• Clinical and Experimental Pediatrics
• /
• v.49 no.8
• /
• pp.882-888
• /
• 2006

Purpose : Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. Methods : We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. Results : There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), ${\alpha}$-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. Conclusion : Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.10 no.2
• /
• pp.179-184
• /
• 2007

Purpose: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. Methods: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. Results: When the mean of ages ($10.5{\pm}1.6$ vs. $10.7{\pm}2.0$ years), total cholesterol levels ($183.0{\pm}29.1$ vs. $183.7{\pm}31.3$ mg/dL), HDL-cholesterol levels ($53.0{\pm}10.2$ vs. $55.7{\pm}13.0$ mg/dL), LDL-cholesterol levels ($113.4{\pm}30.2$ vs. $113.0{\pm}30.0$ mg/dL), triglyceride levels ($99.4{\pm}62.9$ vs. $114.2{\pm}47.3$ mg/dL), obesity indexes ($44.7{\pm}12.2$ vs. $47.9{\pm}15.1%$), and body fat percentages ($32.7{\pm}5.0$ vs. $34.0{\pm}4.8%$) of group 1 (ALT${\leq}$40 IU/L) were compared with those of group 2 (ALT${\geq}$41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG${\geq}$110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). Conclusion: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.

• Neonatal Medicine
• /
• v.15 no.2
• /
• pp.142-151
• /
• 2008

Purpose : The aim of this study was to compare the clinical effects of modified porcine (Curosurf$^{(R)}$) and bovine (Newfactan$^{(R)}$) surfactants in the treatment of neonatal respiratory distress syndrome. Methods : Between April 2004 and December 2006, 65 neonates (birth weight ${\leq}$2,500 g and gestational age ${\leq}$35 weeks) with neonatal respiratory distress syndrome were treated in our neonatal intensive care unit with surfactant. Thirty-one neonates received Curosurf$^{(R)}$ and 34 neonates received Newfactan$^{(R)}$. The neonates were not enrolled if they had major congenital anomalies or meconium aspiration syndrome. We compared the changes in respiratory parameters after surfactant instillation, the incidences of acute and chronic complications, and the mortality between the two treatment groups. Results : Neonatal and maternal demographic characteristics were not different between the groups. The patterns of change in the respiratory parameters after surfactant instillation were not statistically different between the groups. The incidences of surfactant reinstillation and acute complications, such as pneumothorax, patent ductus arteriosus, pulmonary hemorrhage, and grade 3-4 intraventricular hemorrhage, were not different between the neonates who received Curosurf$^{(R)}$ and the neonates who received Newfactan$^{(R)}$. There were no statistically significant differences in the duration of mechanical ventilation, oxygen therapy, hospitalization, prevalence of bronchopulmonary dysplasia, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, and mortality between the groups. Conclusion : In the present comparative study, no significant differences in the clinical effects of Curosurf$^{(R)}$ and Newfactan$^{(R)}$ were observed.

• The Korean Journal of Food And Nutrition
• /
• v.16 no.3
• /
• pp.197-202
• /
• 2003

The purpose of this study was to investigate basic factors of obesity, nutrient intakes, behaviors of dietary life, daily energy expenditure and emphasize on the necessity of school education. Because the growing prevalence of obesity have required a need for health education in school. The results were as follows. 1. The average height of boys and girls was l59${\pm}$13cm(boys), l54${\pm}$11cm(girls). The average weight of them was 68${\pm}$16kg(boys), 70${\pm}$13kg(girls). BMI(body mass index) of them was 26.9${\pm}$3.4(boys), 29.5${\pm}$2.9(girls). 2. For energy and protein, the average intakes of subjects were higher than recommended dietary allowances for Koreans(7th Ed). The average intakes of vitamin A and ascorbic acid were much lower than the recommended dietary allowances. 3. Most of subjects prefer fast food, rich snacks and overeating, irregular meal amount and these dietary behaviors were severe problems. 4. Total energy expenditure was 1,933kcal in boys and 1,789kcal in girls. To reduce weight and treat obesity, the required energy intake to subjects was 1,546kcal(boys) and 1,431kcal(girls). If we prepared the effective program for obesity, school education should be integrated within the larger community. Parents of students and students may be educated to make good health changes in the home. Nutrition education has a direct impact on their life style of their food intake and nutritional status. The use of multi-component obesity treatments will be effective in a school setting. It is more effective to encourage health habits in school, house and it should be integrated within the larger community.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.17
• /
• pp.7825-7829
• /
• 2015

Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

• Journal of agricultural medicine and community health
• /
• v.10 no.1
• /
• pp.42-48
• /
• 1985

This study was carried out to obtain the basic data for epdemiological survey of hypertension in old population (60 years or more). From May, 1983 to April, 1984, 365 males and 335 females who inhabit in Ko-Chang Gun, Chonbuk Province were investigated for several factors as their socio-econmic status and laboratory examinations with blood pressure, and which factors were analysed by simple correlation and multiple regression analysis. The results are summarized as follows; 1) Sample size of this study is equivalent to 5.2%(male;6.7%, female;4.3%) of population in 60 years or more age group, and the mean age of samples is 70.6${\pm}$5.3 (yr.) in males and 71.4${\pm}$5.3 (yr.) in female (P>0.05). 2) Mean blood pressure of males are 135.9${\pm}$21.3mm Hg in systolic and 85.3${\pm}$13.4mm Hg in diastolic phase and in female, 131.0${\pm}$23.6 mm Hg and 84.1${\pm}$19.9 mm Hg (P < 0.01). Their prevalence rates of hypertension (${\geq}$ 140 mm Hg in systolic, ${\geq}$ 95 mm Hg in diastolic phases) are 33.7% in males, 40.6% in females (P < 0.01). 3) Serum cholesterol levels and other independent variables are revealed in normal ranges, and except to Vervaeck index (89.4${\pm}$5.6 in males, 87.5${\pm}$6.7 in females, p<0.01), other are not significant sexual differences (P>0.05). 4) In the simple correlation analysis, the main factors that affect to blood pressure are serum cholesterol levels (P < 0.05) and Vervaeck index (P < 0.01) in males, age (P <0.05) and Vervaeck index (P <0.01) in females. 5) In multiple regression analysis, prediction equations for blood pressure are calculated as follows; Ysm=-64.55+0.161(X1)+0.124(X2)-0.047(X3)+1.953(X4) Ydm=18.61-0.125(X1)+0.060(X2)+0.032(X3)+0.720(X4) Ysf=-0.22+0.536(X1)+0.134(X2)+0.068(X3+0.788(X4) Yaf=-14.46+0.685(X1)+0.033(X2)+0.176(X3)+0.362(X4) Ysm : Systolic blood pressure in male, Ydm : Diastolic blood pressure in male, Ysf : Systolic blood pressure in female, Ydf : Diastolic blood pressure in female. X1 : Age(year), X2 : Serum cholesterol level (mg%), X3 : Fastin blood sugar (mg% ), X4 : Vervaeck index.

• Childhood Kidney Diseases
• /
• v.1 no.1
• /
• pp.4-12
• /
• 1997

Purpose: To evaluate the prevalence and clinical manifestations of various glomerulonephritis (GN) in children, a clinicopathological anlysis of 310 biopsied cases were performed. Method: We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 310 cases diagnosed as glomerulonephritis by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital. Results: 1) Male to female ratio was 1.54:1 and the range of age was from 13 months to 15 years 10 months. 2) Among these, 217 (70.0%) patients were belong to primary GN and 93 (30.0%) patients were belong to secondary GN. As a whole, the most common pathologic diagnosis was minimal change lesion (MC, 32.6%), which was followed by IgA nephropathy (IgAN, 15.8%), $Henoch-Sch\"{o}nlein$ purpura nephritis (HSPN, 13.5%), Poststreptococcal glomerulonephritis (PSAGN, 8.1%). 3) Clinical manifestations of patients were asymptomatic urinary abnormality (43.2%), nephrotic syndrome (41.0%), acute glomerulonephritis (14.2%), chronic glomerulonephritis (1.0%), rapidly progressive glomerulonephritis (0.6%). 4) In primary GN, the most common pathologic diagnosis was MC (46.5%), IgAN (22.6%), thin glomerular basement membrane (GBM) disease (7.8%), membranoproliferative glomerulonephritis (MPGN, 5.5%), mesangial proliferative glomerulonephritis (MesPGN,4.6%), focal segmental glomerulosclerosis (FSGS, 4.6%), membranous nephropathy (MN, 0.9%), sclerosing glomerulonephritis (SCGN, 0.9%), crescentic glomerulonephritis (CreGN, 0.5%) and non-specific glomerulonephritis (NonspGN, 6.0%). 5) Major causes of secondary GN were HSPN (45.2%), PSAGN (26.9%), hepatitis B associated glomerulonephritis (HBGN, 17.2%), lupus nephritis (LN, 6.5%), Alport syndrome (2.2%), hemolytic uremic syndrome (1.0%), fibrillary glomerulonephritis (1.0%) in descending order. Conclusions: There are some differences of the results of clinicopathological stuidies of glomerulonephritis in children because of its different indications of renal biopsy, pathologic classification of renal disease and methods of analysis among investigators. In order to establish more reliable data of incidence and classification of childhood glomerulonephritis in Korea, multicenter cooperative study were necessary.

• Pediatric Infection and Vaccine
• /
• v.23 no.3
• /
• pp.165-171
• /
• 2016

Purpose: Human parechovirus (HPeV) is an increasingly recognized pathogenic cause of central nervous system (CNS) infection in neonates. However, HPeV infections have not been studied in older children. This study determined the prevalence and clinical features of HPeV CNS infection in children in Korea. Methods: Reverse transcription polymerase chain reaction assays were performed using HPeV-specific, 5' untranslated, region-targeted primers to detect HPeV in cerebrospinal fluid (CSF) samples from children presenting with fever or neurologic symptoms from January 1, 2013, to July 31, 2014. HPeV genotyping was performed by sequencing the viral protein 3/1 region. Clinical and laboratory data were retrospectively abstracted from medical records and compared with those of enterovirus (EV)-positive patients from the same period. Results: Of 102 CSF samples, six (5.9%) were positive for HPeV; two of 21 EV-positive samples were co-infected with HPeV. All samples were genotype HPeV3. Two HPeV-positive patients were <3 months of age and four others were over 1 year old. While HPeV-positive infants under 1 year of age presented with sepsis-like illness without definite neurologic abnormalities, HPeV-positive children over 1 year of age presented with fever and neurologic symptoms such as seizures, loss of consciousness, and gait disturbance. The CSF findings of HPeV-positive patients were mostly within the normal range, whereas most (73.7%) EV-positive patients had pleocytosis. Conclusions: Although HPeV is typically associated with disease in young infants, the results of this study suggest that HPeV is an emerging pathogen of CNS infection with neurologic symptoms in older childhood.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.4
• /
• pp.405-412
• /
• 1994

Background: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. Method: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. Results: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to fema1e ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significant1y different. 4) Drug induced hepatitis was most common in the case of moderate advanced pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significant1y different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant tenderness in order. 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occured within the first month. 7) The duration of abnormal liver function was $28{\pm}5$(Mean${\pm}$SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. Conclusion: There are no dicided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as well as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.

• Journal of agricultural medicine and community health
• /
• v.28 no.2
• /
• pp.49-59
• /
• 2003

Objectives: This study was intended to provide basic data available for the establishment of comprehensive and systematic public medical service for older persons about their concurrent pathology and time span for their bedridden state, and thereby, the medical service, and individual cares they have received. Methods: The study subjects included 207 elderly residents of men and women aged over 65, who were in the bedridden state at home at the time of investigation in September of 2002 at 11 'Myon' in Kongju city, Chungchongnamdo Province. They were asked to respond to the questionnaires by using interviews at their homes. Results: Of the elderly population studied, the overall rate of bedridden states was 1.61%(1.46% in men and 1.71% in women) and there was an increasing tendency with age in both sexes. The causes for bedridden states indicated that hypertension and atherosclerosis accounted for 43.6 % of them in men, and lumbago neuralgia spinal disease 40.3% in women as the most frequent cause, respectively. The mean years of bedridden states were greater in men(4.81${\pm}$2.89) than women(4.98${\pm}$2.89). By age groups, both sexes showed an increasing tendency of time span with age. The items of care required for the bedridden showed that bathing was the most frequent and it was followed by toileting, dressing and feeding in a decreasing order of frequency. The number of care per one patient was 3.4 in men and 3.5 in women with the increased tendency with decreasing age Ain both sexes. Conclusions: Though the proportion of bed-ridden patients increased according to the increasing age, there are substantial limitations in reducing the prevalence of chronic diseases. Therefore, it is required to establish the appropriate measures, such as various resources of health care services for dealing with the steadily increasing rate of bed-ridden patients.