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Urinary Excretion of Various Urinary Proteins in Children with Vesicoureteral Reflux (방광요관 역류증 환아에서의 다양한 요단백의 배설)

  • Jung, Da Eun;Koo, Ja Wook
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.977-982
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    • 2003
  • Purpose : This study aimed to examine the excretion of various urinary proteins in children with a history of urinary tract infection(UTI), with or without vesicoureteral reflux(VUR) or reflux nephropathy, and to identify means of predicting the severity of VUR or the presence of reflux nephropathy as indicated by these markers, and to know how these markers are changed after resolution of VUR. Methods : We studied 30 children with previous UTI, without VUR and renal scarring(group I), 12 children with VUR, without evidence of renal scarring(group II), and 34 children with VUR and renal scarring(group III). 24-hour or 12-hour urine ${\beta}_2$ microglobulin(${\beta}_2$ MG), microalbumin and N-acetyl-${\beta}$-D-glucosaminidase(NAG) were measured in each child. Urinary protein excretions were analyzed according to the degree of VUR(mild VUR : a grade reflux I-III, severe VUR : a grade reflux IV-V). Cases of bilateral VUR were graded by the higher grade of reflux detected. A total of 46 children with primary VUR were followed. Among these patients, VUR was completely resolved in 16 children. Voiding cystourethrography(VCUG) and DMSA scan were performed every year. Values for urinary markers were estimated every year. Results : 24 or 12 hour urine microalbumin and NAG excretions were significantly increased in group III compared to group I(microalbumin : $27.7{\pm}26.0mg/gCr$ vs $15.0{\pm}10.7mg/gCr$, P<0.05, NAG : $15.2{\pm}18.7U/gCr$ vs $3.4{\pm}2.2U/gCr$, P<0.05). Urinary ${\beta}_2$ MG excretions were not significantly different between groups. Urinary NAG excretions were elevated in the group of children with severe VUR compared to mild VUR($26.8{\pm}27.1U/gCr$ vs $7.6{\pm}3.8U/gCr$, P<0.05). After resolution of VUR, urinary microalbumin and NAG excretions were decreased(P<0.05). Conclusion : Urinary microalbumin and NAG may be useful clinical indicators to predict the presence of reflux nephropathy and the resolution of VUR. Especially, urinary NAG excretions may be used as a possible method to predict the severity of VUR.

Clinical aspects of chronic urticaria in children (소아 만성 두드러기의 임상 양상 및 경과)

  • Kang, Hye Seon;Shin, Mee Yong
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.205-212
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    • 2009
  • Purpose : Chronic urticaria is a disorder characterized by the appearance of wheals for more than 6 weeks; in most cases, the etiology is unknown. This study was aimed to discover the clinical aspects, the etiologic factors, and the course of chronic urticaria. Methods : 51 children who were diagnosed with chronic urticaria in the past 4 years, and who had had follow-ups more than 6 months after diagnosis in the pediatric department of Soonchunhyang University Hospital in Bucheon, were enrolled in the study. The laboratory findings, clinical aspects, and courses were retrospectively investigated by medical record review and telephone interview. Results : The median age of children with chronic urticaria was 4 years (8 months to 16 years) and the ratio of male to female was 1.4:1. Of the total, 39.2% of patients had a history of atopy. Angioedema occurred concurrently with urticaria in 11.8% of patients, and dermographism was seen in 41.2%. Results of thyroid function tests were normal and thyroid autoantibodies were absent in all cases. Regarding etiology, most cases (74.5%) were forms of idiopathic urticaria. Urticaria was induced by physical factors in 19.6% of patients. Open challenge tests revealed that 3 patients were allergic to food additives (glutamate 2, glutamate, and sulfite 1). In this study, most of the patients reported good response after medication of 1st- or 2nd-generation antihistamines alone. Follow-up at 6 months revealed that 70.6% of patients had experienced remission, and 84.8% of children who had follow-up at 1 year presented remission. Conclusion : Chronic urticaria in most patients was idiopathic. Remission occurred within 1 year of diagnosis, in most cases so chronic urticaria in children seems to have good prognosis.

The Risk Factors of the Pre-hypertension and Hypertension of Rural Inhabitants in Chungnam-do (충남 농촌 지역 주민의 고혈압 전단계와 고혈압의 위험요인)

  • Eom, Ji-Sook;Lee, Tae-Ryong;Park, Seon-Joo;Ahn, Youn-Jin;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.742-753
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    • 2008
  • The purpose of this study is to investigate risk factors of pre-hypertension and hypertension in rural residents. Nine hundred and ninety four subjects aged 40-70 yrs in Chungnam-do participated in this study. The subjects (n = 824) were classified into three groups of hypertensive, pre-hypertensive, and normotensive according to the Joint National Committee (JNC)-7 criteria. The weight, body mass index (BMI), waist-hip ratio (WHR), and serum total protein, albumin, BUN, and triglyceride (TG) were positively correlated with SBP and DBP. After adjusted by age, sex and BMI, the total protein, albumin and TG were significantly correlated with SBP and DBP (p < 0.01). There was no significant difference in eating habits according to the level of blood pressure. The serum albumin, creatinine, Glu-FBS, Glu-PP l20, and triglyceride were higher in both prehypertensive and hypertensive group than in the normotensive group. However, mean serum cholesterol was not different among three blood pressure groups. In this study, the common risk factors of pre-hypertension and hyper-tension were male, age of fifties, lower education level, ex-smoking, higher drinking frequency, higher BMI, body fat %, waist circumference, WHR, serum albumin and diabetes, even though the degree of risks in these variables were higher in the hypertensive group. The higher BUN was a risk factor of prehypertension, while the family history, prediabetes, serum total protein, Glu-PP l20 and higher alcohol drinking amount were the risk factors of hypertension. This result suggests that maintaining good health habit and normal range of blood parameters as well as controlling body weight have to be paid attention in order to prevent hypertention, and further reseasch on the relationship of blood pressure and BUN are needed.

Anorectal Manometry in Idiopathic Constipation in Children (특발성변비 환아에서의 직장항문압측정검사)

  • Beck, Nam-Seon;Seo, Jeong-Kee
    • 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.

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Pulmonary tuberculosis misdiagnosed as lung Metastasis in childhood cancer patients (소아암 환자에서 암의 전이로 오인된 폐결핵)

  • Lee, Hyun-Jae;Kim, Dong-Whan;Lee, Kang-Min;Park, Kyung-Duk;Lee, Jun-Ah;Cho, Soo-Yeon;Kook, Yoon-Hoh;Kim, Hee-Youn;Kim, Dong-Ho
    • 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.

Antimicrobial Drug Resistance and Transferable Resistance Plasmid in Escherichia coli (대장균(大腸菌)의 항균제내성(抗菌劑耐性) 및 전달성(傳達性) Plasmid)

  • Cho, Dong-Taek;Chun, Do-Ki
    • 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.

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Factors Affecting Concentration of Polycyclic Aromatic Hydrocarbons in Oyster, Laver and Rockfish (굴, 김 및 조피볼락에서 다환성방향족탄화수소(Polycyclic Aromatic Hydrocarbons, PAHs)의 잔류에 미치는 요인에 대한 연구)

  • Kim, Kang-Jeon;Choi, Sang-Hoon;Park, Kwan-Ha
    • 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.

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Etiology and Analysis of Severity in Childhood Pancreatitis (소아 췌장염의 원인과 중증도 분석)

  • Park, Jun-Eun;Kim, Kyong-Mo
    • 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.

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Chromosome Aberration in Peripheral Lymphocyte of Radiation Workers in Hospital (병원내 방사선작업종사자들의 염색체이상빈도)

  • Yi, Chun-Ja;Ha, Sung-Whan;Jung, Hae-Won
    • 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.

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The Influence of Estrogen on Dopamine Metabolites in Schizophrenia (정신분열병에서 도파민 대사물에 대한 에스트로겐의 영향)

  • Cheon, Jin-Sook;Lee, Jang-Hyun;Oh, Byoung-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.209-218
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    • 1999
  • Objectives : The aims of this study were to discriminate the clinical differences, to measure the estrogen and homovanillic acid levels, to evaluate a correlation between estrogen and homovanillic acid, and to identify an association of cognitive deficit with estrogen and homovanillic acid among male and female schizophrenics. Methods : In addition to the structured interviews, the plasma estrogen levels by radioimmunoassay and the homovanillic acid levels by HPLC were measured in 20 male and 21 female schizophrenics as well as 10 healthy male and 9 female controls. Results : 1) The plasma estrogen levels were higher in females than males, and significantly higher in female schizophenics than female controls. The homovanillic acid levels were higher in female schizophrenics than female controls, and were lower in male schizophrenics than male controls. 2) The onset age seemed to be earlier in male schizophrenics, and the frequency of admission, duration of antipsychotic drug administration, dosage of antipsychotics and duration of illnesses were more in males. The estrogen and homovanillic acid levels were significantly higher in female schizophrenics. 3) The estrogen levels had a significant positive correlation with sex, age and onset age, while the homovanillic acid levels did with sex. However, estrogen were not correlated with homovanillic acid levels. 4) The estrogen and homovanillic acid levels were not significantly different between male and female schizophrenics with cognitive deficits. In the schizophrenic patients without cognitive deficits, the estrogen levels were significantly higher in females, while there were no significant sex differences in homovanillic acid. 5) In the male and female schizophrenics predominantly with negative symptoms, there were no significant differences in estrogen and homovanillic acid levels. In those predominantly with positive symptoms, the estrogen levels were significantly higher in females, while there were no sex differences in homovanillic acid levels. 6) In schizophrenics with undifferentiated subtype, the estrogen and homovanillic acid levels were significantly higher in females. In those with paranoid or disorganized subtypes, the estrogen levels were significantly higher in females, while there were no sex differences in the homovanillic acid levels. 7) The mean values of PANSS-negative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels were significantly higher in male schizophrenics with cognitive deficits. The mean values of illness duration, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANSS-CF and MMSE-K were significantly higher in female schizophrenics with cognitive deficits. 8) The variables which showed significant correlation with cognitive deficits were PANSS-negative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels in male schizophrenics. The variables which showed significant correlation with cognitive deficits were subtypes, onset age, illness durataion, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANMSS-CF and MMSE-K in female schizophrenics. The estrogen levels were significantly correlated with admission frequencies, history of antipsychotic administration, duration of antipsychotic administration and cognitive deficits in male schizophrenics, while age were not correlated with in females. The homovanillic acid levels had a significant correlation with subtypes and onset age in male schizophrenics, while there were no correlation among variables in females. Conclusions : Although the plasma concentrations of estrogen and homovanillic acid in female schizophrenics were significantly higher than males, we could not find an association between them. Furthermore, the various factors affecting on the cognitive deficits, estrogen and homovanillic acid levels seemed to be somewhat different according to sex.

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