• Radiation Oncology Journal
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• v.16 no.4
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• pp.367-375
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• 1998

Purpose : Xerostomia is a complication met by almost all patients who have radiotherapy for cancers of head and neck. Many studies for prevention of xerostomia will be necessary. Radiation-induced acute response of salivary glands has been defined as interphase death or apoptosis. Increased intracellular calcium level have an important role in radiation-induced apoptosis. Calcium channel blocker may prevent radiation-induced apoptosis of salivary glands. This study was designed to evaluate the effectiveness of diltiazem known as calcium channel blocker and pentoxifylline with inhibition of inflammatory response on the apoptosis as an acute response of radiation in rat salivary glands. Materials and Methods : Sprague-Dawley rats with about body weight 200-250 g were divided into 5 study groups : control, radiation alone, diltiazem with radiation, pentoxifylline with radiation, and diltiazem and pentoxifylline with radiation. The diltiazen and pentoxifylline were injected intraperitoneally 20 mg/kg and 50 mg/kg, 30 and 20 mimute before irradiation. respectively. Irradiation was given with a 4 MV linear accelerator. The 1600 cGy of radiation was delivered in a single fraction through a single anterior portal encompassing the entire neck. After 24 h of irradiation, rats were sacrificed and parotid and submandibular glands were removed and stained with hematoxylin and eosin. The quantification of apoptosis was performed by microscopic examination of stained tissue sections at a magnification of 200X and the percentage of apoptotic cell was calculated. Results : On parotid glands, the percentage of apoptosis by radiation alone, diltiazem with radiation, pentoxifylline with radiation, and diltiazem and pentoxifylline with radiation were 1.72$\%$ (8.35/486), 0.64$\%$ (2.9/453), 0.23$\%$ (1.2/516), and 0.28$\%$ (1.1/399), respectively. The apoptosis was markedly reduced in the groups receiving drugs compared with groups receivinge, radiation alone (p<0.05). In serous cell of submandibular glands, the percentages of apoptosis of radiation alone, diltiazem with radiation, pentoxifylline with radiation, and diltiazem and pentoxifylline with radiation were 1.94$\%$ (l1/567), 0.34$\%$ (1.9/554), 0.28$\%$ (1.8/637), and 0.22$\%$ (1.3/601), respectively. In the mucus cell of submandibular glands, the percentages of apoptosis were 0.92$\%$ (5.1/552), 0.41$\%$ (2.5/612), 0.29$\%$ (1.3/455), and 0.18$\%$ (1.0/562), respectively. The apoptosis was markedly reduced in the serous glands (p<0.05), but there was no difference in development of apoptosis in each group of mucus gland. Conclusion : These results suggest that radiation-induced apoptosis of serous cells of salivary glands may be decreased by diltiazem and pentoxifylline administration.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.407-416
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• 1992

Background: Endobronchial tuberculosis is an important complication of pulmonary tuberculosis. It is highly infetious, difficult to diagnose mimicking bronchogenic carcinoma or bronchial asthma and it can leave bronchial stenosis with parenchymal collapse or bronchiectasis as complications. Early diagnosis, adequate treatment and follow-up are crucial in the management of endobronchial tuberculosis. The most important diagnostic tool in its diagnosis is bronchoscopic examination. Authors have tried to elucidate changes in sequential bronchoscopic findings in these patients to help diagnose and manage these patients. Method: We have analysed the sequential bronchoscopic findings and clinical features of 83 endobronchial tuberculosis patients admitted in Seoul National University Hospital from August 1987 to December 1990. Results: We can observe the following results: 1) In the actively caseating type, improvement of the bronchial stenosis was observed in 29 patients (76.3%) up to 5 months of treatment. Caseation disappeared in 31 patients (81.6%) during the same period. 2) In the stenotic without fibrosis type, improvement of the stenosis was observed in 8 patients (66.4%) during the same period. 3) In the tumorous type, improvement of the stenosis was observed in 12 patients (92.3%) during the same period. Conclusion: We can conclude that improvement of the endobronchial lesions may occur up to about 5 months after adequate treatment of endobronchial tuberculosis.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.159-166
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• 2005

Purpose : Recently the merits of 6 weeks of initial prednisolone treatment for pediatric primary nephrotic syndrome have been reported, and the use of the 6 week regimen is increasing. We compared our experiences with the 6 week treatment versus the 4 week treatment for Korean patients. Methods : We conducted a retrospective analysis of 69 children who had primary nephrotic syndrome and who were followed up for at least 12 months in the 4 major medical centers in Daegu. The remission rate, the relapse rate, the frequency of relapse and complication of steroid treatment were compared between the 4 weeks and 6 weeks treatment group. Results : Of the 69 children, 42 were in the 4 week treatment group and 27 were in the 6 week group. The median age, blood pressure, serum total protein, serum albumin, cholesterol, creatinine, estimated creatinine clearance, 24 hour urine protein and 12 month cumulative dose did not differ between the two groups. Among the children who relapsed after steroid treatment, the relapse time was significantly later for the 6 week treatment group. The relapse rate after 1 year of treatment was 62$\%$ in the 4 week treatment group and 52$\%$ in the 6 week treatment group; however, there was no statistically significant difference between the two groups. The frequency of relapse at 12 months was $1.5{\pm}1.2$ times in the 4 week treatment group and $1.1{\pm}1.2$ times in the 6 week treatment group, and there was not different between the two groups. The most common side effects of steroid treatment were an increase of appetite and a cushingoid appearance, and there was no statistical difference between the two groups. Among the 27 children who had kidney biopsies performed, 21 suffered from minimal change nephrotic syndrome. Conclusion : The first relapse time after steroid treatment was significantly later in the 6 week steroid treatment group. The frequency of relapse and the 12 month cumulative dose of steroid were lower in the 6 week treatment group, but there was no statistical significance between the two groups. The side effects of steroid treatment did not differ between the two groups. We need to study the long term side effects and the advanced regimens of steroid treatment in the future.(J Korea Soc Pediatr Nephrol 2005;9:159-166)

• Childhood Kidney Diseases
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• v.6 no.1
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• pp.68-74
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• 2002

Purpose: Suprapubic bladder aspiration(SBA) of urine is the most reliable method to obtain urine avoiding contamination in non-toilet trained infants. Ultrasonography is a useful tool for guiding the anatomic location as well as for direct visualization during procedure. We evaluated the success rate and complication of ultrasound(US) assisted SBA Methods. Sixty infants who visited Ewha Womans University Mokdong Hospital, with suspected urinary tract infection were randomly divided into the US assisted (n=32) and blind SBA(control, n=28) group. In US assisted SBA group, the anteroposterior(AP), transverse, and sagittal diameters and the volume of the bladder were measured. In the blind SBA group, urine was blindly aspirated when the urinary bladder was palpated at the suprapubic area. The rate of successful urine aspiration, the number of attempts until successful aspiration, aspirated urine volume were compared between the two groups. Results: The success rate was $100\%$(32/32) in the US assisted group, which was significantly higher than $85.7\%$(24/28) of the control group (P<0.05). The aspirated urine volume in the US assisted group was $7.4{\pm}3.7\;mL$, which was significantly higher than $4.5{\pm}3.4\;mL$ of the control group (P<0.05), The diameters and volume of bladder in successful aspiration were $2.1{\pm}0.7\;cm$ in AP diameter, $3.1{\pm}0.6\;cm$ in transverse diameter, $4.2{\pm}1.0\;cm$ in sagittal diameter and $15.2{\pm}10.4\;mL$ in volume, which were significantly higher than those ($1.7{\pm}0.3\;cm,\;1.7{\pm}0.3\;cm,\;1.8{\pm}0.7\;cm,\;2.4{\pm]0.6\;cm,\;3.9{\pm}2.5$) of the control group (P<0.05) The correlations between the AP(r=0.78), transverse (r=0.72), sagittal(r=0.91) diameter and bladder volume were significant (P<0.05). SBA was $100\%$ successful in the AP diameter >3 cm, transverse diameter >4 cm, depth >4 cm and bladder volume >5 mL. Conclusion: US assistance can significantly improve the success rate of SBA in infant with suspected urinary tract infection. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 68-74)

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.473-481
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• 2002

Purpose : Ascending cholangitis is the most common complication after Kasai operations. The aim of this study is to evaluate the therapeutic efficacy of cefotaxime as an empirical antibiotic on ascending cholangitis after Kasai operations. Methods : Thirty-nine episodes of cholangitis in twenty-nine children who underwent Kasai operations at Seoul National University Children's Hospital from January 1991 to December 2000 were included in this study. Empirical cefotaxime treatments were divided into three groups : cefotaxime and amikacin treatment group(CA group), cefotaxime and gentamicin treatment group(CG group) and cefotaxime treatment group(C group). A diagnosis of cholangitis was made on the basis of unexplained fever(>$38^{\circ}C$) and either development of acholic stool or elevation of serum total bilirubin (>1.5 mg/dL). Therapeutic efficacy was judged by elimination of fever up to 72 hours, 120 hours, and 168 hours after antibiotic treatment. Results : There were therapeutic responses in 51%(20/39) up to 72 hours after antibiotic treatment : 54%(13/24) in CA group, 43%(3/7) in CG group and 50%(4/8) in C group. There were therapeutic responses in 69%(27/39) up to 120 hours, in 79%(31/39) up to 168 hours and in 82%(32/39) up to 2 weeks. There were no differences in therapeutic efficacy among the three regimens. In 12 of 39 episodes, the etiologic pathogens including Escherichia coli and enterococcus were cultured from the blood. Conclusion : Cefotaxime can be tried as an initial antibiotic in Korean children with ascending cholangitis after Kasai operation prior to the identification of microorganism on culture. However, further evaluation of pathogen and its resistant strain to cefotaxime should be done.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.41-48
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• 2005

Purpose: Non-A, B, C viral hepatitis is the name given to the disease with clinical viral hepatitis, but in which serologic evidence of A, B, C hepatitis has not been found. Little is known about the etiology and clinical features of non-A, B, C viral hepatitis in children. Methods: A clinical analysis of 45 cases with non-A, B, C viral hepatitis who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 2001 to June 2004 was carried out retrospectively. Patients who were positive for HBsAg, anti-HAV and anti-HCV and had toxic, metabolic, autoimmune, or neonatal hepatitis were excluded in this study. Results: Among 45 cases of non-A, B, C viral hepatitis, the etiology was unknown in 26 (57.8%), CMV (cytomegalovirus) in 14 (31.1%), EBV (Epstein Barr virus) in 2 (4.4%), HSV (herpes simplex virus) in 2 (4.4%) and RV (rubella virus) in 1 (2.2%). Twenty seven out of 45 (60.0%) patients were under 1 year of age. Sixteen (33.3%) patients had no specific clinical symptoms and were diagnosed incidentally. On physical examination, twenty seven out of 45 patients (60.0%) had no abnormal findings. Forty three out of 45 patients (95.6%) showed classic clinical course of acute viral hepatitis, whereas fulminant hepatitis developed in two patients. Mean serum ALT (alanine aminotransferase) level was $448.7{\pm}771.9IU/L$. Serum ALT level was normalized in 31 out of 45 patients (81.6%) within 6 months and all patients within 18 months. Aplastic anemia was complicated in a case. Conclusion: Although most patients with non-A, B, C viral hepatitis showed a good prognosis, a careful follow-up would be necessary because some of them had a clinical course of chronic hepatitis, fulminant hepatitis and severe complication such as aplastic anemia.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.99-107
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• 2009

Statement of problem: Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. Purpose: The purpose of this study was to evaluate the clinical status of fixed prostheses. Material and methods: In order to assess the clinical status of fixed prostheses, a total of 161 individuals(aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined. Results and conclusion: The results of this study were as follows: 1. Length of service of fixed prostheses was $8.6{\pm}0.6$ years(mean), 10.0 years(median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination(P<.05). 3. Longevity of fixed prostheses made of metal was longest(mean: $13.0{\pm}9.3$, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind(P<.05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit(P<.05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in natural dentition(P<.05). 6. Defective margin(28.2%), dental caries(23.0%), periodontal disease(19.3%), periapical disease(16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.674-677
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• 2003

Staple closure of bronchial stump was compared with manual suture closure among 100 cases of pneumonectomy during the recent 5-year period, We have reviewed the incidence of bronchpleural fistula between autosutured group and manual sutured group. Material and Method: During the recent 5-year period, 100 patients underwent pneumonectomy at Hanyang University Hospital. Staple closure of bronchial stump was performed in 65 patients and manual suture in 35 patients. There were 55 males and 10 females in the autosutured group, and 26 males and 9 females in manual sutured group, which showed no significant statistical difference between the two groups. The mean ages of patients for autosutured group and manual sutured group were 56.7$\pm$10.3 years and 61.4$\pm$9.2 years, respectively, which showed no significant statistical difference between the two groups. There were 38 cases of left pneumonectomy and 27 cases of right pneumonectomy in autosutured group, and 22 cases of left pneumonectomy and 13 cases of right pneumonectomy in manual sutured group. There were 53 cases of malignancy and 12 cases of benign imflammatory disease in autosutured group, and 27 cases of malignancy and 7 cases of benign imflammatory disease in manual sutured group. Result: The incidence of bronchopleural fistula was 6.1％ in autosutured group and 5.7％ in manual sutured group. The incidence of other postoperative complication between the two groups showed no significant statistical difference. Conclusion: The incidence of bronchopleural fistula between autosutured group and manual sutured group was not different stastically. Both method for closure of bronchial stump can be performed in pneumonectomy.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1070-1075
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• 1998

Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.57-65
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• 1999

Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.