• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.904-909
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• 2009

Purpose : The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. Methods : We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. Results : There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. Conclusion : It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.1
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• pp.30-39
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• 1999

Purpose: Anorectal manometry is a way of investigation for ano-rectal sphincters. In this paper we evaluated the usefulness of anorectal manometry in constipation patients and compared the anal spnincter function in control, constipation and encopresis patients Methods: We analysed the data of anorectal function studies in normal children (control, n=11), children with constipation (constipation group, n=20) and children with encopresis (encopresis group, n=16). Results: The specific manometric parameters in normal children were like as follows; external anal sphinter pressure $21.0{\pm}8.00$ mmHg, internal anal sphicter pressure $30.0{\pm}14.57$ mmHg, conscious rectal sensitivity threshold $11.4{\pm}4.52$ mmHg. The above results were not different from that of previous studies except conscious rectal sensitivity threshold, which was slightly lower than that of others. Internal and external anal sphincter pressure were elevated significanlty in constipation and encopresis groups than in control, which results was the same in conscious rectal sensitivity threshold. But the values of rectoanal inhibitory threshold and percent relaxation of rectoanal inhibitory reflex were not different among control group, constipation group and encopresis group. External sphincter activity was increased during the act of bearing down for defecation in none of the child in control group, in 6 of 17 children in constipation group and 5 of 12 children in encopresis group. Conclusion: With the results of above we could say that complete history taking and physical examination are important in diagnosis of constipation, and we could say also that the anorectal manometry was a valuable tool to understand the physiology of normal defecation and the pathophysiology of constipation and encopresis.

• The Journal of the Korean Society for Microbiology
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• v.17 no.1
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• pp.21-34
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• 1982

One hundred and twenty-one strains each of Escherichia coli isolated from stools of 60 patients who received various antimicrobial drugs in hospital for more than one week and apparently healthy 60 students who have no history of taking antimicrobial drugs during recent one month, were tested for their resistance to 13 antimicrobial drugs. The frequency of resistance strains was highest to tetracycline with 69.2%, and followed by streptomycin(Sm), sulfisomidine(Su), chloramphenicol(Cm), ampicillin(Ap), and carbenicillin(Cb) in the decreasing order, ranging from 61.2% to 39.3%. Strains resistant to kanamycin(Km), cephaloridine(Cr), and trimethoprim(Tp) occupied about one-fourth of strains, and only four strains were resistant either one or more of nalidixic acid, gentamicin and amikacin, and no strain was resistant to rifampicin. The frequency of resistant strains to Cm, Ap, Km, Cr, and Cb was much higher among patient isolates than student strains, but strains resistant to the other drugs showed almost the same frequencies between patient and student isolates. There was a marked difference in average minimum inhibitory concentrations of between resistant and susceptible strains, suggesting that the resistance to drugs is the plasmid origin. Seventy-six percent of strains were resistant to one to 10 drugs tested, and no much difference was observed between strains from patients and students. However, strains resistant to four or more drugs were much more frequently found among patient isolates than student strains, with the increasing tendency of multiply resistant strains among patient isolates following the increase in the number of resistant drugs. The transfer of drug resistance by conjugation was tested and 98 strains(67.5%) among 145 which were resistant to two or more drugs were found to transfer their drug resistance to E. coli. Among 74 strains resistant to 7 or more drugs, all except one transferred the resistance, and the number of strains with transferable resistance decreased, as the number of resistant drugs decrease. A R plasmid from randomly selected p13 strain was tested for the incompatibility group, and the plasmid was classified into Inc F II. R plasmM DNA bands were identified by polyacrylamide gel electrophoresis.

• The Korean Journal of Malacology
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• v.24 no.3
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• pp.253-260
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• 2008

A total of 15 different residues of polycyclic aromatic hydrocarbons (PAHs) in each 20 samples of Pacific oysters, dried laver and rockfish obtained from seafood markets were analyzed. The prevalence of samples in which more than one PAH residues were found was 75% in oyster, 35% in rock fish hepatopancreas, 0% in rockfish muscle and laver, respectively. To estimate factors contributing to this residue level difference among organisms, tissue concentrations were analyzed after exposing three organisms to phenanthrene, a representative PAH, with concentration of 0.01 or $0.1{\mu}g/mL$ for 2 weeks. Phenanthrene levels after exposure were higher in the oyster digestive gland, laver and rockfish hepatopancreas, but were lower in the oyster whole meat or rockfish muscle. This finding disproved that any close relationship between the residue difference of market samples and concentrating properties of PAHs. The second possible factor analyzed was total lipid contents in the three organisms. Although higher lipid level in hepatopancreas of rockfish may contribute accumulation of PAH residues in the rockfish, lipid factor did not affect to PAH levels in other organism samples. Activity of 7-ethyoxyresorufin-O-deethylase (EROD), a kind of cytochrome $P_{450}$ enzyme, was measured to evaluate the eliminated amount of PAHs through metabolism. The higher EROD activity in rockfish, compared to that in oyster, was likely to contribute to the lower PAH residues in the rockfish. More factors, such as different exposure history, organisms' ability to escape, ingestion through prey organisms, and post-harvest loss, should be studied in the future.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.455-459
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• 2012

Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.

• Journal of Radiation Protection and Research
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• v.22 no.4
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• pp.227-235
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• 1997

Cytogenetic studies were performed in peripheral blood lymphocytes from hospital workers occupationally exposed to low doses of radiation (0.30 - 40.07mSv). The workers were divided into three groups according to their job area : 18 diagnostic radiology, 17 therapeutic radiology, and 16 nuclear medicine. The control group consisted of 49 non-radiation workers with no history of exposure to radiation. A higher percentage of cells with aberration(1.275%) was observed in the workers compared to the controls(0.677%) and the difference was statistically significant(p<0.001). The frequency of chromosomal aberration was $0.706{\times}10^{-2}$/cell in the exposed and $0.344{\times}10^{-2}$/cell in the control(p<0.05). Chromosomal exchange frequency was $0.083{\times}10^{-2}$/cell in the control vs $0.245{\times}10^{-2}$/cell in the workers. There was no evidence of significant increase of chromosome aberration related to age or to the duration of employment. The frequency of chromosomal exchange in workers of nuclear medicine was $0.313{\times}10^{-2}$/cell, which was significantly higher than in the control($0.083{\times}10^{-2}$/cell) or other working groups: therapeutic radiology($0.265{\times}10^{-2}$/cell), and diagnostic radiology($0.167{\times}10^{-2}$/cell). No dose-effect relation was found between chromosome aberration and total cumulative doses, recent 5 yr, recent 2 yr cumulative dose. But in case of last 1 yr cumulative dose, dose-dependant increase was observed when controls were considered(p<0.05). The radiation dose which workers have received was much lower than the maximum permissible dose, but there was a significant difference in the frequency of chromosome aberration between occupationally exposed workers and control. So, it is clear that chromosome aberration is a quite sensitive indicator of radiation exposure and it can be detected at very low dose level of occupational exposure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.194-203
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• 1999

Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.87-100
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• 2011

Objectives: This study aimed to identify factors associated with smoking relapse. Methods: The study sample was recruited among subjects who were enrolled in the smoking cessation clinic of a public health center and had succeeded in quitting smoking for at least six months. A total of 159 male subjects were followed via mail survey one year later. The independent variables in the analyses were socio-demographic characteristics, smoking history and behavior, receipt of smoking cessation aids, health behaviors and components of the health belief model (HBM). The dependent variable was smoking relapse assessed one year after quitting. Ordered logit regressions were used to identify factors associated with smoking relapse. Results: The relapse rate of the ex-smokers in our sample was 25.8%, and the occasional smoking rate was 17.0%. Univariate analyses revealed that only factors related to the HBM, such as perceived susceptibility to diseases (p<0.01), perceived severity of diseases (p<0.01), perceived health benefits of not smoking (p<0.01), perceived barriers to quitting smoking due to increasing stress and difficulty in social life (p<0.01), and self-efficacy (p<0.01) were associated with the likelihood of relapse for ex-smokers. Ordered logit analyses yielded two significant factors affecting the likelihood of relapse, the perceived barriers to quitting smoking and self-efficacy. Conclusions: Our results indicate that higher levels of barriers to quitting smoking and lower levels of self-efficacy were significantly related to risk of smoking relapse. These findings may be useful for identifying those at highest risk for relapse and choosing the optimal strategies for prevention of relapse for ex-smokers.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.489-497
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• 2002

Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

• Sleep Medicine and Psychophysiology
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• v.19 no.1
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• pp.27-34
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• 2012

Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.