• Title/Summary/Keyword: K병원

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Comparison of Results between Tuberculin Skin Test and QuantiFERON®-TB In-Tube Assay for Diagnosis of Latent Tuberculosis Infection in Children and Adolescents (소아청소년에서의 잠복결핵감염 진단을 위한 결핵 피부반응검사와 QuantiFERON®-TB Gold In-Tube 검사와의 결과 비교)

  • Choi, Jong-Won;Kim, Min-Sung;Kim, Jong-Hyun
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.17-27
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    • 2013
  • Purpose: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-${\gamma}$ release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON$^{(R)}$-TB Gold In-Tube (QFT-GIT) and compared their results. Methods: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. Results: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the nonintrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFTGIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. Conclusion: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.

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Clinical Manifestations of PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) Syndrome from a Single Center (단일기관에서 진단한 PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) 증후군의 임상양상)

  • Shin, Minsoo;Choi, Eun Hwa;Han, Mi Seon
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.179-187
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    • 2019
  • Purpose: Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is a leading cause of periodic fever in children. This study describes the clinical characteristics of PFAPA syndrome in patients from a single center. Methods: Thirteen children diagnosed with PFAPA syndrome at Seoul National University Children's Hospital were included in this study. Retrospective medical chart reviews were performed. Results: Among the 13 patients, 8 (61.5%) were male. The median follow-up duration was 3.3 years (range, 10 months-8.3 years). The median age of periodic fever onset was 3 years (range, 1-6 years). All patients had at least 5 episodes of periodic fever and pharyngitis, managed with oral antibiotics, before diagnosis. The median occurrence of fever was every 3.9 weeks and lasted for 4.2 days. All patients had pharyngitis and 12 (92.3%) had cervical lymphadenitis. Blood tests were performed for 12 patients, and no patients had neutropenia. Both the C-reactive protein and erythrocyte sedimentation rate were elevated at medians of 4.5 mg/dL (range, 0.4-13.2 mg/dL) and 29 mm/hr (range, 16-49 mm/hr), respectively. Throat swab cultures and rapid streptococcal antigen tests were negative. Nine (69.2%) patients received oral prednisolone at a median dose of 0.8 mg/kg, and in 6 (66.7%) patients, fever resolved within a few hours. Three (23.1%) patients received tonsillectomy and adenoidectomy. Conclusions: PFAPA syndrome should be considered when a child presents with periodic fever along with aphthous stomatitis, pharyngitis, or cervical lymphadenitis. Glucocorticoid administration is effective for fever resolution and can reduce unnecessary use of antibiotics.

Post-Infarction Ventricular Septal Rupture : 10 Years of Experience (급성 심근경색증 후 심실중격 결손: 10년 경험)

  • Jung, Yo-Chun;Cho, Kwang-Ree;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.351-355
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    • 2007
  • Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.

Mineral Contents in Scalp Hair in Patients with Non-insulin Dependent Diabetes Mellitus (두발중(頭髮中) 일부(一部) 금속(金屬) 농도(濃度)와 인슐린비의존형(非依存形) 당뇨병(糖尿病)과의 관련성(關聯性))

  • Chung, Kyeong-Dong;Kwon, Sam;Kim, Doo-Hee
    • Journal of agricultural medicine and community health
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    • v.22 no.2
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    • pp.215-223
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    • 1997
  • To estimate association of minerals relating to non-insulin dependent diabetes mellitus(NIDDM) the contents of essential minerals and toxic heavy metals in the scalp hair were measured during the period from March 1993 to June 1993. The cases were selected 69 (32 male, 37 female) from the patients who visited Kyungpook University Hospital during the period from March 1993 to June 1993 and 74 controls (47 male 27 female) from normal population. zinc, copper, manganese, lead, cadmium and aluminum were analyzed by atomic absorption spectrophotometer(IL. 551). The results were summarized as follows. In NIDDM group, mean contents of zinc and copper were $132.99{\pm}19.66$ ppm, $8.58{\pm}5.07$ ppm respectively; where as $152.51{\pm}46.15$ ppm, $12.48{\pm}6.56$ ppm in control group. The mean of above two mineral content showed significant difference statistically (p<0.01). But, in manganese the content of NIDDM group; $0.44{\pm}0.27$ ppm were significantly higher than the control group; $0.34{\pm}0.18$ ppm(p<0.05). A thesis submitted to the Council of the Graduate School of Kyungpook National University in partial fulfillment of the require ements for the degree of Ph.D. in Medical Science in June 1994. The mean contents of toxic metals - lead, cadmium, aluminum - in NIDDM group were $10.04{\pm}4.60$ ppm, $0.57{\pm}0.12$ ppm, $11.31{\pm}3.98$ ppm; whereas $8.10{\pm}2.45$ ppm, $0.41{\pm}0.23$ ppm, $7.61{\pm}4.16$ ppm in control group. The mean of above three mineral showed significant difference statistically(p<0.01). Cadmium, zinc and copper were selected statistically significant variables with presence of the NIDDM by multiple logistic regression analysis; copper, zinc and cadmium may be associated with NIDDM.

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The marginal fidelity of $Procera^{(R)}$ AllCeram alumina copings and crowns of patients ($Procera^{(R)}$ AllCeram 을 이용한 도재관의 임상적 변연적합도에 관한 연구)

  • Song, Young-Gyun;Cho, In-Ho;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.470-478
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    • 2008
  • Statement of problem: Use of all-ceramic prostheses fabricated with CAD/CAM systems is increasing in the dentistry. Marginal fidelity in production of all-ceramic restoration has important clinical implications and is a key consideration issue in CAD/CAM production as well. Purpose: The objective of this study was to analyse marginal fidelities of $Procera^{(R)}$ Allceram Crown. Material and methods: On 56 patients treated with $Procera^{(R)}$ system Allceram Crown at Dankook Dental Hospital, marginal discrepancies of 101 abutments were measured by stereomicroscope at coping and final restoration stages. Paired t-test and one-way analysis of variance on marginal discrepancy data were conducted to determine the presence of significant differences between measurement and measuring point stages. Results: Marginal discrepancies of final restoration ($45.82{\pm}30.84\;{\mu}m$) were lower than alumina coping ($53.84{\pm}38.83\;{\mu}m$). Furthermore, the differences were found to be statistically significant at 95% confidence level. Anterior marginal discrepancies were lower than posterior marginal discrepancies, but they were not statistically significant. Lingual marginal discrepancies were higher than other measurement sites, and the differences were found to be statistically significant at 95% confidence level. Conclusion: Within the conditions of this study, marginal fidelities of $Procera^{(R)}$ Allceram Crown were acceptable, and after porcelain build-up, marginal fitness improved over alumina coping. More careful scanning is needed for better results.

THE LATERAL CEPHALOMETRIC STUDY OF THE GROWING CHILDREN WITH CLASS III MALOCCLUSION BY MCNAMARA ANALYSIS (McNamara분석법에 의한 III급 부정교합 아동의 두부방사선 계측학적 연구)

  • Yang, Ku-Ho;Kim, Ji-Young;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.412-420
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    • 2001
  • In the growing children with normal occlusion and class III malocclusion who need the early treatment to be helped to diagnose and to set up treatment plan by calculating the mean values of the lateral cephalometric measurements, cephalometric measurements by McNamara alalysis were achieved and compared on both the 84 elementary school children with normal occlusion and 83 class III malocclusion children at the age of 7 to 9 in Kwangju city and the results were as follows: 1. On the boys group, between normal occlusion and class III malocclusion, Effective maxillary length, Maxillomandibular differential, Facial axis, Nasion perpendicualr to pogonion, Point A perp to Mx 1, and A-Pog line to Mn 1 showed significant differences(p<0.05). 2. On the girls group, between normal occlusion and class III malocclusion significant differences were shown in Effective Maxillary length, Maxillomandibular differential, Mandibular plan angle, Nasion perpendicualr to Point A, Point A perp to Mx 1, A-Pog line to Mn 1(p<0.01). 3. There were no significant differences between normal occlusion and class III malocclusion of boys group but significant differences between them of girls group in Effective mandibular length(P<0.01). On the boys and girls group, Effective maxilla length of class III malocclusion was shorter than that of normal occlusion. 4. There were no significant differences between normal occlusion and class III malocclusion both in boys and girls at Anterior lower facial height. 5. There were significant differences between boys and girls both in class III malocclusion and normal occlusion at Anterior lower facial height and Mandibular plane angle(p<0.01).

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A STUDY OF PARENTAL KNOWLEDGE AND ATTITUDE ABOUT INFANT ORAL HEALTH CARE (유아의 구강관리에 관한 보호자의 인지도 조사)

  • Kim, Myoung-Jin;Shun, Ye-Kyung;Shim, Youn-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.292-299
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    • 2000
  • The purpose of this study was to investigate parental knowledge and attitude and practices relating to infant oral health care and to promote their motivations to their children's oral health care. Authors interviewed 350 persons in Ilwon-Dong and whose children were between 0 to 36 months old and acquired questionnaire from them. The questionnaire constituted of questions about general knowledge of tooth eruption, methods of oral hygiene care, and opinions about preventive dental visit. The collected data were analysed and compared with other researches. The important results obtained from this study were : 1. Females and highly educated persons had more dental knowledge than males and poorly educated persons. But age and economic status did not affect their level of dental knowledge. 2. Fifty nine percents of respondents thought that tooth began to be formed before birth. 3. Seventy six percents of respondents thought that infant oral health care should begin before tooth eruption, but actually only 63% started oral hygiene care before age one. 4. Seventy percents of respondents used gauze for infant oral care. 5. Fifty seven percents of respondents still gave bottles to their children after they reached age one or more and 55% of respondents never heard of nursing caries. 6. Ninety percents of respondents agreed that carious deciduous teeth need restorations, and 31% of respondents thought that age two is the appropriate time for the first dental visit. 7. Forty seven percents of parents did not think that dental caries is an infectious disease. 8. Only Thirty three percents of parents visited dental clinics for examination and prevention during pregnancy and only 11% of expecting parents were offered dental health care education in pediatric or obstetrician clincs. 9. Information about oral health care was mostly given from baby megazines. 10. Overall parental knowledge about infant oral health care was not sufficient to maintain appropriate dental care for infants.

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THE ANTERIOR-POSTERIOR AND VERTICAL RELATIONSHIP OF THE GROWING CHILDREN WITH CLASS III MALOCCLUSION BY LATERAL CEPHALOMETRIC MEASUREMENT (측모두부방사선 사진을 이용한 성장기 III급 부정교합아동의 전후방적, 수직적 악골관계에 대한 연구)

  • Yang, Ku-Ho;Choi, Nam-Ki;Kim, Seong-Nam
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.291-297
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    • 2003
  • While making diagnosis and the treatment plan for the growing children who visited at Chonnam National University Hospital for orthodontic treatment, authors obtained 8 lateral cephalometric measurements in antero-posterior and vertical relationship such as APDI, WITS, ANB, SN-MP, ODI, PFH/AFH, Y-axis, SUM for children aged 7 to 9 with class III malocclusion and compared them with these of 73 children of elementary school aged 7 to 9 with proper profile and normal occlusion in Gwangju. The results were as follows: 1. Between normal occlusion and class III malocclusion, ANB, SN-MP, ODI, SUM, except PFH/AFH and Y-axis showed statistically significant differences(p<0.05). 2. Between mesurements to describe skeletal disorder of antero-posterior relationship such as APDI, WITS, ANB and skeletal disorder of vertical relationship such as SN-MP, ODI, PFH/AFH, Y-axis, SUM, all of them in both normal occlusion and Class III malocclusion showed significant correlation, except Y-axis, SUM correlation(p<0.01). 3. Wald' statistics of WITS, ANB and APDI expressing skeletal disorder of antero-posterior relationship showed 7.118, 5.148, 0.741, respectively and Wald' statistics of ODI, Y-axis, PFH/AFH, SN-MP, SUM were presented 28.348, 2.238, 1.376, 0.090, 0.089, respectively. Therefore, WITS and ODI could be considered as useful diagnotic measurements for class III malocclusion.

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A Study on the Standardization of QSCC II (Questionnaire for the Sasang Constitution Classification II) (사상체질분류검사지(四象體質分類檢査紙)(QSCC)II의 표준화(標準化) 연구(硏究) - 각 체질집단의 군집별(群集別) Profile 분석을 중심으로 -)

  • Kim, Sun-Ho;Ko, Byung-Hee;Song, Il-Byung
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.337-393
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    • 1996
  • The purpose of this study is to evaluate and standardize the four scales of Questionnaire for the Sasang Constitution Classification  II (QSCCII). QSCCII is newly prepared by statistical item analysis and is designed to examine its diagnostic discriminability. QSCCII is administered to 1366 random informants. From the survey, we could get the data for the standardization. The criteria of standardization are based on the data from 265 informants who are examined by professionals. Collectted data are analyzed by internal consistency, variation analysis(ANOVA), Duncan test and discrimination analysis of SPSS PC+ V4.0 program. The results are as follows reliability of four scales for QSCCII is relatively valid. The internal consistency of Tae-yang(太陽) (太陽) scale is Cronbach's a=0.5708. That of So-yang(少陽) scale is a=0.5708. That of Tae-eum(太陰) scale is a =0.5922. That of So-eum(少陰) scale is a=0.6319. 2. There is a significant difference between each group through variation analysis of four scales. 3. The process of standardization is based on the average value and standard deviation with respect to age and sex difference of each criteria 4. This study suggests a source of standardization of Sasang Constitution Classification by providing norms in which the differences of age, sex, and number of items are taken into deep consideration. QSCC Ⅱ, therefore, can be applied to every age(the 10's to the 60's) and sex groups. 5. The recalculation of the raw-score to standard value (T-score) shows that the diagnostic discriminability (Hit-ratio: 70.08%) of QSCC Ⅱ brings about 37% improvement than proportional chance criteria (33.33%). Especially, Hit-ratios of Tae-eum In(74.5%) and So-eum In(70.8%) are higher than that of So-yang In(60.0%). 6. QSCC has discriminability only to male informants. Compared with QSCC, however, QSCC II has relatively efficient discriminability both to male and female informants. 7. These results would be a demonstration of the fact that the QSCC II could be used as a tool for sasang constitution classification.

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A Clinical Study of the Acute Respiratory Distress Syndrome in Children (소아에서의 급성 호흡 곤란 증후군에 대한 임상적 고찰)

  • Lee, Taek Jin;Kim, Dong Soo;Shin, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.42-50
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    • 2003
  • Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.