• Parasites, Hosts and Diseases
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• v.35 no.4
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• pp.251-258
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• 1997

Tachyzoite antigens of Toxoplosnc gondii (RH) were partially purified by immunoaffinity chromatography. The cultivated ToxopLusmc in uiuo (mouse) and in nitro (Hep-2 cell) and peritoneal fluid of T. Bondii infected mice were collected for antigen analy- sis. Tachyzoite antigens collected from infected mouse showed positive bands of 76 kDa, 70 kDa,64 kDa, 53 kDa, 46 kDa, 44 kDa, 41 kDa, 35 kDa, 25 kDa, 18 kDa, and 13 kDa on immunoblot with anti-Toxoplcsmn rabbit sera, and those from infected Hep-2 cells revealed reactive bands of 70 kDa,64 kDa,53 kDa,35 kDa,28 kDa, and 13-10 kDa. After applying to an IgG-Sepharose column, two elusion peaks, E-1 and I-2 fractions, were obtained from both soluble antigen of T. gondii and the peritoneal fluid of infected mice, respectively. Immunoblots of soluble antigen with immunized rabbit sera revealed positive bands of 97 kDa, 63 kDa, 53 kDa and 35 kDa from I-1 fraction and 53 kDa and 35 kDa from I-2. In the case of the eluted peaks from mice peritoneal fluid, E-1 showed protein bands of 84 kDa,76 kDa,53 kDa and 29 kDa bands and 53 kDa and 45 kDa from I-2 on immunoblots. Serum IgG antibody titer of mice immunized with T gonnii tachyzoites was increased on 1 week after booster immunization when analysed by ELISA using crude antigen, while it was elevated on 3 weeks after booster immunization by ELISA using puri- fied antigen.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.143-149
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• 2005

Purpose: The aim of this study was to evaluate the significance of pH monitoring at two levels, hypopharynx and esophagus in gastroesophageal reflux. Methods: 29 patients with pathological gastroesophageal reflux were classified into two groups: Group I had recurrent respiratory symptoms and Group II had not recurrent respiratory symptoms. The ambulatory pH monitoring was performed at the hypopharynx and the esophagus simultaneously with two channel catheter for 18~24 hr. The pathological reflux was defined when the percent of time that pH was below 4.0 exceeding the 95th percentile of normal value. Hypopharyngeal reflux was defined as the pharyngeal pH drops below 4. Results: 39 patients were performed pH monitoring at the level of hypopharynx and esophagus for 24 hours. Among 7 patients with chronic respiratory symptom, 6 patients (85.7%) have pathological esophageal reflux. Among 32 patients without chronic respiratory symptom, 23 patients (71.8%) have pathological esophageal reflux. Thus 29 out of 39 patients (74%) have pathological esophageal reflux. In the Group I, all parameters except the longest episode showed significant differences between hypopharyngeal and esophageal pH monitoring. None of parameters showed significant differences between group I and II in the pharyngeal pH monitoring. Conclusion: Regardless of presence of respiratory symptoms, the pH monitoring at the pharyngeal level in patients with gastroesophageal reflux did not showed any differences compared with the esophageal pH monitoring. Therefore we may reconsider the usefulness of hypopharyngeal pH monitoring in patients with chronic respiratory symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.161-166
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• 2003

Purpose: The purpose of this study was to evaluate the efficiency of treatment of living-related liver transplantation (LRLT) with the parental heterozygote carrier graft in children with Wilson disease. Methods: We retrospectively evaluated 7 children with Wilson disease who had received liver transplantation from 1994 to 2002 at Asan Medical Center. All the donors were parental. Liver functions, Kayser-Fleischer ring, and other factors regarding to copper metabolism were analyzed. Results: Of the 7 children, 5 had fulminant hepatitis and 2 had decompensated liver cirrhosis irresponsive to medical therapy. All donors being parental, all grafts came to be heterozygote carrier grafts. Survival rate was 100% in those 7 children, 87% in all children with liver transplantation in the same period, and 84% in children with non-metabolic liver disease. After liver transplantation, all 7 children could stop low copper diet and penicillamine therapy and their AST, total bilirubin and prothrombin time were recovered to normal. After liver transplantation, ceruloplasmin and serum copper levels were also recovered to normal. A marked reduction in 24 hr-urinary copper excretion was observed in all recipients after transplantation. During follow-up, Kayser-Fleischer rings resolved completely after LRLT in 5 children and partially in 1 child. Conclusion: We concluded that living-related liver tranplantation in children with Wilson disease with parental heterozygote carrier graft is an effective treatment modality.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.103-111
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• 2003

Purpose: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. Methods: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. Results: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. Conclusion: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.169-178
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• 2008

Purpose: The purpose of this study was to determine the efficacy of early low-dose iron supplementation in term breast-fed infants. Methods: Eighty-seven healthy term infants were divided into 3 groups: A, formula-fed; B, breast-fed only; S, breast-fed with iron supplementation (5 mg/day from 2 months of age). We measured ferritin, iron, total iron binding capacity (TIBC), transferrin saturation rate (TFSAT), hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW) at birth, 6 months of age, and 12 months of age. Results: 1) At 6 months of age, ferritin, iron, TFSAT, and Hb in Group B were the lowest among the 3 groups, whereas TIBC and RDW were the highest. The incidences of iron deficiency (ID) and iron deficiency anemia (IDA) in Group B were 33% and 30%, respectively, significantly higher than those seen in Groups A (5% and 8%, respectively) and S (7% and 5%, respectively). 2) At 12 months of age, ferritin, TFSAT, Hb, MCV, and MCH in Group B were the lowest among the 3 groups, whereas TIBC and RDW were the highest. Iron and Hct did not differ among the 3 groups. The incidences of ID and IDA in Group B were 64% and 50%, respectively, again significantly higher than those seen in Groups A (4% and 3%, respectively) and S (9% and 7%, respectively). Conclusion: The prevalences of ID and IDA were higher in breast-fed infants than in formula-fed infants, even at 6 months of age. Early and low-dose iron supplementation in breast-fed infants improved iron status and lowered the incidence of iron deficiency anemia in early infancy.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.239-244
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• 1998

Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.10-39
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• 1987

Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972, 069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major groups (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to S times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Busan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Busan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/l,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/l,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in high school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I ($1968{\sim}1974$), period II ($1975{\sim}1979$), and period III ($1980{\sim}1985$). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and posions was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by $4{\sim}10$ years. However, the mean age at death of the teachers was $2{\sim}5$ years lower than that of the general population in all causes of death and the sex difference in the mean a2e at death was smaller ($2{\sim}3$ years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.129-136
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• 1987

To determine the hepatitis 8 virus infection rate of the medical school students and appropriate time for immunization with hepatitis B vaccine,355 students in the 1st, 2nd and 3rd grades of Medical School of Kyungpook National University who had not been vaccinated and volunteered to participate in this study were tested for HBsAg, anti-HBs and anti-HBc with radioimmunoassay method (Abbott Lab. kit). A questionnaire was administered to ask the history of transfusion, acupuncture and surgery. HBsAg positive students were retested 16 months after the initial test. Overall HBsAg positive rate was 6.8% and the age adjusted rate for male (7.2%) was higher than that for female (4.9%). Anti-HBs positive rate was 35.3% (36.1% for male, 37.9% for female) and anti-HBc positive rate was 45.5% (46.5% for male,44.7% for female). Overall hepatitis B virus (HBV) infection rate was 49.1% and the infection rate for male (50.3%) was slightly higher than that for female (46.5%). HBsAg positive rate and infection rate were increased as the grade increased but it was attributed to the age distribution of the students. HBaAg positive rate for 20 years old students was 1.7%; 21 years, 6.6%; 22 years, 6.1%; 23 years, 12.2%; and 24 years and older, 6.4%. HBV infection rate showed an increasing trend as age increased; 45.8% for 20 years,41.5% for 21 years, 49.5% for 22 years, 55.5% for 23 years and 59.6% for 24 years and older. The age differences in HBsAg positive rates and HBV infection rates did not reach the statistical significance level of 0.05. However, these findings and similar age differences in HBsAg positive rates and HBV infection rates observed in other study suggest that there is a significant age differences. Study of the same age group in other schools and different social classes is warranted to confirm the age difference. Clarification of the reason for such differences would provide a clue to identify the major route of HBV transmission in this age group. Among 26 HBsAg positive students in the initial test, only one student was active hepatitis patient. Out of 24 students who had follow-up test after 16 months 22 students were positive for HBaAg and two students became HBsAg negative and anti-HBs positive. It is obvious that nearly one-half of the medical school students were infected with HBV before 20 years of age and the HBV infection occurs in medical school. Thus, it is recommended to test all the students for HBV infection soon after the admission to the medical school and immunize all the susceptible students with hepatitis B vaccine and give booster as they start to practice at a hospital.

• Journal of Preventive Medicine and Public Health
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• v.20 no.2 s.22
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• pp.312-321
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• 1987

To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitiation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over \610,000, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (p<0.05). Parents noticed the child's abnormality first in 85.1% of the cases whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education is needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.

• Radiation Oncology Journal
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• v.6 no.1
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• pp.63-73
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• 1988

One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP. Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; in case of radiation therapy only, whole pelvic irradiation was given with Co-60 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. In satges Ia, Ib, and IIa with small primary lesion, external irradiation was initially given to pelvis up to $2,000\~3,000\;cGy/2frac{1}{2}\;-3frac{1}{2}$ weeks and then intracavitary insertion was performed using Fletcher-Mini-Declos Applicator with cesium-137 cources and followed by external irradiation of $1,000\~2,000\;cGy/1frac{1}{2}\;-2frac{1}{2}$weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stages IIb, the patients were treated by external beam irradiation up to 5,400cGy/30f for 6 weeks via 4-oblique portals and at the dose of 5,040cGy/28f the field was cut 5cm from the top margin for spare of small bowel, and followed by intracavitary irradiation, If there was residual tumor an additional dose of $900\~l,200cGy/5\~7f$ was given to parametrium and/or residual tumor area. Total dose of radiation to A and B-point were as follows; A-point; In early stages, Ia, Ib, IIa; $8,000\~9,000$ B-point $5,000\~6,000 cGy$ A-point; In advanced stages IIb, IIIa, IIIb; $9,000\~10,000$ B-point $60,000\~7,000cGy$ The results were obtained and as fellows; 1 The patients distribution according to FIGO staging system were stage Ia 6, Ib 27, IIa 28, IIb 54, IIIa 12, IIIb 18, and stage IVa 9. 2. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. 3. Local control rate of tumor according to the size was $91.3\%$ for less than 5cm in size and $44.6\%$ in tumor over 5cm (p<0.0068). 4. Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the para-aortic lymph nodes were the most common site for distant metastases. 5. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. 6. The 5-year survival rates showed; stage la and Ib $95\%,\;stage\;IIa\;81\%\;stage\;lIb\;67\%,\;stage\;IIIa\;37.7\%,\;stage\;IIIb\;23\%$ and 3-year survival rate of stage IVa showed $11.6%$, retrospectively.