• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.149-156
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• 2005

Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.123-131
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• 2009

Purpose: We tested a sample of nuclear medicine workers at Korean healthcare institutions for internal contamination with radioactive isotopes, measuring concentrations and evaluating doses of individual exposure. Materials and Methods: The detection and measurement was performed on urine samples collected from 25 nuclear medicine workers at three large hospitals located in Seoul. Urine samples were collected once a week, 100~200 mL samples were gathered up to 6~10 times weekly. A high-purity germanium detector was used to measure gamma radiations in urine samples for the presence of radioactive isotopes. Based on the detection results, we estimated the amounts of intake and committed effective doses using IMBA software. In cases where committed effective doses could not be adequately evaluated with IMBA software, we estimated individual committed effective doses for radionuclides with a very short half life such as $^{99m}Tc$ and $^{123}I$, using the methods recommended by International Atomic Energy Agency. Results: Radionuclides detected through the analysis of urine samples included $^{99m}Tc$, $^{123}I$, $^{131}I$ and $^{201}Tl$, as well as $^{18}F$, a nuclide used in Positron Emission Tomography examinations. The committed effective doses, calculated based on the radionuclide concentrations in urine samples, ranged from 0 to 5 mSv, but were, in the majority of cases, less than 1 mSv. The committed effective dose exceeded 1 mSv in three of the samples, and all three were workers directly handling radioactive sources. No nurses were found to have a committed effective dose in excess of 1 mSv. Conclusions: To improve the accuracy of results, it may be necessary to conduct a long-term study, performed over a time span wide enough to allow the clear determination of the influence of seasonal factors. A larger sample should also help increase the reliability of results. However, as most Korean nuclear medicine workers are currently not necessary to monitored routinely for internal contamination with radionuclides. Notwithstanding, a continuous effort is recommended to reduce any unnecessary exposure to radioactive substances, even if in inconsequential amounts, by regularly surveying workplace environments and frequently monitoring atmospheric concentrations of radionuclides.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.585-590
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• 2004

Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.

• Progress in Medical Physics
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• v.20 no.1
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• pp.21-29
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• 2009

Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.338-345
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• 2002

Background : Coal workers' pneumoconiosis(CWP) is a fibrotic lung disease resulting from the chronic inhalation of coal dust. Various cytokines and growth factors secreted from macrophages and monocytes play a key role in the pathogenesis of pneumoconiosis. The platelet-derived growth factor (PDGF)-BB and the insulin-like growth factor(IGF)-1 secreated from the macrophages and monocytes are believed to stimulate the accumulation of mesenchymal cells and fibrosis of the lower respiratory tract that is observed in fibrotic lung disease. The serum concentraion of PDGF-BB and IGF-1 in 30 CWP patients and 10 healthy controls were measured in order to determine if PDGF-BB and IGF-1 can be used as sensitive biomarkers in CWP. Method : Serum was collected from 30 patients with CWP(13 with simple CWP and 17 with complicated CWP) and 10 healthy controls. The serum concentrations of PDGF-BB and IGF-1 were measured using ELISA (R&D system, Minneapolis, MN). Results : The serum PDGF-BB concentration in patients with complicated CWP($10083.76{\pm}639.07pg/mL$) was significantly higher than in the patients with simple CWP ($8493.88{\pm}848.51pg/mL$) and the healthy controls ($3726.17{\pm}292.20pg/mL$) (p<0.05). Compared to the healthy controls ($413.40{\pm}1.94ng/mL$), there was no significant difference in the serum IGF-1 concentration in patients with simple ($366.77{\pm}183.67ng/mL$) and complicated CWP ($403.18{\pm}15.39ng/mL$) (p>0.05). Conclusion : These results show the important role of the PDGF-BB mediated pathways in the pathogenesis of CWP. These data suggests that the PDGF-BB serum concentration is a useful biomarkers of the fibrotic extent in CWP patients.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.285-289
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• 2006

Background : North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. Material and Methods : From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. Results : A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. Conclusion : The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1095-1100
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• 2003

Purpose : Children with acute colonic diverticulitis(ACD), can be misdiagnosed with acute appendicitis. Methods : We reviewed 15 cases of ACD during five years, from January 1998 to June 2002 retrospectively. Results : Most patients(80%) with ACD in children presented with right lower quadrant pain. The primary diagnosis on admission was mostly acute appendicitis(87%), and all ACD in children occurred in the right colon. Fourteen patients were managed by conservative treatment including antibiotics. A follow-up study was performed in 15 patients. There were symptomatic recurrences in two patients, but no significant complication was noted. The frequency of ACD was 11.7 per 1000 acute appendicitis. Conclusion : ACD in children can mostly be cured by conservative treatment. It is prudent to choose the management through the diagnostic work up, including abdominal sonography and computed tomography, because there was no significant difference of clinical findings between ACD and acute appendicitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.110-115
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• 2008

Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.30-35
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• 2010

Purpose : We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. Methods : Children diagnosed with UTI at the Department of Pediatrics, Kwandong University MyMyongji Hospital by pyuria and bacterial growth of greater than $1.0{\times}10^5CFU/mL$ on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. Results : Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), $\beta$-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4 %. Only one case of the E. coli was extended spectrum $\beta$-lactamase (ESBL) positive. Conclusion : Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.

• Journal of Radiation Protection and Research
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• v.24 no.4
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• pp.195-203
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• 1999

It is difficult to determine dosimetric characteristics for small field photon beams since such small fields do not achieve complete lateral electronic equilibrium and have steep dose gradients. Dosimetric characteristics of small field 4, 6, and 10 MeV photon beams have been measured in water with a diamond detector and compared to measurements using small volume cylindrical and plane parallel ionization chambers. Percent depth dose (PDD) and beam profiles for 6 and 10 MeV photon beams were measured with diamond detector and cylindrical ion chamber for small fields ranging from $1{\times}1\;to\;4{\times}4cm^2$. Total scatter factors($S_{c,p}$) for 4, 6, and 10 MeV photon beams were measured with diamond detector, cylindrical and plane parallel ion chambers for small fields ranging from $1{\times}1\;to\;4{\times}4cm^2$. The $S_{c,p}$ factors obtained with three detectors for 4, 6, and 10 MeV photon beams agreed well ($\pm1.2%$) for field sizes greater than $2{\times}2,\;2.5{\times}2.5,\;and\;3{\times}3\;cm^2$, respectively. For smaller field sizes, the cylindrical and plane parallel ionization chambers measure a smaller $S_{c,p}$ factor, as a result of the steep dose gradients across their sensitive volumes. The PDD values obtained with diamond detector and cylindrical ionization chamber for 6 and 10MeV photon beams agreed well ($\pm1.5%$) for field sizes greater than $4{\times}4\;cm^2$. For smaller field sizes, diamond detector produced a depth-dose curve which had a significantly shallower falloff than that obtained from the measurements of relative depth-dose with a cylindrical ionization chamber. For the measurements of beam profiles, a distortion in terms of broadened penumbra was observed with a cylindrical ionization chamber since diamond detector exhibited higher spatial resolution. The diamond detector with small sensitive volume, near water equivalent, and high spatial resolution is suitable detector compared to ionization chambers for the measurements of small field photon beams.