• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.83-89
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• 2007

Background: The surgical repair of an isolated coarctation of the aorta, without complex cardiac anomalies, has improved, with very good results. However, despite the success of surgical repair, many long-term complications, such as hypertension, re-coarctation and an aortic aneurysm, still exist. Material and Method: Between 1991 and 2006, 50 patients diagnosed with an isolated coarctation of the aorta were reviewed retrospectively. The incidence of re-coarctation and hypertension were compared with respect to age and surgical methods. Result: There were no early & late mortality, or post operative aortic aneurysms. Hypertension developed in 11 patients (22%). A greater number of patients in the child/adult group had hypertension (52.4%) than in the neonate/infant group (0%). With respect to the surgical methods, the patients in the graft interposition group suffered more hypertension (88.9%) than those in the EEEA (extended end to end anastomosis) group (5.3%). Post operative re-coarctation developed in 2 out of the 29 patients (6.9%) in the neonate/infant group and 2 out of the 21 patients (9.5%) in the child/adult group, but without any statistical difference. There were no statistical differences between the operative type-related groups. Conclusion: Even though the surgical outcomes have greatly improved, an isolated coarctation of the aorta still has many long-term problems, such as hypertension and re-coarctation. An isolated coarctation is accepted as a systemic vascular dysfunction, and often progresses to other cardiovascular diseases. Therefore, patients with a coarctation of the aorta have to be carefully followed-up, and aggressive management must be given when required.

• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1348-1353
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• 2005

Purpose : Influenza is a respiratory disease which prevails widely every year and shows high morbidity and mortality among not only chronic invalids and the old, but also among infants and young children. To prevent community-acquired influenza infection, to facilitate prompt antiviral therapy and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for the influenza virus is needed. We evaluated a lateral-flow immunoassay(QuickVue Influenza Test), compared to viral culture. Methods : During two consecutive years from Jan. 2004 to June 2004 and from Feb. 2005 to Jan. 2005, 408 patients who were suffering from fever, cough and/or sore throat and myalgia were enrolled in our study. A total of 408 patients were tested with $QuickVue^{(R)}$(Quidel Co., San Diego, USA) influenza rapid antigen test and virus cultures at the same time. Results : Of the 408 patients tested, children who showed positive results at the virus culture numbered 77; among them, 55(71.4 percent) were type A/H3N2 and 22(28.5 percent) were type B. QuickVue influenza test had a sensitivity of 71.4 percent and a specificity of 95.8 percent. The positive and negative predictive values were 79.7 percent and 93.5 percent, respectively. Conclusion : In our study, this test had comparable high sensitivity and high specificity and many advantages, such as being easy to perform and simple to interpret, and showing rapid results. If rapid influenza antigen tests are widely applied in the clinic, we can begin treatment more rapidly and reduce influenza complications and the abuse of antibiotics.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.4
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• pp.25-30
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• 2008

Purpose: In this paper, we have analyzed the problems of the Oh's report which is used to the basic data for supply and demand of medical technicians and studied a proposal for improvement to control system and supply and demand of korean optometrists. Methods: We have analyzed errors of Oh's report including supply and demand for medical technicians and management policy, expecting number for future optician, inaccurate estimation by limited data (employment rate, retirement rate, mortality rate) and an incorrect method of measurement for future supply and demand. Results: Oh's report showed the 18% error for estimation of supply which exclude the irregular entrance students. The estimation of supply was calculated by graduation rate 62.6% (college and University of Technology are 78.9% and 85.98% respectively), employment rate 65.8% (the average employment between 2002 and 2007 is 73.96%) and retirement rate is 2.3% (the retirement of pharmacists is 1.3%) but it showed the significant differences to objective data. For estimate the suitable ratio of optometrists to the population, the ratio use of medical facilities by an age group was used, and suggested spectacle wearers 1,280 persons (populations 2,928 persons) per optometrist but the different from reference of Germany (4,706 persons), America (1,789 persons) and Korea (1,825 persons/an optometrist) are applied to estimation on supply. This report applied the low employment rate and argued that maintain the present situation, but claimed that utilize unemployment persons. The above result has induced double weighting effect on estimation of supply. Conclusions: To solve the related problems of supply and demand, we have to make a search for exact data and optimum application model, have to take an example of nation similar job category as Germany and the research result of the job satisfaction into consideration. After we get the integrated research result, we must carried out the policy with fairness and balance for the estimation of supply and demand. Therefore exact research is required prior to beginning policy establishment, government and related group have to make a clear long-term plan and permanent organization for medical technician to establish supply and demand of medical technician.

• Neonatal Medicine
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• v.15 no.1
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• pp.32-37
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• 2008

Purpose : Perinatal asphyxia is an important cause of neonatal mortality and subsequent lifelong neurodevelopmental handicaps. Although many treatment strategies have been tested, there is currently no clinically effective treatment to prevent or reduce the harmful effects of hypoxia and ischemia in humans. In the clinical setting, maternal hyperthermia induces adverse effects on the neonatal brain, but recent studies have shown that hyperthermic pretreatment (PT) plays some role in hypoxic-ischemic (HI) injuries of the developing brain. The present study investigated the effect of hyperthermic PT on HI brain injuries in newborn rats. Methods : HI was produced in 7-day-old neonatal rats by unilateral common carotid artery ligation, followed by hypoxia with 8% oxygen at $38^{\circ}C$ for 2 hours. Twenty-four hours before HI, one-half of the pups were exposed to a $40^{\circ}C$ environment for 2 hours. The severity of the brain injury was assessed 7 days after the HI. Results : Hyperthermic PT reduced the gross and histopathologic findings of brain injury from 64.7 to 31.2% (P<0.05). There were no differences in location and severity of injury between the pretreated and control brains. Conclusion : These findings indicate that hyperthermic PT provides neuroprotective benefits on HI in the developing brain. Also, these findings suggest maternal hyperthermia may have protective effect on perinatal HI brain injuries.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.425-431
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• 1998

Purpose : We retrospectively analyzed the impact of subpleural lesions of early stage non-small cell lung cancer on the patterns of failure to support selection of postoperative adjuvant therapy. Methods and Materials : The study included 91 patients who underwent surgery for early stage non-small cell lung cancer at Dong-A University Hospital from Dec 1990 to Sep 1996. Twenty five patients were excluded due to postoperative mortality (four patients, 4.4$\%$) and stage III (21 patients). Of 66 patients, 22 patients were subpleural lesions (15 patients in stage I, and seven patients in stage II). Postoperative adjuvant radiation therapy was given to seven patients with T2Nl disease. The median follow-up duration was 29.5 months (range; 8-84 months). Results : The overall survival rate was 69.5$\%$ at 3 years. For all patients who presented with (22 patients) and without (44 patients) subpleural lesions, 3-year overall survival rates were 35.5$\%$ and 84.6$\%$, respectively (p=0.0017). For stage I patients who presented with (15 patients) and without (29 patients) subpleural lesions, 3-year overall survival rates were 33.1$\%$ and 92.3$\%$, respectively (p=0.001). For stage II patients who presented with (7 patients) and without (15 patients) subpleural lesions, 3-year overall survival rates were 53.3$\%$ and 45.7$\%$, respectively (p=0.911). For patients with T2N0 disease (34 patients) who presented with (11 patients) and without (23 patients) subpleural lesions, 3-year overall survival rates were 27.3$\%$ and 90.3$\%$, respectively (p=0.009). Conclusion : These observations suggest that the subpleural lesion play an important role as a prognostic factor for early stage non-small cell lung cancer. Especially for T2N0 disease, patients with subpleural lesions showed significantly lower survival rate than those without that.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.7-16
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• 1998

Purpose : To evaluate survival rate and prognostic factors affecting survival of patients with esophageal cancer treated with concurrent chemoradiation. Materials and Methods : Eligibility included biopsy proven invasive carcinoma of the cervical or thoracic esophagus, confined to esophagus and mediastinum with or without regional lymph node and supraclavicular lymph node, and ECOG Performance status $H_0-H_2$. Patients received radiation therapy with 5940cGy over 7 weeks and chemotherapy, consisted of 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days, days 1 to 5 and days 29 to 33) and mitomycin C($8mg/m^2$ intravenous bolus at day 1). After concurrent chemoradiation, maintenance chemotherapy was followed with 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days at 9th, 13th, and 17th weeks) and cisplatin($80mg/m^2$ intravenous bolus at the first day of each cycle). Results : From November 1989 to November 1995, 44 patients were entered in this study. After treatment, complete response rate and partial response rate were $59\%$ and $41\%$. Overall 1, 2, and 5-year survivals were $59\%$, $38\%$, and $9.6\%$(median 17 months), Prognostic factors affecting survival were response to treatment and T-stage. Among 26 complete responders, there were 6 local recurrences, 3 distant recurrences, 1 local and distant recurrence, and 2 unknown site recurrences Acute and chronic complication rates with grade 3 or more were $20\%$ and $13.0\%$ and there was no treatment-related mortality. Conclusion : Concurrent chemoradiation, compared with historical control groups that treated with radiation alone, improved median survival and did not significantly increase treatment-related complications. Complete responders had longer survival duration than partial responders. Predominant failure pattern was local failure. So, efforts to improve local control should be proposed.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.153-159
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• 2002

Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.64-68
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• 2005

Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

• Neonatal Medicine
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• v.15 no.1
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• pp.67-74
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• 2008

Purpose : The purpose of this study was to assess the natural history and perinatal outcomes of twin gestations according to chorionicity. Methods : We retrospectively reviewed the medical records of 99 monochorionic (MC) and 206 dichorionic (DC) twin gestations delivered at Il Sin Christian Hospital in Busan between January 2002 and December 2007. The incidences of twin-to-twin transfusion syndrome (TTS) and selective intrauterine growth restriction (sIUGR), as well as perinatal morbidity and mortality, were evaluated. Results : MC twins had a lower gestational age (35.7 vs. 36.6 weeks, P=0.03) at birth and a higher incidence of intrauterine fetal loss (10% vs. 1.5%, P<0.001) than DC twins. The incidence of intrauterine fetal loss was higher in MC sIUGR than in DC sIUGR (19% vs. 2.5%, P=0.025) twins. The number of admissions to the neonatal intensive care unit (NICU; 31% vs. 16%, P=0.042), and the incidence of periventricular leukomalacia (7% vs. 0%, P=0.031), and respiratory distress syndrome with surfactant treatment (27% vs. 11%, P=0.049) were higher in MC than DC twins. The incidences of sIUGR and TTS were 21 and 9% among the MC twins. The incidences of intrauterine fetal loss were higher in MC twins with TTS [6 of 9 (67%)] or sIUGR [4 of 21 (19%)] than uncomplicated MC twins (P<0.001). The frequency of admission to the NICU (P=0.001), the length of hospital stay (P=0.033), the prevalence of periventricular leukomalacia (P=0.011), and intraventricular hemorrhage (P=0.007) were also higher in MC with TTS or sIUGR than in uncomplicated MC twins. Conclusion : The incidence of neonatal complications was higher in MC twins, especially those gestations complicated by TTS or sIUGR.

• Journal of Animal Environmental Science
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• v.15 no.2
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• pp.171-182
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• 2009

Conventionally, many pig producers have utilized a continual sow managements system that the matings, farrowings and weanings are done weekly basis. But this transitional method is not able to cut the cycle of diseases and fully apply all-in/all-out system because of the continuous flow of sows and pigs. Conventional weekly management system is currently limiting in small farm to work efficiently both for workers and pigs. Therefore, pig producers have found novel management methods for applying all-in/all-out system, improving pig health, leading to better growth, lowering mortality and reducing medication costs nowadays. Moreover, all-in/all-out pig management system has known as a strategy for improving productivity in swine farm. The batch system is one of the best management methods to adopt all-in/all-out pig management system that prevent spreading diseases in pig and remove cycle of diseases. Batch farrowing system is a concept for providing a group of sows that delivery within a specific farrowing interval and inducing a large enough scale of piglets to fill the weaner facilities. There are different types of batch farrowing system with batch size and interval of farrowing when several factors at the swine farm are considered such as total number of sows, available facilities in the farm, and the efficiency of workforce. Sow managements such as farrowing, weaning and breeding, every 3 weeks rather than weekly, 2 or 5-week interval have advantages for workers and reproductive cycle of sows as well as pig flow. Because there are several pros and cons both in weekly and batch management system, various factors should be considered to apply the most suitable management system in each individual farm. To improve poor swine productivity in Korea compared to ED, batch system for sows will be an alternative choice which is able to prevent high incidence of diseases in swine farm such as PMWS, PRRS, PRDC and PED because all-in/all-out pig management can be also applied automatically by using this management system.