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Primary nephrotic syndrome in children : A nationwide survey in Korea (전국 병원을 대상으로 조사한 소아 특발성 신증후군의 임상적 고찰 - 다기관 공동연구 결과보고 -)

  • Cho Bytung-Soo;Kang Hyeon-Ho
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.1-10
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    • 1999
  • Purpose: Up to date there is no nationwide survey on epidemiological or clinical data of nephrotic syndrome, so we investigated about age of onset, sex, result of renal biopsy, treatment method, its results of treatment, its responsiveness, time of response to treatment and pattern of relapse in Korea. Methods: Between 1987 and 1997, 2193 patients with primary nephrotic syndrome diagnosed at 38 university hospital and general hospital in Korea were included. Of these 1655 were male and 538 were female. Incidence peaked at 1-5 years of age. Results: Results were as follows; 1) Among 2193 cases, male was 1655($75.5\%$), female was 538 cases($24.5\%$) and male to female ratio was about 3:1. Among 1752 patients with MCNS, male was 1338, female was 414 and male to female ratio was about 3.23:1. The most prevalent age group was 1-5 years of age. 2) Renal biopsy was done in 942 cases($43\%$), pathologic findings were as follows; MCNS 646 cases($68.6\%$), FSCS 149 cases($15.8\%$). 3) Regimen of treatment were as follows; prednisolone 1191 cases, Calcort 192 cases, cyclophosphamide 251 cases, cyclosporin A 223 cases, MPD pulse therapy 120 cases.4) Complete response to treatment were noted in 1597 cases($82.2\%$, n=1944). 5) Responsiveness according to result of renal biopsy were significantly different between MCNS and FSGS. Complete response were noted in $86.5\%$ among patients with MCNS, $35.8\%$ in patients with FSGS. 6) Time of response to treatment were noted between 1 and 4 weeks after treatment in 879 cases($67.4\%$, n=1305). 7) 994 cases($73.1\%$) relapsed during follow up, most frequently between 2 months and 6 months after response. Conclusion : Nationwide survey of epidemiological and clinical data were performed in childhood primary nephrotic syndrome. Most of the clinical and epidemiological data were similar to other reports from U.S.A. and from Europe, however male to female ratio is higher in Korean nephrotic syndrome(3:1 in contrast to 2:1).

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The Effect of Long-term Steroid Therapy Combined with Azathioprine in Henoch-$Sch{\ddot{o}}nlein$ Nephritis (Henoch-$Sch{\ddot{o}}nlein$(HS) 신염에서 장기 스테로이드와 Azathioprine의 병합치료 효과)

  • Moon, Kyoung-Sang;Jin, So-Young;Kim, Eun-Mi
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.118-124
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    • 1998
  • Purpose : There is no specific treatment guidelines for Henoch-$Sch{\ddot{o}}nlein$(HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine Methods : Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenolisly 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following 1 month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. Results : Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean $7.4{\pm}7.4$ weeks. Clinical remission were seen in 4 cases out of 5 ($80\%$). Mean time period with disappearance of proteinuria and microscopic hematuria were $5{\pm}2.4$ month and $13.3{\pm}2.9$ month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up tidneybiopsiesafterlyearstreatment. Conclusion : As there is no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.

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Diatom Assemblages and its Paleoceanography of the Holocene Glaciomarine Sediments from the Western Antarctic Peninsula shelf, Antarctica (남극반도 서 대륙붕의 빙해양 퇴적물의 규조군집 특성과 고해양 변화)

  • Shin, Yu-Na;Kim, Yea-Dong;Kang, Cheon-Yoon;Yoon, Ho-Il
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.6 no.3
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    • pp.152-163
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    • 2001
  • Based upon the sedimentological, geochemical and micropaleontological analyses of two sediment cores from the Antarctic Peninsula (AP), three distinct lithological units can be recognized: (1) ice-proximal an/or ice-distal diamictons in the lower part of the cores, accumulated just seaward of the grounding line of the ice shlef until 11,000 yrs BP; (2) diatomaceous mud between 6,000 and 2,500 yrs BP in the middle part, resulted from a large influx of organic materials by enhanced production of open marine condition; (3) diatomaceous sandy mud since 2,500 yrs BP, characterized by an increase in sand content and decrease in TOC and diatom abundance in the lower layers, which reflects the formation of more extensive and seasonally persistent sea ice. Based on the C-14 radiocarbon dating, the sub-ice shlef deposition of the diamicton on the AP western shelf completed around 11,000 yrs BP. Colder condition was reinstated between 12,800 and 11,600 BP with a dropin TOC content and diatom abundance, which is coincident with the Younger Dryas event in the North Atlanticregion. At this time, the ice shelf, that is now absent in the study area, appears to advance as evidenced by an abrupt increase in sea-ice taxa. A climatic optimum is recognized between 9,000 and 2,500 BP, coincide witha mid-Holocene climatic optimum 'Hypsithermal Warm Period' from the other Antarctic sites. During this time, diatomaceous mud accumulated by a large influx of organic materials by enhanced production occurred in openmarine condition. Around 2,500 BP, diatomaceous sandy mud reflects the formation of more extensive and seasonally persistent sea ice, coincident with the onset of the Neoglacial in the Antarctic. Our results provide evidence of climatic change from the Antarctic Peninsula`s western shelf that helps in determining the existence and timing of Holocene milennial-scale climatic events in the Southern Hemisphere.

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Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children (소아 만성 기능성 변비의 치료 성적과 장기적 예후)

  • Ahn, Yoon Jin;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.200-209
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    • 2006
  • Purpose: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. Methods: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. Results: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was $21.1{\pm}23.5$ (1.9~84.0) months and $47.1{\pm}34.2$ (6.9~138.0) months, respectively. The mean defecation frequency before treatment was $3.2{\pm}2.3$ (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was $34.2{\pm}14.6$ (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was $4.3{\pm}2.4$ (1.0~36.0), $5.0{\pm}1.4$ (0.8~36.0) and $5.0{\pm}3.1$ (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was $2.9{\pm}1.9$ (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. Conclusion: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.

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Surface Texture Changes due to the Oxidation of Pyrite by Acidithiobacillus Ferrooxidans (애시디싸이오바실러스 페로악시댄스에 의한 황철석 산화에 따른 표면 조직의 변화)

  • Yu, Jae-Young;Koh, Hyun-Jin;Song, Hong-Gyu
    • Journal of the Mineralogical Society of Korea
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    • v.24 no.3
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    • pp.235-244
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    • 2011
  • A batch experiment of pyrite oxidation was performed and the surfaces of the reacted pyrite were regularly observed with the scanning electron microscope (SEM) together with the chemical compositions of the solution to help understand the oxidation mechanisms of pyrite by Acidithiobacillus ferrooxidans (Af). The dissolved Fe concentrations clearly indicated that Af experiences the lag and then exponential growth phase. An Af cell was observed to be attached to the surface of pyrite during the lag, implying that a direct leaching by the microbe really happens for the period. It is not certain, however, whether the main mechanism of pyrite oxidation during that time was the direct leaching or not, because there were just a few cells confirmed to be attached and most of the dissolved Fe was Fe(III). The dissolved Fe concentration stayed almost constant from the mid-lag phase to just before the onset of the exponential phase, suggesting that AI needs an adaptation time to switch its oxidation mechanism from one to the other whichever it is during that stage of growth. The moment of Af's cell division was observed by SEM on the surface of pyrite during the lag phase. The corrosion outline around the dividing cell was quite similar to the shape of the cell itself, which implies that the rate of the microbial oxidation is very uneven and the rate when the cell metabolizes should be much faster than that calculated from the concentration variation of the dissolved Fe. The number of etch holes by Af is much higher on the inoculated surfaces, indicating the average rate of pyrite oxidation is also much faster than that of abiotic oxidation. The microbial etch holes on pyrite surface are small and deep, which may influence the transition of the growth phases of Af from lag to exponential.

Blood Gas Management of a Membrane Oxygenator During Cardiac Surgery with Deep Hypothermic Circulatory Arrest (막형산화기에 의한 저체온 순환정지 심장수술시 혈액가스 조절)

  • Kim, W. G.;Lim, C.;Baek, Y. H.
    • Journal of Biomedical Engineering Research
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    • v.19 no.3
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    • pp.279-284
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    • 1998
  • Deep hypothermic circulatory arrest(DHCA), in which systemic temperatures of 2$0^{\circ}C$ or less are used to allow temporary cessation of the circulation, is an useful adjunct in cardiac surgery. Because man in natural circumstances is never exposed to the extreme hypothermic condition, however, one of the controversial aspects is appropriate blood gas management($\alpha$STAT versus PH-STAT) during DHCA. This study aims to compare $\alpha$STAT with PH-STAT management for control of blood gases in experimental cardiopulmonary bypass(CPB) circuits with a membrane oxygenator. Fourteen young pigs were assigned to one of two strategies of gas manipulation. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopharyngeal temperature fell below 2$0^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below 2$0^{\circ}C$, the animals were subjected to circulatory arrest for 40mins. During cooling, blood gas was maintained according to either $\alpha$$\alpha$STAT or pH-STAT strategies. After DHCA, the body was rewarmed to normal body temperature. Arterial blood gases were measured before the onset of CPB, before cooling, before DHCA, at the point of 27$^{\circ}C$ during re-warming, on completion of re-warming. Cooling time was significantly shorter in $\alpha$-STAT than PH-STAT strategy, while there was no significant differences in rewarming time between two groups. Carbon dioxide was added between 5.5 and 3.0% in PH-STAT, while no carbon dioxide was added in $\alpha$STAT management. Amounts of oxygen administration were gradually lowered as temperature decreased. In this way, criteria of PH, PaCO, and PaO adjustments were satisfied in both $\alpha$STAT and PH-STAT management groups.

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In vitro study of Polymerization shrinkage-strain kinetics of dental resin cements (치과용 레진 시멘트의 중합 수축률 특성에 관한 연구)

  • Kim, Tae-Hoon;Yang, Jae-Ho;Lee, Jai-Bong;Han, Jung-Suk;Kim, Sung-Hun
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.55-60
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    • 2010
  • Purpose: The shrinkage of dental resin cement may cause several clinical problems such as distortion that may jeopardize the accurate fit to the prepared tooth and internal stress within the restorations. It is important to know the polymerization shrinkage-strain of dental resin cement to reduce clinical complications. The purpose of this study was to investigate the polymerization shrinkage-strain kinetics of six commercially available dental resin cements. Material and methods: Three self-cure resin cements (Fujicem, Superbond, M-bond) and three dual-cure resin cements (Maxcem, Panavia-F, Variolink II) were investigated. Time dependent polymerization shrinkage-strain kinetics of the materials were measured by the Bonded-disk method as a function of time at $23^{\circ}C$, with values particularly noted at 1, 5, 10, 30, 60, 120 min after mixing. Five recordings were taken for each materials. The data were analyzed with one-way ANOVA and Scheffe post hoc test at the significance level of 0.05. Results: Polymerization shrinkage-strain values were 3.72%, 4.19%, 4.13%, 2.44%, 7.57%, 2.90% for Fujicem, Maxcem, M bond, Panavia F, Superbond, Variolink II, respectively at 120 minutes after the start of mixing. Panavia F exhibited maximum polymerization shrinkage-strain values, but Superbond showed minimum polymerization shrinkage-strain values among the investigated materials (P < .05). There was no significant differences of shrinkage-strain value between Maxcem and M bond at 120 minutes after the start of mixing (P > .05). Most shrinkage of the resin cement materials investigated occurred in the first 30 minutes after the start of mixing. Conclusion: The onset of polymerization shrinkage of self-cure resin cements was slower than that of dual-cure resin cements after mixing, but the net shrinkage strain values of self-cure resin cements was higher than that of dual-cure resin cements at 120 minutes after mixing. Most shrinkage of the dental resin cements occurred in the first 30 minutes after mixing.

THE COMPARATIVE STUDY ON THE SEDATIVE EFFECT OF DIFFERENT INTRAVENOUS MIDAZOLAM DOSAGES FOR PEDIATRIC DENTAL PATIENTS (소아환자의 Midazolam의 정맥투여 용량에 따른 진정 효과에 관한 비교연구)

  • Kim, Eun-Young;Kim, Jong-Soo;You, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.416-426
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    • 2005
  • Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.

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The clinical study of acne patients (面疱 患者에 對한 臨床的 硏究)

  • Chae, Byeong-yoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.251-268
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    • 1998
  • 125 Cases of Acne were treated by Acupuncture and Herb-med treatment during a three months duration from April 1996 to February 1998 in Kyung Hee Univ. Department of Ophthal, Otolaryngology. College of Oriental Medicine. We have observed the cases and the results as follows: 1. The age of average was 24.55 age : 21.91 in males, 24.55 in females. and in these, the gulf between males and females were showed statically significant diference. In the age of onset, averag was 16.96 age and mode was 18 age and male's average was 16.96 age, minimun was 11 age, maximum 40 age and female's average was 20.14 age, minimun was 10 age, maximum 40 age. and these were showed statically significant diference between males and females. 2. In the distribution of season, winter was the most with $37.8\%$ of out patients, the rest was similar to difference of each other. but there was clear difference between males and females. 3. In the duration of history, the average was 5.10 years and male's average was 5.13 years. on the other hand female's was 5.09 years but there is no any significant difference have a resemblance with each other. 4. In blood type, O type was the most with $35.20\%$ and there was in the order of A type was $26.40\%\;B\;type\;was\;23.20\%,\;AB\;type\;was\;15.20\%$ but these were not significant difference by the chi-tend and analysis of variance with total cases, males and females. 5. In select of the preference food, patients of the prefer worm food was $42.40\%\;and\;cool\;food\;was\;38.40\%,\;tepid\;food\;was\;24\%$ but these were no significant difference by the chi-test and ANOVA of each other. 6. the state of pulse classified into 11 type and average was 7.2 times, maximum was 29 times with Hyun Sae, at the same time, the female's average was 6.73 times, maximum was 27 times and male's average was 1.5 times. The result of test with each other, these were showed statically significant difference as compared total cases with males but there were not females ones. 7. In the frequency of the major cause, oversensitiveness was the most with $34.93\%$. secondly there was in order of indigestion $30.82\%$ and menstrual irregularity and menstruation pain $23.28\%$. constipation $10.96\%$ and these showed statically significant difference as compared the females with males on the result of test for difference with each other. 8. In frequency of the symptoms, itching was the most with $31.97\%$ and there was in order of nodule $20.49\%$, pustule $18.85\%,\;papule\;15.58\%,\;flare\;13.12\%$ and also these showed statically significant difference as compared the females with males 9. for the Distribution of acne region, face was the most with $64.06\%$ and there was in order of back $14.29\%,\;upper-chest\;11.69\%,\;neck\;7.79\%$ and there was no significant difference as compared total cases with males and females. 10. Acne applied 30 prescription to 4 weeks and over and 20 weeks and over was $23.3\%$, 30 weeks and over was $16.67\%$ and average of administration duration were 4.2 weeks(male's average 5.78, maximum 96 weeks and female's average 3.85, maximum 23 weeks) maximum was 96 weeks, minimum was 1 week. 11. In the acupuncture treatment, $96.6\%$ applied to acupuncture and average was 5.44 times, maximum 46 times, minimum 1 time(male's average 4.64, female's 5.62) but these were not any significant differeence. 12. for the medication, author made a investigation and comparison between control group with treated group in order to observe for the therapeutic effect during the 1 month and 2, 3. From these results, we can see that acne was improved by the oriental treatment. in the 1 month, average of control group was 13.24 and treated group was 11.78. these showed statically significant decrease in P<0.02 as compared the treated group with control group. In the 2 months, average of control group was 13.43 and treated group was 9.03. these showed statically significant decrease in P<0.003 as compared the treated group with control group. In the 3 months, average of control group was 13.78 and treated group was 8.06. these showed statically significant decrease in P<0.008 as compared the treated group with control group.

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A Histological and Clinical Study of the Children with Thin Glomerular Basement Membrane (사구체 기저막 비박화를 보인 소아들의 조직학적 및 임상적 고찰)

  • Kim Young-Chol;Lee Dong-Won;Cho Min-Hyun;Kwak Jung-Sik;Ko Cheol-Woo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.31-37
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    • 2005
  • Puruose : Thin glomerular basement membrane disease(TGBMD) is found in patients with family history of hematuria. TGBMD is autosomal dominant and is known to be one of the commonest causes of asymptomatic hematuria. This study was conducted to evaluate the histological and clinical features of patients with TGBMD. Methods : 150 cases diagnosed with TGBMD by renal biopsy while admitted in the department of pediatrics, Kyungpook National University Hospital between January 1999 and December 2003 comprised the study group. The following parameters were retrospectively anaIyzed age of onset, hematuria pattern, existence of proteinuria, process of diagnosis, laboratory findings, thickness and character of basement membrane and family history. Results : The mean age at the time of diagnosis was 7.9 years. The male to female ratio was 65:77. 94 patients or 66% visited the hospital with a chief complaint of persistent microscopic hematuria. Gross hematuria accounted for 13 cases or 9%. 78 cases(55%) were found to have hematuria for the first time from a routine school urinalysis screening. The renal biopsy showed the thickness of basement membrane to be 186$\pm$36 nm. Focal lamellation of the basement membrane was found in eight cases. In the family history, hematuria was shown in 10 cases on the Paternal side, 13 on The maternal side and none on both sides. In seven cases, hematuria was shown among siblings. No significant differences were found among the laboratory test results which were conducted at an average interval of fifteen months. Conclusion : TGBMD is one of the major causes of asymptomatic hematuria in children, which was diagnosed in increasing numbers since school urinary mass screening test started in 1998. In cases with familial progressive renal disease or focal duplication in the basement membrane Alport syndrome should be considered.

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