• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.33-36
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• 2003

Purpose : We evaluated clinical manifestations and laboratory findings in patients with measles according to age distribution. Methods : Retrospective analyses were performed using medical records of patients with measles admitted to The Catholic University of Korea, Daejon St. Mary's Hospital from October 2000 to May 2001. We divided the patients with measles into three age groups, i.e., those who were under two years of age(159 patients), those between 9-11 years of age(39 patients), and those older than 16 years of age who were hospitalized in the department of internal medicine(young adult group; 23 patients). We compared clinical and laboratory characteristics among these three groups. Results : Almost all patients with measles were presented with fever, skin rash and cough. No statistical differences were present between the three groups in total fever duration, number of hospitalization days, complications determined with longer hospitalization for more than eight days, and positive values of anti-measles IgM. Patients under 2 years of age showed statistically higher levels of white bood cell and lymphocyte counts. However, neutropenia and lymphopenia were observed in all age groups compared with age-matched standard values. Campared with the other two age groups, the young adult group showed a higher mean level of liver enzymes(AST/ALT) and more patients with a level twice as high as the normal values. Conclusion : Clinical manifestations including complications according to age groups showed no significant differences in patients with measles. Hepatic involvement was more prevalent in the young adult group.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.184-189
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• 2010

Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.330-338
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• 2009

Purpose : The causes of acute lower respiratory tract infection (ALRTI) are mostly attributable to viral infection, including respiratory syncytial virus (RSV), parainfluenza virus (PIV), influenza virus A/B (IFV A/B), or adenovirus (ADV). Several Korean studies reported human metapneumovirus (hMPV) as a common pathogen of ALRTI. However, studies on seasonal distribution and clinical differences relative to other viruses are insufficient, prompting us to perform this study. Methods : From November 2006 to October 2007, we tested nasopharyngeal aspiration specimens in children hospitalized with ALRTI with the multiplex reverse transcriptase-polymerase chain reaction to identify 6 kinds of common pathogen (hMPV, RSV, PIV, IFV A/B, and ADV). We analyzed positive rates and clinical features by respiratory chart review. Results : We detected 38 (8.4%) hMPV-positive cases out of 193 (41.8%) virus-positive specimens among 462 patients. HMPV infection prevailed from March to June with incidence peaking in April. HMPV-positive patients were aged 15 years (76.3%), and the ratio of boys to girls was 1.2:1. The median age was 27 months. HMPV primarily caused pneumonia (76.3 %) (P=0.018). Average hospitalization of HMPV-associated ALRTI patients was 5.8 days. In addition, they showed parahilar peribronchial infiltration (100%) on chest X-ray, normal white blood cell count (73.7%), and negative C-reactive protein (86.8 %) (P>0.05). All hMPV-positive patients recovered without complication. Conclusion : HMPV is a common pathogen of ALRTI in Korean children, especially in 1-5 year olds, from March to May. Immunocompetent children diagnosed with hMPV-associated ALRTI may have a good prognosis.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.324-329
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• 2009

Purpose : Acute interstitial pneumonia (AIP) is a rare disease, but its prognosis is fatal because of lack of efficient treatment modality. Recently, it has been reported that there was epidemic AIP in Korea. This study aims to investigate the past and current status of AIP in Korea. Methods : We performed a nationwide survey and a prospective study. From August 6 to 15, 2008, a questionnaire survey was conducted to identify the prevalence, local distribution, and response to current treatments. The questionnaire was answered by pediatrician working in 23 referral centers in Korea. In addition, 5 referral centers in Seoul performed a preliminary prospective observational study by obtaining clinical data and specimens from appropriate patients. The Korea Centers for Disease Control and Prevention analyzed the samples for possible pathogens. Results : The survey showed 78 AIP cases had occurred and 36 patients had died. Lung biopsy was performed only on 20 patients. In 2008, 9 AIP cases developed. In a prospective study, 9 (M:F=5:4) patients developed AIP in spring and 7 (78%) died, with the mean rate of death occurring 46 days after diagnosis. Human corona virus 229E, cytomegalovirus, influenza A virus, influenza B virus, and parainfluenza virus were isolated from the respiratory specimens. Conclusion : This study showed nationwide prevalence of AIP in Korea. In addition, because of the high mortality rate and rapid progress, pediatricians need to be aware of the disease. Further studies and a nationwide network are required for reducing the morbidity and mortality rates related to AIP.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.827-833
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• 2008

Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

• Microbiology and Biotechnology Letters
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• v.13 no.4
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• pp.409-415
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• 1985

This study has been carried out in order to investigate the bacterial quality of fish meat paste products and the characteristics of isolated thermodurics from the products. Twenty samples of crab-flavored fish stick (Kematsal), 23 samples of plate fish meat paste (Panomuk, Kamaboko), 5 samples of fried fish meat paste (Tigimomuk), 2 samples of roasted fish meat paste (Puduromuk, Chikuwa), 20 samples of fish sausage were collected from processing plants and supermarkets in Pusan, Korea during the period from May to October in 1984. The results obtained are as follows. Amont the samples collected from supermarkets, roasted fish meat paste and fried fish meat paste marked hish counts in coliforms and fungi while very low in the samples of crab-flavored fish stick and plate fish meat paste. Salmonella was not detected in all the samples examined and Staphylococcus aureus was detected only in fried fish meat paste, Thermoduric bacteria were detected less than 10$^2$/g in the samples of crab-flavored fish stick and plate fish meat paste, which might come from subsidiary materials such as starch and seasonings. Among the isolated bacteria, distribution of the proteolytics were more than 87％ and the lipolytics were less than 20％. Gram positive bacteria was more than 70％ in crab-flavored fish stick and plate fish meat paste, 47.3％ in fried fish meat paste. And rod in shape was almost more than 90％ in all the samples. The most heat resistant bacterium isolated from the samples was identified as a Bacillus licheniformis(named B. licheniformis CR-11). The strain showed strong proteolytic activity and also grew well at above 2$0^{\circ}C$. The growth rate and generation time of CR-11 strain were 0.31 hr$^{-1}$ , 2.24 hr at 2$0^{\circ}C$, 0.64 hr$^{-1}$ , 1.09 hr at 3$0^{\circ}C$ and 0.78 hr$^{-1}$ , 0.89 hr at 35$^{\circ}C$. Heat resistance value of the spores of CR-11 strain suspended in phosphate buffer solution was D$_{85}$ $^{\circ}C$=41.9 min, D$_{90}$ $^{\circ}C$=27.9 min, D$_{95}$ $^{\circ}C$=10.2 min, D$_{100}$ $^{\circ}C$=4.3 min (Z=13.8$^{\circ}C$)

• Progress in Medical Physics
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• v.16 no.1
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• pp.16-23
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• 2005

The objective of this study was to construct multi-element ultrasound applicators for the treatment of gynecologic cancer with high dose rate brachytherapy. For the treatment of uterus, piezo-ceramic crystal transducer (PZT -5A) with outer diameter of 4 mm, wall thickness of 1.3 mm, and length of 24.5 mm was selected. For the treatment of cervix or vagina, it should be possible to insert the applicator into the vagina. Thus, a cylindrical PZT -8 material with outer diameter of 24.5 mm, wall thickness of 1.3 mm, and length of 15.2 mm was selected. The operating frequencies determined by vector impedance measurement were 3.2 MHz for the PZT 5A cylinder (OD=4 mm) and 1.7 MHz for the PZT -8 cylinder (OD: 24.5 mm). The ratios of generated acoustic output power to applied electric power were 33% and 61% for the tandem type crystal and the cylinder type crystal, respectively. The radiated acoustic pressure fields from both transducers were calculated using a Matlab code and measured in water using hydrophone. There was good agreement between measured and calculated acoustic pressure field distribution. For a tandem type transducer, the calculated acoustic pressure field decreased from 0.023 MPa at 10 mm to 0.010 Mpa at 30 mm, the reduction of 57%. For the cylinder type transducer which will be used for the treatment of vagina showed 78% reduction at 15 mm and 66% at 25 mm as compared to values at 5 mm from the surface. Based on the characteristics of the transducers, this study demonstrated the possibility of using the crystals as a heating source. Finally, a 3-element and 4-element prototype applicators were constructed. The 3-element applicator is 75 mm long and 4 mm thick and will be used for the treatment of uterus. The 4-element applicator is 61 mm long and 24.5 mm thick and will be used for the treatment of vagina. Using these applicators, it is possible to generate enough power to increase temperature to therapeutic level.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.7-16
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• 2014

Purpose : To evaluate the prevalence and pattern of perfusion defect (PD) on first-pass stress perfusion MR imaging in relation with the degree of left ventricular hypertrophy (LVH) and late gadolinium-enhancement (LGE) in patients with apical hypertrophic cardiomyopathy (APH). Materials and Methods: Cardiac MR imaging with first-pass stress perfusion, cine, and LGE sequence was performed in 26 patients with APH from January 2008 to December 2012. We analyzed a total of 416 segments for LV wall thickness on end-diastolic phase of cine images, and evaluated the number of hypertrophied segment and number of consecutive hypertrophied segment (NCH). We assessed the presence or absence of PD and LGE from all patients. If there was PD, we subdivided the pattern into sporadic (sporadic-PD) or ring (ring-PD). Using univariate logistic method, we obtained the independent predictor for presence of overall PD and ring-PD. Results: PD on stress perfusion MRI was observed in 20 patients (76.9%), 12 of them (60%) showed ring-PD. Maximal LV wall thickness and number of hypertrophied segment were independent predictors for overall PD (all, p < 0.05). NCH with more than 3 segments was an additional independent factor for ring-PD. However, LGE was not statistically related with PD in patients with APH. Conclusion: About three quarters of the patients with APH showed PD, most of them represented as ring-PD. LVH degree or distribution was related with pattern of PD, however, LGE was not related with PD. Therefore, the clinical significance of PD in the patients with APH seems to be different from those with non-APH, and further comparison study between the two groups should be carried out.

• Investigative Magnetic Resonance Imaging
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• v.12 no.1
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• pp.49-54
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• 2008

Purpose : The purpose of this study was to determine the characteristics of hypoxic-ischemic encephalopathy (HIE) on diffusion-weighted imaging (DWI) and the role of DWI for the diagnosis of HIE. Materials and Methods : Six patients with HIE underwent MRI including DWI. MR examinations were performed within 4 - 32 days (mean, 11.8 days) after hypoxic brain insult. We assessed the distribution of the lesions and compared the DWI and T2, FLAIR images for the subjective conspicuity of the lesions. Results : In all patients, symmetrical hyperintense lesions were demonstrated in the bilateral basal ganglia on T2, FLAIR, and DWI. On ADC map image, the lesions were hypointense in four of six patients and isointense in other two patients. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in four of six patients and similar in other two patients. For the involvement of the cortex and subcortical white matter, in five of six patients, bilateral symmetric hyperintense lesions were seen on T2, FLAIR, and DWI. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in three of them and similar in other two patients. On ADC map image, the lesions showed hypointensity in three of five patients and isointensity in other two patients. For the involvement of the deep cerebral white matter, T2, FLAIR, and DWI showed bilateral symmetric hyperintense lesions in four of six patients. Among them, Lesion conspicuity on DWI was higher than on T2 and FLAIR images in only one patient. Conclusion : HIE is characterized by symmetrical hyperintense lesions in the bilateral basal ganglia, cerebral cortex, and white matter on DWI and the lesions are more conspicuously demonstrated on DWI than on T2 and FLAIR images.

• Korean Chemical Engineering Research
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• v.58 no.2
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• pp.197-208
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• 2020

This study was carried out to analyze spatial and temporal incidence characteristics of scrub typhus and predict the future incidence of scrub typhus since the incidences of scrub typhus have been rapidly increased among vector-borne diseases. A maximum entropy (MaxEnt) ecological model was implemented to predict spatial distribution and incidence rate of scrub typhus using spatial data sets on environmental and social variables. Additionally, relationships between the incidence of scrub typhus and critical spatial data were analyzed. Elevation and temperature were analyzed as dominant spatial factors which influenced the growth environment of Leptotrombidium scutellare (L. scutellare) which is the primary vector of scrub typhus. A temporal number of diseases by scrub typhus was predicted by a deep neural network (DNN). The model considered the time-lagged effect of scrub typhus. The DNN-based prediction model showed that temperature, precipitation, and humidity in summer had significant influence factors on the activity of L. scutellare and the number of diseases at fall. Moreover, the DNN-based prediction model had superior performance compared to a conventional statistical prediction model. Finally, the spatial and temporal models were used under climate change scenario. The future characteristics of scrub typhus showed that the maximum incidence rate would increase by 8%, areas of the high potential of incidence rate would increase by 9%, and disease occurrence duration would expand by 2 months. The results would contribute to the disease management and prediction for the health of residents in terms of public health.