Pulmonary function test is one of the most important tools in the management of patients with respiratory tract diseases and allergic diseases. As with the difficulties in performing the test, it has been seldom used in pediatric field. But with the advent of simple, computerized tools, pediatric pulmonologist and allergist try to manage the patients using PFT. Still the normal predicted values are variable among the reports. So it is important to have normal predicted value in Korean children. From April to July 1992, pulmonary function test was performed in 965(male: 490, female: 475) primary school-aged children except <3 or >97 percentile of Korean-children Physical developemental standards with history of allergic diseases and respiratory tract diseases ay SungNam, KyongKiDo. We evaluated the predicted normal values of the FEV1.0, FVC and PEFR and logarithmic regression equation setting the predicted values by using the microspirometer of Micromedical Ltd. England that could that could be easily applied to children. 1) Predicted values of pulmonary function test items were generally higher in boys than those of girls. 2) Correlation coefficient to the parameters examined was the highest in height 0.78, then age 0.75, weight 0.70 and chest circumference 0.61.
Child* ; England ; Female ; Gyeonggi-do ; Humans ; Peak Expiratory Flow Rate ; Reference Values ; Respiratory Function Tests* ; Respiratory Tract Diseases ; Thorax

Idiopathic myelofibrosis (IMF), which is characterized by marrow fibrosis, leukoerythroblastic anemia, teardrop poikilocytosis and splenomegaly due to extrumedullary hematopoiesis, has known to have no form of therapy. On the ground of the possibility of reversing collagen deposion in IMF using 1, 25dihydroxycholecalciferol [1, 25(OH)2D3], we report here our observations of 5 patients (M:F=1:4) with IMF before and after treatment with 0.5 microgram/day of alfacalcidol, precursor of 1, 25(OH)2D3. In 3 fo 5 patients the hemoglobin rose and in 4 of 5 the platelet count increased. Follow-up marrow examination revealed that marrow trephine reticulin fibrosis decreased according as the amelioration of clinical and laboratory findings. But these did not persist except one patient in spite of the sustained use of alfacalcidol. Our results suggest that alfacalcidol may have a therapeutic role in some patients with IMF. More extensive studies will be clarify the action of alfacalcidol in IMF.
Anemia, Myelophthisic ; Bone Marrow ; Child* ; Collagen ; Fibrosis ; Follow-Up Studies ; Hematopoiesis ; Humans ; Platelet Count ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

PURPOSE: Despite the increasing prevalence of allergic rhinitis, there are difficulties in early diagnosis and proper treatment due to lack of education and misunderstanding of the disease. Development of efficient education materials based on the level of awareness of allergic rhinitis is required. Therefore, this study was aimed to develop a questionnaire for investigating the level of awareness of allergic rhinitis. METHODS: Questions related to the level of awareness of allergic rhinitis were prepared on the basis of the literature, professional advice and inquiries from patients and caregivers. These items were categorized into 4 areas: (1) basic knowledge, (2) symptoms, (3) diagnosis and environmental management and (4) treatment. Through the eight preliminary survey on 38 adults, a questionnaire of 60 items was developed. The results were analyzed by using SPSS 12.0. RESULTS: A tool for investigating the level of awareness was completed, which was composed of 20 items with an internal reliability of 0.67. According to the results of the survey with 60 items, the areas of basic knowledge, symptoms and environmental management of allergic rhinitis showed high awareness. The items regarding the association between allergic rhinitis and asthma, necessity of regular checkup, awareness of maintenance treatment, importance of treatment with intranasal steroids, and the influence of treatment on immunity, growth and development of patient showed low awareness. CONCLUSION: A reliable tool was developed for investigating the level of awareness of allergic rhinitis. It may be useful in developing educational materials to optimize its educational effect on allergic rhinitis.
Adult ; Asthma ; Caregivers ; Early Diagnosis ; Growth and Development ; Humans ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial ; Steroids

PURPOSE: Monocyte chemoattractant protein-1 (MCP-1) is a chemokine that can increase adhesion molecule expression on monocytes and produce superoxide anions. Hyperglycemia induces MCP-1 production in vascular endothelial cells and retinal pigmented epithelial cells, and has been implicated as a causal factor in the facilitation of vascular complications in diabetes. In the present study, we evaluated the association of a single nucleotide polymorphism (SNP) in the MCP-1 gene with proliferative diabetic retinopathy (PDR) in a Korean population with type 2 diabetes. MATERIALS AND METHODS: We conducted a case-control study, which enrolled 590 subjects with type 2 diabetes, and SNP genotyping of c.2518A/G in the MCP-1 gene was performed using polymerase chain reaction followed by digestion with PvuII restriction enzyme. RESULTS: The prevalence of c.2518A/G polymorphism in diabetic patients was 13.2% (A/A), 47.1% (A/G) and 39.7% (G/G). In patients with diabetic retinopathy, the prevalence of PDR was significantly higher (p=0.009) in diabetic subjects with the c.2518A/A genotype (35.9%; n=78) compared to those with either the A/G or G/G genotype (22.3%, n=512). The prevalence of any other micro and macro-complications, including nephropathy and cerebrovascular events, were not different according to the c.2518A/G genotype. CONCLUSION: Our new genetic findings suggest that the c.2518A/A genotype in MCP-1 could be used as a susceptibility gene to predispose Koreans exhibiting type 2 diabetes for the development of PDR.
Aged ; Case-Control Studies ; Chemokine CCL2/*genetics ; Diabetes Mellitus, Type 2/*complications ; Diabetic Retinopathy/etiology/*genetics ; Female ; Genetic Association Studies ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide ; Republic of Korea

BACKGROUND AND PURPOSE: Repetitive transcranial magnetic stimulation (rTMS) has been examined as a potential treatment for many neurological disorders. High-frequency rTMS in particular improves cognitive functions such as verbal fluency and memory. This study explored the effect of rTMS combined with cognitive training (rTMS-COG) on patients with Alzheimer's disease (AD). METHODS: A prospective, randomized, double-blind, placebo-controlled study was performed with 27 AD patients (18 and 8 in the treatment and sham groups, respectively, and 1 drop-out). The participants were categorized into mild [Mini-Mental State Examination (MMSE) score=21-26] and moderate (MMSE score=18-20) AD groups. The rTMS protocols were configured for six cortical areas (both dorsolateral prefrontal and parietal somatosensory associated cortices and Broca's and Wernicke's areas; 10 Hz, 90-110% intensity, and 5 days/week for 6 weeks). Neuropsychological assessments were performed using the AD Assessment Scale-cognitive subscale (ADAS-cog), Clinical Global Impression of Change (CGIC), and MMSE before, immediately after, and 6 weeks after the end of rTMS-COG treatment. RESULTS: Data from 26 AD patients were analyzed in this study. There was no significant interactive effect of time between the groups. The ADAS-cog score in the treatment group was significantly improved compared to the sham group (4.28 and 5.39 in the treatment group vs. 1.75 and 2.88 in the sham group at immediately and 6 weeks after treatment, respectively). The MMSE and CGIC scores were also improved in the treatment group. Based on subgroup analysis, the effect of rTMS-COG was superior for the mild group compared to the total patients, especially in the domains of memory and language. CONCLUSIONS: The present results suggest that rTMS-COG represents a useful adjuvant therapy with cholinesterase inhibitors, particularly during the mild stage of AD. The effect of rTMS-COG was remarkable in the memory and language domains, which are severely affected by AD.
Alzheimer Disease* ; Cholinesterase Inhibitors ; Cognitive Therapy ; Humans ; Memory ; Nervous System Diseases ; Prospective Studies* ; Rabeprazole ; Transcranial Magnetic Stimulation*

BACKGROUND: Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. MATERIAL AND METHOD: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50+/-13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32 (61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6+/-10.5 months (1~39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. RESULT: Mean cardiopulmonary bypass time was 191+/-94.7 minutes with an aortic cross-clamp time of 142+/-51.7 minutes. There was no early and late mortality. Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6+/-6%; bleeding events, 90.2+/-4%; paravalvular leakage 92.3+/-4%; and overall valve-related morbidity at 1 year was 76.6+/-3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7+/-9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8+/-15.9%, p=0.006). Left ventricular mass index was 247.3+/-122.3 g/m2 on preoperative echocardiographic study, but regressed to 155.5+/-58.2 g/m2 at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5+/-38.0 mmHg on preoperative assessment, 18.2+/-6.8 mmHg at immediate postoperative period (p<0.0001), 7.6+/-5.09 mmHg (p<0.0001) at 6 month, 18.0+/-10.8 mmHg (p<0.0001) at 1 year. CONCLUSION: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.
Aortic Valve* ; Cardiopulmonary Bypass ; Classification ; Echocardiography ; Endocarditis ; Follow-Up Studies ; Freedom ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Hemodynamics ; Hemorrhage ; Humans ; Hypertrophy, Left Ventricular ; Jeollanam-do ; Male ; Mortality ; Postoperative Period ; Prostheses and Implants ; Thoracic Surgery ; Thromboembolism ; Thrombosis ; Ventricular Function, Left

Inflammatory myofibroblastoma is a solid tumor, occurring mainly to children and young adults, and occupying 0.7% of total isolated pulmonary nodules. Since 1973, several cases about inflammatory myofibroblastoma have been reported. Firstly, this tumor was found in lungs. Then, tumors have been founded and reported in mesentery or cardioesophageal region. Histologically, this tumor can be classified as a benign tumor. However, since this tumor has two characteristics showing malignancy, that is, local invasion and recurrence, malignancy can not be completely excluded. Recently, a patient with pulmonary inflammatory myofibroblastoma underwent surgical resection without any signs or symptoms of recurrence.
Child ; Humans ; Lung ; Lung Neoplasms ; Mesentery ; Myofibroblasts* ; Neoplasms, Muscle Tissue ; Recurrence ; Young Adult

Burkitt's lymphoma is a distinct pathologic entity characterized as a diffuse undifferentiated malignant lymphoma of B-lymphocyte origin. We experienced a case of Burkitt's lymphoma with bilateral renal enlargement in which a 3year-old male patient was admitted with complaints of abdominal distention and facial edema. Laboratory examination revealed positivity for CD 19, CD 10, CD 20 and c-myc on flow cytometry, bilateral renal enlargement(10x12cm in longitudinal length) on abdominal ultrasonogram and CT, malignant lymphoma of Buritt's type with prominent nucleoli and cytospin of cerebrospinal fluid. Initially he showed tumor lysis syndrome and clinical stage D by Zigler(stage IV by Murphy) with CNS involvement. After initial management with hydration, urine alkalinization and allopurinol, combination chemotherapy had been applied with the craniospinal radiotherapy according to the CCG 503 II regimane, with achievement of complete remission. Thus we report a case of Burkitt's lymphoma with bilateral renal enlargement with a biref review of literatures.
Allopurinol ; B-Lymphocytes ; Burkitt Lymphoma* ; Cerebrospinal Fluid ; Drug Therapy, Combination ; Edema ; Flow Cytometry ; Humans ; Lymphoma ; Male ; Radiotherapy ; Tumor Lysis Syndrome ; Ultrasonography

Telepathology systems will be common systems in hospitals. The two systems were designed and implemented in web environments for test. One was implemented with the Common Object Request Broker Architecture (CORBA) technique. The other system was implemented in the form of ActiveX. The histopathological materials were stained by Hematoxylin and Eosin. By the Donpisha CCD camera attached to an Olympus BX-51 optical microscope 180 color images come to be acquired. For evaluation of the systems, transmission times and telediagnosis concordance rates were measured. Image processing ability was tested using two telepathology systems. For the local area test, system I using CORBA had measured image transmission times of 0.1 s, 0.2 s, and 0.4 s at the file sizes of 100 K byte, 900 K byte and 3.6 M byte respectively. Transmission times for system II using Component Object Model (COM) were slightly slower, ranging from 0.02 s to 0.05 s. In the long distance area test, system II transmission times were 0.5 s, 0.8 s, and 2.0 s. The overall concordance rate of telediagnosis for the 180 images was 78.3%. In this study, we compared our systems about image transmission, and processing for the further development of system configurations.
Eosine Yellowish-(YS) ; Hematoxylin ; Internet* ; Telepathology*

The causes of the chylothorax can be classified to the congenital cases, such as the atresia of thoracic duct and thoracic duct-pleura fistula, and the acquired ones, such as thoracic surgery, trauma, malignant disease, venous thrombosis, infection and so on. We experienced a case of left chylothorax in a 10-year-old girl with a lymphangiomatosis of left thorax extending from axillar to buttock. She first received the two weeks of conservative management, which was unsuccessful to subside the chylothorax. Then she was taken the partial pleurectomy and chemical pleurodesis under the thoracoscopy as a surgical intervention, but this is also insufficient to reduce the chylous effusion. Finally she received 10 times of radiotherapy on left thorax, then the chylothorax is controlled completely.
Buttocks ; Child ; Chylothorax* ; Female ; Fistula ; Humans ; Pleurodesis ; Radiotherapy* ; Thoracic Duct ; Thoracic Surgery ; Thoracoscopy ; Thorax* ; Venous Thrombosis