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Clinical Analysis of Infantile Hypertrophic Pyloric Stenosis (영아 비후성 유문 협착증의 임상적 분석)

  • Huh, Young-Soo;Lim, Myeung-Kook;Kim, Kyu-Rak
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.39-47
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    • 1998
  • Infantile hypertrophic pyloric stensosis(IHPS) occurs in three of 1000 live births, and is a major cause of nonbilious vomiting of early infancy. It's etiology and pathogenesis however are still obscure. The operation of pyloromyotomy described by Ramstedt in 1912 remains the standard treatment. From January 1990 to July 1997, 64 infants with IHPS were treated at the Department of Pediatric Sursery, Yeungnam University Hospital. The ratio of male to female was 7:1, and the most prevalent age ranged from 2 weeks to 8 weeks(81.2 %) of age. Fifty-seven infants were first born (57.8 percent). The body weight of all patients at admission was below the 50 percentile. Age of onset of symptoms was between 2 and 4weeks of age in 23 cases(35.9 %). All infants had a history of nonbilious vomting, generally projectile in nature. Hypokalemia was noted in 14 cases(21.9 %) and hypochloremia in 26 cases(40.6 %). In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.3 mm, 12.3 mm, and 17.8 mm. A total of 13 associated anomalies were noted in 12 patients. All cases were treated with Fredet-Ramstedt pyloromyotomy. Postoperative wound infection occured in 3 cases. Thirteen cases(20.3 %) presented intermittent nonprojectile vomiting after operation. With control of oral intake vomiting subsided within one week in 63 patients, and in thirteen days in another.

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The clinical Characteristics of Mycoplasmal Pneumonia in Adults (성인 Mycoplasma 폐렴의 임상적 특성)

  • Kim, Jin-Ho;Moon, Doo-Seop;Lee, Dong-Suck;Park, Ik-Soo;Lee, Kyeung-Sang;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.175-183
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    • 1995
  • Background: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. Method: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 and a single cold agglutinin titer of $\geq$ 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 or a single cold agglutinin titer of $\geq$ 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. Results: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(${\geq}38.9^{\circ}C$) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. Conclusion: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.

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The Clinical Study of Lung Cancer in Patients Younger than 40 Years of Age (약년자 폐암의 임상적 연구)

  • Kim, Geun-Hwa;Park, Hee-Sun;Kim, Myeng-Hoon;Kang, Dong-Won;Lee, Gyu-Seung;Ko, Dong-Seok;Suh, Jae-Chul;Jeong, Seong-Su;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.748-756
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    • 2000
  • Background : Bronchogenic carcinoma is generally considered as a disease that predominantly affects middleaged and elderly men. A small percentage of patients with lung cancer are diagnosed in the third or fourth decade of life or earlier. The current study was performed to review the clinical characteristics of bronchogenic carcinoma in patients younger than 40 years of age at Chungnam National University Hospital. Method : To determine the clinicopathologic characteristics including survival rates of lung cancer patients younger than 40 years of age and to compare them with those of patients 이der than 40 years of age at diagnosis, data of 905 patients diagnosed as lung cancer from January. 1990 to Marm 1997 were analyzed. Result : Twenty-three of 905 patients(2.5%) belonged to the young age group (less than 40 years). Male to female ratios of young age group and control group were 2.8 : 1 and 5.3 : 1, respectively. The mean duration of symptoms from onset to the definite diagnosis was 3.2 months in the young age group. The most common initial symptoms in the young age group were cough(52.2%) and dyspnea(43.5%). Adenocarcinoma (43.5%) was more frequent in the young age group than in the control group(20.1%). Stage III and IV(70%) tumors were more frequent in the young age group than in the control group(52.3%). Distant metastasis rate of the young age group(56.5%) was higher than that of the control group(22.3%). Conclusion : The predominance of adenocarcinoma, the lower male-female ratio, and the high incidence of advanced stage tumor at diagnosis are the characteristics of lung cancer in patients younger than 40 years of age.

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Depression and Coronary Artery Disease(I) : Pathophysiologic Mechanisms (우울증과 관상동맥 질환(I) : 병태생리적 기전)

  • Bae, Kyung-Yeol;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.275-287
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    • 2008
  • Depression and coronary artery disease are both highly prevalent diseases. Many previous studies suggest that depression is a common comorbid condition in patients with coronary artery disease and has a significant negative impact on the onset, course, and prognosis of coronary artery disease. However, the exact mechanisms that underlie the association between these two diseases remain unclear. Pathophysiologic mechanisms that may explain the effect of depression on coronary artery disease include hypercoagulability, hypothalamus-pituitary-adrenal axis and autonomic nervous system dysregulation, altered inflammatory response. On the contrary, pathophysiologic mechanisms in coronary artery disease that affect depression are less well known. It is also suggested that both diseases may share a common genetic vulnerability. The authors reviewed the literature on the pathophysiologic relationships of depression and coronary heart disease.

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A Study on Degree of Daily Living Activities among Women with Osteoarthritis (여성 골관절염 환자의 일상생활 수행능력)

  • Yang, Kyeong-Ra;Rhee, Seon-Ja
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.57-71
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    • 1998
  • This study purports to examine sociodemographic characteristics and those factors associated with osteoarthritis in women experiencing the disease in order to make suggestions for the prevention and management of osteoarthritis in women. The subjects were 143 women who were diagnosed to have osteoarthritis and under follow-up care at an outpatient department of a university-affiliated hospital. The data were collected through personal interviews by using the structured questionnaire between October 6 and October 24, 1997. The degree of daily living activities was measured with 24 items, which were made based upon Katz Index, Barthel Index and Functional Status Index. Each item has 4 response categories : (1) being able to do alone with any difficulty, (2) being able to do alone with some difficulty, (3) being able to do alone with the help of a person or an instrument, (4) not being able to do at all. The data was analyzed with correlation analysis, t-test, ANOVA, and regression analysis. The results are summarized as follows : 1. As for the age of the subjects, 59.4% were between 45 and 64 years, while 28% were 65 years and above. The subjects having religion were 71.7% and 44.1% of the subjects were protestants. The educational level was low : 31.5% graduated from elementary school, while 30.1% had no formal education. Those married subjects were 72%. Fifty nine percent of the subjects evaluated their economic status as middle class. 2. Those people from whom the subjects currently receive some help were spouses in 35.8% of the subjects. Likewise, 50% of the subjects indicated spouse as the people from whom they want to receive help. 3. The score of the ability of daily living activities ranged between 48 and 96, with the mean of 78.94. Those means of physical activity, ADL(activities of daily living) and IADL(instrumental activities of daily living) were 14.89, 13.97 and 50.09, respectively. Except for the items of carrying heavy stuff and of washing clothes in the sitting position the subjects showed independence in more than 90% of the items, where Independence is defined as being able to do alone or with the help of a person or an instrument. 4. The increase in age was a significant predictor of the decrease in the ability of daily living activities. Those graduated from middle school and above showed a significantly higher degree in the ability of daily living activities than those with less educational level. The married women revealed significantly higher scores in physical activity, ADL, and IADL than the unmarried ones. The ability of daily living activities was not significantly related to having religion, economic status and living with family. 5. The average duration of experiencing osteoarthritis was 4 years and 7 months. Regarding the site of the onset, 65% of the subjects indicated knees. The women with osteoarthritis for less than 3 years were 65%. The ability of daily living activities was significantly different by the duration of illness : the longer the duration of illness, the less the ability of activities. The above findings suggest the need for developing those programs for prevention disabilities in performing daily living activities and for managing diseases targeting the women of middle and old age, with low educational level, and with unmarried status. In addition, there should be developed an instrument for measuring the ability of daily living activities which reflects daily lives of Korean women with osteoarthritis in order to examine comprehensive effects of osteoarthritis on women's daily lives in this country.

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Influence of histologic chorioamnionitis and funisitis on the level of peripheral blood C-reactive protein at birth in preterm infants (조산아에서 조직학적 융모양막염 및 제대 혈관염이 출생 직후 말초 혈액 C-반응성 단백의 농도에 미치는 영향)

  • Kim, Do-Hyun;Lee, Heun Ji;Kim, Hee Sup;Yoo, Byoung Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.33-40
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    • 2010
  • Purpose : The objective of this study is to determine the change of C-reactive protein (CRP) levels in the peripheral blood of preterm infants at birth according to the stage of intrauterine inflammation. Methods : A total of 187 infants (<32 weeks of gestation) were divided into a "no histologic chorioamnionitis" [HCAM (-), n=85] group and a "histologic chorioamnionitis" [HCAM (+), n=102] group according to placental pathologic findings. Furthermore, the HCAM (+) group was subdivided into a "funisitis" [F (+), n=49] group and a "no funisitis" [F (-), n=53] group and also into a "funisitis/amnionitis" [FA (+), n=58] group and an "isolated chorio-deciduitis" [FA (-), n=44] group. High-sensitivity CRP levels in the peripheral blood at birth were measured.Results : Peripheral blood CRP levels were significantly higher in the HCAM (+), F (+), F (-), and FA (+) groups than in the HCAM (-) group, but were not significantly different between the FA (-) and HCAM (-) groups. In addition, peripheral blood CRP levels were significantly higher in the F (+) and FA (+) groups than in the F (-) and FA (-) groups, respectively. For identification of amnionitis or funisitis, a cut-off value of 0.02 mg/dL was chosen. Clinical chorioamnionitis, proven early onset sepsis, histologic chorioamnionitis, and funisitis had higher incidences in infants with peripheral blood CRP levels higher than 0.02 mg/dL. Conclusion : The present study shows that peripheral blood CRP levels at birth in preterm infants born before 32 weeks' gestation is significantly increased in amnionitis or funisitis and might reflect the progress of histologic chorioamnionitis.

Antithrombin-III as an early prognostic factor in children with acute lung injury (급성 폐손상 소아 환자에서 조기 예후 인자로서의 antithrombin-III)

  • Lee, Young Seung;Kim, Seonguk;Kang, Eun Kyeong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.443-448
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    • 2007
  • Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

The Relationship of between Anxiety Tendency and Recurrent Abdominal Pain in Elementary School Children (학동기 소아에서 반복성 재발성 복통과 불안 성향과의 관련성)

  • Moon, Ji-Young;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.129-137
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    • 2007
  • Purpose: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. Methods: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). Results: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. Conclusion: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.

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Study on the Physical Properties of the Gamma Beam-Irradiated Teflon-FEP and PET Film (Teflon-FEP 와 PET Film 의 감마선 조사에 따른 물리적 특성에 관한 연구)

  • 김성훈;김영진;이명자;전하정;이병용
    • Progress in Medical Physics
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    • v.9 no.1
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    • pp.11-21
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    • 1998
  • Circular metal electrodes were vacuum-deposited with chromium on the both sides of Teflon-FEP and PET film characteristic of electret and the physical properties of the two polymers were observed during an irradiation by gamma-ray from $\^$60/Co. With the onset of irradiation of output 25.0 cGy/min the induced current increased rapidly for 2 sec, reached a maximum, and subsequently decreased. A steady-state induced current was reached about in 60 second. The dielectric constant and conductivity of Teflon-FEP were changed from 2.15 to 18.0 and from l${\times}$l0$\^$-17/ to 1.57${\times}$10$\^$-13/ $\Omega$-$\^$-1/cm$\^$-1/, respectively. For PET the dielectric constant was changed from 3 to 18.3 and the conductivity from 10$\^$-17/ to 1.65${\times}$10$\^$-13/ $\Omega$-$\^$-1/cm$\^$-1/. The increase of the radiation-induced steady state current I$\^$c/, permittivity $\varepsilon$ and conductivity $\sigma$ with output(4.0 cGy/min, 8.5 cGy/min, 15.6 cGy/min, 19.3 cGy/min) was observed. A series of independent measurements were also performed to evaluate reproducibility and revealed less than 1% deviation in a day and 3% deviation in a long term. Charge and current showed the dependence on the interval between measurements, the smaller the interval was, the bigger the difference between initial reading and next reading was. At least in 20 minutes of next reading reached an initial value. It may indicate that the polymers were exhibiting an electret state for a while. These results can be explained by the internal polarization associated with the production of electron-hole pairs by secondary electrons, the change of conductivity and the equilibrium due to recombination etc. Heating to the sample made the reading value increase in a short time, it may be interpreted that the internal polarization was released due to heating and it contributed the number of charge carriers to increase when the samples was again irradiated. The linearity and reproducibility of the samples with the applied voltage and absorbed dose and a large amount of charge measured per unit volume compared with the other chambers give the feasibility of a radiation detector and make it possible to reduce the volume of a detector.

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Physicochemical Properties of Brown Rice Flours Produced under Different Drying and Milling Conditions (제조조건에 따른 현미쌀가루 품질특성)

  • Park, Jong-Dae;Choi, Bong-Kyu;Kum, Jun-Seok;Lee, Hyun-You
    • Korean Journal of Food Science and Technology
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    • v.38 no.4
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    • pp.495-500
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    • 2006
  • The physicochemical properties of brown rice flours produced under different drying and milling conditions were investigated. Moisture contents of hot-air dried, microwave dried and zet-milled brown rice flours (BrWZH) were 10.7%,13.7% and 8.0%-8.6%, respectively. Water absorption indices (WAI) and water soluble indices (WSI) of roll-milled brown rice flours (BrWRH) were lower (0.40-0.59 g/g; 0.7-3.0%) than those of zet-milled brown rice flours (0.58-0.79 g/g; 4.0-7.3%). Zet-milled brown rice flours had higher Hunter L values and more damaged starch (94.1-96.8; 28.2%) compared to roll-milled brown rice flours (91.3-91.9: 15.5%). The percentage of damaged starch and L values of brown rice flours increased as particle size of brown rice flours decreased. Roll-milled polished rice flour (Control) had the highest L value and lowest amount of damaged starch (97.1; 8.2%). Control, BrWRH, BrWZH, and ultrafine brown rice flour (HBrZMU) had peak viscosity values of 321, 255, 221, and 162 RVU, respectively and trough viscosity values of 217, 185, 175, and 113 RVU, respectively. Peak and trough viscosity (Rapid Visco Analyzer; RVA) properties of rice floors decreased as the particle size of rice flours decreased. HBrZMU demonstrated a higher onset temperature $(61.1^{\circ}C)$ compared to control $(54.8^{\circ}C)$ by differential scanning calorimetric (DSC). Crystal melting enthalpy $({\Delta}H)$ of control and brown rice flours were 10.4 J/g and 6.1-8.7 J/g, respectively. Results of this study suggested that physicochemical properties of brown rice flours were closely related to their particle size.