• Journal of Korean Ophthalmic Optics Society
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• v.20 no.3
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• pp.341-347
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• 2015

Purpose : This study was to examine a correlation of response AC/A ratio by additional spherical powers with PD(Pupilary distance) and relative accommodation, and was to investigate correlation of CA/C ratio by prism powers. The mean differences between a reciprocal response AC/A ratio and a CA/C ratio were compared, and were suggested to be used as data in the refractive power and prism prescriptions in the clinical. Methods: The open field autorefractometer (Nvision-K 5001, Shin nippon) and Howell target at 40 cm fixation distance to 62 persons with average $22.62{\pm}2.84$ ages were used to measure the response AC/A ratio according to additional Spherical powers. The CA/C ratios were measured using the DOG card at 40cm according to prism powers. Results: When the response accommodation according to Additional Spherical power changes and the response accommodation according to prism power changes were compared, it was larger than the response accommodation according prism power change. These were significant differences statistically. The correlation of response AC/A ratio and PD is showed as r = -0.158, the CA / C ratio is shown as r = 0.093. The correlation of response AC/A ratio and relative accommodation showed as r = -0.253, the CA/C ratio showed as r = 0.566 that is predictable correlation. The correlation of response AC/A ratio and CA/C ratio showed as r = -0.355 that is low minus correlation (p = 0.000). The difference between a reciprocal response AC/A ratio and a CA/C ratio showed $0.12{\pm}0.06D/{\Delta}$ with a significant difference statistically (p=0.000). Conclusions: The correlation of relative accommodation and CA/C ratio showed that depend on the individual, The more a relative accommodation is, the higher a response accommodation of convergence by convergence stimulus is. The reciprocal response AC/A and CA/C ratio showed significant differences statistically. This can have higher CA/C ratio in patients with low AC/A ratio in clinical as an independent variable. Thus when the abnormal binocular vision was prescribed in the clinical, it is necessary to consider the accommodative response even if the AC/A ratio is a normal range.

• 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.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.330-338
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• 2009

Purpose : The causes of acute lower respiratory tract infection (ALRTI) are mostly attributable to viral infection, including respiratory syncytial virus (RSV), parainfluenza virus (PIV), influenza virus A/B (IFV A/B), or adenovirus (ADV). Several Korean studies reported human metapneumovirus (hMPV) as a common pathogen of ALRTI. However, studies on seasonal distribution and clinical differences relative to other viruses are insufficient, prompting us to perform this study. Methods : From November 2006 to October 2007, we tested nasopharyngeal aspiration specimens in children hospitalized with ALRTI with the multiplex reverse transcriptase-polymerase chain reaction to identify 6 kinds of common pathogen (hMPV, RSV, PIV, IFV A/B, and ADV). We analyzed positive rates and clinical features by respiratory chart review. Results : We detected 38 (8.4%) hMPV-positive cases out of 193 (41.8%) virus-positive specimens among 462 patients. HMPV infection prevailed from March to June with incidence peaking in April. HMPV-positive patients were aged 15 years (76.3%), and the ratio of boys to girls was 1.2:1. The median age was 27 months. HMPV primarily caused pneumonia (76.3 %) (P=0.018). Average hospitalization of HMPV-associated ALRTI patients was 5.8 days. In addition, they showed parahilar peribronchial infiltration (100%) on chest X-ray, normal white blood cell count (73.7%), and negative C-reactive protein (86.8 %) (P>0.05). All hMPV-positive patients recovered without complication. Conclusion : HMPV is a common pathogen of ALRTI in Korean children, especially in 1-5 year olds, from March to May. Immunocompetent children diagnosed with hMPV-associated ALRTI may have a good prognosis.

• Investigative Magnetic Resonance Imaging
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• v.17 no.4
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• pp.267-274
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• 2013

Purpose : To re-evaluate additional clinical significance of the apparent diffusion coefficient (ADC) map in the inference of infarction stage, authors studied the evolution patterns of the DWI and the ADC map of the brain infarction. Materials and Methods: In 127 patients with cerebral infarctions, including follow-up checks, 199 studies were performed. They were classified as hourly (117 studies)-, daily (108 studies)-, weekly (62 studies)-based groups. The signal intensity (SI) was measured at the core of the infarction and contralateral area with ROI of 0.3 $cm^2$ or more on the images of the DWI and the ADC map, and calculated the ratios of SI and ADC value of the infarction area / contralateral normal area, and compared the patterns of the change according to the evolution. Results: Infarction was detected as early as 1 hour after the attack, and the ratio of SI in the DWI became over than 2 after 12 hours, which showed a plateau until the 6th day. Thereafter, it decreased slowly to 1 on the 30th day, and changed to lower SI than the surrounding brain. The ratio in the ADC map became 0.46 in 24 hours after the attack, and increased slowly to 1 in the 15th day. Thereafter, it became a higher value than the surrounding brain. Overall, the ratio in the ADC map changed earlier than in the DWI, and the ratio curves showed inverse pattern each other according to the evolution of the infarction. Conclusion: The evolution patterns of infarction on the ADC map showed an inverse curve of DWI curve, which means that the ADC value is accurately predictable from DWI, and the ADC map joined with the DWI seems helpful in the determination of subacute infarction between 15 to 30 days.

• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.995-1004
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• 2007

Purpose : Kawasaki disease is a systemic vasculitis, leading cause of pediatric acquired heart disease. Vascular endothelial growth factor (VEGF) has functions as vascular permeability factor, plays an important role in coronary artery lesion (CAL). We studied the clinical significance of serum VEGF in Kawasaki disease. Methods : Kawasaki group was 49 patients, and control group was 15 patients. Diagnosis followed AHA (American Heart Association) diagnostic criteria, with blood sampling in acute, subacute, and convalescent phase. Echocardiographic abnormalities were defined and the definition of intravenous gamma globulin (IVGG)-responsive and IVGG-resistant was determined. Results : Serum VEGF of Kawasaki group was significantly higher than of control group. Comparison of serum VEGF between CAL and non-CAL group, between carditis group and non-carditis group showed no significant differences. Subacute serum VEGF was statistically higher in IVGG-resistant group than in IVGG-responsive group, and serum VEGF of IVGG-resistant group in subacute phase was statistically higher than in the other phases. Serum VEGF of convalescent CAL and non-CAL group in acute and subacute phase had meaningful differences. Total fever duration and subacute serum VEGF had positive correlation. Acute serum VEGF had positive correlation with ESR and CRP, all phases serum VEGF had also positive correlation with WBC. Acute and subacute serum VEGF had negative correlations with hemoglobin and albumin. Conclusion : Serum VEGF can help to determine the severity of Kawasaki disease, especially subacute serum VEGF seems to be used as a prognostic factor of coronary complication. Afterward, further studies needed with more strict diagnostic criteria and more study groups.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.51-58
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• 1993

We tried to establish the theoretical basis of clinical use of combined modality of hyperthermia and radiation therapy. For this purpose, we made an in vitro experiment in order to get the synergistic and/or additive effects on the cell killing of hyperthermia combined with radiation therapy by using the microwave-hyperthermia machine already installed at our department. In our experiment, we use two human cell lines: MKN-45 (adenocarcinoma of stomach) and K-562 (leukemia cell lines). In cases of combined treatments of hyperthermia and gamma-irradiation, the therapeutic effect was the highest in the simultaneous trial. Hyperthermia after gamma irradiation showed slightly higher therapeutic effect than that before irradiation without significant difference, but its effect was the same in the interval of 6 hours between hyperthermia and irradiation. The higher temperature and the longer treatment time were applied, the higher therapeutic effects were observed. We could observe the thermoresistance by time elapse at $43^{\circ}C$. When hyperthermia was done for 30 minutes at the same temperature, thermal enhancement ratio (TER) at DO. 01 (dose required surviving fraction of 0.01) were $2.5{\pm}0.08,\;3.75{\pm}0.18$, and $5.0{\pm}0.15\;at\;436{\circ}C,\;44^{\circ}C,\;and\;45^{\circ}C$ respectively in K-562 leukemia cell lines. Our experimental data showed that more cell killing effect can be obtained in the leukemia cell lines, although they usually are known to be radiosensitive, when treated with combined hyperthermia and radiation therapy. Furthermore, our data show that leukemia cell lines may have various intrinsic radiosensitivity, especially in vitro experiments. The magnitude of cell killing effect, however, will be less than that of MKN-45.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.105-110
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• 2006

A three-layer, feed-forward artificial neural network (ANN) with sixteen input neurons, three hidden neurons, and one output neuron was developed to identify the presence of infectious bronchitis (IB) infection as early as possible in laying hen flocks. Retrospective data from flocks that enrolled IB surveillance program between May 2003 and November 2005 were used to build the ANN. Data set of 86 flocks was divided randomly into two sets: 77 cases for training set and 9 cases for testing set. Input factors were 16 epidemiological findings including characteristics of the layer house, management practice, flock size, and the output was either presence or absence of IB. ANN was trained using training set with a back-propagation algorithm and test set was used to determine the network's capability to predict outcomes that it has never seen. Diagnostic performance of the trained network was evaluated by constructing receiver operating characteristic (ROC) curve with the area under the curve (AUC), which were also used to determine the best positivity criterion for the model. Several different ANNs with different structures were created. The best-fitted trained network, IBV_D1, was able to predict IB in 73 cases out of 77 (diagnostic accuracy 94.8%) in the training set. Sensitivity and specificity of the trained neural network was 95.5% (42/44, 95% CI, 84.5-99.4) and 93.9% (31/33, 95% CI, 79.8-99.3), respectively. For testing set, AVC of the ROC curve for the IBV_D1 network was 0.948 (SE=0.086, 95% CI 0.592-0.961) in recognizing IB infection status accurately. At a criterion of 0.7149, the diagnostic accuracy was the highest with a 88.9% with the highest sensitivity of 100%. With this value of sensitivity and specificity together with assumed 44% of IB prevalence, IBV_D1 network showed a PPV of 80% and an NPV of 100%. Based on these findings, the authors conclude that neural network can be successfully applied to the development of a screening model for identifying IB infection in laying hen flocks.

• 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.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.137-146
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• 2006

Purpose : A regional lymphadenitis is the most frequent adverse reaction of BCG. In order to find out developmental factors and establish a strategy of management, we investigated the clinical courses of children with lymphadenitis following BCG on the aspect of BCG strains, suppurative rates according to the sizes of lymph node and the clinical difference with or without treatment. Methods : From January 1997 to June 2004, 52 children less than 24 month-age-old diagnosed as BCG lymphadenitis in Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea were enrolled. The type of BCG strain, place of vaccination, location and size of lymphadenitis were assessed with medical records, retrospectively. Finally, we analysed the correlations between BCG strains or the sizes of lymph node and natural remission or suppuration. Results : The first detected mean age of BCG lymphadenitis was 5.5 month-age. The larger of the measurement was at the first visiting, the younger of age that was first presented. The most frequent location was the same sided axillary region of BCG injection. Among 52 subjects, 46 cases(88.5%) were vaccinated with intradermal Pastuer strain, and only 5 cases(9.6%) were done with percutaneous multipunctured Tokyo strain. Twenty eight cases(53.8%) were regressed naturally, otherwise 24 cases(46.2%) were suppurated. The larger those were sized, the higher freqeuncies those were suppurated on, significantly. Treatment with medications could not prevent the suppuration and could not shorten the healing periods. Conclusion : We predict that there are differences between the occurrent rate of BCG lymphadenitis and BCG strains or methods. Treatment with medication is not recommended owing to its ineffectiveness. Especially, in case of non-suppurative lymphadenitis should be onlyless influence on the tuberculin skin test, cause less adverse reactions, and is inexpensive. observed without treatment, because it could be regressed naturally. An ideal BCG makes a scar, We should make an effort to choose the best BCG strain that can fulfill such requirements.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.161-167
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• 1998

Purpose: Segmental parenchymal excretion delay on Tc-99m DISIDA scan is caused by intrahepatic bile duct obstruction. However, the diagnostic value for intrahepatic bile duct obstruction is unknown. We conducted this study to assess the positive predictive value of segmental excretion delay for the diagnosis of intrahepatic bile duct obstruction, and additional benefit over other noninvasive radiologic studies. Materials and Methods: The study population consisted of 43 patients (48 scans) who showed segmental parenchymal excretion delay on Tc-99m DISIDA scan. The results of abdominal CT or ultrasonography, which was done within 1 month of Tc-99m DISIDA scan, were compared with scintigraphic findings. Results: The etiology of segmental parenchymal excretion delay was determined by ERC or PTC in 31 scans, and follow-up studies in 13 scans. No causes were identified in 4 scans. The positive predictive value of segmental parenchymal excretion delay for intrahepatic bile ductobstruction was 92% (44/48). On the other hand, 13% (5/38) of CT and 28% (5/18) of ultrasonography were normal. In 18% (7138) of CT and 17% (3/18) of ultrasonography, only intraheipatic bile duct dilatation was noted without any diagnostic findings of intrahepatic bile duct obstruction. Conclusion: Segmental parenchymal excretion delay on Tc-99m DISIDA scan had a high positive predictive value for the diagnosis of intrahepatic bile duct obstruction. Tc-99m DISIDA scan may be useful for the diagnosis of intrahepatic bile duct obstruction, especially in patients with nondiagnostic CT or ultrasonography. The diagnostic usefulness need to be confirmed by further prospective studies.