kind of Bogandan, one kind of Boganeum, one kind of Boganjoo, one kind of Boganjeon, one kind of Bogango, and two kinds of Bocheonghwan. Combination of herbal medicines, carried out in formulas for invigorating the liver, consists of various kinds depending on medical scientists' personal experience in medical treatment without any general principles, which makes it difficult to apply it to clinical use. The objectives of this study lie in theoretical establishment of Bogan-tang for curing the asthenic syndrome of liver through analyzing the component medicines and combination principles of Hyeongok's Bogan-tang, and furthermore, maximizing the clinical use of Began-tang. This study analyzed the component medicines and combination principles of Hyeongok's Bogan-tang based on the theory for properties and tastes of herbal medicines from the ${\ulcorner}$yellow Emperor's Canon of Internal Medicine${\lrcorner}$ , the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine, and the five elements doctrine. Hyeongok's Began-tang is an odd prescription, composed of 7 kinds of ingredients No.1 Radix Angelicas Sinensis (2don;7.5g), No.2 Rhizoma Chuanxiong (1don;3.75g), No.3 Radii Polygoni Multiflori (1don), No.4 Fructus Lycii (1don), No.5 Cortex Cinnamomi (1don), No.6 Rhizoma Gastrodiae (1don), and No.7 Radix Glycyrrhizae (1don). There are three methods for curing the asthenic syndrome of liver according to the five elements doctrine invigorating the liver, invigorating the kidney and purging the lung. First, if you suffer from the asthenic syndrome of the liver, you need to invigorate your liver. There are two available methods, including taste and property invigoration according to the theory for properties and tastes of herbal medicines. They each imply the pungent taste and the warm property invigorate the liver. In the case of taste invigoration, two herbal medicines with pungent taste, Radix Angelicas Sinensis and Rhizoma Chuanxiong, are combined into the principal and assistant herbal medicine, respectively. For property invigoration, two herDal medicines with the warm property, Cortex Cinnamomi and Rhizoma Gastrodiae, are combined into adjuvant herbal medicines. Secondly, if you suffer from the asthenic syndrome of the liver, you need to invigorate your kidney which is mother in the mother-child relationship in inter-promotion among the five elements. There are two methods to invigorate the kidney, including taste and property invigoration according to the theory for properties and tastes of herbal medicines. They each mean the bitter taste and the cold property invigorate the kidney. Therefore, it is important to use bitter herbal medicines for taste invigoration and cold ones for property invigoration. Both Differ and cold herbal medicines, Radix Polygoni Multiflori and Fructus Lycii, are combined into adjuvant herbal medicines. Lastly, if you suffer from the asthenic syndrome of the liver, you need to purge your lung which is an element being surpassed in the relationship between the elements surpassed and ones not surpassed in inter-restraint among the five elements. There are two methods to purge the lung, which include taste and property invigoration according to the theory for properties and tastes of herbal medicines. Taste invigoration means to purge the lung with pungent taste and property invigoration to purge the lung with warm property. Therefore, it is important to use pungent herbal medicines for taste invigoration and warm ones for property invigoration. Both pungent and warm herbal medicines, Radix Angelicas Sinensis and Rhizoma Chuanxiong, were combined to invigorate and purge the lung. In addition, Radix Glycyrrhizae are combined as dispatcher herbal medicine, harmonizing all the herbal medicines composing the formula. First, to cure the asthenic syndrome of the liver, the methods of invigorating the liver and the kidney, and purging the lung should be used according to the five elements doctrine. Secondly, herbal medicines appropriate for those treatment methods should be chosen according to the theory for properties and tastes of herDal medicine and thirdly, the combination of those herbal medicines should be carried out according to the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine. As a good example, Hyeongok's Bogan-tangon is combined according to the above theories. In conclusion, this formula was created by applying to the theory for properties and tastes of herbal medicines.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.64-71
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• 2007

Purpose : The purpose of this study was to evaluate the clinical utility of rapid detection of Down syndrome and Edward syndrome by Interphase Fluorescence in Situ Hybridization (FISH) analysis. Methods : Aretrospective study in 309 cases of amniotic fluid samples, analysed by interphase FISH with DNA probes specific to chromosome 18 and 21, was performed. All FISH results w ere compared with conventional cytogenetic karyotypings. Results : The results were considered as informative and they were obtained within 48 hrs. A case of Down syndrome and a case of Edward syndrome were diagnosed by FISH and confirmed by subsequent cytogenetic analysis. In 12 cases with normal FISH results, the cytogenetic analysis showed a case of partial trisomy 22, three cases of sex chromosomal aneuploidy, two cases of mosaicism, two cases of microdeletion, and four cases of structural rearrangement. Conclusion : FISH is a rapid and effective diagnostic method, which can be used as an adjunctive test to cytogenetic analysis, for prenatal identification of chromosome aneuploidies. For the more genome-wide screening with variety of probes, the technique of FISH is both expensive and labor-intensive.

• Journal of dental hygiene science
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• v.18 no.6
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• pp.349-356
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• 2018

The demand for medical care and welfare for patients with disabilities is expanding, and healthcare professionals are also increasingly interested in the need for medical care for patients with disabilities. The purpose of this study was to evaluate the competency of disabled patients' management and the education experience of dental hygiene students, who are the main players of oral health care for disabled patients. A total of 196 students in the dental hygiene department and 3rd and 4th grade students were surveyed using questionnaires. As a result, most of the students had a positive awareness of disabled patients; 84.7% answered with the need to train dental hygienists in specializing in handicapped patients, 76.5% were willing to attend seminars related to disabled patients after graduation, and 71.4% of the students provided dental treatment for patients with disabilities in curriculum and comparative curriculum. The students who provided treatment for disabled patients showed that their competence in most areas of knowledge of disabled patients, oral health education, and oral disease prevention was highly evaluated as significant. The competence of respondents who answered that the theoretical education was sufficient was significantly higher. Based on this, institutional support for the education of dentistry for disabled patients is needed, and sufficient theoretical education and practical training should be offered to foster personnel capable of contributing to the improvement in the oral health of patients with disabilities. In addition, in-depth discussions on the training of dental hygienists specialized in handicapped patients should be conducted.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.21 no.1
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• pp.7-14
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• 2021

Purpose: Pseudohypoparathyroidism (PHP) is caused by genetic and epigenetic alteration in the GNAS locus, and characterized by the resistance to multiple hormones and the Albright's hereditary osteodystrophy (AHO) phenotype. This study investigated the phenotypic characteristics and molecular features of PHP. Methods: Eight patients who diagnosed as PHP were enrolled at Pusan National University Children's hospital and clinical features, biochemical and genetic findings were retrospectively reviewed. Results: Of a total of 8 patients, 5 were diagnosed with PHP1a, and 3 were diagnosed with PHP1b. Patients with PHP1a had three different mutations in the GNAS gene, and patients with PHPIb had imprinting defect in differentially methylated regions (DMRs) of the GNAS locus. Two novel GNAS variants were identified in patients with PHP1a, including c.313-2A>T and c.1094G>A. All patients with PHP1a displayed AHO features; short stature (80%), brachydactyly (80%), a round face (80%), obesity (40%), heterotopic ossification (60%), and intellectual disability (60%), whereas only one patient (33.3%) with PHP1b showed AHO feature such as a round face. When phenotypic features between PHP1a and PHP1b patients were compared, patients with PHP1b showed a tendency of higher current height standard deviation scores (SDS) compared to patients with PHP1a, (-3.2±2.1 vs.-1.1±0.8; P=0.06) Conclusions: This study summarizes the phenotypic and genetic features of the PHP patients. Although we found considerable clinical overlap between PHP1a and PHP1b, further long-term follow-up is needed to evaluate the growth and development of children with PHP, as well as the effects of end-organ resistances to endocrine hormones.