• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.17-24
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• 2014

Purpose : To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). Materials and Methods: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. Results: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). Conclusion: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1332-1339
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• 2002

Purpose : Through a survey undertaken among doctors practicing pediatric patients in primary medical facilities on nutrition during infancy, the present study was done to determine whether these doctors were giving appropriate advice on infant nutrition. Methods : We visited pediatric specialists(group one) and non-pediatric specialists or general practitioners(group two) who were practicing in Daegu to ask them to fill out a questionaire on infant nutrition. Results : When 10 points were given to each question for a total of 100 points, the results of the evaluation showed that the score in group one was $73.0{\pm}15.8$ points and $45.1{\pm}18.4$ points in group two, showing a significant difference. No statistical difference was seen in the scores between non-pediatric specialists and general practitioners. Each answer to each question on the feeding period of breast milk, on loose stools during breast milk feeding, methods to deal with jaundice during breast milk feeding, choice of commercial baby food, criteria on directing soy milk, and criteria of guiding infant cereal was different between group one and two. Conclusion : The results of the present investigation showed that specialists in other fields or general practitioners were giving inappropriate advice on nutrition during the infant stage compared with pediatric specialists; thus, we need to confirm methods to prevent inappropriate consultations by specialists of other fields, together with continued education of pediatric specialists.

• Journal of Korean Physical Therapy Science
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• v.1 no.1
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• pp.135-144
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• 1994

The authors studied therapeutic effects and related clinical data retrospectively on a series of 48 consecutive patients with head injury who were referred to physical therapy and occupational therapy, Kosin University Medical Center during 1 year, from March, 1993. through March, 1994. The conclusions were as follows : 1. Average age of the subject patients was 50.6 years, their age remped from 14 to 72 years, and the incidence between male and femele was 1:1.1. 2. In respect to the educational level high school graduates showed the highest incidence 18 (39.1 %) of 46 cases, and in respect to economy level, middle class revealed the highest incidence, 31(64.6 %) in 48 cases. 3. The HBP was the most common cause of spontaneity injury, disclosing 19 cases in 35 patients(54.3%), whereas the main cause of traumatic injury was a traffic accident, 7 cases ( 53.8 %) in 13 patients. 4. As for the region of injury in the cases of spontaneity ICH was 14 persons (40%). In the cases of trauma, hematoma was seen in 6 cases(42.2 %) in 48 total cases ICH was seen in 17 cases (35.4 %) to be the most common region. 5. Among 35 persons, spontaneity CBR was the highest region of injury, 13 cases(37.1 %) ; the side of paralysis in extremities the right side showed higher incidence, 18 cas (1.4 %) as compared to the left, 16 cases(45.7%). In the case of traumatic injury, CBR was the highest region of injury, 4(30.8% )in 13 cases and as for the paralysis side, right side showed higher incidence 7 cases(53.8%) as compared to the left side 5 cases(38.5%). 6. In respect to recurrence, HBP was seen in 5 cases to be the most common cause, and as for the region of injury, CBR was the highest. 7. A period of rehabilitation therapy in the cases of physical therapy the highest term was 1-2 month, 14 persons(29.2%). As for occupational therapy within 2 week-term was the highest, 24 persons(50%). 8. Physical strenth grade M.T in the cases of the upper extrimities before therapy, the low mark(grade 0) was 30 cases(62.5%), compared to the high mark(above grade 3)seen in 1 case(2.1%), And after therapy, the lowest mark(grade 0)was seen in 5 cases(10.4%) where as the high mark(above grade 3)was seen in 29 cases(60.4%). In the case of the lower extremities before therapy, the mark(below grade 1)was 37 cases(77.1 %), while the high mark(above grade 3)was seen n 4 cases(8.4%). And after therapy the low mark(below grade 1)was seen in 5 cases (10.4 %) and the high mark (above grade 3)was seen in 29 cases(60.4 %). 9. Before therapy conigtive function-level evaluation utilized R.L.A.L, the low mark(below level 3)was seen in 9 cases(18.8%), while the high mark(above level 7)was seen in 18 cases(37.5%). And after therapy the low mark (below level 3)was 4 cases(8.3%) and high mark(above level 7)was seen in 38 cases(79%). 10. After rehabilitation therapy, patients who were able to walk independently were 29 persons(60.4%), among which 16 cases(55.2%) depended on cane. The ratio between the cases who were able to walk and unable to walk was 1.5:1.

• Clinical and Experimental Pediatrics
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• v.50 no.2
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• pp.190-197
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• 2007

Purpose : Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. Methods : We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. Results : Final height SDS was $-0.11{\pm}1.15$ ($-0.26{\pm}1.33$ in females, $0.04{\pm}0.91$ in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average $HbA_{1C}$. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average $HbA_{1C}$ than patients without complications. Patients whose microalbuminuria regressed had lower levels of average $HbA_{1C}$, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. Conclusion : The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.46-52
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• 2011

Purpose: This study was performed to assess the usefulness of non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique. Materials and Methods: Twenty-two patients were followed up more than 1 year after non-anatomical repair for irreparable large and massive rotator cuff tears using the arthroscopic margin convergence technique. The clinical evaluation was performed according to the KSS score, the UCLA score and the Visual analogue scale (VAS). The measurement of the acromio-humeral distance was performed using the shoulder anterior-posterior radiographs. The measurement of fatty degeneration and the healing status was performed using the shoulder MRI after 6 months. Results: Among twenty-two patients, follow up MRI was performed in eleven cases. Three cases were well healed, four cases were partial healed and another four cases were re-torn. The KSS and UCLA scores had significantly improved from a preoperative average of 45.0${\pm}$8.014 and 10.8${\pm}$2.302 points to 77.1${\pm}$10.151 and 30.0${\pm}$1.521 points, respectively, and the pain VAS had decreased from a preoperative average of 7.7${\pm}$0.616 points to 3.0${\pm}$1.021 points at the last follow up. Less favorable results were obtained when the patient had a grade of fatty degeneration higher than grade 3 on the preoperative MRI. Conclusion: Non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique showed good functional results. It seems to be one of the effective treatment methods for irreparable large and massive rotator cuff tears.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.73-80
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• 1994

From December 1989 to February 1993, 108 patients with Non-Small Cell Lung Cancers(NSCLC) were studied retrospectively to evaluate radiotherapeutic significance of serum levels of NSE. We considered elevated serum neuron specific enolase(S-NSE) level as one of the neuroendocrine features in NSCLC. Histopathologic evaluation revealed 86 squamous cell carcinomas, 11 adenocarcinomas.3 large cell carcinomas, 3 mucoepidermoid carcinomas, and 5 unknown pathology. Eight Patients had stage 1,40 stage IlIA, and 60 stage lIIB.S-NSE level greater than 15 ng/ml was considered as elevated, and below this considered as normal. All patients recieved radiotherapy as primary treatment modality. The responders to radiotherapy had significantly higher mean S-NSE level than non-responders (28.5 ng/ml vs 20 ng/ml, p=0.01). Overall 2-year survival rate(YSR) was 23.6$ \% $. According to radiotherapy response, 2 YSR for Patients with CR, PR, and NR were 39.2$ \% $, 28.6$ \% $, and 6.2$ \% $ respectively(p=0.001). 2 YSR for patients with elevated and normal S-NSE were 14.6$ \% $ and 31.7$ \% $(p=0.02). The patients with NR showed no difference in survival according to S-NSE level. When we considered all patients, S-NSE level showed no significant impact on response. But for squamous cell carcinomas alone, patients with elevated S-NSE had more responders(80$ \% $ vs 61$ \% $, p=0.05). There was no correlation between tumor characteristics and S-NSE level. But the patients with elevated S-NSE had more patients with higher nodal stage, Based on our and other datas, NSCLC with neuroendocrine features have different response to treatment and clinical behavior compared to other NSCLC. Thus, this subgroup may need different treatment modality, and S-NSE level may have prognostic significance.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.59-66
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• 1994

Seventy-five patients with tumors of the head and neck treated with either radiation therapy alone or combined with surgery or chemotherapy were studied prospectively to evaluate the effects of radiation therapy to the neck on thyroid gland between September 1986 and October 1992. All patients were serially monitored for thyroid function tests before and after radiation therapy. Radiation dose to the thyroid gland ranged from 35 to 60 Gy with a median dose of 50 Gy. Median follow-up time was 30 months with a range of 11 to 85 months. The incidence of thyroid dysfunction was 40$ \% $: forty-five patients(60$ \% $) euthyroid, 2 patients(3$ \% $) clinical hypothyroidism, 27 patients(36$ \% $) subclinical hypothyroidism and 1 patient(1$ \% $) hyperthyroidism. No thyroid nodules or thyroid cancer were detected in any patients. Thyroid dysfunction appeared earlier in patients who underwent surgery than in those patients treated with radiation therapy alone or combination of chemotherapy and radiation therapy(P=0.0013). By multivariate analysis, risk factors that significantly influenced a higher incidence of thyroid dysfunction were female sex(p=0.0293) and combination of total laryngectomy and radiation therapy(p : 0.0045). In conclusion, evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests are recommended to detect thyroid dysfunction in time and thyroid hormone replacement therapy is recommended whenever thyroid dysfunction develops.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.136-140
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• 1999

Purpose : Prostate specific antigen (PSA) is a useful tumor marker, which is widely used as a diagnostic index and predictor of both treatment and follow-up result in prostate cancer. A prospective analysis was carried out to obtain the period of PSA normalization and the half life of PSA and to analyze the factors influencing the period of PSA normalization. The PSA level was checked before and serially after radical radiotherapy. Materials and Method : Twen쇼 patients with clinically localized prostate cancer who underwent radical external beam radiotherapy were enrolled in this study. Accrual period was from April 1993 to May 1998. Median follow-up period was 20 months. Radiotherapy was given to whole pelvis followed by a boost to prostate. Dose range for the whole pelvis was from 45 Gy to 50 Gy and boost dose to prostate, from 14 Gy to 20 Gy. The post-irradiation PSA normal value was under 3.0 ng/ml. The physical examination and serum PSA level evaluation were performed at 3 month interval in the first one year, and then at every 4 to 6 months. Results : PSA value was normalized in nineteen patients (95%) within 12 months. The mean period of PSA normalization was 5.3 (${\pm}$2.7) months. The half life of PSA Of the nonfailing patients was 2.1 (${\pm}$0.9) month. The nadir PSA level Of the nonfailing Patients waS 0.8 (${\pm}$0.5) ng/ml. The period of PSA normalization had the positive correlation with pretreatment PSA level (R$^{2}$=0.468). The nadir PSA level had no definite positive correlation with the pretreatment PSA level (R$^{2}$=0.075). The half life of serum PSA level also had no definite correlation with pretreatment PSA level (R$^{2}$=0.029). Conclusion :The PSA level was mostly normalized within 8 months (85%). If it has not normalized within 12 months, we should consider the residual disease in prostate or distant metastasis. In 2 patients, the PSA level increased 6 months or 20 months before clinical disease was detected. So the serum PSA level can be used as early diagnostic indicator of treatment failure.

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.73-80
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• 2004

Purpose : The serial clinical findings, biochemical results, and serological hepatitis B virus(HBV) markers in Korean children with chronic HBV infection were analyzed to determine the relationships among these factors. Methods : Ninety children have been chosen from those who have visited to the Department of Pediatrics at St. Vincent's Hospital in The Catholic University of Korea from July 1st, 1995 to June 30th, 2000. The sample patients were followed up for over six months. HBV markers and liver function tests were all performed. Results : All children were asymptomatic at presentation. Eighty-three percent of the children had a history of chronic HBV infection in their families. Eighty-one percent were HBeAg positive, 16% were anti-HBe positive, while 3% were all HBeAg and anti-HBe negative. The prevalence of HBeAg among three age groups : 0~5; 6~10; and 11~15 year-old was 90%, 96% and 61% respectively. The prevalence of HBeAg in less than 10 year-old group was significantly higher than 11~15 year-old group(P=0.001). Serum ALT levels were within 40 IU/L in 64% children, 41~80 IU/L in 17%, 81~200 IU/L in 10%, and beyond 201 IU/L in 9%. The percentage of abnormality of ALT levels in HBeAg positive patients was significantly higher than that of HBeAg negative(P=0.036). Eleven of the 73 HBeAg positive children lost their HBeAg and seroconverted to anti-HBe. In these cases, all had transient elevations in ALT levels before HBeAg seroconversions. The annual rates of spontaneous seroconversion of HBeAg and HBsAg were 9.7% and 0.6%, respectively. Conclusion : Recognition of the dynamics of these changes in viral markers and biochemical findings is needed in the selection and evaluation of therapeutic regimens, establishment of treatment, and calling for controlled trials with adequate follow-up. The hepatitis B carrier state may be asymptomatic in children however, continued surveillance of carriers is important to determine the individual adverse prognostic factors of chronic HBV infections.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.111-119
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• 2000

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a common pediatric discase presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. Method : Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998. Results : 1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4$\%$, gross hematuria 17.6$\%$, microscopic hematuria 50$\%$. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C). Conclusion : Among the 디le patients with Henoch-$Sch{\ddot{o}}nlein$ purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.