• Pediatric Infection and Vaccine
• /
• v.10 no.2
• /
• pp.223-228
• /
• 2003

Purpose : We evaluated and compared clinical and laboratory characteristics of patients with measles in three epidemics(1989~90, 1993~94, and 2000~01) in Daejeon, Korea. Methods : Retrospective analyses were performed using medical records of 520 patients with measles at the Catholic University of Korea, Daejeon St. Mary's Hospital during three epidemics. We divided the subjects into three groups, i.e., those who admitted during 1989~1990(group I, 116 patients), those during 1993~1994(group II, 127 patients), and those during 2000~2001(group III, 277 patients). We compared clinical, demographic and laboratory characteristics among these 3 groups. Results : In age distribution, ratios of under 2 years of age in three groups were 61%, 58% and 57%, respectively with no statistical differences. However there are differences in age distribution above 2 years of age, as 21% in 2~5 years of group I, 28% in 6~9 years of group II, and 21% above 10 years of group III. No statistical differences were present between 3 groups in the male to female ratio, MMR vaccination rate in above 2 years of age, duration of fever, incidence of hepatitis. Hospitalization days(P=0.019) and rate of complications(P=0.012) were longer and higher in group I than in group III. Conclusion : In three epidemics, the second peak age group(except 0~1 year) of children above 2 years of age who had mostly received MMR vaccination showed a trend for increased age with increasing time(statistical difference). This result suggest that secondary vaccine failure may have a role in each epidemics. So, if measles outbreaks is happened in the future, we will have consideration in this aspect.

• Journal of the Korean Arthroscopy Society
• /
• v.15 no.1
• /
• pp.13-18
• /
• 2011

Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

• Childhood Kidney Diseases
• /
• v.8 no.1
• /
• pp.1-9
• /
• 2004

Purpose : Minimal Change Disease (MCD) is the most common primary nephrotic syndrome in children. Some suggested that tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) are involved in the pathogenesis of MCD. Methods : This study was done to see the changes of plasma and urinary $TNF-{\alpha}$, and its effect on the determination of permeability of the glomerular basement membrane (BM) contributed by heparan sulfate proteoglycan (HSPG). Study patients consisted of 19 biopsy-proven MCD children aged 2-15 years old. Both plasma and urinary $TNF-{\alpha}$ were measured. Employing the Millicell system, $TNF-{\alpha}$ was screened for the permeability factors. We examined whether $TNF-{\alpha}$ regulated BM HSPG gene expression and HS synthesis in the glomerular epithelial cells (GECs). Results : Urinary $TNF-{\alpha}$ during relapse was significantly increased when compared with that of during remission or controls ($364.4{\pm}51.2$ vs $155.3{\pm}20.8,\;36.0{\pm}4.5$ ng/mg cr) (P<0.05). However, negative results were obtained in the permeability assay using the Millicell system. No difference was seen in the BM HSPG gene expression and HS synthesis in the GECs. Conclusion : It seems that $TNF-{\alpha}$ may not play a disease-specific role in the pathogenesis of MCD.

• Proceedings of the KHEEA Conference
• /
• 2002.08a
• /
• pp.5-19
• /
• 2002

재한국, 1995년제일차출대국가제정적가정과교육과정. 지후, 한국적가정과교육과정경마료7차적수정여개혁과정. 재차과정중, 가정과정불단지추극출신, 기과목명칭재변화, 필수자선 등 선과성질야재변화, 과치함축, 여기술과정합. 이차, 가정과변위남녀생공수적과목, 저취순응료사회발전적수요. 종한국적교육과정래간, 1년급도10년급시국민공용기본교육계단, 11년급도12년급시자선교육계단. 거차, 가정과교육과정적접배위여하 : 소학(5~6학년)위실과, 중학화고중(7~10학년)위"기술.가정", 고중(11~12학년)위"가전과학". 장종2003년개시실시적가정과과시안배위여하 : 소학각2과시, 7~12학년시각2.3.3.3과시, 11~12학년위6개등차. 최근, 청소년문제, 교육환경, 상시인성, 가정파양, 소비과잉, 학대아동, 등사회문제도근가정생활유착밀절적연계, 인차, 재반지교육중, 가정교육응수중시. 단시, 실제상병불시여차. 작위교육주체적교사화부모도몰유인식도저개실정. 인차, 가정학자여교사유심요주근지거연구가정교육. 우기시, 유필요근중국, 일본, 등저사아주국가호상교류화합작적과정중거탐색가정교육적안정발전. 하면파미래가정학육발전적방향건의여하 : 1) "가정" 과시이가정과위연구대상적가정학적독립적연구요영역. 가정경적연구감상시 "가정", 타이가정생활질량적제고위기연구목적. 인차, 재가정교육중, 과목적명칭명명위 "기술. 가정", "가정일반". "가사" 시부합리적. 이응위 "가정" 2) 가정교육웅사중시성각색적변환, 직업적인직변고적각도출발, 사소학도고중분개위필수화선수과, 유남녀생공수. 3) 가정과과시재축점축단. 도시유우교육과정적축단이인기적피면불료적현상. 단시고 여가정과시실천, 실험성과목응보장기최저적과시, 최기마필수유지현재적과시. 4) 향래, 한국적가정교육과정기이가정과위기본철학배경화리념, 우급시파국가교육과정적배경화이념, 가정학적발전동태반영재교육과정중, 즉강조즘요교. 단시, 경력료반복적변혁지후, 최근, 각중시즘양거배양학생적십 요 양적능력여가치. 인차, 가정교육파교육목라방재즘루거제고가정생활적질량, 즘루거호조화가정생활화직업생활, 즘양거개발합리지해결화실천가정생활적가치관. 5) 최근, 가정교육파교육방향화목라방재거배양학생작위독립적개인, 작위가족적성원, 작위사회성원래주인생도로적능력. 인차, 가정교육이인적생활위중심. 우거섭급학생재성장과정중소우도적문제,재거포괄재가정화사회생활중소우도적문제. 즉거배양해결가정생활중소우도적소유적 문종적종합능력. 6) 가정과재교학방법화교학평개상, 응채용실험, 실습, 관찰 등방식, 응반체험성, 실천성경험. 위차, 응필편기험적실험, 실습설비. 7) 확정교육과정편제적치후, 응제고일반교육학자적참여율, 가정교육학자응적극참여 제정교청정책적유관교육적각종위원회. 재제정정책적과정중각진소능, 적극제출건고성적의황. 8) 한, 중, 일 삼국권원층립가정교육과정도작사, 위삼국교육과정적량호발전주공헌.

• Clinical and Experimental Reproductive Medicine
• /
• v.37 no.1
• /
• pp.73-81
• /
• 2010

Objective: To examine the efficacy of letrozole in infertile women showing a poor endometrial development at previous ovulation induction cycle by using clomiphene citrate. Methods: Eighteen infertile women were selected who showed a poor endometrial development (endometrial thickness$\leq$6.5 mm) after clomiphene treatment (50~100 mg) as ovulation induction for timed coitus. The mean age of the patients was $30.7{\pm}2.8$ years old and the mean duration of infertility was $33.1{\pm}26.6$ months. The infertility factors were identified as corrected endometriosis (n=1), polycystic ovary syndrome (n=5) and unexplained (n=12). Letrozole was given orally in a dose of 2.5 mg for 5 days starting 3~5 of menstrual cycle. Results: The number of follicles was significantly lower in the letrozole cycle when compared with previous clomiphene cycle ($1.1{\pm}0.3$ vs. $2.2{\pm}1.5$, p=0.011). The endometrial thickness (mm) at the time of triggering or LH surge was significantly greater in the letrozole cycle ($8.4{\pm}1.7$ vs. $5.8{\pm}0.5$, p<0.001). The endometrial pattern 'type C' was significantly higher in the letrozole cycle (94.4% vs. 50%, p=0.036). The pregnancy was achieved in 11.1% of the letrozole cycle. Conclusion: Use of letrozole was associated with more thick and improved endometrium than previous clomiphene cycles in which thin endometrium was identified. Use of letrozole appears to be an effective strategy for second-line treatment in women with inadequate endometrial response to clomiphene.

• Clinical and Experimental Pediatrics
• /
• v.48 no.12
• /
• pp.1317-1323
• /
• 2005

Purpose : This study was performed to evaluate the recent frequency of karyotypes in different sex chromosome abnormalities and to evaluate the age and clinical manifestations at diagnosis. Methods : Peripheral blood leukocytes were obtained from subjects who were clinically suspected to have sex chromosome abnormalities and referred to the cytogenetic laboratory in the Department of Pediatrics, Kyungpook National University Hospital from February 1981 to August 2001. Results : The relative frequencies of different sex chromosome abnormalities were Klinefelter(52 percent), Turner(42 percent), XXX syndrome(3 percent) and mixed gonadal dysgenesis(3 percent). The populations of different karyotypes in Klinefelter syndrome were 47,XXY(97 percent) and 46,XY/47,XYY(3 percent). The populations of different karyotypes in Turner syndrome were 45,X(67 percent,), mosaicism(23 percent), and structural aberrations(10 percent). The populations of different karyotypes in XXX syndrome were 47,XXX(67 percent,) and 46,XX/47,XXX(33 percent). All mixed gonadal dysgenesis were 45,X/46,XY. Eighty one percent of sex chromosome abnormalities was diagnosed after puberty. Patients diagnosed with Klinefelter and Turner syndrome in infancy showed nearly normal phenotypes or had minor congenital malformations. Conclusion : Early diagnoses of sex chromosome abnormalities is required to prevent associated morbidities and to maximize growth and development. We have to pay careful attention in diagnoses of Turner syndrome because of the high proportion of mosaicism and structural aberrations.

• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1216-1220
• /
• 2009

Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

• Radiation Oncology Journal
• /
• v.24 no.4
• /
• pp.280-284
• /
• 2006

$\underline{Purpose}$: To evaluate biological characteristics of neutron beam generated by MC50 cyclotron located in the Korea Institute of Radiological and Medical Sciences (KIRAMS). $\underline{Materials\;and\;Methods}$: The neutron beams generated with 15 mm Beryllium target hit by 35 MeV proton beam was used and dosimetry data was measured before in-vitro study. We irradiated 0, 1, 2, 3, 4 and 5 Gy of neutron beam to EMT-6 cell line and surviving fraction (SF) was measured. The SF curve was also examined at the same dose when applying lead shielding to avoid gamma ray component. In the X-ray experiment, SF curve was obtained after irradiation of 0, 2, 5, 10, and 15 Gy. $\underline{Results}$: The neutron beams have 84% of neutron and 16% of gamma component at the depth of 2 cm with the field size of $26{\times}26\;cm^2$, beam current $20\;{\mu}A$, and dose rate of 9.25 cGy/min. The SF curve from X-ray, when fitted to linear-quadratic (LQ) model, had 0.611 as ${\alpha}/{\beta}$ ratio (${\alpha}=0.0204,\;{\beta}=0.0334,\;R^2=0.999$, respectively). The SF curve from neutron beam had shoulders at low dose area and fitted well to LQ model with the value of $R^2$ exceeding 0.99 in all experiments. The mean value of alpha and beta were -0.315 (range, $-0.254{\sim}-0.360$) and 0.247 ($0.220{\sim}0.262$), respectively. The addition of lead shielding resulted in no straightening of SF curve and shoulders in low dose area still existed. The RBE of neutron beam was in range of $2.07{\sim}2.19$ with SF=0.1 and $2.21{\sim}2.35$ with SF=0.01, respectively. $\underline{Conclusion}$: The neutron beam from MC50 cyclotron has significant amount of gamma component and this may have contributed to form the shoulder of survival curve. The RBE of neutron beam generated by MC50 was about 2.2.

• The Journal of Korean Society for Radiation Therapy
• /
• v.25 no.1
• /
• pp.77-85
• /
• 2013

Purpose: The accurate movement of gantry rotation, collimator and correct application of dose rate are very important to approach the successful performance of Volumetric Modulated Arc Therapy (VMAT), because it is tightly interlocked with a complex treatment plan. The interruption and restart of dose delivery, however, are able to occur on treatment by various factors of a treatment machine and treatment plan. If unexpected problems of a treat machine or a patient interrupt the VMAT, the movement of treatment machine for delivering the remaining dose will be restarted at the start point. In this investigation, We would like to know the effect of interruptions and restart regarding dose delivery at VMAT. Materials and Methods: Treatment plans of 10 patients who had been treated at our center were used to measure and compare the dose distribution of each VMAT after converting to a form of digital image and communications in Medicine (DICOM) with treatment planning system (Eclipse V 10.0, Varian, USA). We selected the 6 MV photon energy of Trilogy (Varian, USA) and used OmniPro I'mRT system (V 1.7b, IBA dosimetry, Germany) to analyze the data that were acquired through this measurement with two types of interruptions four times for each case. The door interlock and the beam-off were used to stop and then to restart the dose delivery of VMAT. The gamma index in OmniPro I'mRT system and T-test in Microsoft Excel 2007 were used to evaluate the result of this investigation. Results: The deviations of average gamma index in cases with door interlock, beam-off and without interruption on VMAT are 0.141, 0.128 and 0.1. The standard deviations of acquired gamma values are 0.099, 0.091, 0.071 and The maximum gamma value in each case is 0.413, 0.379, 0.286, respectively. This analysis has a 95-percent confidence level and the P-value of T-test is under 0.05. Gamma pass rate (3%, 3 mm) is acceptable in all of measurements. Conclusion: As a result, We could make sure that the interruption of this investgation are not enough to seriously affect dose delivery of VMAT by analyzing the measured data. But this investigation did not reflect all cases about interruptions and errors regarding the movement of a gantry rotation, collimator and patient So, We should continuously maintain a treatment machine and program to deliver the accurate dose when we perform the VMAT for the many kinds of cancer patients.

• Clinical and Experimental Pediatrics
• /
• v.46 no.9
• /
• pp.871-875
• /
• 2003

Purpose : This study was performed to follow the natural course and size change of isolated atrial septal defect(ASD) secundum. Methods : Among the newly diagnosed with ASD secundum at the division of pediatric cardiology in Yonsei cardiovascular hospital from January 1996 to December 2000, 89 patients with pure ASD secundum were checked by the serial echocardiographic evaluation to measure the size change. Results : There was a statistical difference(P<0.05) in the rate of spontaneous closure and size change of the defect between the group of bigger defect(>8 mm) and the group of smaller defect (${\leq}8mm$). There was also a statistical difference(P<0.05) in the rate of spontaneous closure and size change of the defect between the group of younger than three years of age and the group of older than three years of age. The initial size of the defect and change of size were the significant influencing factors in the rate of spontaneous closing of ASD. In the group of patients who have persistent ASD, the size of defect showed a tendency of increasing size of defect with the age(P<0.005); however in the correction of these values by the body surface area of each patients, there was no statistical difference. Conclusion : The possibility of spontaneous closure of pure ASD secundum was higher in the group of patients who have smaller defect and who were younger. The ASD secundum that did not have spontaneous closure showed an increase in size with the growth of the patients; however when this size was corrected by the body surface area, there was no statistical difference. The closure of the defect was at 26.2 months of age so close follow-up of the patients is important.