• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.655-659
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• 2008

Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.

• Biomedical Science Letters
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• v.8 no.3
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• pp.127-135
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• 2002

Anterior subcapsular cataract was developed by opacification with transdifferentiation and abnormal proliferation of lens epithelial cells (LECs) and pathological accumulation of extracellular matrix (ECM). After-cataract also be caused by a similar transdifferentiation of LECs remaining after surgery and the accompanying increase of ECM deposits. It is blown that prostaglandin E2 and cytokine, such as TGF-$\beta$, bFGF, and IL-1, were associated with abnormal proliferation and transdifferentiation of LECs. The aim of this study was to detect the expression of transforming growth factor-$\alpha$ (TGF-$\alpha$), transforming growth factor-$\beta_1$(TGF-$\beta_1$) and basic fibroblast growth factor (bFGF) in LECs of senile and diabetic cataract. The expressions of these growth factors in lens epithelial cells were determined. The sample for growth factor determination were collected in senile cataract patients without metabolic disorder, especially diabetes mellitus and diabetic cataract patients. The mRNA expression of growth factors was detected by semi-quantitative reverse transcription - polymerase chain reaction (RT-PCR) followed by Southern blot analysis. Statistics were analysed using Wilcoxon rank sum test. Semi-quantitative RT-PCR/southern analysis of RNA obtained from thirty surgical specimens demonstrated that the level of mRNA expression of TGF-$\alpha$, -$\beta_1$ and bFGF was increased in diabetic cataract lens tissues compared with senile cataract specimens but non-significant, bFGF and TGF-$\beta_1$ mRNA expression were detected in most patients, expression level of TGF-$\beta_1$ was most high on the basis of normal ocular concentration. Detection rate of TGF-$\alpha$ in diabetic cataract was 1.5 fold higher than in senile cataract (P=0.098). TGF-$\alpha$, TGF-$\beta_1$, and bFGF mRNA expression of LECs were detected in senile and diabetic cataract. In both patient groups, expression level of TGF-$\beta_1$, mRNA was high, so We suggest TGF-$\beta_1$ strong influence in development of senile cataract and of diabetic cataract also. TGF-$\alpha$ expression level was similar but more frequently detected in diabetic cataract than in senile cataract. In conclusion, TGF-$\alpha$ may be associated with early development of diabetic cataract.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.218-232
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• 1985

Congenital hereditary disease is in devided into Infantile type and Adult type, Adult type is hidden for many years and keeps normal renal function till middle age. Cyst is stimultaneously made in both sides and becomes lowered in renal function in 30's to 40's. Infantile type is generally born with the big kidneys, renal failure, undergrowth of intrahepatic bile duct. Both infantile and childhood type have ureteral dilatation and portal hypertension In infantile type, it is mostly developed into renal failure, but generally faces death as a result of hepatic disease. The reason of death is that an abnormal condition of recessive autosome affects the liver and kidneys. While the incidence of infantile type is rare as $0.017{\sim}0.07%$ and it is autosomal recessive heredity, Adult type can rarely exist in infantile period. Though it exists in middle period, 50% of patients can live for 2-4 years after the first symptom incidence and 25% can less than 2 years. It is hard to cure completely in medicine and surgery. Three difficulties in familial incidence are comparative decrease of the donor who have no affection on renal transplantation. For another consideration it is to show the family history for several generations. We, the Med. Dept. of Dae Han Kyouk Life Insurance Co. Ltd., used the ultrasonic apparatus in diagnosing the one case of adult type bilateral polycystic kidney and then doubted the family history. As a result of inspecting the family we experienced bilateral polycystic kidney from 3 persons out of 4 who can be inspected. The results are as follows: 1) We could confirm the polycystic kidney from 3 persons out of 4(75%). 2) Then when they came for check up, chief complaint was the pain in all 3 cases(100%). 3) Accompanying disease was hypertension in 2 cases(67%). 4) In early disease incidence, we couldn't observe the specific change in pathological opinion. 5) All 3 cases are not accompanied with cystic lesion in liver, spleen, pancreas.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1365-1371
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• 2000

Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.223-231
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• 2002

Purpose : We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction. Methods : We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl-triglycerine scan and the degree of hydronephrosis by renal ultrasonography. Results : In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement. Conclusion : We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1399-1405
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• 2001

Objectives : Gliomatosis cerebri is an uncommon primary brain tumor characterized by diffuse neoplastic proliferation of glial cells, with the preservation of the underlying cytoarchitecture. The aim of this study is to evaluate clinical features, outcome of surgical treatment and adjuvant therapy of gliomatosis cerebri. Methods : Between Jan. 1990 and Dec. 2000, 12 patients were diagnosed with gliomatosis cerebri based on characteristic radiological and histological findings. The patients' age ranged from 18 to 77(mean 44) years and the male to female ratio was 7 : 5. Nine patients underwent decompressive surgery and three, biopsy only. Postoperative radiation therapy was given in all cases except three. In addition to radiation therapy, four patients received chemotherapy. The mean duration of follow-up period was 18.8 months. Results : The most common presenting symptom were seizure and motor weakness. The mean duration of symptom was 5.9 months. There was 5 bilateral lesions and tumor involved corpus callosum in 5, basal ganglia-thalamus in 4, and brain stem in 2. There was no operative mortality but four patients died during the follow-up. The mean survival period for 11 patients was 20.5 months from the time of diagnosis. In univariate analysis, the lesion involving corpus callosum, basal ganglia-thalamus and brain stem correlated significantly with the short length of survival(p<0.05). Also, postoperative radiation as a adjuvant therapy prolonged the patient's survival(p<0.05). Conclusions : In the management of gliomatosis cerebri patients, early detection by MR imaging, active management of increased intracranial pressure, decompressive surgical removal and postoperative adjuvant therapy such as radiation is thought to be a good treatment modality.

• Journal of the Korean Society of School Health
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• v.7 no.1
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• pp.9-28
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• 1994

This study is to investigate the status and problems in the anual physical examination in elementary & secondary schools. The study helps the introduction of health assessment. Two hundreds and forty nurse teachers of elementary & seconcary school in Seoul received in-service traomong fpr 20 daus frp, September 7 to September 27, 1992. Questionnaires were given to the 240 teachers and the number of collected questionnaire is 112. The result of the questionnaire analysis is like the following. First, the answered teachers aged 35~39, 36.6%; experience 6~10 years 37.5%; the number of class 31~40, 28.6%. Among the answered of the school doctors is practicioners. The doctors major subjects are 26.8% of internal medicine and 35.7% of surgery. Second, in elementary & secondary school nurse teachers received in-service training for the primary health assessment. And then 37.5% of schools practiced the health assessment. The term of the health assessment is largely a-year-length, occurately its rate of schools have practiced the assessment reaches 81.0%. The number of health assessment are consist of eyes, nose, ear, throat, skin, spine, heart and other abnormal regions and diseases all over the body. And 83.3% of the rate of the health assessment includes all these contents. The period of the health assessment is 7 to 28 days. Third, the physical examination conducted by school doctors is 91.0%. The method is various; one is 56.6% of the students who checked first by he nurse teacher. The number of 15.1% of the schools is directly checked by the school doctor. The invited medical doctors are divided into two categories. The number of general physician is 61.9%. Contrary to that school doctors are 38.1%. The contents of the medical examination is all the items printed on the medical examination sheet. To follow the medical examination sheet the number of school is 59.6%. Eyes, throat, skin and heart etc. partly medical examination is 40.4%. The rate of schools that used only stethoscope, tongue pressor as the medical instruments reaches 53.4% and 87.1% of elementary & secondary school give the invited doctors the allowance a nurse teachers conference decided. The number of 8.9% schools pay the doctors independent allowance. The medical examomatopm allowance is 200 to 250 won per capita. The rate is 56.1%. Forth, after the medical examination 72.1% of school sends letter to the parents to notice the result of the examination. The number of response from parent is 12.5%. The observation record in secondary school is 70.6% for junior, and 80.0% for senior respectively, and 65.5% is for the elementary school children. To conclude the regular physical examination in elementary & secondary school is very important. Because the students are in the stage of rapid growth and development. Early finding of the students diseases can help to cure with ease. In the light of public health the management of health program in the elementary & secondary school is of consequence.

• Radiation Oncology Journal
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• v.29 no.3
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• pp.147-155
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• 2011

Purpose: This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI). Materials and Methods: The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were finally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis. Results: Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p = 0.061) and biologically equivalent dose $(BED)_3$ (p = 0.084) were the only marginally influencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed <6 months after radiotherapy was associated with inferior overall survival rates compared to cases of RIBI that occurred ${\geq}6$ months (p = 0.085). Conclusion: Our study demonstrated that RIBI could occur in early periods after conventional fractionated brain radiotherapy within normal tolerable dose ranges. Studies with a larger number of patients are required to identify the strong influencing factors for RIBI development.

• Journal of Periodontal and Implant Science
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• v.39 no.sup2
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• pp.213-222
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• 2009

Purpose: Recently, interest in chitosan has increased due to its excellent biological properties such as biocompatibility, antibacterial effect, and rapid healing capacity. On the other hand, hydroxyapatite is used as a bone substitute in the fields of orthopedics and dentistry. The hydroxyapatite-chitosan (HA-CS) complex containing hydroxyapatite nanoparticles was developed for synergy of both biomaterials. The objective of this study was to evaluate the effect of hydroxyapatite (HA)-chitosan (CS) membrane on bone regeneration in the rat calvarial defect. Methods: Eight-millimeter critical-sized calvarial defects were created in 70 male Sprague-Dawley rats. The animals were divided into 7 groups of 10 animals and received either 1) chitosan (CS) 100% membrane, 2) hydroxyapatite (HA) 30%/CS 70% membrane, 3) HA 30%/CS 70%, pressed membrane, 4) HA 40%/CS 60% membrane, 5) HA 50%/CS 50% membrane, 6) HA 50%/CS 50%, pressed membrane, or 7) a sham . surgery control. The amount of newly formed bone from the surface of the rat calvarial defects was measured using histomorphometry, following 2- or 8- week healing intervals. Results: Surgical implantation of the HA - CS membrane resulted in enhanced local bone formation at both 2 and 8 weeks compared to the control group. The HA - CS membrane would be significantly more effective than the chitosan membrane in early bone formation. Conclusions: Concerning the advantages of biomaterials, the HA-CS membrane would be an effective biomaterial for regeneration of periodontal bone. Further studies will be required to improve the mechanical properties to develop a more rigid scaffold for the HA-CS membrane.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.757-765
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• 2008

Maxillary central incisor impactions occur infrequently. Their origins include various local causes, such as odontoma, supernumerary teeth, space loss, and disturbances in the eruption path, also trauma and apical follicular cysts. Impacted teeth can cause serious dental and aesthetic difficulties as well as psychological problems especially in anterior regions. Although the impaction of maxillary incisor occurs less frequently than that of the maxillary canine, it is of concern to parents during the early mixed dentition stage because of the uneruption of the tooth. Forced eruption of impacted teeth should be considered in young patients because this technique can lead to suitable results from a periodontal, occlusal, and esthetic perspective at an earlier stage better than with other treatment options. This report presents the surgical and orthodontic treatment of cases with horizontally impacted and dilacerated maxillary central incisors. For each patient, we used the closed eruption method, placed an attachment on the impacted tooth on surgery, and fully closed the flap. Traction was applied immediately. The impacted tooth erupts through the healed tissue in a manner resembling normal eruption.