• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.100-100
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• 1993

Palatopharyngoplasty has been widely performed for the treatment of chronic snoring and obstructive sleep apnea syndrome. Lack of literature for long term effectiveness and complications of palatopharyngoplasty made us to report our result with minimum follow up of 5 years, compare to preop and postop 8 weeks deta. We evaluated subjective symptom and objectively documented polysomnographic improvement of 25 among 37 patients undergoing palatopharyngoplasty from 1987 to 1985. The remaining 12 patients were lost to follow up (1) snoring was abolized in 10 patients(40%) of these 25 patients and with vary degree(Grade 1-3), reduced in remainders except 3 patients (2) Sleep apnea seen preoperatively in 15 patient (AI > 20) was reduced to Grade 0 or Grade 1 in 13 patients. And marked change in AI & body weight was not seen at 5 year after operation. (3) 3 cases of mild velopharyngeal insufficiency, 1 case of asymmetry of soft palate 5 cases of pharyngeal dryness, were observed in this retrospective study and there was no nasopharyngeal stenosis loss of taste respiratory and cardiovascular complications.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.9.2-9
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• 1977

A Statistical study was carried out on 64 cases of the foreign bodies in the food and air passages, who visited the Dept. of Otolaryng. of Korea General Hospital from Jan. 1971 to Dec. 1976. The following results were obtained. 1. The total number of foreign bodies were 64 cases, which is approximately 0.69% of the total number of new patients who visited the out patient department during the same period. Among them 55 cases were foreign bodies in the food passage and 9 cases were foreign bodies in the air passage. The ratio between the food and air passages was about 6.1 : 1. 2. The frequently encountered foreign bodies in the esophagus were coin, bone, meat and food particle in order. Bean and peanut were male and 31 case the most frequent foreign bodies in the air passage. 3. In sex distribution, 33 cases were male and 31 cases were female, and the ratio between male was 1.1:1. 4. In the age distribution, 35 cases (54.7%) of all foreign bodies were under 5-year-old, especially coin was 96.2%. 5. The most prevalent site of lodgement in the food passage was the 1st esophageal narrowing, which corresponds to 69.1%. 6. In duration of lodgement, 38 cases (69.1%) of foreign bodies in the food passage were removed within 24 hours, and the longest duration was 90 days. 7. Almost all of the foreign bodies in the food and air passages were removed under local or no anesthesia by esophagoscopy, laryngoscopy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.10.1-10
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• 1983

We have analysed the 76 cases of the foreign bodies of our ENT department during the period from Jun. 1973 to Feb. 1983. The following results were obtained and were reported. 1) Distribution of these whole 105 cases, 68 cases (64.8 %) were lodged in esophagus, 13 cases (12.4 %) were in the nasal cavities, 9 cases (8.5 %) were in the oral cavity and throat, 8 cases (7.6 %) were in the air passages, and 7 cases (6.7 %) were in the external auditory canal. 2) The sorts of the esophageal foreign bodies, the coins were the most cases(53 cases - 77.9 %) and other sites were shown of variable kinds. 3) Age distribution of the esophageal foreign bodies were mostly in under 5 years of age (49 cases - 72 %) and in cases of the air passages, all the 8 cases were in under 10. 4) In the localities of the esophageal foreign bodies, first narrowing was the most frequent site (61 cases - 89.7 %), and of air passages, 6 cases were in the left main bronchus, more that of Rt. main bronchus. 5) During the lodgement of esophageal foreign bodies, 58 cases (85.3 %) were visited to our ENT department within 24 hours. In the cases of air passages, most were viaited in 3 to 7 days (6 cases -75 %).

• The Korean Journal of Malacology
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• v.9 no.1
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• pp.1-16
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• 1993

한국의 담수에 광범위하게 서식하고 있으면서 역학적으로 중요한 역할을 하고 있는 두 종의 복족류 즉 쇠우렁이(Parafossarulus manchouricus)와 물달팽이(Radix auricularia coreana)의 소화기관 중에서 식도, 소화선 및 장에 대한 미세구조 관찰을 시도하였다. 이 부위들은 간흡충(간디스토마)과간질(소간디스토마)의 유생들이 그들의 생활사 중 거쳐가는 곳으로 알려진 소화관들이어서 이후 흡충류의 유충들이 위의 소화관에 주는 영향을 연구하는데 필요한 기초자료를 얻고자 수행된 것이었다. 관찰해 본 결과 다음과 같은 결론을 얻을 수 있었다. 식도의 상피조직은 두 종류에서 공히 원주세포와 원주섬모세포 및 점액분비 세포로 이루어져 있었다. 식도강상피 내에서도 어느 정도의 흡수와 소화가 이루어 지고 있음은 특이한 현상이라 하겠다. 소화선은 두 종에서 공히 복분지 관상선으로서 그 상피는 micovilli를 선강 또는 도관에 연한 유리표면에 가지고 있어 brush boredr을 이루고 있는 원주세포과 원주섬모세포로 구성되어 있었다. 이들 세포들의 내부 구조로 보아 소화세포와 배석세포로 구분할 수 있었다. 장의 상피는 원주세포와 원주섬모세포로 구성되어 있었으며 이들도 장강에 연한 유리표면에는 brush border를 이루고 있었다. 흡수와 분비기능이 활발한 것으로 사료된다. 전반적으로 보아 본 연구에서 관찰한 두 복족류의 소화관은 모든 부위에서 세포의 유리표면에 microvilli를 가지고 있어 물질의 흡수기능을 가지고 있음을 시사해주고 있었고, 이들 세포 중에는 때로 밀집한 cilia를 가지고 있어 소화관 내의 액체물질이나 이에 내포된 미세입자들의 유동을 도와주고 있음을 추측할 수 있었다.)은 결합조직으로 이루어진 근육질의 두꺼운 벽을 가지고 있었으며 내강은 돌출부위에 의해 4부분으로 갈라져 있었다. 내강에 연한 상피는 원주세포로 되어 있었다. 상음경(epiphallus)의 벽은 근섬유 다발은 벽의 외곽으로 갈수록 밀도가 높아졌다. 상부에 내강과 연결되는 함입구조(groove)를 가지며, 내강에 연한 상피는 섬모가 없는 원주세포로 이루어져 있었다. 음경(penis)은 근섬유가 산재된 두꺼운 벽을 가졌으며 상음경보다 굵은 원통형이었다. 내강은 많은 돌출부에 의해 복잡하게 나뉘어 있으며 상피세포는 원주 세포로 이루어져 있었고 섬모는 관찰되지 않았다. 내강 내의 분비물과 세포의 형태로 보아 내강상피세포는 분비기능을 가진 것으로 사료된다.술적 문제가 적절히 해결되는 경우 비활성 가스 제너레이터는 민수용으로는 대형 빌딩, 산림, 유조선 등의 화재에 매우 적절히 사용되어 질 수 있을 뿐 아니라 군사적으로도 군사작전 중 및 공군 기지의 화재 그리고 지하벙커에 설치되어 있는 고급 첨단 군사 장비 등의 화재 뿐 아니라 대간첩작전 등에 효과적으로 활용될 수 있을 것으로 판단된다.가 작으며, 본 연소관에 충전된 RDX/AP계 추진제의 경우 추진제의 습기투과에 의한 추진제 물성 변화는 미미한 것으로 나타났다.의 향상으로, 음성개선에 효과적이라고 사료되었으며, 이 방법이 편측 성대마비 환자의 효과적인 음성개선의 치료방법의 하나로 응용될 수 있으리라 생각된다..7%), 혈액투석, 식도부분절제술 및 위루술·위회장문합술을 시행한 경우가 각 1례(2.9%)씩이었다. 13) 심각한 합병증은 9례(26.5%)에서 보였는데 그중 식도협착증이 6례(17.6%), 급성신부전증 1례(2.9%), 종격동기흉과 폐염이 병발한 경우와 폐염이 각

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.27-36
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• 1997

초기후두암에 있어서 보존적 술식의 장점은 후두 전적출술시와 같은 국소치료효과를 얻을 수 있으면서도 후두의 생리적 기능을 최대한 보존하는데 있다. 성공적인 후두부분절제술을 위해서는 후두내에서 종양의 발생위치 및 그 확산에 대한 연부조직들의 해부학적 역할에 대한 이해가 필요하다. 과거에는 초기후두암환자에서 정상적인 목소리를 보존할 수 있다는 이점 때문에 방사선 치료가 일차적 치료요법으로 많이 시행되어 왔다. Wang 과 Wong은 성대 막양부에 국한된 병변에서 방사선치료에 대한 5년간 조절율(5-year control rate)이 92%, 전연합부를 침범한 경우가 81%, 그리고 후방으로 전파된 경우 76%로 감소된다고 보고하였다. Olofsson 등은 전연합부를 침범한 57례의 환자에서 방사선 치료를 시행하여 85.7%의 5년 생존율을 얻었으나, 57례중 15례에서 재발하여 구제수술(salvage surgery)을 시행하였고, Jesse 등$^{13)}$ 은 전연합부를 침범한 91례의 T1, T2 성문암을 방사선 치료를 시행하여 8.8%의 실패율을 보였으나 22례의 환자에서 재발하여 후에 salvage surgery를 시행하였다. 그러나 Ogura 등은 피열 연골을 침범한 79례의 환자에서 보존적 수술을 시행한 결과 6례의 환자에서 재발하여 90%의 3-years control rate를 얻을 수 있었다고 보고하였다. 이처럼 병변이 전연합부, 피열연골 혹은 후방성문하부로의 침범이 있는 경우는 방사선 치료 효과가 떨어지고, 따라서 방사선 치료에 실패할 가능성이 보다 높기 때문에 비록 방사선 치료 후 실패한 경우에서 구제 수술을 시행할 수는 있지만 후두기능을 보존하려는 궁극적인 목표를 생각할 때 보존적 수술을 우선적으로 시행하는 것이 바람직하다고 할 수 있다. Biller 등은 방사선 요법에서 실패한 성문부 종양에서는 대부분 전적출술을 시행하지만 일부는 보존적 수술을 시행할 수 있다고 보고하였다. 이들은 반대측 성문부에 종양의 침범이 없어야 하고, 전연 합으로의 파급은 있어도 가능하며 성대돌기를 제외한 피열연골이 정상이어야 하고, 종양의 성문하부로의 파급이 5mm 이내라야 하며, 연골에 침범이 없어야 하고, 성대고정이 없어야 하며, 재발 병소가 방사선요법 전의 원발병소와 상관관계가 있어야 하며, 원발병소가 후두부분적출술에 합당할 경우 보존적 술식을 시행할 수 있다고 하였다. 최근에는 다양한 후두 재건술의 발달로 보다 진행된 후두암에 대한 보존적 후두절제술들이 소개되고 있다. 단측 T3,T4 후두암 혹은 경성문암, 이상와에 위치한 암의 경우 음성만을 재건하는 후두근적출술 (near total laryngectomy)을 시행하기도 한다. 본원 이비인후과에서 1986년부터 초기성문암 51례 중 24례(47.1%)와 초기성문상암 17례 중 12례 (70.6%)에 대하여 보존적 술식을 시행하였다. 초기 성문암의 보존적 술식을 시행한 24례중, 2례(8.3%)에서 경부재발, 1례(4.2%)에서 경부재발과 동반된 폐의 원격전이가 있었으나 원발부위의 재발은 관찰되지 않았고, 술후 합병증으로 1례(4.2%)에서 후두협착, 3례(12.5%)에서 수술부위의 육아종형성, 그리고 1례(4.2%)에서 기관지염이 발생하였으나 오연으로 인한 폐렴은 발생하지 않았다. 초기성문 상암의 보존적 술식을 시행한 12례 중 1례(8.3%)에서 원발병소의 재발, 2례(16.7%)에서 경부재발이 있었으며, 술후 합병증으로 3례(16.7%)에서 오연으로 인한 폐렴의 발생이 있었지만 다른 합병증은 발생하지 않았다. 초기성문암 24례 중 재발이 나타난 3례의 환자를 제외한 21례(97.5%)와 초기성문상암 12례 중 재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를 보이고 있지만 아직까지 증례가 많지 않기 때문에 생존율을 얻기에는 미흡한 점이 있으며, 향후 지속적인 추적관찰이 필요할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.147-158
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• 1996

Background : Endobronchial tuberculosis(ET) is known to affect frequently young female and serious complication like bronchial stenosis would occur if early diagnosis and treatment for ET is not performed immediately. But ET shows normal chest roentgenogram in about 10% of patients, and is often confused with bronchial asthma because ET presents clinical features like cough, dyspnea, wheezing in history and physical examination. The pulmonary function test(PFT) feature of ET is not well known, but when we consider the fact that ET is pathophysiologically different from bronchial asthma, if there is any feature of PFT in ET, and we know it, PFT will be very helpful for diagnosis and follow up of ET. Methods : We performed both PFT and bronchoscopy in 68 ET patients who visited Boramae hospital, and were confirmed as ET by bronchoscopic biopsy and were followed prospectively from November 1991 to March 1995. After history taking and physical examination, we performed chest roentgenogram, complete blood count, sputum AFB stain and culture, and also performed PFT before anti-tuberculosis chemotherapy. PFT was classified as restrictive, if only PVC was reduced below 80%, and obstructive, if only FEV1 was reduced below 75%. In the case of both FVC and FEV1 were reduced, PFT was classified as restrictive if FEY1/FVC was greater than 75%, and mixed if FEV1/FVC was reduced below 75%. We repeated the PFT and bronchoscopy for 68 ET patients who were proven by biopsy in the first month and sixth month after starting anti-tuberculosis chemotherapy, and studied the feature and change of PFT of the ET and the relation between PFT and the bronchoscopic finding, and obtained following results. Results: 1) Number of male patients was 12, and that of female patient was 56, and mean age was $35.4{\pm}17yr$.(17-74yr). Clinical symptom was in the order of cough(86.8%), dyspnea(63.2%), fever(17.6%) and hemoptysis (10.3%), and the wheezing and stridor were audible among the 40 patients(58.4%) in the physical examination. 2) Hemoglobin level was below 12g/dl among 25 patients (36.8%), and WBC level was above $10,000/mm^3$ among 9 patients(13.2%) and ESR was above 20 among 46 patients (67.6%) and AFB stain and culture were positive among 50 patients(73.5%). 3) The dominant roentgenographic finding of ET was fibronodular feature in 35 patients(51.5%), pneumonic feature in 14 patients (20.6%), collapse in 11 patients(16.2%), mass-like lesion in 3 patients(4.4%), cavitary lesion in 2 patients(2.9%), and normal in 3 patients(4.4%). 4) PFT feature at the time of diagnosis of ET was normal in 16 patients(23.5%), restrictive pattern in 32 patients (47%), obstructive in 4 patients(5.8%), and mixed in 14 patients(23.5%). So restrictive pattern was the dominate feature of ET. 5) The PFT feature was little correlated with the gross finding of bronchoscopy, but the change of PFT during treatment of ET showed relatively good correlation with the change of bronchoscopic finding. 6) FVC(2.30L vs. 2.61L) and FEV1(1.74L vs. 2.06L) increased significantly (p < 0.01), but FEV1/FVC(82% vs. 83%) and PEF(3.45L/sec vs. 3.95L/sec) did not change significantly after 1 month of treatment (p > 0.01), and there was no significant change among all parameters during first and sixth month of treatment(p > 0.01). Conclusion : PFT may be useful in the diagnosis and treatment follow up of ET but further study would be needed to confirm it.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.266-275
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• 2005

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTIs) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus(PIV), influenza virus (Flu), and adenovirus(ADV), etc. Our purpose was to determine seasonal epidemiology and clinical characteristic features of each viral infection. Methods : Nasopharyngeal aspirate(NPA)s were collected from 4,554 hospitalized children diagnosed as LRTIs on the first day of admission. The study period was from September 1998(Autumn) through May 2003(Spring). Respiratory viruses were detected in 881(19 percent) cases by isolation of the virus or by antigen detection method using indirect immunofluorescent staining. We reviewed the medical records of 837 cases retrospectively. Results : The identified pathogens were RSV in 485 cases(55 percent), PIV in 152 cases(17 percent), FluA in 114 cases(13 percent), ADV in 79 cases(9 percent) and FluB in 51 cases(6 percent). Outbreaks of RSV occurred every year, mostly in the November through December period and of PIV in the April through June period. LRTIs by FluA reached the highest level in January, 2002. FluB infection showed an outbreak in April, 2002. The clinical diagnoses of viral LRTIs were bronchiolitis in 395 cases(47 percent), pneumonia in 305 cases(36 percent), croup in 73 cases(9 percent) and tracheobronchitis in 64 cases(8 percent). Conclusion : Viruses are one of the major etiologic agents of acute LRTIs in chidren. Therefore, we must continue to study their seasonal occurrence and clinical features to focus on management, and also for reasons of prevention.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.88.1-88
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• 1976

The authors have been performed a statistical survey for 228 cases with foreign bodies in the food and air passages who had visited the department of Otolaryngology, National Medical Center and removed endoscopically during the period of last 10 years from 1966 to 1975. The following results were obtained: 1. The total numbers of foreign bodies in the food and the air passages were 228 cases, and among of them 181 cases were foreign bodies in the food passage and 47 cases were foreign bodies in the air passage. The ratio between the food and the air passages was about 3.7 : 1. 2. The prevalent foreign bodies in the esophagus were coin, meat and food particles and bone in order of frequency. In air passage, bean and peanut were most prevalent foreign bodies and the next were metalic substances, fish bone in order of frequency. 3. In the age incidence, 65.4% of the esophageal foreign bodies and 67.6% of foreign bodies in the air passage were under 5 years of age especially coin, 92.9%. 4. In sex distribution, 99 cases were female, and the ratio between male and female was 1.3:1. There was no significant difference between male and female in the foreign bodies of the esophagus but the foreign bodies in the air passage were more prevalent in male as the ratio of 2.1:1. 5. The most prevalent site of lodgement in esophagus was first physiologic narrowing of the esophagus as the count of 83.8%. In foreign bodies of the air passage, bronchial foreign bodies were most frequent. And bronchial foreign bodies were more frequent in the right side as the ratio of 3.7:1. 6. In duration of lodgement, 56.0% of foreign bodies of the food passage were removed within 24 hours and almost of them were removed within 5 days. In foreign bodies in the air passage, only 32.4% were removed within 24 hours but 29.7% were removed within more than 1 week in the air passage. 7. Under the esophagoscope, granulation tissue were noted in the 5 cases of the foreign bodies in the esophagus due to foreign bodies. In foreign bodies of the air passage, complication were encountered in the 4 cases and also removed surgically and among of them, 2 patients were expired due to complications during post operative course.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.573-579
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• 2008

Background: Composite valve graft replacement is currently the treatment of choice for a wide variety of the lesions of aortic root disease. The purpose of this study was to explore the results of aortic root replacement after using the Cabrol technique over a 13-year period at our institution, and we analyzed the results to help surgeons make better decisions when repairing aortic root disease. Material and Method: Between January 1994 and December 2006, twenty-five patients underwent a Cabrol technique operation at our institution. The mean patient age was $43.7{\pm}14.1$ years old (range: $6{\sim}65$ years) and the male and female ratio was 21:4 (84% : 16%). The patients' follow-up was 100% complete, and the mean follow-up period was $60.7{\pm}50.4$ (range:$1{\sim}162$) months. Annuloaortic ectasia (n=18) was the most frequent cause of aortic disease in this series, followed by aortic dissection (n=7). The mean cardiopulmonary bypass time was $177.2{\pm}44.9$ minutes and the mean aortic cross clamping time was $123.4{\pm}34.1$ minutes. Nine patients were checked with MDCT (Multidetector computed tomography) for evaluating a well functioning secondary graft and the coronary anastomosis site. Result: The early mortality rate was 4% (1 of 25 patients). A significant stenosis, kinking or occlusion of the secondary graft was detected by MDCT in 4 patients. The overall survival rate was 88%. Conclusion: The Cabrol technique demonstrated a significant incidence of long-term complications such as secondary graft stenosis or obstruction. It could be used when the modified Bentall technique is not feasible.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.178-187
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• 2002

Purpose : The detection of hydronephrosis(HN) with antenatal ultrasonography was first reported in the 1970s. Prenatal HN is diagnosed with an incidence of 1:100 to 1:500 on antenatal screening. Recently, the purpose of antenatal screening has changed from simple detection to selection for specific diagnosis-based management. this study is to evaluate the usefulness of antenatal sonography for HN and to investigate the differential causes of HN and their clinical outcomes. Patients and methods : 11,783 live neonates with prenatal ultrasonographic examination at Ajou University School of Medicine, from Sep. 1994 to Aug. 2001 were analyzed. Results and conclusion : Hydronephrosis (>10 mm) was detected in 119 (1.0%) cases antenatally and among these, 91 were proved to have HN postnatally Males were three times more affected than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis (47%), followed by multicystic dysplastic kidney, vesicoureteral junction obstruction and vesicoureteral reflux. During 20 months' follow-up(3 to 72 months), 58(48%) renal units showed spontaneous resolution and surgical interventions were necessary in 10 (7.4%) of postnatally confirmed hydronephrotic renal units.