Chronic HBV Infection in Children: The histopathologic classification and its correlation with clinical findings (소아의 만성 B형 간염: 새로운 병리조직학적 분류와 임상 소견의 상관 분석)
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- Pediatric Gastroenterology, Hepatology & Nutrition
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- v.1 no.1
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- pp.56-78
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- 1998
Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.
The aim of our research was to apply experimental design methodology in the optimization condition of Photo-Fenton oxidation of the residual livestock wastewater after the coagulation process. The reactions of Photo-Fenton oxidation were mathematically described as a function of parameters amount of Fe(II)(
Background: The dysfunction of multiple organs is found to be caused by reactive oxygen species as a major modulator of microvascular injury after hemorrhagic shock. Hemorrhagic shock, one of many causes inducing acute lung injury, is associated with increase in alveolocapillary permeability and characterized by edema, neutrophil infiltration, and hemorrhage in the interstitial and alveolar space. Aggressive and rapid fluid resuscitation potentially might increased the risk of pulmonary dysfunction by the interstitial edema. Therefore, in order to improve the pulmonary dysfunction induced by hemorrhagic shock, the present study was attempted to investigate how to reduce the inflammatory responses and edema in lung. Material and Method: Male Sprague-Dawley rats, weight 300 to 350 gm were anesthetized with ketamine(7 mg/kg) intramuscular Hemorrhagic Shock(HS) was induced by withdrawal of 3 mL/100 g over 10 min. through right jugular vein. Mean arterial pressure was then maintained at
An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.
With the issuance of one-week fine dust emergency reduction measures in March 2019, the public's anxiety about fine dust is increasingly growing. In order to assess the application of air purifying plant-based bio-filters to public facilities, this study presented a method for measuring pollutant reduction effects by creating an indoor environment for continuous discharge of particle pollutants and conducted basic studies to verify whether indoor air quality has improved through the system. In this study conducted in a lecture room in spring, the background concentration was created by using mosquito repellent incense as a pollutant one hour before monitoring. Then, according to the schedule, the fine dust reduction capacity was monitored by irrigating for two hours and venting air for one hour. PM10, PM2.5, and temperature & humidity sensors were installed two meters front of the bio-filters, and velocity probes were installed at the center of the three air vents to conduct time-series monitoring. The average face velocity of three air vents set up in the bio-filter was 0.38±0.16 m/s. Total air-conditioning air volume was calculated at 776.89±320.16㎥/h by applying an air vent area of 0.29m×0.65m after deducing damper area. With the system in operation, average temperature and average relative humidity were maintained at 21.5-22.3℃, and 63.79-73.6%, respectively, which indicates that it satisfies temperature and humidity range of various conditions of preceding studies. When the effects of raising relatively humidity rapidly by operating system's air-conditioning function are used efficiently, it would be possible to reduce indoor fine dust and maintain appropriate relative humidity seasonally. Concentration of fine dust increased the same in all cycles before operating the bio-filter system. After operating the system, in cycle 1 blast section (C-1, β=-3.83, β=-2.45), particulate matters (PM10) were lowered by up to 28.8% or 560.3㎍/㎥ and fine particulate matters (PM2.5) were reduced by up to 28.0% or 350.0㎍/㎥. Then, the concentration of find dust (PM10, PM2.5) was reduced by up to 32.6% or 647.0㎍/㎥ and 32.4% or 401.3㎍/㎥ respectively through reduction in cycle 2 blast section (C-2, β=-5.50, β=-3.30) and up to 30.8% or 732.7㎍/㎥ and 31.0% or 459.3㎍/㎥ respectively through reduction in cycle 3 blast section (C-3, β=5.48, β=-3.51). By referring to standards and regulations related to the installation of vegetation bio-filters in public facilities, this study provided plans on how to set up objective performance evaluation environment. By doing so, it was possible to create monitoring infrastructure more objective than a regular lecture room environment and secure relatively reliable data.
The intermittent freshwater discharge has an critical influence upon the biophysical environments and the ecosystems of the Yeongsan Estuary where the estuary dam altered the continuous mixing of saltwater and freshwater. Though freshwater discharge is controlled by human, the extreme events are mainly driven by the heavy rainfall in the river basin, and provide various impacts, depending on its magnitude and frequency. This research aims to evaluate the magnitude and frequency of extreme freshwater discharges, and to establish the magnitude-frequency relationships between basin-wide rainfall and freshwater inflow. Daily discharge and daily basin-averaged rainfall from Jan 1, 1997 to Aug 31, 2010 were used to determine the relations between discharge and rainfall. Consecutive daily discharges were grouped into independent events using well-defined event-separation algorithm. Partial duration series were extracted to obtain the proper probability distribution function for extreme discharges and corresponding rainfall events. Extreme discharge events over the threshold 133,656,000
Purpose: Regurgitation, vomiting and feeding intolerance are frequent in the neonates. Esophageal function and gastric peristalsis are not fully developed in the neonates, so we should give attention to reduce the incidence of regurgitation and vomiting after feeding. It is necessary to shorten the gastric emptying by change of feeding types and postprandial postures. Gastric emptying time was measured by ultrasound in the neonates to evaluate the effect of feeding types and postprandial postures. Method: We measured gastric antral cross sectional area along the abdominal aorta at the level of the superior mesenteric artery in longitudinal section at NPO state (4 hours after feeding), 0 and every 30 min. after feeding until the value goes below or back to the NPO state. Fifteen neonates were examined in each breast-fed and formula-fed group in supine position. Eighteen and 15 neonates were examined in supine and prone posture after formula feeding, respectively. We used 5 MHz convex prove with Aloka Echo Camera SSD-650. Result: 1) Gastric emptying time of breast-fed infants was
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
Log data, which record the multitude of information created when operating computer systems, are utilized in many processes, from carrying out computer system inspection and process optimization to providing customized user optimization. In this paper, we propose a MongoDB-based unstructured log processing system in a cloud environment for processing the massive amount of log data of banks. Most of the log data generated during banking operations come from handling a client's business. Therefore, in order to gather, store, categorize, and analyze the log data generated while processing the client's business, a separate log data processing system needs to be established. However, the realization of flexible storage expansion functions for processing a massive amount of unstructured log data and executing a considerable number of functions to categorize and analyze the stored unstructured log data is difficult in existing computer environments. Thus, in this study, we use cloud computing technology to realize a cloud-based log data processing system for processing unstructured log data that are difficult to process using the existing computing infrastructure's analysis tools and management system. The proposed system uses the IaaS (Infrastructure as a Service) cloud environment to provide a flexible expansion of computing resources and includes the ability to flexibly expand resources such as storage space and memory under conditions such as extended storage or rapid increase in log data. Moreover, to overcome the processing limits of the existing analysis tool when a real-time analysis of the aggregated unstructured log data is required, the proposed system includes a Hadoop-based analysis module for quick and reliable parallel-distributed processing of the massive amount of log data. Furthermore, because the HDFS (Hadoop Distributed File System) stores data by generating copies of the block units of the aggregated log data, the proposed system offers automatic restore functions for the system to continually operate after it recovers from a malfunction. Finally, by establishing a distributed database using the NoSQL-based Mongo DB, the proposed system provides methods of effectively processing unstructured log data. Relational databases such as the MySQL databases have complex schemas that are inappropriate for processing unstructured log data. Further, strict schemas like those of relational databases cannot expand nodes in the case wherein the stored data are distributed to various nodes when the amount of data rapidly increases. NoSQL does not provide the complex computations that relational databases may provide but can easily expand the database through node dispersion when the amount of data increases rapidly; it is a non-relational database with an appropriate structure for processing unstructured data. The data models of the NoSQL are usually classified as Key-Value, column-oriented, and document-oriented types. Of these, the representative document-oriented data model, MongoDB, which has a free schema structure, is used in the proposed system. MongoDB is introduced to the proposed system because it makes it easy to process unstructured log data through a flexible schema structure, facilitates flexible node expansion when the amount of data is rapidly increasing, and provides an Auto-Sharding function that automatically expands storage. The proposed system is composed of a log collector module, a log graph generator module, a MongoDB module, a Hadoop-based analysis module, and a MySQL module. When the log data generated over the entire client business process of each bank are sent to the cloud server, the log collector module collects and classifies data according to the type of log data and distributes it to the MongoDB module and the MySQL module. The log graph generator module generates the results of the log analysis of the MongoDB module, Hadoop-based analysis module, and the MySQL module per analysis time and type of the aggregated log data, and provides them to the user through a web interface. Log data that require a real-time log data analysis are stored in the MySQL module and provided real-time by the log graph generator module. The aggregated log data per unit time are stored in the MongoDB module and plotted in a graph according to the user's various analysis conditions. The aggregated log data in the MongoDB module are parallel-distributed and processed by the Hadoop-based analysis module. A comparative evaluation is carried out against a log data processing system that uses only MySQL for inserting log data and estimating query performance; this evaluation proves the proposed system's superiority. Moreover, an optimal chunk size is confirmed through the log data insert performance evaluation of MongoDB for various chunk sizes.