• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.89-95
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• 2009

Objectives : To assess the protective effects of wearing protective devices among the residents and volunteers who participated in the cleanup of the Hebei Spirit oil spill. Methods : A total of 288 residents and 724 volunteers were surveyed about symptoms, whether they were wearing protective devices and potential confounding variables. The questionnaires were administered from the second to the sixth week following the accident. Spot urine samples were collected and analyzed for metabolites of 4 volatile organic compounds(VOCs), 2 polycyclic aromatic hydrocarbons(PAHs), and 6 heavy metals. The association between the wearing of protective devices and various symptoms was assessed using a multiple logistic regression adjusted for confounding variables. A multiple generalized linear regression model adjusted for the covariates was used to test for a difference in least-square mean concentration of urinary biomarkers between residents who wore protective devices and those who did not. Results : Thirty nine to 98% of the residents and 62-98% of volunteers wore protective devices. Levels of fatigue and fever were higher among residents not wearing masks than among those who did wear masks(odds ratio 4.5; 95% confidence interval 1.23-19.86). Urinary mercury levels were found to be significantly higher among residents not wearing work clothes or boots(p<0.05). Conclusions : Because the survey was not performed during the initial high-exposure period, no significant difference was found in metabolite levels between people who wore protective devices and those who did not, except for mercury, whose biological half-life is more than 6 weeks.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.1
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• pp.46-58
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• 1999

Purpose: The aim of the present study was to evaluate the long-term clinical profile including the underlying etioligy and the prognostic factors of the neonatal cholestasis. Method: We studied the 190 infants presented with neonatal cholestasis for the last 12 years (from 1981 to 1992). The underlying causes, clinical findings and long-term outcomes were evaluated. And the prognostic factors were also analyzed. Result: Underlying disease were neonatal hepatitis in 101 (idiopathic in 77 and infectious in 24), intrahepatic bile duct paucity in 5, biliary atresia in 79, choledochal cyst in 5. Metabolic disease was not observed in this study. The important clinical problems during follow-up were persistent high fever, gastrointestinal bleeding, hepatic encephalopathy and ascites. The main causes of the death were hepatic encephalopathy and gastrointestinal bleeding. While three fourth of infants with idiopathic and infectious neonatal hepatitis recovered usually within a year, five-year survival rate for biliary atresia was just 40%, the mortality observed usually within the first year after Kasai operation and prognostic factor was the time of operation. Underlying disease was the most important prognostic factor of neonatal cholestasis. Conclusion: This study showed that most common causes of neonatal cholestasis were biliary atresia and idiopathic neonatal hepatitis, infectious neonatal hepatitis, choledochal cyst and Alagille syndrome, but few neonatal cholestasis of genetic or metabolic liver disease was observed. The most important long-term prognostic factor of neonatal cholestasis was the underlying disease.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.965-975
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• 1996

Background : Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 10 July 1996, were included. They hadn a history of laking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients look 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X - ray. The major radiologic findings by simple chest X - ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and Lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X -ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene". Conclusion: Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.256-261
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• 2008

Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.263-291
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• 2015

In May, 2015, a 68 years old man, who has been Middle East Saudi Arabia and the United Arab Emirates, had high fever, muscle aches, cough and shortness of breath. he went two local hospital near his house and the S Medical Center emergency center. He was diagnosed MERS(Middle East respiratory syndrome) and the diseases had put South Korea the fear of epidemics for three months. Especially, this disease has firstly reported in Middle East Asia in September 2012 and spreaded to twenty-six countries. In 21, July, 2015, European Center for disease prevention and control reported 533 people were died and in South Korea, 186 people were infected, 36 people were died and 16,693 people were isolated from MERS. South Korea government were faced into epidemic control and blamed from public. Especially, hospital acquired infection, disease control chain, opening of information, ventilation, lack of isolation bed, the problem of function of local health center, the issue of reparation for hospital and insurance cover rate, the classification of disease, the role of Korea Centers for disease control and prevention, the culture of visiting hospital to see sick people, the issue of hospital multiple room and other related social support policy. it is time to study and discuss to solve these problems. South Korea citizens felt fear and fright from MERS. What is wore, they thought the dieses were out of their government control. It was unusual case for word except Middle East Asia. numerous tourists canceled visiting korea. South korea economic were severly damaged especially, tourism industry. South korea government should admit that they had failed initial action against MERS and take full reasonability from any damages. The government have to open information to public in terms of epidemic diseases and try to prevent any other epidemic diseases and try to work with local governments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.158-165
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• 2002

Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.61-66
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• 2002

Purpose : To determine wether varicella can be prevented by administration of oral acyclovir(ACV) during the incubation period of the disease. Methods : Starting 9 days after exposure to the index case in their families, ACV(40 mg/kg/day in four divided doses) was given orally to 20 exposed children for 5 days. Their clinical features was compared with those of 20 control subjects. Antibody titers to VZV were measured in both group 1 week and 4 weeks after finishing the oral ACV administration. Results : The mean age of family members with varicella(51.4 months) were significantly high compared to that of ACV prophylaxis group(28.5 months) and control group(31 months) (P<0.05). Among the 12 children with ACV prophylaxis who completed follow up blood sampling, nine children were diagnosed as VZV infection on the serologic test(75%). Among them six children showed positive VZV IgM on the first blood sample and two children showed serocoversion to positive IgM on the second test after ACV prophylaxis. One child who was negative on both IgM and IgG, showed positive IgG on the second test. The incidence of fever and severity of skin rashes were significantly low in children received oral ACV than in the control group. No or reduced number of maculopapular eruption were observed in the oral ACV group compared to multiple vesicles of the control group. Conclusion : In the present study, we observed that oral ACV prophylaxis to the family contacts is effective in reducing severity of skin lesion. It is likely that oral ACV 9 days after contact prevents or reduces blood dissemination of VZV. Little is known about clinical effect and immunity to the virus in exposed children with no varicella symptom after treatment. We propose the checking up antibody to VZV some period after oral ACV, and considering vaccination to whom with no antibody. But further more studies are needed to practical application of oral ACV for the postexposure prophylaxis of varicella.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.227-232
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• 2018

Purpose: Febrile seizure (FS) is the most common type of seizure in children between 6 months to 5 years of age. A family history of febrile seizures can increase the risk a child will have a FS. Yet, prevalence of FS regarding external environment has not been clearly proved. This study attempts to determine the association between prevalence of FS and weather. Methods: This study included medical records from the Korea National Health Insurance Review and Assessment Service. Data were collected from 29,240 children, born after 2004, diagnosed with FS who were admitted to one of the hospitals in Seoul, Korea, between January 2009 and December 2013. During the corresponding time period, data from the Korea Meteorological Administration on daily monitoring of four meteorological factors (sea-level pressure, amount of precipitation, humidity and temperature) were collected. The relationships of FS prevalence and each meteorological factor will be designed using Poisson generalized additive model (GAM). Also, the contributory effect of viral infections on FS prevalence and weather will be discussed. Results: The amount of precipitation was divided into two groups for comparison: one with less than 5 mm and the other with equal to or more than 5 mm. As a result of Poisson GAM, higher prevalence of FS showed a correlation with smaller amount of precipitation. Smoothing function was used to classify the relationships between three variables (sea-level pressure, humidity, and temperature) and prevalence of FS. FS prevalence was correlated with lower sea-level pressure and lower humidity. FS prevalence was high in two temperature ranges (-7 to $-1^{\circ}C$ and $18-21^{\circ}C$). Conclusion: Low sea-level pressure, small amount of precipitation, and low relative air humidity may increase FS prevalence risk.

• Journal of Life Science
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• v.29 no.11
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• pp.1227-1234
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• 2019

Prunus mume, also known as maesil, is a popular fruit consumed in East Asia (Korea, Japan, and China). It contains high amounts of organic acids, minerals, and polyphenols and has been used as a medication for fever, vomiting, and detoxification. In this study, the anti-proliferative and apoptotic effects of solvent fractions from maesil were evaluated using sulforhodamine B (SRB) assays, morphological evaluations, Hoechst 33258 staining, and western blotting. Addition of the maesil methanol fraction (MMF) and the maesil butanol fraction (MBF) significantly and dose-dependently decreased the cell viability of HT-29 human colon cancer cells. Colony-forming assays confirmed that the MMF and MBF treatments decreased colony numbers when compared with untreated control cells. Treatment of HT-29 cells with MMF and MBF caused a distortion of the cell morphology to a shrunken cell mass. Treatment with MMF and MBF also dose-dependently increased nuclear condensation and the formation of apoptotic bodies in HT-29 cells. Treatment with MMF and MBF significantly and dosedependently increased the expression of Bax (a pro-apoptotic protein), caspase-3, and poly ADP-ribose polymerase (PARP) and decreased the expression of Bcl-2 (an anti-apoptotic protein). MMF significantly and dose-dependently inhibited cell proliferation induced by bisphenol A, an environmental hormone. Therefore, MMF may have potential use as a functional food and as a possible therapeutic agent for the prevention of colon cancer.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.92-100
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• 2021

Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire^® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire^® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert^® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at -70℃ until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire^® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire^® ME panel testing. Conclusions: Compared with the currently available etiologic tests for CNS infection, BioFire^® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire^® ME panel testing in children must be evaluated for its wider application.