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Urinary Lithiasis in Children : A Single Center Study (소아 요로 결석 : 단일 기관 연구)

  • Lee, Hyun-Kyung;Lee, Sung-Ha;Han, Kyoung-Hee;Lee, Beom-Hee;Choi, Hyun-Jin;Ha, Il-Soo;Choi, Yong;Cheong, Hae-Il
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.280-287
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    • 2007
  • Purpose : Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases. Methods : A total of 73 children(male:female=42:31, mean age $6.6{\pm}5.3$ years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children's Hospital. The medical records were reviewed retrospectively. Results : The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%). and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology. Conclusion : The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.

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Risk Factors for the Progression of Pediatric Chronic Kidney Disease-A Single Center Study (소아 만성 신질환 진행의 위험인자 분석-단일기관 연구)

  • Han, Kyoung-Hee;Lee, Sung-Ha;Lee, Hyun-Kyung;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.239-246
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    • 2007
  • Purpose : The progressive deterioration of renal function in children can impose a serious and lifelong impact on their lives. The ultimate goal in the management of children with chronic kidney disease(CKD) is to prolong survival, to prevent complications, and to promote growth and neurodevelopment. The aim of this study is to investigate the risk factors for the decline of renal function in pediatric CKD patients. Methods : Data from patients who met the criteria for the Kidney Disease Outcomes Quality Initiative(K/DOQI) CKD stage 2 to 4 between August 1999 and March 2007 were retrospectively analyzed. The estimated glomerular filtration rate(eGFR) was calculated by the Schwartz formula, using serum creatinine levels and height. We calculated the annual eGFR change from the difference between the baseline eGFR and the last eGFR divided by the duration(years) of the follow-up period. We analyzed the association between the annual eGFR change and factors such as age, gender, K/DOQI stage, underlying renal disease, serum calcium, and inorganic phosphorous during the follow-up period. Results : Sixty one children(44 boys & 17 girls) were enrolled. The age at entry was $7.1{\pm}4.7$ years. The annual eGFR change was $-1.2{\pm}11.9 mL/min/1.73m^2/year$. Our study showed that older age(P=0.005). hypocalcemia(P=0.012), and hypenhosphatemia(P=0.002) were significantly related to more rapid decline in renal function. Conclusion : In pediatric CKD, older age, hypocalcemia and hyperphosphatemia are related to more rapid deterioration of renal function.

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Evaluation of Neoadjuvant Chemotherapy Effect in Osteosarcoma (골육종에서 술전 항암화학요법의 효과 판정)

  • Joo, Min Wook;Kang, Yong-Koo;Yoo, Ie Ryung;Choi, Woo Hee;Chung, Yang-Guk;Kim, Dong-Hyun;Kang, Jin-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.66-73
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    • 2014
  • Purpose: Various diagnostic imaging modalities have been used to evaluate the effect of neoadjuvant chemotherapy for osteosarcoma early and noninvasively. We evaluated the effectiveness of imaging studies of plain radiographs and positron-emission tomography/computed tomography (PET/CT) in predicting neoadjuvant chemotherapy effect for osteosarcoma and tried to establish a general principle in interpretation of PET/CT parameters. Materials and Methods: Eighteen patients who underwent two cycles of neoadjuvant chemotherapy and surgical excision for osteosarcoma were enrolled. There were 13 males and 5 females, with a median age of 19 (11-63) years. Fifteen patients of 18 had the American Joint Committe on Cancer (AJCC) stage IIB. They had plain radiographs and PET/CT before and after neoadjuvant chemotherapy. The resected tumor specimens were pathologically examined to determine histological response grade using a conventional mapping method. Statistical analysis was performed to evaluate the correlation between histopathological necrosis rate, and radiographic finding category, post-chemotherapy maximum standardized uptake value (SUVmax), average standardized uptake value and metabolic tumor volume (MTV) as well as reduction rates of them. Results: Eight patients were good responders to neoadjuvant chemotherapy based on histological evaluation. Median SUVmax reduction rate was 73 (23-77) % in good responders and 42 (-32-76) % in poor responders. Median MTV reduction rate was 93.5 (62-99) % in good responders and 46 (-81-100) % in poor responders. While radiographic finding category was not different according to histological response (p=1.0), SUVmax reduction rate was significantly different (p=0.041). Difference in MTV reduction rates approached statistical significance as well (p=0.071). Conclusion: While radiographic finding category was not reliable to assess neoadjuvant chemotherapy effect for osteosarcoma, reduction rate of SUVmax was a useful indicator in this study. As parameters of PET/CT can be influenced by various factors of settings, different centers have to make an effort to establish their own standard of judgement with reference of previous studies.

The Korean Girl Group Kara's Differentiation Strategy Which Overcome the Trilemma and Led to the Great Reversal Success (삼중고 탈피 후 대역전의 성공을 이끈 걸 그룹'카라'의 차별화 전략)

  • Kim, Jeong-Seob
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.2
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    • pp.169-178
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    • 2021
  • The Korean girl group "Kara" has suffered the trilemma of its de facto failure to debut, the crisis of team breakup, and the CEO crisis of the agency. But the group has made an outstanding achievement in the history of Korean pop music after overcoming all odds. Their success strategy has never been disclosed by insiders involved in Kara's total music projects. This study has been carried out in the analysis of the strategy to provide academic implications and to honor the contribution of the late CEO Ho-yeon Lee and Kara's key member Ha-ra Gu. Therefore, between Nov. and Dec. 2020, we conducted in-depth interviews with managers, composers, stylists and Ha-ra Gu(Only in 2019, before her death) who took part in the project. The research model is set up by combining Porter's Competitive Advantage Strategy and the music value chain model into categories of "Product Innovation Differentiation (PD)" (producing, album production, performance activities) and "Marketing Differentiation (MD)" (market targeting, image specialization, promotion and communication). The analysis showed that the PD focused on complete rediscovered harmonization and revalued members' personality and sincerity with peppy songs and dainty dances as well as emission of "bright energy" which caused healing effects instead of mimicking other star singers recklessly. In terms of MD, they selected Japan's 10-20s as their main market, increasing intimacy with fans and media with the image of cute+pretty+classy+sexy. The result suggests that Poter's differentiation can function as a meaningful strategy frame in the fostering, hit, and revival of idol groups. In addition, it reaffirmed that spontaneous and passionate activities of early-stage or celebrity fan may serve as a valid catalyst for realizing differentiation, as Kara's caller of Japanese actor Gekidan Hitori caused a strong "priming effect" that drove Kara's unexpected wonderful success in Japan.

Assessment for the Utility of Treatment Plan QA System according to Dosimetric Leaf Gap in Multileaf Collimator (다엽콜리메이터의 선량학적엽간격에 따른 치료계획 정도관리시스템의 효용성 평가)

  • Lee, Soon Sung;Choi, Sang Hyoun;Min, Chul Kee;Kim, Woo Chul;Ji, Young Hoon;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Kim, Kum Bae
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.168-177
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    • 2015
  • For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.

Concordance of Seropositivity between Helicobacter pylori and Hepatitis A Virus IgG in Children of Gwangju and Chonnam Area (광주.전남 지역에 거주하는 소아에서 Helicobacter pylori와 A형 간염 바이러스의 혈청 IgG 항체 양성률 비교)

  • Kim, Seon-Young;Kim, Young-Ok;Chung, Hae-Yul;Kim, Byung-Ju;Ma, Jae-Sook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.191-198
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    • 2001
  • Purpose: This study was undertaken to investigate the seroepidemiologic pattern of Helicobacter pylori (H. pylori) and hepatitis A virus (HAV) infections in children. Methods: A total of 315 serum samples were obtained from healthy children, living in Gwangju and Chonnam area. All serum samples were assayed for H. pylori IgG level using enzyme immunoassay techniques. HAV IgG level in serum were tested by a competitive radio-immunoassay in 215 subjects. The age-specific seroprevalence of H. pylori and HAV was separately analysed. The concordance of seropositivity and seronegativity between H. pylori and HAV infection was examined by the kappa statistic analysis. Results: Seropositivity was found in 17.5% (55/315) and 30.2% (65/215) of the subjects for H. pylori and HAV, respectively. Cross-tabulation of these data showed that 21 subjects (9.8%) were seropositive and 135 (62.8%) were seronegative for both H. pylori and HAV, 15 (7.0%) were seropositive for only H. pylori and 44 (20.5%) for only HAV. The seroprevalence of H. pylori and HAV increased significantly with age. There was a slight agreement between H. pylori and HAV seropositivity (${\kappa}$=0.26). Conclusion: This study shows a slight similarity in the concordance of seropositivity and seronegativity between H. pylori and HAV infection and provides evidence that H. pylori and HAV may share a common mode of transmission.

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Characteristics of Exposure to Humidifier Disinfectants and Their Association with the Presence of a Person Who Experienced Adverse Health Effects in General Households in Korea (일반 가구의 가습기살균제 노출 특성 및 건강이상 경험과의 연관성)

  • Lee, Eunsun;Cheong, Hae-Kwan;Paek, Domyung;Kim, Solhwee;Leem, Jonghan;Kim, Pangyi;Lee, Kyoung-Mu
    • Journal of Environmental Health Sciences
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    • v.46 no.3
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    • pp.285-296
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    • 2020
  • Objective: The objective of this study was to describe the characteristics of exposure to humidifier disinfectants (HDs) and their association with the presence of a person who experienced the adverse health effects in general households in Korea. Methods: During the month of December 2016, a nationwide online survey was conducted on adults over 20 years of age who had experience of using HDs. It provided information on exposure characteristics and the experience of health effects. The final survey respondents consisted of 1,555 people who provided information on themselves and their household members during the use of HD. Exposure characteristics at the household level included average days of HD use per week, average hours of HD use per day, the duration within which one bottle of HD was emptied, average input frequency of HD, amount of HD (cc) per one time used, and active ingredients of HD products (PHMG, CMIT/MIT, PGH, or others). The risk of the presence of a person who experienced adverse health effects in the household was evaluated by estimating odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for monthly income and region using a multiple logistic regression model. Subgroup analyses were conducted for households with a child (≤7 years) and households with a newborn infant during HD use. Results: The level of exposure to HD tended to be higher for households with a child or newborn infant for several variables including average days of HD use per week (P<0.0001) and average hours of HD use per day (P<0.0001). The proportion of households in which there was at least one person who experienced adverse health effects such as rhinitis, asthma, pneumonia, atopy/skin disease, etc. was 20.6% for all households, 25.3% for households with children, and 29.9% for households with newborn infants. The presence of a person who experienced adverse health effects in the household was significantly associated with average hours of HD use per day (Ptrend<0.001), duration within which one bottle of HD was emptied (Ptrend<0.001), average input frequency of HD (Ptrend<0.001), amount of HD per one use (Ptrend=0.01), and use of HDs containing PHMG (OR=2.23, 95% CI=1.45-3.43). Similar results were observed in subgroup analyses. Conclusion: Our results suggest that level of exposure to HD tended to be higher for households with a child or newborn infant and that exposure to HD is significantly associated with the presence of a person who experienced adverse health effects in the household.

Depressive Disorders among Hansen Disease Patients Living in a Collective Farm (한 집단 농원 한센병 환자들의 우울장애)

  • Kim, Yun-Gu;Park, Min-Ho;Park, Jae-Won;Song, Joon-Ho;Sim, Seong-Gyun;Lee, Joo-Hyoung;Lee, Hee-Young;Yun, Dong-Il;Jung, Sung-Hwan;Min, Young-Sun;Bae, Geun-Ryang;Jung, Cheoll;Lim, Hyun-Sul;Cheong, Hae-Kwan
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.133-145
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    • 2004
  • Objectives: Depression is a major health concern that can be life threatening if not recognized and treated early. However, there is few report on the depressive disorder of Hansen disease patients in Korea. Therefore, the authors executed this study in order to check factors related to a depressive disorder of a Hansen disease patients and compare with factors to reach to a depressive symptoms of ordinary people with studying their life state and the trouble that Hansen disease patients were currently experiencing Method: The authors surveyed depressive symptoms using self-reported questionnaires in 74 Hansen disease patients and 84 controls. The severity of depressive symptoms was measured using Korean Form of Geriatric Depression Scale (KGDS) score. Result: Positive rate of depressive disorders among Hansen disease patients was 70.3% and that the referents was 31.0%. There is significant difference positive rate of depressive disorders between Hansen disease group and the referents in the factors such as gender, age, frequency of going out, familial type, and familial income. Depressive disorder of Hansen disease group was associated with sex, familial income. According to the multiple logistic regression, the odds ratios of the Hansen disease group versus referents, gender, familial income, frequency of going out were significant (p<0.05). Conclusion: Hansen disease patients had statistically significant higher depressive symptom score than the referents. Also, Hansen disease patients who have lower familial income were more likely to have depressive disorders. Therefore, Economical supports and policy are required for the Hansen disease patients.

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Analysis of Micronuclei and Its Association with Genetic Polymorphisms in Hospital Workers Exposed to Ethylene Oxide (에틸렌옥사이드(Ethylene oxide)에 노출된 병원 근로자들의 소핵 빈도와 유전적 감수성 지표와의 연관성)

  • Lee, Sun-Yeong;Kim, Yang-Jee;Choi, Young-Joo;Lee, Joong-Won;Lee, Young-Hyun;Shin, Mi-Yeon;Kim, Won;Yoon, Chung-Sik;Kim, Sung-Kyoon;Chung, Hai-Won
    • Journal of Environmental Health Sciences
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    • v.37 no.6
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    • pp.429-439
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    • 2011
  • Objectives: Ethylene oxide (EtO) is classified as a human carcinogen, but EtO is still widely used to sterilize heat-sensitive materials in hospitals. Employees working around sterilizers are exposed to EtO after sterilization. The aim of the present study was to assess the exposure of EtO level, coupled with occupationally induced micronuclei from hospital workers. The influence of genetic polymorphisms of detoxifying genes (GSTT1 and GSTM1) and DNA repair genes (XRCC1 and XRCC3) on the frequencies of micronuclei in relation to exposure of EtO was also investigated. Methods: The study population was composed of 35 occupationally exposed workers to EtO, 18 student controls and 44 unexposed hospital controls in Korea. Exposure to EtO is measured by passive personal samplers. We analyzed the frequencies of micronuclei by performing cytokinesis-block micronucleus assay (CBMN assay) and GSTM1, GSTT1, XRCC1, and XRCC3 were also genotyped by performing polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The frequencies of micronuclei in EtO exposure group, student controls and hospital controls were $18.00{\pm}7.73$, $10.47{\pm}7.96$ and $13.86{\pm}6.35$ respectively and their differences were statistically significant, but no significant differences according to the level of EtO were observed. There was a dose-response relationship between the frequencies of micronuclei and cumulative dose of EtO, but no significantly differences were observed. We also investigated the influence of genetic polymorphisms (GSTM1, GSTT1, XRCC1, and XRCC3) on the frequencies of micronuclei, but there were no differences in the frequencies of micronuclei by genetic polymorphisms. Conclusions: The frequencies of micronuclei in EtO exposure group was significantly higher than control groups. A dose-response relationship was found between the level of EtO exposure and the frequencies of micronuclei, but no statistically differences were observed. We also found that the frequencies of micronuclei were increased according to cumulative EtO level. There was no association of the genetic GSTM1, GSTT1, XRCC1, and XRCC3 state with the frequency of micronuclei induced by EtO exposure.

A Study on the Establishment of Management Methods about Occupational Dermatoses (직업성 피부질환에 대한 현황 파악 및 관리 대책 수립을 위한 연구)

  • Lim, Hyun-Sul;Cheong, Hae-Kwan;Choi, Byung-Soon;Kim, Ji-Yong;Sung, Yeol-Oh;Kim, Yang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.617-637
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    • 1996
  • Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

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