• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.157-163
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• 2005

Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.112-120
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• 2004

Purpose : Methicillin Resistant-Coagulase Negative Staphylococcus(MR-CNS) infection has become an increasingly important cause of morbidity in NICU infants. We investigated the c linical characteristics of MR-CNS sepsis. Methods : This study included 40 neonates with MR-CNS sepsis who were admitted to the neonatal intensive care unit of Kangnam Sacred Heart Hospital, Hallym University from January 1998 to July 2002. MR-CNS sepsis was defined as MR-CNS recovery from blood with clinical symptoms and signs of infection. Retrospective analyses of the medical records of patients with MR-CNS sepsis were performed. The analyses included demographic findings, clinical features, hospital courses, risk factors for infection including invasive procedures and mortality. Results : From 1998 to 2002, there were 40 cases of MR-CNS sepsis, comprising 17.7% of late onset infections in NICU of Kangnam Sacred Heart Hospital. The male/female ratio was 1.5 : 1. The mean gestational age of infected babies was $32.4{\pm}4.3$ weeks at birth. And the first positive MR-CNS culture was done in the day $10.6{\pm}9.3$ after birth. Clinical symptoms such as fever, dyspnea, cyanosis, grunting, bradycardia, vomiting and diarrhea were frequent in MR-CNS. Mechanical ventilation was applied in 12 cases and catheter was inserted in 11 cases. The mortality(12.5%) directly attributable to MR-CNS sepsis was similar to other late onset infections. Conclusion : MR-CNS is a pathogen responsible for most late onset and nosocomial infections. And it will be life-threatening in high-risk neonate. Awareness of increasing infections due to MR-CNS in NICU is important not only for infection control but also placing a great limit in use of antibiotics and invasive procedures, especially in premature infants.

• Development and Reproduction
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• v.11 no.3
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• pp.245-251
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• 2007

Vinclozolin(VCZ), a systemic dicarboximide fungicide, has been used in the control of diseases caused by microorganism of some species in fruits, vegatables and ornamental plants. Although VCZ itself is a very weak antagonist for androgen receptor binding, both melabolites M1 and M2 are effective antagonists. The present study was undertaken to examine whether prepubertal exposure to VCZ affects on the onset of puberty and the associated reproductive parameters such as hormone receptor expressions in female rats. VCZ(10 mg/kg/day) was administered daily from postnatal day 21(PND 21) through the day when the first vaginal opening(V.O.) was observed. Gross anatomy and weight of reproductive tissues were compared to test the VCZ's effects on the cell proliferation. Furthermore, histological studies were performed to assess the structural alterations in the tissues. To determine the transcriptional changes in progesterone receptor(PR), total RNAs were extracted and applied to the semi-quantitative reverse transcription polymerase chain reaction(RT-PCR). As a result, delayed V.O. was shown in the VCZ group(PND $34.00{\pm}1.22$) compared to the control group(PND $38.20{\pm}1.92$; p<0.01). VCZ treatment significantly decreased the wet weight of ovaries and uteri compared to the control group(p<0.01). Graafian follicles and corpora lutea were observed only in the ovaries from the control animals, while numerous primary, secondary follicles and small atretic follicles were observed in the ovaries from VCZ group. Similarly, hypotrophy of luminal and glandular uterine epithelium was found in the VCZ group. In the semi-quantitative RT-PCR studies, the transcriptional activity of PR in ovary(p<0.01) from VCZ group were significantly lower than those from the control group while in uterus were similar compared with the control group. The present studies demonstrated that the acute exposure to VCZ during the critical period of prepubertal stage could inactivate the reproductive system resulting delayed puberty in female rats.

• Journal of Life Science
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• v.29 no.7
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• pp.800-808
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• 2019

Charcot-Marie-Tooth disease (CMT) is a group of rare peripheral neuropathies characterized by progressive muscle weakness and atrophy and areflexia in the upper and lower extremities. The most common subtype of CMT is CMT1A, which is caused by a tandem duplication of the PMP22 gene in the 17p12 region. Patients with CMT1A show a loose genotype-phenotype correlation, which suggests the existence of secondary genetic or association factors. Recently, polymorphisms of rs71428439 (n.83A>G) and rs2292832 (n.86T>C) in the MIR149 have been reported to be associated with late onset and mild phenotypic CMT1A severity. The aim of this study was to examine the intrafamilial heterogeneities of clinical phenotypes according to the genotypes of these two SNPs in MIR149. For this study, we selected 6 large CMT1A families who showed a wide range of phenotypic variation. This study suggested that both SNPs were related to the onset age and severity in the dominant model. In particular, the AG+GG (n.83A>G) and TC+CC genotypes (n.86T>C) were associated to late onset and mild symptoms. Motor nerve conduction velocity (MNCV) was not related to the MIR149 genotypes. These results were consistent with the previous studies. Therefore, we suggest that the rs71428439 and rs2292832 variants in MIR149 may serve as genetic modifiers of CMT1A intrafamilial phenotypic heterogeneity, as they have a role in the unrelated patients. This is the first study to show an association using large families with variable clinical CMT1A phenotypes. The results will be helpful in the molecular diagnosis and treatment of patients with CMT1A.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.20-25
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• 2019

Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• Asian-Australasian Journal of Animal Sciences
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• v.18 no.10
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• pp.1479-1484
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• 2005

A study was conducted to determine the effects of restricted feeding and feed form on the growth performance, characteristics of carcass and digestive tract, and days to first egg of Japanese quail (JQ, Coturnix coturnix japonica). A total of 240 oneweek-old JQ chicks were allocated randomly into 4 experimental groups that consisted of 3 replicates according to a 2${\times}$2 factorial arrangement for two feeding methods (ad libitum, AF and restricted feeding, RF) and two diet forms (mash, MD and crumble, CD). The JQ chicks were placed in a room with floor battery brooders and fed a commercial starter diet from 7 to 14 d of age. According to the experimental design, four treatments (1: ad libitum MD, 2: restricted MD, 3: ad libitum CD, and 4: restricted CD) were applied. Feed restriction was applied by 30% reduction of ad libitum feed intake for both MD and CD from 15 to 28 d of age. All birds were fed ad libitum with treatment diets from 29 d of age until the first laid egg seen (45 d of age). The commercial starter diet, MD and CD were in the same nutrient content (240 g crude protein with 13.4 MJ ME per kg diet). The body weight and overall feed conversion ratio (g feed/g gain) were higher (p<0.05) for the AF quails than the RF at 42 d of age. Carcass weights, dressing percentage and percentage yields of breast and back were similar for AF and RF groups at 42 d of age. The RF delayed (p<0.05) onset of egg production 2 days compared to the AF. Quail fed with the CD showed higher value (p<0.05) for carcass weight and dressing percentage at 42 d of age compared to birds fed with the MD. The interaction effect of feeding method${\times}$feed form on any of the studied parameters was not significant. The results suggest that feed restriction as in the present study can achieve a better feed conversion without reduction in carcass weight, and a significant benefit of feeding the crumble diet over the mash diet was obtained in terms of carcass weight in the JQ.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7467-7472
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• 2015

Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.905-914
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• 2006

Background and Purpose : The purpose of this study was to classify according to the TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) acute stroke patients (first-ever stroke) treated at the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital. Methods : In the time period Oct. 2005 to Oct. 2006. 101 patients with a first-ever stroke admitted to the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. They had neurological deficits for a time more than 24 hours. We classified patients according to the original TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) Results : The incidence in males was 54.4%, in females was 45.6%. Ischemic stroke (86.l%) was more common than hemorrhagic stroke (13.9%). The results of TOAST classification in this study were as follows: small-vessel occlusion, 72.4% large-artery atherosclerosis. 14.9 % cardioembolism, 4.6% stroke of other determined etiology, 4.6%: stroke of undetermined etiology, 3.5%. Patients in the small-vessel occlusion subgroup in this study were the most frequent. The result of this study is that Korean stroke registry is not in accordance with western medicine. Conclusions : The TOAST classification system is the most widely accepted tool to categorize stroke subtypes in western medicine, but in oriental medicine, it is not yet widely accepted. The authors suggest the general use of the TOAST classification to determine adequate management for stroke patients, to predict the prognosis and recurrence of stroke and to develop a Korean standard of stroke in oriental medicine.

• The Mathematical Education
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• v.27 no.1
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• pp.15-23
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• 1988

We are at the onset of a major revolution in education, a revolution unparalleled since the invention of the printing press. The computer will be the instrument of this revolution. Computers and computer application are everywhere these days. Everyone can't avoid the influence of the computer in today's world. The computer is no longer a magical, unfamiliar tool that is used only by researchers or scholars or scientists. The computer helps us do our jobs and even routine tasks more effectively and efficiently. More importantly, it gives us power never before available to solve complex problems. Mathematics instruction in secondary schools is frequently perceived to be more a amendable to the use of computers than are other areas of the school curriculum. This is based on the perception of mathematics as a subject with clearly defined objectives and outcomes that can be reliably measured by devices readily at hand or easily constructed by teachers or researchers. Because of this reason, the first large-scale computerized curriculum projects were in mathematics, and the first educational computer games were mathematics games. And now, the entire mathematics curriculum appears to be the first of the traditional school curriculum areas to be undergoing substantial trasformation because of computers. Recently, many research-Institutes of our country are going to study on computers in orders to use it in mathematics education, but the study is still start ing-step. In order to keep abreast of this trend necessity, and to enhance mathematics teaching/learning which is instructed lecture-based teaching/learning at the present time, this study aims to develop/present practical method of computer-using. This is devided into three methods. 1. Programming teaching/learning method This part is presented the following five types which can teach/learn the mathematical concepts and principle through concise program. (Type 1) Complete a program. (Type 2) Know the given program's content and predict the output. (Type 3) Write a program of the given flow-chart and solve the problem. (Type 4) Make an inference from an error message, find errors and correct them. (Type 5) Investigate complex mathematical fact through program and annotate a program. 2. Problem-solving teaching/learning method solving This part is illustrated how a computer can be used as a tool to help students solve realistic mathematical problems while simultaneously reinforcing their understanding of problem-solving processes. Here, four different problems are presented. For each problem, a four-stage problem-solving model of polya is given: Problem statement, Problem analysis, Computer program, and Looking back/Looking ahead. 3. CAI program teaching/learning method This part is developed/presented courseware of sine theorem section (Mathematics I for high school) in order to avail individualized learning or interactive learning with teacher. (Appendix I, II)