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A Clinical Study for Gall Bladder Stones in Children (소아 담석증에 대한 임상적 연구)

  • Eun, Ho Seon;Baek, Seoung Yon;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.194-201
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    • 2005
  • Purpose: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. Methods: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. Results: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2 : 1 with the mean age of $6{\pm}4.3years$. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. Conclusion: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.

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The Correlation of Verbal Expression of Stool, Bristol Stool Form Scale and Colon Transit Time for Children with Gastrointestinal Symptoms (소화기 증상이 있는 환아의 대변표현형, Bristol 대변형태척도 및 대장통과시간검사와의 상관관계)

  • Lee, Yong Ju;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.130-136
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    • 2005
  • Purpose: The aim of this study was to evaluate the correlation among descriptions regarding one's stool, Bristol stool form scale and colon transit time (CTT) in children with gastrointestinal symptoms, along with the clinical significance of Bristol stool form scale. Methods: 489 patients treated in the pediatric department of Severance hospital with gastrointestinal symptoms between May 2002 to May 2004 were included. We analyzed their age, sex, verbal descriptions of stool, Bristol stool form types, and CTT measured by Metcalf's method. Results: 116 children were under 5 years of age, 202 children between 5.1~10, and 171 children 10 years of age or older. Their mean age was $8.2{\pm}3.9years$. Stools were described as loose in 65 children (13.3%), normal in 221 (45.2%), hard in 188 (38.4%), and mixed (loose+hard) in 15 (3.1%). According to Bristol stool form scale, 57 children(11.7%) were classified as type 1, 66 (13.5%) as type 2, 203 (41.5%) as type 3, 109 (22.3%) as type 4, 36 (7.4%) as type 5, 18 (3.7%) as type 6, and 1 (0.2%) as type 7. Their mean CTT was checked $35.9{\pm}19.5hours$. Though no significant relationship was observed between age and CTT (p=0.4), a significant relationship was noted among patient's stool description, Bristol stool form scale and CTT (p<0.001). However, concordance between stool description and Bristol stool form was relatively low in the loose stool group (29%) and normal stool group (37%) while high in the hard stool group (87%). Conclusion: Bristol stool form scale could be used in the estimation of CTT in clinical practice.

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The Effect of 2-Week Dual Therapy with Proton Pump Inhibitor and Amoxicillin in the Eradication of Helicobacter pylori Infection for Treatment of Children with Recurrent Abdominal Pain (만성 반복성 복통 환아에서 Helicobacter pylori 감염에 대한 Proton Pump Inhibitor 및 Amoxicillin 2주 치료 효과)

  • Lee, Young-Mock;Lee, Chang-Han;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.23-29
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    • 2000
  • Purpose: It has recently been recognized that Helicobacter pylori (H. pylori) is an important factor in the pathogenesis of recurrent abdominal pain (RAP) in children. But, the best treatment for H. pylori infection is still unsettled. This study was performed to evaluate the efficacy of 2 weeks dual therapy with proton pump inhibitor (PPI) and amoxicillin for children with H. pylori infection associated with RAP. Method: Our study included 24 children with RAP who were H. pylori positive assessed by CLO test and histologic examination (silver stain). We used the regimen consisted of PPI (omeprazole, 0.7 mg/kg/day) and amoxicillin (50 mg/kg/day) for 2 weeks to eradicate H. pylori. Eradication of H. pylori was determined 4 weeks after the termination of treatment using the CLO test and histologic examination. Results: The endoscopic diagnoses of patients were nodular gastritis in 11 cases, superficial gastritis in 7 cases, peptic ulcer in 4 cases and normal finding in 2 cases. H. pylori was eradicated in 12 cases by omeprazole and amoxicillin dual therapy for 2 weeks and the eradication rate was 50%. In 4 of 12 children in whom H. pylori had not been eradicated with that regimen, we successfully eradicated H. pylori with other regimens of which 2 or 3 drugs among omeprazole, amoxicillin, clarithromycin, colloidal bismuth subcitrate ($Denol^{(R)}$) and metronidazole were used. Conclusion: The dual therapy with PPI and amoxicillin for 2 weeks had no clear advantage over other regimens for the eradication of H. pylori infection in children. We concluded that the combi-nation of PPI and amoxicillin for 2 weeks is not so good for H. pylori eradication as other commonly used regimens.

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Geographic Distribution of Physician Manpower by Gini Index (GINI계수에 의한 의사의 지역간 분포양상)

  • Moon, Byung-Wook;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.301-311
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    • 1987
  • The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of disparity in physician distribution and in identifying changes in the distributional pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physicians located counties to whole physicaians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1955, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of genral surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1955, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 to 0.5868 for counties indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.

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Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

Degenerative Joint Disease After Medial Patellar Luxation Repair in Dogs with or Without Trochleoplasty (개의 슬개골 내측 탈구 교정술에서 활차성형술의 유무에 따른 퇴행성 변화)

  • Yoon, Dae-Young;Kang, Byung-Jae;Kim, Yongsun;Lee, Seung Hoon;Rhew, Daeun;Kim, Wan Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.22-27
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    • 2015
  • We evaluated outcomes of dogs surgically treated for grade 2 or 3 medial patellar luxation (MPL) with and without trochleoplasty. A retrospective study of 63 dogs with grade 2 or 3 MPL surgically treated with or without trochleoplasty was performed. Results of radiographic evaluation were expressed numerically as degenerative joint disease score and were compared between the groups with and without trochleoplasty. The study included 7 (7/68, 10.3%) cases of reluxation and 1 case of tibial tuberosity transposition implant failure. Reluxation and complications requiring additional surgery were confirmed in 3 cases (3/47, 6.4%) in trochleoplasty group and in 1 case (1/21, 4.8%) in nontrochleoplasty group. The nontrochleoplasty group showed a shorter recovery time than the trochleoplasty group (P < 0.05). There was a significant difference in degenerative joint disease scores over time between the groups, with nontrochleoplasty group having lower scores (P < 0.05). This study suggests that surgical treatment without trochleoplasty results in favorable outcomes compared to treatment with trochleoplasty. It is not mandatory to exclude trochleoplasty when performing surgery for grade 2 or 3 MPL, but we propose that surgical treatment without trochleoplasty is one option when choosing a combination of surgical techniques.

Study on Temporal Decay Characteristics of Naturally Occurring Radionuclides in Groudwater in Two Mica Granite Area (복운모화강암지역 지하수 중 자연방사성 물질의 경시적 붕괴특성 연구)

  • Kim, Moon Su;Kim, Tae Seung;Kim, Hyun Koo;Kim, Dong Su;Jeong, Do Hwan;Ju, Byoung Kyu;Hong, Jung Ki;Kim, Hye Jin;Park, Sun Hwa;Jeong, Chan Ho;Cho, Byong Wook;Han, Jin Seok
    • Journal of Soil and Groundwater Environment
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    • v.18 no.4
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    • pp.19-31
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    • 2013
  • To figure out the decay characteristics of naturally occurring radionuclides, eight sampled groundwaters from a monitoring borehole having high levels of uranium and radon concentrations in a two mica granitic area have analyzed by liquid scintillation counters (LSC) for over 1 year. In December 2011, three groundwater samples (DJ1, DJ2, DJ3) were obtained from each aquifer system located at -20 m, -40 m, -60 m of the monitoring borehole below the ground surface, respectively. Five samples (DJ4, DJ5, DJ6, DJ7, DJ8) were additionally gained from each aquifer positioned -20 m, -40 m, -60 m, -100 m, -105 m of the borehole in February 2012, respectively. Temporal variation characteristics of uranium and radon concentrations have showed over maximum 2.1 times and 1.4 times fluctuations of the values in the same sampling intervals over time, respectively. The intervals of -40 m and -105 m in the borehole have the highest values of uranium and radon concentrations, respectively. This may imply that the concentrations of naturally occurring radionuclides such as uranium and radon in groundwater have been changed over time and indicate that the qualities of groundwaters from the aquifers developed at each interval in the borehole are different each other. This discrepancy, moreover, could be caused by behaviour differences between uranium which is in ionic status having a half life of 4.6 billion years and is transported along with the flowing groundwater, and radon which is in gaseous status having a 3.82 day's half life in the aquifer systems. Physicochemical characteristics of groundwaters from the aquifer systems could be identified by the results of the on-situ measuring items such as pH and Eh, and the major ionic contents. The CPM values of eight groundwater samples analysed by LSC over one year have shown not to follow the theoretical decay curve of the radon. The CPM values of the samples have ranged from 2 to 7.5 after it had passed two months when the theoretical CPM values of the radon started zero since the initial analysis. Alpha and beta particle spectrums have shown the peaks of radium-226, however they have not revealed any peaks of radon and it's daughter products such as polonium-218 and 214, bismuth-214 for the late stage of the analysis. This implies that the groundwater from the borehole may contain radium-226 having a half life of 1,600 years which decays continuously.

Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

  • Lee, Sub;Kim, Han-Woong;Kang, Hyoung-Seok;Bae, Chi-Hoon;Jheon, Sang-Hoon;Kwon, Oh-Choon;Ahn, Wook-Su
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.672-679
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    • 2001
  • Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

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A Study on the Safety of Powdered Agricultural Products in Incheon (분말 농산물가공품의 안전성 조사)

  • Park, Byung-Kyu;Kim, Sun-Hoi;Ye, Eun-Young;Lee, Han-Jung;Seo, Soon-Jae;Kwon, Sung-Hee;Song, Sung-Min;Joo, Kwang-Sig;Heo, Myung-Je
    • Journal of Food Hygiene and Safety
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    • v.35 no.2
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    • pp.136-145
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    • 2020
  • This study was conducted to evaluate pesticide residues and foreign metallic matter on a total of 104 powdered agricultural products in Incheon. Residue testing for 373 pesticides was conducted by GC-MS/MS, LC-MS/MS, GC-ECD, GC-NPD and HPLC-UVD. Foreign metallic matter was detected by magnetic rod. As a result pesticide testing, 7 of the 104 products were found to be within the MRL of the pesticides. The detected pesticides were chlorpyrifos, etofenprox, fenoxanil, malathion, permethrin, tebuconazole and tetraconazole. As for foreign metallic matter, 16 samples were above the allowable limits set by Korean regulations. Therefore, the inspection of residual pesticides in raw material, and the removal of foreign metallic matter will require further stringent attention for the safety of powdered agricultural products.

Comparison of Yield, Physico-chemical and Sensory Characteristics for Chicken Surimi Manufactured by Alkaline Adjustment with Different Raw Materials (원료육 종류에 따라 알칼리 조절법으로 제조한 계육 수리미의 수율, 이화학적 및 관능적 특성 비교)

  • Jin, Sang-Keun;Kim, Il-Suk;Kim, Dong-Hoon;Jeong, Ki-Jong;Choi, Yeung-Joon
    • Food Science of Animal Resources
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    • v.26 no.4
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    • pp.431-440
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    • 2006
  • This study was carried out to compare of yield, physico-chemical and sensory characteristics for chicken surimi manufactured by alkaline (pH 11) adjustment with different raw materials. Four experimental groups were surimi with chicken breast (T1) and chicken leg (T2) by spent hen, SF-MDCM (T3) and JY-MDCM (T4). Yield was higher in order of T1>T2>T3>T4 (p<0.05). The yield, physico-chemical and sensory characteristics of T1 were significantly higher than those of other treatments. Especially, $L^*$ and W value, shear force, textural properties, folding test, breaking force, gel strength, breaking $force{\times}deformation$, flavor, color and overall acceptability were higher in T1 but ar value, cooking loss, collagen and myoglobin content of T1 were lower than those of other treatments (p<0.05). Deformation, aroma, juiciness, tenderness were higher but met-myoglobin and yield of T4 were lower than those of T2 and T3 (p<0.05). Crude fat cooking loss and met-myoglobin content were higher in T2 but $b^*$ value, brittleness, hardness, gumminess, chewiness, folding test, breaking $force{\times}deformation$ and aroma of T2 were lower than those of other treatments (p<0.05). pH, collagen and moisture content and br value were higher but crude protein, folding test, $L^*$ and W value, cohesiveness, tenderness of T3 were lower than those of other treatmene (p<0.05). Correlation coefficients (r>0.8) between folding test and other items was positive in crude protein $L^*$ value, shear force and cohesiveness but negative in moisture content (p<0.05).