• Childhood Kidney Diseases
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• v.4 no.2
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• pp.92-101
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• 2000

Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

• Childhood Kidney Diseases
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• v.12 no.1
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• pp.30-37
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• 2008

Purpose: The present study is an investigation of the progression and prognosis of acute intrinsic renal failure in neonates and children with a diagnosis of acute renal failure or other diseases on admission. Methods: This research is based on a retrospective analysis conducted on 59 patients(male: female=2.2:1) diagnosed with acute intrinsic renal failure between January 2000 and June 2006 at Busan Paik Hospital. The clinical diagnostic criteria of acute renal failure used was serum creatinine <1.2 mg/dL, oliguria with urine output$\leq$0.5 mL/kg/hr and anuria with urine output <50 mL per day. Results: Among those placed under investigation, 7 patients were neonates, 10 patients were 2 months-2 years old, 12 patients were 3-6 years old, 21 patients were 7-12 years old and 9 patients were 13-16 years old. It took 3.1${\pm}$2.8 days on average until the diagnosis was made. The urine output distribution was 21 persons for the oliguria group, and 36 persons for the non-oliguria group, and 2 persons for the anuria group. For the underlying causes, 30 persons were classified in the primary renal disease group, 14 persons in the infection group, 9 persons in the malignancy group, and 6 persons were categorized in another group. As for age distribution, the infected group was predominantly neonates, whereas the dominant age ranges for the primary renal disease and infection categories were 2 months to 2 years old. Also, the primary renal disease was dominant among older children, aged 3 and up. No difference was detected according to seasonal prevalence. However, there was a high morbidity rate among hemolytic uremic syndrome diagnosed in the summer. Peritoneal dialysis was used to treat 4 patients. It took 10.0${\pm}$6.7 days until the patients improved. 18 patients died. The non-oliguria group's mortality rate was lower than other groups. There was a high mortality rate in the neonates and malignancy group. Conclusion: Acute renal failure in childhood seems to take a better clinical course than in adulthood when there is an early diagnosis and proper treatment of underlying diseases.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.644-651
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• 2004

Background: Refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with arrhythmia surgery in patients who had Fontan operation. Material and Method: Between July 1986 and December 2003, 275 early survivors after Fontan operation were reviewed. Fourteen patients underwent. arrhythmia surgery at reoperation after Fontan operation, and mean age at reoperation was 16.8$\pm$7.1 (range: 4.5 ∼ 30.6) years. Mechanisms of arrhythmia included atrial flutter in 8 patients, and atrial fibrillation in 2. Arrhythmia surgery has evolved from isthmus cryoablation in 12 patients to right-sided maze in 2 patients. Thirty-two patients. underwent prophylactic isthmus cryoablation concomitantly at initial Fontan operation. Result: Postoperative arrhythmias occurred in 68 patients (24.7%) among 275. There was no early and late mortality after the arrhythmia surgery. After redo Fontan operation, all patients maintained normal sinus rhythm. Atrial flutter recurred in 3 patients who had sinus conversion with medication and 7 required permanent pacemakers with a mean follow-up of 26.5$\pm$29.1 (range: 2 ∼ 73) months. All patients have improved to NYHA class I or II. After prophylactic cryoablation at initial Fontan operation, 29 patients (90.6%) had sinus rhythm, 1 patient had junctional tachycardia, 1 patient had sinus nodal dysfunction, and 1 patient had AV block with a mean follow-up of 51.3$\pm$19.8 (range: 4∼80) months. Conclusion: Redo Fontan operation, and concomitant arrhythmia surgery reduced atrial arrhythmias and improved NYHA functional classification.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.186-191
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• 1994

Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment of radiotherapy in non-small cell lung cancer. Twenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenoca) were studied with Tc-99m MIBI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squamous cell ca and adenoca were $1.50{\pm}0.16$ and $1.45{\pm}0.15$ on planar images, and $2.73{\pm}0.46$ and $2.54{\pm}0.37$ on tomographic images, respectively. The concordance between radiological change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8% ). In conclusion, Tc-99m MIBI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.178-183
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• 2007

Purpose: The prevalence and mortality of gastric lancer is high. We studied clinical characteristics and prognostic factors of the advanced gastric canter patients who had died in the hospice care unit. and our study is the basic report for efficient hospice and palliative care for the terminally ill patients with gastric cancer. Methods: We retrospectively reviewed the medical records of 99 advanced gastric cancer patients who had died in a hospice rare unit from May 2004 to August 2007. The survival days during the hospice and palliative care were analyzed using Kaplan-Meier method of SPSS version 13.0. Results: There were 62 males (63%) and 37 females (37%). Median age of patients was 60.9 years and liver metastasis was as high as 38 patients (38%) of all. The most prevalent symptom of admission was general weakness (97%) and poor or intake (86%). There were also bypoalbuminemia (88%), anemia (73%), and hyponatremia (61%). Palliative procedure was performed on 17 (63%) out of 27 patients with intestinal obstruction. Of these stents were inserted to 11 patients. The stores of ECOGPS and dyspnea were significantly correlated with the length of survival. The duration of median survival and hospitalization in the hospice and palliative care was 22 days and was 20 days respectively. Conclusion: We need to study more about clinical characteristics of advanced gastric rancor patients to predict the length of survival for an effective hospice and palliative care.

• Korean Journal of Ecology and Environment
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• v.51 no.1
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• pp.71-85
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• 2018

A recent topic of interest within ecology is ecosystem services that are importantly connected with biodiversity. Biodiversity is a fundamental component of ecological studies and has been the subject of many studies worldwide. However, studies on the diversity and distribution of freshwater fish were not undertaken in earnest until 2000, and the number of internationally available studies is therefore still limited. In this study, we used data from "The Survey and Evaluation of Aquatic Ecosystem Health (hereafter SEAEH)" within the framework of which whole water systems on the Korean peninsula are annually monitored to investigate and determine the current status of the diversity and distribution of freshwater fish, as well as to elucidate major factors impacting freshwater fish. A total of 130 species from 28 families were identified at around 953 sites in the SEAEH investigation of 2014. The species Zacco platypus (relative abundance: 28.2%) and Z. koreanus (19.3%) were identified as the most abundant species on the Korean peninsula, and besides these 20 endangered species, 51 endemic species and 4 exotic species were also collected. Highest (96 species) and lowest (72 species) diversity were identified in the Han River Watershed and the Yeongsan/Seomjin River Watershed, respectively. The mean endemic rate was 32.7%, which is higher than the previous rate determined in 1995. The exotic species Micropterus salmoides, Lepomis macrochirus and Carassius cuvieri were found in the whole river system except north Yeongdong, whereas Oreochromis niloticus occurred only at three sites due to the cold water temperatures in winter. Totally, 28 species were found to be translocated to different water systems not connected with known original habitats, most translocations occurring in the Nakdong River and the Yeongdong region. Among the translocated species, Opsariichthys uncirostris amurensis, and Erythroculter erythropterus were dominantly distributed in the mid- to lower reaches of Nakdong River where they may be harmful to the native fish assemblages due to their strong predation. The construction of weirs in connection with the "4 River Project" generated changes in fish assemblages before, during and after the project, resulting in altered habitat condition. Especially, a decrease in the number of endemic species and an increase in the abundance of lentic species were seen. Human-induced global warming will allow exotic species requiring high water temperatures to adapt to the environmental conditions of the Korean peninsula, which may enhance the diversity of native fishes and create changes in distribution. For the establishment of realistic and efficient management and protection strategies for Korean freshwater fish, SEAEH, which produces fundamental and quantitative data for Korean streams, is an important and necessary tool.

• Korean Journal of Ecology and Environment
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• v.51 no.1
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• pp.60-70
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• 2018

The distribution of benthic macroinvertebrates was investigated at 1,157 sites of 7 main water systems in Korea, including 442 sites of Han River system (Namhan River, Bukhan River, Han River main stream, Anseongcheon, etc.), 305 sites of Nakdong River system (Nakdong River, Hyeongsan River, Taehwa River, etc.), 199 sites of Geum River system (Geum River, Sapgyocheon, Mangyeong River, Dongjin River, etc.) 102 sites of Seomjin River system (Seomjin River), 102 sites of Yeongsan River system (Yeongsan River, Tamjin River, etc.), and 7 sites of Jeju stream system. A total of 151 families were found in the whole survey sites, including 141 families in Han River, 122 in Nakdong River, 115 in Geum River, 106 in Seomjin River, 113 in Yeongsan River, and 50 in Jeju. Chironomidae (20.8%) was the most dominant species in Korea, followed by Hydropsychidae (17.1%), Baetidae (12.6%), Tubificidae (10.3%), Heptageniidae (8.6%), Ephemerellidae (6.3%), Asellidae (2.7%), Leptophlebiidae (2.4%), Planariidae (1.7%), and Tipulidae (1.6%). Substrates compositions consisted of large sand (22.6%), large gravel (18.4%), silt (10.5%), and boulder (8.2%). The mean stream width was 133.5 m and the mean watercourse width was 61.7 m. The mean water depth and velocity were 30.2 cm and $33.1cm\;s^{-1}$, respectively. Results of cluster analysis based on distributional characteristics of benthic macroinvertebrates were divided into six groups according to the frequency of benthic macroinvertebrate taxa which appeared in the study area. Finally, altitude, current velocity and substrate composition were the most influencial factors determining the distribution patterns of macroinvertebrate communities.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.115-123
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• 2006

Purpose : We investigated whether there had been any change in the epidemiology of Streptococcus pneumoniae in Korea before and after introduction of heptavalent pneumococcal conjugate vaccine(PCV7). Methods : Between September 2001 and August 2006, clinical isolates were collected from patients with pneumococcal infection in Severance Hospital, Seoul, Korea. We analyzed trends in serotype distribution and antibiotic resistance before and after the introduction of PCV7. Results : There were 363 strains of Streptococcus pneumoniae isolated from clinical specimens; 143 before and 220 after PCV7 introduction. The predominant serotypes, in order of decreasing frequency, were 19F, 19A, 23F, 6B, 6A, 3, 9V, 14, 11A, 4, 29, and 18C; 152 isolates(41.9%) belonged to types included in PCV7. The proportion of clinical isolates that were nonsusceptible to penicillin increased from 58.8% in 2001 to 83.6% in 2006(P=0.046). There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7. In children younger than age 2 years, the proportion of clinical isolates that were vaccine serotypes was higher than in persons older than age 15 years (59.3% vs 37.8%, P=0.004). Conclusions : There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7, therefore more universal pneumococcal immunization program is recommended especially for children younger than age 2 years.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.65-73
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• 1984

To assess the status of industrial injuries, a large scale textile company located around Taegu city was selected. And it was investigated from January 1981 to December 1982. After the department for workers safety was established, frequency rate of injury was 9.70 in 1981 and 4.15 in 1982, incidence rate per 1,000 workers was 27.11 in 1981 and 12.96 in 1982, and then, intensity rate was 0.33 in 1981 and 0.01 in 1982. The average duration of working loss was 36.64 days in 1981 and 3.34 in 1982. The incidence rate per 100 workers was 2.3 in annual average, 2.7 in men and 2.0 in women. The monthly incidence rate per 1,000 workers was highest as 3.6 in June; daily incidence rate, lowest as 1.8 on Sunday; and the highest as 14.7 from 10 to 12 o'clock in a day. The frequency by injured parts of body was highest as 42.3% on finger and 14.4% on the other part of hand, and the lower extremities as 14.4% followed. According to the kind of injuries, the laceration was the highest as 46.1%, the next was contusion as 15.4%, and the third was superficial injuries as 6.7%, According to the cause of injuries, the machinery accidents showed the highest as 47.1% and the accidents due to hand tool followed as 16.3%. By underlying cause of injuries, the environmental factors were 13.5% and the human factors 86.5%. The psychologic factors among human factors were the most common as 60.6%.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.33-42
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• 2004

Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.