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Clinical Significance of Antibodies Against Platelet HLA Class I in Children with Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소증에서 항-HLA Class I항체의 임상적 의미)

  • Lee, Hong Jun;Yeom, Jung-Sook;Park, Ji Sook;Park, Eun Sil;Seo, Ji-Hyun;Lim, Jae Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • The Korean Journal of Blood Transfusion
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    • v.24 no.3
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    • pp.233-240
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    • 2013
  • Background: A previous history of transfusion has been known to be associated with production of anti-HLA class I antibodies. However, platelet glycoproteins are the main target of idiopathic thrombocytopenic purpura (ITP). The mechanism of antibody production is known to differ significantly between glycoproteins and anti-HLA class I. The aim of this study was to evaluate the clinical significance of anti-HLA class I antibodies in childhood ITP. Methods: Enrollment for the normal control group targeted 48 people who visited Gyeongsang National University Hospital from 1990 to 2010, and 48 young children with ITP. Anti-glycoproteins and anti-HLA class I antibodies were tested using the Modified Antigen Capture Enzyme-linked immunosorbent assay (MACE) kit. Results: The positive rate of anti-HLA antibodies was significantly different [36/39 (92.3%) vs 29/46 (63%)] [ITP group vs normal control group] (P=0.002). The mean positive S/C ratio of anti-HLA antibodies was also significantly different (3.55 vs 1.51) [ITP group vs normal control group] (P=0.0000). The positive rate of anti-HLA did not differ significantly between the transfused group and the non-transfused group [12/12 (100%) vs 24/27 (88%)] [transfused ITP vs non-transfused ITP]. The mean positive S/C ratio of anti-HLA antibodies did not differ significantly between the transfused ITP group and the non-transfused ITP group (4.30 vs 3.25) [transfused ITP vs non-transfused ITP]. Consecutive testing showed that positive rate and positive S/C ratio of anti-HLA antibodies did not change significantly between sampling times in both groups [transfused ITP vs non-transfused ITP] (P=1.00 and P=0.15). Conclusion: Anti-HLA class I antibodies may be involved in childhood ITP. Transfusion did not affect the course of childhood ITP.

Severe Human Rhinovirus Lower Respiratory Tract Infections in Young Children

  • Doo Ri Kim;Kyung-Ran Kim;Hwanhee Park;Esther Park;Joongbum Cho;Jihyun Kim;Hee Jae Huh;Kangmo Ahn;Nam Yong Lee;Yae-Jean Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.111-120
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    • 2023
  • Purpose: Human rhinovirus (HRV) infections can result in lower respiratory tract infections (LRTIs). We aimed to investigate the characteristics of severe HRV LRTI in young children. Methods: Medical records were reviewed retrospectively in patients who were hospitalized for HRV LRTIs from 2016 to 2020 at the Samsung Medical Center in Seoul, Korea. Patients aged 90 days or older and younger than 5 years were included. Patients with co-infections with other respiratory pathogens were excluded. Severe HRV LRTI was defined as the following: the need for high-flow oxygenation, mechanical ventilation, or intensive care unit admission. Results: A total of 115 cases were identified. The median age was 17 months (range, 3-56 months) and the median hospital days were 4 days (range, 2-31 days). Of the 115 cases, 18 patients (15.7%) developed severe HRV LRTI. The median age was younger in the severe group compared to the non-severe group (9.5 months vs. 19.0 months, P=0.001). Of 18 patients with severe HRV LRTI, 11 (61.1%) had underlying diseases - chronic lung diseases accounted for the largest proportion (63.6%). Six patients (33.3%) required mechanical ventilation. Of note, 7 previously healthy children were diagnosed with severe HRV LRTI. Of those 7 children, 4 of them were diagnosed with asthma later. When the 115 cases were divided into previously healthy (n=60) and underlying disease (n=55) groups, severe courses of HRV LRTI were observed in 11.7% and 20.0% of children, respectively (P=0.219). Conclusions: HRV can cause severe LRTI even in previously healthy children as well as in children with comorbidities.

Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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Development of a Measuring Tool for Spiritual Care Performance of Hospice Team Members (호스피스 팀원들의 영적 돌봄 수행도 측정 도구 개발)

  • Yoo, Yang-Sook;Han, Sung-Suk;Lee, Sun-Mi;Seo, Min-Jeong;Hong, Jin-Ui
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.86-92
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    • 2006
  • Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.

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Study on Development in Professional Work of Radiological Technologists (방사선사 업무의 발전에 관한 조사 연구)

  • Choi, Jong-Hak;Kim, Chang-Kyun;Kim, Won-Chul;Kim, Seung-Chul
    • Journal of radiological science and technology
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    • v.29 no.3
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    • pp.197-210
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    • 2006
  • This study explored several agenda related to license system, education, professional work of radiological technologists(RTs) and a transition process of law for them to investigate a developmental strategy of RTs as a professional career. The results are as followings : 1. The national license system for RTs was started from 1965, 1965-1972 x-ray technicians(medical assistance), 1973-present(2006) radiotechnologist(medical technologist) since then. 2. The average pass ratio of national license examination(1965-2006) for RTs was 46.6%. The method, subjects and level of the examination should be improved. 3. The education term for RTs has been changed since 1963 ; 1963-1990 two year college, 1991-1999 three year college, 2000-2006 four year and three year college depending on universities and colleges. As of 2006, there are twelve 4-year universities and eighteen 3-year colleges. The total number of new students were 1,956. 4. The new developmental paradigm should be made for technology education of RTs corresponding to the development of medicine and science. 5. The qualification system of clinical specialists in radio-technology field needs to be operated not by the non-governmental body(The Korean Radiological Technologists Association) but by the governmental body. 6. The vertical relationship among RTs, doctors and other medical workers should be rebuilt through the revision of law. Especially, doctors and dentists 'guidance authority' for RTs should be changed to 'request authority'. 7. The service extent of RTs should be extended in medical fields corresponding to professional work of RTs and a revision of the law needed for this situation.

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Clinical Findings of Mycoplasma Pneumonia in Children, from 1998 to 2003 (최근 6년간(1998-2003) 소아 Mycoplasma 폐렴의 임상 양상)

  • Kim, Ji-Hyun;Chae, Soo Ahn;Lee, Dong-Keun
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.969-975
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    • 2005
  • Purpose : We performed a study of clinical findings of Mycoplasma Pneumonia in children, to know differences between recent clinical manifestations of Mycoplasma pneumonia and previous studies. Methods : The subjects of this study were 393 children who were diagnosed as Mycoplasma pneumonia with high titers of Mycoplasma antibody(${\geq}1$ : 160) or fourfold rises of Mycoplasma antibody at Chung Ang University Hospital from January 1998 to December 2003. We practiced a retrospective study on the clinical manifestations of Mycoplasma pneumonia based on their medical records. Results : Male to female ratio was 1.06 to 1 and mean age was $4.32{\pm}2.94years$. The highest incidence was in the age of 2 to 3 years(18.6 percent). Most frequent months were October, and November in 2000, April in 2002, and October and, December in 2003. Twenty six point seven percent showed allergic diseases. Second degree relatives of 10.7 percent patients had allergic diseases. Forty three point three percent were admitted before this admission for pneumonia. Allergic tests were positive in 65.7 percent. Cough, and sputum were the most common symptoms and abdominal pain, and vomiting were the most frequent extrapulmonary symptoms. Atelectasis and pleural effusion were seen in 2.5 percent and 1.8 percent. Infiltrations were more common on the right side. Titers of each simultaneous test for cold agglutinin and mycoplasma antibody were not in proportion to each other (P=0.163). Conclusion : The onset age of mycoplasma pneumonia was found to be lower than it used to be. More patients had a past medical history or a family history of allergic disease, and more wheezing was heard and associated with recurrent pneumonia.

A CASE OF TREATMENT-RESISTANT CHILDHOOD-ONSET SCHIZOPHRENIA WITH LONG-TERM TRIAL OF CLOZAPINE (치료저항성 소아기 발병 정신분열증의 Clozapine 장기치험 1례)

  • Jang, Soon-Ah;Kim, Kyung-Hee;Lee, Hong-Shick;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.98-104
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    • 1998
  • A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

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The effect of copper alloy scaler tip on the surface roughness of dental implant and restorative materials (구리 합금 초음파 스케일러 팁이 치과 임플란트 및 수복 재료 표면에 미치는 영향)

  • Lee, Ah-Reum;Chung, Chung-Hoon;Jung, Gyu-Un;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.3
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    • pp.177-185
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    • 2014
  • Purpose: This study is designed to investigate the various impacts of different types of scaler tips such as cooper alloy base tip and the others on the surface roughness of teeth and implant by the method which is currently in clinical use. Materials and methods: Four different types of disc shaped porcelain, titanium, zirconia, and Type III gold alloy dental materials sized 15 mm diameter, 1.5 mm thickness were used for the experiment. Plastic hand curette (Group PS), cooper alloy new tip (Group IS), and stainless steel tip (Group SS) were used as testing appliances. A total of 64 specimens were used for this study; Four specimens for each material and appliance group. Surface roughness was formed with 15 degree angle in ultrasonic scaler tip and with 45 degree angle in hand curette of instrument tip and the specimen surface with 5 mm long, one horizontal-reciprocating motion per second for 30 seconds by 40 g force. To survey the surface roughness of each specimen, a field emission scanning electron microscope, an atomic force microscope, and a surface profiler were used. (Ra, ${\mu}m$). Results: According to SEM, most increased surface roughness was observed in SS group while IS groups had minimal roughness change. Measurement by atomic force microscope presented that the surface roughness of SS group was significantly greater than those of PS, IS and control groups in the type III gold alloy group (P<.05). IS group showed lesser surface roughness changes compared to SS group in porcelain and gold alloy group (P<.05). According to surface profiler, surface roughness of SS group showed greater than those of PS, IS and control groups and IS group showed lesser than those of SS group in all specimen groups. Type III gold alloy group had large changes on surface roughness than those of porcelain, titanium, zirconia (P<.05). Conclusion: The result of this study showed that newly developed copper alloy scaler tip can cause minimal roughness impacts on the surface of implant and dental materials; therefore this may be a useful alternative for prophylaxis of implant and restored teeth.

Association between Tumor Necrosis Factor-$\alpha$ Gene Polymorphism and Bronchopulmonary Dysplasia in Preterm Infants (조산아 기관지폐이형성증과 Tumor Necrosis Factor-$\alpha$ 유전자 다형성과의 연관성)

  • Jo, Heui-Seung;Chang, Yoon-Hwan;Kim, Han-Suk;Kim, Byeong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.42-48
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    • 2011
  • Purpose: Several factors including prolonged inflammatory response are thought to contribute to the pathogenesis of bronchopulmonary dysplasia (BPD). The clinical findings can be explained by an increased production of proinflammatory cytokines such as tumor necrosis factor alpha (TNF-$\alpha$ ). We investigated the relationship between susceptibility to BPD and TNF-$\alpha$ promoter polymorphisms to identify genetic factors of the disease. Methods: Thirty-eight preterm infants who had developed BPD and 55 controlled infants with a birth weight <1,500 g were analyzed for TNF-$\alpha$ genotypes. The alleles of five promoter sites (-1031/-863/-857/-308/-238) of TNF-$\alpha$ gene were determined using $Taqman^{(R)}$-based allelic discrimination assays. Results: Gestational age ($27^{+5}{\pm}2^{+0}$ wk vs. $29^{+2}{\pm}1^{+4}$ wk, P<0.0001) and birth weight (990${\pm}$270 g vs. 1,220${\pm}$230 g, P<0.0001) were lower in the BPD group compared to the control group. The incidence of respiratory distress syndrome (71.1% vs. 49.1%, P=0.035) and patent ductus arteriosus (71.1% vs. 50.9%, P=0.052) was higher in the BPD group compared to the control group. The frequencies of the alleles and genotypes of five promoter sites (-1031/-863/-857/-308/-238) of TNF-$\alpha$ gene did not show differences between the BPD group and the control group. Conclusion: TNF-$\alpha$ promoter polymorphisms are not associated with susceptibility to BPD in Korean preterm infants.

Socioeconomic Factors Relating to Obesity and Inadequate Nutrient Intake in Women in Low Income Families Residing in Seoul (서울지역 저소득층 여성의 비만 및 영양소 섭취 부족과 관련된 사회경제적 요인)

  • Hwang, Ji-Yun;Ru, Sung-Yeap;Ryu, Han-Kyoung;Park, Hee-Jung;Kim, Wha-Young
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.171-182
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    • 2009
  • This study was performed to investigate socioeconomic factors relating to obesity and inadequate nutrient intake in women in low income families residing in Seoul. The subjects were 125 women (aged 41-87 y) recruited from the local health center for free health examination for low income families. The socioeconomic status such as educational level, income level, and housing condition were poor. For subjects aged less than 65 years, the prevalence of obesity was 44% based on BMI (${\geq}\;25\;kg/m^2$), 48% based on WHR (${\geq}\;0.85$), and 50% based on waist circumference (${\geq}\;80\;cm$) and for those more than 65 years, these were greater and 57%, 81%, and 79%, respectively. The main food sources of daily diet were vegetables, grains, and fruits. Energy and other nutrient intake was not adequate for all subjects and the inadequacy was more profound in the elderly, showing percentages of subjects whose intake was less than EAR were greater than 50% for all nutrients except for iron and below RI were also greater than 50% for all nutrients. The prevalence of obesity and nutrient inadequacy were not associated with socioeconomic status in subjects aged less than 65 years, however, obesity was associated with household income and nutrient inadequacy was related to education (vitamin A) and housing status (protein, phosphate, and iron) in the elderly. After adjustment for ages, in the elderly, OR for obesity (BMI ${\geq}$ 25, OR = 12.601; 95% CI = 2.338-67.911) and central obesity (WC ${\geq}$ 80 cm, OR = 4.778; 95% CI = 1.103-20.696) were greater in subjects who earned less than 500 thousand Won per month than who earned more. For inadequate nutrient intake, the OR for inadequate intake of Vitamin A (OR = 4.555; 95% CI = 1.491-13.914) was greater in subjects with no education than those educated. Subjects without her own house had greater risk for inadequate intake for protein (OR = 3.660; 95% CI = 1.118-11.981), phosphate (OR = 3.428; 95% CI = 1.157-10.158), and iron (OR = 3.765; 95% CI = 1.205-11.766) than subjects possessing her house. In elderly females in low income families, the socioeconomic status was associated with the risk for obesity (income level) and inadequate nutrient intake (education level and housing status). More attention on these groups should be given for prevention of obesity and inadequate nutrient intake.