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The work performance and the factor contributing to the work performance of nutrition teacher & school dieticians (영양교사 (정규직)와 학교영양사 (비정규직)의 직무수행도 및 직무수행에 영향을 미치는 요인)

  • Han, Jang-Il
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.558-570
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    • 2015
  • Purpose: The objective of this study is to investigate the work performances and the factors contributing to the work performance of nutrition teachers and school dieticians according to employment status in Daejeon and Chungcheongnamdo. Methods: A survey was conducted among 415 school dieticians from selected elementary, middle, and high schools in the area. This survey was used for analysis of the general characteristics and the status of working and foodservice environments. The frequency of occurrence was measured using the ${\chi}^2$-test while analysis of differences in work performance of 57 variables grouped according to 12 categories by mean ${\pm}$ SD was performed using student t-test. In addition, a regression analysis was performed to assess the influence of occupational (working and foodservice) environment on work performances. Results: All 14 environmental factors including general characteristics were different between nutrition teachers and school dieticians. In 12 of 57 variables there were significant differences in work performance between the two groups. When compared using average work performance, 5 domains showed significant difference in work performance between the two groups. These 5 domains were other works (T = 6.050), dietary habit guide (T = 4.789), menu (nutrition) management (T = 3.524), foodservice administration and evaluation (T = 2.757), and production and service management (T = 2.588). Overall, the work performances of nutrition teachers were comparably higher than those of school dietitians. A correlation analysis between occupational (working or foodservice) environments and work performances of the two groups showed that the work performances of nutrition teachers were influenced by the number of employees, number of students, meal frequency a day, annual salary, age, foodservice years of school, and school type. Conclusion: Meanwhile, the work performances of school dieticians were influenced by the number of students, number of employees, meal frequency a day, work hour, education level, age, school type, and service years as a dietitian.

A Study on Garden Design Principles in "Sakuteiki(作庭記)" - Focused on the "Fungsu Theory"(風水論) - (「사쿠테이키(作庭記)」의 작정원리 연구 - 풍수론(風水論)을 중심으로 -)

  • Kim, Seung-Yoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.6
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    • pp.1-19
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    • 2013
  • This study tries to review 'Sakuteiki(作庭記)', the Book of Garden Making, compiled at the end of the 11th Century during the Heian Period of Japan, from the East-Asian perspective. 'Sakuteiki' is a Garden Theory Book, the oldest in the world as well as in Asia, and it contains the traditional knowledge of Japanese ancient garden culture, which originated from the continent(Korea and China). Traditional knowledge related to East-Asian garden culture reviewed in this paper is "Fungsu Theory"(風水, Asian traditional ecology: Fengshui in Chinese; Fusui in Japanese), stemmed from the culture to seek sound and blessed places to live in. Viewed from modern landscape architecture, the Fungsu Theory corresponds to ecology(science). The Fungsu Theory was established around the Han Dynasty of China together with the Yinyangwuxing(陰陽五行) Theory and widely used for making human residences including gardens. It was transmitted to Japan via Korea as well as through direct transaction between Japan and China. This study reinterprets garden design principles represented in Sakuteiki, which were selected in 5 key words according to the Fungsu Theory. The 5 key words for the Fungsu Theory are "the place in harmony of four guardian gods(四神相應地)", "planting trees in the four cardinal directions", "flow of Chi(氣)", "curved line and asymmetry", and "mountain is the king, water is the people". Garden design principles of "the place in harmony of four guardian gods(四神相應地)" and "planting trees in the four cardinal directions" are corresponding to "Myeongdang-ron(明堂論, Theory of propitious site)". The place in harmony of four guardian gods mentioned in Sakuteiki is a landform surrounded by the flow of water to the east, the great path to the west, the pond to the south, and the hill to the north. And the Theory originated from Zhaijing(宅經, Classic of dwelling Sites) of China. According to this principle, the city was planned and as a miniature model, the residence of the aristocrat during the Heian period was made. At the residence the location of the garden surrounded by the four gods(the flow of water, the great path, the pond, and the hill) is the Myeongdang(明堂, the propitious site: Mingtang in Chinese; Meido in Japanese). Sakuteiki explains how to substitute for the four gods by planting trees in the four cardinal directions when they were not given by nature. This way of planting originated from Zhaijing(宅經) and also goes back to Qiminyaoshu (齊民要術), compiled in the 6th Century of China. In this way of planting, the number of trees suggested in Sakuteiki is related to Hetu(河圖) and Luoshu(洛書), which are iconography of Yi(易), the philosophy of change, in ancient China. Such way of planting corresponds to that of Yongdoseo(龍圖墅, the villa based on the principle of Hetu) presented in Sanrimgyeongje (山林經濟), an encyclopedia on agriculture and living in the 17th Century of Korea. And garden design principles of "the flow of Chi(氣)", "curved line and asymmetry" is connected to "Saenggi Theory(生氣論, Theory of vitality)". Sakuteiki explains the right flow of Chi(氣) through the proper flow and the reverse flow of the garden stream and also suggests the curved line of the garden stream, asymmetric arrangement of bridges and stones in the garden, and indented shape of pond edges, which are ways of accumulating Chi(氣) and therefore lead to "Saenggi Theory" of the Fungsu Theory. The last design principle, "mountain is the king, water is the people", is related to "Hyeongguk Theory(形局論, Theory of form)" of the Fungsu Theory. Sakuteiki explains the meaning of garden through a metaphor, which views mountain as king, water as the people, and stones as king's retainers. It compares the situation in which the king governs the people with the help of his retainers to the ecological phenomena in which mountain(earth) controls water with the help of stones. This principle befits "Hyeongguk Theory(形局論, Theory of form)" of the Fungsu Theory which explains landform on the analogy of social systems, people, animals and things. As above, major garden design principles represented in Sakuteiki can be interpreted in the context of the Fungsu Theory, the traditional knowledge system in East Asia. Therefore, we can find the significance of Sakuteiki in that the wisdom of ancient garden culture in East-Asia was integrated in it, although it described the knowhow of a specific garden style in a specific period of Japan.

Ecophysiological Interpretations on the Water Relations Parameters of Trees(VII) - Measurement of Water Flow by the Heat Pulse Method in a Larix leptolepis Stand - (수목(樹木)의 수분특성(水分特性)에 관(關)한 생리(生理)·생태학적(生態學的) 해석(解析)(VII) - Heat pulse법(法)에 의한 낙엽송임분(林分)의 수액류속(樹液流速) 계측(計測) -)

  • Han, Sang Sup;Kim, Sun Hee
    • Journal of Korean Society of Forest Science
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    • v.82 no.2
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    • pp.152-165
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    • 1993
  • This is the basic study in order to know the amount of transpirational water loss in a Larix leptorepis stand by a heat pulse method. Especially this study has been measured and discussed the diurnal and seasonal trends of heat pulse velocity by changes of radiation, temperature and humidity, differences of heat pulse velocity by direction and depth in stem, differences of heat pulse velocity by dominant, codominant and suppressed trees, diurnal change of heat pulse velocity by change of leaf water potential, sap flow path way in sapwood by dye penetration and amount of daily and annual transpiration in a tree and stand. The results obtained as follows : 1. Relation between heat pulse velocity(V) and sap flow rate(SFR) was established as a equation of SFR=1.37V($r=0.96^{**}$). 2. The sap flow rate presented in the order of dominant, codominant and suppressed tree, respectively. The daily heat pulse velocity was changed by radiation, temperature and vapor pressure deficit. 3. The heat pulse velocity in individual trees did not differ in early morning and in late night, but had some differed from 12 to 16 hours when radiation was relatively high. 4. The heat pulse velocity and leaf water potential showed similar diurnal variation. 5. The seasonal variation of heat pulse velocity was highest in August, but lowest in October and similar value of heat pulse velocity in the other months. 6. The heat pulse velocity in stem by direction was highest in eastern, but lowest in southern and similar velocity in western and northern. 7. The difference of heat pulse velocity in according to depths was highest in 2.0cm depth, medium in 1.0cm depth, and lowest in 3.0cm depth from surface of stem. 8. The sap flow path way in stem showed spiral ascent turning right pattern in five sample trees, especially showed little spiral ascent turning right in lower part than 3m hight above ground, but very speedy in higher than 3m hight. 9. The amount of sap flow(SF) was presented as a equation of SF=1.37AV and especially SF in dominant tree was larger than in codominant or suppressed tree. 10. The amount of daily transpiration was 30.8ton/ha/day and its composition ratio was 83% at day and 17% at night. 11. The amount of stand transpiration per month was largest in August(1,194ton/ha/month), lowest in May (386ton/ha/month). The amount of stand transpiration per year was 3,983ton/ha/year.

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Analysis of the Korea Traditional Colors within the Spatial Arrangement and Form of the Traditional Garden of Seyeonjeong (보길도 세연정(洗然庭)의 공간구조 형식에 내재한 전통색채 분석)

  • Han, Hee-Jeong;Cho, Se-Hwan
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.4
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    • pp.14-23
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    • 2014
  • The purpose of this study is to contribute in building credibility of the methodology of the appearance of the traditional colors and the interpretation of the meaning of those appearances by analyzing the spatial construction and configuration and the traditional colors that appear in spatial elements about the scenery component that appear in Seyeonjeong. We conducted a literature research about the traditional colors, the background of the creation of Seyeonjeong, and etc. For the contents for the empirical analysis, we took the scenery and space elements in the poems, such as Eobusasisa and O-u-ga, and the contents of poems related to ojeongsaek (five Korean traditional colors) based on the Yin-Yang and the Five Elements ideology Particularly, after dividing the spatial elements appearing in Seyoenjeong into visual, synesthetic, symbolic/cognitive spatial element, we further distinguished the visual space into positions and directions of the of the spaces and the scenery of the season; the synesthetic space into seasons, time and five senses; and the symbolic/cognitive space into chiljeong (or the seven passions) and sadan (or the four clues). Then we carried out the study by analyzing the correlation between the intention of the garden creation and the meaning of the spaces, through the analysis of ojeongsaek system for each spatial element. Firstly, spatial structure and format that appear in Seyeonjeong can be divided into two directional axes of southeast and northwest according to the flat form of the Seyeongjeong's rectangular palace, with Seyeongjoeng as the center. Secondly, in spatial component element, the frequencies of appearance of the traditional colors of Seyoenjeong are 33.2% for white, 20.8% for blue, 20.8% for black, 18.7% for red and 6.3% for yellow. Thirdly, based on the analysis of the traditional colors the most frequent appearance of 'white' left a room for interpretation like the creation of Seyeonjeong was to enjoy secular living without lingering political feelings so that the high mountains remain clear and clean. Also, the predominant frequency of appearance of blue, similar frequency of appearance of black and red, and the least frequent appearance of yellow is in agreement with or can be at least interpreted related to Yun Seon-do's intention for creating Seyeonjeong not for political rank or power but as a place to enjoy nature, through which he can build on his knowledge, and to lead rest of his life as a noble being through plays, like dancing and writing poems. Fourthly, these interpretations of the analysis of the frequency of appearance of the traditional colors of Seyeongjong shows the reliability, validity, and consistency of the methodology of the analysis of the frequency of appearance of the traditional colors and the interpretation of the meanings in the context that the color white appears most frequently in Soswewon as well and that the background life of the Soswewon's creator Yangsanbo can be interpreted in a similarly way. Above all, this study is significant from the fact that we proposed a theory about the method of analysis and interpretation of the traditional colors in a traditional landscape space. Moreover, there is a great significance of discovering that traditional colors appear in traditional spaces and this can be used as a methodological framework to interpret things like, intention for creation of (buildings/architectures).

The Planting and Occurrence Status of Exotic Plants of the Folk Village as National Cultural Heritage - Focus in Hahoe.Yangdong.Hangae Villages - (국가지정 문화재 민속마을의 외래식물 식재 및 발생현황 - 하회.양동.한개마을을 대상으로 -)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Han, Yun-Hee;Park, Kyung-Uk;Byun, Moo-Sup;Huh, Joon;Choi, Yung-Hyun;Shin, Sang-Sup;Lee, Hyun-Woo;Kim, Hyo-Jung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.31 no.2
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    • pp.1-19
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    • 2013
  • This study was carried out to analyze distribution situation of alien plants and to propose management plan in the 3 Folk village in Gyeongsangbuk-do which is Cultural property designated by the State; Hahoe, Yangdong and Hangae. This research is for improve of sincerity of historical site and provide basic information which use about administration of preservation. The results are as follows. 1. Overall flora and alien plants appearance The total flora in the 3 folk villages were listed total 752 taxa including 127 families, 430 genera, 614 species, 5 subspecies, 100 varieties and 33 forms. Among them, woody plants take 263 taxa(35.0%) and herbaceous plants take 489 taxa (65.0%). Flora in the Hahoe, Yangdong and Hangae village were total 534, 479 taxa and 408 taxa and exotic plant index was 30.1%, 38.2% and 37.0% respectively. In types of exotic plants, ornamental exotic plants were 135 taxa, deciduous exotic plants were 21 taxa, cultivating exotic plants were 64 taxa, and naturalized exotic plants were 80 taxa and those result lead that the ornamental exotic plants is the highest ratio. According to the villages, Hahoe village had 161 taxa(30.1%), Yangdong Village had 183 taxa(38.2%), and Hangae village had 151 taxa(37.0%) that Yangdong village showed the most number of exotic plants. 2. Planting of landscape exotic plants in the unit cultural assets Meanwhile, Ornamental exotic plants in old house's gardens in Andong Hahoe village which is designated as a unit assets, those are total 30 taxa; followed by the Okyeon house(8 taxa) is highest and the Yangjindang(7), the Hadong house(6) and the Chunghyodang(5). Magnolia denudata appears the most as for 4 times and Campsis grandiflora etc. each took 2 times. Based on the Yangdong village, Gyeongju, that are found total 51 taxa; followed by the Dugok house(16 taxa) the Sujoldang(14), the Mucheondang(13), and the Sangchunheon (12). High appearance rate of ornamental exotic plants were Viburnum opulus for. hydrangeoides, Lycoris squamigera, Caragagna sinica and Magnolia denudata etc. Based on the Hangae village, Seongju, that are designated total 62 taxa; followed by the Jinsa house(35 taxa), the Gyori house(25), the Hanju head family house(20), and the Hahoe house(16). Taxa with high appearance rates were Caragana sinica, Juniperus chinensis var. horizontalis, Magnolia denudata, Viburnum opulus for. hydrangeoides, Chaenomeles speciosa etc. 3. Problems of exotic plant landscapes in the outer spaces of the folk villages Problems of exotic plant landscapes in the outer spaces of the Hahoe village are as follows. In lower of the Mansongjeong forest, Ambrosia artemisifolia, which are ecosystem disturbance plants designated by the Ministry of Environment, live with high dominance value. This should be have a remove with Sicyos angulatus immediately. In the Nakdong river bed around the Mansongjeong forest is covered with a riparian vegetation forest belt of Robinia pseudoacacia L. forest, Populus nigra var. italic community, and Populus x tomentiglandulosa community colony. Based on the Yangdong village, the planted or naturally distributed Ailanthus altissima colony, sporadically distributed Robinia pseudoacacia as well as Amorpha fruticosa are detected all over the village and ecotones. Based on the Hangae village, Ailanthus altissima and Robinia pseudoacacia are sporadically distributed around the village and there is a sign of spreading. similarity of exotic plantsis 47.0% to 48.6% and a reason why this happened is all of research site in Gyeongsanbuk-do and that is why growth norm of plant is similar, exotic plant which is sales for ornamental and it infer to require related countermeasure of each villages and joint related countermeasure.

Dosimetry of the Low Fluence Fast Neutron Beams for Boron Neutron Capture Therapy (붕소-중성자 포획치료를 위한 미세 속중성자 선량 특성 연구)

  • Lee, Dong-Han;Ji, Young-Hoon;Lee, Dong-Hoon;Park, Hyun-Joo;Lee, Suk;Lee, Kyung-Hoo;Suh, So-Heigh;Kim, Mi-Sook;Cho, Chul-Koo;Yoo, Seong-Yul;Yu, Hyung-Jun;Gwak, Ho-Shin;Rhee, Chang-Hun
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.66-73
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    • 2001
  • Purpose : For the research of Boron Neutron Capture Therapy (BNCT), fast neutrons generated from the MC-50 cyclotron with maximum energy of 34.4 MeV in Korea Cancer Center Hospital were moderated by 70 cm paraffin and then the dose characteristics were investigated. Using these results, we hope to establish the protocol about dose measurement of epi-thermal neutron, to make a basis of dose characteristic of epi-thermal neutron emitted from nuclear reactor, and to find feasibility about accelerator-based BNCT. Method and Materials : For measuring the absorbed dose and dose distribution of fast neutron beams, we used Unidos 10005 (PTW, Germany) electrometer and IC-17 (Far West, USA), IC-18, ElC-1 ion chambers manufactured by A-150 plastic and used IC-l7M ion chamber manufactured by magnesium for gamma dose. There chambers were flushed with tissue equivalent gas and argon gas and then the flow rate was S co per minute. Using Monte Carlo N-Particle (MCNP) code, transport program in mixed field with neutron, photon, electron, two dimensional dose and energy fluence distribution was calculated and there results were compared with measured results. Results : The absorbed dose of fast neutron beams was $6.47\times10^{-3}$ cGy per 1 MU at the 4 cm depth of the water phantom, which is assumed to be effective depth for BNCT. The magnitude of gamma contamination intermingled with fast neutron beams was $65.2{\pm}0.9\%$ at the same depth. In the dose distribution according to the depth of water, the neutron dose decreased linearly and the gamma dose decreased exponentially as the depth was deepened. The factor expressed energy level, $D_{20}/D_{10}$, of the total dose was 0.718. Conclusion : Through the direct measurement using the two ion chambers, which is made different wall materials, and computer calculation of isodose distribution using MCNP simulation method, we have found the dose characteristics of low fluence fast neutron beams. If the power supply and the target material, which generate high voltage and current, will be developed and gamma contamination was reduced by lead or bismuth, we think, it may be possible to accelerator-based BNCT.

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A Retrospective Study of the Radiotherapy Care Patterns for Patients with Laryngeal Cancer and Comparison of Different Korean Hospitals Treated from 1998 through 1999 (한국인 후두암 환자의 방사선치료 과정 및 내용에 관한 분석 (1998~1999년도))

  • Chung, Woong-Ki;Kim, Il-Han;Yoon, Mee-Sun;Ahn, Sung-Ja;Nam, Taek-Keun;Song, Ju-Young;Chung, Jae-Uk;Nah, Byung-Sik;Lee, Joon-Kyoo;Wu, Hong-Gyun;Lee, Chang-Geol;Lee, Sang-Wook;Park, Won;Ahn, Yong-Chan;Kang, Ki-Moon;Kim, Jung-Soo;Oh, Yoon-Kyeong;Cho, Moon-June;Park, Woo-Yoon;Kim, Jin-Hee;Choi, Doo-Ho;Yun, Hyong-Geun;Kim, Woo-Cheol;Yang, Dae-Sik;Sohn, Seung-Chang;Suh, Hyun-Suk;Ahn, Ki-Jung;Chun, Mi-Son;Lee, Kyu-Chan;Choi, Young-Min;Jeung, Tae-Sik;Kang, Jin-Oh
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.201-209
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    • 2009
  • Purpose: To investigate the care patterns for radiation therapy and to determine inter-hospital differences for patients with laryngeal carcinoma in Korea. Materials and Methods: A total of 237 cases of laryngeal carcinoma (glottis, 144; supraglottis, 93) assembled from 23 hospitals, who underwent irradiation in the year of 1998 and 1999, were retrospectively analyzed to investigate inter-hospital differences with respect to radiotherapy treatment. We grouped the 23 hospitals based on the number of new patients annually irradiated in 1998; and designated them as group A (${\geq}$900 patients), group B (${\geq}$400 patients and <900 patients), and group C (<400 patients). Results: The median age of the 237 patients was 62 years (range, 25 to 88 years), of which 216 were male and 21 were female. The clinical stages were distributed as follows: for glottis cancer, I; 61.8%, II; 21.5%, III; 4.2%, IVa; 11.1%, IVb; 1.4%, and in supraglottic cancer, I; 4.3%, II; 19.4%, III; 28.0%, IVa; 43.0%, IVb; 5.4%, respectively. Some differences were observed among the 3 groups with respect to the dose calculation method, radiation energy, field arrangement, and use of an immobilization device. No significant difference among 3 hospital groups was observed with respect to treatment modality, irradiation volume, and median total dose delivered to the primary site. Conclusion: This study revealed that radiotherapy process and patterns of care are relatively uniform in laryngeal cancer patients in Korean hospitals, and we hope this nationwide data can be used as a basis for the standardization of radiotherapy for the treatment of laryngeal cancer.

Effect of Eddy on the Cycle of 210Po and 234 in the central Region of Korean East Sea (동해 중부해역에서 210Po과 234Th의 순환에 대한 소용돌이의 영향)

  • YANG, HAN SOEB;KIM, SOUNG SOO;LEE, JAE CHUL
    • 한국해양학회지
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    • v.30 no.4
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    • pp.279-287
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    • 1995
  • The vertical profiles of natural 210Pb, 210Po and 234Th activities were measured for the upper 100 m of water column at three stations in the middle region of the Korean East Sea during May 1992. And the distribution of these radionuclides was discussed associated with the formation of warm eddy or water mass. The main thermocline was maintained between the depth of 50 and 100 m at the southern station (Sta. A1), and between the depth of 10 to 50 m at the coastal station of Sockcho (Sta. B10). Contrastingly, a main thermocline at Sta. A10, which locates near the center of warm eddy, was observed below 230 m depth. Between 50 and 220 m depth of Sta. A10 is there a relatively homogeneous water mass of 10.1${\pm}$0.5$^{\circ}C$, which is significantly higher in temperature and lower in nutrient than the other two stations. It seems to be due to sinking of the warm surface water in which nutrients were completely consumed. Both 210Pb and 210Po show the highest concentration at Sta. A1 and the lowest at Sta. B10 among the three stations. Also, the 210Pb activity is generally higher in the upper layer than in the lower layer, while 210Po activity represents the reversed pattern at all three stations. At Sta. A1 and Sta. B10, the activities of 210Po relative to its parent 210Pb were deficient in the water column above the main thermocline, but were excess below the thermocline. However, the station near the center of warm eddy(Sta. A10), shows no excess of 210Po in the depths below 50 m, although its defficiency is found in the upper layer like the other stations. At Sta. A1 and b10. 234Th activities are slightly lower in the surface mixed layer than in the deeper region However, at Sta. A10, 234Th activity in the upper 30 m is higher than below 50 m or in the same depth of the other stations, probably because of the high concentration of particulate matter. The residence time of 210Po in the surface mixed layer at Sta. A10 is 0.4 year, much shorter than at the other two stations(about one year). Above 100 m depth, the residence times of 234Th range from 18 to 30 other two stations(about on year). Above 100 m depth, the residence times of 234Th range from 18 to 30 days at all stations, without significant regional variation. The percentages of recycled 210Po within the thermocline are 39% and 92% at Sta. A1 and Sta. B10, respectively. Much higher value at Sta. B10 may be due to a thin thickness of the mixed layer as well as the slower recycling rate of 210Po in the main thermocline.

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Clinical Characteristics of Childhood Henoch-Sch$\"{o}$nlein Purpura with Duodenal Involvement by Upper Gastrointestinal Endoscopy (내시경상 십이지장을 침범한 Henoch-Sch$\"{o}$nlein Purpura 환아의 임상적 특징)

  • Park, Sun-Hee;Nam, Yoo-Nee;Park, Sang-Hui;Sim, So-Yeon;Eun, Byung-Wook;Choi, Deok-Young;Sun, Yong-Han;Cho, Kang-Ho;Ryoo, Eell;Son, Dong-Woo;Jeon, In-Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.156-162
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    • 2009
  • Purpose: The aim of this study was to investigate the clinical usefulness of upper gastrointestinal (GI) endoscopy in children with Henoch-Sch$\"{o}$nlein purpura (HSP). Methods: We retrospectively analyzed the clinical, endoscopic, and histopathologic records of children with HSP who had been admitted to the Department of Pediatrics of Gil Hospital and underwent upper GI endoscopy between January 2002 and June 2009. Patients were classified into the following two groups for statistical analysis: duodenal involvement (+) and duodenal involvement (-). Results: Fifty-one children with HSP underwent upper GI endoscopy; the mean age was 7.2${\pm}$2.9 years. The upper GI endoscopy showed abnormalities of the duodenum in 38 cases (74.5%), 22 of which had duodenal ulcers. Among the biopsy specimens obtained from the duodenum of 37 cases, 13 cases (35.1%) had leukocytoclastic vasculitis, neutrophil debri, and/or extravasation of RBCs. Steroid use was more frequent in the duodenal involvement (+) group (86.8%) than the duodenal involvement (-) group (53.8%; p=0.02). The mean length of hospitalization was 13.9${\pm}$8.43 days in the duodenal involvement (+) group and 8.1${\pm}$4.62 days in the duodenal involvement (-) group (p=0.003). The recurrence rate was significantly higher in the duodenal involvement (-) group than the duodenal involvement (+) group (p=0.027), whereas none of the other study parameters, such as the age of onset, renal involvement, and steroid use, led to significantly higher or lower recurrence rates. Conclusion: These results suggest that duodenal involvement can influence the clinical course and prognosis of HSP in children.

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Deep Neck Abscesses in Korean Children (소아 심부 경부 농양에 대한 임상적 고찰)

  • Lee, Dae Hyoung;Kim, Sun Mi;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.81-89
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    • 2004
  • Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

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