• Advances in pediatric surgery
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• 제3권2호
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• pp.133-142
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• 1997

Hepatoblastoma is a rare pediatric malignancy which frequently presents at an advanced un resectable stage. With the neoadjuvant chemotherapy, improved resectability and survival have been reported. Twenty children with biopsy proven hepatoblastoma were treated during the period between January 1987 and June 1995. Median age at diagnosis was 13 months(2 months to 7 year and 10 months), and 13 were male. Histologic profile was 13 epithelial(5 fetal, 4 mixed, 1 embryonal, 3 undetermined), and 5 mixed mesenchymal and epithelial and 2 of undetermined type. Chemotherapy effectively reduced the tumor volume($p$=0.008), and was able to convert 7 out of 9 initially unresectable cases(78%) to resectable ones. Twelve radical and 2 palliative operations were done with or without adjuvant chemotherapy. The Median follow up period was 33 months and the median survival was 26 months. The group with curative resection had a 61.1% 5 year survival rate, but none of palliative resection group survived more than 13 months($p$=0.0001). In univariate analysis for prognostic factors revealed, large tumor size at diagnosis and abscence of thrombocytopenia were associated with poor survival, but these differences were not statistically significant. Histological pure fetal type did not mean a better prognosis. Even with a recent neoadjuvant chemotherapy, the strategy should be focused on the radical resection as early as possible.

• 한국수정란이식학회지
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• 제26권1호
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• pp.45-51
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• 2011

This study investigated potential relationship between fetal deaths and plasma progesterone concentrations of bitches. Serial ultrasonographic examinations were performed on small-pet 23 dogs from gestation day (GD) 15 through parturition. The dogs were 3 non-pregnant bitches, 9 spontaneous delivery bitches, 6 partial early embryonic death bitches, 2 whole early embryonic death bitches, and 3 aborted bitches. The late pregnancy (GD 51-54) appeared in 2 of the 3 aborted bitches and the hypoluteoidism appeared in 1 of the 3 aborted bitches. The plasma progesterone concentrations of partial early embryonic death bitches (n=6) showed no significant difference when compared with the spontaneous delivery bitches. We observed that plasma progesterone concentrations were dramatic decrease before the onset of embryonic death in whole early embryonic death bitches that plasma progesterone concentrations of aborted bitches at late pregnancy were significantly decreased when compared with those of spontaneous delivery bitches. The plasma progesterone concentrations of the hypoluteoidism bitch were lower than those of spontaneous delivery bitches. At the hypoluteoidism bitch, fetuses were resorbed in early pregnancy and aborted in late pregnancy. On the basis of the results, the diagnosis of partial early embryonic death could not be confirmed without ultrasonographic examination. The partial early embryonic death was considered a spontaneous phenomenon and uncorrelated with plasma progesterone concentration. However, aborted bitches and whole early embryonic death bitches were related to plasma progesterone concentrations and that of bitches gradually decreased before fetal death. These findings suggest that administration of progesterone may be a useful preventing agent against fetal death.

• Childhood Kidney Diseases
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• 제5권2호
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• pp.182-187
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• 2001

목 적 : 산전 초음파상 경증의 태아 신우확장의 임상적 의의와 배뇨성 방광요도조영술의 역할을 평가하고자 하였다. 대상 및 방법 : 1999년 1월부터 1999년 9월까지 산전 초음파상 경증의 태아신우확장(신우전후직경 <10mm)이 발견된 28명 신생아의 44개 신장을 대상으로 하여 생후에 신장 초음파와 배뇨성 방광요도조영술을 시행하였다. 결 과 : 생후 초음파 검사에서 29개 신장인 $65.9\%$에서 신우확장이 정상화되었고, 15개 신장인 $34.1\%$에서 신우확장이 지속되었다. 배뇨성 방광요도조영술상 남아 3명 ($10.7\%$)의 4개 신장 ($9.1\%$)에서 방광요관역류가 발견되었다. 태아 신우확장의 산전변화인 진행성이나 퇴행성과 방광요관역류와는 상관성이 없었고 생후 신우확장의 지속여부와도 상관성이 없었다. 방광요관역류로 진단된 4개 신장의 생후 초음파 검사는 모두 정상이었다. 결 론 : 산전 초음파상 경증의 신우확장은 무시될 수 없으며 생후 초음파 검사상 신우확장이 정상화되었더라도 배뇨성 방광요도조영술이 필요할 것으로 생각된다.

• Neonatal Medicine
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• 제17권2호
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• pp.262-264
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• 2010

요막관은 총 배설관에서 유래된 구조물로서, 태생기에 방광의 첨부와 제대 사이를 연결해주는 관이며, 임신 8-9개월에 완전히 막히게 되어 출생시에는 정중제인대로 남게된다. 드물게 요막관이 출생 후에도 요막관 게실, 요막관 낭종, 개방성 요막관 등으로 남아 있는 경우가 있는데, 그중 가장 심한 형태가 개방성 요막관으로 이를 통해 방광이 탈출되는 경우는 매우 드문 것으로 알려져 있다. 환아는 재태연령 41주, 출생체중 3,110 g, 아프가점수 1분 1점, 5분 7점, 정상 질식 분만되었으며, 산모는 35세로 임신 기간 중 약물 복용이나 다른 병력은 없었다. 재태연령 20주 2일에 시행한 산전 초음파상 낭성의 요막관 잔여물이 발견되었으며, 태아 자기공명영상에서 방광과 연결되는 낭종이 관찰되었다. 재태연령 40주 4일에는 고형종물 양상으로 관찰되어 초기의 낭종 형태에서 변화된 양상을 보였다. 출생 후 진찰 소견상, 제대 하방에 점막으로 둘러싸인 $3{\times}4cm$의 종물이 있었으며 요도로 삽입한 도관이 종물의 개구부를 통해 나오는 것이 확인되어 종물이 요도와 연결된 천공된 상태의 방광임을 추정할 수 있었다. 생후 1일에 시행한 복부 초음파상 수신증이나 다른 요로기형은 발견되지 않았으며, 생후 2일째 방광 복원술 및 요막관제거술을 시행하였다. 생후 9일째 시행한 배설성 방광 요로 조영술에서 방광 요로 역류는 없었고, 방광 기능은 좋은 것으로 확인되었다. 생후 10일째, 정상적인 배뇨를 보여 퇴원하였고 이후 특별한 문제없이 외래 추적 관찰 중이다. 저자들은 재태연령 20주 2일에 산전 초음파에서 요막관 잔여물로 추정되었던 낭종이 출생 후 요막관을 통한 방광 탈줄증으로 확진된 후 합병증 없이 수술적으로 완치되어 국내 최초로 보고하는 바이다.

• Journal of Genetic Medicine
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• 제15권1호
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• pp.8-12
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• 2018

Purpose: This study aimed to investigate fetal ultrasonographic findings in cases of prenatally diagnosed de novo balanced translocations and the role of fetal ultrasound in prenatal genetic counseling. Materials and Methods: We collected cases with de novo balanced translocations that were confirmed in chorionic villus sampling, amniocentesis, and cordocentesis between 1995 and 2016. A detailed, high-resolution ultrasonography was performed for prediction of prognosis. Chromosomes from the parents of affected fetuses were also analyzed to determine whether the balanced translocations were de novo or inherited. Results: Among 32,070 cases with prenatal cytogenetic analysis, 27 cases (1/1,188 incidence) with de novo balanced translocations were identified. Fourteen cases (51.9%) showed abnormal findings, and the frequency of major structural anomalies was 11.1%. Excluding the major structural anomalies, all mothers who continued pregnancies delivered healthy babies. Conclusion: Results of a detailed, high-resolution ultrasound examination are very important in genetic counseling for prenatally diagnosed de novo balanced translocations.

• 한국방사선학회논문지
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• 제6권3호
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• pp.201-206
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• 2012

진단적 초음파가 태아에 미치는 영향에 대하여는 대부분의 연구결과, 심각한 영향을 미칠 가능성이 매우 낮다고 보고되고 있으나, 장시간의 과도한 조사는 초음파가 인체조직에 온도 상승이나 물리적인 영향을 줄 수 있어 초음파 검사시간에 따라 허벅지의 온도 변화를 조사하여 태아 초음파 검사 시 영향이 없는 시간을 알아보았다. 그 결과 초음파 검사 전보다 40분 안에는 온도가 떨어졌고 50분에는 허벅지의 온도가 검사 전보다 $1^{\circ}C$이상 올라가는 것을 확인하였다. 그러므로 40분 안에 초음파 검사를 한다면 안전한 것으로 추론해 본다.

• Clinical and Experimental Pediatrics
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• 제54권3호
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• pp.133-136
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• 2011

Fetus-in-fetu (FIF) is a rare congenital condition in which a fetiform mass is detected in the host abdomen and also in other sites such as the intracranium, thorax, head, and neck. This condition has been rarely reported in the literature. Herein, we report the case of a fetus presenting with abdominal cystic mass and ascites and prenatally diagnosed as meconium pseudocyst. Explorative laparotomy revealed an irregular fetiform mass in the retroperitoneum within a fluid-filled cyst. The mass contained intestinal tract, liver, pancreas, and finger. Fetal abdominal cystic mass has been identified in a broad spectrum of diseases. However, as in our case, FIF is often overlooked during differential diagnosis. FIF should also be differentiated from other conditions associated with fetal abdominal masses.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.434-437
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• 2000

일측성 수두증은 여러가지 원인에 의해 발생될 수 있으나 주로 종양이나 감염등에 의한 후천적인 몬로공 폐쇄의 경우가 대부분이고 선천성 몬로공 폐쇄에 의한 일측성 수두증은 그 예가 많지 않다. 산전초음파 검사로 태아의 선천성 일측성 수두증을 진단했고 출산 후 수술적 방법을 통해 치료한 예는 국내에 아직 보고된 바가 없어 이를 문헌고찰과 함께 보고한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2061-2066
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• 2016

Purpose: To determine the significance of P57KIP2 immunohistochemistry expression in the histopathological diagnosis of hydatidiform mole. Materials and Methods: Hydatidiform mole patients at King Chulalongkorn Memorial Hospital between January 1999 and December 2011 were recruited. Two gynecologic pathologists reviewed histopathologic slides to confirm diagnosis. Formalin-fixed, paraffin-embedded tissue sections were stained using a bstandard immunostaining system with monoclonal antibodies against P57KIP2 protein. Correlations among pathological features, immunohistochemical expression and clinical data were analyzed. Results: One hundred and twenty-seven hydatidiform mole patients were enrolled. After consensus review, 97 cases were diagnosed as complet (CHM) and 30 cases as partial (PHM). Discordance between the first and final H&E diagnoses was found in 19 cases (14.9%, k= 0.578). Significant pathological features to classify the type of hydatidiform mole are central cisterns, trophoblastic proliferation, trophoblastic atypia, two populations of villi, fetal vessels and scalloped borders. After performing immunohistochemistry for P57KIP2, 107 cases were P57KIP2 negative and 20 cases positive. Discordant diagnoses between final H&E diagnosis and P57KIP2 immunohistochemistry was identified in 12 cases (9.4%). Sensitivity of final H&E diagnosis for CHM was 89.7%; specificity was 95.0%. PHM sensitivity and specificity of final H&E diagnosis was 95.0% and 89.7%, respectively. Conclusions: Histopathological diagnosis alone has certain limitations in accurately defining types of hydatidiform mole; P57KIP2 immunohistochemistry is practical and can be a useful adjunct to histopathology to distinguish CHM from non-CHM.

• 한국수정란이식학회지
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• 제11권3호
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• pp.291-300
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• 1996

Real time B-mode ultrasound was used to detect the early conceptus in 187 Korean native cattles between days 10 and 60 after last insemination. The ultrasound diagnostic findings were systemically confirmed by palpation per rectum after the 60th day of last insemination. The embryonic vesicle and the embryo proper within the veside were first visible on mean day fl and 23, respectively. The heartbeat of the embryo proper could be detected on day 26, and the limb buds, placentomes, amnion, fetal movement, umbilical cord, optic area and split hooves were first visible on day 33, 34, 34, 44.5, 45, 32 and 48, respectively. The mean length of embryo proper was 3.8mm on day 23 which later increased to 56. 6rnrn on day 60. When ultrasound was used to detect the conceptus between days 20 and 30 after insemination and palpation per rectum after the 60th day of insemination, the accuracy rates of pregnancy detection by ultrasound scanning at days 20, 22, 24, 26, 28, 30 were 44.4, 69.2, 78.6, 87.5, 90.0, 93.3%. In summary, the early pregnancy diagnosis of Korean native cattle with ultrasound appears high accuracy rates. It is considered that ultrasound can be used in veterinary practice well.