• Advances in pediatric surgery
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• 제18권2호
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• pp.68-74
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• 2012

Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.

• 대한임상독성학회지
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• 제6권1호
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• pp.9-15
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• 2008

Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

• 동의생리병리학회지
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• 제28권4호
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• pp.417-424
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• 2014

The purpose of this study was to analyze the psychobiological traits of each Sasang typology based on the Sasang Digestive function Inventory (SDFI) which measures the Sasang type-specific pathophysiological digestive symptom. The SDFI, Temperament and Character Inventory (TCI) and NEO-Personality Inventory (NEOPI) were measured with 199 College students. The correlation coefficient was measured with Pearson correlation among SDFI, TCI, and NEOPI. The influence of TCI, sex and age on SDFI and its subscales were analyzed with regression analysis. We also compared the psychobiological features between high and low SDFI score groups to elucidate its psychobiological profiles. There was significant correlation between SDFI and TCI Harm-Avoidance (r=-0.192, p<0.001). The SDFI subscales were showed to have significant correlations with subscales of NEOPI and TCI. The regression model with TCI can explain 8-16% of type-specific pathophysiological digestive symptoms. The low SDFI score group ($39{\pm}9.3$) has significantly (p=0.007) higher than the high SDFI group ($33.6{\pm}12.2$) in TCI Harm-Avoidance which is considered important for the gastrointestinal dysfunction and So-Eum type differentiation. We found that the TCI may explain the mechanism underneath the Sasang type-specific pathophysiological symptom. It was suggested that the TCI Reward-Dependence would be useful for the study on Tae-Eum Sasang type, and its clinical meanings were discussed in the pathophysiological perspectives.

• Parasites, Hosts and Diseases
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• 제22권1호
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• pp.51-60
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• 1984

반염수산 어류를 중간숙주로하여 매개되는 Heterephyopsis continua에 의한 인체감염 2예가 1983년 praziquantel 치료로 성충을 얻음으로써 화인되었다. 또, 정화한 감염원을 알아보기 위하여 전라남도 해안지방에서 잡은 반염수어에 있어서의 피낭유충 감염상황을 조사하였다. 환자는 24세 및 50세된 남자로 남해안 지방이 고향이며 상복부통, 설사 등 일반적인 소화기 중상을 호소하거나 조충류의 편절이 배출됨을 호소하여 prasiquantel 10-15 mg/kg을 단루 투여하고 하제를 사용하여 치료하였다. 그 결과 조충은 물론 2예에서 각각 2마리 및 46마리의 H. continua 흡충이 설사편으로부터 수집되었다. 환자들은 몇가지 종류의 반염수어를 생식한 경력이 있었다. 어류 중문오주 조사결과는 다음과 같다. 1. 검사한 27마리의 농어 (Lateolabrax japonicas)중 17마리 (63.0%), 34마리의 문절망둑(Acanthogobius yavimanus)중 10마리(29.4%)에서 H. continua의 피낭유충이 검출되었으나 42마리의 숭어(Mugil cephalus)는모두 음성으로 나타났다. 2. 농어 및 문절망둑에 있어서 마리당 평균감염 피낭유충수는 55.4 띤 18.7 개이었고 대부분의 피낭유충은 농어의 경우 몸체부 근육에서 발견되었다. 3. 피낭유충을 실험적으로 2마리의 횐쥐 및 1마리의 어린 개(견)에 감염시켜 성충을 얻고자 한 바 휜쥐에서는 얻을 수 없었고 개에서 2마리의 H. continua 성충을 얻을 수 있었다. 이상의 결과로 보아 환자들이 생식한 농어, 문절망둑 등 반염수산 어류가 이들에 있어서 H. continua의 감염원이었을 것으로 추정할 수 있었다.

• 한국보건간호학회지
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• 제12권2호
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• pp.221-235
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• 1998

This study is a descriptive survey to explore the health lifestyle of adults. The study subjects are teachers of elementary. middle and high school. and staffs of research institutes located in Chungchung Province and Daejon city. The data was collected from Jan. to march 1997 through self reporte for structured questionnaire. Fantastic check list of Wilson and Ciliska for Health Lifestyle Assessment and DSM-III-R for somatic symptom were used as tools. Data was analysed by frequency, $X^2_test$, t-test and Anova using SAS program. The results are as follows: 1. There were statistically significant differences In drinking(t=7.75, P=.000), exercise(t=-2.99, P=.003)and interpersonal relationship(t=2.22, P=.027) among 10 health lifestyle between smoking group and non-smoking group, in drinking(t=17.98, P=.000), exercise(-4.71. P=.000), and job satisfaction(t=2.22, P=.027) between drinking group and non-drinking group, and in eating habit(t=-2.00, P=.045), drinking (t=4.47, P=000), exercise (t= -16.49, P=000), keeping traffic law(t= -2.68, P=.007), personality (t= -2.05, P=.040) and anxiety/depression(t=-3.47, P=.000) between exercise group and non-exercise group. 2. There was statistically significant difference in cardiovascular symptom(F=4.22, P=.0l) among somatic symptoms of subjects according to exercise level. 3. There was statistically significance difference in lifestyle according to smoking level(F=, 3.33, P=.011), drinking level(F=9.17, P=.0001) and exercise level(F=11.93, P=.000l), and in somatic symptom according to sex(t=-3.93, P=.0001), weight(F=3.83, P=.022), exercise level (F=3.29, P=.03) among general characteristics. 4. There was statistically significant difference between sex in general (t= -3.64, P=.0001), gastrointestinal(t=-2.21, P=.02), musculoskeletal(t=-3.92, P=.001), and total symptom (t= -3.92, P=.0001). 5. There was statistically very highly signigicant difference In weight according to smoking($x^2=25.18,\; P=.001)$ and exercise$(x^2=16.46,\; P=001)$. 6. There was statistically significant difference in frequency between smoking group, drinking group and exercise group$(x^2=24.52,\;P=.001)$. Among a number of habit, smoking, drinking and exercise are important factors of human health to prevent related disease morbidity and death. It is essential for industrial health nurse to committ in this subject considering the influence of those factors and lifestyle on health. There is also a relationship of weight with smoking and exercise, the frequency of overweight/obesiy in smoking/ no-exercise group were high. It is quite necessary for the people having cardiovascular symptom to exercise to lower morbidity and mortality. The industrial health nurse has to keep In mind on this point and consider of time and facilities of fitness of employee. It needs to explore the cause by further research on somatic symptom of women. This research shows that concerning the relationship between smoking, drinking, and exercise, health care provider must take not only management of disease, but health behaviors and lifestyle into consideration.

• Clinical and Experimental Pediatrics
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• 제58권6호
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• pp.211-217
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• 2015

Purpose: Mycoplasma pneumoniae (MP) infection is a major cause of respiratory infection in school-aged children. Extrapulmonary manifestations of MP infection are common, but liver involvement has been rarely reported. The aim of this study was to determine the clinical characteristics of MP-associated hepatitis. Methods: This prospective study included 1,044 pediatric patients with MP infection diagnosed serologically with MP IgM at one medical center from January 2006 to December 2012. Eighty of these patients had elevated levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), each greater than 50 IU/L, without any other specific liver disorder and were compared with the 964 children without liver disorders. Results: In total, 7.7% of patients with MP infection had a diagnosis of hepatitis, especially in fall and winter. The ratio of male to female patients was 1.7:1, and the mean age of the patients was 5 years and 5 months. The most common symptoms were cough, fever, and sputum. Anorexia was the most common gastrointestinal symptom, followed by nausea/vomiting, diarrhea, and abdominal pain. Mean levels of AST and ALT were 100.65 IU/L and 118.73 IU/L, respectively. Serum AST/ALT level was normalized within 7.5 days on average without complications. The mean duration of hospitalization (11.3 days) was longer for children with hepatitis than for those without hepatitis (P=0.034). Conclusion: MP-associated hepatitis is not uncommon and has a relatively good prognosis. Therefore, clinicians should be concerned about liver involvement in MP infection but avoid further unnecessary evaluation of hepatitis associated with MP.

• Clinical and Experimental Pediatrics
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• 제60권3호
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• pp.86-93
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• 2017

Purpose: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. Methods: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. Results: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4.8% for LT and 2.9% for KT). PTLD usually presented with fever or gastrointestinal symptoms in a median period of 7 months after SOT. Eight cases had malignant lesions, and all the patients except one had evidence of Epstein-Barr virus (EBV) involvement, assessed by using in situ hybridization of tumor tissue or EBV viral load quantitation of blood. Remission was achieved in all patients with reduction of immunosuppression and/or rituximab therapy or chemotherapy, although 1 patient had allograft kidney loss and another died from complications of chemotherapy. The first case of PTLD was encountered after the introduction of tacrolimus for pediatric SOT in 2003. The recent increase in PTLD incidence in KT coincided with modification of clinical practice since 2012 to increase the tacrolimus trough level. Conclusion: While the outcome was favorable in that all patients achieved complete remission, some patients still had allograft loss or mortality. To prevent PTLD and improve its outcome, monitoring for EBV infection is essential, which would lead to appropriate modification of immunosuppression and enhanced surveillance for PTLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권1호
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• pp.41-48
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• 2013

Purpose: Meckel's diverticulum (MD) has various clinical manifestations, and diagnosis or selectection of proper diagnostic tools is not easy. This study was conducted in order to assess the clinical differences of MD diagnosed by scintigraphic and non-scintigraphic methods and to find the proper diagnostic tools. Methods: We conducted a retrospective review ofthe clinical, surgical, radiologic, and pathologic findings of 34 children with symptomatic MD, who were admitted to Gachon University Gil Medical Center, Inha University Hospital, and The Catholic University of Korea, Incheon St. Mary's Hospital between January 2000 and December 2012. The patients were evaluated according to scintigraphic (12 cases; group 1) and non-scintigraphic (22 cases; group 2) diagnosis. Results: The male to female ratio was 7.5: 1. The most frequent chief complaint was lower gastrointestinal (GI) bleeding in group 1 and nonspecific abdominal pain in group 2, respectively. The most frequent pre-operative diagnosis was MD in both groups. Red blood cell (RBC) index was significantly lower in group 1. MD was located at 7 cm to 85 cm from the ileocecal valve. Four patients in group 1 had ectopic gastric tissues causing lower GI bleeding. The most frequent treatment modality was diverticulectomy in group 1 and ileal resection in group 2, respectively. Conclusion: To diagnose MD might be delayed unless proper diagnostic tools are considered. It is important to understand indications of scintigraphic and non-scintigraphic methods according to clinical and hematologic features of MD. Scintigraphy would be weighed in patients with anemia as well as GI symptoms.

• 대한핵의학회지
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• 제1권2호
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• pp.61-74
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• 1967

In order to confirm whether acquired immunity or resistance can be developed by the repeated hookworm infections, the 150 mature actively moving filariform ancylostoma duodenale larvae obtained from the severe hookworm anemia patients were orally given to 8 healthy volunteers in three divided doses, 50 in each, at 5 day interval. Also the hematological changes as well as several ferrokinetics using $^{59}Fe$ were done and were compared with 10 controls. The clinical symptoms and signs were checked every day for the first 3 weeks and then twice weekly until the end of the experiment. The appearance of the ova in the stool was examined by the formalin ether method and the ova was counted by the Stoll's method. The following laboratory tests were done: 1) Red blood cell count, venous blood hematocrit(micromethod), hemoglobin count (cyanomethemoglobin method) were checked every 5 to 7 day interval. 2) Plasma iron concentration (Barkan's modified method) was determined every 2 to 3 week interval. 3) Radioisotope studies: a) Ferrokinetics: Huff et al and Bothwell's method were applied. Erythropoietic Index (% of normal)=$\frac{Subject's\;turnover/100ml\;whole\;blood{\times}100}{Average\;normal\;turnover/100ml\;whole\;blood}$ of the gastrointestinal absorption of iron: Radioiron($^{59}Fe$) balance b) Quantitative measurement method was applied. c) Determination of the plasma erythropoietin activity: Fried's method was applied. Following were the results: 1) The serum iron level was lower. The red cell volume was decreased, but with relative increase of plasma volume. 2) The plasma iron disappearance time was accelerated and the plasma iron turnover rate was decreased. The red cell iron turnover rate was markedly increased, while all of the red cell iron concentration, circulating red cell iron. plasma iron pool were decreased. The daily iron pool turnover and red cell renewal rate were increased. 3) The erythropoietic index, erythropoietin activity and intestinal absorption of iron($^{59}Fe$) were markedly increased. 4) The infectivity was $9.8{\pm}1.31%$ which was lower than that observed in the single infection. 5) From these observations, it is concluded that the hookworm anemia is essentially iron deficieny in its origin and some immunity acquisition is possible with repeated infections.

• 한국식품과학회지
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• 제38권3호
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• pp.427-431
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• 2006

췌장에 ${\beta}-cell$에만 특이적으로 작용하고 다른 기관에는 영향을 주지 않는 것으로 보고되어 있는 streptozotocin을 흰쥐에게 투여하여 당뇨병을 유발시킨 다음 백미, 현미, 거대배아미를 6주간 급여한 후 혈당강화 효과를 알아보았다. 실험기간동안 모든 당뇨군들의 체중증가는 정상군에 비해서는 유의적으로 낮았다. 당뇨대조군에 비해서는 거대배아마를 급여한 군에서 체중감소현상이 억제되었다. 장기중 맹장의 경우 2배 이상의 비대현상이 나타났고 정상쥐에 비해 당뇨쥐가 수분섭취량, 소변배설량, 혈당이 유의적으로 높게 나타났는데 당뇨병의 주요 증세가 다갈(polydipsia), 다뇨(polyuria), 다식(polyphagia), 고혈당인점에서 당뇨군에 비해서 가대배아미는 당뇨증세가 어느 정도 호전효과가 있음을 보여주고 있다. 식이섭취량은 정상군에 비해 당뇨실험군들이 높게 나타났으며 수분섭취량은 정상군에 비해 당뇨대조군이 수분 섭취량증가가 나타났다. 당뇨실험군 내에서는 당뇨대조군에 비해 가대배아미군이 수분섭취량이 감소하였다. 뇨 배설량은 정상군에 비해 당뇨대조군이 유의적으로 높게 나타났으며 당뇨대조군에 비해서 거대배아미군이 감소하였다. 장 기능 조절로서 장통과 시간과 분변고형물의 양에는 역의 상관관계로 식이섬유소의 함량이 높은 쌀 품종인 거대배아미는 장통과 시간이 짧으며 분변고형물의 양을 유의적으로 증가시켰으며 변의 수분보유량도 정상군에 비해 당뇨실험군들중 거대배아미군 전반적으로 높았다. 위 결과에서 거대배아미 급여가 당뇨동물의 공복시 혈당 수준을 유의적으로 낮추는데 효과가 있었으며 이당류 분해 효소 활성의 경우 정상군에 비해서 당뇨군이 lactase, maltase, sucrase 활성이 현저하게 증가 되었지만 당뇨실험군중에는 거대배아미가 소장점막부분의 lactase, maltase, sucrase의 활성을 저해시킴으로서 혈당상승을 억제시키는 것으로 볼 수 있었다. 이상의 결과로 백미, 현미에 비해서 거대배아미를 급여한 당뇨동물에서 혈당을 억제시키는 효과를 보았다.