• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.110-115
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• 2008

Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.211-226
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• 1988

Among 165 patients of esophagus cancer treated by either radiation alone or postoperative radiation, median survival period was 6.6 months, $16\%$ 3 years and $8\%$ 5years crude survival. In biphasic plotting of survival curve semilogarithmically all nonresponder died within one year regardless of treatments and in responder each 1, 2, 3 years survival rate was $80\%,\;70\%,\;60\%$ in the group of postoperative radiation among 20 patients ($54\%$ of 37 patients) respectively and $62\%,\;38\%,\; 23\%$ each in the group of radiation alone among 61 patients ($48\%$ of 128 patients) respectively, better survival rate of postoperative radiation vs radiation alone in 3 year (P<0.01). The most common cause of death was dysphagia $55\%$, and majority of patients died by failure to control the disease locally $62\%,\;88\%$ of stricture were associated with persistenece of cancer in esophagus. $50\%$ of patients was found to have locoregional metastatc nodes. Preoperative diagnostic failure rate was for metastatic locoregional nodes was $54\%$, for grossly metastatic nodes $29.7\%$, for blood borne organ metastasis $13.5\%$, and for local extent of the disease $14\%$. The residual cancer at surgical margin o. postitive node was not effectively killed by either 5000 to 5500 cGy conventional radiation or 5290 to 5750 cGy with 115 cGy fraction in 2 times daily; hyperfractionated radiation. However hyperfractionation schedule decreased the both acute and late complications in this study.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.170-175
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• 1997

Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.92-101
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• 2000

Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.315-321
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• 1997

A clinical analysis was performed on 326 cases of the non-penetrating rib fractures experienced in the department of thoracic and cardiovascular surgery, Chosun University Hospital and 102 cases of the non-penetrating rib fractures those has been admitted and treated in the department of thoracic and cardiovascular surgery, Jeonnam Hwasoon lung-ang Hospital during a period from Jan. 1994 to Dec. 1995. 1. Sex ratio was 3.4:1 in urban and 3.6:1 in rural communities with male predominance. 2. Most· common cause were traffic accident in both communities. 3. Hemothorax, pneumothorax and hemopneumothorax which needed thoracostomy were observed iii 146 cases(44.7%) in the urban and 12 cases(11.7%) in the rural communities. 4. Left thorax was the spell site of rib fractures in both communiti s. 5. Rib fracture was prevalent from 3rd to 6th rib in both communities. 6. Open thoracotomy was performed in 37 cases(11.3%) in urban and 3 cases(2.9%) in rural communities. 7. Overall mortality was 4.29%(14 cases) in urban area and, 1.96%(2 cases) in rural communities, and cause of death were hypovolemic shock, brain edema, sepsis, respiratory failure, asphyxia, and cardiogenic shock.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8281-8285
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• 2016

Background: Helicobacter pylori is a cause of chronic gastritis, peptic ulcer disease, and gastric malignancy, infection being a serious health problem in Thailand. Recently, clarithromycin resistant H. pylori strains represent the main cause of treatment failure. Therefore this study aimed to determine the prevalence and pattern of H. pylori resistance to clarithromycin in Suranaree University of Technology Hospital, Suranree University of Technology, Nakhon Ratchasima, Northeastern Thailand, Nakhon Ratchasima province, northeast of Thailand. Materials and Methods: This hospital-based cross-sectional study was carried out between June 2014 and February 2015 with 300 infected patients interviewed and from whom gastric mucosa specimens were collected and proven positive by histology. The gastric mucosa specimens were tested for H. pylori and clarithromycin resistance by 23S ribosomal RNA point mutations analysis using real-time polymerase chain reactions. Correlation of eradication rates with patterns of mutation were analyzed by chi-square test. Results: Of 300 infected patients, the majority were aged between 47-61 years (31.6%), female (52.3%), with monthly income between 10,000-15,000 Baht (57%), and had a history of alcohol drinking (59.3%). Patient symptoms were abdominal pain (48.6%), followed by iron deficiency anemia (35.3%). Papaya salad consumption (40.3%) was a possible risk factor for H. pylori infection. The prevalence of H. pylori strains resistant to clarithromycin was 76.2%. Among clarithromycin-resistant strains tested, all were due to the A2144G point mutation in the 23S rRNA gene. Among mutations group, wild type genotype, mutant strain mixed wild type and mutant genotype were 23.8%, 35.7% and 40.5% respectively. With the clarithromycin-based triple therapy regimen, the efficacy decreased by 70% for H. pylori eradication (P<0.01). Conclusions: Recent results indicate a high rate of H. pylori resistance to clarithromycin. Mixed of wild type and mutant genotype is the most common mutant genotype in Nakhon Ratchasima province, therefore the use of clarithromycin-based triple therapy an not advisable as an empiric first-line regimen for H. pylori eradication in northeast region of Thailand.

• Tuberculosis and Respiratory Diseases
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• v.62 no.4
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• pp.314-317
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• 2007

The Inhalation of certain freshly formed metal oxides can cause metal fume fever, which is an acute, self-limiting, flu-like illness. The most common cause of this syndrome is the inhalation of zinc oxide. The inhalation of zinc oxide can lead to tracheobronchiolitis, chemical pulmonary edema or to respiratory failure and acute respiratory distress syndrome(ARDS). We encountered a 43-years-old man who developed severe dyspnea after inhaling of zinc oxide while working for 5 hours in a closed space. He was diagnosed with ARDS and was treated successfully with glucocorticoid. We report a case of ARDS caused by the inhalation of zinc fumes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.330-337
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• 2003

This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.24-34
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• 1991

Delayed emergence of speech or language are frequent causes for concern about development during early childhood. Dealy in evaluation and proper management until school entry in more likely to result in frustration, anxiety and school failure. Many language disturbances and their attendant behavior disorders respond to intensive language therapy. Authors analyzed the medical recoreds of 52 children with delayed language development evaluated during 30 months from January 1986 through June 1988. The results were as follows : 1. The majority of cases were evaluated at the age of 2-2.9 year old(16 cases, 30.8%) and 3-3.9 year old(11 cases, 21.2%) 2. Male to female ratio was 3 : 1 3. The most common cause was mental retardation(53.8%), followed by developmental language disorder(23.1%) and autism(13.5%) 4. The most common associated condition was dysarticulation(17.3%), followed by strabismus(9.6%) and seizures(7.7%) 5. Special education was recommended in cases of 23(44.2%), speech therapy in 12 cases(23.1%) and consultation to child psychiatry in 7 cases (13.5%). Making diagnosis of underlying disorders is not simple because assessment of intelligence in young children is difficult and only a few tests are standardized. More detailed study on children with delayed language development and development of psychometric tests for the handicapped children are necessary, especially in Korea.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.220-227
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• 1998

The clinical and pathological features of 35 cases of anaplastic thyroid cancer were studied. These tumors occurred in 12 men and 23 women ranging in age from 19 to 83 years(mean age; 61.7 years). A rapidly enlarging thyroid mass was the most common presentation. The duration of the presence of mass varied from 20 days to 12 months with an average of 2.7 months. Systemic metastasis at the time of initial examination was found in 14 patients(40.0%) and the lung was the most common site of involvement. The overall rate of distant metastasis was about 65.7%. The tumors were subdivided morphologically into giant cell type of 10 cases, spindle cell type of 7 cases, epidermoid cell type of 1 cases, and mixed giant cell and spindle cell type of 5 cases. The mean survival period of 6 among 35 patients who had biopsy alone was 1.4 months. The 22 patients underwent the incomplete combined treatment modalities (palliative surgery with or without chemotherpy or radiation therapy) survived for a mean period of 3.0 months, among them, 7 patients who had surgery combined with chemotherapy and radiation therapy showed mean survival period of 3.7 months. The mean survival of 7 patients who had complete combined treatment modality(curative surgery combined with chemotherapy and hyperfractionated radiation therapy) was 6.6 months, only one patient survived for 21 months and one patient has been alive for 1 month after operation, and the others survived for a mean period of 4.8 months. So far, as of July 31, 1998, 34 patients among 35 were died(one has been survived for 1 month) despite the various treatment modalities, and the main cause of death were failure of local control and systemic metastasis. None of the various treatment modalities gave consistently favourable results. However, a combination of surgery, radiation therapy and chemotherapy seemed to have a slight positive effect on survival. Furthermore, the aggressive treatment modalities will be indicated only in the early diagnosed and minimal cases.