• Journal of radiological science and technology
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• v.39 no.1
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• pp.1-11
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• 2016

The purpose of this study was to provide resources for medical exposure reduction through evaluation of organ dose and image resolution for lumbar spine around according to the size of the collimator in DR system. The size of the collimator were varied from $8^{\prime\prime}{\times}17^{\prime\prime}$ to $14^{\prime\prime}{\times}17^{\prime\prime}$ by 1" in AP and lateral projection for the lumbar spine radiography with RANDO phantom. The organ dose measured for liver, stomach, pancreas, kidney and gonad by the glass dosimeter. The image resolution was analyzed using the Image J program. The organ dose of around lumbar spine were reduced as the size of the collimator is decreased in AP projection. There were no significant changes decreasing rate whenever the size of the collimator were reduced 1" in the gonad. The organ dose showed higher on liver and kidney near the surface in lateral projection. There were decreasing rate of less than 5% in liver and kidney, but decreasing rate was 24.34% in the gonad whenever the size of the collimator were reduced 1". Organ dose difference for internal and external of collimator measured $549.8{\mu}Gy$ in the liver and $264.6{\mu}Gy$ in the stomach. There were no significant changes organ dose difference that measured $1,135.1{\mu}Gy$ in the gonad. Image Quality made no difference because SNR and PSNR were over than 30 dB when the collimator size is less than $9^{\prime\prime}{\times}17^{\prime\prime}$ on AP projection and $10^{\prime\prime}{\times}17^{\prime\prime}$ on lateral projection. Therefore, we are considered that the recommendations criterion for control of collimator were suggested in order to reduce unnecessary X-ray exposure and to obtain good image quality because lumbar spine radiography contains a lot of peripheral organs rather than other area radiography.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1306-1315
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• 1996

This study reviewed the changes of hemodynamlcs and centrAl pulmonary artery dimension in 54 patients who underwent bidirectional cavopulmonary shunt(BCPS) between February 1992 and December 1995 at Seoul National University Childrell's Hospital. Ag and body weight of patients averaged 36.8 $\pm$ 37.7 months and 8.0$\pm$3.0 kg, respectively Eightynine percent of patients had more than 2 violations of the risk factors for Fontan operation, resulting overall hospital mortality of 16.6%(9154). Serial hemodynamic and anglographic examinations before and mean 16.3 $\pm$ 14.3 months iirter BCPS were compared. The arterial oxygen saturation improved from a preoperative value of 71 9: 10.1 % to 79.H $\pm$ 8. 5% (n:4), p<0.05). The values of arterial oxygen saturation were lower as the age of the patients with BCPS in place was older(n=22, R'=0.341, p=0.004). A mean pulmonary artery pressure and pulmonary vascular resistance reduced from 31 $\pm$17 to 1).5$\pm$3.SmmHg(n=22, p<0.05) and from ).2$\pm$2.1 to 2.3$\pm$2.7 unit (n=7. p>0.05), respectively. Follow-up study showed a significant Increase of absolute values of ipsilateral pulmoanry artery (n: 14, p<0.05), but no change of contralateral pulmonary artreries (n: 14. p=not significant(HSI). However, there w re significant decreases in diameters of both ipsilateral and contralateral pulmonary arteries standardized by patients' body surface areas(16.8% decrease, n: 14, p< 0. 05 for ipsilatreal, 25.1%, n=14, p<0.05 for contralateral). Pulmonary artery indices for cross sectional areas of both pulmonary arterises decreased 9.3 $\pm$ 13.8% with showing a trend of more decrease as the follow-up duration was longer, We conclude that the bidirectional cavopulmonary shunt provide an excellent.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.311-317
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• 1991

Ten patients with deep muscle-invading bladder carcinoma (clinical stages T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the tumors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a, 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60$\%$ for all patients. The complete responses were achieved in 4 of 5(80$\%$) with stage cT3a, in 2 of 3(67$\%$)with stage cT3b and in none of 2(0$\%$) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80$\%$. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher grade tumors showed partial responses in 2 and no response in 2, and all died of their bladder cancer. Six patients who showed complete responses after treatment are alive and only one of them showed a local recurrence 10 months after treatment. Distant metastases developed in 3 patients: lungs in 2(cT4b) of those who were never locally free of disease and spine in 1 patient (cT3b) among those with a partial response. Two patients died of metastases to lungs. During the follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.

• Neonatal Medicine
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• v.15 no.1
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• pp.80-83
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• 2008

Purpose : Inguinal hernias are common in children and sometimes are associated with dangerous complications, such as incarceration. There are no established management guidelines for ovarian hernias. We have reviewed the clinical course of ovarian hernias in infants. Methods : We reviewed the medical records of female infants diagnosed with ovarian hernias by ultrasonogram at Kwandong University College of Medicine, Cheil General Hospital, and the Women's Healthcare Center between March 2001 and August 2007. We analyzed the patients gestational age, birth weight, age at the time of detection of the inguinal mass, the patients chief complaints, operative time, post-operative complications, and ultrasonographic findings. Results : Eight female infants had ovarian hernias, four of whom were born prematurely. Seven infants had left-sided ovarian hernias, and one infant had a right-sided ovarian hernia. Five infants underwent surgery and there were no postoperative complications or recurrences. Three girls did not have surgery, and the ovarian hernias regressed spontaneously, with no recurrences or complications. The regression time of inguinal masses ranged from 70-161 days after birth. Conclusion : Physical examination to detect movable masses within the labium major in premature female infants is important because the incidence of premature inguinal hernias is much higher than in term infants. No rational medical treatment plans for female ovarian hernias have been published to date. We cared for three girls with spontaneous regression of ovarian hernias. Pediatricians should be aware whether emergent surgery for ovarian hernias is indicated.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.31-38
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• 2006

Purpose: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. Methods: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. Results: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). Conclusion: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.154-163
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• 2015

Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.79-86
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• 2017

Purpose: This study was aimed at analyzing the serotypes of group B streptococcus (GBS) isolated from Korean infants with invasive disease and evaluating their association with disease manifestation. Methods: Data were retrospectively collected from invasive GBS infections at Gachon University Gil Medical Center from January 2006 to June 2012 and at Samsung Medical Center from April 2010 to November 2012. Serotypes were determined by slide agglutination test. Results: A total of 37 cases were identified, which included 22 full-term infants and 15 preterm infants. Fifteen cases (40.5%) were early-onset, 19 (51.4%) was late-onset, and three (8.1%) was very late-onset. Early-onset diseases among preterm infants were higher than those among full-term infants (60.0% [9/15] vs. 27.3% [6/22], P=0.17). The most common manifestation was bacteremia (70.3%), followed by meningitis and septic arthritis. Among 24 isolates retrievable for serotyping, serotype III (41.7%) was most common, followed by V (16.7%), Ia, Ib, and II (12.5%, respectively), and non-typeable (4.2%). Serotype III was more common in isolates from full-term infants (10/22) than from preterm infants (0/15), whereas serotype V was more common in isolates from preterm infants (4/15) than from full-term infants (0/22) (P=0.002). No penicillin-resistant strain was detected, and resistance to erythromycin and clindamycin were both 64.9%. Conclusions: GBS is an important pathogen in both preterm and full-term infants, and serotype distribution of GBS causing invasive diseases can differ between preterm and full-term infants. It is necessary to monitor the nationwide epidemiology of GBS diseases, including in preterm infants, in order to prepare preventive measures without underestimating early-onset diseases.

• Childhood Kidney Diseases
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• v.14 no.1
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• pp.42-50
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• 2010

Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.

• Journal of muscle and joint health
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• v.3 no.1
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• pp.90-103
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• 1996

The purpose of this paper is to compare two approach to assessment of coping patterns. The sampling method was a purposive sampling technique. The study participants were out patients 113 of rheumatoid arthritis center of one University hospitals in Seoul. Datas were collected from Nov. 13 to Nov. 24, 1995. The instruments used for this study were Graphic Rating Scales of pain, The Beck Depression Inventory and Coping Patterns tool. The collected data were analyzed for frequency, means, SD, factor analysis., Pearsons' correlations and ANOVA. The results were summerized as follows ; 1. When raw scores were used : there were not correlation in all three coping patterns. 2. When relative scores were used : there were significantly correlated in all three coping patterns. 1) Active coping and Positive-cognitive coping (r=-0.352, p< 0.0001) 2) Positive-cognitive coping and Negative-cognitive coping (r=-0.594, p< 0.0001) 3) Active coping and Negative-cognitive coping(r=-0.544, p< 0.0001) The results of this research with relative scales provided more insight into the correlation in all three coping patterns. 3. Pearsons' Correlations were computed for each coping pattern, age, pain level, duration of pain and BDI. 1) Using raw score : (1) Active coping was significantly related to pain level(sensory score ; r=0.268, p<0.05, affective score ; r=0.266, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r=-0.252, p< 0.05), pain level (sensory score ; r= -0.244, p< 0.05) (3) Negative-cognitive coping was significantly related to depression level (r=0.312 p< 0.0001). 2) Using relative score (1) Active coping was significantly related to pain level(sensory score ; r=0.299, p<0.05, affective score ; r=0.246, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r= -0.187, P< 0.05), pain level (sensory score ; r=-0.317, p<0.0001, affective score : r=-0.305, p<0.0001) and depression level(-0.339, p<0.0001)) (3) Negative-cognitive coping was significantly related to depression. level(r=0.313, p<0.0001). 4. When raw and realtive coping scores were compared to those of age groups, religious groups and BDI level(high, middle, low) ; 1) Using raw score : (1) Active coping : there were not significantly difference (2) Positive-cognitive coping ; 20-39 age group and 50-59age group had significantly higher scores than over 60age group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping : 20-39age group and over 60age group had significantly higher scores than 40-49age group. Non-religious group had significantly higher scores than christian group. BDI-high level group had significantly higher scores than other groups. 2) Using relative score : (1) Active coping : over 60 age group had significantly higher scores than 20-39 age group and 40-49age group had significantly higher scores than 20-39 age group (2) Positive-cognitive coping ; 40-49age group, 20-39age group and 50-59age group had significantly higher scores than over 60age group. Christian group had significantly higher scores than non-religious group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping ; Non-religious group had significantly higher scores than christian group and buddhistic group. BDI-high level group had significantly higher scores than other groups. The current data suggest that relative scores may yield a different perspective on coping patters than raw scores. The use of relative scores reveals the relation clearly, without its being blurred statistically by the effect of other coping strategies or being relegated to a partial correlation. The use of relative scores holds promise for delineating the relations between ways of coping and health-related behavior.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.353-359
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• 2000

Purpose: Although ${\alpha}$-fetoprotein is one of the most commonly used tumor markers in Korea, most of the radioimmunoassay kits for ${\alpha}$-fetoprotein have been imported from foreign countries. The purpose of this study was to evaluate the performance of a recently developed domestic immunoradiometric kit for ${\alpha}$-fetoprotein (Riakey AFP IRMA $CT^R$, Sin-Jin Medics, Seoul, Korea). Materials and Methods: We evaluated intra- and inter-assay precision, recovery rate, parallelism, and sensitivity of serum ${\alpha}$-fetoprotein measurement using Riakey AFP IRMA $CT^R$ kit. The values of ${\alpha}$-fetoprotein measured by Riakey AFP IRMA $CT^R$ kit were compared with those measured by two foreign commercial kits (${\alpha}$-fetoproteina of Radim and ${\alpha}$-feto.riabead of Abbott). Results: Intra-assay coefficients of variation on three different levels were 5.3% for 18.9 ng/ml, 3.4% for 133 ng/ml and 1.6% for 330 ng/ml. Inter-assay coefficients of variation were 9.7% for 20.9 ng/ml, 3.2% for 137 ng/ml and 4.1% for 330 ng/ml respectively. Recovery rate tests on all three different levels showed within $100{\pm}10%$. Parallelism was also good and the sensitivity was 0.63 ng/ml. There was strong correlation between the measurement of ${\alpha}$-fetoprotein by Riakey AFP IRMA $CT^R$ and that by two foreign commercial kits(r=0.98). Conclusion: The first Korean domestic immunoradiometric kit for ${\alpha}$-fetoprotein, Riakey AFP IRMA $CT^R$, performed well for clinical use.