• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.531-535
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• 2007

Purpose : Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively. Results : The single-administered group was 19 patients out of 29 (65.5%) and among the repeated-administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger ($3.66{\pm}0.8mm$ vs $2.55{\pm}0.8mm$, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated-administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities. Conclusion : In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1216-1220
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• 2009

Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.295-302
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• 2011

To n the field of nuclear medicine, with regard to checking regular patients, from the moment they register up to the doctor's diagnosis, the person in charge of the checks can find errors in the diagnosis, reexamine, reanalyze the results or save images to PACS. Through this process, the results obtained from the readings are delayed due to checks and additional tests which occur in hospitals, causing patient satisfaction and affected reliability. Accordingly, the purpose is to include visual inspection of the results to minimize error, improve efficiency and increase patient satisfaction. Nuclear medicine and imaging tests from examines at Asan Medical Center, Seoul, from March 2008 to December 2008, were analyzed for errors. The first stage, from January 2009 to December 2009, established procedures and know-how. The second stage from January 2010 until June 2010 conducted Pre-and Post-filtering assessment, and the third stage from July 2010 until October 2010 consisted of cross-checks and attaching stickers and comparing error cases. Of 92 errors, the 1st, 2nd and 3rd stage had 32 cases, and there were 46 cases after the 4th stage, with the overall errors reduced by 74.3% from 94.6%. In the field of general nuclear medicine, where various kinds of checks are performed according to the patient's needs, analysis, image composition, differing images in PACS, etc, all have the potential for mistakes to be made. In order to decrease error rates, the image can continuously Cross-Check and Confirm diagnosis.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.149-155
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• 1998

Thirty three members of the Korean Association of Pediatric Surgeons were surveyed to determine the clinical manifestations and current management of infantile hypertrophic pyloric stenosis (IHPS). The members completed a registration form and a questionnaire that indicated their treatment preferences for patients treated during 1996. The response rate was 84.8 %, and 23 institutions participated. Three hundred and sixty-three cases of IHPS were analysed. The male to female ratio was 5.15: 1. The presenting symptoms were nonbilious vomiting in 363 cases(100 %), palpable mass in the upper abdomen in 200 cases (55.1 %) and visible peristaltic waves in 67 cases(18.5 %). Fluid therapy was done in 161 cases(44.4 %) for preoperative preparation. Twenty patients(5.5 %) were premature. There were 27 low birth weight babies(7.7 %). The onset of symptoms ranged from 1 to 14 weeks of age with a peak occurrence at 2 to 4 weeks of age. Two hundred and thirty-six cases(66.6 %) presented within 4 weeks of age. There was one set of male twins and a family history of twins. The modes of feedings were: breast feeding; 69 cases(24.5 %), formula feeding; 176 cases(62.4 %) and mixed feeding; 37 cases(13.1 %). The preferred diagnostic modalities were ultrasonography (US) 229 cases(63.1 %), UGI series 27 cases(7.4%) and US and UGI series combined 86 cases(23.7 %). Only 21 cases(5.8 %) were operated on without imaging study, ie. with positive physical finding. Perforation of the mucosa during pyloromytomy occurred in 5 cases. All were treated successfully with primary closure. Persistent vomiting over 2 weeks after operation were reported in 5 cases. Three wound infections, one aspiration pneumonia and one postoperative bleeding were reported. There was no mortality in 363 cases.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.59-68
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• 1997

Background : Tuberculous chest wall abscess is a rare complication of tuberculosis. However, there have been few reports about the variable extents and shapes of tuberculous chest wall abscesses. We analyzed the extent and shape of tuberculous chest wall abscess-es and grouped them according to combined pleuroparenchymal lesions by CT scans. Materials and Methods : CT findings were evaluated in 20 patients of tuberculous chest wall abscesses. We classified 29 abscesses in 20 patients into three types according to pleuroparnechymal lesions. Type 1 was defined when there was no active pleuroparenchymal lesion, Type 2, when intrathoracic tuberculosis was contacted with chest wall abscess, Type 3, when ipsilateral subpleural nodules were not contacted with chest wall abscess. Results : The type 1 included 6 abcesses in 6 patients. They showed rib and/or costal cartilage destruction in their center. They were relatively large and round. The type 2 included 13 abscesses in 10 patients. The abscesses in contact with pleural lesion or mediastinal lesion were mainly located in the outer muscle layer, and they were relatively large in size. However, the abscesses in contact with parenchymal lesion were mainly located in extrapleural space. They were relatively small and they were longest along the long axis of ribs. The type 3 included 10 abscesses in 6 patients. They were located mainly in the extrapleural space. Conclusion : Tuberculous chest wall abscess-es showed variable extents and shapes according 10 pleuroparenchymal lesions. CT is a good diagnostic modality to visualize the extent of tuberculous chest wall abscess and combined pleuroparenchymal lesion.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.163-169
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• 2014

Purpose: This study is for compared the change of corneal refractive power before and after wearing of rigid gas permeable contact lense with diagnostic method which is 1 D flatter than alignment fitting on right eye and alignment fitting on left eye for 2 months and investigate the preference. Methods: Twenty middle school and high school students (40 eyes) who had never worn a contact lense before for no corneal topographical change, no ocular disease, no experience of ophthalmic surgery and have normal tear amount were selected for this study and corneal refractive power were examined before wearing rigid gas permeable contact lense and adaptation status and corneal examination were performed after 10 days of wearing and after cheking up the continuation of wearing, all candidate wear contact lens 8 hours per day for 2 month and corneal refractive power were compared. Results: After 2 months of wearing with 1 D flatter than the alignment fitting on right eyes, there was significant difference in the central corneal refractive power was $43.84{\pm}1.33D$, flat K power was $43.05{\pm}1.29D$, and steep K power was $44.61{\pm}1.42D$ decreased than before wearing (p<0.001, 0.001, 0.047). The e-value of the principal meridians also shows statistically significant difference (p=0.037, 0.015). After 2 months of wearing with alignment fitting on left eyes, the central corneal refractive power was $44.40{\pm}1.26D$, flat K power was $43.57{\pm}1.23D$. and flat K e-value was $0.58{\pm}0.05$ which showed no statistically significant difference (p = 0.769, 0.614, 0.181). But steep K power was $45.25{\pm}1.36$, and steep K e-value was $0.45{\pm}0.18$ which shows statistically significant difference (p=0.018, 0.027). Conclusions: Consider the comfort, clear vision, dryness for preference fitting investment, 6 students (30%) prefer right eye which is 1 D flatter fitting, 14 students (70%) prefer left eye which is alignment fitting. For rigid gas permeable fitting needed for accurate examination and should prescribe the alignment fitting which is suitable for each cornea.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.2
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• pp.217-224
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• 2014

Purpose: This study was conducted to compare and analyze the accommodative system (accommodative response and accommodative lag) according to the material and font size of near visual media that we often encounter in daily life. Methods: Forty adult men and women aged 20 to 30 who not had specific ocular diseases and refractive surgery experience were examined to measure and compare the accommodative response according to the material of near visual media (print paper, newspaper, magazine, the I-Phone, LCD monitor) and font size (6, 8, 10, 12) by using both eyes open-view auto-refractometer. Results: The accommodative stimulus was $2.28{\pm}0.11D$ and the accommodative response was $1.66{\pm}0.30D$. The accommodative lag namely the difference between accommodative stimulus and accommodative response was $0.62{\pm}0.28D$. The accommodative response according to material of visual media using LCD monitor was $1.35{\pm}0.26D$ (p=0.00) and using the I-Phone was $1.55{\pm}0.25D$ (p=0.04). Both of them were statistically significant lower. The accommodative lag using LCD monitor was $0.93{\pm}0.24D$ (p=0.00) and using the I-Phone was $0.73{\pm}0.25D$ (p=0.04) and they were statistically significant higher. The accommodative response and accommodative lag according to font size were not statistically significant (p>0.05). Conclusions: During near working, the accommodative system was more affected by material than font size of visual media. Especially, visual media of non-luminous material (print paper, newspaper, magazine) are considered fewer burdens on eyes than luminous material (I-Phone, LCD monitor) in terms of accommodative system.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.345-354
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• 2014

Purpose : We evaluated the usefulness of $Fraxion^{(R)}$ system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. Materials and Methods : 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while $Fraxion^{(R)}$ system was used for the other 3 patients (group2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. Results : The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when $Fraxion^{(R)}$ system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using $Fraxion^{(R)}$ system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when s-thermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using $Fraxion^{(R)}$ system showed only 1.9%. All percentage were calculated with respect to average value. Conclusion : Using $Fraxion^{(R)}$ system including mouthpiece, Fraxion frame, frontpiece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.269-275
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• 2013

Purpose: The aim of this retrospective study was to evaluate the influence of implant diameter, length and placement to implant stability. Materials and methods: Total 90 implants (US II plus$^{TM}$, Osstem co, Busan, Korea) of 72 patients were determined as experimental samples. The factors of diameters(${\phi}$ 4 mm, ${\phi}$ 5 mm), lengths (10 mm, 11.5 mm, 13 mm), and implant placement (maxilla, mandible) were analyzed. The stability of the implants was measured by resonance frequency analysis (RFA) at the time of implant placement and impression taking. The difference of ISQ values according to patient's gender was evaluated by Independent t-test. ISQ values were compared between implant diameter, length and placement using one-way ANOVA and Tukey HSD test (${\alpha}=.05$). To compare ISQ values between at the time of surgery and impression taking, paired t-tests were used (${\alpha}=.05$). Results: The change of implant length did not show significant different on the ISQ value (P>.05). However, 5 mm diameter implants had higher ISQ values than 4 mm diameter implants (P<.05). Implants placed on the mandible showed significantly higher ISQ values than on the maxilla (P<.05). Conclusion: In order to increase implant stability, it is better to select the wider implant, and implants placed on mandible are possible to get higher stability than maxilla. ISQ values at impression taking showed higher implant stability than ISQ values at implant placement, it means that RFA is clinically effective method to evaluate the change of implant stability through the osseointegration. The consideration of the factors which may affect to the implant stability will help to determine the time of load applying and increase the implant success rate.

• Investigative Magnetic Resonance Imaging
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• v.17 no.2
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• pp.73-82
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• 2013

Purpose : To determine the quantitative parameters of breast MRI that predict tumor invasion in biopsy-proven DCIS. Materials and Methods: From January 2009 to March 2010, 42 MRI examinations of 41 patients with biopsy-proven DCIS were included. The quantitative parameters, which include the initial percentage enhancement ($E_1$), peak percentage enhancement ($E_{peak}$), time to peak enhancement (TTP), signal enhancement ratio (SER), arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC) value, long diameter and the volume of the lesion, were calculated as parameters that might predict invasion. Univariate and multivariate analyses were used to identify the parameters associated with invasion. Results: Out of 42 lesions, 23 lesions were confirmed to be invasive ductal carcinoma (IDC) and 19 lesions were confirmed to be pure DCIS. Tumor size (p = 0.003; $6.5{\pm}3.2$ cm vs. $3.6{\pm}2.6$ cm, respectively) and SER (p = 0.036; $1.1{\pm}0.3$ vs. $0.9{\pm}0.3$, respectively) showed statistically significant high in IDC. In contrast, E1, Epeak, TTP, ADC, AEF and volume of the lesion were not statistically significant. Tumor size and SER had statistically significant associations with invasion, with an odds ratio of 1.04 and 22.93, respectively. Conclusion: Of quantitative parameters analyzed, SER and the long diameter of the lesion could be specific parameter for predicting invasion in the biopsy-proven DCIS.