• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.37-41
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• 2003

Purpose : Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. Methods : We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. Results : Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. Conclusion : The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.47-53
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• 2001

Purpose: Following up the cases of cow's milk-sensitive enteropathy (CMSE), We observed the development of clinical tolerance with cow's milk and other foods. We investigated the clinical outcome of CMSE. Methods: We reviewed the clinical records of patients who had been admitted and diagnosed as CMSE by responses to cow's milk challenge and elimination test and the findings of small intestinal biopsy at Department of Pediatrics, Taegu Catholic University Hospital from March 1992 to March 1997. All of them were being fed with protein hydrolysate before 6 months old, and tried cow's milk and other foods challenge test at following each two month. Twenty-one cases of them returned to be followed. The age at admission was $30.7{\pm}8.8$ (18~47) days old and at survey was $43.4{\pm}23.7$ (16~84) months old. Results: 1) Although the body weight at birth of the patients was 25~75 percentile, all on admission was below 3 percentile. The body weight on interview was 25~75 percentile. 2) The development of clinical tolerance in cow's milk was observed at 16~24 months of age and the tolerance rate was 61% at 12 months of age, 90% at 16 months of age. The development of clinical tolerance in other foods was observed at 10~24 months of age and the tolerance rate was 33% at 12 months of age, 80% at 18 months of age. 3) Adverse reactions after challenge test with cow's milk were observed at 19 cases, manifestated as vomiting (31%), diarrhea (31%), irritability or lethargy (21%), skin rash (10%), and abdominal distention (5%). 4) Comparing serum IgE and milk RAST positive group on admission (5 cases) and negative group on admission (16 cases), there was no significant difference at the age of tolerance in cow's milk (p>0.05), the age of tolerance in other foods (p>0.05), allergy history in family, and the incidence of other allergic diseases. 5) The history of family allergy was observed in 3 cases (14%) in 21 patients and 3 cases (14%) showed rhinitis, urticaria or asthma through a follow-up interview. Conclusion: The development of clinical tolerance in cow's and other foods was sharply increased at 12 months of age and most of all tolerated within 24 months of age. CMSE is a temporary disorder of infancy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.193-199
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• 2006

Purpose: The proper diagnosis of Meckel's diverticulum (MD) is difficult and delayed because of the variety of clinical manifestations. We reviewed clinical characteristics of symptomatic MD to facilitate early detection. Methods: We analyzed retrospectively the clinical manifestations, diagnostic tools, histopathological findings, and operative findings in 58 patients with symptomatic MD. Results: The male to female ratio was 2.8 : 1. The most common symptom of MD was bleeding. Others symptoms included: vomiting, abdominal pain, irritability, abdominal distension and fever in the order of frequency. The clinical manifestations of symptomatic MD were lower gastrointestinal bleeding, intestinal obstruction, perforation, diverticulitis and hemoperitoneum, in the order of frequency. The causes of intestinal obstruction were intussusception, internal hernia, band, volvulus, invagination, in the order of frequency. Seventy five percent of patient with MD were diagnosed prior to 5 years of age. The most frequently used diagnostic tool was the Meckel's scan. The diverticulum was located 2 cm to 120 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 1 cm to 10 cm and 94% were less than 5 cm. The most common ectopic tissue found in the MD was gastric mucosa. Ileal resection was more frequently performed than diverticulectomy. Conclusion: In cases of unexplained gastrointestinal bleeding, obstruction and repeated intussusception, the meckel's scan, ultrasound and computed tomography shoud be considered to rule out MD, and if clinically necessary, an exploratory laparotomy when needed.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.7
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• pp.790-800
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• 2017

As men get older, total testosterone levels decline gradually, and concentrations of free and bioavailable testosterone decline sharply with each decade beyond their 30s. Andropause or testosterone deficiency syndrome (TDS) is defined as a decrease in sexual satisfaction or decline in general well-being accompanied by low levels of testosterone in older men. This male climacteric is characterized by nervousness, reduced potency, decreased libido, irritability, fatigue, depression, memory problems, sleep disturbances, and hot flushes. Cirsium japonicum (CJ) is used as a traditional medicine for hemorrhage, blood congestion, and inflammation in Korea. However, there is no report on the efficacy of CJ treatment for TDS. In this study, we observed the mitigating effect of CJ extract (CE) and fermented CJ extract (FCE) on symptoms of TDS. In elderly male rats, total and testosterone levels, hind limbs muscles, forced swimming time, and total and motile sperm counts significantly increased after daily intake of CE and FCE for 6 weeks. In contrast, sex hormone binding globulin, retroperitoneal fat, total serum cholesterol, and triglyceride levels were significantly reduced in CE and FCE groups. However, there was no difference in prostate specific antigen, aspartate aminotransferase, and alanine aminotransferase levels among all groups, which means CE and FCE did not have putative adverse effects. In a cell experiment, we also observed that CE and FCE enhanced expression of genes related to testosterone biosynthesis but reduced genes involved in testosterone conversion. On the whole, these positive effects on TDS were greater in FCE compared to CE. Thus, these results suggest the potential of FCE as a promising natural product for recovering testosterone levels and alleviating TDS.

• Journal of agricultural medicine and community health
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• v.29 no.2
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• pp.223-235
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• 2004

Objectives: This study was to evaluate the actual condition of falls among community-dwelling elderly people and its related factors to prepare for the establishment of comprehensive prevention programs of senior population. Methods: The study subjects included 460 home residents over 65 years in a district of Chungnam Province and interviews were given to all of them, asking about experiences of falls and their related factors. The analysis of study results came to the following conclusions. Results: The rate of falls among total subjects was 35.5%. With the percentage by age and sex, over 70's and female were significantly higher than male(p=0.000) and under 69 (p=0.008). The groups with poor visual acuity and hearing ability had higher rate of falls than the normal groups based on their health status. In terms of place they experienced falls, out-door occurrence accounted for 53.4% of total falls, which was higher 46.6% of in-door. By season when falls are experienced, "winter" showed the greatest rate, and by time of the day, evening had the highest rate. By causes of falls, "Slippery ground"accounted for 30.5% and "Tumbled over" 23.5% of total falls, respectively, showing the major role of environmental causes for falls. For individual factors, "Irritability" and "Carelessness" occupied 11.3%, 10.8% of total falls, respectively. The Odds Ratios for falls in women was 2.19 times higher than in men, and those in 70's are 2.01 times higher than in 60's, and those with abnormal BMI was 3.68 times higher than in normal groups, and those with perceived symptoms was 1.94 times higher than those without. Conclusions: It is suggested that more consideration should be directed toward taking comprehensive and systematic prevention measures ranging from setting-up the injury-protective environments to allowing senior citizens to have competence in ADL activity as well as proper general health conditions, considering the higher rate of falls for elderly persons in a rural part of this country than that of western countries and the greater proportion of falls which can be ascribed to environmental factors.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.257-264
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• 1997

Purpose: We performed this study to find out short period humoral immunogenicity and safety of 47 passaged Oka strain live attenuated varicella vaccine(1,400PFU) in 12 months to 15 years aged healthy children. Methods: Ninety nine healthy chidren, who have no histories of varicella vaccination, recent chicken pox illness and contact, allergy to other vaccines and underlying severe diseases, were involved in this study from April 1997 to August 1997. 5ml blood were collected before vaccination and after vaccination from all vaccinees to measure varicella membrane antibody by FAMA, and varicella IgG antibody by EIA. And immediate reactions within 30 minutes after vaccination, local and systemic reactions within 3 days after vaccination and vaccine induced systemic illness during 6 weeks postvaccination period were observed in all vaccinees to identify side effects of study vaccine. Results: 1) 49 seronegative and 50 seropositive vaccinees were identified in both prevaccination serologic tests. 2) Serologic responses after vaccination measured by the FAMA in seronegative group showed that the mean GMT level revealed 64.0, and seroconversion rate was 97.9%. And serologic responses after vaccination measured by the FAMA in seropositive group showed that the mean GMT level(242.2) was markedly elevated comparing with the mean GMT level(9.2) of pre vaccination. 3) The results of EIA in seronegative group revealed that postvaccination mean GMT was 435.2(prevaccination GMT; 78.7), and 100% seroconversion rate. Also, the results of EIA in seropositve group showed that the mean GMT level(769.9) of postvaccination was almostly two fold hihger than the mean GMT level(419.7) of prevaccination. 4) Observed local reactions like injection sites redness, pain, hardness and itching sense were mild and disappeared within 3 days, also shorterm systemic reactions like irritability, lethargy, poor appetites and rash were not remarkable. And there were no remarkable side effects due to vaccine during study period in all vaccinees. Conclusion: We confirmed that 47 paasaged Oka strain live attenuated varicella vaccine has high shorterm humoral immunogenicity and safety. However, we need more detail and longterm humoral and cell mediated immunogenicity studies of this vaccine including clinical field trials.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.71-80
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• 2003

Purpose : Four kinds of Haemophilus influenzae type b protein conjugate vaccines, PRPD, PRP-T, PRP-OMP and PRP-CRM197, have been developed, and PRP-T vaccines are currently produced by two manufacturer, $ActHib^{(R)}$ by Aventis and $Hiberix^{TM}$ by GlaxoSmith-Kline Biologicals. The purpose of this study is to evaluate the immunogenicity and safety of $Hiberix^{TM}$ in Korean infants. Methods : Seventy-three healthy infants(43 male infants) were recruited for this study after parental informed consent was obtained. Each infant was vaccinated at 2, 4 and 6 months of age with the study vaccine. At each visit, infants were also immunized with DTaP, trivalent oral polio vaccine and hepatitis B vaccine when indicated. The serum anti-PRP antibody was measured at prevaccination, 2 month later after the 2nd dose, and 1 month later after the 3rd dose by the ELISA method. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Immunogenicity of vaccine was evaluated in infants who received all the scheduled immunization and the adverse reactions were evaluated for infants who received at least one dose of the study vaccine. Results : Among seventy three infants, enrolled in this study; sixty three(37 male infants) completed all the scheduled immunizations. The geometric mean titer(GMT) of anti-PRP antibodies at prevaccination was 0.17 ${\mu}g/mL$(95% confidence interval[CI]; 0.13~0.22). The GMT of anti-PRP antibodies increased to 4.14 ${\mu}g/mL$(95% CI; 2.65~6.48) at 2 month later after the 2nd dose of PRP-T and 14.65 ${\mu}g/mL$(95% CI; 10.83~19.81) at 1 month later after the 3rd dose. Anti-PRP antibody ${\geq}0.15$ ${\mu}g/mL$, was observed in 98.4%(95% CI; 91.8~100) after 2 doses and 100%(95% CI; 100~100) after 3 doses. Anti-PRP antibody ${\geq}1.0$ ${\mu}g/mL$, was obtained in 77.8%(95% CI; 67.5~88.0) after 2 doses, and 98.4%(95% CI; 95.3~100) after 3 doses. Most of the adverse reaction after vaccination were mild. Irritability, the most common systemic reaction, was observed in 45.5%, followed by drowsiness(30.5%), poor feeding(26.7%) and fever(5.6%). Among the local reactions tenderness was observed in 7.9%, redness(${\geq}5$ mm) in 2.8% and swelling(${\geq}5$ mm) in 1.8%. Conclusion : The PRP-T vaccine used in this study was highly immunogenic and safe in Korean young infants. The finding that high GMT and high frequency of infants with a protective titer achieved after 2 doses is consistent with the previous studies which were done with a PRP-T vaccine of other manufacturer. This study suggests that the immunization schedule of PRP-T vaccine for Korean infants may need re-evaluation.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.163-173
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• 2006

Purpose : To reduce the number of injections necessary to vaccinate young infants, various combined vaccines have been developed. The $Comvax^{TM}$ manufactured by Merck & Co. is a combination of Hepatitis B and PRP-OMP conjugate Haemophilus influenzae Type b vaccine. The purpose of this study is to evaluate the immunogenicity and safety of $Comvax^{TM}$ in Korean infants. Methods : The infants who were vaccinated at 0 months of age with Hepatitis B vaccine, were recruited for this study after parental informed consent was obtained. The subjects were vaccinated with $Comvax^{TM}$ at 2 and 4 months of age. At each visit, infants were also immunized with DTaP, inactivated poliovirus vaccine, and pneumococcal vaccine when indicated. The serum anti-PRP and anti-HBs were measured at 2 months after the 1st dose(4 months age), and the 2nd dose(6 months age) by the ELISA and chemiluminescent microparticle immunoassay method, respectively. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Results : Among sixty-five healthy infants(35 male infants) enrolled in this study; fifty eight(32 male infants) completed the scheduled immunizations. The geometric mean titers (GMTs) of anti-PRP at 2 months after the 1st dose and the 2nd dose were 1.96 ${\mu}g/mL$ (95% CI; 1.38~2.78) and 10.02 ${\mu}g/mL$ (95% CI; 7.04~14.26), respectively. Anti-PRP ${\geq}1.0$ ${\mu}g/mL$, was obtained in 63.2%(95% CI; 53.75~72.65) after 1 dose, and 96.6%(95% CI; 93.05~100) after 2 doses. The GMTs of anti-HBs were 38.32 mIU/mL(95% CI; 22.42~65.51), and 101.17 mIU/mL(95% CI; 65.94~155.25) at 2 month after the 1st dose and 2nd dose of $Comvax^{TM}$, respectively. Anti-HBs ${\geq}10$ mIU/mL was observed in 73.7%(95% CI; 65.07~82.33) after 1 dose and 94.8%(95% CI; 90.45~99.15) after 2 doses. Most of the adverse reactions after vaccination were mild. Irritability, the most common systemic reaction, was observed in 24.8%, followed by drowsiness(19.2%), poor feeding(19.2%) and fever(7.2%). Among the local reactions tenderness was observed in 25.6%, redness(${\geq}5$ mm) in 19.2% and swelling(${\geq}5$ mm) in 4.8%. Conclusion : The $Comvax^{TM}$ vaccine was highly immunogenic for PRP and safe in Korean infants. Although the hepatitis B vaccine component was administered at 0, 2, 4 months, this study showed good immunogenicity against HBsAg.