• Childhood Kidney Diseases
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• v.7 no.1
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• pp.60-66
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• 2003

Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

• Journal of radiological science and technology
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• v.33 no.1
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• pp.19-24
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• 2010

The aim of this study was to evaluate the change of bone mineral density according to distal radius rotation and the correlations of the lowest BMD measured by DXA at the lumba versus distal radius. The eleven males were projected distal radius by DR X-ray and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 21 males. The healthy 11 and 21 volunteers without any history of operations, anomalies, or trauma were enrolled. The experiment was performed by two methods. First, The DR X-ray was measured distal radius of 11 males in pronation and supination with three, six and nine degrees, including a neutral position. The ROI was measured by the m-view program on the PACS monitor. Second, The DXA was measured distal radius of 21 males in pronation and supination with five and ten degrees, including a neutral position to evaluate the changes of BMD according to the rotation. A correlation of the BMD in the distal radius with BMD that lumbar spine was performed, along with analysis of the data by SPSS 12.0v. The mean rotation angle of the distal radius about eleven males DR X-ray measured $7^{\circ}$ of pronation (82%, n = 9), $6^{\circ}$ of supination and $0^{\circ}$ of neutral of (9%, n = 1), The total average rotation angle in 11 male was $5.1^{\circ}$ of pronation. The rotation angle of the distal radius about twenty one males on DXA measured $7.2^{\circ}$ of pronation (43%, n = 9), $7^{\circ}$ of supination (24%, n = 5), and $0^{\circ}$ of neutral (33%, n = 7), The total average rotation angle in 21 people was $4.1^{\circ}$ of pronation. The correlation of the analysis of lumba and distal radius were r = 3.0, p = 0.18. consequently, The correlation was not significance. Because BMD of lumba was not coverd for BMD of the distal radius, with a neutral position, Pronation is needed for BMD in the distal radius with the rotation angle measuring at the lowest BMD. the rotation angle about five degrees of pronation of the distal radius is recommended.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.107-111
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• 2003

Purpose: To establish the role of stereoactic radiosurgery using a linear accelerator for the treatment of patients with cavernous angloma. Materials and Methods: Between February 1995 and May 1997, 11 patients with cavernous angioma were treated with stereotactic radiosurgery using a linear accelerator. Diagnoses were based on the magnetic resonance imaging in 8 patients, and the histological in 3. The vascular lesions were located on the brainstem (5 cases), cerebellum (2 cases) thalamus (1 case) and cerebrum (3 cases). The clinical presentation at onset included previous intracerebral hemorrhages (9 cases) and seizures (2 cases). All patients were treated with a a linac-based radiosurgery. The median dose of radiation delivered was 16 Gy ranging from 14 to 24 Gy, which was typically proscribed to the 80$\%$ isodose surface (range 50 $\~$ 80$\%$), corresponding to the periphery of the lesion with a single isocenter. Ten patients were followed-up. Results: The median follow-up was 49 months ranging from 8 to 73 months, during which time two patients developed an intracerebral hemorrhage, 1 at 8 months, with the other at 64 months post radiosurgery. One patient developed neurological deficit after radiosurgery, and two developed an edema on the T2 weighted images of the MRI surrounding the radiosurgical target. Conclusion: The use of stereotactic radiosurgery in the treatment of a cavernous angioma may be effective in the prevention of rebleedlng, and can be safely delivered. However, a longer follow-up period will be required.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.780-785
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• 1997

Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

• Neonatal Medicine
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• v.17 no.1
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• pp.13-20
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• 2010

Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

• Journal of Food Hygiene and Safety
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• v.13 no.2
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• pp.121-128
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• 1998

Ochratoxin A (OA) is a mycotoxin produced by Aspergillus ochraceus as well as other molds. It is a natural contaminant of mouldy food and feed. OA has a number of toxic effects, the most prominant being nephrotoxicity. Futhermore, OA is immunosuppressive, genotoxic, teratogenic and carcinogenic. OA inhibits protein synthesis by competition with phenylalanine in the phenylalanine-tRNA aminoacylation reaction. Recently, lipid peroxidation induced by OA has been reported, indicating that the lesion induced by this mycotoxin could be also related to oxidative pathway. Since it seems impossible to avoid contamination of foodstuffs by toxigenic fungi, detoxification and detoxication of OA are needed. In this study we investigated the protective effects of aspartame (Asp), phenylalanine (Phe), polyphenol 70S (PP) and aloe extract (AE) on the nephrotoxicity induced by subacute exposure to the OA. Asp and Phe are structural analogues of OA. PP, an ingredient of Green Tea and AE have been known as antioxidant and radical scavenger. Phe (40 mg/kg, i.p.) and Asp (25 mg/kg, p.o.) were administered to Sprague-Dawley rats simultaneously with OA (2.0 mg/kg, p.o.) for 2 weeks. PP (200 mg/kg, p.o.) and AE (50 mg/kg, i.v.) were pretreated before administration of OA, for 2 weeks and 3 days, respectively. Using enzymuria, BUN level, creatinemia and histophathologic examination as indices of renal damage, we observed that all of four compounds prevented the nephrotoxic effects induced by OA. It seems that structural analogues of OA such as Asp and Phe have better protective effect on the nephrotoxicity of OA than antioxidants. These results indicate that 1) formation of free radical and lipid peroxidation are likely to be involved in the nephrotoxicity of OA in vivo, 2) Asp, PP and AE might be used for prevention of renal lesions in cases of ochratoxicosis.

• Journal of Bio-Environment Control
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• v.6 no.2
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• pp.110-116
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• 1997

This experiment was conducted to investigate the effects of root zone warming on fruit yield of oriental melon (Cucumis melo L. var. Makuwa) in winter season. Root zone was warmed by hot water flowing through pipe set at 35cm depth from the ridge. Treatments of minimum soil temperature at 20cm depth were 17, 21, $25^{\circ}C$ and non-warming from Jan. 18 to Apr. 18. The results are summarized as follows. 1. The blooming of female flower was faster 1 days in 17$^{\circ}C$ plot, 6 days in 21$^{\circ}C$ plot, and 7 days in $25^{\circ}C$ plot than in control plot and the days from blooming to harvesting were shorter 5 days in 17$^{\circ}C$ plot, 11 days in 21$^{\circ}C$ plot, and 12 days in $25^{\circ}C$ plot than in control plot. 2. Mean fruit weight was the highest in 21$^{\circ}C$ plot, followed $25^{\circ}C$, 17$^{\circ}C$ and control plots, respectively, and flesh thickness was the highest in $25^{\circ}C$ plot, followed by 21, 17$^{\circ}C$ and control plots, respectively. 3. Early and middle-phase yield was the highest in $25^{\circ}C$ plot, followed by 21$^{\circ}C$, 17$^{\circ}C$ and control plots but late yield was the highest in 17$^{\circ}C$ plot, followed by control, 21, and $25^{\circ}C$ plots. Total yield per 10a was higher 33% in 17$^{\circ}C$ plot, 49% in 21$^{\circ}C$ plot, and 37a in $25^{\circ}C$ plots than in control plot, harvested 1, 490kg per 10a. 4. Total yield was highest in 21$^{\circ}C$ plot, followed by $25^{\circ}C$, 17$^{\circ}C$, and control plots. Malformed and fermented fruit rates were the highest in control, followed by 17, 25, and 21$^{\circ}C$ plots and marketable fruit rate was 21, 25, 17$^{\circ}C$, and control plot in order.

• Korean Journal of Food Science and Technology
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• v.32 no.3
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• pp.544-549
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• 2000

This study was performed to compare optimum analytical method for the contents of naturally occurring sulfur dioxide in foods and to investigate the contents of sulfur dioxide in foods in order to provide a fundamental data when distinguish between added and naturally occurring sulfur dioxide. The determination of the contents of sulfur dioxide in foods from the 20 kinds, 180 cases of samples has been analyzed by the optimized Monier-Williams method, modified Rankine method and Acid Distillation/Ion Chromatography. As a result of the study, the contents of naturally occurring sulfur dioxide in foods by the optimized Monier-Williams method showed from 1.02 to 43.87 ppm and highly content of 43.87, 15.37, 11.50, 11.21 and 10.60ppm were observed in garlic, platicodon, green onion, cabbage and onion, the others were less than 10.00ppm. The sulfur dioxide contents in green onion and garlic by modified Rankine method were showed to be 2.87 and 6.14ppm, respectively, the others were detected less than 2.50ppm. The contents of sulfur dioxide by Acid Distillation/Ion Chromatography showed 15.43, 9.82, 5.74, 5.37, 2.14 and 0.49ppm in garlic, cabbage, green onion, onion, potato and apple, respectively and the others were not detected. And the contents of sulfur dioxide in green onion, onion, cabbage and garlic showed higher levels of sulfur dioxide in these foods than the others because of the naturally occurring sulfur containing compounds. The optimized Monier-Williams method, which is the of official analytical method of Korean Food Code, was suitable for monitoring of sulfur dioxide of most foods. Acid Distillation/Ion Chromatography was thought to be adequate for sulfur containing foods such as green onion, onion and cabbage. In order to distinguish between added and naturally occurring sulfur dioxide, it is though to be need of the fundamental data for the contents of sulfur dioxide in sulfite-free foods and continue the investigation for it.

• Advances in pediatric surgery
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• v.6 no.2
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• pp.106-123
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• 2000

The purpose of the survey was to clarify the clinical features and management of the anorectal malformations (ARM) in Korea. Twenty-seven members of the Korean Association of Pediatric Surgeons were surveyed. The members completed a case registration form for each patient during the two years period of 1996-1997, and a questionnaire that contained their management preferences for primary and complicated patients. Twenty-four members of the 22 institutions registered 295 cases of the ARM, and 27 out of 34 members (77.1 %) responded to the questionnaire. The patients were classified by the Wingspread classification of ARM(1984). The case registration form was a modification of Wingspread workshop for the postoperative assessment and case registration. The male to female ratio was 1.7 : 1. The average number of patients per surgeon was 6.1 cases per year. Prematurity(< 36 weeks) was present in 1.9 % of cases and low birth weight (< 2.6 Kg) in 12.1 %. Among 187 male patients, 62 were high(H) type, 29 intermediate(l) type, 88 low(L), and 8 unclassified. In female, there were 2 cases of cloacal anomalies(C), 4 H type, 30 I type, 66 L type and 6 unclass ified. For male, 87.9 % of H and I type were operated by the Pena procedure, but only 7.9 % in L types. In female, all of C, H and I types, and 40.9 % of L type were done by the Pena procedure. One case expired (MR; 0.003%) as a result of surgical complication. Over-all complication rate was 12.5 %. Among 6 cases of reoperation, 4 were failed Pena procedures. Among 140 colostomies sigmoid colon was utilized in 75.7%, and loop colostomy was commonly used. Ten surgeons prefered primary maturation of the stoma. In conclusion, posterior sagittal anorectoplasty is popular for high types of ARM in this country, but considerable number of patients are still suffering from failed operations. For better understanding and analysis, necessity of prospective study by new classification was discussed.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.140-149
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• 2007

Cleft lip and palate are congenital craniofacial malformation. Reconstruction of dental arch in patient with alveolo-palatal clefts is very important, because they have many problems in functions and esthetics. Malnutrition, poor oral hygiene, respiratory infections, speech malfunctions, maxillofacial deformity, and psychological problems may be occured without proper treatment during the long period of management of the cleft lip and palate. So the treatment should be managed with a multidisciplinary approach. Bone grafting is a consequential step in the dental rehabilitation of the cleft lip and palate patient A complete alveolar arch should be achieyed of the teeth to erupt in and to form a stable dentition. And the presence of the cleft complicate the orthodontic treatment. Therefore bone grafting in patients with cleft lip and palate is a widely adopted surgical procedure. Grafted bone stabilizes the alveolar process and allows the canine or incisor to move into the graft site. After the bone grafting, orthodontic closure of the maxillary arch has become a common practice for achieving dental reconstruction without any prosthodontic treatment. Various grafting materials have been used in alveolar clefts. Iliac bone is most widely fovoured, but tibia, rib, cranial bone, mandible have also been used. And according to its time of occurrence, the bone graft may be divided into primary, early secondary, secondary, late secondary. Bone grafting is called secondary when performed later, at the end of the mixed dentition. It is the most accepted procedure and has become part of treatment of protocol A secondary bone graft is performed preferably before the eruption of the permanent canine in order to provide adequate periodontal support for the eruption and preservation of the teeth adjacent to the cleft. In this report, we report here on a patient with unilateral cleft lip and palate, who underwent iliac bone graft. The cleft was fully obliterated by grafted bone in the region of the alveolar process. The presence of bone permitted physiologic tooth movement and the orthodontic movement of adjacent tooth into the former cleft area. Satisfactory arch alignment could be achieved in by subsequent orthodontic treatment.