• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.593-601
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• 2006

Allergic rhinitis is a common disease of childhood characterized by nasal, throat, and ocular itching, rhinorrhea, sneezing, nasal congestion. Those affected with allergic rhinitis often suffer from associated inflammatory conditions of the mucosa, such as allergic conjunctivitis, rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Allergic rhinitis must be diagnosed and treated properly to prevent complications and impaired quality of life. Despite a high prevalence, allergic rhinitis isoften undiagnosed and inadequately treated, especially in the pediatric population. The first step in treatment is environmental control when appropriate. It may be difficult to eliminate all offending allergens effectively to reduce symptoms, so medications are often required. Many different classes of medications are now available, and they have been shown to be effective and safe in a large number of well-designed, clinical trials. Antihistamines are effective in treating immediate symptoms of sneezing, pruritus, watery eyes, and rhinorrhea. Second generation antihistamines are the preferred antihistamines because of their superior side effect profile. Thus, decongestants are commonly used with oral antihistamines. Intranasal corticosteroids are the most effective therapy for allergic rhinitis. Leukotriene modifier may be as effective as antihistamines in treating allergic rhinitis symptoms. Cromolyn sodium is an option for mild disease when used prophylactically, and ipratropium bromide is effective when rhinorrhea is the predominant symptom. When avoidance measures and medications are not effective, specific immunotherapy is an effective alternative. Only immunotherapy results in sustained changes in the immune system. Because of improved understanding of the pathogenesis, new and better therapies may be forthcoming. The effective treatment of allergic rhinitis in children will reduce symptoms and will improve overall health and quality of life, making a happier, healthier child.

• Parasites, Hosts and Diseases
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• 제49권1호
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• pp.91-94
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• 2011

We report 2 cases of Thelazia rhodesii infection in the African buffaloes, Syncerus caffer, in Zambia. African buffalo calves were captured from the livestock and wildlife interface area of the Kafue basin in the dry season of August 2005 for the purpose to translocate to game ranches. At capture, calves (n = 48) were examined for the presence of eye infections by gently manipulating the orbital membranes to check for eye-worms in the conjunctival sacs and corneal surfaces. Two (4.3%) were infected and the mean infection burden per infected eye was 5.3 worms (n=3). The mean length of the worms was 16.4 mm (95% CI; 14.7-18.2 mm) and the diameter 0.41 mm (95% CI; 0.38-0.45 mm). The surface cuticle was made of transverse striations which gave the worms a characteristic serrated appearance. Although the calves showed signs of kerato-conjunctivitis, the major pathological change observed was corneal opacity. The calves were kept in quarantine and were examined thrice at 30 days interval. At each interval, they were treated with 200 ${\mu}g/kg$ ivermectin, and then translocated to game ranches. Given that the disease has been reported in cattle and Kafue lechwe (Kobus lechwe kafuensis) in the area, there is a need for a comprehensive study which aims at determining the disease dynamics and transmission patterns of thelaziasis between wildlife and livestock in the Kafue basin.

• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.519-524
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• 2010

목 적: 지속적인 발열과 3개 이하의 가와사끼병 진단 기준을 만족하는 환자군에서 불완전 가와사끼병을 감별하는데 있어 NT-proBNP가 가지는 진단적 의미를 살펴보고자 하였다. 방 법: 2008년 1월부터 2009년 6월까지 가와사끼병으로 진단 및 치료 받은 환자 96명을 대상으로 하였다. 진단은 입원 당일 열을 포함한 가와사끼병의 고전적인 진단 기준에 따랐고, 진단 기준의 만족 정도에 따라서 완전 가와사끼병 환자군과 불완전 가와사끼병 환자군으로 구분하였으며, NT-proBNP를 포함한 혈액검사를 시행하였다. 지속되는 열과 함께 3개 미만의 진단 기준을 만족하였지만 임상 경과와 여러 검사들을 통해 환자 19명을 대조군으로 하여 분석하였다. 결 과: 96명의 가와사끼병 환자 중 고전적인 진단 기준을 3가지 이하로 만족한 불완전 가와사끼병 환자는 33명으로 전체 가와사끼병 환자의 34% 였다. 임상 양상으로 구강 점막의 변화와 안검 충혈이 가장 많았는데 완전 가와사끼병에 비해 발생 빈도는 적었다(76% vs 98%, 76% vs 90%). 불완전 가와사끼병 환자의 NT-proBNP는 대조군에 비해 유의하게 높았으며($1407.7{\pm}1633.5pg/mL$ vs $126.2{\pm}135.5pg/mL$, $P$<0.001), cutoff value를 158 pg/mL으로 하였을 때 민감도 81%, 특이도 74% 로 C 반응성 단백 ${\geq}3mg/dL$의 민감도 74%, 특이도 68% 보다 높았지만, 적혈구 침강 속도 ${\geq}40mm/hr$의 민감도 70%, 특이도 84%로 특이도에서 적혈구 침강 속도보다 낮았다. 결 론: 지속되는 열, 안검 충혈, 구강 점막의 변화가 있어 불완전 가와사끼병으로 의심해야 하는 환자에서 NT-proBNP 검사를 시행하고 진단에 이용하는 것이 가와사끼병의 빠른 진단과 치료에 도움이 될 것이다.

• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.376-382
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• 2002

목 적 : 최근에 고전적인 진단 기준을 만족하지 않는 비정형 가와사키병에 대한 보고가 증가하고 있어 이의 조기 진단 및 치료를 위한 진단 기준을 마련하고자 하였다. 방 법: 1998년 1월부터 2000년 6월까지 가와사키 병으로 진단 받은 환아 총 167명을 대상으로 비정형 가와사키병의 임상적 특징을 전형적 가와사키병과 비교 분석하였다. 결 과 : 1) 총 환아 167명 중 비정형 가와사키병은 28명(16.8%)이었고, 1세 미만 환아의 비율은 25.0%로 전형적 가와사키병에서의 16.5% 보다 높은 경향을 보였다(P=NS). 2) 전형군과 비정형군 간에 임상 증상의 발생 빈도를 비교하면 구강 점막 변화를 제외하고 안구 결막의 충혈, 부정형 발진, 사지 말단의 변화, 경부 림프절 종대는 비정형군에서 유의하게 낮았다. 비정형군의 임상 증상 중에서 구강 점막 변화가 제일 흔하며(96.4%), 다음으로 안구 결막 충혈(57.1%), 부정형 발진(46.4%)의 순이었다. 급성기의 검사 소견은 대부분 두 군간에 차이가 없었으며, 적혈구 용적 <35%, ESR >30mm/hr, CRP >3.1 mg/dL의 빈도는 두 군에서 모두 높았다. 3) 관상동맥 병변은 비정형군에서는 28명 중 7명(25.0%), 전형군에서는 139명 중 20명(14.4%)에서 발생하여 비정형군에서 빈도가 더 높은 경향을 보였다(P=NS). 4) 관상동맥 병변이 있는 환아 총 27명 중에서 7명(25.9%)이 비정형 가와사키병 환아였다. 5) 구강 점막 변화를 주기준, 안구 결막 충혈, 부정형 발진 및 적혈구 용적 <35%, ESR >30 mm/hr 또는 CRP >3.1 mg/dL을 부기준으로 할 때 발열과 주 기준 그리고 2개 이상의 부기준이 있을 때, 또는 발열과 4개의 부기준이 있을 때를 비정형 가와사키병의 진단 기준으로 정할 때 민감도는 89.3%였다. 결 론 : 비정형 가와사키병의 조기 진단을 위해 본 연구에서 제안한 진단 기준이 도움이 되리라고 생각된다.

• 한국환경보건학회지
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• 제40권5호
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• pp.367-375
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• 2014

Objectives: The main purpose of this study is to produce background data which can be compared with several large-scale industrial complex regions. Methods: The framework of this study was designed to evaluate and monitor health effects associated with low-level and long-term exposure to environmental pollutants. In this study, 1,009 local residents were recruited in the city of Chungju using personal questionnaires, medical check-ups, and allergen skin-prick tests for 12 common allergens. The prevalence rate of skin allergens was reviewed together with that from large-scale industrial areas. Results: The diagnosis prevalence and medical treatment prevalence of asthma was 5.6% and 1.7%, respectively. Allergic rhinitis was 25.4% and 16.7%, allergic dermatitis was 16.6% and 9.9% and allergic conjunctivitis was 18.7% and 7.9%, respectively. These results were similar with those of industrial complexes. The prevalence of allergen skin-prick test was 16.4% and the most common allergen was dust mites (27.9-31.6%). This result was lower than those of the industrial complexes (22.5-39.9%) and Gangneung (18.2-24.7%). Conclusion: Further study is required to find the cause of the regional differences in skin prick prevalence.

• 약학회지
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• 제43권1호
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• pp.16-22
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• 1999

Scutellaria baicalensis Georgi (Labiatae) has been extensively used in treatment of diarrhea, conjunctivitis, gastritis, enteritis and skin disease. As instructed in old description, the Scutellariae Radix should sometimes be processed before use. To 노디 light on the changes of chemical compositions by processing as well as processing method-activity relationships, Scutellariae Radix was heated at 16$0^{\circ}C$-20$0^{\circ}C$ for 30 min. in furnace or soaked with 20% EtOH (SPE) and boy's urine(SPU), respectively, which are one of processing methods and then heated at 17$0^{\circ}C$ for 30 min. To isolate the chemical components, Scutellariae Radix with/without processing were extracted with EtOH and EtOH extract was fractionated with ether, ethyl acetate and butanol to give respective fractions. Ether and EtOAc fractions obtained from the processed drug with urine (SPU) were subjected to chromatography to obtainsix components, oroxylin A, Wogonin, chrysin, baicalein, baicalein 7-O-$\beta$-D-glucopyranoside and $\beta$-sitosterol 3-O-$\beta$-D-glucopyranoside. All the isolated compounds were identified by means of physicochemical and spectroscopic methods (IR, $^1H-NMR,{\;}^13C-NMR$, Mass). By HPLC determination, the changes of the contents for each isolated components from SPE and SPU samples were observed. It was found that the content of nonglycosidic flavones such as oroxylin A, wogonin, chrysin and baicalein was increased markedly, whereas the content of baicalin and baicalein 7-O-$\beta$-D-glucopyranoside was significantly decreased in both samples as compared with those of Scutellariae Radix. When the sample was soaked with boy's urine, the total amount of nonglycosidic flavones was higher than that of processing with 20% EtOH.

• 대한미생물학회지
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• 제22권3호
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• pp.197-208
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• 1987

Chlamydia trachomatis has now shown that this interesting intracellular parasite is a cause of nongonococcal urethritis, infantile pneumonia, pelvic inflammatory disease and epididymitis, in addition to lymphogranuloma venerum and inclusion conjunctivitis. There are several diagnostic methods for C. trachomatis, but the method using monoclonal antibody is the most sensitive and specific. The hybride cell were prepared by fusion of myeloma cell($P_3X_{63}\;Ag_8{\cdot}V_{653}$) of mouse and lymphocyte of mouse(BALB/c) that were immunized with formalin killed C. trachomatis serotype D. The cell mixtures after fusion were dispensed into 640 wells of the 96 well culture plates and continuously cultured in HAT medium for 2 weeks. The supernatants of culture media in 83(13%) wells were reacted with C. trachomatis, which were determined by enzyme-linked immunosorbent assay in 96 well microplate. The clones that secreted antibody to C. trachomatis were cloned by limiting dilution. Only six monoclones secreted antibody to C. trachomatis. The antibody titer of ascitic fluid that collected from same BALB/c mice bearing hybridoma cells was above 1:100,000. These monoclonal antibodies that were IgG reacted with elementary and reticulate bodies of all serotypes(Ba, D, E, F, G, H, J and LGV type-I) using ELISA and indirect immunofluorescence stain, but there were no cross reaction with other bacteria(coagulase negative Staphylococcus, Proteus and E. coli). We concluded these six monoclones secreted the same monoclonal antibody to C. trachomatis. The sensitivity and specificity of the monoclonal antibody compared with Microtrak(confirmatory test of C. trachomatis, Syva) was 100%, respectively.

• 한국환경보건학회지
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• 제34권1호
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• pp.20-26
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• 2008

The objective of the study which utilised population based data was to determine the respiratory condition of elementary school children in Gangneung. From October 9th to December 14th, 2006, Pulmonary Function Tests (PFT) including Forced Vital Capacity (FVC) and Forced Expiratoy Volume in I Second $(FEV_1)$ were conducted on the target group of children using a spirometer. The prevalence of asthmatic symptoms was 29.8% among boys and 39.6% among girls. By using logistic regression, we found that family history of allergic rhinitis (OR=3.90, CI=1.05-14.51), experience of allergic conjunctivitis (OR=4.67, CI=1.54-14.16) and atopic dermatitis (OR=2.86, CI=1.17-7.05) significantly increased the asthmatic symptoms. Also, a family history of asthma and food allergy were associated with asthmatic symptoms. In relation to housing and environmental risk factors, residences under the ground (OR=3.59, CI=1.35-9.51) and big-size dolls (OR=2.71, CI=0.86-8.53) significantly increased the prevalence of asthmatic symptoms. For PFT, above four families, exposure of passive smoking and pets significantly reduced FVC in both groups (p<0.05). In girls, a big-size doll was significantly associated with decreased lung function (FVC and $FEV_1$). In boys, using bed significantly reduced $FEV_1$. Also, the risk of asthmatic symptoms was found to increase when the house has been built for 5 years or more, the house is close to a road $({\leq}100m)$, a gas/Kerosene heater or carpet is utilized within the house. However, their differences were not significant. It is concluded that genetic factor such as a family history of respiratory disease, allergic symptoms and housing risk factor are related to asthmatic symptoms. These results were worth noting because the findings will help address risk factors related respiratory symptoms especially in relation to housing and environment.

• 한국임상수의학회지
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• 제27권6호
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• pp.751-754
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• 2010

6 년령 중성화 암컷 페르시안 고양이가 3개월동안 우안의 재발성 각막궤양, 각막혼탁, 각막 혈관화를 주증상으로 내원하였다. 병변은 그 기간동안 국소적인 항생제와 비스테로이드성 소염제 점안에 치료반응이 없었다. 우안에서 유루증, 안검경련과 같은 안구통증 증상이 확인되었다. 미세 틈새등 현미경 검사에서 우안의 각막 전체에 분홍색에서 흰색을 띄는 부종성의 불규칙한 덩어리와 미약한 결막염을 확인하였다. 임상증상을 통해 고양이 증식성 호산구성 각막염으로 잠정 진단하였다. 각막의 세포학적 검사결과에서 다수의 호산구와 비만세포가 관찰되어 잠정적으로 내렸던 진단을 확진하였다. 본 환자는 국소적인 항생-코르티코스테로이드 합제, 사이클로스포린 연고, 트리플루리딘 점안과 전신적인 L-lysine 의 경구투여로 치료하였다. 치료시작 18일 후 내원 시 병변은 눈에 띄게 호전되었다. 국소적인 코르티 코스테로이드와 사이클로스포린의 병용치료는 고양이 증식성 호산구성 각막염에 유용한 치료법으로 생각된다.

• Pediatric Infection and Vaccine
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• 제25권3호
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• pp.148-155
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• 2018

목적: 가와사키병이 있는 소아에서 진단 및 결과 예측에 있어서 Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) 접종 부위 반응의 임상적 중요성을 알아보고자 하였다. 방법: 2006년 1월부터 2017년 2월까지 가와사키병으로 서울아산병원에 입원한 1,058명의 환자를 대상으로 각 연령대에서 BCG 부위 반응의 발생 빈도를 조사하였다. 이 중 생후 18개월 미만인 416명의 환자를 BCG 부위 반응과 실험실 및 임상소견들과의 연관성을 분석하기 위한 대상자들로 선정하였다. 분석은 완전형과 불완전형 발현 두 그룹으로 구분하여 수행되었다. 결과: 1,058명의 환자들을 관찰한 결과, BCG 부위 반응의 발생률은 생후 6-12개월(83%) 연령의 환자에게 가장 많았고, 12개월 후 연령이 증가함에 따라 감소했다(P<0.001). BCG 부위 반응은 생후 18개월 미만 환자의 70%이상에서 발생하였고, 경부 림프절 종대보다 빈발했다. 로지스틱 회귀분석결과, 결막염(P=0.781), 입술/구강의 변화 (P=0.963), 발진 (P=0.510), 경부 림프절 종대 (P=0.363), 사지 말단의 변화 (P=0.283) 및 관상 동맥류 (P=0.776)는 BCG 부위 반응과 관련이 없었다. 결론: BCG 부위 반응은 BCG 예방 접종을 받은 18개월 미만 소아에서 가와사키병의 주요 임상 소견과는 독립적으로 유용한 진단 도구가 될 수 있다는 것을 확인하였다. 관상동맥 합병증 결과는 완전 가와사키병 및 불완전 가와사키병 모두에서 BCG 부위 반응이 있거나 없는 그룹간에 차이가 없었다.