Sohn, Yu Rak;Kim, Jong Hee;Ma, Sang Hyuk;Lee, Kyung Yil;Kang, Jin Han
Pediatric Infection and Vaccine
/
v.18
no.2
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pp.193-200
/
2011
Purpose : The effect of corticosteroid on severe pneumonia caused by 2009 pandemic influenza (H1N1) A virus is controversial. This study was aimed to present the effects of early, short-term corticosteroid treatment for severe pneumonia with this virus infection. Methods : A retrospective analysis was performed on severe pneumonia patients (37 patients) who had severe respiratory distress at presentation requiring oxygen therapy and received intravenous methylprednisolone (MP, 8-10 mg/kg, divided in 4 doses/day for 2-3 days) with oseltamivir. The clinical and laboratory characteristics of the patients were evaluated through the medical records and chest radiographic findings. Results : The mean age and male-to-female ratio of the patients were 6.5${\pm}$2.9 years of age, and 3.4:1 (male 29 patients), respectively. The 5-9 aged group was predominant among the age groups (25 patients, 67.6%). Duration of fever prior to admission was 1.4${\pm}$0.6 days and dyspnea developed within 24 h after beginning of respiratory symptoms in all patients. All patients were previously healthy and received oseltamivir within 48 h. Thirteen patients (35.1%) developed dyspnea during oseltamivir treatment. Following MP infusion, all 37 patients including 13 progressive pneumonia patients during oseltamivir treatment showed an immediate halt in the progression of pneumonic infiltration with rapid clinical improvement. There were no side-effects following steroid use. Conclusion : For severe pneumonia patients, early corticosteroid treatment halted clinical exacerbation, and possibly prevented progression to acute respiratory distress syndrome. Further controlled clinical studies are needed for the role of corticosteroids and antivirals on severely affected patients with influenza virus infections.
As the basic old-age pension system was enforced in 2008, the base for old-age income security was founded. However, due to the basic old-age pension played a minor role as assistant allowance, it did not reach to sufficient level to cover full income security system. It is estimated that the dependency on private transfer income among the elderly who are difficult to be economically independent is still high. Therefore the poverty rate of the elderly households, who are not economically active or who are not protected by old-age income security system, is more likely to be higher than that of non-elderly households. Based on the assumption that public transfer income system should become a central means of old-age life guarantee, this study examined the poverty mitigation effects among the elderly households by comparing the private transfer income and the public transfer income. For this purpose, we selected single-elderly-households who have been considered the most vulnerable to poverty. We used 2006- 2008 Household Income and Expenditure Survey dataset that contained single-elderly who were older than 65 years old. To understand the conditions of poverty among single-elderly-households and the degree of poverty-reducing effect originated from income transfer system, we compared the poverty rates of total households and the whole elderly households. Next, we analysed the poverty of the single-elderly-households by social demographic factors such as gender, age, and economic activity. Our major findings are as follows: First, the poverty rate of the whole elderly households were not reduced, even though the basic old-age pension and long-term care management system were enforced in 2008. Second, half of the elderly households including single-elderly-households belonged to the absolute poverty line. Relatively higher level of poverty among the single-elderly-households was found especially those who were female, unemployed, low-educated, older, and rural single-elderly-households. Third, the effect of the public transfer income on mitigating the single-elderly-households poverty showed a little progress. However, even greater poverty reducing effect was found by the private transfer income system. Fourth, in a group of the public transfer systems, the public assistance such as supporting living costs contributed more to reduce poverty of the elderly population than the public pension system did.
Purpose: The aim of this study was to evaluate the clinical usefulness of ultrasound examination of children performed by a pediatrician. Methods: One thousand children who presented with symptoms of a gastrointestinal disorder and underwent abdominal ultrasound evaluation in the Department of Pediatrics, between January 2003 and June 2006, were included in this study. We analyzed the patient's medical records and ultrasound results retrospectively. Results: Among the 1,000 patients, 58.4% were male and 41.6% were female. The mean age of the patients was $4.7{\pm}4.0$ years. The main reasons for ultrasound were abdominal pain (43.9%), vomiting (17.3%), elevated liver enzymes (11.8%), and jaundice (9.8%). Abnormal ultrasound findings were present in 57.9% of cases. The major abnormal findings were mesenteric lymphadenitis (29.2%), fatty liver (12.1%), hepatitis (6.4%), hepatosplenomegaly (6.2%), and acute appendicitis (4.8%). The time interval between the initial medical evaluation and the ultrasound evaluation was within 24 hours in most cases (78.5%). The main findings in children with abdominal pain were mesenteric lymphadenitis (32.6%), fatty liver (5.9%), intussusception (2.7%), and acute appendicitis (2.7%). The main findings in children with vomiting were mesenteric lymphadenitis (12.7%), hypertrophic pyloric stenosis (10.4%), and acute appendicitis (3.5%). The major ultrasound findings in children with urinary tract diseases were hydronephrosis (45.4%), urolithiasis (21.5%) and cystic renal disease (18.1%). Conclusion: Ultrasound examination played an important role as a non-invasive and prompt screening examination for detection of abdominal diseases. Ultrasound was an important tool for pediatricians to determine timely information for patient management.
Purpose: This study examined the factors related to skipping breakfast in high school girls. Methods: A survey of a total of 581 high school girls residing in Incheon was conducted. The subjects were classified into 2 groups according to the breakfast frequency: "breakfast skipping" group (eating breakfast ≤ 2 times/week, n = 250) and "breakfast eating" group (eating breakfast ≥ 3 times/week, n = 331). This study compared the general characteristics, lifestyles, interest in weight control and beauty care, food habits, the reasons and symptoms of skipping breakfast, as well as the attitude toward breakfast between the 2 groups. Results: The mean age of the subjects was 16.5 years old. Approximately, 33.9%, 33.6%, and 32.5% of the subjects were in first grade, second grade, and third grade, respectively, with no significant difference between the 2 groups. The breakfast skipping group showed a high interest in weight control, and beauty care than the breakfast eating group. The breakfast skipping group consumed more afternoon snacks and late-night snacks, and ate dinner irregularly. Although the breakfast skipping group experienced the negative effects of skipping breakfast, they showed low recognition for the importance or role of breakfast. The most common reason for skipping breakfast was lack of time, which appears to be related to the late wake-up time and the time spent on make-up or beauty-care. Conclusion: Skipping breakfast by high school girls was related to a high interest in beauty care, irregular meals and low attitude toward the importance of breakfast for health and nutrition. Therefore, it is necessary to conduct nutrition education to change the perceptions and attitudes of female adolescents regarding the importance of breakfast by recognizing that breakfast can affect not only balanced nutrition and health, but also healthy physical beauty.
The slow development of histopathological changes and long period required for stabilization of lesions have suggested that secondary injury processes exacerbate the effect of initial mechanical insult after traumatic spinal cord injury (SCI). The importance of glutamate receptors in the normal functions of spinal cord, in concert with the large body of evidence that points to their involvement in neurotoxicity due to both ischemic and traumatic insults to the CNS, suggested a probable role of glutamate receptors in secondary injury process after traumatic SCI. In order to investigate the involvement of excitatory amino acid in the secondary injury process after SCI, this study examined the effect of dextrorphan, a noncompetitive NMDA receptor antagonist, on the recovery of hindlimb function and the residual tissue at injury site following SCI. Locomotor function was assessed using open field test (21 point scale). At 8 weeks spinal cord tissue was examined using quantitative histopathologic technique. Prior to surgery female Long-Evans rats were adapted to the test environment. Rats received laminectomies (T9/T10), and spinal cord contusions (NYU impactor) were produced by a 10 gm weight dropped 25 mm. DXT (15 or 30 mg/kg, i.p.) or saline was injected 15 min before contusion. Behavioral testing resumed 2 days post-injury and continued twice a week for 8 weeks. No differences between DXT and saline groups were found for hindlimb function and sparing tissue at the lesion site. These results suggest that NMDA receptor might not be involved in secondary injury processes after traumatic SCI.
Background : The $p16^{INK4a}$ (p16) twnor suppressor gene is frequently inactivated in hwnan non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon $\gamma$-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. Methods : This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. Results : Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57. $8{\pm}10.5$ years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I (1 IA, 10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III (9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. Conclusion: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.
Purpose : Brain tumors are the most common solid tumor in children. We retrospectively investigated the clinical characteristics of pediatric brain tumors, such as age, sex, tumor site and survival, as seen in a single institution over the last 15 years. We tried to evaluate the role of chemotherapy on the survival of some brain tumors. Methods : Three hundred fifty four children with primary brain tumor who were treated at Severance Hospital from Jan. 1985 to Sep. 2001 were enrolled. Results : Pediatric brain tumors were found most frequently in 10-15 years of age group(35.3%) and the ratio of male to female was 1.3 : 1. Supratentorial tumors(52%) were more frequent than infratentorial tumors(48%). Medulloblastoma/primitive neuroectodermal tumor(PNET) was the most common type(24.6%), followed by cerebellar astrocytoma(14.1%). Ten year survival rate of medulloblastoma, cerebellar astrocytoma and cerebral astrocytoma were 59.4%, 79.3% and 71%, respectively. The prognosis for brain stem glioma and glioblastoma multiforme were still grim with a 10 year survival rate of 12.7% and 13.3%, respectively. The addition of chemotherapy for high grade medulloblastoma led to an improved 10 year survival rate of 54.5%, compared with 40% without chemotherapy. Conclusion : The combined use of chemotherapy and radiation and surgery improved survival rate of pediatric brain tumors in our study. Chemotherapy for high grade medulloblastoma improved the 10 year survival rate. Further data analysis of the treatment modalities will lead to better comparisons.
Kim, Mok-Jin;Han, Kuk-Sun;An, Jae-Hong;Suh, Jeung-Ho;Lee, Young-Gi;Park, Yoon-Kee;Lee, Tae-Hyung
Journal of Yeungnam Medical Science
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v.14
no.1
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pp.168-174
/
1997
Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.
Lim, Eun Gyeong;Kim, Guen Tae;Kim, Bo Min;Kim, Eun Ji;Ha, Sung Ho;Kim, Sang-Yong;Kim, Young Min
Journal of Life Science
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v.26
no.6
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pp.663-672
/
2016
The Cnidium monnieri (L.) Cusson is an annual plant distributed in China and Korea. The fruit of C. monnieri is used as a medicinal herb that is effective for the treatment of carbuncle and pain in female genitalia. However, the anti-cancer effects of CME have not yet been reported. In this study, we assessed the apoptotic effects and cell cycle arrest effects of ethanol extracts from C. monnieri on HCT116 colon cancer cells. The results of an MTT assay and LDH assay demonstrated a decrease in cell viability and the cytotoxic effects of CME. In addition, the number of apoptotic body and the apoptotic rate were increased in a dose-dependent manner through Hoechst 33342 staining and Annexin V-PI double staining. In addition, cell cycle arrest occurred at the G1 phase by CME. Protein kinase B (Akt) plays an important role in cancer cell survival, growth, and division. Akt down-regulates apoptosis-mediated proteins, such as mammalian target of rapamycin (mTOR), p53, and Glycogen Synthase kinase-3β (GSK-3β). CME could regulate the expression levels of p-Akt, p-mTOR, p-GSK-3β, Bcl-2 family members, caspase-3, and PARP. Furthermore, treatment with CME, LY294002 (PI3K/Akt inhibitor), BIO (GSK-3β inhibitor), and Rapamycin (mTOR inhibitor) showed that apoptotic effects occurred through the regulation of the AKT/mTOR/GSK-3β signaling pathway. Our results demonstrated CME could induce apoptosis and cell cycle arrest in HCT116 colon cancer cells.
Background: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. Methods: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology(106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. Results: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was $57.4{\pm}12.1$ years. 2) The site of origin was lung cancer 46.9%(53/113), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37%(20/54), breast cancer was 24.1%(13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/113) of cases, and lymphocyte predominance($71{\pm}27%$) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6%(40/66), and ADA levels in pleural fluid were under 40U/L in 95%(57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was $12.7{\pm}13.5$ weeks. Conclusion: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.
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