• Title/Summary/Keyword: 소아과

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Study on Reduction Effect of the Non-Point Pollutants through Riparian Buffer Zones (비점오염부하 저감을 위한 수변완충지대의 효율적 조성 연구)

  • Choi, I-Song;Kim, Sung-Won;Jung, Sang-Jun;Woo, Hyo-Seop;Oh, Jong-Min
    • Proceedings of the Korea Water Resources Association Conference
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    • 2007.05a
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    • pp.1793-1797
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    • 2007
  • 한강 "수변구역"에서 비점오염물질의 공공수역 유입을 억제하기 위한 다양한 방법들 중에서 보편적이고 자연친화적인 방법은 다양한 생물의 서식공간이며, 동시에 본류로 유입되는 과정에서 수질을 정화시키는 수질개선 공간인 수변완충구역, 또는 지대를 설정하여 관리하는 것이다. 그러나 이러한 수변완충지대 효과 분석 및 설정에 관한 연구는 국내에서 아직 수행되지 않았다. 본 연구의 목적은 수변구역의 자정능력을 높이는 것은 물론 그 밖의 하천 연안에서 비점오염물질의 차단과 처리능력을 증진시키고 수변 생태계의 서식처 보전 및 복원을 위해서 수변완충지대의 수질정화 기술개발과 생물다양성을 창출하는 수변완충지대 조성 기법을 개발하는데 있다. 본 연구에서는 기존 수변완충지의 추가적인 조성과 보완, 시험완충지 생태구조 및 기능 기초조사, 시험완충지 오염부하 저감효과의 실험 및 분석, 수변완충지대 설치 구상 등의 연구를 수행하였다. 수행 지역은 한강수계 지역으로 남한강 수변인 경기도 양평군 병산리에서 실시하였으며, 잔디와 갈대, 갯버들, 혼합지역, 자연그대로의 상태(대조지역)의 5 구역으로 구분하였고, 깊이별로 샘플을 채취하여 유입수와 표면유출, 하부유출을 비교해 보았다. 연구 결과, 5 가지 구역 중 잔디 구역의 SS, T-N, T-P, TOC의 제거 효율이 각각 76.7%, 85.2%, 97.6%, 83.3%로 가장 좋은 오염물질 제거 효율을 보였으며, 깊이 별 분석에서는 표면유출에서 하부유출로 갈수록 월등한 효율을 보였다. 따라서 본 연구를 통하여 비점오염원에 대한 한강수계의 수자원 보호 효과를 기대할 수 있고, 수변완충지대의 조성, 유지관리기술의 개발을 통한 수변완충지대의 계획과 설계에 직접적인 기여를 할 수 있으며, 수변구역에 설치 가능한 Riparian Buffer Zone의 중요성과 효율성을 알려 현재 하상 저니 준설 및 폭기 위주의 사업에서 생태 공학적 복원을 적극 고려한 정화사업으로 확대 추진하고자 한다.해결책을 얻어내는 상호보완적인 결과를 추구한다. 그가 디자인하는 작품은 전형적인 이미지를 내포하지 않는다. 즉 그의 작품은 기존의 가치와 이념적인 것은 배제하고, 창의적인 개념을 도출하였다.형모서리는 건물 특화 성격이 강하므로 불가피할 경우 소형 액센트 광고 위치를 미리 벽면으로 할애하는 것이 경관 및 입면계획에 유리한 것으로 분석되었다. 불확실도 해석모형 등의 새로운 기능을 추가하여 제시하였다. 모든 입출력자료는 프로젝트 단위별로 운영되어 data의 관리가 손쉽도록 하였으며 결과를 DB에 저장하여 다른 모형에서도 적용할 수 있도록 하였다. 그리고 HyGIS-HMS 및 HyGIS-RAS 모형에서 강우-유출-하도 수리해석-범람해석 등이 일괄되게 하나의 시스템 내에서 구현될 수 있도록 하였다. 따라서 HyGIS와 통합된 수리, 수문모형은 국내 하천 및 유역에 적합한 시스템으로서 향후 HydroInformatics 구현을 염두에 둔 특화된 국내 수자원 분야 소프트웨어의 개발에 기본 토대를 제공할 것으로 판단된다.았다. 또한 저자들의 임상병리학적 연구결과가 다른 문헌에서 보고된 소아 신증후군의 연구결과와 큰 차이를 보이지 않음을 알 수 있었다. 자극에 차이가 있지 않나 추측되며 이에 관한 추후 연구가 요망된다. 총대장통과시간의 단축은 결장 분절 모두에서 줄어들어 나타났으나 좌측결장 통과시간의 감소 및 이로 인한 이 부위의 통과시간 비율의 저하가 가장 주요하였다. 이러한 결과는 차가운 생수 섭취가 주로 결장 근위부를 자극하는 효과를 발휘하는 것이 아닌가 해석된다. 이와 같은 연구결과를 통해 생다시마를 주원료로 개발된 생다시마차와 생다시마 음료가 만성 기능성 변비 증세를 개선하는 효능이 잠재적으로 있음을 확인하였다. 그러나 생약제재의 변비약 수준으로 변비 개선 효능을 증대하기 위해서는 재료 배합비의 개선이나 대장 운동기능을 향상시키는 유효성분의 보강 등이 필요하다는 점도 알 수 있었다.더불어 산화물질 해독에 관여하는

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Clinical findings of Glycogen Disease Type Ia Patients in Korea (당원병 제 Ia형 환아들의 임상적 고찰)

  • Park, Minju;Ahn, Hee Jae;Le, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.142-149
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    • 2014
  • Purpose: There are 15 types of Glycogen storage disease (GSD) that have been identified, and GSD type Ia is the most common type. There are several studies of Korean GSD type Ia patients' long-term complications. The aim of this study to find out clinical symptoms and prognosis of GSD type Ia patients. Methods: We performed clinical, biochemical and genetic analysis retrospectively on five patients diagnosed with GSD type Ia in a Soonchunhyang University Hospital from July 2002 to July 2014. Results: All patients had hepatomegaly at diagnosis, and they were all confirmed to have fatty liver at abdomen USG. They had no developmental delay, but two of them had growth retardation. Elevated blood lactate, triglyceride, and uric acid levels can find out all patients, but only one patient had hypoglycemia. They are diagnosed with GSD through gene analysis, and by gene analysis, they have c.648G>T (homozygote, splicing mutation), c.122G>A/c.648G>T, c.248G>A/c.648G>T mutations. Treatment with three times meals, three times snacks and four to six times use of uncooked constarch for all patients. Following the progress, one of them resulted in hypothyroidism, other one had renal stones. A patient diagnosed at 16 years old had liver cirrhosis and started having hemodialysis for ESRD. Conclusion: GSD type Ia patients had hepatomegaly, hyperlipidemia, hyperuricemia, and lactacidemia. Therefore patients who have such these symptoms are recommended gene analysis. A patient diagnosed at 16-years-old had liver cirrhosis and ESRD in progress, early diagnosis and treatment are important for GSD type Ia patients.

The Clinical Features of Chronic Neonatal Hepatitis: Non-familial, Non-metabolic and Non-A, B, C Viral Hepatitis (만성 신생아 간염의 임상적 고찰: 비-가족형, 비-대사성, 비-A, B, C형 바이러스성 신생아 간염)

  • Park, Ji Ae;Lee, Chang Hun;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.242-248
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    • 2006
  • Purpose: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. Methods: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. Results: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). Conclusion: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.

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Clinical Features of Symptomatic Meckel's Diverticulum (증후성 멕켈 게실의 임상적 고찰)

  • Lee, Young Ah;Seo, Ji Hyun;Youn, Hee Sang;Lee, Gyeong Hun;Kim, Jae Young;Choi, Gwang Hae;Choi, Byung Ho;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.193-199
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    • 2006
  • Purpose: The proper diagnosis of Meckel's diverticulum (MD) is difficult and delayed because of the variety of clinical manifestations. We reviewed clinical characteristics of symptomatic MD to facilitate early detection. Methods: We analyzed retrospectively the clinical manifestations, diagnostic tools, histopathological findings, and operative findings in 58 patients with symptomatic MD. Results: The male to female ratio was 2.8 : 1. The most common symptom of MD was bleeding. Others symptoms included: vomiting, abdominal pain, irritability, abdominal distension and fever in the order of frequency. The clinical manifestations of symptomatic MD were lower gastrointestinal bleeding, intestinal obstruction, perforation, diverticulitis and hemoperitoneum, in the order of frequency. The causes of intestinal obstruction were intussusception, internal hernia, band, volvulus, invagination, in the order of frequency. Seventy five percent of patient with MD were diagnosed prior to 5 years of age. The most frequently used diagnostic tool was the Meckel's scan. The diverticulum was located 2 cm to 120 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 1 cm to 10 cm and 94% were less than 5 cm. The most common ectopic tissue found in the MD was gastric mucosa. Ileal resection was more frequently performed than diverticulectomy. Conclusion: In cases of unexplained gastrointestinal bleeding, obstruction and repeated intussusception, the meckel's scan, ultrasound and computed tomography shoud be considered to rule out MD, and if clinically necessary, an exploratory laparotomy when needed.

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The Changes of Intestinal Normal Flora in Neonates for Seven Days Postnatally (정상 신생아의 대변에서 생후 1주일 동안 장내세균총의 변화)

  • Sung, Nam-ju;Lee, Seung Gue;Kim, Me Jin;Kim, Young Ho;Yang, Seung;Hwang, Il Tae;Jung, Ji A;Lee, Hae Ran;Kim, Jae-Seok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.162-168
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    • 2006
  • Purpose: Microbial colonization of the intestine begins just after birth and development of the normal flora is a gradual process. The first bacteria colonizing the intestine in newborns are Staphylococcus, Enterobacteriaceae and Streptococcus. For several days after birth, the number of Bifidobacterium spp. increase. The aim of this study was to investigate the changes of microflora for seven days postnatally in neonatal stool. Methods: Fifteen neonates (breast : formula : mixed feeding 1 : 8 : 6, vaginal delivery : cesarean section 3 : 12) who were born at the Kangdong Sacred Heart Hospital, Hallym University were enrolled. First meconium and stools of postnatal 1-, 3-, and 7-day were innoculated. Blood agar plates for total aerobes, trypton bile X-glucuronide agar for E. coli, phenylethyl alcohol agar for gram positive anaerobes, MRS agar for Lactobacillus spp., bifidobacterium selective agar for Bifidobacterium spp. and cefoxitin-cycloserine-fructose agar for Clostridium difficile were used in the general incubator ($CO_2$ free incubator), $CO_2$ incubator or the anaerobic chamber for 48 or 72 hours at $37^{\circ}C$ and then colony forming units were counted. Results: No microflora was identified in the first meconium. Total aerobes, E. coli, and gram positive anaerobes were significantly increased with advancing postnatal days. In only one baby, Lactobacillus acidophilus was detected $2{\times}10^5CFU/g$ in the seven-day stool. Bifidobacterium spp. was detected in two babies. Clostridium difficile was not detected during the seven days. There were no significant differences in the bowel flora depending on the delivery pattern and feeding method. Conclusion: This study shows many changes in the intestinal normal flora in neonatal stool during seven days postnatally. If these findings are confirmed with larger studies, the data may be preliminary findings to support use of probiotics in neonates.

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A Possible Relation of the Helicobacter pylori pfr Gene to Iron Deficiency Anemia? (Helicobacter pylori 연관 철분 결핍성 빈혈과 H. pylori pfr 유전자 다형성과의 관련성)

  • Lee, Ji-Eun;Choe, Yon-Ho;Hwang, Tae-Sook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.28-33
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    • 2001
  • Purpose: H. pylori infection is thought to contribute to iron-deficiency anemia, especially during puberty. The ferritin protein Pfr of H. pylori is homologous to eukaryotic and prokaryotic ferritins. The purpose of this study was to analyze the H. pylori pfr status in gastric biopsy specimens according to clinical data, including antral gastritis with or without iron-deficiency anemia. Methods: A total of 26 H. pylori-positive patients aged from ten to 18 years were categorized into subgroups based on the presence or absence of iron-deficiency anemia. All of them had antral gastritis. Sixteen patients were proved to have iron-deficiency anemia by hematological study, two of which had a duodenal ulcer. The other ten patients showed normal hematological findings. DNA isolation was performed from each of the gastric biopsy specimens. PCR amplification of the pfr gene coding was done using two sets of primers. The pfr region, 501 bp, was generated by linking the sequences of the two PCR products. The nucleotide and protein sequences were compared between the pfr regions from Korean H. pylori strains and the NCTC 11638, 26695, and J99 strain, which were obtained from the Genbank. Sequence comparisons were also performed for the pfr regions between the iron-deficiency anemia (+) and (-) groups. Results: Analysis of the complete coding region of pfr gene revealed three sites of mutation. The Ser39Ala mutation was found in 100% (26/26), Gly111Asn in 26.9% (7/26), and Gly82Ser in 11.5% (3/26). There were no significant differences in the mutations of the pfr regions between the iron deficiency anemia (+) and (-) groups. Conclusion: The mutation in the pfr gene did not relate with the clinical phenotype, iron deficiency anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate the mechanisms by which the H. pylori infection might lead to iron deficiency anemia.

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Evaluation of Acid Steatocrit in Korean Infants (한국인 영아에서의 Acid Steatocrit 표준치에 관한 연구)

  • Kim, Kyo-Sun;Park, Ji-He;Sim, Jae-Geon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.77-82
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    • 2001
  • Purpose: The fecal acid steatocrit is an improved steatocrit method for the evaluation of fecal fat. The present study was set up in order to define the normal range of acid steatocrit values during the first 3 months of life. Methods: Fecal acid steatocrit values were determined in 78 healthy full term and in 21 healthy prematurely born infants between May 1998 and April 2000. The acid steatocrit method was performed in these babies during the first 3 months of life. Results: Steatorrhea occurs during the first month and then decreases, as shown by the fall in the acid steatocrit curve from 1st to 3rd month in our subject. Very high acid steatocrit results (above 90%) were found in all full term and premature infants during the first month of age. Acid steatocrit results of human milk-fed infants were significantly lower than those of formula-fed infants (p=0.0018). Conclusion: We conclude that high acid steatocrit results during the first 1 month of age can be due to physiologic steatorrhea. The acid steatocrit micromethod can be used for the evaluation of milk fat absorption in infants and monitoring steatorrhea instead of other more cumbersome methods.

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Study on Gastroesophageal Reflux according to Feeding Types (수유 종류에 따른 위식도 역류의 빈도)

  • Yun, Seok-Kang;Park, Jae-Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.1-9
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    • 2001
  • Purpose: Gastroesophgeal reflux (GER) is defined as involuntary movement of gastric contents into esophagus. Relaxation of lower esophageal sphincter caused by immature anatomical development in newborn and young infants produces GER frequently. We wanted to know whether the frequency of GER is influenced by feeding types and position or not. We studied in 16 subjects according to feeding types (breast feeding group: BFG-7, formula feeding group: FFG-9) who admitted to the Soonchunhyang university hospital for recurrent regurgitation with 24 hr esophageal pH monitoring from August 1996 to July 1999. Methods: We compared two groups by number of reflux episode, reflux rate, longest episode, numbers of episodes lasting >5 minutes, longest episode in upright position and longest episode in supine position. We used Mann-Whitney test for statistical analysis. Results: 1) The subjects were 7 infants in BFG and 9 infants in FFG, 16 in total, and mean age was 2.1, and 2.6 months for BFG and FFG, respectively. 2) The reflux numbers were $244{\pm}151/day$, $275{\pm}155/day$ for BFG and FFG, respectively. 3) The reflux rate was $14{\pm}15%$ for BFG and $28{\pm}22%$ for FFG. It was lower in BFG. 4) The longest episode was $20{\pm}28$ minutes for BFG and $58{\pm}66$ minutes for FFG. It was significantly longer in FFG. 5) The numbers of episodes lasting >5 minutes were $5{\pm}6$ for BFG and $9{\pm}3$ for FFG. 6) The longest episode in upright position was $10{\pm}8$ minutes for BFG and $40{\pm}47$ minutes for FFG. It was significantly shorter in BFG. 7) The longest episode in supine position was $18{\pm}29$ minutes for BFG and $52{\pm}66$ minutes for FFG. It was significantly shorter in BFG. Conclusion: Breast feeding is strongly recommended to reduce the regurgitation in infancy. It is an another benefit of breast feeding.

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Effect of the Nutrition Education for Infant Feeding on Mother's Knowledge, Attitude, Practice of Weaning (영유아 섭식에 관한 영양교육이 어머니의 영양지식.태도 및 실천에 미치는 효과)

  • Kim, Mi-Yang;Ahn, Hong-Seok
    • Journal of the Korean Society of Food Culture
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    • v.18 no.4
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    • pp.320-332
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    • 2003
  • This study evaluated the effect of the nutrition education about infant feeding on the change of mother's knowledge, attitude and practice of weaning. The subjects consisted of treatment group (n=54) and control group (n=34). The treatment group participated in 6 times nutrition education and 5 times surveys. Nutrition education for weaning of the treatment group improved nutrition knowledge, attitude and practice in infant feeding. Before education, mean scores of control group and treatment group were 7.3 and 7.5 respectively but there was no significant difference. Both group got low score in a statement about weaning period, but they got good score in a statement about weaning method. After education, treatment group got better score(9.1) than control group(8.3) significantly (p<0.05). Treatment group was more desirable than control group specially in a use of Sun-sik, sugar, salt and weaning food mixed with formula after education (p<0.05). Practice of spoon feeding was more frequent in treatment group after education, however, control group used sugar and commercial weaning food more frequently than treatment group(p<0.05). Intake frequency of cow's milk and cookies of infants at age 9-12 month in control group was higher than treatment groups(p<0.01). Thus the nutrition education to mother seems to be effective in achieving desirable dietary behavior of infants.

Isolation of Mycoplasma pneumoniae and Antimicrobial Susceptibilities of the Isolates(III) (Mycoplasma pneumoniae의 분리 및 항생제 감수성 검사(III))

  • Chang Myung-Woong;Kim Kwang-Hyuk;Park In-Dal;Song Gap-Young;Kim Sung-Won;Lee Eun-young;Kim Moon-Chan;Cho Myung-Hoon;Kim Kyu-Earn;Choi Choong-Eon;Park Seon Yeong;Jo Hyeon Jang
    • Journal of Life Science
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    • v.15 no.3 s.70
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    • pp.479-485
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    • 2005
  • The 994 throat swabs obtained from 688 adults and 306 children patients with respiratory diseases were examined for Mycoplasma pneumoniae infection by culture method. Antimicrobial susceptibilities of the resulting 123 M. pneumoniae isolates were evaluated by testing minimum inhibitory concentrations (MICs) of erythromycin, minocycline, tetracycline, josamycin, sparfloxacin, ofloxacin, and ciprofloxacin by a broth micro-dilution method. The erythromycin resistant strains of M. pneumoniae was determined above $1.0{\mu}g/ml$ of MIC for erythromycin. The erythromycin resistant strains of M. pneumoniae was confirmed resistant gene mutation of the portions of genes 23S rRNA (domain II and V), and ribosomal protein 14 and L22 by PCR amplified and their nucleotide sequenses were compared to those of the susceptible strain M129. The isolation rate of M. pneumoniae was $12.9\%$ (89/688) for the adults and $11.1\%$ (34/306) for the children. The $MICs_{90}$ of the M. pneumoniae isolates were $0.12{\mu}g/ml$ for minocycline, $0.25{\mu}g/ml$ for sparfloxacin, $0.5{\mu}g/ml$ for ciprofloxacin, ofloxacin, and tetracycline, respectively, and $2.0{\mu}g/ml$ for josamycin and erythromycin, respectively. The isolation rate of erythromycin resistant M. pneumoniae from patients was $49.4\%\;(44/89)$ for the adults, $47.1\%\;(16/34)$ for children, and $48.8\%\;(60/123)$ for the total. No mutation could be detected in the ribosomal protein L22 region, but all strains were mutated in the ribosomal protein L4 as two point mutation M144V. Two point mutations in domain V of 23S rRNA were selected in the presense of erythromycin resistant M. pneumoniae isolates, such as one strain was G2057C mutant, two strains were A2059C mutants, three strains were C2611G mutants, four strains were A2058C mutants, five strains were A2058T mutants, twenty strains were A2059G mutants, and twenty-five strains were A2058G mutants, respectively. These results show that erythromycin was not the most active compound against M. pneumoniae infection in Korea and clinical studies of macrolides in human patients are demanded.