• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권4호
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• pp.251-257
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• 2015

Objectives : We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods : The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results : Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion : Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

• IMMUNE NETWORK
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• 제7권2호
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• pp.75-79
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• 2007

Background: Defective or immature antibody responses to pathogens in children may explain the increased susceptibility to acute otitis media. However, there is no study in Korea patients whether a correlation exists between otitis media with effusion and the levels of serum immunoglobulins, IgG subclasses, IgA, IgM and IgE. Methods: 45 children with otitis media with effusion more than 4 episodes in 12 months or 3 episodes in 6 months, 62 children with otitis media with effusion less than 3 episodes in 12 months and 102 children for control group took part in the study at the Department of Otorhinolaryngology of the KyungHee University from May 2004 to Feburary 2007. Serum immunoglobulin levels were determined by nephelometry. And then the relationship between otitis media with effusion and serum immunoglobulin level was evaluated. Results: In otitis media prone group, serum IgG1, IgG2, IgG4, and IgA level was lower than those level of control group, it was significantly decreased (p<0.05). In otitis media group, serum IgA, IgE, and IgG4 level was lower than those level of control. But it was not statistically significant (p>0.05). Conclusion: Lower immunoglobulins in children with otitis media with effusion suggest a generalized decreased antibody responses. Lower levels of serum IgG1, IgG2, IgG4, and IgA may be related with chronicity or intractability of otitis media with effusion.

• IMMUNE NETWORK
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• 제8권2호
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• pp.59-65
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• 2008

Background: Toll-like receptors (TLRs) detect microbial infection and can directly induce innate host defense responses, which are thought to play critical roles in protecting the tubotympanum from infection. However, little is known about the relationship between TLRs, which are related to innate immunity, and immunoglobulins, which are related to adaptive immunity, in recurrent otitis media with effusion (OME). We therefore investigated the expression of TLR2 and TLR4 and immunoglobulin in children with OME. Methods: The study population consisted of 72 children with OME, 31 with more than 4 episodes in 12 months or more than 3 episodes in 6 months (otitis-prone group), and 41 with fewer than 3 episodes in 12 months (non-otitis prone group). The expression in middle ear effusion of TLR2 and TLR4 mRNA, as determined by Real time- -polymerase chain reaction (RT-PCR), and the concentrations of IgG, IgA, and IgM, as determined by Enzyme-linked immunosorbent assay(ELISA), were compared between the two groups. Results: Expression of TLR2 and TLR4 mRNA was lower in the otitis prone than in the non-otitis prone group, but the difference was not statistically significant (p>0.05). Between group differences in the concentrations of IgG, IgA and IgM in effusion fluid were not significant (p>0.05), and there were no correlations between immunoglobulin concentration and the expression of TLR2 and TLR4. Conclusion: Although there was a trend toward lower expression of TLR2 and TLR4 in the otitis-prone group, the differences, and those in immunoglobulin concentration, did not differ significantly between the otitis-prone and non-prone groups.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.147-152
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• 2008

Objectives : Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Methods : Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. Results : The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the non-fluoridated cities. Conclusions : We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

• 한국대기환경학회지
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• 제22권5호
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• pp.627-641
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• 2006

Atmospheric $PM_{2.5}$ and $PM_{10}$ were measured to investigate their levels and water-soluble ions(${SO_4}^{2-},\;{NO_3}^-,\;{NO_2}^-,\;Cl^-,\;{NH_4}^+,\;Na^+,\;Ca^{2+},\;Mg^{2+},\;and\;K^+$) in Daegu between February 17 and April 18, 2006. Four Asian dust episodes during the period were examined for the influence of Asian dust on the particulate properties. Daily $PM_{2.5}\;and\;PM_{2.5-10}$ concentrations ranged between $10.83{\sim}136.76{\mu}g/m^3$ with a mean of $38.43{\mu}g/m^3$ and $16.13{\sim}409.13{\mu}g/m^3$ with a mean of $79.98{\mu}g/m^3$, respectively. For all measured ions the mean fractions of $PM_{2.5}\;and\;PM_{2.5-10}$ were 51.8% and 28.9% being lowered to 30.7% and 9.4%, respectively, during the dust episodes. Secondary ions (i.e., non-sea salt ${SO_4}^{2-},\;{NO_3}^-,\;and\;{NH_4}^+$) contributed 44.3% and 14.8% to $PM_{2.5}\;and\;PM_{2.5-10}$, respectively, with a decreased contribution during the episodes. The average equivalent ratio of ${NH_4}^+$ to the sum of ${SO_4}^{2-}\;and\;{NO_3}^-$ was 0.99 and 0.89 for $PM_{2.5}\;and\;PM_{2.5-10}$, respectively, indicating high source strength of $NH_3$ and its dominance in the neutralization of the acidic ions. Correlations and charge balance between ions suggest that neutralization of the acidic ions results in substantial depletions of carbonate both in $PM_{2.5}\;and\;PM_{2.5-10}$ and chloride only in $PM_{2.5}$.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권1호
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• pp.12-19
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• 2016

Purpose: This study was performed to evaluate the quality of sleep in snoring obese children without obstructive sleep apnea (OSA); and to study the possible relationship between sleep interruption and gastroesophageal reflux (GER) in snoring obese children. Methods: Study subjects included 13 snoring obese children who were referred to our sleep lab for possible sleep-disordered breathing. Patients underwent multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography. Exclusion criteria included history of fundoplication, cystic fibrosis, and infants under the age of 2 years. Significant association between arousals and awakenings with previous reflux were defined by symptom-association probability using 2-minute intervals. Results: Sleep efficiency ranged from 67-97% (median 81%). A total of 111 reflux episodes (90% acidic) were detected during sleep, but there were more episodes per hour during awake periods after sleep onset than during sleep (median 2.3 vs. 0.6, p=0.04). There were 279 total awakenings during the sleep study; 56 (20.1%) of them in 9 patients (69.2%) were preceded by reflux episodes (55 acid, 1 non-acid). In 5 patients (38.5%), awakenings were significantly associated with reflux. Conclusion: The data suggest that acid GER causes sleep interruptions in obese children who have symptoms of snoring or restless sleep and without evidence of OSA.

• 근관절건강학회지
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• 제14권2호
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• pp.181-187
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• 2007

Purpose: The purpose of the study was to identify the relationship between obesity and bone mineral density in middle aged women. Methods: A cross-sectional survey design was utilized with a check list and physiological measurements. A total of 827 convenient samples were recruited from women who lived in the community. Bone mineral density was measured by T-score using the pixi method of Lumar on the left heel. Descriptive statistics and pearson correlation coefficient were utilized for data analysis. Results: Most were assessed as having normal weight(37.9%) or obese (57.4%) by BMI. Only 32% was assessed as having normal bone mineral density, while 40.3% had osteopenia, and 27.7% as osteoporosis. The BMI scores were significantly related to age, and episodes of fractures. Those with lower bone mineral density reported significantly more episodes of fractures and chronic disease. The T scores of Bone mineral density were significantly correlated with the scores of BMI (r= .126, p< .001). Conclusion: There is a strong need to develop intervention programs for this age group to manage bone mineral density loss to prevent occurrences of osteoporosis, and episodes of fracture.

• Neonatal Medicine
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• 제28권1호
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• pp.14-21
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• 2021

Purpose: Premature infants have immature respiratory control and cerebral autoregulation. We aimed to investigate changes in cerebral oxygenation during apnea with and without peripheral oxygen desaturation in premature infants. Methods: This prospective observational study was conducted at Inha University Hospital. Near-infrared spectroscopy (NIRS)-monitored regional cerebral oxygen saturation (rScO₂) and pulse oximeter-monitored peripheral oxygen saturation (SpO₂) were assessed during the first week of life in 16 stable, spontaneously breathing preterm infants. Apneic episodes that lasted for ≥20 seconds or were accompanied by desaturation or bradycardia were included for analysis. The average rScO₂ value during the 5-minute prior to apnea (baseline), the lowest rScO₂ value following apnea (nadir), the time to recover to baseline (recovery time), the area under the curve (AUC), and the overshoot above the baseline after recovery were analyzed. Results: The median gestational age and birth weight of the infants were 29.2 weeks (interquartile range [IQR], 28.5 to 30.5) and 1,130 g (IQR, 985 to 1,245), respectively. A total of 73 apneic episodes were recorded at a median postnatal age of 2 days (IQR, 1 to 4). The rScO₂ decreased significantly following apneic episodes regardless accompanied desaturation. There were no differences in baseline, nadir, or overshoot rScO₂ between the two groups. However, the rScO₂ AUC for apnea with desaturation was significantly higher than that for apnea without desaturation. Conclusion: Cerebral oxygenation can significantly decrease during apnea, especially when accompanied by reduced SpO₂. These results add the evidence for the clinical utility of NIRS in monitoring premature infants.

• Korean Circulation Journal
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• 제54권3호
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• pp.140-153
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• 2024

Background and Objectives: Although a single-lead electrocardiogram (ECG) patch may provide advantages for detecting arrhythmias in outpatient settings owing to user convenience, its comparative effectiveness for real-time telemonitoring in inpatient settings remains unclear. We aimed to compare a novel telemonitoring system using a single-lead ECG patch with a conventional telemonitoring system in an inpatient setting. Methods: This was a single-center, prospective cohort study. Patients admitted to the cardiology unit for arrhythmia treatment who required a wireless ECG telemonitoring system were enrolled. A single-lead ECG patch and conventional telemetry were applied simultaneously in hospitalized patients for over 24 hours for real-time telemonitoring. The basic ECG parameters, arrhythmia episodes, and signal loss or noise were compared between the 2 systems. Results: Eighty participants (mean age 62±10 years, 76.3% male) were enrolled. The three most common indications for ECG telemonitoring were atrial fibrillation (66.3%), sick sinus syndrome (12.5%), and atrioventricular block (10.0%). The intra-class correlation coefficients for detecting the number of total beats, atrial and ventricular premature complexes, maximal, average, and minimal heart rates, and pauses were all over 0.9 with p values for reliability <0.001. Compared to a conventional system, a novel system demonstrated significantly lower signal noise (median 0.3% [0.1-1.6%] vs. 2.4% [1.4-3.7%], p<0.001) and fewer episodes of signal loss (median 22 [2-53] vs. 64 [22-112] episodes, p=0.002). Conclusions: The novel telemonitoring system using a single-lead ECG patch offers performance comparable to that of a conventional system while significantly reducing signal loss and noise.

• 한국지구과학회지
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• 제31권6호
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• pp.600-607
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• 2010

2008년 동아시아 대륙에서 발생기원이 다른 먼지(황사)와 인위적 오염입자의 광역적 이동 사례를 NOAA위성 RGB 합성영상과 지상 입경별 분진(TSP, $PM_{10}$, $PM_{2.5}$)의 질량농도 관측으로 분석하였다. 또한 Terra/Aqua 위성 MODIS(Moderate resolution Imaging Spectroradiometer) 센서의 AOD(Aerosol Optical Depth)와 FW(Fine aerosol Weighting)를 통해 동아시아 지역에서 발생기원이 다른 대기 에어로졸의 분포와 입자 크기 특성을 분석하였다. 중국 북부와 몽골, 그리고 중국 황토고원에서 모래폭풍이 발생하여 광역적으로 이동하여 청원에 먼지입자(황사)로 영향을 주는 6 개의 사례분석을 실시하였다. 질량농도 TSP중 $PM_{10}$은 70%, $PM_{2.5}$는 16%로 조대입자(> $2.5\;{\mu}m$)의 비율이 큰 것은 사막과 반사막의 자연적 발생원에서 생성되었기 때문이다. 그러나, 모래 폭풍이 이동 과정에서 중국 동부의 산업 지역을 거쳐 유입하는 사례에서는 TSP 중 $PM_{2.5}$가 23%까지 증가하기도 했다. 중국 동부로부터 황해를 거쳐 한반도로 유입한 5개 다른 사례의 경우, TSP 중 $PM_{10}$, $PM_{2.5}$가 각각 82, 65%로 나타났다. 이와 같이 $PM_{2.5}$의 상대적 비율이 증가한 것은 인위적 오염입자의 영향 때문이다. 동아시아 지역에서 인위적 오염입자의 광역적 이동 사례에 대한 평균 AOD는 $0.42{\pm}0.17$로 황사에 의한 AOD($0.36{\pm}0.13$)와 비교하여 대기 에어로졸에 대한 비율이 높게 나타났다. 특히, 중국 동부에서 황해, 한반도, 동해에 이르는 광역적 지역에 AOD값이 높게 분포했다. 인위적 오염입자의 사례는 FW가 평균 $0.63{\pm}0.16$로 모래폭풍의 이동 사례의 $0.52{\pm}0.13$ 보다 높은 값을 보였다. 이는 대기 에어로졸에 대한 인위적 미세 오염 입자의 기여도가 클 수 있음을 제시하고 있다.