• Pediatric Infection and Vaccine
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• 제11권1호
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• pp.81-89
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• 2004

Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

• Journal of the Korea Institute of Information and Communication Engineering
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• 제22권8호
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• pp.1107-1113
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• 2018

Ultrasonography and photodynamic therapy have been proposed as useful tools as a treatment for inducing necrosis of cells using reactive oxygen species. Apoptosis is an internal mechanism necessary for cells regardless of damage. Ultrasound has the effect of inducing the apoptosis of these cells, and the frequency of 1 MHz is the most applicable area for medical use. The laser which is generally used in photodynamic therapy has a heat reaction and the treatment is limited. However, as a small light emitting diode is developed, it shows possibility to minimize the equipment and reduce heat reaction. On the other hand, there are relatively few researches on direct effects of light compared with studies using photosensitizers, and the area is also limited. Therefore, in this paper, we have developed a cancer cell proliferation control module using ultrasonic and light emitting diodes, which have relatively few side effects, and quantitatively analyze the effect of the module to propose an optimal suppression technique.

• Clinical and Experimental Pediatrics
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• 제50권4호
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• pp.363-368
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• 2007

Purpose : It has been reported that deep neck abscesses are recently increasing again. We analyzed pediatric cases with deep neck abscesses during the last several years to contribute to the treatment of the disease. Methods : The clinical data of 30 children under 16 years of age with deep neck abscess from February 2001 to July 2006 were analysed retrospectively. Results : The mean age was 9 years (2-16 years), and the male/female ratio was 19/11. Abscesses in the peritonsillar space were most common (57%), followed by the retropharyngeal (30%) and parapharyngeal (13%) spaces. Upper respiratory infection in 10 cases (33%), dental infection in four case (14%), cervical lymphadenitis in three case (10%) and sinusitis in two case (6%) contributed to the development of deep neck infections. The frequent symptoms were fever in 16 case (53%), sore throat in 15 case (50%), poor oral intake in 10 (33%), odynophagia in eight (27%), and neck pain in eight (27%). Unilateral tonsillar hypertrophy and displacement in 15 case (50%) were most common. Neck mass in 13 patients (43%), neck stiffness in three (10%) and trismus in three (10%) were also found. Bacteria were isolated in 8 among 10 pus cultures; Streptococcus species 7 and Micrococcus luteus 1. All of those bacteria except Micrococcus luteus were sensitive to penicillin G. Surgical intervention was applied to 12 cases (40%), and the remaining 18 patients (60%) were treated with antibiotics only. There were no differences between the two groups in the duration of admission and antibiotic treatment. No complicated cases were observed. Conclusion : Peritonsillar abscesses were most frequent. Upper respiratory infection was the most common predisposing factor, followed by dental infection and sinusitis. Symptoms of respiratory tract obstruction were not found. The most common pathogens were Streptococcus species. Deep neck abscesses in children, if diagnosed at the early stage, possibly can be treated by antibiotics only, without surgical intervention.

• Clinical and Experimental Pediatrics
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• 제48권7호
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• pp.745-752
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• 2005

Purpose : Adolescent obesity is known to be associated with complications such as hypertension, coronary artery disease and insulin resistance. We measured the common carotid artery by ultrasound as a predictor of atherosclerosis, and investigated the relationship between carotid artery parameters and serum cytokines in obese adolescents. Methods : Twenty-nine obese adolescents(16-17 years old, obesity index>130 percent) and twentyseven normal controls were included. Obesity index and body mass index were calculated from their height and weight. Skin fold thickness was measured at the triceps, and fat mass and fat distribution by bioelectrical impedence analysis. Blood pressure was measured at resting state and serum lipid, insulin, and homocysteine levels after a 12-hour fasting period. Intimal wall thickness, systolic and diastolic diameters of the common carotid artery were measured by ultrasound, and compliance and distensibility calculated by equation. Results : Systolic and diastolic diameters of the carotid artery significantly correlated with arm circumference, body mass index, fat distribution and fat mass. The higher systolic blood pressure was, the larger systolic and diastolic diameter. The higher diastolic blood pressure was, the larger carotid intimal thickness. Insulin levels had positive correlations with systolic, diastolic diameters and serum homocysteine level with intimal thickness. Conclusion : The carotid artery diameter significantly increased with the degree of obesity and blood pressure. The carotid intimal wall thickness significantly correlated with diastolic blood pressure. Measurement of carotid artery thickness, insulin and homocysteine levels might be useful to predict the development of coronary artery disease.

• Advances in pediatric surgery
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• 제2권1호
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• pp.64-67
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• 1996

Aberrant migration of thymic tissue occurs as an ectopic thymus in the mediastinum, base of skull, tracheal bifurcation, and cervical region. A recent review of the literature by Nowak et al. showed over 70 reported cases of aberrant thymus or thymic cyst in patients who presented with primary neck masses. Authors experienced a case of ectopic cervical thymus and reviewed the literature. A one-year-old boy with left neck swelling which had been noticed since one month of age visited out patient clinic. Ultrasonography showed a well-defined cystic mass containing homogeneous, low-echogenic content locating in the lateral aspect of the left carotid sheath. Operation was performed under the impression of branchial cleft cyst. At surgery, a multiseptated, well-encapsulated, brownish and doughy mass which was extending into the vicinity of the carotid bifurcation with sland stalk-like portion ending between the hypoglossal nerve and external carotid artery was excised completely. The cut-surface showed homogenous solid mass, and on frozen section the tissue revealed a normal thymic histology. Postoperative ultrasonography showed bilateral thymus in the superior mediastinum. The patient has no immunologic problem and is doing well now.

• Proceedings of the Korea Water Resources Association Conference
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• 한국수자원학회 2021년도 학술발표회
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• pp.249-249
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• 2021

도시지역의 우수유출해석 모형인 SWMM 모형의 매개변수는 유역유출관련 매개변수와 우수관로 매개변수로 구분이 된다. 이중 우수관로내 수리거동에 영향을 대표적인 매개변수는 조도계수가 있다. 우수관로 조도계수는 우수관로의 규격 및 재료에 따라 적용범위가 제시되어 있지만 현상태 관로내 퇴적 및 협잡물 등에 의한 조도변화가 발생하게 된다. 따라서 본 연구에서는 우수관로 조도계수의 변화에 따른 유량의 민감도를 검토하고 모니터링 유량과 비교를 통한 연구 대상지역의 최적 조도계수를 선정하였다. 연구 대상지역은 울산광역시 삼호동 일대이며 대상지역 내 발생한 우수유출은 최종적으로 태화강으로 방류되는 구조를 갖고 있는 배수분구이다. 조도계수 민감도 분석에 적용한 조도계수의 범위는 일반적인 원형 우수관로의 조도계수 0.013을 기준으로 하고 0.002씩 증감을 시켜 총 6개 CASE에 대한 민감도 분석을 수행하였다. 모의 유량의 비교군이 되는 관측 유량의 경우는 초음파 유량계로 관측한 총 3개 지점의 유량자료를 이용하여 민감도 분석에 활용하였다. 조도계수 민감도 분석결과 조도계수 증가에 따라 첨두유량은 감소하게 된다. 각 지점별 첨두유량 변화 폭은 지점 4, 5, 6에 각각 7.0% (-3.4~3.6%), 14.3% (-7.5~6.8%), 15.6% (-7.7~7.9%) 증감 폭을 갖는 것으로 분석되었으며, 유역의 하류부로 갈수록 변동 폭이 커지는 것으로 분석되었다. 시계열 수문곡선 비교결과 지점 4에서는 조도계수 0.011, 지점 5는 0.013, 지점 7은 0.015를 적용하는 것이 실측치와의 상관계수가 가장 높게 나타나는 것으로 분석되었다. 이상의 분석 결과를 토대로 유역의 관 흐름 상태의 변화는 관로의 퇴적, 부유물, 폐유부착 등의 유지관리 상태에 따라 달라지며 특히 유역의 하류부로 갈수록 퇴적, 부유물 등의 축척이 누적되어 조도계수를 상류부 보다 기준 값보다 크게 적용해야 관측치 유량과 유사하게 모의되는 것을 확인하였다. 따라서 도시유출해석 모형에서의 조도계수 적용은 우수관로의 유지관리 상태 등을 고려하여 우수관로별 적용 값 다르게 입력하는 것이 타당한 것으로 판단된다.

• Journal of Chest Surgery
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• 제36권2호
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• pp.91-97
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• 2003

With the advent of stage-adapted multimodal regiments for esophageal malignancy, accurate staging has become of utmost importance. Endoscopic ultrasono graphy(EUS) i.: a diagnostic method for the local staging of esophageal cancer, in particular for T and N evaluation. The aim of this study was to examine the diagnostic efficacy of the EUS and to evaluate the relation between prognosis and EUS findings. Material and Method : We reexamined the cases of 88 consecuitive patients who underwent transthroacic esophagectomy and cervical esophagogastrostomy for esophageal cancer from January 1991 to July 2001 We compared EUS findings, histological results and outcomes. Result : There were 83 male(94.3%) and 5 female. Median age was 61.3 years old. Overall staging accuracy were 59.0% for T staging and 76.0% for N staging, In early T staging group, the accuracy was 74.9% except 74 stage. However significant differences were not found in the ability of EUS-determined T-stage and N-Stage to predict survival. Multivariate analysis showed EUS-stage to predict survival. Conclusion : EUS provides a high degree of accuracy in assessing both T and N parameters in staging esophagal cancer. EUS should be performed in all patients with esophageal cancer, not only for staging before therapy, but also as a valuable method of determining prognosis.

• Clinical and Experimental Pediatrics
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• 제50권3호
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• pp.241-247
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• 2007

Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.

• Journal of Veterinary Clinics
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• 제26권4호
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• pp.371-375
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• 2009

A three-year-old Beagle dog was presented with the neck mass. Mass was located at ventral part of the mandible. The dog showed excessive drooling. Sialocele with calculi was evaluated based on physical exam, radiographs, ultrasonography, and computed tomography. Salivary gland resection was performed. Histopathological examination confirmed sialoadenitis concurred with sialocele.

• The Korean Journal of Nuclear Medicine Technology
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• 제14권2호
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• pp.181-185
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• 2010

Purpose: Several studies report that detection of thyroglobulin (Tg) in fine-needle aspiration (FNA) biopsy washout fluid from lymph nodes identifies recurrences or metastases of differentiated papillary thyroid cancer (DPTC) in the neck with higher sensitivity and specificity than fine-needle aspiration cytology (FNAC). We evaluate the diagnostic efficacy and usefulness of Tg measurement in FNA washout fluid (FNA-Tg) and compare with FNAC. Materials and Methods: Forty-eight FNA samples of 37 patients who undergone ultrasonography to detect cervical lymph node metastasis of DPTC, were included for this study. Lymph node metastasis was confirmed by histopathologic examination or long-term imaging follow-up. Sensitivity, specificity and accuracy of FNA-Tg and FNAC were calculated. In 34 patients, we evaluated diagnostic accuracy of FNA-Tg according to the presence or absence of Tg antibody. Results: Sensitivity, specificity and accuracy of FNAC were 75.0%, 97.2% and 91.7%, respectively, and those of FNA-Tg were 100%, 88.9% and 91.7%, respectively. The presence of Tg antibody was not relevant to the diagnostic accuracy of FNA-Tg. Conclusion: FNA-Tg is a as accurate as FNAC with higher sensitivity. FNA-Tg and FNAC are complement techniques for diagnosing lymph node metastasis of DTPC.