• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.103-109
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• 2008

목 적: 소아에서 식도염은 성인과 달리 나이별로 다양하고, 비특이적인 증상이나 징후를 보인다. 또한 식도염을 진단하기 위한 상부 위장관 내시경과 조직 생검을 시행하는 것도 쉽지 않다. 이에 본 연구에서는 소아에서 식도염의 유병률과 조직 검사의 필요성 및 위험 인자에 대해 알아보고자 하였다. 방 법: 2006년 1월부터 2007년 12월까지 가천의대 길병원 소아과에 내원하여 급만성 상복부 복통을 보인 환자들 266명을 대상으로 문진 및 신체 검사, 상부 위장관 내시경과 함께 식도 및 위 조직 생검을 시행하였다. 식도염의 진단은 조직 검사로 확진 하였으며, H. pylori 감염 여부는 CLO 검사, H&E 염색과 Giemsa 염색 혹은 요소호기검사로 확인하였다. 식도염과 관련된 위험인자 및 내시경 소견과 조직학적 소견의 관련성을 비교분석하였다. 결 과: 상부 내시경과 조직 생검을 시행 환자 266명 중 조직학적 식도염 환자는 전체 266명 중 53명(19.9%)이었으며, 남자 18명(34.0%), 여자 35명(66.0%)으로 평균 나이는 11.6${\pm}$0.87세였다. 내시경 소견의 민감도는 41.5%, 특이도는 77.0%, 양성 예측도 31.0%였다. 조직학적 식도염 환자 중 역류성 식도염은 50명, 호산구성 식도염은 2명, 캔디다 감염증에 의한 식도염은 1명이었다. 모든 연령에서 복통이 가장 흔한 증상으로 나타났으며, 8세 이하 환아들에서 구토가 의미 있게 많았다(p<0.05). 봄에 좀더 많이 내원하는 것으로 나타났으며(OR 2.5, 95% CI 1.2544 to 4.8286), H. pylori 감염군에서 식도염의 가능성이 의미 있게 높게 나타났다(OR 2.5, 95% CI 1.1598 to 4.2798). 결 론: 상부 위장관 증상이 있는 환자에서 상부 위장관 내시경 검사를 시행할 때, 특히 학령 전기 환자에서 구토를 동반한 위장관 증상이 있거나, 봄에 내원시, H. pylori 감염이 있을 경우 식도염의 가능성이 더욱 높으므로 식도 조직 생검을 고려해야 할 것으로 생각된다.

• 센서학회지
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• 제26권1호
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• pp.7-14
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• 2017

A threshold-based fall recognition algorithm using a tri-axial accelerometer and a bi-axial gyroscope mounted on the skin above the upper sternum was proposed to recognize fall-like activities of daily living (ADL) events. The output signals from the tri-axial accelerometer and bi-axial gyroscope were obtained during eight falls and eleven ADL action sequences. The thresholds of signal vector magnitude (SVM_Acc), angular velocity (${\omega}_{res}$), and angular variation (${\theta}_{res}$) were calculated using MATLAB. When the measured values of SVM_Acc, ${\omega}_{res}$, and ${\theta}_{res}$ were compared to the threshold values (TH1, TH2, and TH3), fall-like ADL events could be distinguished from a fall. When SVM_Acc was larger than 2.5 g (TH1), ${\omega}_{res}$ was larger than 1.75 rad/s (TH2), and ${\theta}_{res}$ was larger than 0.385 rad (TH3), eight falls and eleven ADL action sequences were recognized as falls. When at least one of these three conditions was not satisfied, the action sequences were recognized as ADL. Fall-like ADL events such as jogging and jumping up (or down) have posed a problem in distinguishing ADL events from an actual fall. When the measured values of SVM_Acc, ${\omega}_{res}$, and ${\theta}_{res}$ were applied to the sequential processing algorithm proposed in this study, the sensitivity was determined to be 100% for the eight fall action sequences and the specificity was determined to be 100% for the eleven ADL action sequences.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.271-275
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• 2015

Objective : This study was designed to evaluation the diagnostic value of procalcitonin (PCT) in patients with spinal infection, compare to the classical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count. Methods : All patients who were diagnosed as a spinal infection between January, 2013 and July, 2014 were included in this study. Serum PCT, CRP, ESR, and WBC count were checked at initial hospital visit and once a week serially until they were discharged. Patient's medical history, causes and pathogens of spinal infection were reviewed. Results : Total 34 (16 men, 18 women) patients were included in this study. Mean age of the patients was 65.6 year-old. Causes of spinal infection were pain block procedure (14, 41.2%) and post-operation (5, 14.7%). Out of 25 patients who showed elevated initial serum PCT level, 20 patients (80%) had a combined systemic infection. 14 patients (6.7%) had a sepsis, 3 patients (14.2%) had a urinary tract infection and 2 (9.6%) had a pneumonia. 14 patients (41.2%) showed elevation of serum PCT level during treatment. Among them, 9 patients (64.3%) had a combined infection such as sepsis and urinary tract infection. Conclusion : Serum CRP showed more sensitivity compared to serum PCT in patients with spinal infection. Patients with spinal infection who showed elevated serum PCT level should be investigated for combined infection and proper antibiotics should be applied.

• The Korean Journal of Physiology and Pharmacology
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• 제17권1호
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• pp.51-56
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• 2013

Many intracellular proteins and signaling cascades contribute to the sensitivity of N-methyl-D-aspartate receptors (NMDARs). One such putative contributor is the serine/threonine kinase, protein kinase C (PKC). Activation of PKC by phorbol 12-myristate 13-acetate (PMA) causes activation of extracellular signal-regulated kinase (ERK) and promotes the formation of new spines in cultured hippocampal neurons. The purpose of this study was to examine which PKC isoforms are responsible for the PMA-induced augmentation of long-term potentiation (LTP) in the CA1 stratum radiatum of the hippocampus in vitro and verify that this facilitation requires NMDAR activation. We found that PMA enhanced the induction of LTP by a single episode of theta-burst stimulation in a concentration-dependent manner without affecting to magnitude of baseline field excitatory postsynaptic potentials. Facilitation of LTP by PMA (200 nM) was blocked by the nonspecific PKC inhibitor, Ro 31-8220 ($10{\mu}M$); the selective $PKC{\delta}$ inhibitor, rottlerin ($1{\mu}M$); and the $PKC{\varepsilon}$ inhibitor, TAT-${\varepsilon}V1$-2 peptide (500 nM). Moreover, the NMDAR blocker DL-APV ($50{\mu}M$) prevented enhancement of LTP by PMA. Our results suggest that PMA contributes to synaptic plasticity in the nervous system via activation of $PKC{\delta}$ and/or $PKC{\varepsilon}$, and confirm that NMDAR activity is required for this effect.

• Advances in pediatric surgery
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• 제10권2호
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• pp.117-122
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• 2004

Diagnosis of acute appendicitis in children is sometimes difficult. The aim of this study is to validate a clinical scoring system and ultrasonography for the early diagnosis and treatment of appendicitis in childhood. This is a prospective study on 59 children admitted with abdominal pain at St. Mary's Hospital, the Catholic University of Korea from July 2002 to August 2003. We applied Madan Samuel's Pediatric Appendicitis Score (PAS) based on preoperative history, physical examination, laboratory finding and ultrasonography. This study was designed as follows: patients with score 5 or less were observed regardless of the positive ultrasonographic finding, patients with score 6 and 7 were decided according to the ultrasonogram and patients above score 8 were operated in spite of negative ultrasonographic finding. The patients were divided into two groups, appendicitis (group A) and non-appendicitis groups (group B). Group A consisted of 36 cases and Group B, 23 cases. Mean score of group A was 8.75 and group B was 6.13 (p<0.001). Comparing the diagnostic methods in acute appendicitis by surveying sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, PAS gave 1.0000, 0.3043, 0.6923, 1.0000, and 0.7288, and ultrasonography gave 0.7778, 0.9130, 0.9333, 0.7241, and 0.8300 while the combined test gave 1.0000, 0.8696, 0.9231, 1.0000, and 0.9490, respectively. Negative laparotomy rate was 3 %. In conclusion, the combination of PAS and ultrasonography is a more accurate diagnostic tool than either PAS or ultrasonography.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.107-113
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• 2017

Purpose: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. Methods: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. Results: Twenty-four patients (70.6%) were male. The mean age of the patients was $8.5{\pm}6.2$ (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p< 0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. Conclusion: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.96-101
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• 2007

Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

• 치위생과학회지
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• 제17권3호
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• pp.202-208
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• 2017

Korea has been running the community oral health program for the elderly, including topical fluoride application and scaling. The aim of this study was to compare the subjective and objective oral health status of 345 participants according to the number of participants in the program and of 37 participants before and after the 5-year program. The survey consisted of an interview questionnaire and oral examinations. Analysis of variance was used to compare the variables of the 345 participants according to the numbers of participants. Paired t-test was used to compare the oral health statuses before and after the 5-year program in 37 subjects. There was no difference in subjective oral health status according to the number of participants in the oral health program in the elderly, including subjective health status, subjective oral health status, satisfaction with oral health, concern about oral health, need of dental treatment, oral pain, tooth sensitivity, subjective periodontal health, and subjective symptoms of periodontitis. The community periodontal index (CPI) of the 1 time participants was significantly higher than that of 3 times, 4 times or 5 times participants in the upper center, lower left, lower center, and lower right areas. There was a significant improvement in CPI from $2.59{\pm}1.14$ to $1.41{\pm}1.54$ (p<0.001) and positive oral behavioral change (daily tooth brushing frequency from $2.27{\pm}0.73$ to $2.54{\pm}0.90$) before and 5 years after the program. However, the program did not prevent tooth loss as the numbers of the remaining teeth significantly reduced from $23.77{\pm}1.84$ to $21.95{\pm}2.03$ over 5 years. We showed that running the community oral health program for the elderly for more than three years might have positive effects on the periodontal health of participants.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2177-2183
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• 2016

Background: To evaluate the predictive role of a risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Materials and Methods: A total of 408 patients with adnexal masses managed surgically between January 2010 and February 2014 were included. The risk of malignancy indices (RMI) 1, 2, 3 and 4 were calculated using findings for ultrasonography, menopausal status, and CA125 levels. Histopathologic results were the end point. ROC analysis was used for the sensitivity and the specificity of the models. Results: Some 37.6 % of the cases were malignant in the postmenopausal group while 7.9 % were malignant in the premenopausal group. Pelvic pain was the most common complaint, and the majority of the cases were diagnosed at stage 3. The RMI 1, 2, 3 and 4 yielded percentage sensitivities of 76.1, 79.1, 76.1 and 76.1 and specificities of 91.5, 89.1, 90.6, 88.6, respectively. RMI 1 was the most reliable test in the general population according to AUC levels and Kappa statistics. From ROC analysis results of post/premenopausal women, the RMI 1 (cut off: 200) yielded sensitivities of 84.0/60.9 and specificities of 87.7/92.5. With RMI 2 they were 88.6/60.9 and 80.0/91.0, with RMI 3 84.0/60.9 and 87.7/91.8, and with RMI 4 (cut off:400) 81.8/47.8 and 83.6 /44.0. Although test performance of RMI methods were good in a general population and postmenopausal women, the RMI inter-agreement validity was only moderate or fair in premenopausal women. Conclusions: Our study confirms the effectiveness of RMI algorithms in postmenopausal women. However, more sensitive tests are needed for premenopausal women.

• Restorative Dentistry and Endodontics
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• 제35권3호
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• pp.198-210
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• 2010

30% 과산화수소를 함유한 전문가 미백제인 레메화이트(Remewhite, Remedent Inc., Deurle, Belgium)를 시험군 피험자 37명, 시험용 미백제에서 과산화수소를 제외한 동일한 제재를 대조약으로 대조군 피험자 34명에게 1일 3회씩, 2차례에 걸쳐서 시행하였다. 미백의 임상적 안전성은 전기치수검사, 치은염증지수, 지각과민증, 이상반응, 활력징후 등을 통하여 평가하였다. 미백시행 직후, 14주 후, 26주 후에 평가하여 다음과 같은 결론을 얻었다. 30% 과산화수소를 함유한 전문가 미백제를 임상적 적용시에 전기치수검사 결과에서는 미백 전후에 차이가 없었다. 치은염증지수, 지각과민증 평가 결과에서는 시험군에서 다소 경미한 통증 반응이 나타났으나 시간이 지나면서 사라지는 것을 확인하였다. 따라서 30% 과산화수소를 함유한 전문가 미백제를 사용하여 미백시에 임상적 안전성을 확인할 수 있었다.