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Analysis of Hepatobiliary Disorders from a Nationwide Survey of Discharge Data in Korean Children and Adolescents (전국 퇴원자료조사를 통한 소아청소년 간담도 질환의 분석)

  • Park, Hyun-Ju;Shin, Chang-Gyun;Moon, Jin-Soo;Lee, Chong-Guk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.16-22
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    • 2009
  • Purpose: To update the epidemiologic information of hepatobiliary diseases in pediatric inpatients using cross-sectional survey data throughout the Republic of Korea. Methods: Nationwide cross-sectional survey was obtained from the 85 residency training hospitals in Korea to gather the final diagnosis on discharge. The surveyed periods were from 2004 to 2006. All the reports regarding the diagnosis were based on ICD-10 system. In this study, we focused on hepatobiliary diseases. Results: A total of 826,896 cases with discharge data were collected, of which 4,151 (5.0%) hepatobiliary cases were identified; 2,385 cases (57.4%) of hepatobiliary disease were hepatitis, which was the most common hepatobiliary disease. Other diseases included congenital hepatobiliary diseases (524 cases [12.6%]) and biliary diseases (315 cases [7.6%]). The prevalence of hepatobiliary disease according to age differed. Biliary atresia was the most common hepatobiliary disease in the neonatal period, whereas the prevalence of hepatitis increased in adolescents. The total number of hepatobiliary operations was 416 cases. With the comparison of annual data, there was no definite difference in the total number of hepatobiliary cases. The average duration of hospital stay appeared to decrease gradually. Conclusion: In this study, we have summarized the recent epidemiology of hepatobiliary disorders in Korean children based on discharge data. Hepatobiliary disorders in pediatric inpatient units consisted of diverse disorders with a low prevalence, so multi-center approaches should be considered to enhance the clinical and public health outcomes. To improve this nationwide survey, a new data collecting system should be developed.

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The study of Intercostal Nerve Block and Patient-Controlled Analgesia for Post-Thoracotomy Pain (개흉술 후 동통억제에 대한 신경차단법 및 환자자가 치료법의 비교연구)

  • 김우종;이길노
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.920-926
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    • 1997
  • Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

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The Result of the Surgical Treatment for Non-small Cell Lung Cancer (비소세포성 폐암의 외과적 치료에 대한 성적)

  • Park, Jin-Gyu;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.899-907
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    • 1997
  • Recently, primary lung cancer has increased markedly in incidence & prevalence in korea. Prom July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:P=8.6: 1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asymptomatic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveol r cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, stagmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage H 14.8%, stage llla 31.1%, and stage IIIb 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage 153.0%, stage H 46.5%, stage I[la 28.2%, and stage IIIb 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were Nl 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3 (p>0.05).

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Effects on Surgical Repair of VSD by TATV (막성주위형 심실중격결손중의 봉합시 경삼첨판륜 절개방법의 외과적 치료효과)

  • Gwak, Mong-Ju;Kim, Bo-Yeong
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.869-875
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    • 1997
  • Perimembranous ventri ular septal defects(PMVSDS) are the most common type of ventricular septal defects(VSDs) and consist morphologically of deficiency of the membranous septum and variable portions of the adjacent muscular septum. Repair of VSD has begun via a right ventriculotomy. Even with this exposure, however, it mght lead to ventricular dysfunction. Transatrial exposure of VSDs is luiown to a versatile approach to PMVSDS and even malaligunent defects can be repaired by this method. Although transatrial exposure can be improved by taking down'the atrioventricular valve at the annulus, surgeons have been hesitant to do so because of concern for valvular competence. Therefore, this study was undertaken to clarity the effects of transamlular approach of tricuspid valve (TATV) at operation of PMVSD. During last 5 years, twenty eight cases from 96 patients of PMVSD were closed by TATV and follow up study was done from 3 months to 33 months and results were obtained as follows. 1. Age at operation was fr m 4 months to 38 years and most patients(17, 62%) were above 5 years. 2. Preoperative pulmonary-systemic flow ratio(QPIQS) was ranged from 1 to 2.8 and 22 patients(79%) were less than 2. 3. Peak systolic pulmonary artery pressure was below 30mmHg in 8, 30-50mmHg in 17, above 50mmHg in 3 patients and 25 patients(89%) were less than 50mmHg. 4. Preoperative tricuspid regurgitation(TR) is none in 12, trivial in 6, mild in 3, moderate in 5, severe in 2 patients but postoperative TR was none in 18, trivial in 6, mild in 4 patients, so TR in most patients had decreased or not. 5. Indications for operation were based on the presence of a significant shunt. However, in patients with small shunts, indications for operation were included additional factors, tricuspid valve pouch, RVOT obstruction(right ventricular outflow tract obstruction), subacute bacterial endocarditis and associated anomalies. 6. There were no hospital deaths and residual shunts in postoperative echocardiography. Therefore TATV is especially a good method in PMVSn where patients have trcuspid valve pouch. And it is a safe and effective technique that improves exposure for PMVSD repair and does not adversely affect tricuspid valvular competence.

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Effect of Addition Lonicera japonica Thunberg on Productivity md Development of Intestinal Organs in Broiler Chickens (금은화 첨가가 육계 생산r성과 장기 발육에 미치는 영향)

  • 조성구
    • Korean Journal of Poultry Science
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    • v.19 no.1
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    • pp.27-34
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    • 1992
  • Seventy-five commercial male day-old broiler chicks were used to investigate the effects of Oxytetracycline(OTC) and Lonicera japonica Thunberg(LJT) to be active in anti-bacteria and anti-virus on the growth rate, carcass rate and various intestinal organs sizes in broiler at 3 wk of age. Five experimental diets were formulated to have similar protein and energy levels, with OTC 0.04% as low-level antibiotics and OTC 0.34% as high-level antibiotics and 0.5%, 1.0%, 3.0% level of LJT. Birds were housed randomly in 15 battery cages. Birds were 3 replicates per treatment and 5 chicks per replicate. In the body gain, 0.5% level of LJT addition grew significantly higher than the other birds. The feed intake and feed efficiency were not significantly between other birds. The addition levels in OTC and LJT did not any consistent effect on the carcass rate. However, the chest meat percentage vs carcass volume in LJT 0.5% treatment and the leg meat percentage vs carcass volume in DTC 0.04% addition level were significantly higher than those of birds fed other diets. The liver weight rate was significantly higher in OTC 0.04% level. However, the 0% and LJT levels did not exert any consistent effect on the weights of gizzard, heart, bursa of fabricius, head and spleen of broilers. The abdominal and gizzard surrounding fat content rate was higher in bird LJT 1.0% level than birds fed other levels.

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Immunohistochemieal study on the antigenicity of body compartments of Payugonimus westermani (폐흡충 충체 부위별 항원성에 대한 면역 조직화학적 연구)

  • Lee, Sun-Hyeong;Seong, Suk-Hwan;Chae, Jong-Il
    • Parasites, Hosts and Diseases
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    • v.27 no.2
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    • pp.109-118
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    • 1989
  • Production of circulating specific antibodies to the lung fluke (Paragenimus westermani) by its host is well known and used in various kinds of immunodiagnostic methods, However, it has not been well documented which compartments (or structures) of the lung fluke are most responsible for the production of specific antibodies. The present immunohistochemical study was undertaken to demonstrate the antigenicity of each body compartment of p. westermani such as suckers, tegument, spines, vitelline glands, intestine, reproductive organs(male and female), and eggs. Indiret immunoperoxidase(IP) stain technique was applied, using formalin-fked, paraffin- embedded lung tissues of P westermani-infected cats sectioned in 4 Um thickness as the antigen and cat antisera (11~20 weeks of infection) as the primary antibody. Peroxidase-conjugated goat anti-cat IgG was used as the secondary antibody and diaminobensidine(DAB) as the coloring agent. Strong yellow or yellowish brown staining was regarded positive. The primary and secondary antibody dilutions were made at 1 : 500~1 : 2, 000 and 1 : 200~1 : 500 respectively, and IP stain was repeated 10 times for each dilution. A consistent result obtained was that the intestinal epithelial border, intestinal content, vitelline glands, and eggs scattered around the worm capsule showed strong positive staining, while uterine eggs and some parenchymal portions showed weak positive reaction. On the other hand, the suckers, tegument, spines, subtegumental cells, cytoplasm of intestinal epithelial cells, male reproductive organs, and ovary revealed negative staining. The body compartments showing higher antigenicity were, in the decreasing order, the intestinal epithelial border, intestinal content, eggs in the worm capsule, vitelline glands, uterine eggs, and parenchymatous portions. The intestinal epithelial border and luminal contents revealed positive staining even at a few concentration of 1 : 4, 000 primary antibody(secondary ab., 1 : 200) whereas the parenchymatous portion showed positive reaction only at higher concentrations than 1'500 (secondary ab., 1 : 200). The results suggest that the specific antibody responses of the host to p. westermani occur most strongly upon the excretes from the intestinal epithelium of the worm and e99s Produced around the worm capsule,

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Cross-reacting and specific antigenic components in cystic fluid from metacestodes of Echinococcus grannlosus and Taenia solium (포충 및 유구낭미충 낭액에 있어서 공통항원 및 특리이원 분획)

  • Yoon Kong;Shin-Yong Kang;Seung-Yull Cho;Duk-Young Min
    • Parasites, Hosts and Diseases
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    • v.27 no.2
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    • pp.131-140
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    • 1989
  • Sera from confirmed patients of 5 hydatidosis, 67 neurocysticercosis and 89 other parasitic diseases were tested for specific antibody (IgG) levels by ELISA to cystic quid antigens from metacestodes of Echinococcus granuzosus (HF) and Taenia sodium (CF). All hydatidosis sera reacted positively to both HF and CF while neuro- cysticercosis sera did in 49.3% to HF and 85.1% to CF, The frequencies of cross- reactions were lower in other parasitic diseases to both antigens, By SDS-PAGE, protein bands of 64, 35, 22 and 7 kilodaltons (kDa) were found common in HF and CF. SDS-PAGE/immunoblot exhibited that hl·datidosis sera reacted crossly to CF at 135, 110, 100, 86, 64, 45, 39, 35 and 24 kDa bands while neurocysticercosis sera did to HF at 135, 100, 86, 64, 52, 39, 35, 29 and 24 kDa bands. These results indicated that protein bands of 135, 100, 86, 64, 39, 35 and 24 kDa were major common components in HF and CF. Protein bands of 7 kDa in HF and 15, 10 and 7 kDa in CF did not react crossly and were specific components in respective antigens.

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Histological Studies on the Exuvial Gland in a Non-moulting Silkworm, Bombyx mori L (회피불능잠의 피선에 관한 조직학적 연구)

  • 윤종관;사기언
    • Journal of Sericultural and Entomological Science
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    • v.16 no.2
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    • pp.119-125
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    • 1974
  • When the nomal silkworms reached active time of 3rd instar stage both non-moulting larva and normal silkworms from the same rearing tray were collected and fixed. The silkworms in 4th instar stage whose growth was as dwarfish as those in 1st and 2nd instar stages were also collected and fix with the normal silkworms. Non-moulting larva and normal silkworms were morphologically compared and the examined results from the tissue inspection are summarized as follows: 1. In spite of the fact that the normal silkworms reached the active eating time of 3rd instar stage non-moulting silkworms were dwarfish as if they had been reared for two days. Non-moulting silkworms which were observed at the time of 4th instar stage showed no much difference in their growth. 2. There was the tendency that the exuvial gland as was shown in Fig. 1 and 2 was flat cyslidium of ellipse and its size at thorax was small shile the gland at abdomen was big. 3. The exuvial gland at thorax has been reported to be bigger at thoracic base than at dorsal vessel but according to the present it was examined to be irregular. 4. The size of exuvial gland of silkworms in the active eating stage of 3rd instar was from 151.3${\mu}$ (major axis) to 94.5${\mu}$ (minor axis) at prothorax and from 568.6${\mu}$ (major axis) to 495.1${\mu}$ (minor axis) at 7th abdominal segment. The sire oe exuvial gland of non-moulting silkworm was 57.5${\mu}$ (major axis) to 51.3${\mu}$ (minor axis) at prothorax and from 91.5${\mu}$ (major axis) to 75.5${\mu}$ (minor axis) at 5th abdominal segment (see Fig. 1) 5. When the normal silkworms reached 4th instar active eating stage its exuvial gland was compared to that of dwarfish silkworm. The result was that the size of normal silkworm at prothorax was from 252.2${\mu}$ (major axis) to 131.6${\mu}$ (minor axis) and the size of exuvial gland at 7th abdominal segment was from 691.5${\mu}$ (major axis) to 493.4${\mu}$ (minor axis) while the sire of exuvial gland of non-moulting at prothorax was from 71.4${\mu}$ (major axis) to 61.5${\mu}$ (minor axis) and the size of the non-moulting silkworm's 8th abdominal segment was from 94.6${\mu}$ (major axis) to 71.5${\mu}$ (minor axis) (See Table 2) 6. There was a remarkable difference in the from of exuvial gland of non-moulting silkworm. The size of alveolar of the non-moulting silkworm was many times larger compared to that of normal silkworm 7. There was no great difference between secretory cells of normal and non-moulting silkworms but the granular type exuvial gland was small in sire compared to that of normal silkworm.

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One Anchor Double Fixation (OADF) Technique for Arthroscopic Bony Bankart Repair (두가닥의 봉합사를 가진 봉합나사못을 이용한 새로운 관절경적 골성 방카르트 병변 봉합술)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Bae, Seung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.40-46
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    • 2010
  • Purpose: The aim of this study was to evaluate the usefulness of arthroscopic Bony Bankart repair using a One Anchor Double Fixation Technique. Materials and Method: Seventeen patients with a Bony Bankart lesion were treated using the One Anchor Double Fixation Technique (OADF Technique). There were 13 males and 4 females. The average age was 24 years (range 17-42). The average follow-up period was 22.3 months. One 3.0 mm suture anchor with doubly loaded sutures was inserted into the glenoid rim. One suture strand was passed the around the small bony fragment and tied first. Another suture strand was passed through the capsule and tied over the bony fragment. The result was measured using Rowe's evaluation index & KSS score. The glenoid defect & bony fragment were measured by 3D-CT scan. Results: Rowe's evaluation index on the final follow-up showed an overall improvement from an average of 54 (range, 23-71) to 83.4 (range 71-90). Of the 17 cases, 13 were excellent, 3 were good, and 1 was fair. KSS scores showed improvement from an average of 71 (range 49-82) to 92.5 (range 82-94). There were no cases where pain continued to the final follow-up, and no cases being re-dislocated during the follow-up period. For six cases, we confirmed the bony healing of the bony Bankart lesion by CT. Conclusion: Bony Bankart lesion repair using this new method achieves excellent clinical results with low recurrence rates and is considered another choice for bony Bankart lesions.

Clinical Evaluation of Tissue Biopsy for Children with Neck Mass; A Single Center Study (조직검사를 시행한 소아 경부 종류의 임상적 고찰 : 단일 기관 연구)

  • Youn, You Sook;Yun, Hye Won;Kim, Sun Young;Sul, Ji Yeong;Song, Chang Jun;Kim, Jin Man;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.839-845
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    • 2005
  • Purpose : Neck masses, in pediatric population, derive from a multitude of congenital, inflammatory, or neoplastic diseases. The majority of these masses represent benign conditions. However, thorough clinical evaluation is required to rule out malignant diseases. We evaluated the causes, clinical characteristics and outcomes of children with neck masses who underwent tissue biopsy. Methods : A total of 28 medical records of children with neck mass who underwent tissue biopsy at Chungnam National University Hospital, from January 2000 to March 2004 were retrospectively analyzed. The methods of biopsy were ultrasonography guided core biopsy(CB), fine needle aspiration biopsy(FNAB) and excisional biopsy. Results : Out of 28 patients, half were boys. The most common location of the mass was the posterior cervical area(N=19, 67.9%). Laboratory findings of peripheral blood and serologic studies were nonspecific. In 25(89.3%) cases, CB or FNAB was initially performed for neck masses. Among them 10 cases(40%) were reactive hyperplasia, 8(32%) inflammatory granulation tissues, 4(16%) necrotizing lymphadenitis, and 3(12%) acute suppurative inflammations. Initially, excisional biopsy was performed for diagnosis in 3(10.7%) cases. Diagnosis of these cases was thyroglossal duct cyst, dermoid cyst and lymphoblastic lymphoma, respectively. Conclusion : Most neck masses in children were benign. CB and FNAB were safe methods for tissue sampling, without need for general anesthesia.