• Advances in pediatric surgery
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• v.10 no.1
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• pp.17-21
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• 2004

Improvement in prenatal ultrasonography is leading to diagnose choledochal cyst before birth and before onset of classical symptom more frequently. But, there is a controversy about optimal timing for Cyst excision of prenatally diagnosed asymptomatic choledochal cyst. To identify the most appropriate timing for surgery in prenatally diagnosed choledochal Cysts, we analyzed 6 patients who had operation for choledochal cysts within 30days after birth at the division of Pediatric Surgery, Samsung Medical Center and Inha University School of Medicine, from June 1995 to June 2002. Males were four and females 2, the mean age at operation was 11.2 days, and the median age 8.0 days. The range of gestational ages of the antenatal diagnosis of bile duct dilatation was 24 weeks to 32 weeks, mean was 38.3 weeks, and mean birth weight was 3,298.3 g. After birth, abdominal ultrasonography, hepatobiliary scintigraphy, and magnetic resonance cholangiopancratography (MRCP) were performed. Mean age at operation was 11.2 days. All patients had the cyst excision and Rouxen-Y hepaticojejunostomy. Immediate postoperative complication was not found. During the median follow-up period of 41 months, one patient was admitted due to cholangitis, and the other due to variceal bleeding. Early operative treatment of asymptomatic newborn is safe and effective to prevent developing complications later in life.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.73-79
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• 2016

Background: The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition. Methods: Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA. Results: The mean age was $72.4{\pm}5.1years$, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was $269.8{\pm}72.3minutes$. The mean total length of aortic coverage was $186.0{\pm}49.2mm$. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of $16.8{\pm}14.8months$, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown. Conclusion: TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.85-90
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• 2009

Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

• Advances in pediatric surgery
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• v.16 no.1
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• pp.25-31
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• 2010

Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was $7.6{\pm}5.1$ years old. The mean operation time was $67.4{\pm}21.3$ minutes and C-arm fluoroscopy was used in 47(30.5 %). The causes of Hickman catheter removal were termination of use in 82 (57.3 %), catheter related bloodstream infection in 44(30.8 %), mechanical malfunction in 11(7.7 %), and accidents in 6(4.2 %). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was $214.9{\pm}140.2$ days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was $198.0{\pm}116.0$ days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.

• Journal of the Korean Home Economics Association
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• v.24 no.2
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• pp.37-50
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• 1986

A nutrition survey of 128 perschool children, 4 to 6 years old, in the Saemaul Youlgok day care center, located in one uplane, overpolulated, poor area of the city of Seoul, sponsered by the Korean Red Cross Society, was undertaken between August 21 and 31, 1984, to investigate dietary and nutritional status. RESULTS: Mean values of height, weight, arm circumference, girth of chest, and head circumference ranged from 95 to 100% of KIST mean. However, 4.8~14.2% of the subjects were assessed as undernourished in terms of 'weight for height'. Mean hemoglobin vcalue was 12.1±0.7gm%, and mean hematocrit value was 38.5±2.2%; 4.1% of the subjects were proven to be anemic according to the criterion of hemoglobin established by the ICNND. Mean urinary urea nitrogen/creatinine ratio was 11.4±3.8. Regarding mean energy and nutrient intake, the following percentages had intakes below two-thirds of the 1985 RDAs: 28.8% of children, for protein; 48.8% of children, for iron; and 28.8% of children, for calcium. About 25% of children had vitamin A intake below one-third of the recommended allowance. Carbohydrate provided 71% of total energy intake; protein accounted for 13%; fat provided 16%. Energy intake was divided among breakfast, lunch, dinner and snacks in a percentage ration of 19:26:21:34. The lunch, and snacks which were served at the day care center provided 36.5~79.1% of daily energy and nutrient intake. The survey clarified that the day care feding largely supplemented the inadequate dietary intakes of these young children at home. According to factor analysis of energy and nutrient intake, there were two factor groups : the first factor group, for energy, protein, carbohydrate, iron and niacin, mainly provided by grains; and the second factor group, for calcium, vitamin A, thamin, riboflavin and ascorbic acid, provided by vegetables, fruits, milk and milk products. The survey also revealed significant correlation coefficients between family factors such as family income, educational level of parents, and number of children; and dietary or nutritional status of the subjects.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.365-371
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• 2012

Objective : To document lumbar lordosis (LL) of the spine and its change during surgeries with the different height but the same angle setting of the anterior cage. Additionally, we attempted to determine if sufficient LL is achieved at different cage heights and to quantify the change in LL during multi-level anterior lumbar interbody fusion (ALIF). Methods : The medical records and radiographs of 42 patients who underwent more than 2 level ALIFs between 2008 and 2009 were retrospectively reviewed. We evaluated 3 parameters seen on lateral whole spine radiographs : LL, pelvic incidence (PI), and sagittal vertical axis (SVA). The mean follow-up time was 28.1 months and the final follow-up radiographs of all patients were reviewed at least 2 years after surgery. Statistical analysis was performed using the paired t-tests. Results : Lumbar lordosis had changed up to 30 degrees immediately and 2 years after surgery (preoperative mean LL, SVA : 22.45 degrees, 112.31 mm; immediate postoperative mean LL, SVA : 54.45 degrees, 37.36 mm; final follow-up mean LL, SVA : 49.56 degrees, 26.95 mm). Our goal of LL is to obtain as much PI as possible, preoperative mean PI value was $55.38{\pm}3.35$. The pre-operative and two year post-surgery follow-up mean of the Japanese Orthopedic Association score were $9.2{\pm}0.6$ and $13.2{\pm}0.6$ (favorable outcome rate : 95%), respectively. In addition, we were able to obtain good clinical outcomes and sagittal balance with a subsidence rate of 22.7%. Conclusion : We were able to achieve sufficient LL, such that it was similar to the PI, utilizing multi-level ALIF with the use of a tall cage with the same angle setting of the cage. We have found out that achieving sufficient lumbar lordosis and sagittal balance require an anterior lumbar cage with high angle and height.

• Korean Journal of Adult Nursing
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• v.18 no.4
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• pp.543-552
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• 2006

Purpose: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. Method: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characteristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. Results: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was $36.76{\pm}55.7$ hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. Conclusion: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.

• Fisheries and Aquatic Sciences
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• v.15 no.2
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• pp.151-155
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• 2012

We used nine microsatellite DNA markers to estimate genetic variation among wild and cultured populations of the sea squirt Halocynthia roretzi. The loci were polymorphic, with 6-32 alleles, and allelic richness ranged from 6.0 to 26.1 in each population. The wild and the cultured populations had similar mean heterozygosities ($H_O$ and $H_E$), allele numbers, and allelic richness. One cultured population with softness syndrome had a lower mean in the observed heterozygosity ($H_O$ = 0.57) and higher mean inbreeding coefficient ($F_{IS}$ = 0.261) than any other populations. This suggests that the loss of genetic variation in the diseased population might be due to increased inbreeding. A neighbor-joining tree and pairwise population estimates of $F_{ST}$ showed moderate genetic differentiation between the wild and the cultured populations. Additionally, the softness syndrome population was genetically divergent from wild populations, but it was genetically close to the cultured populations.

• Wind and Structures
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• v.17 no.2
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• pp.227-244
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• 2013

Non-stationary extreme winds such as thunderstorm downbursts are responsible for many structural damages. This research presents a time domain approach for estimating along-wind load effects on tall buildings using multiple wind speed time history samples, which are simulated from evolutionary power spectra density (EPSD) functions of non-stationary wind fluctuations using the method developed by the authors' earlier research. The influence of transient wind loads on various responses including time-varying mean, root-mean-square value and peak factor is also studied. Furthermore, a simplified model is proposed to describe the non-stationary wind fluctuation as a uniformly modulated process with a modulation function following the time-varying mean. Finally, the probabilistic extreme response and peak factor are quantified based on the up-crossing theory of non-stationary process. As compared to the time domain response analysis using limited samples of wind record, usually one sample, the analysis using multiple samples presented in this study will provide more statistical information of responses. The time domain simulation also facilitates consideration of nonlinearities of structural and wind load characteristics over previous frequency domain analysis.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.3
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• pp.1521-1527
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• 2018

The original focus of this study was to investigate the immediate effects of lumbar rotational mobilization on the one-legged standing ability. Fifteen subjects (6 men and 9 women, mean age = 22.77 (SD = 1.21), mean height = 165.46cm (SD = 11.65), mean weight = 61.46kg (SD = 8.29) volunteers from healthy individuals were recruited and randomized to a lumbar rotational mobilization (LRM) group and a trunk rotational exercise (TRE) group. Mobilization (grade 3 or 4) was applied to the LRM group on the lumbar spine (L1 to L5) in a side-lying, and trunk twist exercise (left and right side) was applied the to the TRE group with lunge position. Center of pressure (COP) and the velocity of the center of pressure (VCOP) of each participant were measured as a balance ability through one leg standing position. Results are as follows. In within-group difference, the COP of the LRM group reduced during standing with the right foot, but the VCOP change of the LRM was not statistically significant. In between-groups difference, COP of TRE group was decreased compared with LRM group only during left leg standing in the eyes (p <.05). The results of this study suggest that LRM is more effective than TRE in improving balance ability.