• Journal of Chest Surgery
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• v.32 no.8
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• pp.702-708
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• 1999

Background: Surgical closure of the PDA in premature infants with complications or contraindications to indomethacin use, or recurrence of symptomatic PDA is a safe and effective procedure with low operative risk and minimal complications. Material and Method: From April 1996 to August 1998, 11 premature infants with body weight under 1.5 kg at operation underwent operation for a symptomatic PDA (male:5, female: 6). Associated dise ases were congenital heart disease(7), hyaline membrane disease(6), intraventricular hemor rhage(4), pneumonia(4), pneumothorax(3), hyperbilirubinemia(2), necrotizing enterocolitis(2), renal failure(1), epilepsy(1), and hydrocephalus(1). Surgical techniques are hemoclipping(8) and ligation(3). The size of PDA was 3~6 mm (5.0$\pm$1.2). Result: Systolic and diastolic blood pressure rised and heart rates decreased after PDA closure. ABGA improved postoperatively. There were no surgical complications. Six infants with improved ABGA data were weaned from mechanical ventilatory support. The follow-up durations after discharge were 3 month to 12 month. Five deaths were not related to operation. The causes of death were hyaline membrane disease(2), bronchopulmonary dysplasia with pneumonia(1), sepsis(1), and con gestive heart failure with respiratory distress syndrome(1). Conclusion: Early operative closure is the treatment of choice in most premature infants with a hemodynamically significant shunt(PDA), recurrence of symptomatic PDA, complications of Indomethacin, or contraindi cations to Indomethacin.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.132-137
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• 1999

Displaced tibial spine fractures need the anatomical reduction of the displaced bone fragment to achieve normal range of motion and anterior stability of the knee joint. The purpose of this paper is to describe details of arthroscopic technique using suture hook and pull-out PDS and to evaluate the clinical results. We report 7 cases who underwent arthroscopic reduction and internal fixation using suture hook and pull-out PDS. All cases had fresh fractures generated within 3 weeks. The follow up period was at average 16.6 months. The fracture union was achieved at average 7.4 weeks. Knee exercise was started 2 weeks after the operation. One of the patients, who had combined injury of posterior cruciate ligament and lateral meniscus, showed limitation of knee movement. But he was underwent the arthroscopic fibrolysis at one year later, he returned to normal range of motion. Arthroscopic treatment of displaced tibial spine fracture using suture hook and pull-out PDS showed good results including rigid fixation and early mobilization. Therefore it is thought to be one of the effective operative techniques in treatment of the tibial spine fractures.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.543-548
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• 1999

Background: These days, lung volume reduction surgery (LVRS) is used as an alternative or a bridge operation to lung transplantation in treating patients with severe emphysema. The procedure can be used in patients with pulmonary nodules combined with severe emphysema. We report the results of 21 months follow up after lung volume reduction surgery in 7 cases including 2 cases of concurrent resection of pulmonary nodules. Material and Method: Seven patients with emphysema, including 2 cases of preoperatively suspected lung cancer were operated with LVRS technique between July 1996 and June 1997. Result: Postoperative mortality was observed in a case of squamous cell carcinoma in LUL with brain metastasis, detected at postoperative 13months. Average of 21months(19-25months) follow up was done for other cases without specific events. Conclusion: LVRS is a useful operation in the treatment of patients with severe emphysema, but further evaluation should be done about the long term results and precise criteria for patient selection. Simultaneous LVRS and tumor resection could be done in patients with emphysema with marginal reserve in the hope of maximizing postoperative lung functions.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.184-190
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• 2011

Scrotal involvement has been reported from 2% to 38% of males with Henoch-Sch$\ddot{o}$nlein purpura (HSP). It may present before the rash occurs or even long time after it has disappeared. Scrotal involvement of HSP usually results in pain, tenderness, swelling or discoloration of scrotum. Scrotal pain sometimes mimics testicular torsion to various degrees, which can be followed by unnecessary operation. In our 2 cases, one was a 5-year and 11-month-old boy who came to our emergency department due to scrotal pain before the diagnosis of HSP, and the other was a 5-year and 1-month-old boy who came to the outpatient clinic due to scrotal pain after the resolution of HSP about 1 month before the visit. We performed Doppler ultrasonography (USG) to evaluate the acute scrotal pain in the two boys. On Doppler USG, epididymis showed increased blood flow, and testis showed normal blood flow. These findings enabled the diagnosis of acute epididymitis and excluded testicular torsion. Epididymitis was improved by conservative management including shortterm steroid therapy within 5 days. It is important to perform adequate evaluation with tools such as Doppler USG in the early course of acute scrotum of HSP, to avoid unnecessary scrotal exploration.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.108-112
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• 2011

Purpose: To evaluate the thickness of the posterior horn of the medial meniscus accompanying with degenerative radial tear. Materials and Methods: We retrospectively reviewed 170 cases which show degenerative meniscal tear with variable degree of meniscal degeneration from February 2000 to February 2010. All cases were older than 40 years and 57 cases were men and 113 cases were women. Mean age were 55-year-old. We grouped the cases into 3 categories. Group A were composed with cases which showed horizontal and radial tear in posterior horn of medial meniscus. Group B showed horizontal tear only and group C showed intrasubstance degeneration without meniscal tear. Results: The mean thickness of medial meniscus posterior horn in group A, B, C were 7. 44 mm, 6.52 mm, 6.04 mm respectively. Group A showed significant increase of the thickness of medial meniscus posterior horn than group B, C. Group B also showed significant increase of thickness than group C. The degree of meniscal degeneration was highest in group A, which showed significant higher meniscal degeneration than group B and C, and, group B showed higher degeneration than group C, however, there was no statistically difference between group A and B regarding the degree of meniscal degeneration. Conclusion: The thickness of medial meniscus posterior horn was increased when accompanied with radial tear, which may elicit pain caused by meniscal impingement.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.127-131
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• 2009

Most mediastinal teratomas are histologically well-differentiated tumors and benign. The majority of patients with a mediastinal teratoma are asymptomatic and their tumors are usually discovered incidentally on chest radiography. On rare occasions this tumor will rupture spontaneously into the adjacent organs. A 72-year-old female patient was admitted for dyspnea and she had a multiloculated pleural effusion in the left lung field. Although repeated pleural biopsy and pleural fluid cytology did not prove the presence of malignancy, we assumed that this was a malignant effusion because it revealed consistently high levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and the chest CT scan did not show typical fat or bone density in the mass. Secondary infection and an uncontrolled septic condition due to pleural empyema finally compelled the patient to undergo a surgical operation. Mature teratoma was the final diagnosis and she has done well without recurrence for 2 months.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.76-83
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• 1991

A total of 53 gastric adenomas from endoscopically biopsied gastric mucosa were examined histopathologically. The average age at the time of endoscopic biopsy was 59 years, and gastric adenomas were found to be more frequent in the aged, particularly above the age of 50. The majority of adenomas occurred at the antrum. Concerning the shape of the adenomas, Yamada type II was more frequent(55%). All adenomas were accompanied by varying degree of intestinal metaplasia, and this findings suggest that gastric adenoma develops from intestinal metaplasia. In adenomas with severe atypia(grade III), endocrine cells(argyrophil and argentaffin cells)were markedly decreased or absent. Gastric adenocarcinomas coexistent with adenoma were seen in 5(9.4%) out of 53 cases, and were more frequent in male than female patients(sex ratio, 4 : 1) and the average age was 61.4 years. It is suggested that there is a necessity of thorough follow-up study for definitive correlation between gastric adenoma and adenocarcinoma.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.323-327
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• 2008

Systemic lupus erythematosus (SLE) is a multisystem disorder where the etiology is not clearly known. Symptomatic chronic interstitial pneumonitis is an uncommon manifestation, with a reported prevalence of 3~13%. Achalasia is rare disease that presents with failure in the relaxation of the esophagus sphincter. A 22-year-old woman was admitted to our hospital because of fever, cough and dyspnea. The patient had a history of pericardial effusion and Raynaud's phenomenon. The results of laboratory tests indicated the presence of lymphopenia and included positive antibody tests for antinuclear antibody and anti Sm antibody. A chest X-ray demonstrated the presence of peribronchial infiltration on both lung fields. A Chest CT image showed interlobar septal thickening, ground-glass opacity and a honeycomb appearance in both lung fields and esophageal dilatation with air fluid level. An esophagogram showed the presence of dilated esophagus ends that represented the non-relaxed lower esophageal sphincter. Manometry demonstrated incomplete sphincter relaxation. The case was diagnosed as systemic lupus erythematosus associated with interstitial pneumonia and achalasia.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.141-149
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• 1994

The prevalence rates of disruptive behavior disorders(attention deficit hyperactive disorder, conduct disorder and oppositional defiant disorder, ADHD, CD and ODD respectively) were studied in 780 elementary school children from 4th to 6th grades. The results are summarized as follows : 1) The prevalences rates of ADHD were in boys 10.3%(45/436), 4.1%(14/344) in girls and the overall prevalence rate was 7.6%(59/780). 2) The prevalence rates of CD were 5.0%(22/436) in boys, 2.3%(8/344) in girls and the overall prevalence rate was 3.8%(30/780). 3) The prevalence rates of ODD were 5.7%(25/436) in boys, 2.3%(8/344) in girls and the overall prevalence rate was 4.2%(33/780). 4) These three disorders were significantly more common in boys than in girls. 5) There were no significant differences in the prevalence rates of ADHD, CD and ODD by grades or urban-rural status. 6) The comorbidity of ADHD was also explored, 3.5% (2/59) of ADHD also had CD, 13.6% (8/59) had both CD and ODD. 7) The mild forms of these three disorders were about two times more common than typical forms.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.6-9
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• 2009

Gastric cancer with gastric outlet obstruction has a high incidence of direct invasion into neighboring organs, with a low resection rate and a poor prognosis. Traditionally, open gastrojejunostomy has been the standard palliative treatment in these patients. Recently, endoscopic self-expanding metal stents have been used increasingly for the palliative treatment of malignant gastric outlet obstruction, but the choice of modality to treat the obstruction caused by gastric cancer is still controversial. Many studies have shown that endoscopic stenting is less invasive and offers not only a shorter time to oral intake and length of hospital stay, but also less frequent complications compared to open gastrojejunostomy. However, recurrent obstruction by tumor overgrowth and ingrowth occur more frequently and re-intervention for recurrent obstructive symptoms are more frequently performed after stent placement than after gastrojejunostomy. Thus, stent placement may be associated with more favorable results in patients with a relatively short life expectancy, while gastrojejunostomy is preferable in patients with a more prolonged prognosis. Also, open surgery affords a greater chance for curative surgery. However, most underlying diseases analyzed in previous studies were pancreaticobiliary malignancies, and there have been few prospective studies specific for patients with gastric cancer. Additional randomized controlled trials with larger sample sizes are expected to decide the treatment modality for unresectable gastric cancer with gastric outlet obstruction.