• Pediatric Infection and Vaccine
• /
• v.23 no.1
• /
• pp.10-17
• /
• 2016

Purpose: The diagnosis of Kawasaki disease depends on clinical symptoms, which makes it difficult to diagnose early in patients with only cervical lymphadenopathy. The purpose of this study is to understand the clinical characteristics of cervical-lymph-node-first presentation of Kawasaki disease and compare them with those of typical Kawasaki disease. Methods: We surveyed 283 patients who were admitted to Hallym Sacred Heart Hospital and were diagnosed with Kawasaki disease from January 2012 to December 2014. The patients were divided into two groups: cervical-lymph-node-first presentation of Kawasaki disease (LKD, N=24) and typical Kawasaki disease (KD, N=259). The medical records were retrospectively reviewed. Results: The mean age of the LKD group was higher than that of the KD group (P=0.04). At admission, the LKD patients had on average 1.62 out of 5 symptoms, whereas the KD patients had 3.47. The time from fever to diagnosis and administration of IV immunoglobulin was longer in the LKD group than in the KD group (P<0.001). The mean C-reactive protein of the LKD group was higher than that of the KD group (P=0.01). There were no statistical differences in the presence of coronary artery complications between the two groups at two weeks or at two months after diagnosis (P=0.52, P=0.08). Conclusions: The Kawasaki disease patients with fever and cervical lymphadenopathy usually do not present obvious clinical symptoms, which makes it hard to diagnose in the early phase of disease. Clinician must pay attention when examining these patients.

• The Korean Journal of Nuclear Medicine
• /
• v.11 no.1
• /
• pp.39-48
• /
• 1977

Radioactive iodine(RAI), principally $^{131}I$, effectively controls hyperthyroidism in the majority of patients. The subsequent development of hypothyroidism, however, has been of increasing concern since it was first pointed out by Chapman and Maloof in 1955. And the steady increase of late hypothyroidism during the passage of time was known with its relation with dosage of RAI. The authors have investigated the development of hypothyroidism in 935 patients with diffuse toxic goiter(DTG) who were treated with ($RAI^{131}I$) at the Seoul National University Hospital from 1960 to 1977 to reveal its relation with the number of RAI treatments, dosage of RAI, age of patients and exophthalmos with the following results. 1) The incidence of hypothyroidism by year after RAI therapy among 631 patients with DTG who were treated with single RAI regimen was 7.4%(1 year), 11.8%(2 year), 16.2%(3 year), 22.1%(4 year) and 25.5%(5 year), and that among 163 patients given multiple RAI treatments was 8.6%(1 year), 10.4%(2 year), 13.3%(3 year), 29.1%(4 year), and 54.1%(5 year)respectively showing much higher year1y increments from 4 years after RAI treatment. in comparison with the former. 2) Among 550 patients in the lower dose group treated with single RAI regimen less than 5.0mCi ($Mean{\pm}S.D.:\;4.3{\pm}0.6mCi$), the incidence of hypothyroidism by year after RAI treatment was 6.8%(1 year), 11.4%(2 year), 15.4%(3 year), while among 81 patients in the higher dose group given single RAI treatment not less than 5.5 mCi ($Mean{\pm}S.D.:\;6.3{\pm}0.5mCi$) it was 12.0%(1 year), 15.4%(2 year) and 20.4%(3 year) respectively. However, the duration till euthyroid state after RAI therapy in the two groups was $5.1{\pm}3.6$ months and $4.8{\pm}2.8$ months respectively showing no statistically signficant difference (p>0.1). 4) The incidence of hypothyroidism after RAI treatment in patients younger than 30 years of age was 4.3%(1 year) and 7.7%(2 year); in patients from 30 years to 49 years of age, 5.8%(1 year) and 11.1%(2 year); and in those older than 50 years, 11.0%(1 year) and 14.4%(2 year). The data revealed rising incidence of hypothyroidism with increase of patients' age. 4) Among 116 patients with exophthalmos the incidence of hypothyroidism by year after RAI treatment was 7.1%(1 year) and 12.1%(2 year) while that among 184 patients without exophthalmos was 7.3%(1 year) and 12.2%(2 year) respectively. With the above data the authors could conclude that the hypothyroidism in patients with DTG who were treated by RAI developed more frequently than reported by others in Korea till now, and increased with the passage of time, the yearly increments from 4 years after RAI treatment increasing markedly in the multiple dose group, and the incidence could be reduced by decreasing the administered RAI doe not increasing the duration till euthyroid state after RAI therapy.

• Neonatal Medicine
• /
• v.17 no.1
• /
• pp.21-33
• /
• 2010

Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.

• Clinical and Experimental Reproductive Medicine
• /
• v.24 no.3
• /
• pp.281-292
• /
• 1997

The objective of this study was to compare retrospectively the survival and pregnancy rates(PR) of cryopresered-thawed embryos obtained from intracytoplasmic sperm injection (ICSI) or conventional in vitro fertilization (IVF). Ninety-six cycles of cryopresered-thawed embryo transfer (ET) were performed in 79 patients from June, 1996 to September, 1997 and grouped as followings: 20 cycles (16 patients) inseminated by ICSI (ICSI Group) and 76 cycles (63 patients) by conventional IVF (IVF Group). Slow-freezing and rapid-thawing protocol was used with 1.5M propanediol (PROH) and 0.1M sucrose as cryoprotectant. All embryos were frozen-thawed at the two pronuclear (2 PN) stage excluding four cycles in which the early cleavage stage embryos were frozen, and allowed to cleave in vitro for one day before ET. The duration from freezing to thawing was comparable in both groups ($mean{\pm}SD$, $112.1{\pm}80.0$ vs. $124.8{\pm}140.1$ days). The age of female ($31.2{\pm}3.4$ vs. $32.6{\pm}3.3$ years) and the endometrial thickness prior to progesterone injection ($9.4{\pm}2.0$ vs. $9.3{\pm}1.8$ mm) were also comparable in both groups. There was no significant difference in the outcomes of cryopreserved-thawed ET between two groups: survival rate ($85.2{\pm}16.1%$ vs. $82.2{\pm}19.7%$), cleavage rate ($96.9{\pm}6.7%$ vs. $94.7{\pm}13.0%$), cumulative embryo score (CES, $54.5{\pm}31.1$ vs. $49.0{\pm}20.0$), preclinical loss rate (5.0% vs. 5.3%), clinical miscarriage rate (0% vs 29.4%), clinical PR per transfer (35.0% vs. 22.4%), implantation rate (9.9% vs. 5.6%), and multifetal PR (42.9% vs. 17.6%). In conclusion, human embryos resulting from ICSI can be cryopreserved-thawed and transferred successfully, and the survival rate and PR are comparable to conventional IVF.

• Childhood Kidney Diseases
• /
• v.18 no.1
• /
• pp.24-28
• /
• 2014

Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.1
• /
• pp.87-102
• /
• 1999

Objectives : The purposes of this study were to estimate the prevalence rate of eating disorders in Korean males and to clarify their characteristics in sociodemograhic data, the eating traits, and general psychopathology through the comparison with those of female high scored group on the Korean version of Eating Attitudes Test-26(KEAT-26). Methods : Using a multi-stage questionnaire sampling method including area sampling, proportionated stratified sampling, and quota sampling, we surveyed a total of 4,400 Korean adults over 18 in a nationwide area(9 kus, 10 middle or small cities, and 17 kuns), obtaining usable responses on 3,896. Of the 3,062 subjects(1249 males and 1813 females) who were available for analysis, we ascertained 52 males and 208 females who had high score($\geq$ cutoff point 21) on the KEAT-26. Results : 1) The proportion of this high score group was 1.7% in male and 6.8% in female with a sex ratio(male versus female) of 1 : 4. 2) The mean age was higher in the male group than in the female group, although it was not statistically significant(p=0.0514). Mean Body Mass Index(BMI) of the male group was significantly higher than that of female group, and the number of male subjects with below 20 of BMI was also significantly lower than in the female group. 3) There were no significant difference in past history of physical illness between two groups. However, frequency of smoking and alcohol use, and mean amount of alcohol consumption per month were significantly higher in the male group than in the female group. There were no significant differences between the two groups on various socio-demographic correlates such as economic status, total duration of education, number of family, marital status, religious status, and area of residence, but the exception of being occupational status. 4) The 'Eating Habits Scale' score and score of 'preference for vegetables and fish, and dislike for sweet-tasting food' of the male group were significantly lower than those of the female group. Although there was no significant difference between the two groups in total scores of the KEAT-26, the mean score on 'pursuit of thinness' subscale was higher in the female group than in the male group, while scores of 'food preoccupation' and 'self-control' subscales were higher in the male group than in the female group. 5) Scores on 'psychoticism' was significantly higher in the male group than in the female group, although there were no significant differences between the two groups on 'locus of control for weight', 'depression' and 'hypochondriasis'. Conclusion : These results support a possibility of a high prevalence of eating disorders in Korean males. These results suggest that eating related characteristics of high scorer on the EAT are different by sex in spite of the same high score on the EAT, and also suggest that male patients with eating disorders have more serious personality pathology than female patients with eating disorders.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.36 no.11
• /
• pp.1399-1408
• /
• 2007

This study was conducted to compare health and nutritional status of 45 home-living elderly people receiving free Meals on Wheels (MOW) (13 men, 32 women) and 81 low income class elderly people receiving free congregate meals (CM) (10 men, 71 women) served in Seoul. Data were obtained from questionnaires, anthropometry and interviews for the 24-hour dietary recall methods. There were no significant differences between the two groups in age and body mass index. Education level, type of housing, family type and income of the two groups also were not significantly different. In MOW, frequencies of exercise were lower while the prevalence of stroke, respiratory disease and loneliness were higher, compared with the CM. The scores of ADL, IADL and food habit of MOW were lower than those of CM. The average daily nutritional intake of both MOW and CM were as a whole under the DRI for Koreans. Energy and macro-nutrient intakes of MOW were tended to be lower than CM (except protein intakes for female). Ca, K, vitamin A, vitamin $B_1$, vitamin $B_2$, vitamin C and folate intakes of MOW were less than 50% of DRI. Percentages of subjects consuming energy less than 75% of EER and 4 nutrients intakes less than EAR were higher in MOW (42.2%) than in CM (1.2%). Our results indicated that dietary nutritional status of MOW was very poor, especially in the case of female elderly groups. For the welfare of the home-living elderly people receiving free MOW, meal service programs should be improved in quality of diet by national supports.

• The korean journal of orthodontics
• /
• v.29 no.1 s.72
• /
• pp.51-72
• /
• 1999

In orthodontic field, it is very important to understand the normal growth. Such an understanding can be derived from observation of normal growth in various samples from childhood to adulthood, and this builds a foundation from which growth abnormality or variation can be defined. Thus, a broad data collection of normal children, as well as basic study reviewing such data become necessary. The relationship between the mean values of cephalometric measurements in Growth and Development was studied among the groups(boys and girls) of Korean chidren from the ages 6-years to 16-years. 220 boys 170 girls were chosen as subjects : Cephalometric X-ray were taken for 3 years and hard tissue analysis on McNamara and Ricketts Analysis which was divided into measurements of 5 parts(Cranial base, Cranial base and Maxilla & Mandible, Maxilla and Mandible, Mandible, Dental measurements). The relationship of craniofacial growth was studied. The following conclusions were obtained: 1. There were statistically significant differences in anterior cranial base between the two sexes of 14 and 15-year grouips. 2. In comparison of growth amounts among different age groups, statistically singnificant difference in Posterior facial height exhisted among $10\~11,\;12\~13\;and\;14\~15$ year-old interval groups. This pattern increased with aging. 3. Na perpendicular to A showed earlier growth peak in females(11-12years) than males(12-13years). When horizontal measurements of point A and Pogonion are compared, mandibular growth appeared to be greater. 4. Maximum growth peak of cranial base and mandible was earlier in females (11-12years) than males(13-14 years). 5. Upper central incisor flared out with aging, and there were increases in lower incisor to A-Pg, and lower incisor inclination There was significant difference between the two sexes in 10-year-old group.

• Journal of agricultural medicine and community health
• /
• v.24 no.1
• /
• pp.79-89
• /
• 1999

The purpose of this study is to compare health status and activities for the pain and no-pain groups in the elderly. The study subjects included 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes through interview using a closed-ended questionnaire from Nov. 6th. to Nov. 16th. 1997. The instrument used in the study was selected after carefully reviewing pain-related articles and records well described the characteristics of the elderly. The data were analysed by using descriptive statistics and chi-square tests. The findings were as follows : Of the 189 subjects, 83.6% reported experiencing the pain for the last year. By the age, there were significant differences between the pain and no-pain group(${\chi}^2$=9.572, p=.023). The percentage of the pain complainers was the highest in 80 years and older(100.0%), followed by 70~74(89.1%), 75~79(81.3%), 65~69(76.8%) which presented crude increase according to age. By sex, men had lower pain prevalence(69.5%) than that of women(90.0%). The number of pain complainers was higher in women than men(${\chi}^2$=12.448, p=.023). There were significant differences between the pain and no-pain groups by spouse distribution(${\chi}^2$=10.736, p=.001), educational state(${\chi}^2$=13.020, p=.000), occupation(${\chi}^2$=18.807, p=.000). Pain prevalence in the subjects having no spouse(59.3%) was higher than those having spouse(40.7%), Illiteracy rate was higher in pain group(49.0%) than no-pain group(13.3%). The number of the subjects having occupation(full time or part time) was fewer in pain group than no-pain group. By health status, there were significant differences between two groups(${\chi}^2$=40.055, p=.000). : the pain group showed poor(61.4%), followed by moderate(22.1%), good(16.5%) while no-pain group showed good(64.5%), moderate(29.0%), poor(6.5%). By activities, there were significant differences between the pain and no-pain groups. The pain group was disturbed more severely than the no-pain group in movement(${\chi}^2$=57.829, p=.000), sleep(${\chi}^2$=12.785, p=.000), usual activities(${\chi}^2$=39.196, p=.000), receiving guests(${\chi}^2$=13.163, p=.000), and hobbies and recreation(${\chi}^2$=28.177, p=.000).

• Neonatal Medicine
• /
• v.15 no.2
• /
• pp.142-151
• /
• 2008

Purpose : The aim of this study was to compare the clinical effects of modified porcine (Curosurf$^{(R)}$) and bovine (Newfactan$^{(R)}$) surfactants in the treatment of neonatal respiratory distress syndrome. Methods : Between April 2004 and December 2006, 65 neonates (birth weight ${\leq}$2,500 g and gestational age ${\leq}$35 weeks) with neonatal respiratory distress syndrome were treated in our neonatal intensive care unit with surfactant. Thirty-one neonates received Curosurf$^{(R)}$ and 34 neonates received Newfactan$^{(R)}$. The neonates were not enrolled if they had major congenital anomalies or meconium aspiration syndrome. We compared the changes in respiratory parameters after surfactant instillation, the incidences of acute and chronic complications, and the mortality between the two treatment groups. Results : Neonatal and maternal demographic characteristics were not different between the groups. The patterns of change in the respiratory parameters after surfactant instillation were not statistically different between the groups. The incidences of surfactant reinstillation and acute complications, such as pneumothorax, patent ductus arteriosus, pulmonary hemorrhage, and grade 3-4 intraventricular hemorrhage, were not different between the neonates who received Curosurf$^{(R)}$ and the neonates who received Newfactan$^{(R)}$. There were no statistically significant differences in the duration of mechanical ventilation, oxygen therapy, hospitalization, prevalence of bronchopulmonary dysplasia, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, and mortality between the groups. Conclusion : In the present comparative study, no significant differences in the clinical effects of Curosurf$^{(R)}$ and Newfactan$^{(R)}$ were observed.