Background: Follow-up studies have shown that although outcomes have improved substantially over time, results of the Fontan operation and its modifications remain suboptimal. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus early and midterm change of internal diameter of PTFE conduit. Material and Method: Between April 1997 and July 2000 were reviewed. Twelve patients (M:6, F:6, mean age 42.04 $\pm$ 12.43months, mean body weight 13.80$\pm$ 1.94kg) underwent extracardiac conduit Fontan operation with expanded PTFE graft. Mean cardiopulmonary bypass time was 109.7$\pm$26.99minute and mean operation time was 455$\pm$89.51minute. Intraoperative fenestration was performed in 10 patients. The aortic cross clamping was not performed in all patients. Result: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%) and 4 patients(33.3%). Conduit patency was evaluated by magnetic resonance imaging studies. A 9.84$\pm$3.84% mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019, p=0.955). Conclusion: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia. And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.
Purpose : This study was performed to determine the predictors of failed closure of a patent ductus arteriosus (PDA) following the first course of indomethacin in symptomatic preterm infants. Methods : Forty three of 43 preterm infants, admitted to the neonatal intensive care unit diagnosed with PDA and treated with indomethacin at the Korea University Medical Center between January 1990 and October 2007, ware studied. The perinatal risk factors affecting the failed closure of PDA were retrospectively assessed. Results : The failed PDA closure group included 16 (37%) out of 43 infants three of whom underwent surgery. The closure group included 27 (63%) out of 43 infants. In the failed closure group, the Apgar scores (1 min, 5 min) were significantly higher (P<0.05) and antenatal steroid administration was significantly lower (P<0.05). In addition, dopamine administration was significantly lower (P<0.05) and the mean postnatal age at diagnosis was significantly lower (P<0.05). Multiple logistic regression for the prediction of failed PDA closure found only antenatal steroid administration (OR 0.092, CI 0,010-0.826, P=0.0331) as an associated factor. Conclusion : In patients with antenatal steroid administration the failed PDA closure rate was significantly lower. Therefore, antenatal steroid administration can be considered as an important factor for the closure of PDA in preterm pregnancies.
Purpose: We underwent this study to evaluate the diagnostic potential of I-123/I-131 metaiodobenzylguanidine (MIBG) scintigraphy alone in the initial diagnosis of pheochromocytoma, compared with biochemical test and anatomic imaging. Materials & Methods: Twenty two patients (M:F=13:9, Age: $44.3{\pm}\;19.3$ years) having the clinical evaluation due to suspicious pheochromocytoma received the biochemical test, anatomic imaging modality (CT and/or MRI) and I-123/I-131 MIBG scan for diagnosis of pheochromocytoma, prior to histopathological confirmation. MIBG scans were independently reviewed by 2 nuclear medicine physicians. Results: All patients were confirmed histopathologically by operation or biopsy (incisional or excisonal). In comparison of final diagnosis and findings of each diagnostic modality, the sensitivities of the biochemical test, anatomic imaging, and MIBG scan were 88.9%, 55.6%, and 88.9%, respectively. And the specificities of the biochemical test, anatomic imaging, and MIBG scan also were 69.2%, 69.2%, and 92.3%, respectively. MIBG scan showed one false positive (neuroblastoma) and one false negative finding. There was one patient with positive MIBG scan and negative findings of the biochemical test, anatomic imaging. Conclusion: Our data suggest that I-123/I-131 MIBG scan has higher sensitivity, specificity, positive predictive value, negative predictive value and accuracy than those of biochemical test and anatomic imaging. Thus, we expect that MIBG scan is e tectively used for initial diagnosis of pheochromocytoma alone as well as biochemical test and anatomic imaging.
Kim, Hye-Sook;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
The Korean Journal of Nuclear Medicine Technology
/
v.12
no.3
/
pp.241-246
/
2008
Purpose: To study of difference among primary aldosteronism patients and normal groups and essential hypertension patients and to confirm aldosterone/plasma renin activity ratio increase in secondary hypertension group which was diagnosed as primary aldosteronism. Materials and method: 1. Period: from April 2006 to March 2008. 2.Targets: 901 patients who visited seoul national university bundang hospital. 3. Groups: we divided by three groups. (normal group (n=147), essential hypertension (n=709), primary aldosteronism (n=45)) 4. Then calculated aldosterone/plasma renin activity ratio. 5. We used ROC curve to measure sensitivity and specificity. Results: 1. normal groups aldosterone/plasma renin activity ratio: $52.8{\pm}52.46$ essential hypertension patients aldosterone/plasma renin activity ratio: $171.04{\pm}291.56$ primary aldosteronism patients aldosterone/plasma renin activity ratio: $2325{\pm}2200$. 2. Aldosterone/renin ratio was significant in comparing each groups (p<0.001). 3. The sensitivity was 91.1% and the specificity was 92.4% when cut off of aldosterone/renin ratio was 485. Conclusion: It was confirmed that aldosterone/plasma renin activity ratio in primary aldosteronism was higher than normal group. According to this result, we can tell that aldosterone/ plasma renin activity ratio is very useful in diagnosis of primary aldosteronism.
Purpose: There have been few reports about common gastrointestinal diseases in children visiting emergency room. The aim of this study was to present basic data and their meanings about emergency room utilization in children with nonsurgical gastrointestinal disorders. Methods: The authors prospectively studied 1,228 consecutive children with gastrointestinal diseases, amongst 6,179 nonsurgical pediatric patients who visited the emergency room of Seoul Red Cross Hospital from Jan. 1st 1998 to Dec. 31st 1999. Results: 1) First visit was 60.7% of total visits and 30.7% were between 1 and 3 years of age while 80.4% were below 6 years of age. Male patients were predominant by a ratio of 1.3:1. 2) The peak month of visits was December (12.1%), and the peak time of visits was between 8:00 pm and midnight (35.9%). Average length of stay at emergency room of the total patients were 0.86 hour. 3) Five major diseases were acute gastroenteritis (44.3%), fecal impaction &/or constipation (21.3%), acute gastritis (16.4%), intussusception (4.6%), and infantile colic (4.3%) in order. 4) 19.6% of the total patients were hospitalized. Conclusion: There were differences in various distributions regarding each nonsurgical gastrointestinal disease entity in children visiting emergency room even though distributions of the total patients in our study were not so different from those in previous reports by others.
Lee Gyu-Joon;Park Soon-Tae;Ha Woo-Song;Kwon Soo-In;Choi Sang-Kyeon;Hong Soon-Chan;Lee Young-Joon;Lee Young-Jae
Korean Journal of Head & Neck Oncology
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v.14
no.2
/
pp.244-252
/
1998
The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).
Park, Kyung-Woo;Kim, Yun-Sam;Park, Jung-Won;Jeune, Kyung-Hee;Kim, Mi-Kyung
Korean Journal of Ecology and Environment
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v.44
no.2
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pp.239-251
/
2011
To compare the different water environments in the Jigsaw stream (st. 1, 2) and Jujin stream (st. 3, 4) crossing over the Byeonsan-Bando and Seonunsan parklands, the physico-chemical factors and the species compositions of epilithic diatoms were analyzed from March 2009 to February 2010. The mean values of conductivity (681.1 ${\mu}S\;cm^{-1}$), suspended solids (27.83 mg $L^{-1}$), biological oxygen demand (3.15 mg $L^{-1}$), total nitrogen (3.24 mg $L^{-1}$), total phosphorus (0.24 mg $L^{-1}$) and chlorophyll-${\alpha}$ (12.99 mg $m^{-3}$ ) in Jujin stream were significantly higher than each element in Jigsaw stream. Eighty taxa were classified into 73 species and seven varieties belonging to 24 genera, eight families, three suborders and two orders in Jigsaw stream. Eighty eight taxa were classified into 81 species and seven varieties belonging to 22 genera, seven families, three suborders and two orders in Jujin stream. Biological water quality assessments revealed that Jigsaw stream was ${\beta}$~${\alpha}$-oligosaprobic and Jujin stream was ${\beta}$-mesosaprobic. Dominant and diversity indices were indicated from 0.25~0.81 and from 1.73~4.14 in Jigsaw stream, respectively, and from 0.29~0.64 and from 2.72~4.02 in Jujin stream, respectively. Jujin stream was more eutrophic than those of Jigsaw stream. The different water environments between the two streams could be due to the different ecosystems of the neighboring basins of each stream crossing over in the mountain. Further studies should investigate the water environments of two streams by continuous and regular monitoring to analyze the different ecosystem mechanisms.
Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.
Kim, Byoung-Hak;Min, Byeong-Hee;Choi, Nak-Joong;Oh, Bong-Se;Park, Ki-Yeol;Min, Kwang-Sik
Journal of Aquaculture
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v.21
no.3
/
pp.157-166
/
2008
Species composition and standing crop of phytoplankton were investigated in the ark shell Scapharca broughtonii farming areas from March, 2006 to February, 2007 in Jinhae Bay. Water temperature ranged from 7.56 to $25.90^{\circ}C$, salinity from 13.74 to 34.78 psu, dissolved oxygen from 4.13 to 13.20 mg/L, chlorophyll $\alpha$ from 2.77 to 104.98 $mg/m^2$ and pH from 7.83 to 8.65. Dominant species was Nitzschia and Rhizosolenia from March to May, Skeletonama costatum and Prorocentrum from June to August, Skeletonama costatum, Thalassiosira, Chaetoceros from September to November and Thalassiosira, Chaetoceros from December to February. Colonial diatoms were more dominant than the single cell diatoms. Standing crop was the highest in July at three stations. Standing crop of Skeletonama costatum was the highest as 1,760.0 cells/mL at St. 1, 1,075.2 cells/mL at St. 2 and 698.4 cells/mL at St. 3 in July.
Kim, Soo-Hwa;Hwang, Yoon-Sook;Kim, Kwang-Soo;Jung, Jae-Yeon;Yoo, Young-Jae;Lim, Mi-Hee
Journal of dental hygiene science
/
v.13
no.3
/
pp.271-280
/
2013
This study aims to analyze the effects of tooth-brushing facilities (TBF) at middle schools that installed TBF in 2012 as part of the oral health project in Seongdong-gu, Seoul. The subjects were the first graders at A middle school that installed TBF previously and B middle school that installed TBF in 2012. The results are as follows: DMFT, DMFS and CPI didn't show significant difference by schools (p>0.05), but code (0) was higher and code (2) was lower in female students than male students (p<0.05). As to PHP index, the students at A school with TBF indicated better oral hygiene (p<0.01). In the research on before and after installing TBF, the oral hygiene was improved significantly more after the installation than before (p <0.01). In the comparison on the oral health-related behavior, the percentage of not brushing after lunch was higher B school than A school and the frequency of toothbrushing after lunch was higher A school than B school (p<0.01). About the reasons why not to brush after lunch, there was difference in 'lack of the place' as A school showed 2.6% while B school without TBF indicated 14.2% (p<0.01). About the changes of the oral health-related behavior before and after TBF installation, the percentage of not brushing after lunch increased from 78.7% to 83.8% after the installation. The average frequency of tooth-brushing after lunch for one week also decreased from 0.50 to 0.34 (p>0.05). Among the reasons why not to brush after lunch, 'lack of the place' significantly reduced, but 'because other friends don't do it' increased greatly after the installation (p <0.05). Only with the improvement of oral health knowledge, we cannot expect either clinical or behavioral significance. Not only schools but policies of governmental agencies and financial support, cooperation of community-related groups for program development and evaluation will contribute altogether to helping teenagers to habitualize proper oral health management.
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