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Clinical features of vaccination-associated thrombocytopenic purpura in children (예방접종과 관련된 소아 혈소판 감소 자반병의 임상적 특성)

  • Lee, Wan Soo;Yu, Seung Taek;Shin, Sae Ron;Young Du
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.610-615
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    • 2008
  • Purpose : Idiopathic thrombocytopenic purpura (ITP) is a relatively common hematological disease in children. It generally occurs after exposure to a common viral infection episode; however, it may occasionally follow immunization with measles, measles-mumps-rubella (MMR), hepatitis B (HBV), influenza, diphtheria-tetanus-pertussis (DTP), or chickenpox vaccines. In this study, the incidence, clinical characteristics, and treatment outcome of vaccination-associated ITP were investigated and compared with non-vaccination-associated ITP. Methods : The admission records of 105 pediatric ITP patients between 0-14 years of age admitted to Department of Pediatrics, Wonkwang University Hospital from January 1994 to July 2007 were retrospecitively reviewed. Patients were grouped into a vaccination-associated group and a non-vaccination-associated group according to vaccination history within the previous 1 month, and various clinical features between the two groups were statistically analyzed. Results : Thirteen patients (12%) had a preceding vaccination. Eight had received DTP vaccination, 2 had received hepatitis B, and 1 each had received influenza, MMR, and Japanese B encephalitis vaccination. However, none of the patients had a recurrent thrombocytopenia after subsequent vaccinations. In the vaccination-associated group, the age was significantly lower, anemia was more common, and the risk period with blood platelet count $<20{\times}10^9/L$ was significantly shorter than for the in non-vaccination-associated group. Also, wet purpura was less prominent and the remission within 1month was more frequently achieved in the vaccination-associated ITP group. Conclusion : Vaccination-associated ITP patients showed mild symptoms with a more benign and shorter lasting course than non-vaccination-associated ITP patients. Moreover, platelet count assessment at the time of the next immunization may not be necessary.

The Utilities of Lung Biopsy in Pediatric Lung Disease (소아 폐질환에서 폐생검의 유용성)

  • Lee, Jae Hee;Lee, So Yeon;Kim, Ja Hyung;Kim, Bong Sung;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1230-1234
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    • 2003
  • Purpose : The aim of this study is to evaluate the value of lung biopsies for the management of children with lung disease. Methods : We retrospectively reviewed 19 lung biopsies done at Asan Medical Center, Seoul between 1993 and 2001. Data gathered included demographic information, underlying conditions, diagnosis before biopsy, final diagnosis, change in therapy, morbidity and mortality. Results : Nineteen patients underwent lung biopsy. Among them, 13 patients were male and six patients were female; the median age was 3.6 years(0.8 to 8.6 years). Twelve patients underwent open lung biopsies and seven patients had thoracoscopic biopsies. The overall diagnosis rate was 95 %. The most common diagnosis was interstitial lung disease(12 patients, 64%) and infection was detected in four patients(21%). The biopsy-proven bronchiolitis obliterance was confirmed in two of seven patients suspected by CT findings. Specific treatment was changed after biopsy in 16 patients (85%). The morbidity & overall mortality rates of the patients were 5%(one patient) and 21%(four patients) respectively. Only one complication was seen : empyema. The causes of death were acute respiratory distress syndrome(one patient), respiratory failure(two patients), and septicemia(one patient). Conclusion : The lung biopsy is a safe procedure and it contributes to more accurate diagnosis and proper management of pediatric lung diseases. We recommend lung biopsies should be considered more positively in the diagnosis of pediatric lung diseases.

Analysis of Prognostic Factors in 1,435 Surgically Treated Patients with Gastric Cancer (위암 수술 1,435에의 예후 인자 분석)

  • Seo, Won-Hong;Seo, Byoung-Jo;Yu, Hang-Jong;Lee, Woo-Yong;Lee, Hea-Kyoung
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.143-151
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    • 2009
  • Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

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The Nature of Patient's Disagreement with Doctors among Some Rural Residents (일부 농촌주민에서 의사에 대한 환자의 의견불일치)

  • Lee, Moo-Sik;Cho, Hyong-Won;Kim, Eun-Young;Chun, Byung-Chul;Shin, Dong-Hoon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.315-329
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    • 1999
  • Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

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Analysis of temperature changes and sterilization effect of diode laser for the treatment of peri-implantitis by wavelength and irradiation time (임플란트 주위염 치료용 diode laser의 파장 및 조사시간에 따른 온도 변화와 살균효과 분석)

  • Seol, Jeong-Hwan;Lee, Jun Jae;Kum, Kee-Yeon;Lee, Jong-Ho;Lim, Young-Joon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.178-188
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    • 2017
  • Purpose: We compared the effects of newly developed diode laser (Bison 808 nm Diode laser) on the treatment of peri-implantitis with conventional products (Picasso 810 nm Diode laser) by comparing the surface temperature of titanium disc and bacterial sterilization according to laser power. Materials and Methods: The titanium disc was irradiated for 60 seconds and 1 - 2.5 W using diode laser 808 nm and 810 nm. The surface temperature of the titanium disc was measured using a temperature measurement module and a temperature measurement program. In addition, in order to investigate the sterilizing effect according to the laser power, 808 nm laser was irradiated after application of bacteria to sandblasted large-grit acid-etched (SLA) and resorbable blast media (RBM) coated titanium discs. The irradiated disks were examined with scanning electron microscopy. Results: Both 808 nm and 810 nm lasers increased disk surface temperature as the power increased. When the 810 nm was irradiated under all conditions, the initial temperature rise rate, the descending rate, and the temperature change before and after was higher than that of 808 nm. Disk surface changes were not observed on both lasers at all conditions. Bacteria were irradiated with 808 nm, and the bactericidal effect was increased as the power increased. Conclusion: When applying these diode lasers to the treatment of peri-implantitis, 808 nm which have a bactericidal effect with less temperature fluctuation in the same power conditions would be considered safer. However, in order to apply a laser treatment in the dental clinical field, various safety and reliability should be secured.

The effect of alendronates administration duration on the healing of extraction socket in rats: pilot study (알렌드로네이트의 투여기간이 발치와의 치유에 미치는 영향: 예비실험)

  • Kim, Jee-Hwan;Hong, Jong-Hwan;Choi, Hyun-Min;Park, Young-Bum;Moon, Hong-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.3
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    • pp.175-182
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    • 2013
  • Purpose: The purpose of this study was to investigate the effect of different administration duration of alendronate on initial wound healing and new bone formation of extraction socket in rats. Materials and methods: Fifteen male Sprague-Dawley rats (body weight 130-140 g, 4 weeks old, male) were divided into control group (no alendronate administration) and experimental group (alendronate administration). Experimental group was subdivided into 1 week administrated group, 2 week administrated group, 4 week administrated group and 6 week administrated group according to duration of administration. For the experimental groups, during the designated time period (at the time of extraction, 1 week before extraction, 3 week before extraction and 5 week before extraction) till 1 week after extraction, rats were subcutaneously injected with Alendronate at the dose of 1.0 mg/Kg three times a week. Each specimen from 6 week experimental group and control group were used for microarray analysis, and other specimens were used for histological analysis. The rate of new bone formation within the extraction site and bone loss activity was analyzed using TRAP staining. Statistical analysis was performed using Kruskal Wallis test. (${\alpha}=.05$) Results: After one week from the time of extraction, the rate of new bone formation within extraction site for the control group ($16.77%{\pm}1.36%$) compared to the 4 week experimental group ($14.99%{\pm}6.26%$) was lower. However, no statistically significant difference was found. Increase in the number of inactive lacuna (empty lacuna) and decrease in the number of TRAP positive cell were identified with increased duration of administration. There was no significant difference. Conclusion: The results of this study showed as the duration of Alendronate administration increased the rate of new bone formation decreased with loss of bone activity and reduced number of osteoclast.

An Analysis of the Use of Media Materials in School Health Education and Related Factors in Korea (학과보건교육에서의 매체활용실태 및 영향요인 분석)

  • Kim, Young-Im;Jung, Hye-Sun;Ahn, Ji-Young;Park, Jung-Young;Park, Eun-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.2
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    • pp.207-215
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    • 1999
  • The objectives of this study are to explain the use of media materials in school health education with other related factors in elementary, middle, and high schools in Korea. The data were collected by questionnaires from June to September in 1998. The number of subjects were 294 school nurses. The PC-SAS program was used for statistical analysis such as percent distribution, chi-squared test, spearman correlation test, and logistic regression. The use of media materials in health education has become extremely common. Unfortunately, much of the early materials were of poor production quality, reflected low levels of interest, and generally did little to enhance health education programming. A recent trend in media materials is a move away from the fact filled production to a more affective, process-oriented approach. There is an obvious need for health educators to use high-quality, polished productions in order to counteract the same levels of quality used by commercial agencies that often promote "unhealthy" lifestyles. Health educators need to be aware of the advantages and disadvantages of the various forms of media. Selecting media materials should be based on more than cost, availability, and personal preference. Selection should be based on the goal of achieving behavioral objectives formulated before the review process begins. The decision to use no media materials rather than something of dubious quality usually be the right decision. Poor-quality, outdated, or boring materials will usually have a detrimental effect on the presentation. Media materials should be viewed as vehicles to enhance learning, not products that will stand in isolation. Process of materials is an essential part of the educational process. The major results were as follows : 1. The elementary schools used the materials more frequently. But the production rate of media materials was not enough. The budget was too small for a wide use of media materials in school health education. These findings suggest that all schools have to increase the budget of health education programs. 2. Computers offer an incredibly diverse set of possibilities for use in health education, ranging from complicated statistical analysis to elementary-school-level health education games. But the use rate of this material was not high. The development of related software is essential. Health educators would be well advised to develop a basic operating knowledge of media equipment. 3. In this study, the most effective materials were films in elementary school and videotapes in middle and high school. Film tends to be a more emotive medium than videotape. The difficulties of media selection involved the small amount of extant educational materials. Media selection is a multifaceted process and should be based on a combination of sound principles. 4. The review of material use following student levels showed that the more the contents were various, the more the use rate was high. 5. Health education videotapes and overhead projectors proved the most plentiful and widest media tools. The information depicted was more likely to be current. As a means to display both text and graphic information, this instructional medium has proven to be both effective and enduring. 6. An analysis of how effective the quality of school nurse and school use of media materials shows a result that is not complete (p=0.1113). But, the budget of health education is a significant variable. The increase of the budget therefore is essential to effective use of media materials. From these results it is recommended that various media materials be developed and be wide used.

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The Change of Cell Distribution in the lung and the Expression Pattern of IL-4 and IL-10 in Asthma Induced Mouse (천식유발 마우스에서의 폐 내 세포조성 변화와 IL-4 및 IL-10의 발현 양상)

  • Lee, Soo-Jin;Park, Se-Jong;Li, Tian-Zhu;Jang, Yang-Ho;Choe, Nong-Hoon
    • Journal of Life Science
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    • v.16 no.5
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    • pp.780-787
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    • 2006
  • Asthma is a chronic inflammatory disorder of the airways, which characterized by bronchial hyperresponsiveness, reversible airflow limitation and respiratory symptoms. Internationally, the prevalence of asthma has been increased over last 3 decades. Recently, several studies of asthma have been reported with gradually increasing importance. To tesify the hypothesis that interleukin (IL)-4 and IL-10 may be an important determinant of the severity of airway inflammation, their expression was studied in mouse model of asthma. BALB/c mouse, IL-4 Knockout (KO) mouse and IL-10 KO mouse were sensitized with intraperitoneal injection of ovalbumin adsorbed to aluminum potassium sulfate, followed by challenges with intranasal ovalbumin on 3 consecutive days. The severity of pulmonary inflammation was assessed by eosinophilia in BAL fluid, number of total BAL cells, histopathological changes in lung tissues, and immunohistochemical staining against IL-4 and IL-10. In BAL fluid, the number of total cells was significantly increased in asthma induced mouse compare to the control. In asthma induced mouse, eosinophil was increased to 56% and neutrophil was 0.2%. In H &E stains, eosinophilic infiltration and epithelium hyperplasia were clearly noticed in asthma induced mouse. In immunohistochemical staining for IL-4 and IL-10, there was no positive reaction in control group. However, very strong reactions were appeared in asthma induced group. In this research, IL-4 and IL-10, which seem to play a central role in allergic asthma, KO mouse was utilized to test the causative relationship between airway inflammation and role of specific cytokine. Asthma induced IL-4 and IL-10 KO mice showed much decreased inflammatory reactions in the number of total BAL cells, in eosinophilic infiltration, and in immunohistochemical stains against diverse inflammatory proteins. These results suggest that IL-4 and IL-10 increase the asthmatic reactions in vivo mice model.

Comparison of Collimator Choice on Image Quality of I-131 in SPECT/CT (I-131 SPECT/CT 검사의 에서 조준기 종류에 따른 영상 비교 평가)

  • Kim, Jung Yul;Kim, Joo Yeon;Nam-Koong, Hyuk;Kang, Chun Goo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.33-42
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    • 2014
  • Purpose: I-131 scan using High Energy (HE) collimator is generally used. While, Medium Energy (ME) collimator is not suggested to use in result of an excessive septal penetration effects, it is used to improve the sensitivities of count rate on lower dose of I-131. This research aims to evaluate I-131 SPECT/CT image quality using by HE and ME collimator and also find out the possibility of ME collimator clinical application. Materials and Methods: ME and HE collimator are substituted as Siemens symbia T16 SPECT/CT, using I-131 point source and NEMA NU-2 IQ phantom. Single Energy Window (SEW) and Triple Energy Windows (TEW) are applied for image acquisition and images with CTAC and Scatter correction application or not, applied different number of iteration and sub set are reconstructed by IR method, flash 3D. By analysis of acquired image, the comparison on sensitivities, contrast, noise and aspect ratio of two collimators are able to be evaluated. Results: ME Collimator is ahead of HE collimator in terms of sensitivity (ME collimator: 188.18 cps/MBq, HE collimator: 46.31 cps/MBq). For contrast, reconstruction image used by HE collimator with TEW, 16 subset 8 iteration applied CTAC is shown the highest contrast (TCQI=190.64). In same condition, ME collimator has lower contrast than HE collimator (TCQI=66.05). The lowest aspect ratio for ME collimator and HE collimator are 1.065 with SEW, CTAC (+) and 1.024 with TEW, CTAC (+) respectively. Conclusion: Selecting a proper collimator is important factor for image quality. This research finding tells that HE collimator, which is generally used for I-131 scan emitted high energy ${\gamma}$-ray is the most recommendable collimator for image quality. However, ME collimator is also applicable in condition of lower dose, lower sensitive if utilizing energy window, matrix size, IR parameter, CTAC and scatter correction appropriately.

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Analysis of consumers' needs and satisfaction related to food culture in Jeonju Hanok Village: Application of the Push-Pull factor theory (전주 한옥마을 음식문화에 대한 소비자 요구도 및 만족도 분석 : Push-Pull factor theory를 적용하여)

  • Na, Hee Ra;Park, Eun Ju;Yang, Soo Jin;Cha, Youn-Soo;Lee, Min A
    • Journal of Nutrition and Health
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    • v.50 no.2
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    • pp.192-200
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    • 2017
  • Purpose: The purposes of this study were to analyze visitors' food needs and identify the Push-Pull factor in Jeonju Hanok Village. Methods: A questionnaire was developed based on previous research to survey Korean adults who visited Jeonju city. A total of 580 questionnaires were used for the analysis. Results: Most of the subjects who visited Jeonju Hanok Village had food purchase experiences in Jeonju Hanok Village (96.4%). 'Traditional Korean food (26.5%)' was the most purchased food, followed by 'foreign food (25.8%)' and 'Korean food combined with foreign food (16.8%)'. Satisfaction of food purchases (3.35 points) was higher than average. The primary reason for satisfaction was 'the food is delicious (23.0%)', and the reason for dissatisfaction was 'the food is expensive (48.1%)'. In the push and pull factor analysis for identifying visit motivation, 'local food seeking', 'experience seeking', 'relaxation seeking', and 'friendship seeking' were push factors while 'traditional culture', 'facility convenience', 'experience activity', and 'food experience' were pull factors. There was a significant correlation between the push and pull factors. Regression analysis showed that all push factors influenced satisfaction. However, among pull factors, only 'food experience' and 'traditional culture' influenced satisfaction. Conclusion: In conclusion, this study indicates that food-related factors are destination characteristics (Pull factor) influencing intrinsic visit motivation (Push factor) and satisfaction. It is necessary to develop various food tourism products to satisfy visitors' needs and continuous visits in Jeonju Hanok Village. This study suggests the importance of research on food factors and provides useful basic data to establish positioning strategies for food cultural development in Jeonju Hanok Village.