• Childhood Kidney Diseases
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• v.6 no.1
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• pp.37-47
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• 2002

Purpose: We reviewed the clinical manifestations, responsiveness to treatment, and prognosis in children with nephrotic syndrome. Methods: Medical records of 159 children with idiopathic nephrotic syndrome who were admitted to the pediatric department of Chonbuk National University Hospital from January 1979 to December 2000 w ere retrospectively reviewed. Results: There were 32 females and 127 males. The most common age group was between 3 and 5 years of age among the 159 children with nephrotic syndrome. Generalized edema ($75.5\%$), scrotal edema ($20.1\%$), upper respiratory infection ($19.5\%$), and ascites ($28.3\%$) were frequently observed. After the initial steroid therapy, diuresis occurred within tile first two weeks in 138 children, and proteinuria disappeared within the first two weeks in 105 children. Among 159 patients who received initial daily steroid therapy, 110 children were in complete remission, 29 children were in partial remission and 20 children were in poor response state. Hematuria, hypertension and elevated serum creatinine were more frequently observed in the partial and the poor response groups than in the complete remission group. Among 107 children who were followed up for more than one year, 78 children were in complete remission and 55 children were relapsed within the first one year after steroid therapy. Renal biopsy was undertaken in 76 children and 53 children had minimal change nephrotic syndronm. Conclusion: Our study showed that illost children with idiopathic nephrotic syndrome have a good responsiveness to steroid therapy and even most children show frequent relapse during 1st year after remission, long term prognosis is excellent.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.161-169
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• 2009

Purpose : This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. Methods : We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. Results : Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. Conclusion : Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.130-137
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• 2009

Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.1
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• pp.55-65
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• 1999

From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was $10.05{\pm}2.75\;KAU$, $66.67{\pm}9.88\;IU／L$, $43.80{\pm}7.74\;IU／L$, $1.89{\pm}1.22\;mg／dl$ and $1.10{\pm}1.14\;mg／dl$ respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $11.01{\pm}3.16\;KAU$, $56.47{\pm}7.19\;IU／L$, $59.00{\pm}7.57\;IU／L$, $2.54{\pm}1.78\;mg／dl$, $1.64{\pm}1.59\;mg／dl$ respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.51{\pm}3.49\;KAU$, $77.85{\pm}7.17\;IU／L$, $58.00{\pm}9.09\;IU／L$, $2.54{\pm}1.97\;mg／dl$, and $1.80{\pm}1.81\;mg／dl$ respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.43{\pm}3.14\;KAU$, $41.13{\pm}6.49\;IU／L$, $50.40{\pm}7.17\;IU／L$, $1.66{\pm}1.90\;mg／dl$ and $1.14{\pm}1.50\;mg／dl$ respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.30{\pm}3.25\;KAU$, $31.07{\pm}3.85\;IU／L$, $43.33{\pm}5.49\;IU／L$, $1.62{\pm}1.95\;mg／dl$, $1.17{\pm}1.71\;mg／dl$ respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was $28.73{\pm}5.19\;mg／dl$ and $1.82{\pm}1.27\;mg／dl$ respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was $32.12{\pm}5.65\;mg／dl$ and $2.31{\pm}0.45\;mg／dl$ respectively. From 4th day to 7th day, the mean BUN and Creatinine level was $31.07{\pm}5.47\;mg／dl$ and $1.92{\pm}0.79\;mg／dl$ respectively. From 7th day to 10th day, the mean BUN and Creatinine level was $17.47{\pm}3.57\;mg／dl$ and $1.33{\pm}0.59\;mg／dl$ respectively. From 11th day to 14th day, the mean BUN and Creatinine level was $11.93{\pm}3.16\;mg／dl$, $1.27{\pm}0.38\;mg／dl$ respectively.

• Journal of the Korean Society of Radiology
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• v.7 no.5
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• pp.353-358
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• 2013

Recently, the Percutaneous Coronary Intervention has become a main treatment for treating Coronary because of increase of Circulatory Disease. Because of this reason, the increase of intervention using radiation causes the radiation exposure to workers. Therefore, the latent radiation injury can be increased. Thus, this study/experiment measured around under knee whether using radiation collimator shielding or not. We measured the exposure does by the experiment methods which are using 60kV, 200mA, and 10ms of Automatic exposure conditions and using the major method of the Cinefluography of Coronary in our hospital. As the result of right coronary artery test cases, LAO $30^{\circ}$ when the curtains if you use lead 98.4%, $Cranial30^{\circ}$ 98.3% have a protective effect of the radiation. left circumflex coronary artery test cases, Caudal $30^{\circ}$ if the shielding effect of 90.2%, Caudal $30^{\circ}LAO$ $30^{\circ}$ 88.7% have a protective effect of the radiation. left anterior descending artery test cases, Cranial $30^{\circ}$ 98.3%, Cranial $30^{\circ}RAO$ $30^{\circ}$ 80.3%, Cranial $30^{\circ}$LAO $30^{\circ}$ 98% of the radiation has a protective effect. OS(Spider view) in the case of test Caudal $40^{\circ}LAO$ $40^{\circ}$ 71.2% appeared to have the effect of radiation shielding. For these reasons, radiation workers need to be aware on taking care of their radiation exposure by using the radiation collimator shielding even though it is uncomfortable for them.

• The Journal of Korean Society for School & Community Health Education
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• v.10 no.1
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• pp.87-104
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• 2009

Objective: In this study, the dental health care knowledge, dental health behaviors and dental health status of elementary school students were compared and analyzed in the cases of their schools having dental health care center or not one. Methods: The target groups were 167 students of A school (experimental group) where pit-and-fissure sealants, fluoride mouthrinsing, and fluoride gel application were carried out with all grades of students by school dental health care center and 158 students of B school (control group) where fluoride mouthrinsing, for all grades students and pit-and-fissure sealants for the first grade students are carried out but have no the school dental health care center. Results: This study was carried out through the answer sheets and recordings of dental inspection. The findings of this study are as follows: 1. The dental health care knowledge was compared and the results showed that on average 14.2$\pm$2.1 in experimental group and 14.0$\pm$1.9 in the control group were no significantly different (p>0.05). 2. The dental health behaviors were compared and the results showed that the experimental group was significantly different(p<0.05) in terms of the number of times of dental brushing a day, the method of tooth brushing, the time of tooth brushing, the experience of tooth brushing with fluorine, the kinds of snacks and tooth brushing in school after lunch. But there was no significant difference(p>0.05) in the time of tooth brushing and the tooth brushing after eating snacks. 3. The DMF rate was compared and the results showed the significantly difference between the average experimental group and 53.8$\pm$5.0 in the control group(p<0.05). 4. The DMFT index was compared and the results showed the significantly difference between the average 0.6$\pm$2 in the experimental group and 1.4$\pm$1.6 in the control group(p<0.05). 5. The DMFI rate was compared and the results showed the significantly difference between the average 4.2$\pm$8.3 in the experimental group and 9.5$\pm$11.0 in the control group. (p<0.05). 6. The DT rate were compared and the results showed the significantly difference between the average 10.2$\pm$29.5 in the experimental group and 32.4$\pm$44.0 in the control group(p<0.05). 7. The FT rate were compared and the results showed the significantly difference between the average 88.5$\pm$31.0 in the experimental group and 67.5$\pm$44.0 in the control group(p<0.05). Conclusions: Based on the results, above there was no significant difference in dental health care knowledge between both the experimental and the control group. But we discovered that the experimental group is better than the other one in dental health care behaviors and dental health status. Therefore, we could conclude that the school dental health care center efficiently carried out the dental care and treatment. As school dental health care centers did not work out efficiently in terms of their educating on the dental health acre knowledge, the related programs to be developed and supported.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.183-194
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• 1988

Twenty five patients with histologically proven medulloblastoma received craniospinal radiotherapy (CSRT) at the Seoul National University Hospital from 1979 to 1984. The extent of tumor removal was biopsy only in 2 patients, partial in 18, and near total in 5. With orthogonal technique of CSRT, mainly 55Gy was delivered to the posterior fossa (PF), 40Gy to whole brain (WB), and 30Gy to whole spine (WS). And with AP; PA technique, 50Gy to PF, 45-50Gy to WB, and 36 Gy to WS. Complete remission was obtained in $84\%$ of patients. Among 21 CR's 10 failures were observed, thus total failure rate was $56\%$ (14/25). Of 14 faiure 13 had the primary failure, 11 failed in primary site alone, 1 failure was combined with ventricular seeding, and another 1 was combined with neck node metastasis. There was 1 isolated spinal failure. Actuarial overall survival rates at 3 and 5 years were $75\%$ and $54\%$, and disease-free survival rates were $58\%$ and $36\%$, respectively. Better 5 year disease-free survival was noted in patients with 55 Gy to the posterior fossa than those with 50Gy $(62\%\;vs\;17\%,\;p<0.05)$, in patients treated with orthogonal technique than those treated with AP:PA technique $(87\%\;vs\;12\%,\;p<0.05)$, and in patients with near total removal than those with partial or less removal of tumor $(56\%\;vs\;30\%,\;N.S.)$ Re-irradiation was not satisfactory No severe late sequelae was noted among the survivors. For the higher control of medulloblastoma, dose to posterior fossa should be at least 55Gy with orthogonal CSRT to small tumor burden. And dose reduction in the subarachnoidal spaces might be safe, but optimal dose to the subarchnoidal spaces should be determined by the thorough tumor staging before radiotherapy.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.769-776
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• 1996

The application of video-assisted thoracic surgery (VATS) in the examination of the thoracic cavity can be a new option in patients with mediastinal tumor because it provides outstanding visibility of the structures of the mediastinum. By clear viewing through the thoracoscope, a mediastinal tumor can be biopsied or resected, depending on the findings during an operation. We reviewed all patients who underwent curative or diagnostic operations from March 1990 to August 1995 under the impression of a mediastinal mass. The total number of patients were 113 with 59 males and 54 females. Group A underwent resection of tu or by thoracotomy(38 patients: 18 males, 20 females), and group B underwent resection of tumor by VATS (36 patients : 20 males and 16 females). Seven patients in group B were excluded because they underwent thoracotomy due to pleural adhesion or intra-operative bleeding ; therefore, the true VATS group numbered 29 cases. Group C underwent Iymph node biopsy by VATS(33 patients'16 males, 17 females), and group D(6 patients: 5 males, 1 female) underwent Iymph node biopsy through anterior mediastinotomy. The mean age in group A was 36.2 years compared to 41.3 years In group B. We compared operation time, frequency of injection for pain control, duration of chest tube insertion, postoperative hospital stay, and diagnostic yield. In group A, they were 164 minutes, 3.4 times, 5.2 days, and 11.3 days, respectively, in comparison to 152 minutes, 2 times, 4.7 days, and 8.3 days, respectively, in group B. These data revealed that the day of discharge was significantly shorter in group B (p valu : 0.03). In group C, the mean age was 45.8 years (range 1 ∼70). The operation time was from 30 to 335 minutes (mean 105), pain control was required from 0 to 15 times(mean 3.2), and a chest tube was needed for 1 to 36 days (mean 6.1). In group D, mean age was 53.3 years, operation time 121 minutes, pall control injec- tion frequency 2.6 times, and mean chest tube duration 10.5 days. The diagnostic yield in group C was 8 oyo compared to 100 oyo in group D although the number of patients in group D is small.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.51-58
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• 2018

Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

• Journal of Biomedical Engineering Research
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• v.19 no.6
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• pp.617-622
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• 1998

A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.