• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.136-142
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• 2002

Purpose: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. Methods: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. Results: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. Conclusion: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.154-162
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• 2011

Purpose : The aim of this study was to identify the clinical characteristics of lower respiratory tract infection due to respiratory syncytial virus (RSV) in young children and to provide information for an effective guideline for palivizumab administration in Korea. Methods : We reviewed medical charts of 167 patients under 3 years of age who were hospitalized in Dongguk University Ilsan Hospital for lower respiratory tract infection between January 2007 and February 2011. Diagnosis of the virus was made based on the multiplex real time polymerase chain reaction. Results : There were 113 patients who were infected by respiratory syncytial virus. 90 patients were term infants and 23 patients were preterm infants. No difference was shown between term and preterm infants except the days of admission which was 9.0${\pm}$6.0 days and 12.6${\pm}$21.0 days respectively. In the preterm group their mean age at the time of admission was 5.21${\pm}$4.9 months and the mean gestational age was 33.1${\pm}$4.3 weeks, and the mean birth weight was 2,152${\pm}$950 g. Only 4 patients were born under 28 weeks gestational age and were candidates for palivizumab administration. Conclusion : Most of the patients with severe RSV lower respiratory tract infection were term or near term infants who were not candidates for palivizumab prophylaxis. A nationwide study is needed to make a new risk stratified guideline for RSV prophylaxis for our country.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.71-78
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• 2017

Purpose: The aim of this study was to identify the pathogens of blood stream infection (BSI) in children with hemato-oncologic disorders, to analyze susceptibility patterns of microorganisms to guide empirical antimicrobial therapy, and to compare temporal trends of the pathogen and antimicrobial susceptibility with those of previous studies. Methods: We retrospectively analyzed the medical records of children with hemato-oncologic disorders whose blood culture grew pathogens at the Seoul National University Children's Hospital between 2011 and 2015. Results: A total of 167 patients developed 221 episodes of bacteremia. Among 229 pathogens, gram-negative bacteria (GNB) accounted for 69.0% (64.0% in 2002 to 2005, 63.4% in 2006 to 2010); gram-positive bacteria (GPB) accounted for 28.8% (31.3% in 2002 to 2005, 34.6% in 2006 to 2010); and fungus accounted for 2.2%. Among GNB, Klebsiella species (53.2%, 84/158) and Escherichia coli (19.6%, 31/158) were common. Staphylococcus aureus (48.5%, 32/66) and viridans streptococci (21.2%, 14/66) were frequently isolated among GPB. The susceptibilities of oxacillin and vancomycin in GPB were 54.8% and 96.9% (51.5% and 95.5% in 2002 to 2005; 34.1% and 90.5% in 2006 to 2010), respectively, whereas in GNB, the susceptibilities of cefotaxime, piperacillin/tazobactam, and imipenem were 73.2%, 77.2%, and 92.6% (75.9%, 82.8%, and 93.4% in 2002 to 2005; 62.8%, 82.9%, 93.8% and in 2006 to 2010), respectively. There were no significant differences in the proportion of etiologic agents or the antimicrobial susceptibilities between the current study and that of the previous two studies from 2002 to 2010. Overall fatality rate was 13.1%. Conclusions: GNB predominated in BSI among children with hemato-oncologic disorders. The etiology of bacteremia and antimicrobial susceptibility were comparable to those of the previous studies. Thus, piperacillin/tazobactam can be used as the initial empirical antimicrobial agent in febrile neutropenia.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.150-156
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• 2003

Purpose : Efforts to predict the clinicopathological outcome of IgA nephropathy have been made but have yielded conflicting results and have not helped in deciding the appropriate timing of the renal biopsy. In this study, we reviewed the predictive factors of clinicopathological outcome for finding out the criteria of renal biopsy timing of IgA nephropathy. Methods : Forty children diagnosed with biopsy proven IgA nephropathy at Wonju Christian Hospital were studied retrospectively, based on medical records. Results : Among 39 patients, 2 children progressed to higher serum creatinine level. One of them reached to the end stage renal disease within 2 year 7 months. According to WHO histopathological classification, there were 15 cases of class I, 14 cases of class II, 7 cases of class III, and 3 cases of class IV. In the mild histological classes(class I, II), gross hematuria was shown in 23 out of 29 children(P=0.02). In the severe histological classes(class III, IV), gross hematuria was noted in 4 out of 10(P>0.05). The tubulointerstitial changes were grade 1 in 24 cases, grade 2 in 4 cases, grade 3 in 8 cases, and grade 4 in 3 cases. With an increase in the tubulointerstitial grade, the 24 hour urine protein/albumin ratio increased. Serum creatinine less than 0.79 mg/dL could predict the lower grade(grade 1 and 2) of tubulointerstitial changes. But serum creatinine greater than 1.13 mg/dL could predict the higher grade(grade 3 and 4) of tubulointerstitial changes. In children with gross hematuria(n=27), serum creatinine was lower(0.78 vs 1.09 mg/dL, P=0.027), serum IgA was higher(316.3 vs 198.8 mg/dL), and the cases of lower WHO classification(I and II) were more common(23 vs 4, P=0.029) than the children with microscopic hematuria. Conclusion : Serum creatinine less than 0.79 mg/dL, macroscopic hematuria, and higher 24 hour urine protein/albumin ratio would predict the lower grade glomerulo tubulointerstitial lesion in IgA nephropathy and could be used as the criteria delaying the renal biopsy.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.73-78
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• 2013

Purpose: We aimed to investigate the clinical characteristics and associated diseases in children with a horseshoe kidney and compared these data between children and adults. Method: We performed a retrospective analysis of the medical records and radiological findings of 43 patients diagnosed with a horseshoe kidney in the Busan Paik Hospital. The subjects were divided into the children's group (14 cases, age <18 years) and the adult group (29 cases, age ${\geq}18$ years). Results: The study group consisted of 17 males and 26 females with a median age of 34 years. In the children's group (14 cases), 5 subjects were male and 9 were female, with a mean age of $6.7{\pm}6.2$ years. Most of the subjects were asymptomatic and were incidentally diagnosed with horseshoe kidney during their evaluation for another disease. Among the associated diseases in the children's group, Turner syndrome was the most common (5 cases), whereas ureteropelvic junction (UPJ) stricture was observed in 2 cases (14.2%). None of the children exhibited abnormal renal function during the follow-up period. In the adult group (29 cases), 12 subjects were male and 17 were female, with a mean age of 48 years. Eighteen patients were incidentally diagnosed with horseshoe kidney during their evaluation for another disease, and 11 patients had hematuria or abdominal pain due to renal stones. Among the associated diseases in the adult group, Turner syndrome was the most common (5 cases), and UPJ stricture was observed in 5 cases; the other accompanying diseases included hydronephrosis and overactive bladder. Six patients exhibited decreased renal function (serum creatinine level >1.5) during the follow-up period. Conclusion: Horseshoe kidney is usually diagnosed incidentally in both children and adults. In the present study, we noted that Turner syndrome was the most common associated disease in children. In addition, most children were asymptomatic but had a high risk of urologic complications after the transition to adulthood. Therefore, children with horseshoe kidney require continuous follow-up.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.64-71
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• 2007

Purpose : The purpose of this study was to evaluate the clinical utility of rapid detection of Down syndrome and Edward syndrome by Interphase Fluorescence in Situ Hybridization (FISH) analysis. Methods : Aretrospective study in 309 cases of amniotic fluid samples, analysed by interphase FISH with DNA probes specific to chromosome 18 and 21, was performed. All FISH results w ere compared with conventional cytogenetic karyotypings. Results : The results were considered as informative and they were obtained within 48 hrs. A case of Down syndrome and a case of Edward syndrome were diagnosed by FISH and confirmed by subsequent cytogenetic analysis. In 12 cases with normal FISH results, the cytogenetic analysis showed a case of partial trisomy 22, three cases of sex chromosomal aneuploidy, two cases of mosaicism, two cases of microdeletion, and four cases of structural rearrangement. Conclusion : FISH is a rapid and effective diagnostic method, which can be used as an adjunctive test to cytogenetic analysis, for prenatal identification of chromosome aneuploidies. For the more genome-wide screening with variety of probes, the technique of FISH is both expensive and labor-intensive.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.11 no.3
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• pp.190-197
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• 2001

Noise-induced hearing loss(NIHL) was the highest rate (43.5%~58.5% from 1996 to 1998) of positive findings through specific medical program in Korea. There were much more NIHL at workers of automobile manufacturing factories than other manufacturing factories. The specific aim of the present study was to determine the noise exposure of automobile press lines, according to their job titles, press line types(auto, semiauto), dosimeter parameters setting. There were a total 11 press lines sampled at a automobile manufacturing company. Among those press lines, 10 press lines were autolines with acoustic enclosure, one semiauto press line was no aucostic enclosure Noise exposure data were sampled for an work shift using noise dosimeter, which recorded both time-weighted average(TWA) and 1-min average. The mean OSHA TWA(Korea TWA with threshold 90) was $80.7dB(A){\pm}4.7dB(A)$ for leader, $82.8dB(A{\pm}4.5dB(A)$ for pallette man, $76.7dB(A){\pm}4.3dB(A)$ for press operators, $76.6dB(A){\pm}5.6dB(A)$ for crane operators, $77.1dB(A){\pm}2.8dB(A)$ for forklift drivers, whereas the mean NIOSH TWA was $88.9dB(A){\pm}1.7dB(A)$ for leader, $89.6dB(A){\pm}2.1dB(A)$ for pallette man, $86.7dB(A){\pm}1.8dB(A)$ for press operators, $88.5dB(A){\pm}2.0dB(A)$ for crane operators, $87.7dB(A){\pm}1.0dB(A)$ for forklift drivers. While L10 for NIOSH TWA samples was 84.8 dB(A) ~ 87.3 dB(A), L10 for OSHA TWA samples was 69.5 dB(A) ~ 77.4 dB(A). L10 means that the TWA for 90% of the samples exceeded L10. Among OSHA TWA(Korea TWA with threshold 90) samples for pallette man, 7.7 % exceeded 90 dB(A), the OSHA permissible exposure level, but OSHA TWA samples for the other job titles didn't. Among NIOSH TWA samples, the samples over 85 dB(A), the NIOSH recommended exposure limit, was 100% (leaders), 83.3 %(operators), 97.4%(palletteman), 100%(forklift drivers), 91.7 %(crane operator). The results of One-way random effects analysis of variance models shows that the difference between job titles was significant by OSHA TWA(p<0.05), but not significant by NIOSH TWA(p>0.05). NIOSH TWA samples were significantly higher than OSHA TWA samples(P<0.05). Regression analysis was used to obtain relationships between OSHA TWA samples and NIOSH TWA samples. In this case the coefficient of determination = 0.90, which shows the high degree association between two methods. Regression equation, NIOSH TWA = 0.552 * OSHA TWA + 42.13 dB(A), shows that if OSHA TWA is known, NIOSH TWA can be predicted by the equation. The mean TWA difference between threshold 80 dBA and 90 dBA was significant(p<0.01). While the TWA noise exposures were 7.7% above the Korea(OSHA) PEL, they were more than 83.3% over NIOSH REL. Automobile workers were exposed to noise level that could be potentially damaging to their hearing. It found that there is approximately 25% excess risk of hearing loss even if a worker is protected to the PEL in according to NIOSH study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.11
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• pp.4985-4994
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• 2011

The purpose of this study was to investigate the level of knowledge, health belief and sick role behavior, and the influencing factors on them among the patients with coronary artery disease. The study subjects were 168 patients diagnosed as having coronary artery disease at a university hospital during the period from July 1st, to August 31th, 2010. As a results, Based on the mean scores of knowledge about coronary artery disease according to the general characteristics, they were significantly higher in males than in females(p=0.033). The mean scores of health belief were significantly higher according to age decrease(p=0.043). The mean scores of sick role behaviors were significantly higher in females than in males(p=0.006), with their increasing tendency in the age range from 40's to 60's and decreasing tendency in the age over 70's(p=0.015), the group with religion were significantly higher than the one without(p=0.050). In terms of the mean scores of knowledge and sick role behaviors about coronary artery disease according to the related characteristics, there was a significant difference with the time period elapsed after diagnosed as coronary artery disease, frequency of admissions, perception about the disease, information gathering through mass com. but in terms of those of health belief, there was a not significant difference in all the variables. The significantly influencing factors on degree of knowledge by multivariate regression analysis included degree of perception about a disease, scores of sick role behavior, presence of coronary artery diseases in a family or friends, and the time period elapsed after diagnosed as having coronary artery disease. Those on health belief included age and scores of sick role behavior, and those on sick role behaviors included score of knowledge, perception about a disease, age, BMI, and religion. The results showed a significant difference with their general characteristics or coronary artery disease-related factors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.11
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• pp.4346-4353
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• 2010

The purpose of this study was to estimate the cervical range of motion and the effects of massage and static stretching in their 20s of normal adult. One hundred participants(massage=50, stretching=50) with no musculoskeletal and nervous system problems volunteered for this study. Massage and static stretching were applied to sternocleidomstoid, scalenes, trapezius, semispinalis, splenius, suboccipital, multifidi and rotatores. Both groups received intervention for 3 times in a week. The time the intervention was applied was for 10minutes. Effleurage, petrissage and stripping technique was applied to massage group and static stretching technique was applied to stretching group. The cervical range of motion (CROM) instrument was used to measure eight cervical motions (suboccipital flexion, suboccipital extension, neck flexion and extension, and left and right lateral flexion, left and right rotation). As a result of making a statistical analysis of the data, the following findings were given: First, normal cervical range of motion revealed; suboccipital flexion($2.39^{\circ}$) and extension($38.36^{\circ}$), flexion($54.11^{\circ}$) and extension($69.39^{\circ}$), lateral flexion on left($43.50^{\circ}$) and right($41.28^{\circ}$), rotation on left($66.39^{\circ}$) and right($65.94^{\circ}$) in male and suboccipital flexion($5.14^{\circ}$) and extension($36.47^{\circ}$), flexion($55.92^{\circ}$) and extension($71.22^{\circ}$), lateral flexion on left($43.34^{\circ}$) and right($41.06^{\circ}$), rotation on left($69.38^{\circ}$) and right($68.63^{\circ}$) in female. Second, women had greater range of motions than men in suboccipital flexion, left and right rotation(p<0.05). Third, it showed significantly increasing cervical range of motion in all directions within groups following treatments but not between groups(p<0.05). Our results suggest that massage and static stretching are an appropriate intervention to increase cervical range of motion by muscle relaxation and stretching and may be provided a basis for future studies investigating the cervical range of motion.

• Journal of Nutrition and Health
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• v.31 no.7
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• pp.1139-1150
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• 1998

The purpose of this study is to investigate the effects of the silkworm powder on blood levels of glucose, Hb Alc, insulin, and lipids. Thirty-one NIDDM patients from Kyung Hee Medical Center were divided into two groups : patients with silkworm powder supplements and drug treatments(Drug diabetes) and patients with silkworm powder supplement only(Non-drug diabetes). For the control group, age-matched subjects were recruited. During the 4 weeks of the experimental period, silkworm powder(500mg/mea1) was given to the subjects right after each meal. Nutritional assessments and dietary education were carried out periodically, and body weight and blood pressure were measured when patients visited the hospital. Overnight fasting and 2-h postprandial blood glucose levels were measured at 2 week intervals. The blood levels of insulin, Hb Alc, and lipids were measured before and after the supplements. The mean ages of the three groups were 56.7-59.6 years old. The height, weight, and BMI did not differ among the groups. The fasting blood glucose levels were 138.1$\pm$22.0mg/dl for the Drug treated diabetes group, 175.0$\pm$32.0mg/dl for the Non-drug diabetes group, and 108. 3$\pm$16.gmg/dl for the control group at the begining of the supplement. After 4-wks of supplements, the blood levels of glucose tended to decrease in all three experimental groups. Before the supplements, the 2-h postprandial blood glucose levels of the Drug diabetes, Non drug diabetes, and control groups were 244.7$\pm$62.6mg/dl, 272.4$\pm$40.1mg/dl, and 147.7$\pm$28.0mg/dl, respectively. After the supplement, the levels were 197.2$\pm$30.gmg/dl, 208.6$\pm$ 56.6mg/dl, and 151.3$\pm$30.3mg/dl, respectively. This shows that silkworm powder tended to lower blood levels by 19.4% and 23.4% in NIDDM patient groups. However, the changes in the blood levels of insulin, Hb Alc, ind lipids were not observed after the supplement. In conclusion, the present study has demonstrated that silkworm powder has a tendency to decrease 2-h postprandial blood glucose levels, but it should be used with caution in controlling the diabetes. (Korean J Nutrition 31(7) 1139-1150, 1998)