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Epidemiology and Clinical Manifestations of $Henoch-Sch\"{o}nlein$ Purpura in Children (소아 $Henoch-Sch\"{o}nlein$ 자반증의 역학 및 임상양상)

  • Kim Se-Hun;Lee Chong-Guk
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.166-173
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    • 2003
  • Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.

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Performance Evaluation of Radiochromic Films and Dosimetry CheckTM for Patient-specific QA in Helical Tomotherapy (나선형 토모테라피 방사선치료의 환자별 품질관리를 위한 라디오크로믹 필름 및 Dosimetry CheckTM의 성능평가)

  • Park, Su Yeon;Chae, Moon Ki;Lim, Jun Teak;Kwon, Dong Yeol;Kim, Hak Joon;Chung, Eun Ah;Kim, Jong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.93-109
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    • 2020
  • Purpose: The radiochromic film (Gafchromic EBT3, Ashland Advanced Materials, USA) and 3-dimensional analysis system dosimetry checkTM (DC, MathResolutions, USA) were evaluated for patient-specific quality assurance (QA) of helical tomotherapy. Materials and Methods: Depending on the tumors' positions, three types of targets, which are the abdominal tumor (130.6㎤), retroperitoneal tumor (849.0㎤), and the whole abdominal metastasis tumor (3131.0㎤) applied to the humanoid phantom (Anderson Rando Phantom, USA). We established a total of 12 comparative treatment plans by the four geometric conditions of the beam irradiation, which are the different field widths (FW) of 2.5-cm, 5.0-cm, and pitches of 0.287, 0.43. Ionization measurements (1D) with EBT3 by inserting the cheese phantom (2D) were compared to DC measurements of the 3D dose reconstruction on CT images from beam fluence log information. For the clinical feasibility evaluation of the DC, dose reconstruction has been performed using the same cheese phantom with the EBT3 method. Recalculated dose distributions revealed the dose error information during the actual irradiation on the same CT images quantitatively compared to the treatment plan. The Thread effect, which might appear in the Helical Tomotherapy, was analyzed by ripple amplitude (%). We also performed gamma index analysis (DD: 3mm/ DTA: 3%, pass threshold limit: 95%) for pattern check of the dose distribution. Results: Ripple amplitude measurement resulted in the highest average of 23.1% in the peritoneum tumor. In the radiochromic film analysis, the absolute dose was on average 0.9±0.4%, and gamma index analysis was on average 96.4±2.2% (Passing rate: >95%), which could be limited to the large target sizes such as the whole abdominal metastasis tumor. In the DC analysis with the humanoid phantom for FW of 5.0-cm, the three regions' average was 91.8±6.4% in the 2D and 3D plan. The three planes (axial, coronal, and sagittal) and dose profile could be analyzed with the entire peritoneum tumor and the whole abdominal metastasis target, with planned dose distributions. The dose errors based on the dose-volume histogram in the DC evaluations increased depending on FW and pitch. Conclusion: The DC method could implement a dose error analysis on the 3D patient image data by the measured beam fluence log information only without any dosimetry tools for patient-specific quality assurance. Also, there may be no limit to apply for the tumor location and size; therefore, the DC could be useful in patient-specific QAl during the treatment of Helical Tomotherapy of large and irregular tumors.

Modeling of Estimating Soil Moisture, Evapotranspiration and Yield of Chinese Cabbages from Meteorological Data at Different Growth Stages (기상자료(氣象資料)에 의(依)한 배추 생육시기별(生育時期別) 토양수분(土壤水分), 증발산량(蒸發散量) 및 수량(收量)의 추정모형(推定模型))

  • Im, Jeong-Nam;Yoo, Soon-Ho
    • Korean Journal of Soil Science and Fertilizer
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    • v.21 no.4
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    • pp.386-408
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    • 1988
  • A study was conducted to develop a model for estimating evapotranspiration and yield of Chinese cabbages from meteorological factors from 1981 to 1986 in Suweon, Korea. Lysimeters with water table maintained at 50cm depth were used to measure the potential evapotranspiration and the maximum evapotranspiration in situ. The actual evapotranspiration and the yield were measured in the field plots irrigated with different soil moisture regimes of -0.2, -0.5, and -1.0 bars, respectively. The soil water content throughout the profile was monitored by a neutron moisture depth gauge and the soil water potentials were measured using gypsum block and tensiometer. The fresh weight of Chinese cabbages at harvest was measured as yield. The data collected in situ were analyzed to obtain parameters related to modeling. The results were summarized as followings: 1. The 5-year mean of potential evapotranspiration (PET) gradually increased from 2.38 mm/day in early April to 3.98 mm/day in mid-June, and thereafter, decreased to 1.06 mm/day in mid-November. The estimated PET by Penman, Radiation or Blanney-Criddle methods were overestimated in comparison with the measured PET, while those by Pan-evaporation method were underestimated. The correlation between the estimated and the measured PET, however, showed high significance except for July and August by Blanney-Criddle method, which implied that the coefficients should be adjusted to the Korean conditions. 2. The meteorological factors which showed hgih correlation with the measured PET were temperature, vapour pressure deficit, sunshine hours, solar radiation and pan-evaporation. Several multiple regression equations using meteorological factors were formulated to estimate PET. The equation with pan-evaporation (Eo) was the simplest but highly accurate. PET = 0.712 + 0.705Eo 3. The crop coefficient of Chinese cabbages (Kc), the ratio of the maximum evapotranspiration (ETm) to PET, ranged from 0.5 to 0.7 at early growth stage and from 0.9 to 1.2 at mid and late growth stages. The regression equation with respect to the growth progress degree (G), ranging from 0.0 at transplanting day to 1.0 at the harvesting day, were: $$Kc=0.598+0.959G-0.501G^2$$ for spring cabbages $$Kc=0.402+1.887G-1.432G^2$$ for autumn cabbages 4. The soil factor (Kf), the ratio of the actual evapotranspiration to the maximum evapotranspiration, showed 1.0 when the available soil water fraction (f) was higher than a threshold value (fp) and decreased linearly with decreasing f below fp. The relationships were: Kf=1.0 for $$f{\geq}fp$$ Kf=a+bf for f$$I{\leq}Esm$$ Es = Esm for I > Esm 6. The model for estimating actual evapotranspiration (ETa) was based on the water balance neglecting capillary rise as: ETa=PET. Kc. Kf+Es 7. The model for estimating relative yield (Y/Ym) was selected among the regression equations with the measured ETa as: Y/Ym=a+bln(ETa) The coefficients and b were 0.07 and 0.73 for spring Chinese cabbages and 0.37 and 0.66 for autumn Chinese cabbages, respectively. 8. The estimated ETa and Y/Ym were compared with the measured values to verify the model established above. The estimated ETa showed disparities within 0.29mm/day for spring Chinese cabbages and 0.19mm/day for autumn Chinese cabbages. The average deviation of the estimated relative yield were 0.14 and 0.09, respectively. 9. The deviations between the estimated values by the model and the actual values obtained from three cropping field experiments after the completion of the model calibration were within reasonable confidence range. Therefore, this model was validated to be used in practical purpose.

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Studies on the Morphological, Physical and Chemical Properties of the Korean Forest soil in Relation to the Growth of Korean White Pine and Japanese Larch (한국산림토양의 형태학적 및 이화학적성질과 낙엽송, 잣나무의 성장(成長)에 관한 연구(硏究))

  • Chung, In-Koo
    • Korean Journal of Soil Science and Fertilizer
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    • v.12 no.4
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    • pp.189-213
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    • 1980
  • 1. Aiming at supply of basic informations on tree species siting and forest fertilization by understanding of soil properties that are demanded by each tree species through studies of forest soil's morphological, physical and chemical properties in relation to tree growth in our country, the necessary data have been collected in the last 10 years, are quantified according to quantification theory and are analyzed in accordance with multi-variate analysis. 2. Test species, larch and the Korean white pine, are plantable in extensive areas from mid to north in the temperate zone and are the two most recommended reforestation tree species in Korea. However, their respective site demands are not known and they have been in confusion or considered demanding the same site during reforestation. When the Korean white pine is planted in larch sites, it has shown relatively good growth. But, when larch is planted in the Korean white pine site it can be hardly said that the larch growth is good. To understand on such a difference soil factors have been studied so as to see how the soil's morphological, physical and chemical factors affect tree growth helped with the electronic computer. 3. All the stands examined are man-made mature forests. From 294 larch plots and 259 white pine plots dominant trees are cut as samples and through stem analysis site index is determined. For each site index soil profiles are made in the related forest-land for analysis. Soil samples are taken from each profile horizon and forest-land productivity classification tables are worked out through physical and chemical analysis of the soil samples for each tree species for the study of relationships between physical, chemical and the combined physical/chemical properties of soil and tree growth. 4. In the study of relationships between physical properties of soil and tree growth it is found out that larch growth is influenced by the following factors in the order of deposit form, soil depth, soil moisture, altitude, relief, soil type, depth of A-horizon, soil consistency content of organic matter soil texture bed rock gravel content aspect and slope. For the Korean white pine the influencing factors' order is soil type, soil consistency bed rock aspect depth of A-horizon soil moisture altitude relief deposit form soil depth soil texture gravel content and slope. 5. In the study of relationships between chemical properties of soil and tree growth it is found out that larch growth is influenced by the following factors in the order of base saturation organic matter CaO C/N ratio, effective $P_2O_5$ PH.exchangeable $K_2O$ T-N MgO C E C Total Base and Na. For the Korean white pine the influencing factors' order is effective $P_2O_5$ Total Base T-N Na C/N ratio PH CaO base saturation organic matter exchangeable $K_2O$ C E C and MgO. 6. In the study of relationships between the combined physical and chemical properties of soil and tree growth it is found out that larch growth is influenced by the following factors in the order of soil depth deposit form soil moisture PH relief soil type altitude T-N soil consistency effective $P_2O_5$ soil texture depth of A-horizon Total Base exchangeable $K_2O$ and base saturation. For the Korean white pine the influencing factors' order is soil type soil consistency aspect effective $P_2O_5$ depth of A-horizon exchangeable $K_2O$ soil moisture Total Base altitude soil depth base saturation relief T-N C/N ratio and deposit from. 7. In the multiple regression of forest soil's physical properties larch's correlation coefficient is 0.9272 and for the Korean white pine it is 0.8996. With chemical properties larch has 0.7474 and the Korean white pine has 0.7365. So, the soil's physical properties are found out more closely related with tree growth than chemical properties. However, this seems due to inadequate expression of soil's chemical factors and it is proved that the chemical properties are not less important than the physical properties. In the multiple regression of the combined physical and chemical properties consisting of important morphological and physical factors as well as chemical factors of forest soils larch's multiple correlation coefficient is found out to be 0.9434 and for the Korean white pine it is 0.9103 leading to the highest correlation. 8. As shown in the partial correlation coefficients larch needs deeper soil depth than the Korean white pine and in the deposit form colluvial and creeping soils are demanded by the larch. Adequately moist to too moist should be soil moisture and PH should be from 5.5 to 6.1 for the larch. Demands of T-N soil texture and soil nutrients are higher for the larch than the Korean white pine. Thus, soil depth, deposit form, relief soil moisture PH N altitude and soil texture are good indicators for species sitings with larch and the Korean white pine while soil type and soil consistency are indicative only limitedly of species sitings due to their wide variation as plantation environments. For larch siting soil depth deposit form relief soil moisture PH soil type N and soil texture are indicators of good growth and for Korean white pine they are soil type soil consistency effective $P_2O_5$ and exchangeable $K_2O$, which is demanded more by the Korean white pine than larch generally. 9. Physical properties of soil has been known as affecting tree growth to greatest extent so far. However, as a result of this study it is proved through computer analysis that chemical properties of soil are not less important factors for tree growth than chemical properties and site demands for larch and the Korean white pine that have been uncertain So far could be clarified.

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Analysis on the Relation between the Morphological Physical and Chemical Properties of Forest Soils and the Growth of the Pinus koraiensis Sieb. et Zucc. and Larix leptolepis Gord by Quantification (수량화(數量化)에 의(依)한 우리나라 삼림토양(森林土壤)의 형태학적(形態学的) 및 이화학적(理化学的) 성질(性質)과 잣나무 및 낙엽송(落葉松)의 생장(生長) 상관분석(相關分析))

  • Chung, In Koo
    • Journal of Korean Society of Forest Science
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    • v.53 no.1
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    • pp.1-26
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    • 1981
  • 1. Aiming at supply of basic informations on tree species siting and forest fertilization by understanding of soil properties that are demanded by each tree species through studies of forest soil's morphological, physical and chemical properties in relation to tree growth in our country, the necessary data have been collected in the last 10 years, are quantified according to quantification theory and are analyzed in sccordance with multi-variate analysis. 2. Test species, japanese larch (Larix leptolepis Gord) and the Korean white pine, (pinus koraiensis S et Z.) are plantable in extensive areas from mid to north in the temperate forest zone and are the two most recommended reforestation tree species in Korea. However, their respective site demands are little known and they have been in confusion or considered demanding the same site during reforestation. When the Korean white pine is planted in larch sites, it has shown relatively good growth, but, when Japanese larch is planted in Korean white pine site it can be hardly said that the Japanese Larch growth is good. To understand on such a difference soil factors have been studied so as to see how th soil's morphological, physical and chemical factors affect tree growth helped with the electronic computer. 3. All the stands examined are man-made mature forests. From 294 Japanese larch plots and 259 Korean white pine plots dominant trees are cut as samples and through stem analysis site index is determined. For each site index soil profiles are made in the related forest-land for analysis. Soil samples are taken from each profile horizon and forest-land productivity classification tables are worked out through physical and chemical analyses of the soil samples for each tree species for the study of relationships between physical, chemical and the combined physical/properties of soil and tree growth. 4. In the study of relationships between physical properties of soil and tree growth it is found out that Japanese larch growth is influenced by the following factors in the decreasing order of weight deposit form, soil depth, soil moisture, altitude, relief, soil type, depth a A-horizon, soil consistency, content of organic matter, soil texture, bed rock, gravel content, aspect and slope. For the Korean white pine the influencing factors' order is soil type, soil consistency, bed rock, aspect, depth of A-horizon, soil moisture, altitude, relief, deposit form, soil depth, soil texture, gravel content and slope. 5. In the study of relationships between chemical properties of soil and tree growth it is found out that Japanese larch growth is influenced by the following factors in the order of base saturation, organic matter, CaO, C/N ratio, effective $P_2O_5$, PH, exchangeable, $K_2O$, T-N, MgO, CEC, Total Base and Na. For the Korean white pine the influencing factors' order is effective $P_2O_5$, Total Base, T-N, Na, C/N ratio, PH, CaO, base saturation, organic matter, exchangeable $K_2O$, CEC and MgO. 6. In the study of relationships between the combined physical and chemical properties of soil and tree growth it is found out that Japanese larch growth is influenced by the following factors in the order of soil depth, deposit form, soil moisture, PH, relief, soil type altitude, T-N, soil consistency, effective $P_2O_5$, soil texture, depth of A-horizon, Total Base, exchangeable $K_2O$ and base saturation. For the Korean white pine the influencing factors' order is soil type, soil consistency, aspect, effective $P_2O_5$, depth of A-horizon, exchangeable $K_2O$, soil moisture, Total Base, altitude, soil depth, base saturation, relief, T-N, C/N ratio and deposit form. 7. In the multiple correlation of forest soil's physical properties larch's correlation coefficient for Japanese Larch is 0.9272 and for Korean white pine, 0.8996. With chemical properties larch has 0.7474 and Korean white pine has 0.7365. So, the soil's physical properties are found out more closely related with tree growth than chemical properties. However, this seems due to inadequate expression of soil's chemical factors and it is proved that the chemical properities are not less important than the physical properties. In the multiple correlation of the combined physical and chemical properties consisting of important morphological and physical factors as well as chemical factors of forest soils larch's multiple correlation coefficient is found out to be 0.9434 and for Korean white pine it is 0.9103 leading to the highest correlation. 8. As shown in the partial correlation coefficients Japanese larch needs deeper soil depth than Korean white pine and in the deposit form of colluvial and creeping soils are demanded by the larch. Moderately moist to not moist should be soil moisture and PH should be from 5.5 to 6.1 for the larch. Demands of T-N, soil texture and soil nutrients are higher for the larch than the Korean white pine. Thus, soil depth, deposit form, relief, soil moisture, PH, N, altitude and soil texture are good indicators for species sitings with larch and the Korean white pine while soil type and soil consistency are indicative only limitedly of species sitings due to their wide variations as plantation environments. For the larch siting soil depth, deposit form, relief, soil moisture, pH, soil type, N and soil texture are indicators of good growth and for the Korean white pine they are soil type, soil consistency, effective $P_2O_5$ and exchangeable $K_2O$. In soil nutrients larch has been found out demanding more than the Korean white pine except $K_2O$, which is demanded more by the Korean white pine than Japanese larch generally. 9. Physical properties of soil has been known as affecting tree growth to the greatest extent so far. However, as a result of this study it is proved through computer analysis that chemical properties of soil are not less important factors for tree growth than chemical properties and site demands for the Japanese larch and the Korean white pine that have been uncertain so far could be clarified.

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