• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.507-512
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• 2006

Purpose : Early detection and intervention of hearing impairment is believed to improve speech and language development and behavior of children. The aim of this preliminary study was to determine the prevalence of hearing impairments, and to identify the association of risk factors relating to refer response in high risk neonates who were screened using distortion product otoacoustic emissions (DPOAE). Methods : The subjects included 871 neonates who were admitted to the neonatal intensive care unit of the Pediatric Department in Soonchunhyang University Bucheon Hospital from May, 2001 to December, 2004. They were screened using DPOAE. Based on DPOAE, we divided the neonates in two groups : 'Pass' and 'Refer'. The differences in risk factors between the pass group and the refer group were analyzed. Results : The incidence of the refer group was 12.1 percent(106 out of 871). The bilateral refer rate was 5.4 percent(47 out of 871). And the unilateral refer rate was 6.7 percent(59 out of 871). Gender, birth place, family history of hearing loss, small/large for gestational age, obstetrical factor, hyperbilirubinemia and use of gentamicin were not statistically related to the refer rate. Statistically related to refer rate were birth weight, resuscitated neonates, Apgar score, craniofacial anomaly, mechanical ventilator application, sepsis, using of vancomycin(P<0.05). The prevalence of hearing impairment (${\geq}60dB$) in this study was 2 percent(18 out of 871). Conclusion : This study showed a higher prevalence of hearing impairment in high-risk neonates. Thus neonatal hearing screening should be carried out in high-risk neonates.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.647-654
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• 2003

Purpose : This study was done to evaluate the parents' or guardians' compliance of obtaining individual informed consent before vaccination and the possible problems of using informed consent. Methods : One hundred and twelve children were randomly selected among 2,820 children who visited Samsung Cheil Hospital during July 2002. A questionnaire about using informed consent of vaccination was given to all parents or guardians of these children. Results : Most of the responders were mothers(80.4%). As for the places of vaccination, 87(77.7%) persons vaccinated their children at general hospitals. In response to a request for informed consent of vaccination, 73(65.2%) complied well with requests every time. In subscribing to informed consent, 62(55.4%) were pleased, 40(35.7%) stated it was necessary despite in inconveniance. Because of dislike of subscribing to informed consent(55), 33(60%) persons stated that it was difficult to subscribe to informed consent during the inconveniant time of nursing baby. Eighty(71.4%) found it useful to read informed consent for an understanding of potential negative reactions. Being informed of potential negative reactions, 105(93.8%) stated that they would vaccinate their children despite of the potential of a worrisome negative reaction. In dealing with negative reaction, 77(68.8%) said that they would contact a hospital, 32(28.6%) said that they would care for their children at home. Eleven(9.8 %) experienced negative reactions after vaccination. Conclusion : Compliance of parents to informed consent was relatively good. Parents or guardians should receive relevant information and the aim of informed consent also should be adequately understood.

• Clinical and Experimental Pediatrics
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• v.52 no.6
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• pp.667-673
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• 2009

Purpose : Toll-like receptor 2 (TLR2) is critical in the immune response to mycobacterial infections. The purpose of this study was to analyze TLR2 surface expressions and TLR2-mediated tumor necrosis factor-alpha ($TNF-{\alpha}$) and interleukin-6 (IL-6) production in patients with BCG vaccine-associated suppurative lymphadenitis. Methods : Peripheral monocytes were separated from 16 patients with BCG vaccine-associated suppurative lymphadenitis and 10 healthy controls using a magnet cell isolation kit. Monocytes ($1{\times}10^6$ cells/well) were incubated with a constant amount of $Pam_3CSK_4$ ($100{\mu}g/mL$) for 24 hours. TLR2 surface expression on monocytes was analyzed by FACS analysis and TLR-2 mRNA expression was determined by RT-PCR. TLR2-mediated $TNF-{\alpha}$ and IL-6 production were measured by ELISA. Results : In patients with BCG vaccine-associated suppurative lymphadenitis, low TLR2 expression on monocytes ($3.39{\pm}$1.2% versus $4.64{\pm}2.6%$) together with significantly lower TLR2 mRNA expression than in the healthy controls was seen after $Pam_3CSK_4$ stimulation. TLR2-mediated $TNF-{\alpha}$ and IL-6 production in patients with BCG vaccine-associated suppurative lymphadenitis ($TNF-{\alpha}$, $775.5{\pm}60.8pg/mL$; IL-6, $4,645.8{\pm}583.9pg/mL$) were also lesser than that in healthy controls ($TNF-{\alpha}$, $1,098.5{\pm}94.3pg/mL$; IL-6, $6,696.3{\pm}544.3pg/mL$). Conclusion : These findings suggest that low TLR2 expression on monocytes might be associated with increased susceptibility to BCG vaccine-associated suppurative lymphadenitis.

• Progress in Medical Physics
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• v.23 no.3
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• pp.138-144
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• 2012

Dose distribution throughout the clinical organ range of motion was analyzed using a respiratory-motion simulator that was equipped with a polymer gel dosimeter and EBT2 film. The normoxic polymer gel dosimeter was synthesized from gelatin, MAA, HQ, THPC and HPLC. The gel dosimeter and EBT2 film were irradiated with Co-60 gamma rays that were moved along the x-axis and y-axis in ${\pm}1.5cm$ steps at five-second intervals. The field size was $5{\times}5cm^2$. The SSD was 80 cm and set to 10 Gy at a depth of 2 cm. The PDD at a depth of 50 mm was 75.2% in the ion chamber, 82.3% in the static state and 86.1% in the dynamic state in the gel dosimeter. The penumbra for the dynamic state target, which was measured using the gel dosimeter, averaged 10.89 mm, this is a 40.5% increase over the penumbra of the static state target of 7.74 mm. In addition, when measuring with gel dosimetry, the value for the penumbra is 36.6% smaller in the static state and 29.4% smaller in the dynamic state compared to measuring with film. The aim of this study was to investigate the dosimetric properties of a normoxic polymethacrylic acid gel dosimeter in static and dynamic states and to evaluate the potentiality as a relative dosimeter for dynamic therapeutic radiation.

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.865-870
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• 2005

Purpose : The use of growth hormone(GH) to promote growth in normal short children without classical GH deficiency is controversial. Numerous foreign studies have shown the effects of GH therapy in children with idiopathic short stature(ISS) whereas few has been interested in Korea. Therefore, this study is designed to investigate the effects of GH therapy on ISS by observing correlations and changes among various growth parameters such as, insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3). Methods : This study was conducted retrospectively with 15 children with ISS in Chungbuk National University Hospital in Korea. Mean age was $11.44{\pm}2.81$ and the children were treated with 0.66 IU/kg/wk dosage of GH for 1 or 2 years. Also, the growth parameters before and after the GH therapy were observed. Results : Height standard deviation score(HT-SDS) was increased from $-1.85{\pm}0.70$ to $-1.58{\pm}0.56$ at 1 year and to $-1.21{\pm}0.37$ at 2 years after GH therapy. Predicted adult height standard deviation score(PAH-SDS) was also increased from $-2.10{\pm}0.52$ to $-1.67{\pm}0.59$ at 1 year, and to $-0.96{\pm}0.60$ at 2 years. Serum IGF-I and IGFBP-3 levels were significantly increased after 1 year and marginally increased after 2 years of GH therapy. Conclusion : It is concluded that GH therapy has growth promoting effect. The significant increase in IGF-I and IGFBP-3 levels during the GH therapy suggests that IGF-I and IGFBP-3 are useful predictors of response to the use of GH therapy. It is expected that larger patient samples would provide more reliable information about the effect of GH therapy.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.323-328
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• 2008

Purpose : Asthma is defined as chronic inflammation of the lower small airways, and bronchial hyperreactivity (BHR) is a pathophysiologic feature of asthma. It has been proposed that although there is no direct variable capable of assessing the small airways, a forced expiratory flow of between 25 and 75 percent ($FEF_{25-75}$) might be considered a more sensitive early marker of small airway obstruction than the forced expiratory volume in 1 second ($FEV_1$). Thus, we proposed that the presence and degree of positive responses to bronchial methacholine testing were related to the difference (DFF) and ratio (RFF) between $FEV_1$ and $FEF_{25-75}$ in asthmatic children. Methods : The subjects were 583 symptomatic children, including 324 children with BHR and 259 controls. Pulmonary function tests, methacholine challenge tests, and skin prick tests were performed, and the total eosinophil count, total serum IgE, and serum eosinophil cationic protein level were measured in all subjects. From a concentration-response curve, the methacholine concentration required to produce a decrease of 20% from post-saline $FEV_1$ was calculated ($PC_{20}$). Results : The median DFF and RFF values decreased in controls compared to subjects with bronchial hyperresponsiveness, and this trend was found in groups ranked by its severity. $PC_{20}$ had a negative correlation with DFF and RFF. Cutoff values of 0.5 for DFF and 1.042 for RFF were identified, and sensitivity and specificity were calculated. Conclusion : This study revealed that DFF and RFF might be predictive of bronchial hyperresponsiveness in the context of normal $FEV_1$ in children.

• Journal of Nutrition and Health
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• v.44 no.3
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• pp.243-254
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• 2011

The purpose of this study was to investigate the general characteristics, body shape, and perceptions of weight control in individuals consuming functional health foods and weight-control foods. The survey was conducted between April 15 and June 17, 2010 among 199 (57 males and 142 females; age range, 25-45 years) in Seoul and Gyeonggi-do, who experienced eating functional health foods or weight control foods during the past year (June 2009 to June 2010). The subjects were divided into a weight-control food group (89 adults) and a functional health food group (110 adults). The subjects were comprised of a high proportion of aged (average age, $34.2{\pm}5.9$ years), graduates (71.9%), and married (65.8%) individuals. In the weight control food group, gender, age, and educational background were similar and the ratios of service/technical employees, college students, and normal-weight individuals [body mass index (BMI), < 23] were high. BMI was significantly different by gender (p < 0.001), age (p < 0.01), marital status (p < 0.001), and job type (p < 0.001). Self-perceived health status showed a higher response for "in good health" in the 35-44 year old group than that in the 25-34 year old group (p < 0.05). Male group satisfaction for body shape was significantly higher than that in the female group. The main reason for going on a diet was significantly different by gender (p < 0.05) and BMI (p < 0.01). The main motives for dieting were "because I am not at an ideal weight" and "because of the social atmosphere and the attention of others " in men, but "can't wear the clothes I want" in women (p < 0.01). The most preferable product type related to the two groups was significantly different by job (p < 0.001) and BMI (p < 0.05). However, no significant differences were observed for questions about body shape perception and weight control. Consumers who had different general characteristics and used diet products perceived body shape and weight control differently. Additionally, no meaningful differences were observed when the results were categorized by product type, except job and BMI, but the distribution of consumer characteristics showed different tendencies. These results can be utilized as basic data for developing new diet products to help people control their weight more scientifically and appropriately in the future.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.368-374
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• 2006

Purpose : The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. Methods : Thirty-eight obese children(14-16 years old of age, male, body mass index $29.40{\pm}3.18kg/m^2$) and forty-five age and sex-matched healthy control children(body mass index $18.43{\pm}1.01kg/m^2$) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flowmediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. Results : The obese children had significantly increased IMT($0.52{\pm}0.09mm$ vs $0.40{\pm}0.07mm$, P< 0.001) and markedly impaired FMD($7.35{\pm}7.78$ percent vs $20.34{\pm}16.81$ percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P<0.001) and reduced FMD(r=-0.414, P<0.001). Conclusion : We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.541-547
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• 2003

Purpose : Gap junction intercellular communication(GJIC) is an important mechanism of the bystander effect in herpes simplex thymidine kinase/ganciclovir(HSVtk/GCV) gene therapy Therefore, we attempted to enhance the bystander effect in vitro by exogenous overexpressing connexin 37(Cx37) in cells to increase GJIC. Methods : NIH3T3 cells were transfected with the Cx37 and HSVtk gene or the HSVtk gene alone by the calcium phosphate method, and we detected their expression from these cells by RT-PCR. GCV-mediated cytotoxicity and the bystander effect of each transfectant was then assessed and compared. Results : Cells transfected with HSVtk became sensitive to low concentration of GCV. We found significantly increased cytotoxicity in HSVtk/GCV gene therapy after introduction of the HSVtk and Cx37 genes together compared with the cytotoxicity seen after introduction of the HSVtk gene in vitro. Co-expression of the HSVtk and Cx37 genes potentiates HSVtk/GCV gene therapy through the bystander effect. Conclusion : These results indicated that the increase of GJIC using Cx37 have potentiated the bystander effect of HSVtk/GCV therapy, and may be a new approach to improve response in suicidal cancer gene therapy.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.889-892
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• 2003

Purpose : This study aimed to evaluate risk factors of the first year relapse in children with nephrotic syndrome(NS) without the need for biopsy. Methods : We reviewed, retrospectively, 78 children diagnosed with steroid responsive nephrotic syndrome between July 1997 and June 2002. Median years to follow up were 4.4 years(range : 1-5 years). We divided the patients into two groups(group I : primary responders with no relapse or with only two relapses in the first year after initial response; group II : initial steroid responders with three or more relapses within the first year). We retrospectively reviewed and compared variables - sex, onset age, serum albumin, serum cholesterol, 24 hours urinary protein, creatinine clearance(Ccr), presence of hematuria and hypertension(HTN), and days from initial attack to remission. Results : Of 78 patients(male : 61(78.2%), female : 17(21.8%), age range 1.1 years to 14 years, median $5.1{\pm}3.0years$), 47(60.3%) were in group I and 31(39.7%) were in group II. There were no statistically significant differences in sex, serum albumin, serum cholesterol, 24 hours urinary protein, Ccr, presence of hematuria or HTN. The median age of onset showed no statistical difference between the two groups. However, if the patients are dividing into two groups according to the age of onset of three-years, patients theree yrs old or less fit into group II, as opposed to patients older than three yrs in age(63.2% vs. 32.2%, P<0.05). The days from initial attack to remission was longer in group II($12.9{\pm}0.5$ vs. $16.2{\pm}1.1$, P<0.05). Conclusion : We may conclude that the age of onset of three yrs old or less, and the longer time remission to initial steroid therapy, are risk factors of the first year relapse.