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Minimal Invasive Surgery: A National Survey of Its Members by the Korean Association of Pediatric Surgeons (최소 침습 수술: 대한소아외과학회 회원을 대상으로 한 전국조사)

  • Kim, Dae Yeon;Kim, I.S.;Kim, H.Y.;Nam, S.H.;Park, K.W.;Park, W.H.;Park, Y.J.;Park, J.H.;Park, J.Y.;Park, J.S.;Park, J.Y.;Boo, Y.J.;Seo, J.M.;Seol, J.Y.;Oh, J.T.;Lee, N.H.;Lee, M.D.;Jang, J.H.;Jung, K.H.;Jung, S.Y.;Jung, S.E.;Jung, S.M.;Jung, E.Y.;Jung, J.H.;Cho, M.J.;Choi, K.J.;Choi, S.J.N.;Choi, S.O.;Choi, S.H.;Choi, Y.M.;Hong, J.
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.1-6
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    • 2014
  • Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).

Image analysis of Specialized Vocational high school recognized by middle school student (중학생이 인식하는 특성화 고등학교 이미지 분석)

  • Kim, Yeong-Hun;Kim, Tae-Hoon
    • 대한공업교육학회지
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    • v.38 no.2
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    • pp.114-135
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    • 2013
  • The purpose of this study is to provide base line data for right concept and identity establishment of Specialized Vocational high school, to identify recognition of Specialized Vocational high school, to analyze image of Specialized Vocational high school recognized by middle school student. The population was all middle school third year students in Korea. Using random sampling technique, 50 classes of 61 schools were sampled for the study. A survey questionnaire used Semantic Differential(SD) suggested by Osgood(1957). SD consisted of a number of adjective pairs, finally, this study used 11 adjective pairs to have validity. 1,198 out of 1,441 questionnaire were returned (a return rate of 83.14%), among which 935 were used for the analysis after data cleaning. An alpha level of 0.05 was established a prior for determining significance. All data analysis was accomplished using the SPSS 20.0 Win. Based on the finding of the study, the major results of the this study were as follows : 1. Higher average is female students' image of Specialized Vocational high school than male students' that, but, The difference between the two samples was not statistically significant. 2. It was only 20% that receive career education of Vocational high school. It is necessary to accomplish and expand career education of Specialized Vocational high school for proper career education from middle school, to realize career exploration and decide one's career path based on one's specialty. 3. They have positive images who hope for going on to the Specialized Vocational high school of education than the others. 4. It is necessary to accomplish and expand career education of Specialized Vocational high school for proper career education from middle school, to realize career exploration and decide one's career path based on one's specialty, because the result was statistically significant. 5. They have the more possitive image of Specialized Vocational high school, the more know it, totally.

Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis (성인 말성 부비동염에서 내시경적 부비동 수술 전.후의 증상 호전도와 음향비강통기도 검사 결과)

  • Kim, Yong-Dae;Kim, Jae-Yeul;Chang, Keun-Young;Lee, Hyung-Joong;Song, Si-Youn;Yoon, Seok-Keun
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.28-38
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    • 2002
  • Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusions: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

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Gametogenesis and Reproductive Cycle of the Cockle, Fulvia mutica (Reeve) (새조개, Fulvia mutica (Reeve)의 생식세포형성과정 및 생식주기)

  • CHANG Young Jin;LEE Taek Yuil
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.15 no.3
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    • pp.241-250
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    • 1982
  • The structure of gonads, gametogenesis and reproductive cycle of the cockle, Fulvia mutice, were studied mainly by histological observation. The materials were monthly sampled in the southern area of Yeosu from October 1980 to September 1981. F. mutica was monoecious. The gonads were situated between the liver tissues and the outer fibronuscular layers compacted by the connective tissue fibers and muscle fibers beneath the outermost layer of simple cuboidal epithelium. The gonad was composed of a number of the ovarian sacs and the testicular tubules which form the tubular structure. Testicular tubules in the mature stage sometimes contained 'testis-ova' The undifferentiated mesenchymal tissues and the eosinophilic cells were abundantly distributed on the germinal epithelium in the early development stage. With the further development of the ovary and testis, these tissues and cells gradually disapprared. The undifferentiated mesenchymal tissues and the eosinophilic cells are related to the growing of the oocytes and spermatocytes . Early multiplicating oogonium was about $10{\mu}m$ in diameter. As the oocytes grow to $27-34\times50-58{\mu}m$ by increasing cytoplasm, the oocytes connected to the basement membrane by their egg-stalks. The ripe eggs were about $60{\mu}m$ in diameter and they were surrounded by gelatinous membrane. Most male germ cells in mature stage were transformed into the spermatozoa and they formed the sperm bundles. After spawning, undischarged ripe eggs and spermatozoa remained in the ovarian sac and the testicular tubule respectively for some time, then they finally degenerated. Especially the early spent ovarian sacs in May did not contract significantly and then they took part in the secondary maturation within two or three months during the summer season. The monthly changes of the fatness well agreed with the reproductive cycle. The reproductive cycle of F. mutica could be classified into six successive stages : multiplicative, growing, mature, spent, degenerative and recovery stage. It seems that the spawning season is closely rotated to the water temperature, and the spawning occurs from May to October at about $20^{\circ}C$ in water temperature. The peak spawning seasons appeared twice a year between June and July and in September. Acknowledgement The authors wish to express their gratitude to Dr. Kim, In Bae, Dr. Chun, Seh Kyu and Dr. Yoo, Sung Kyoo of National Fisheries University of Busan and Mr. Min, Byoung Seo of National fisheries Research and Development Agency for their critical reading of the manu script.

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An Observation of the Chief Complint and a Weak Child of Prediatric outpatinets (소아과(小兒科) 외래(外來) 환자(患者)의 주소증(主訴症) 및 허약아(虛弱兒)에 관(關)한 연구(硏究))

  • Shin Ji-Na;Shin Youn-Guo
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.149-168
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    • 2000
  • The Purpose of this study was to investigate the new effective oriential medicine tretments in pediatric disease and its clinical applicability The study was composed of 1245 new patients who had been treated at the all unit in the Dong-Seo oriential Medicine Hospitial for 1 year, from 1 April 1999 to 31 March 2000, and aged between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. Result 1. The numbers of children who involved in this study is total 1245: Male children are 668 and female children are 577 children. The sex rate between male and female is 1.15 to 1. 2. Most of the above patients came to the hospital at first time from diseases such as musculoskelectal disease, weakness, asthma, cough, anorexia, common cold, rhiorrhea, sweating, dyspepsia, dematitis, night terror, obesity, stomach, short stature, Besides, they also came to the hospital at first time from various diseases such as epistasxis, pyrexia. Bell's palsy, nocturia, contipation, cerebral palsy, disorder, CVA. diarrhea. stress disease, Allergic disease, Tic disorder. Visual disorder, Kawasaki disease, Pierre Robin's syndrom, hematuria, edema and so on. 3. Looking at the frequent diseases, Respiratory dis. children including asthma, cough, rhiorrhea, sweating, common cold, pyrexia covers 36%, in 399 numbers. digestive dis. children including anorexia, dyspepsia, stomach, diarrhea, constipation, indigestion covers 19%, in 211 numbers. cadiovasculary disease children including arrthymia, terror in frequency, night crying, sediation, Tic disorder covers 8%, in 85 numbers. Hepatobiliary disease children including short stature, dizziness, visual difficulty, sprain, disorder of nail covers 21%, in 238 numbers. renal disease. children including nocturia, hematuria, hemation, disorder of hair, menorrhea, cerebral palsy, edema in 44 numbers. Fatigue children covers 13%. in 143 numbers. 4. In case of respatory disease children. total number is 399 children. dematitis children are 108 numbers and asthma children are 96 numbers. These show that children seem to the best have dematitis and asththma. The age from 0 to 6 is 290 numbers, covering 73 percentage. The others are covering 27 percentage. These data demonstrate that the age from 0 to 6 age could easily get these kinds - of diseases. The 29 percent of children had these kinds of diseases in spring. The 28 percent of children had these kinds of diseases in autumn. These show that children seem to frequently have these kinds of diseases in both spring and autumn season.(inter-season) 5. In case of digestive disease, anorexia covers 39%, in 83 numbers, dyspepsia covers 28%, in 59 numbers, anorexia and dyspepsia were the lagest group in digestive disease and the age from 0 to 6 covers 59%, in 125 numbers and the other age covers 39%. According to these data, infant seems to be vulnerable to these kinds of diseases. The 24 percent of children had these kinds of diseases in spring and summer. The 33 percent of children had these kinds of diseases in winter, which means that children mostly had winter. but decreased significant in autumn. 6. In case of cadiovasculary diseases, it can be divided into two categories: night covers 73% and nervous characteristics covers 27%. The age from 0 to 6 occupies 75%, and the other age occupies 25%. These data also show that infants can easily infected with these kinds of diseases. Analyzing by the season, summer could be the most frequent season that children have these kinds of diseases. but decreased in autumn. 7. In case of hepatobiliary children, sprains covers 166 numbers, fatigue covers 32 numbers, epistasxia covers 24 members, the reasion which sprain occupyied most of % were sprain covered ages. The age from 0 to 14 covers 59% and from 15 to 18 covers 41%. In the conclusion the adolescent seems to be vulnerable to sprains. In spring 29%, insummer 31%, in autumn 23%, and in winter 28% of children got these kinds of diseases, which show that children seems to have this kinds of disease in summer season. and decreased in autumn. 8. In case of renal disease. nocturia and hematuria covers 52%(occupied overhalf). The age from 0 to 6 covers 52%(occupied overhalf). Analyzing by season, in spring increased in summer(59%), decreased in autumn(45%) Conclusion 1. The chief complant in pediatric diseases that needed an oriental medical tretment was mainly the disease that tends to take iong time and the weakness. and appeared frequency in respiratory disease : 2. The oriential medical tretment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In paticular, the study shows that the oriental medical tretment should be emphasized in terms of preventing the disease 3, The new disease, which were developed with the change of human life and envir oment(just like seual disorder, short stature, obesity, dynamic disorder, examinee disease), should be in vestigated as a new field of oriental medical tretment.

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Therapeutic Effect of Anti-Rotavirus Chicken Egg Yolk Immunoglobulin(IgY) on Diarrhea by Infection of Rotavirus (로타바이러스 감염성 설사에 대한 항-로타바이러스 난황항체의 치료 효과)

  • Lim, In Seok;Lee, Ho Seok;Kim, Wonyong;Choi, Eung Sang;Jung, Dong Hyuk;Jung, Hoo Kil;Yun, Sung Seob;Chun, Ho Nam
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1354-1361
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    • 2005
  • Purpose : Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of antirotavirus IgY in the treatment of infants and children with gastroenteritis. Methods : First, the amount of viral particle in the stools of thirteen patients(seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT-PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups(an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. Results : First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. Conclusion : Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.

Nutritional Assessment and the Effectiveness of Dietary Counseling in Infants and Young Children with Iron Deficiency Anemia (철결핍성 빈혈을 가진 영유아에서 영양학적 평가 및 영양상담 효과)

  • Kim, Ja Kyoung;Ko, Eun Young;Lee, Yu Jin;Jun, Yong Hun;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.11-16
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    • 2003
  • Purpose : Iron deficiency is still the most common nutrient deficient disorder despite the improvement in general health and nutrition. This study is designed to evaluate the dietary history of infants and young children with iron deficiency anemia(IDA) and the effects of nutritional counseling. Methods : This study was conducted on 120 children from 6 to 36 months of age with IDA. Their parents completed a questionnaire and took counsel for nutrition. IDA was defined as Hb <11.0 g/dL, ferritin <10 ng.mL or transferrin saturation <15%, or Hb increase >1 g/dL after iron preparation. The questionnaire consisted of their feeding patterns, weaning time and kinds of food. Results : In the 120 infants and young children aged from 6 to 36 months, the parents of 82 cases was counseled about nutrition. Fifty six infants among 82 cases have started weaning and the main foods of weaning were rice and/or rice gruel. Nutritional problems in weaning were that some children over one year of age were using a bottle, and parents restricted weaning food at will because of allergic disease or chronic disease. Most parents were satisfied with the nutritional counseling given from a clinical dietitian and showed good compliance. Conclusion : Many infants and young children with IDA were provided with non iron-fortified foods and made an inadequate wean. Most parents were satisfied with the nutritional counseling and showed good compliance. The need of dietary counseling was required for prevention and treatment of iron deficiency anemia because of inadequate weaning.

Gastrointestinal surgery in very low birth weight infants: Clinical characteristics (극소 저체중 출생아에서 시행한 소화기계 수술의 임상적 특성)

  • Kim, Ji Eun;Yoo, Hye Soo;Kim, Hea Eun;Park, Soo Kyoung;Jeong, Yoo Jin;Choi, Seo Heui;Seo, Hyun Joo;Chang, Yun Sil;Seo, Jeong Meen;Park, Won Soon;Lee, Suk Koo
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.295-302
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    • 2009
  • Purpose : To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics. Methods : Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed. Results : The mean gestational age ($27^{+6}2^{+3}$ vs. $28^{+5}{\pm}$2^{+6}$) and birth weight (979${\pm}$241 g vs. 1,071${\pm}$271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period. Conclusion : GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.

Pseudomembranous colitis in children: Experience of a university hospital in Korea (소아 가막성 대장염: 단일 대학병원의 경험)

  • Park, Jae Hyun;Kang, Kyung Ji;Kang, Yu Na;Kim, Ae Suk;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.184-189
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    • 2010
  • Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

Effects of Nutrient Intake and Exercise on Bone Mineral Density and Bone Mineral Density in Premenopausal Women (폐경 전 성인여성에서 영양섭취 상태와 운동이 골밀도 및 골무기질 함량에 미치는 영향)

  • 최미자
    • Journal of Nutrition and Health
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    • v.35 no.4
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    • pp.473-479
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    • 2002
  • This study investigated associations between calcium intake, exercise behaviors, lumbar bona mineral density (BMD), and bone mineral content (BMC) among 79 premenopausal women (mean age = 41yr). The BMD and BMC of the lumbar spine (L$_2$-L$_4$) were measured by dual energy x-ray absorptiometry. Nutrient intake was estimated by the convenient method and a quantitative food frequency questionnaire was designed for this study that included the most commonly consumed floods sources of Ca. Participants were asked to identify all activities of exercise they had participated in including estimation of number of years of participation, number of weeks per year, number of times per week, and the number of hours per session. Participants were then categorized into the exercise group or nonexercise group (control). To meet the criteria for inclusion in the exercise group, the subjects participated more than 3 sessions per week and more than 30 minutes per session and the length of the exercise participation was at least more then 6 months. The participants were also grouped by calcium intake. The total calcium intake of all participants was estimated by dietary calcium intake and then the subjects were divided into quartiles to assess the lumbar BMD and BMC of the upper 25% (average calcium intake = 910 mg) and the lower 25% (average calcium intake = 414 mg). Results indicated that there were no significant differences in energy and calcium intake, and that there were no significant differences in lumbar BMD and BMC between participants in exercise group and the nonexercising control group. However, the exercise group had significantly lower ALP concentration than the nonexercise group. The upper 25% calcium intake group had significantly greater lumbar bone mineral density and bone mineral content than the lower 25% calcium intake group. Also the upper 25% calcium intake group had significantly lower ALP concentration than the lower 25% calcium intake group. Correlation analysis revealed that the spinal BMB was positively associated with body weight, while calcium intake was negatively associated with ALP concentration in nonexercising women. However, neither body weight nor dietary calcium intake were associated with both spinal BMD or ALP concentration in exercising women. These results suggest that calcium intake positively influence bone mineral density and bone mineral content in nonexercisulg premenopausal women. Exercise group did not affected by body weight and dietary calcium, but decreased ALP concentration than nonexercising group. Both exercise and calcium intake positively influence bone mineral density and bone mineral content in premenopausal women.