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Therapeutic Effect of Nocturnal Water Restriction in Children with Primary Nocturnal Enuresis (일차성 야뇨증 아동에서 야간 수분 제한의 치료 효과)

  • Lee Soo Jin;Yang Jae Young;Kim Hae Soon;Lee Seung Joo
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.51-58
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    • 2001
  • Purpose : Treatment of primary nocturnal enuresis (PNE) includs folk remedies and various treatments based on pathogenesis. We assessed the therapeutic effect of nocturnal water restrict ion as the primary treatment of PNE. Materials and methods : From October 1998 to June 1999, 41 children with PNE (>3 wet nights per week) who visited Ewha Womans University Mokdong hospital and who had good compliances to nocturnal water restriction for 2 months were included. Before and during nocturnal water restriction, daily fluid intake and urine volume were recorded for 2 days every 2 weeks. Responses to nocturnal water restriction were classified according to the decrease of wet nights as complete (>90$\%$), partial (50-90$\%$) and no (<50$\%$) response. Predictors such as age, sex, daytime voiding dysfunction, fluid intake, urine volume, maximum urine volume per void and fasting urine osmolality were evaluated. Results . The response rate to nocturnal water restriction fir 2 month was 82.9$\%$(34/41) [complete response 39.0$\%$(16/41), partial response : 43.9$\%$(18/41)]. The response rate to nocturnal water restriction was significantly higher in monosymptomatic PNE than polysymptomatic PNE and more effective in PNE with or nocturnal fluid intake, nocturnal urine volume, and maximum urine volume than lower nocturnal fluid intake, nocturnal urine volume and maximum urine volume per void (P<0.05). Nocturnal urine volume, maximum urine volume per void and luting urine osmolality after nocturnal water restriction has significantly increased higher in complete response and partial response group than in no response group (P<0.05). Conclusion : The nocturnal water restriction was effective in monosymptomatic PNE with nocturnal polydypsia, nocturnal polyuria and high bladder capacity. (J, Korean Soc Pediatr Nephrol 5 : 51- 8, 2001)

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Immune reactions between excretory-secretory antigens and specific antibodies of Clonorchis sinensis before and after praziquantel treatment in experimentally infected rabbits (간흡충 감염 토끼에서 프라지콴텔 치료 전후의 특이항체의 간흡충 분비배설항원에 대한 면역반응양상)

  • 김석일
    • Parasites, Hosts and Diseases
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    • v.32 no.1
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    • pp.35-42
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    • 1994
  • This study was designed to evaluate the humoral immune reactions in clonorchiasis before and after praziquantel treatment. Rabbits were infected with 150 or 450 metacercariae, treated on 4 and 8111 months after infection, and observed for 13 months of posttreatment. Infection controls were maintained for 22 months. Antigen was the metabolic product of worms incubated in physiologic saline. The immune reactions of anti-clonorchis IgG were observed using SDS-PAGE/immunoblot. During the Infection and Posttreatment, the antigenic Proteins of 66, 63, 54, 52, 50,47,42, 40, 38, 34,33,30, 27, 25, 23, 20, 19, 18, 17, 16, 15, 14, 13, 12.5 and 11.5 kDa were detected. Of them, 33,27, 13, and 12.5-kDa antigens were highly antigenic and observed predominently in infection controls. After the treatment, 13 and 12.5-kDa antigens faded in 6 months after the second treatment, but 33 and 27-kDa antigens were detected until 13 months of posttreatment. The results clearly demonstrate that 13 and 12.5-kDa antigens represent attenuated host immune reactions by praziquantel treatment. As the 12.5-kDa antigen had a large amount of protein in SDS-PAGE, it was designated as'K2-Ag'of C. sinenis.

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Antibody changes in paragonimiasis patients after praziquantel treatment as observed by ELISA and immunoblot (폐흡충증에서 치료 후 혈청내 특이 항체의 변화)

  • 조승열;김석일
    • Parasites, Hosts and Diseases
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    • v.27 no.1
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    • pp.15-22
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    • 1989
  • To observe antibody changes after praziquantel treatment in paragonimiasis, a total of 46 serum samples from 13 serologically diagnosed patients was collected for 4~28 months. The specific antibody (IgG) levels were measured by enzyme- linked immunosorbent assay (ELISA). All but one patient who needed retreatment became symptom-free within a week. Antibody levels were dropped near to or below a cut-off absorbance (abs.) of 0.25 in varying intervals from 4 to 18 months. Of 9 patients who were retested within 3 months, 5 revealed temporary elevation of antibody level. After the elevation, the levels be낙an to decline slowly to negative ranges. If treated earlier after symptoms developed, the temporary elevation did not occur and intervals to negative conversion were shorter. By sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) /immunoblot, antigen-antibody reactions in individual patient faded gradually without significant changes in reacting antigen bands.

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Factors Contributing to Treatment Outcome of Functional Constipation in Children (소아 기능성 변비의 치료에 영향을 미치는 인자)

  • Kim, Hyung-Seok;Hong, You-Rha;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.36-43
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    • 2010
  • Purpose: The aim of this study was to evaluate the clinical features and factors contributing to treatment outcome for chronic functional constipation in children. Methods: We analyzed the medical records of patients with constipation, who visited the inpatient or outpatient clinic of the Department of Pediatrics of Pusan National University Hospital, between January 1998 and December 2007. The clinical features, outcomes, and factors affecting the treatment response according to the main drug (lactulose vs. PEG 4000) were analyzed retrospectively. Results: Two hundred forty children (142 males and 98 females) were enrolled in this study. The mean age was 51.2${\pm}$37.9 months. The duration of symptoms was 32.6${\pm}$33.7 months. The accompanying symptoms were as follows: encopresis, 91 (30.4%); abdominal pain, 76 (31.6%); and blood-tinged stool, 37 (15.4%). The treatment response was achieved earlier in females (p<0.001), patients with accompanying symptoms (p<0.05), and patients treated with PEG 4000 (p=0.001). The duration of symptoms (p<0.05) and stool frequency before treatment (p<0.05) were related to a delayed treatment response. Relapse occurred in 7 children, all of whom were treated successfully later. Conclusion: Factors contributing to treatment response are female gender, accompanying symptoms, duration of symptoms, and stool frequency before treatment. PEG 4000 is superior to lactulose in response time and taken into consideration as a primary drug for the treatment of functional constipation of children. Early treatment and sufficient treatment time may also be important factors to achieve an early response and prevent relapse.

Evaluation of Electric Pulp Test (EPT) as a Tool for Measurement of Dentinal Hypersensitivity (상아질 지각과민 측정 도구로서의 전기치수검사에 대한 평가)

  • Kim, Young-Sung
    • Journal of Periodontal and Implant Science
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    • v.32 no.2
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    • pp.371-378
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    • 2002
  • In this study, 40 hypersensitive teeth of 19 patients were investigated. The procedures performed were as follows: Before desensitization, EPT at occlusal third of buccal surface was done for the evaluation of pulp vitality and the EPT value was recorded for the reference value. And mechanical and thermal test was executed for the test of hypersensitivity. If the tooth responded to the above tests, we did EPT at the exposed surface, using toothpaste as a electrolite medium and recorded the EPT value at patient's response. After the tests had been done, desensitization procedures with Gluma(R) Desensitizer were performed according to the manufacturer's instructions. After desensitization, the same tests except EPT at occlusal third were repeated. All the 40 teeth responded positive before desensitization and negative after desensitization procedures. The EPT value at occlusal third ranged from 31 to 65 (48.9${\pm}$7.2). Before desensitization 34 teeth responded at EPT value of 2 and the remaining 6 teeth was in the range of 17 to 25. After desensitization all 40 teeth responded from 12 to 27 (19.6${\pm}$3.5). The 6 teeth responded at greater number than 2 before desensitization was in the range of 18 to 23. Within the limitations of this study we can conclude that: When a tooth with dentinal hypersensitivity responds to mechanical and thermal stimulation, the tooth shows very low resistance to electricity at the exposed surface while when a tooth is desensitized and doesn't show respond to mechanical and thermal stimuli, the tooth shows increased level of resistance to electric stimulation at the exposed surface. EPT can be used for the diagnosis of dentinal hypersensitivity. Furthermore EPT will be useful to evaluate the outcome of desensitization procedures. However, EPT is not a valid tool for measuring dentinal hypersensitivity.

Serological and Histological Changes after Interferon Alfa Therapy in Children with Chronic Hepatitis B (소아 만성 B형 간염의 Interferon Alfa 치료 후 혈청학적, 조직학적 소견의 변화)

  • Ko, Jae-Sung;Chung, Ju-Young;Jang, Ja-Joon;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.56-62
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    • 2000
  • Purpose: The aim of this study was to evaluate the efficacy and histologic changes of interferon-alfa therapy on chronic hepatitis B virus infection in children. Patients and Methods: Thirty five children aged 3~16 years who were seropositive for HBV DNA, HBsAg and HBeAg were enrolled. Interferon-alfa 2a ($3.4\;MU/m^2$) were given for 6 months. Serologic markers of viral replication was evaluated 1 year after therapy. Post treatment liver biopsy was performed in 18 patients who showed serologic response. Results: Serum HBeAg and viral DNA became negative in 22 (63%) of treated children at 12 months after therapy. Serum aminotransferase levels normalized in all of the responders and HBsAg became negative in one responder. Horizontal transmission, serum aminotransferase levels more than twice normal, and active inflammation on liver biopsy were predictive factors for response to interferon therapy. Periportal piecemeal necrosis, lobular activity, portal inflammation, fibrosis, and total histologic activity index were reduced in responders. Conclusion: In children with chronic hepatitis B, interferon alfa promotes loss of viral replication and improves aminotransferase. Serologic response is associated with improvement in hepatic histology.

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Relationship between Subjective Oral Health Recognition and Dental Fear in Dental Clinic Patients (치과내원환자의 주관적 구강건강인식과 치과공포의 관련성)

  • Yoon, Hyun-Seo;Park, Ji-Hyun
    • The Journal of the Korea Contents Association
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    • v.12 no.6
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    • pp.371-379
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    • 2012
  • The purpose of this study is to develop basic data in improving quality of life along with the enhancement in oral health, by arranging a plan for being able to reduce dental fear given the dental treatment in the future by grasping the subjective oral health recognition & status, and the dental fear level of the dental treatment field targeting patients of visiting dental clinics in Busan and Gyeongnam area. In the whole items of DFS, a sense of fear was higher in women than men. A factor of avoiding dental treatment stood at 1.72 points in men and 2.10 points(p<0.001) in women. A factor of response to stimulation stood at 2.75 points in men and 3.20 points(p=0.001) in women. A fear level according to dental kind was high in a factor of avoiding implant treatment(p=0.015), a factor of avoiding orthodontic treatment(p=0.002), physiological reaction(p=0.009), a factor of avoiding prosthesis treatment(p=0.014), a factor of avoiding pulpectomy treatment(p=0.005), a factor of physiological reaction(p=0.017), a factor of avoiding periodontal therapy(p=0.013), a factor of physiological reaction(p=0.004), and a factor of avoiding treatment given not receiving regular checkup(p=0.027). In the above results, to reduce dental fear, there will be a need of developing diverse programs and oral health eduction for regular checkup and preventive treatment.

A Role of Trial Radiation Therapy in the Pineal Region Tumors (송과체부 종양에서 시험적 방사선치료의 역할)

  • Kim, Yeon-Shil;Ryu, Mi-Ryung;Chung, Su-Mi;Kim, Moon-Chan;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.100-107
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    • 2002
  • Purpose : The aim of this retrospective study was to assess the treatment results of 30 patients with pineal region tumors who were underwent radiation therapy under the diagnosis by either CT or MRI. There was no histological verification. We analyzed the prognostic factors that have a significant effect on the overall survival (OS) and disease free survival (DFS) rates. Materials and Methods : A total 30 patients with pineal region tumors were treated between March 1983 and August 1995. After a trial radiation therapy of $20\~30\;Gy/2\~3$ weeks, the patients were evaluated for their clinical response and radiological response by either CT or MRI and the final treatment direction was then decided. According to their response to the trial radiation therapy and the involved site, radiation treatment was given in various fields i.e., local, ventricle, whole brain and craniospinal field. The radiation dose ranged from 40.8 to 59.4 Gy (Median 50.4 Gy). The median follow up was 36.5 months $(4\~172\;months)$. Results : An improvement or stability in the clinical symptoms was observed in 28 patients $(93.3\%)$ after the trial RT. Nineteen patients $(63.3\%)$ showed a partial or complete response by CT or MRI. The two-year and five-year survival rates of the patients were $66.7\%$ and $55.1\%$, respectively. No significant difference in the survival rates according to the degree of the radiological response was abserved after the trial RT. The results of univariate analysis showed that age, the primary site, the performance status $(KPS\geq70)$, the degree of response after completing RT and the RT field were significant prognostic factors affecting the survival and disease free survival rates (p<0.05). Conclusion : The clinical and histological characteristics of pineal region tumors are quite complex and diverse. Therefore, it is difficult to predict the histological diagnosis and the possibility of radiocurability only with the initial response to RT. We think that the development of less invasive histological diagnostic techniques and tailored treatment to the histological type of each tumor are needed.

The Effect of Sensory Integrative Intervention Focused on Proprioceptive-Vestibular Stimuli on Adaptive Response of Children With Sensory Defensiveness: Case Study (고유-전정감각 중심의 감각통합 중재가 감각방어 아동의 적응반응에 미치는 효과: 사례보고)

  • Park, Ji-Hoon;Kim, In-Sun
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.2
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    • pp.29-39
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    • 2011
  • Objective : The purpose of this study is to verify the effect of sensory integrative intervention focused on proprioceptive-vestibular stimuli on adaptive response of children with sensory defensiveness. Methods : Subject of this study was a 6 years and 5 month old boy. The subject underwent a sensory integration (SI) treatment which was part of the SI treatment course administered by the Korean Sensory Integration Society, in 2011. The treatment goal and treatment plan had established based on the evaluation results. Treatment was done with 4 sessions and the adaptive responses of the subject were measured as outcome of the SI treatment. Results : During the SI treatment, the subject could participate in activities involving tactile stimulation without over-arousal. He also showed improved social interaction skills and his play was qualitatively extended. Conclusion : According to the results of this study, it was verified that sensory integrative intervention focused on proprioceptive-vestibular stimuli has positive effective on adaptive response for children with sensory defensiveness. For the future study, it is suggested to use standardized assessments in evaluation and provide information in changes of daily occupation as outcome data.

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Neoadjuvant Chemotherapy and Radiotherapy in Locally Advanced Hypopharyngeal Cancer (국소 진행된 하인두암의 선행 항암화학요법 후 방사선치료)

  • Kim Suzy;Wu Hong-Gyun;Heo Dae-Seog;Park Charn I1
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.244-250
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    • 2000
  • Purpose : To see the relationship between the response to chemotherapy and the final outcome of neoadiuvant chemotherapy and radiotherapy in patients with mocanry advanced hypopharyngeal cancer. Methods and Materials :A retrospective analysis was done for thirty-two patients with locally advanced hypopharyngeal cancer treated in the Seoul National University Hospital with neoadiuvant chemotherapy and radiotherapy from August 1979 to July 1997. The patients were treated with Co-60 teletherapy unit or 4MV or 6MV photon beam produced by linear accelerator. Daily fractionation was 1.75 to 2 Gy, delivered five times a week. Total dose ranged from 60.8 Gy to 73.8 Gy. Twenty-nine patients received continuous infusion of cisplatin and 5-FU. Other patients were treated with cisplatin combined with bleomycin or vinblastin. Twenty-four (75$\%$) patients received all three prescribed cycles of chemotherapy delivered three weeks apart. Six patients received two cycles, and two patients received only one cycle. Results :The overall 2-year and 5-year survival rates are 65.6$\%$ and 43.0$\%$, respectively. 5-year local control rate is 34$\%$. Organ preservation for more than five years is achieved in 12 patients (38$\%$). After neoadjuvant chemotherapy, 24 patients achieved more than partial remission (PR): the response rate was 75$\%$ (24/32). Five patients had complete remission (CR), 19 patients PR, and 8 patients no response (NR). Among the 19 patients who had PR to chemotherapy, 8 patients achieved CR after radiotherapy. Among the 8 non-responders to chemotherapy, 2 patients achieved CR, and 6 patients achieved PR after radiotherapy. There was no non-responder after radiotherapy. The overall survival rates were 60$\%$ for CR to chemotherapy group, 35.1$\%$ for PR to chemotherapy group, and 50$\%$ for NR to chemotherapy group, respectively (p=0.93). There were significant difference in five-year overall survival rates between the patients with CR and PR after neoadjuvant chemotherapy and radiotherapy (73.3$\%$ vs. 14.7$\%$, p<0.01). The prognostic factor affecting overall survival was the response to overall treatment (CR vs. PR, p<0.01). Conclusion :In this study, there were only five patients who achieved CR after neoadiuvant chemotherapy. Therefore the difference of overall survival rates between CR and PR to chemotherapy group was not statistically significant. Only the response to chemo-radiotherapy was the most important prognostic factor. There needs to be more effort to improve CR rate of neoadjuvant chemotherapy and consideration for future use of concurrent chemoradiotherapy.

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