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Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis (임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과)

  • Na, Hyun Jung;Kim, Ji Young;Lee, Gyeong Hoon;Lee, Jun Hwa;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1187-1192
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    • 2005
  • Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

Predictive factors for severe infection among febrile infants younger than three months of age (발열을 주소로 내원한 3개월 미만의 영아에서 중증 감염의 예측 인자)

  • Cho, Eun-Young;Song, Hwa;Kim, Ae-Suk;Lee, Sun-Ju;Lee, Dong-Seok;Kim, Doo-Kwun;Choi, Sung-Min;Lee, Kwan;Park, Byoung-Chan
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.898-903
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    • 2009
  • Purpose : This study investigated the predictive factors for identifying infection-prone febrile infants younger than three months. Methods : We conducted a retrospective study of 167 infants younger than three months with an axillary temperature >$38^{\circ}C$ who were hospitalized between 2006 and 2008. If they met any of the following criteria, positive blood culture, CSF WBC ${\geq}11/mm^3$ or positive CSF culture, urinalysis WBC ${\geq}6$/HPF and positive urine culture, WBC ${\geq}6$/HPF on microscopic stool examination or positive stool culture, they were considered at high risk for severe infection. Infants with focal infection, respiratory infection or antibiotic administration prior to admission to the hospital were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and the clinical course between the high risk and low risk groups for severe infection. Results : The high-risk group included 77(46.1%) infants, and the most common diagnosis was urinary tract infection (51.9%). Factors, such as male sex, ESR and CRP were statistically different between the two groups. But, a multilinear regression analysis for severe infection showed that male and ESR factors are significant. Conclusion : We did not find the distinguishing symptoms and laboratory findings for identifying severe infection-prone febrile infants younger than three months. However, the high-risk group was male and ESR-dominated, and these can possibly be used as predictive factors for severe infection.

Growth and clinical efficacy of fortified human milk and premature formula on very low birth weight infants (극소 저체중출생아에서 강화된 모유와 미숙아 전용분유가 성장 및 임상에 미치는 효과)

  • Chueh, Heewon;Kim, Myo Jing;Lee, Young-A;Jung, Jin-A
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.704-712
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    • 2008
  • Purpose : A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil $HMF^{(R)}$; Maeil Dairies Co., Ltd.). Methods : We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with $HMF^{(R)}$, and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. Results : Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day ($8.00{\pm}3.27d$ vs. $8.86{\pm}5.37d$) (P=0.99) and the number of days required to reach full feeding after start feeding ($41.78{\pm}20.47d$ vs $36.86{\pm}20.63d$) (P=0.55) were not significantly different in the group fed human milk fortified with $HMF^{(R)}$ when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with $HMF^{(R)}$ showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post-discharge follow up growth indices. Conclusion : Premature infants fed human milk fortified with $HMF^{(R)}$ showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.

The effects of shortened dexamethasone administration on remission rate and potential complications during remission induction treatment for pediatric acute lymphoblastic leukemia (급성림프구성백혈병 환아의 관해유도 치료 중 덱사메타손 투여기간의 단축이 관해유도율 및 합병증 발생에 미치는 영향)

  • Lee, Jae Wook;Lee, Kwang Hee;Kwon, Young Joo;Lee, Dae Hyoung;Chung, Nak Gyun;Jeong, Dae Chul;Cho, Bin;Kim, Hack Ki
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1217-1224
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    • 2007
  • Purpose : Due to its high potency against leukemic blasts, our institution has opted for the use of dexamethasone during acute lymphoblastic leukemia (ALL) remission induction, but in our most recent treatment protocol, CMCPL-2005, we shortened the length of steroid treatment from 4 to 3 weeks. We compared both the rates of remission induction and significant complications observed during induction with CMCPL-2005, with those noted for our previous protocol, CMCPL-2001. Methods : We retrospectively reviewed the records of patients diagnosed with ALL from January, 2001 to December, 2006 at the Department of Pediatrics, St. Mary's Hospital, the Catholic University of Korea. Data concerning age, sex, WBC count at diagnosis, immunophenotype, cytogenetic traits, and risk group were collected for each patient. Results of remission induction treatment were compared between the two patient groups. Infection and other major complications resulting from treatment were investigated according to NCI toxicity criteria. Results : A total of 141 and 88 patients received remission induction under CMCPL-2001 and CMCPL-2005 respectively. In the CMCPL-2001 group, 136 (96%) achieved complete remission while 82 (93%) achieved CR in the CMCPL-2005 group. Patients in the CMCPL-2005 group were more likely to undergo remission induction without experiencing major complications. However, with regards to steroid related toxicities such as infection, no significant differences were noted. Conclusion : We shortened the length of steroid administration from four to three weeks, yet found the remission induction rate to be comparable to that of our previous regimen. However, rates of steroid related toxicities such as infectious complications remain unchanged despite shortened exposure to dexamethasone.

A Study on Findings from Simple Chest Radiographes without Any Clinical Symptoms (임상적 증상이 없는 흉부 단순X선영상 소견에 대한 분석)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.30 no.2
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    • pp.95-104
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    • 2007
  • In this study, the analysis on findings from simple chest radiography(CXR) test with total 1,669 subjects without any special clinical symptom came to the following conclusions : 1. In terms of the general characteristics of subjects hereof, male and female group accounted for 55.2% and 44.8% respectively out of all 1,669 people. 2. Pulmonary disease cases amounted to 249 persons(14.9%) out of all subjects. 3. In the analysis on prevalence rate by age distribution, it was noted that the older age led to the more number of diseases, which was demonstrated by age 34 or younger(6.1%), age $35{\sim}39(9.7%)$, age $40{\sim}49(13.3\;%)$, and age 50 or older(30.8%). 4. In regard of pulmonary disease alone, the region of onset was represented primarily by right upper lobe, which was followed by both upper lobe and left upper lobe, respectively. 5. In terms of disease types, it was found that most cases were represented by pulmonary nodule(55.0%), which was followed by cardiomegaly(24.5%), CP angle blunting(4.8%), scoliosis(4.6%), tortuous aorta(2.8%), bronchial luminal dilatation(2.4%), and pleural thickening(2.0%). However, dextrocardia, cystic dilation of bronchus, cavitary lesion, and lung collapse accounted for relatively low rate(0.4% respectively). 6. In terms of disease types by sex, it was found that male group accounted for higher percentage of having pulmonary nodule than female group, while the latter accounted for higher percentage of having cardiomegaly, tortuous aorta and scoliosis than the former. 7. In terms of disease types by age distribution, it was noted that age 34 or younger group accounted for higher percentage of scoliosis than any other age groups, while age $40{\sim}49$ group, age $35{\sim}39$ group, and age 50 or older group represented the case of CP angle blunting, pulmonary nodule, and cardiomegaly/tortuous aorta, respectively.

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The Effect of Antipsychotic Drug Treatment on Serum VEGF, sVEGFR-1, and sVEGFR-2 Level in Schizophrenia - A Preliminary Study - (정신분열병 환자에서 항정신병약물 치료가 혈청 VEGF, sVEGFR-1 및 sVEGFR-2의 농도에 미치는 영향 - 예 비 연 구 -)

  • Kim, Tae Hyun;Kim, Do Hoon;Lee, Sang Kyu;Son, Bong Ki;Jung, Jun Sub
    • Korean Journal of Biological Psychiatry
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    • v.14 no.4
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    • pp.232-240
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    • 2007
  • Objectives : Vascular endothelial growth factor(VEGF), one of potent cytokines, and its receptors were related with various biological functions and pathological conditions. The purpose of this study was to investigate the changes of serum level of free VEGF, soluble VEGFR-1, and soluble VEGFR-2 after treatment with atypical antipsychotic drug in schizophrenia. Method : The schizophrenic patients were diagnosed with DSM-IV and were prospectively followed up for 4 and 8 weeks. Thirteen schizophrenic patients were evaluated their clinical assessment with serum levels of free VEGF, sVEGFR-1, sVEGFR-2, and positive and negative symptom scale(PANSS) at baseline, 4 weeks, and 8 weeks after treatment with atypical antipsychotic drug. Thirteen normal control subjects were recruited and matched with the patient group by age and sex. Result : The serum level of free VEGF($295.2{\pm}43.7$pg/ml)and sVEGFR-2($8259{\pm}336.7$) at baseline(before treatment) in schizophrenic patients were not significantly different, compared with the control group($199.0{\pm}28.8$ and $8481{\pm}371.9$) respectively. However, the serum level of sVEGFR-1($86.2{\pm}10.3$, p<0.05) was significantly increased in the schizophrenic patients compared with the control group($59.0{\pm}6.4$). After treatment with antipsychotic drug, the serum levels of free VEGF at 4 weeks($338.9{\pm}56.5$) and 8 weeks($309.5{\pm}58.7$) were not significantly, different compared with baseline. But the serum levels of sVEGFR-1 was significantly decreased at 8 weeks ($57.3{\pm}6.3$, p<0.05) after antipsychotic drug treatment. The serum levels of sVEGFR-2 were decreased at 4 weeks ($7761{\pm}403.0$, p<0.05) and 8 weeks($7435{\pm}333.5$, p<0.05) compared with baseline. Conclusion : The decreased serum level of sVEGFR-1 and sVEGFR-2 might be affected by dopaminergic system which was influenced by antipsychotic drug.

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The Vogue about Outwearization of Underwear in a Tendency to the Century-end (세기말 현상으로 본 속옷의 겉옷화 현상)

  • 이상례
    • Journal of the Korean Society of Costume
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    • v.35
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    • pp.325-341
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    • 1997
  • One of the noticeable trends of female wear in 1990s is the Outwearization of Underwear as it is called 'Lingerie look' This trend meaned 'Exposure Fashion' raised splendidly its head to the whole stage of fashion destrying the tradional concept having divided the fashion between outwear and underwear by Madonna an Americal populer singer showed up in front of the audience wearing the corset-dress as a stage custome. This corset-dress which can not be recognised whether it is underwear or outwear has been diffused into the mass as a fashionable trend re-gardless of any reason; therefore discrimi-nation of wear by space by far that is underwear should have the sstandard telling between private and public sector has been gradually tumbled. By the way what has propelled desigers to introduce the style continuously having the underwear motive such as outwear almost as same as underwear or underwear worn on out-wear etc. and has made it a fashion trends? How do we accept this "Ligerie look'fashion" The rearch on vogue of outwearization of underwear started by the questions above can be summarized as the followings The division between the sprit and the ma-terial-economic shrinkage by the collapse of the bubble economy in the late of 20 century and expectation for the next century doubt by changes of international politics dynamics for the next century and increasement of psycho-logical tention by the environmental destruc-tion etc, has been extended to break the sense of value down These frustration of the tra-ditional values and dissatisfaction on the pres-ent have reflected on the fashion pursuing some more sensational style to increase the ex-posure of the body. The revolution of wearing bouncing the con-servatismhas outwardly expressed underwear of the private sector. Therefore the spatial concept of wear which for the public sec-tor has been fallen into pieces and has broken the wall of the concept fixed by outwear on underwear. in addition the stage costome for the popular people like Madonna has not been limited by the specularity any more and has been assimilated with the normal wear on the street to take the distinction for away. The circumstances of the late of 20 century pursuing sensation and making sex commer-cialized have accordance with the outweari-zation of underwear. there it is on the basis of Minimalist's dogmatism has been expressed the maximization of expoure in the pubric space to popularize bra pants(knickers) as outwear. The reaction on the attribute of hiding and shanding has brought 'See-Through fashion' with the transparent materials, The contemporary doubt recalling the mem-ory of the past has sublimated corset which was an instument of toture for women into Romanticism to introduce it to fashion with the development of a new material not to be a tool of any oppression and maltretment any longer. The popularization of outwear like underwear what's more has brought high quality of underwear. There it has called for the variety of materials such as knit demin and velvet etc, and has urged the famous designers to enlarge their working boundaries to underwear designs, Besides outwearization of underwear has been popular even in the Orient which has the con-servative opinions on exposure ; so changes of the thoughts can be seen among the establish-ment generation on exposure of the body. As the more high tech information publi-cized and the more technology and media digitalized the more expression being analog the pursue for the new in fashion with vision never been seen and even though it is imprac-tical the experimental designers have drived the freedom beyond the traditional roles of the previous century. Consequently outwearization of underwear may be viewd as a trial as an expression responded the contemporary background. This trend in my opinion will have been lasted for a while by being proliperlated among lasted for a while by being proliperlated among the pub-lic who has the century-end anxiety and doubt and expectation for the next century.

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Neurochemical Profile Quantification of Regional Adult Mice Brain Using: ex vivo $^1H$ High-Resolution Magic Angle Spinning NMR Spectroscopy (생체 외 조직 고 분해능 Magic Angle Spinning을 이용한 정상 Adult Mice에서의 뇌 부위별 뇌 신경화학 대사물질 정량분석)

  • Lee, Do-Wan;Woo, Dong-Cheol;Lee, Sung-Ho;Kim, Sang-Young;Kim, Goo-Young;Rhim, Hyang-Shuk;Choi, Chi-Bong;Kim, Hwi-Yool;Lee, Chang-Wook;Choe, Bo-Young
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.35-41
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    • 2010
  • The purpose of this study is to quantitate regional neurochemical profile of regional normal adult mice brain and assess regional metabolic differences by using ex vivo $^1H$ high-resolution magic angle spinning nuclear magnetic resonance spectroscopy ($^1H$ HR-MAS NMRS). The animals were matched in sex and age. The collected brain tissue included frontal cortex, temporal cortex, thalamus, and hippocampus. Quantitative 1D spectra were acquired on 40 samples with the CPMG pulse sequence (8 kHz spectral window, TR/TE = 5500/2.2 ms, NEX = 128, scan time: 17 min 20 sec). The mass of brain tissue and $D_2O$+TSP solvent were 8~14 mg and 7~13 mg. A total of 16 metabolites were quantified as follow: Acet, NAA, NAAG, tCr, Cr, tCho, Cho, GPC + PC, mIns, Lac, GABA, Glu, Gln, Tau and Ala. As a results, Acet, Cho, NAA, NAAG and mIns were showed significantly different aspects on frontal cortex, hippocampus, temporal cortex and thalamus respectively. The present study demonstrated that absolute metabolite concentrations were significantly different among four brain regions of adult mice. Our finding might be helpful to investigate brain metabolism of neuro-disease in animal model.