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Congenital Urinary Tract Anomalies Associated with Urinary Tract Infection in Infants and Children (요로감염증과 연관된 방광요관역류 이외의 선천성 요로계 이상에 관한 고찰)

  • Chung So-Hee;Kim Jung-Sim;Kim Hyun-Jung;Lee Mi-Na;Uhm Mee-Ryung;Jin Dong-Kyu;Shin Hwa-Sook
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.180-186
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    • 1999
  • Purpose : It has been well known that urinary tract infection(UTI) in infants and children is frequently associated with vesicoureteral reflux(VUR). However, the publishied papers dealing with congenital anomalies associated with UTI emphasized the importance of VUR only. The aim of our study was to evaluate the type, incidence and spectrum of urologic anomalies associated with UTI. Methods : Medical records of clinical, bacteriologic and radiologic study were assessed retrospectively in 65 infants or children with documented UTI who were admitted to the Department of Pediatrics, Samsung Seoul Hospital from March 1996 to February 1998. Results : Spectrum of anomalies were associated with UTI as follows: VUR(n=23), both ectopic kidney(n=1), ureterovesical junction(UVJ) obstruction(n=1), multicystic dysplastic kidney(n=1), ureteropelvic junction(UPJ) obstruction with hydronephrosis(n=1), hutch diverticulum(n=1), UPJ stenosis(n=1), posterior urethral valve(n=1), urachal remnant(n=1) and bladder diverticula(n=1). Congenital urinary anomalies other than VUR were detected in 9 children among 65 patients with UTI(13.8%). 4 children among 9 congenital urinary anomalies other than VUR were combined with VUR. Sex distribution with congenital urinary anomalies other than VUR was more prevalent in male than female (7 males : 2 females). Age distribution at the time of UTI was less than 5 years in most patient (under 1 year in 1 patient, 1-2 year in 5 patients, 3-5 year in 1 patient, and above 5 year in 2 patients). And age distribution at the time of UTl associated with VUR was less than 5 years in most patient (under 1 year in 6 patients, 1-2 year in 8 patients, 3-5 year in 5 patients, and above 5 year in 4 patients), too Conclusion : Because congenital urinary anomalies other than VUR are seen in as high as 13.8% of patients, more careful evaluation of all possible congenital urinary anomalies as well as VUR is mandatory in pediatric patient with UTI.

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Characteristics and Recurrence Risk Factors of Urinary Tract Infection in Early Infancy (6개월 미만 영아 요로 감염의 특성과 재발의 위험 인자)

  • Kang Hee-Gyung;Kim Nam-Hee;Kang Ju-Hyung;Ha Il-Soo;Cheong Hae-Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.223-228
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    • 2004
  • Purpose and Methods: Urinary tract infection(UTI) is one of the most important diseases of childhood, especially for young infants. To characterize the patients diagnosed with febrile UTI in their first 6 months of life and to explore the risk factors of recurrent UTI, a retrospective study was performed. Results: Among the 90 patients studied, 77 were boys(86%). First episodes of UTI were diagnosed at the age of $2.5{\pm}1.4$ months. These patients underwent ultrasonographic evaluation of urinary tract(n=90) and voiding cystourethrography(n=81) where 53 and 35 studies showed abnormal findings respectively, and a total of 45 cases of urinary tract anomaly including vesicoureteral reflux(VUR, n=35) were diagnosed. Normal findings on ultrasonography indicated decreased risk of VUR in boys of 1-3 months of age(n=30). 53 patients were followed up more than 6 months and 45 episodes of subsequent UTI developed in 29 patients during the first 6-month period. Patients with relapse were older than patients without relapse at the diagnosis of first UTI, but other clinical parameters including abnormal findings on the imaging studies and prophylactic antibiotics prescription were not different between the two groups. Conclusion: UTI in early infancy occurred mainly in male infants and half of the patients had structural anomalies. USG was of clinical value in detecting anomalies requiring surgical intervention, and to rule out high grade VUR in 1-3 months old boys. Results of the imaging study or prophylactic antibiotics could not modify the risk of recurrent UTI. (J Korean Soc Pediatr Nephrol 2004;8:223-228)

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Efficacy and Cost Benefits of Rapid Antigen Detection Test for Group A Streptococci Obtained from Acute Pharyngitis in Children (소아 세균성 인두 편도염의 진단에 있어 신속 항원 검출 검사의 유용성과 비용 효과의 평가)

  • Youn, Suk;Chung, Hye-Jeon;Kim, Yun-Ho;Choi, Jin-Dong;Lee, Sang-Hoon;Min, Jung-Sik;Jung, Sang-Young;Jung, Sung-Ki;Ahn, Byung-Moon;Lee, Hee-Joo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.124-134
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    • 2005
  • Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

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The Study of IgG subclasses in Acute stage of Kawasaki Disease (급성기 가와사끼병 환아의 IgG 아형항체에 대한 연구)

  • Kim, Minshik;Kim, Youngsook;Cho, Namji;Kim, Kyungsook
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.140-149
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    • 1997
  • Purpose : Kawasaki Disease(KD) is a febrile disease with acute multisystemic vasculitis which is seen commonly in early childhood. The cause and etiologic agents are still unknown to identify using ordinary bacterial and viral culture, but the clinical labaratory studies suggest that KD is one of autoimmune disorder caused by infectious agents, but that is not proved yet. The study was performed to investigate the IgG subclasses in acute stage of KB before treatment of IVIG(Intravenous immunoglobulin). Method : The 35 cases in acute stage of KD before treatment of IVIG who were hospitalized from jan. 1995 to dec. 1996. The obtained sera were measured level of total IgG, IgM, IgA, IgE and IgG subclasses IgGl, IgG2, IgG3, IgG4 by using EIA and SRID method. Results : 1) The sex ratio is male to female is 1.5: 1.0, and male is prone to infected. 2) Total IgG, IgM, IgA and IgE level is normal range with age adjusted, but few cases are shown slight high level of total IgG compare to normal range of age adjusted. 3) acute phage reactants such as CRP, C3, ESR are all increased in acute stage of cases. 4) IgG subclasses IgGl, IgG2, IgG3 are shown normal range of age adjusted, but remarkably low level of IgG4 in all of cases. Conclusions : The low level of IgG4 is able to increasing the incidence of KD, and may use early diagnostic tools combine with other clinical symptoms and signs. But the resulsts of reported studies are different to each other, so it needs more times and cases to get final evaluation of changes of serum immnunoglobulin levels correlate to increase the incidence of high risk group of KD patients.

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Clinical manifestation of human bocavirus infection in children (소아 human bocavirus의 임상적 고찰)

  • Choi, Chang Sun;Pak, Chan Hee;Jung, Kwan;Lee, Gun;Sun, Kyu Keun;Kim, Eun Young;Kim, Kyoung Sim;Kim, Yong Wook;Seo, Jin-Jong;Chung, Yoon-Seok
    • Pediatric Infection and Vaccine
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    • v.14 no.2
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    • pp.136-144
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    • 2007
  • Purpose : Human bocavirus (HBoV) was recently identified world widely in clinical specimens from infants and children with respiratory tract illness, but the role of HBoV in respiratory tract illnesses is unknown. The aim of this study was to investigate the frequency and the clinical manifestation of HBoV in pediatric patients. Methods : We retrospectively investigated 1,777 throat swab obtained between 2005 and 2006 from pediatric in-patients with acute respiratory tract diseases at the Kwang-ju Christian Hospital. The medical records of patients with positive results were reviewed for demographic and clinical data of HBoV infections. Results : HBoV DNA was found in 84 (4.7%) of the 1,777 hospitalized children and the mean age was 19 months. The most common diagnosis were pneumonia (67.8%), bronchiolitis (35.7%). HBoV infections were found year-round, though most occurred in spring and winter months. Conclusion : HBoV is frequently found in hospitalized infants and children with acute respiratory tract diseases in Korea, but an association of HBoV with a distinct respiratory tract manifestation was not apparent. To clarify the clinical significance of HBoV, further evaluation of various age groups and clinical groups is needed.

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Earthquake Monitoring : Future Strategy (지진관측 : 미래 발전 전략)

  • Chi, Heon-Cheol;Park, Jung-Ho;Kim, Geun-Young;Shin, Jin-Soo;Shin, In-Cheul;Lim, In-Seub;Jeong, Byung-Sun;Sheen, Dong-Hoon
    • Geophysics and Geophysical Exploration
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    • v.13 no.3
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    • pp.268-276
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    • 2010
  • Earthquake Hazard Mitigation Law was activated into force on March 2009. By the law, the obligation to monitor the effect of earthquake on the facilities was extended to many organizations such as gas company and local governments. Based on the estimation of National Emergency Management Agency (NEMA), the number of free-surface acceleration stations would be expanded to more than 400. The advent of internet protocol and the more simplified operation have allowed the quick and easy installation of seismic stations. In addition, the dynamic range of seismic instruments has been continuously improved enough to evaluate damage intensity and to alert alarm directly for earthquake hazard mitigation. For direct visualization of damage intensity and area, Real Time Intensity COlor Mapping (RTICOM) is explained in detail. RTICOM would be used to retrieve the essential information for damage evaluation, Peak Ground Acceleration (PGA). Destructive earthquake damage is usually due to surface waves which just follow S wave. The peak amplitude of surface wave would be pre-estimated from the amplitude and frequency content of first arrival P wave. Earthquake Early Warning (EEW) system is conventionally defined to estimate local magnitude from P wave. The status of EEW is reviewed and the application of EEW to Odesan earthquake is exampled with ShakeMap in order to make clear its appearance. In the sense of rapidity, the earthquake announcement of Korea Meteorological Agency (KMA) might be dramatically improved by the adaption of EEW. In order to realize hazard mitigation, EEW should be applied to the local crucial facilities such as nuclear power plants and fragile semi-conduct plant. The distributed EEW is introduced with the application example of Uljin earthquake. Not only Nation-wide but also locally distributed EEW applications, all relevant information is needed to be shared in real time. The plan of extension of Korea Integrated Seismic System (KISS) is briefly explained in order to future cooperation of data sharing and utilization.

Study on the radiographic evaluation of marginal bone loss around short-length implant after functional loading (기능적 부하 후 "Short Implant" 주변의 골 흡수에 대한 방사선학적 연구)

  • Park, Young-Ju;Nam, Jeong-Hun;Noh, Kyung-Lok;Yeon, Byoung-Moo;Yu, Woo-Geun;Lee, Jeong-Won;Ahn, Jang-Hun;Gang, Tae-In;Park, Mi-Hee
    • The Journal of the Korean dental association
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    • v.48 no.8
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    • pp.615-620
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    • 2010
  • Purpose: The short dental implant is considered as possible solution in the alveolar bone height deficient cases. The aim of this study was to evaluate clinical availability of short implants by measuring the marginal bone loss of short length implants and comparing with that of conventional length implants. Materials and Methods: The groups were composed of patients who had received at least one implant. The samples of this study were selected from patients who with functional loading after prosthetic treatment for 1 year follow up period. The implants with a length of 5.7 mm and 6mm were considered short. (Bicon Dental implants, USA). The experiment group was composed of $4.5{\times}6mm$, $5{\times}6mm$, $6{\times}5.7mm$ implants (total 18 implants were placed in 14 patients, 8 on maxilla, 10 on mandible). The control group was composed of $4.5{\times}8mm$, $5{\times}8mm$, $4.5{\times}11mm$, $5{\times}11mm$. All implants were selected only by implants placed on molar area. We evaluated marginal bone loss in radiographic images at baseline (implant loading) and 3, 6, 12 months after loading. Additionally, crown-to-implant ratio was evaluated, and marginal bone loss according to crown-to-implant ratio after functional loading was analyzed. Results: The short implant group had a mean marginal bone level of $-0.52{\pm}0.69mm$; the 8mm group, $-0.22{\pm}0.82mm$; and the II mm group, $-0.10{\pm}1.09mm$ after I year of functional loading. But significant differences were not detected between three groups at every follow-up period. Crown-to-implant ratio in short implant group was $1.55{\pm}0.23$; 8mm group was $1.15{\pm}0.18$; and 11mm group was $0.92{\pm}0.15$. Additionally, significant differences between three groups were founded. (P<.0001) The greatest marginal bone loss after 1 year follow-up was founded at crown-to-implant ratio 1~1.49 range in short implant. Conclusion: The marginal bone loss of short implants was comparable to that of long implants. So, the short implants can be a clinically acceptable option.

Evaluation of polymerization shrinkage stress in silorane-based composites (Silorane계 복합레진의 중합수축응력의 평가)

  • Ryu, Seung-Ji;Cheon, Ji-Hoon;Min, Jeong-Bum
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.188-195
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    • 2011
  • Objectives: The purpose of this study was to evaluate the polymerization shrinkage stress among conventional methacrylate-based composite resins and a silorane-based composite resin. Materials and Methods: The strain gauge method was used for the determination of polymerization shrinkage strain. Specimens were divided by 3 groups according to various composite materials. Filtek Z-250 (3M ESPE) and Filtek P-60 (3M ESPE) were used as a conventional methacrylate-based composites and Filtek P-90 (3M ESPE) was used as a silorane-based composites. Measurements were recorded at each 1 second for the total of 800 seconds including the periods of light application. The results of polymerization shrinkage stress were statistically analyzed using One way ANOVA and Tukey test (p = 0.05). Results: The polymerization shrinkage stress of a silorane-based composite resin was lower than those of conventional methacrylate-based composite resins (p < 0.05). The shrinkage stress between methacrylate-based composite resin groups did not show significant difference (p > 0.05). Conclusions: Within the limitation of this study, silorane-based composites showed lower polymerization shrinkage stress than methacrylate-based composites. We need to investigate more into polymerization shrinkage stress with regard to elastic modulus of silorane-based composites for the precise result.

Evaluation of apical canal shapes produced sequentially during instrumentation with stainless steel hand and Ni-Ti rotary instruments using Micro-computed tomography (Stainless steel hand file과 Ni-Ti rotary file을 이용한 근관 형성시 근단부 근관 형태의 순차적 변화에 대한 평가)

  • Lee, Woo-Jin;Lee, Jeong-Ho;Chun, Kyung-A;Seo, Min-Seock;Yoo, Yeon-Jee;Baek, Seung-Ho
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.231-237
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    • 2011
  • Objectives: The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file) hand file, ProFile and LightSpeed using microcomputed tomography (MCT). Materials and Methods: Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1-, 2-, 3-, and 5- mm level from the apex. Data were statistically analyzed according to 'repeated nested design' and Mann-Whitney test (p = 0.05). Results: In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels. Conclusions: SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.

Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis (비결핵성 기관지탄분섬유화증의 임상 양상)

  • Lee, Hee-Seub;Maeng, Joo-Hee;Park, Pae-Gun;Jang, Jin-Gun;Park, Wan;Ryu, Dae-Sik;Kang, Gil-Hyun;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.510-518
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    • 2002
  • Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.