• Journal of Chest Surgery
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• v.35 no.10
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• pp.705-711
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• 2002

The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.265-270
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• 2003

Purpose : To characterize the infants under 3 months of age with urinary tract infections(UTIs), and especially patients with bacteremia or meningitis Methods : Hospital records of all the infants under 3 months of age discharged from our hospital for 69 consecutive months with the diagnosis of initial episode of UTI were reviewed. UTI was defined when patients had fever with pyuria, and had urine culture results of ${\geq}10^5$ colony forming units/mL from a bag specimen. Patients with previously known urologic abnormality or immunodeficiency were excluded. Nosocomial infections were also excluded from the study. Results : The male:female ratio was 35 : 6. Of the urine cultures, 40(97.6%) yielded single pathogen, one yielded two pathogens. Escherichia coli was the predominant isolate from the urine. Five patients(12%) also had bacteremia. Pathogens isolated from the blood cultures were E. coli(4) and Enterococcus faecalis(1). No patient had culture-positive meningitis or cerebrospinal fluid pleocytosis. Clinical or laboratory findings between patients with and without bacteremia were not different significantly. The rate of vesicoureteral reflux(VUR) was 44%. The sensitivity of ultrasound for detection of VUR was 38%; specificity was 50%. Conclusion : Clinical and laboratory data were not helpful for identifying patients with bacteremia at the time of presentation. Consequently, blood cultures need to be obtained from all febrile infants under 3 months of age with UTIs. A large-scale study including the indication of lumbar puncture for infants with a febrile UTI and study of evaluation and treatment of infants under 3 months of age with UTIs are required.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.83-91
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• 2007

Purpose : Childhood primary VUR is generally diagnosed after urinary tract infection, is more prevalent among girls and has a low spontaneous resolution rate in cases of severe VUR. The aim of the present study is to examine the age and gender-related characteristics and the spontaneous resolution rate of infantile primary VUR. Methods : The medical records of 96 infants with primary VUR, diagnosed after their first UTI, were retrospectively reviewed(1995-2004). The clinical characteristics including gender, the degree of VUR and presence of renal scars were evaluated. The spontaneous resolution rate and contributing factors were also analyzed Results : Infantile primary VUR was more prevalent in males than females. The percentage of atrophic scarred kidney was significantly higher in males than females(17.2% vs 3.4%) (P<0.05). The cumulative spontaneous resolution rate in 3 years was very high(89.1%), and was not significantly different between gender and among VUR grades. But in the first year, the spontaneous resolution rate of severe refluxing ureters was significantly higher in males than in females(46.2% vs 7.1%)(P<0.05) and the spontaneous resolution rate of refluxing ureters with no scarred kidneys was significantly higher than those associated with atrophic scarred kidneys(76.6% vs 20%)(P<0.05). Conclusion : Infantile Primary VUR was more prevalent among males and tends to be associated with atrophic scarred kidneys In male infants. The cumulative spontaneous resolution rate in 3 years was very high, even in high-grade VUR and associated atrophic scarred kidneys. In infantile primary VUR, surgery should be withheld even in infants with high-grade VUR with atrophic scarred kidneys.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.447-463
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• 2007

Periodontal ligament (PDL) cells have been known as multipotential cells, and as playing an important rolesin periodontal regeneration. The PDL cells are composed of heterogeneous cell populations which have the capacity to differentiate into either cementoblasts or osteoblasts, depending on needs and conditions. Therefore, PDL cells have the capacity to produce mineralized nodules in vitro in mineralization medium which include ascorbic acid, ${\beta}$-glycerophosphate and dexamethasone. In spite of these well-known osteoblast like properties of PDL cells, very little is known about the molecules involved in the formation of the mineralized nodules in the PDL cells. In the present study, we analysed gene-expression profiles during the mineralization process of cultured PDL cells by means of a cDNA microarray consisting of 3063 genes. Nodules of mineralized matrix were strongly stained with alizarin red S on the PDL cells cultured in the media with mineralization supplements. Among 3,063 genes analyzed, 35 were up-regulated more than two-fold at one or more time points in cells that developed matrix mineralization nodules, and 38 were down-regulated to less than half their normal level of expression. In accord with the morphological change we observed, several genes related to calcium-related or mineral metabolism were induced in PDL cells during osteogenesis, such as IGF-II and IGFBP-2. Proteogycan 1, fibulin-5, keratin 5, ,${\beta}$-actin, ${\alpha}$-smooth muscle actin and capping protein, and cytoskeleton and extracellular matrix proteins were up-regulated during mineralization. Several genes encoding proteins related to apoptosis weredifferentially expressed in PDL cells cultured in the medium containing mineralization supplements. Dkk-I and Nip3, which are apoptosis-inducing agents, were up-regulated, and Btf and TAXlBP1, which have an anti-apoptosis activity, were down-regulated during mineralization. Also periostin and S100 calciumbinding protein A4 were down-regulated during mineralization.

• Clinical and Experimental Pediatrics
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• v.50 no.2
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• pp.170-177
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• 2007

Purpose : Clinicopathological features were investigated to clarify the outcome and prognostic indicators for patients with IgA nephropathy in Korean children. Methods : We reviewed the outcomes of 61 patients in whom IgA nephropathy was diagnosed before the age of 15 years from 1991 to 2005 and followed-up at least for one year. All patients were confirmed by renal biopsy. Results : After mean follow-up of 5.2 years from onset, 24 patients of 61 (39.3%) were in clinical remission at the last examination. Thirty patients (49.2%) had hematuria or mild proteinuria (<$1g/m^2/d$), five (8.2%) had severe proteinuria (${\geq}1g/m^2/d$), and two (3.3%) had chronic renal failure. By univariate analysis, initial presentation at onset and Haas classification were less concordant with outcome. Hypertension during follow-up, rather than hypertension at presentation, was significantly correlated with outcomes (P<0.01). Sixty percent of patients who had more than 20% of glomerular sclerosis or crescent progressed to severe proteinuria or chronic renal failure, as compared with 7.1% of those who did not (P<0.01). Conclusion : Prognosis of childhood IgA nephropathy had a relatively benign course during a mean follow-up of 5.2 years. Persistent hypertension during follow-up and more than 20% of glomerular sclerosis or crescent were strong predictors of a progressive course of IgA nephropathy. A new histologic classification according to characteristics of childhood IgA nephropathy must be established to assess prognosis. Further efforts should be made to understand the prognosis of IgA nephropathy through long-term follow-up.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.29-35
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• 2014

Introduction: Persistent vesicoureteral reflux (VUR), a major cause of urinary tract infection (UTI) in children, can result in serious renal complications, such as reflux nephropathy and chronic renal failure. We evaluated the clinical characteristics and prognostic factors of VUR. Methods: From December 1993 to May 2011, we examined 117 children with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Chungbuk National University hospital for a UTI. The patients were managed medically or surgically. Results: Male patients had a slightly higher prevalence of VUR than female patients (55%). The degrees of the 161 refluxing ureters, as classified by the International Reflux Study Committee, were as follows: grade I, 15 ureters; grade II, 32 ureters; grade III, 54 ureters; grade IV, 26 ureters; grade V, 34 ureters. One hundred and sixty-one renal units (115 cases) underwent a 99m TC-DMSA renal scan, and 62% showed abnormal findings. The incidence of renal cortical defects showed a direct correlation with the severity of VUR. Ninety-four refluxing ureters were followed up medically, and 66 ureters (67%) either disappeared or improved. However, 9 refluxing ureters persisted. The spontaneous resolution rate of VUR seemed to be higher in younger patients with lower grades of reflux, and without renal cortical defects. Sixty-seven refluxing ureters (41%) were treated surgically, 62 refluxing ureters (92%) disappeared, and 5 refluxing ureters (8%) persisted. Conclusion: The incidence of renal cortical defects in patients with UTIs was 62% (in a 99m TC-DMSA renal scan), and showed a direct correlation with the severity of VUR. The spontaneous resolution rate seemed to be lower in the patients with higher grades of VUR, older age (over 4 years old) and diffuse renal cortical defects.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.661-674
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• 2005

The purpose of this study was to quantify and compare the level of MMP-2, MMP-8 in the healthy, inflammed gingival tissue and inflammed gingival tissue associated with type 2 DM. We investigate whether expression of MMP-2, MMP-8 is increased by chronic periodontitis associated with type 2 DM. Gingival tissue samples were obtained during periodontal surgery or tooth extraction. Based on patient's systemic condition & clinical criteria of gingiva, each gingival samples were divided into three groups. Group l(n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from 8 systemically healthy patients. Group 2(n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3(n=8) is inflammed gingiva from type 2 diabetic patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of MMP-2, MMP-8 was performed using a densitometer and statistically analyzed by ANOVA. MMP-2, MMP-8 was expressed in all samples including healthy gingiva and increased in group 3 compared to group 1 and 2, and showed that significant variation was observed between group 1 & 3 in MMP-8 results. In conclusion, this study demonstrated that human gingival tissue with chronic periodontitis associated to type 2 diabetes showed slightly elevated MMP-2, MMP-8 levels compared to healthy gingiva and non-diabetic inflamed gingiva.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.34-43
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• 2009

Purpose: Glomus tumors are rare benign vascular tumors, usually located in the skin or soft tissue of extremities. Approximately 30-50% of glomus tumors occur in subungal area, but glomus tumors have been described in every location even where glomus bodies are not or rarely present. The purpose of this study was to identify clinical, histologic and MRI characteristics of soft tissue glomus tumor. Materials and Methods: Between 1993 and 2008, eight patients underwent surgery of soft tissue Glomus tumor at our institution. Exclusion criteria were patients with Glomus tumors in digits, stomach, trachea and glomus tympanicum. We analyzed medical records, interviews, physical examinations, MR findings and histolocial types retrospectively. Results: There were four men and four women. The mean age was fourty-seven years. The mean prevalence time was eight-point-nine years. In the classic triad of symptoms, all eight patients had pain and tenderness. Two patients complained of cold sensitivity. Two showed skin color changes. After surgery, two showed symptom improvement (VAS $9^{\circ}{\rightarrow}8$, $8^{\circ}{\rightarrow}5$) and?six showed complete disappearance of symptoms. Slightly symptom improvemented (VAS $9^{\circ}{\rightarrow}8$) one had additional surgery two times after first surgery due to relapse/remaining Glomus tumor. The mean size was 13.9 mm. In histology, six were 'solid glomus tumor', one was a mixture of 'solid glomus tumor' and 'lomangioma' and one was 'malignant glomus tumor'. MR findings showed isointense signal on T1 image, high signal on T2 image and strong enhancement on the Gadolinium enhanced image. Conclusion: Glomus tumor has low recurrence rate and malignant change, rapid diagnosis and surgical excision is critical in treatment to prevent unnecessary pain of patient.

• Korean Journal of Heritage: History & Science
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• v.42 no.1
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• pp.100-121
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• 2009

This study is subjected to those gardens of the Korean Folk Village 'Oeam-Ri' designed in 1920s. - transitional period of traditional gardens - and define socio-cultural change's influences and through documents on garden design, descendant's testimony and measured drawings, to understand that period's garden culture's characteristics according to garden design elements. This study applied following analysis methods and procedures to derive out characteristics of transitional garden culture. Analysis on socio-cultural characteristics in 1920s. Analysis on actual condition of transitional garden's design. In this point Outline of the Garden, Space formation, Garden designing elements are (1) water landscape, (2) plant, (3) structures, (4) paving, to derive out characteristics of the transitional garden. The results follow as below; First, during the transitional period 1920s, the economical development, fueled by opening nation's door to foreign countries and indication of collapse of statue systems together with idea of practical science and Enlightenment Thought, was element of changes in garden style. Second, Garden Designers of transitional gardens in 'Oeam-Ri' were limited to upper class of the society. They were wealthy enough to maintain their high social statue in rapidly changing society. As results, tendency of returning to nature developed gardens located in a site of scenic beauty and development of geographical features arranging techniques, and also showed copying foreign styles. Third, arrangement of garden and space composition, in most cases, composed of buildings and yards. Changes in water landscape features and garden spaces are centered to main-yard. Major changes of the garden spaces are water landscapes and plants that showing foreign influences. Fifth, scenic appearance techniques appears with dense garden space and emphasizing visual scenic view. Sixth, the characteristics of transitional garden design techniques are development of geographical feature arranging techniques, changes and mixture of the materials and garden types, emphasizing garden's decorative beauty, change of concept of yard within house into garden, changes from 'borrowing of landscapes' to 'selecting landscapes', changes of front garden from emptiness to fullness, changes of attitudes of enjoying gardens from 'staying calm in the garden' to 'moving or walking in the garden', changes to inner-oriented view, and changes from 'just watching and enjoying the nature' to 'enjoying specific objects'. This study is one of the efforts to restore the identity of Korean Traditional Garden by approaching and observing modern era which function as bridge between tradition and present day, and we observed transitional aspects of changes of traditional garden into modern garden. Hereafter, more studies will be needed to Modern Garden Design be recognized as part of Korean Garden Design History and these would be author's next assignment.

• Korean Journal of Heritage: History & Science
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• v.39
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• pp.165-189
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• 2006

The purpose of this study is to examine process and organization of local government-managed construction by reviewing official documents and materials in regard to the official residences and castles officially constructed in Dongnae in the 19c Chosun Dynasty. Results of this study can be described as follows. 1) The construction of official residences requires exchanges of official documents among upper and lower governmental agencies concerned. Previously prepared for some 1 or 2 months, the construction was proceeded through proceeded from Paok to Gaegi, Ipju, Sangryang, Gaeok and to Iptaek. Such construction was carried out independently and concurrently Gijang and Yangsan neighboring Dongnae provided cooperation by way of supplying labor and timbers. 2) Dongnaebu castle was constructed under local autonomy system, like other government-oriented works, as governor of Dongnae became responsible for defending such establishment in 1739. The castle was built up in 1731 as an establishment with 6 gated and 15 forts. Directly controlled by governor of Dongnae, the castle continued to be partially repaired until the 19th century. Under the regime of Daewongun, the castle was enlarged and extended for military strengthening. Besides the gate having double-gated structure for the outside wall, the other five gates came to have bastions and 30 forts were additionally established, dramatically changing the structure of the castle as whole. 3) Government-managed construction was often implemented by an organization whose members included local government officials, lower administrative agencies and local influential persons. The construction of official residences was implemented by Gamyeokdogam which was headed by Jwasu of Hyangcheong. In the construction, chief of military officials became supervisor, who was responsibly supported by Saekri. The construction of castled were divided into several works, for example, establishments of fortress, tower gate and quarrying stone were implemented by the organization of Paejang, Gamkwan and Saekri. As a military official, Gamkwan supervised the construction. Saekri was in charge of related internal affairs. Paejang was an technical expert leading several workers. The construction of castles in 1870 were organized as a general rule having particularity of social conditions on Dongnae.