• 대한한의학회지
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• 제39권3호
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• pp.51-60
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• 2018

Objectives: This study aimed to investigate the opinions of Korean medical doctors on how to elucidate possible remedial measures for expanding the health insurance benefits coverage item of Korean medicine (KM). Methods: An online survey was conducted to all members who had registered e-mail address in the association of Korean medicine from 1 to 17 November, 2016. Statistical analysis was performed and odds ratio with 95% confidence interval were calculated by each subgroup. Results: A total of 743 members answered the questions and the response rate was 4.1%. The priorities for expanding health insurance benefits were as follows: thermographic imaging, Sasang constitution typing test, and pulse wave among examinations; pharamacopuncture, embedding acupuncture, and acupotomy among procedures; Chuna manual therapy, manual therapy for meridian muscle, and Daoyin exercise therapy among manual therapies; low-frequency electrical therapy, traction, paraffin bath, and light therapy among physical therapies; and aromatherapy, enema therapy, and color therapy among activities of KM. Conclusions: It should be covered by the national health insurance (NHI) of KM that thermographic imaging, pharmacoacupuncture, Chuna manual therapy, low-frequency electrical therapy, aromatherapy as a top priority. We also suggest that basic medical tests, such as blood, urine, or imaging, should be included in the coverage of the NHI of KM. It is necessary to review the expertise and public opinions about the plans and priorities for the conversion of the desired medical services to be covered by the NHI.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.174-181
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• 2006

Purpose : To analyse the results of the renal biopsies and the clinical diagnoses of patients who had undergone percutaneous kidney biopsies in the department of pediatrics at Kyunghee University Hospital for 22 years from 1984 to 2005. Methods : We retrospectively reviewed the medical records of 1559 patients and analyzed the chief complaints that led to a renal biopsy, age, sex, histopathologic findings and diagnosis. Routine kidney biopsies were performed by automated gun biopsy guided by real time ultrasonography. The diagnoses were made based on the specimen's light microscopy, immunofluorescence microscopy and electron microscopy findings and clinical symptoms and signs. Results : The mean age of the patients was 10 years with the male to female ratio being 1.3:1. The chief complaints that led to a renal biopsy included hematuria only(753 cases, 48.3%), proteinuria only(125 cases, 8.0%) and hematuria combined with proteinuria(537 cases, 34.4%). The most frequent histopathological finding was primary glomerular disease(75.4%) which included IgA nephropathy(30.1%) and mesangial proliferative glomerulonephritis(27.6 %). Systemic disease comprised 11.4% which included Henoch-$Sch\ddot{o}nlein$ nephritis(10.5%) and lupus nephritis(0.8%). Alport syndrome was found in 1.1% of cases which was attributed to hereditary causes. 628 children(40.3%) visited the clinic due to abnormal school urine screening abnormalities and among these, 237 children had mesangial proliferative glomerulonephritis and 234 children who had IgA nephropathy were managed thereafter. Conclusion : IgA nephropathy and mesangial proliferative glomerulonephritis were the two major forms of primary glomerulonephritis found in Korean children who had kidney biopsies from 1984 to 2005.

• Toxicological Research
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• 제17권
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• pp.127-133
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• 2001

Together with cytochrome P450 (CYP), flavin-containing monooxygenase (FMO) present in liver microsomes oxidizes various endogenous and exogenous chemicals. In an effort to determine the human FMO activity, we have developed two non-invasive urine analysis methods using caffeine (CA) and ranitidine (RA) as the probe compounds. As the production of theobromine (TB) and ranitidine N-oxide (RANO) from CA and RA is catalyzed primarily by the hepatic FMO, we have assigned the urinary molar ratios of TB/CA and RA/RANO as the in vivo FMO activity. In 200 age-matched Korean volunteers, the obtained TB/CA ratio ranged from 0.4 to 15.2 (38-fold difference) and the RA/RANO ratio from 5.7 to 27.2 (4.8-fold). The FMO activity of 20's, determined by caffeine metabolism, was the highest (2.5$\pm$l.9) and those of 30's, 40's, 50's, 60's and 70's were 40%, 50%, 24%, 39% and 36% of the 20's, respectively. Intake of grapefruit juice, known to contain flavonoids, inhibited the in vivo FMO (TB/CA) activity by 79%. Addition of the flavonoids like naringin, quercitrin and kaempferol, present in grapefruit juice, to the in vitro microso-mal FMO assay, thiobenzamide S-oxidation, produced 75%, 70% and 60% inhibition, respectively. Obtained Ki values of quercitrin, kaempferol and naringin on the in vitro FMO activity were 6.2, 12.0 and 13.9 $\mu\textrm{M}$, respectively. This suggested that the dose of drug should need to be adjusted to suit the individual FMO activities when the drugs metabolized by FMO are given to patients. As the intake of grapefruit juice has been identified to inhibit the FMO as well as CYP3A4 and lA2 activities, patients taking drugs metabolized by these enzymes should not drink grapefruit juice as the carrier.

• 농약과학회지
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• 제20권4호
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• pp.300-304
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• 2016

이 연구의 목적은 살포기의 종류에 따른 피레스로이드 농약의 노출량을 평가하고자 하였다. 피레스로이드계 농약의 노출을 평가하기 위하여 사과 농작업자의 소변중 피레스로이드계 농약의 대사물질을 평가하였다. 결과에서는 살포량이 SS기 살포 그룹이 동력분무기 그룹보다 높았다. 하지만, 살포량과 살포면적을 통제하기 위하여 다변량 분석법으로 분석한 결과 SS기 살포자와 동력분무기 살포자의 노출량은 차이가 없었다. 농약노출에 대한 정확한 모델을 만들기 위해서는 농약 노출에 관련된 인자들이 통제되어야하고 추가적인 연구가 필요하다고 할 수 있다.

• Clinical and Experimental Pediatrics
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• 제56권8호
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• pp.351-354
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• 2013

Isovaleric aciduria (IVA) is caused by an autosomal recessive deficiency of isovaleryl-CoA dehydrogenase (IVD). IVA presents either in the neonatal period as an acute episode of fulminant metabolic acidosis, which may lead to coma or death, or later as a "chronic intermittent form" that is associated with developmental delays, with or without recurrent acidotic episodes during periods of stress, such as infections. Here, we report the case of a 2-year old boy with IVA who presented with the chronic intermittent form. He was admitted to Asan Medical Center Children's Hospital with recurrent vomiting. Metabolic acidosis, hyperammonemia, elevated serum lactate and isovalerylcarnitine levels, and markedly increased urine isovalerylglycine concentration were noted. Sequence analysis of the IVD gene in the patient revealed the novel compound mutations-a missense mutation, c.986T>C (p.Met329Thr) and a frameshift mutation, c.1083del (p.Ile361fs$^*11$). Following stabilization during the acute phase, the patient has remained in a stable condition on a low-leucine diet.

• Clinical and Experimental Pediatrics
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• 제61권4호
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• pp.114-120
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• 2018

Purpose: Routine screening for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become a common practice. However, the incidence of TORCH varies across countries, and the cost of TORCH testing may be disadvantageous compared to disease-specific screening. To evaluate the efficacy of TORCH screening, the medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. Methods: The clinical data of the 126 IUGR or SGA neonates were gathered, including gestational age, Apgar scores, neonatal sonographic findings, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and fetal sonography were collected, and placental findings were recorded when available. TORCH screening was done using serum IgM, CMV urine culture, quantification of CMV DNA with real-time polymerase chain reaction, and rapid plasma reagin qualitative test for syphilis. Tests were repeated only for those with positive results. Results: Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This result was deemed false positive due to negative IgM on repeated testing and the absence of clinical symptoms. Conclusion: Considering the incidence and risk of TORCH in Korea, the financial burden of TORCH screening, and the single positive TORCH finding in our study, we suggest disease-specific screening based on maternal history and the clinical symptoms of the neonate. Regarding CMV, which may present asymptomatically, universal screening may be appropriate upon cost-benefit analysis.

• Journal of Nutrition and Health
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• 제26권1호
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• pp.89-97
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• 1993

This study was carried out to estimate the relationship between dietary intake, blood level, and urinary excretion of minerals and blood pressure in 30 healthy adults living in rural area of Korea(12 males and 18 females). Analysis for the nutritional status of the subjects were performed by 3-day dietary intake record, duplicated diet collection, 24-hour urine collection, and venous blood sampling before measuring blood pressure. The mean blood pressure of subjects was 117.50/80.83mmHg in males and 110.00/73.89mmHg in females. The mean daily intakes of Na, K, Ca, P, Mg, Fe, Cu, Zn estimated for 3 days were 199.97mEq, 49.56mEq, 452.50mg, 725.57mg, 240.40mg, 12.48mg, 3.41mg, 8.28mg, respectively. The serum concentration of Na, K, Ca, P, Mg, Fe, Cu, Zn were 139.83mEq/dl, 4.06mEq/dl, 8.86mg/dl, 3.28mg/dl, 2.13mg/dl, 0.12mg/dl, 0.12mg/dl, 0.14mg/dl, respectively. The 24-hour urinary excretions of Na, K, Ca, p, Mg, Fe, Cu, Zn estimated for 169.60mEq, 39.37mEq, 80.40mg, 398.97mg, 64.77mg, 0.21mg, 0.07mg, 0.29mg, respectively. No significant correlation was found between dietary intake, serum concentration, and urinary excretion of minerals and blood pressure. But, the serum Ca/Mg ratio showed negative correlation with the systolic and diastolic blood pressure at the level of significance of 5%. The study verifies the need for more systematic studies on interrelationship among minerals and mineral requirements in normotensive and hypertensive subjects.

• Journal of Nutrition and Health
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• 제40권5호
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• pp.419-427
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• 2007

This study explored the effects of dietary calcium level and Hijikia fusiforme supplementation on bone indices and serum lipid levels using 36 female Sprague-Dawley rats as a model. Rats received low Ca diet for 3 weeks after ovariectomy. The rats were then divided into six dietary groups and fed low (0.1% Ca), normal (0.5% Ca) and high (1.5% Ca) Ca diets (CaL, CaN, CaH) and low, normal, high Ca diets with Hijikia fusiforme supplementation (CaLH, CaNH, CaHH) for 3 weeks. After each experimental periods, 24 hour urine and/or blood samples, left and right femurs were collected for analysis. Serum Ca concentration showed no significant difference by dietary Ca levels and Hijikia fusiforme supplementation. Alkaline phosphatase activity was significantly higher in normal and high Ca group compared to low Ca group. Serum total cholesterol, triglyceride and total lipid were not significantly different among groups. HDL-cholesterol showed no significant difference by Hijikia fusiforme supplementation. However, the normal and high Ca groups showed significantly higher HDL-cholesterol compared to the low Ca group. Urinary hydroxyproline and hydroxyproline/creatinine ratio were not significantly different among groups. The wet weight of the femur was significantly higher in low Ca group compared to normal or high Ca group. The dry weight, wet weight/body weight, length and breaking force of the femur were not significantly different among groups. Ash contents/wet weight of the femur was significantly increased as dietary Ca levels up and significantly higher in Hijikia fusiforme supplementation groups. The Ca content of the femur were significantly higher in the normal and high Ca groups than the low Ca group. However, there was no significant difference in Ca content by Hijikia fusiforme supplementation.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9927-9931
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• 2014

The objectives of this study were to examine serum periplakin expression in patients with urothelial carcinoma of the urinary bladder and in normal controls, and to examine relationships with clinicopathological findings. Detection of serum periplakin was performed in 50 patients and 30 normal controls with anti-periplakin antibodies using the automatic dot blot system, and a micro-dot blot array with a 256 solid-pin system. Levels in patients with urothelial carcinoma of the urinary bladder were significantly lower than those in normal controls (0.31 and 5.68, respectively; p<0.0001). The area under the receiver-operator curve level for urothelial carcinoma of the urinary bladder was 0.845. The sensitivity and specificity, using a cut-off point of 4.045, were 83.7% and 73.3%, respectively. In addition, serum periplakin levels were significantly higher in patients with muscle-invasive cancer than in those with nonmuscle-invasive cancer (P = 0.03). In multivariate Cox proportional hazards regression analysis, none of the clinicopathological factors was associated with an increased risk for progression and cancer-specific survival. Examination of the serum periplakin level may play a role as a non-invasive diagnostic modality to aid urine cytology and cystoscopy.

• Environmental Analysis Health and Toxicology
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• 제19권2호
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• pp.169-176
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• 2004

ETS (environmental tobacco smoke) is composed of exhaled mainstream smoke (MS) from the smoker, sidestream smoke (SS) emitted from the smoldering tobacco between puffs and contaminants that diffuse through the cigarette paper and mouth between puffs. These emissions contain both vapor phase and particulate contaminants. ETS is a complex mix of over 4,000 compounds. This mix contains many known or suspected human carcinogens and other toxic agents. More of these toxic compounds are found in SS than in MS. Workplace exposure to ETS can result in significant smoke intake, and passive smoke exposure may be related to impair respiratory function and an increase risk of lung cancer in nonsmokers. For nonsmokers sharing a work environment with cigarette smokers, the workplace must be considered hazardous independently of any specific industrial toxic exposure. The risk is particularly important when a high percentage of the workers smoke or where smokers and nonsmokers work in poorly ventilated areas. Nicotine is converted in the body to cotinine; cotinine therefore can be used as an indirect measure of a person's recent exposure to tobacco smoke. Levels of nicotine in hair and levels of cotinine in body fluids (saliva and urine) have been shown to increase with increasing environmental nicotine levels and with self-reported ETS exposure. The measurement of nicotine or cotinine in hair may be more appropriate for longer-term exposure to tobacco. The purpose of this study is to comparing airborne nicotine levels and hair cotinine level in restaurant workers. Concentration of airborne nicotine and hair nicotine (and cotinine) is closely related to exposed frequency of sidestream smoke in the workplace. Nicotine in hair is a better predictor of airborne nicotine than hair cotinine. Hair nicotine can be a useful tool to assess ETS exposure interventions. It may have limiting levels of ETS exposure by placing regulatory restrictions on smoking in workplaces and in public spaces.