• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2159-2164
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• 2016

Background: A diagnosis of chronic myeloid leukemia (CML) is made on discovery of the presence of a Philadelphia (Ph) chromosome. The success of the treatment of this form of leukemia with tyrosine kinase inhibitor (TKI) is monitored by reduction of the Ph chromosome. Objective: To compare the role of conventional cytogenetic (CC) methods with a real time quantitative polymerase chain reaction (RQ-PCR) and fluorescence in situ hybridization (FISH) for diagnosis and treatment monitoring of CML patients. The secondary outcome was to analyze the treatment responses to TKI in CML patients. Materials and Methods: This was a retrospective study of CML patients who attended the Hematology clinic at Chiang Mai University Hospital from 2005-2010. Medical records were reviewed for demographic data, risk score, treatment response and the results of CC methods, FISH and RQ-PCR. Results: One hundred and twenty three cases were included in the study, 57.7% of whom were male with a mean age of 46.9 years. Most of the patients registered as intermediate to high risk on the Sokal score. At diagnosis, 121 patients were tested using the CC method and 118 (95.9%) were identified as positive. Five patients failed to be diagnosed by CC methods but were positive for BCR-ABL1 using the FISH method. Imatinib was the first-line treatment used in 120 patients (97.6%). In most patients (108 out of 122, 88.5%), a complete cytogenetic response (CCyR) was achieved after TKI therapy and in 86 patients (70.5%) CCyR was achieved long term by the CC method. Five out of the 35 analyzed patients in which CCyR was achieved by the CC method had a positive FISH result. Out of the 76 patients in which CCyR was achieved, RQ-PCR classified patients to only CCyR in 17 patients (22.4%) with a deeper major molecular response (MMR) in 4 patients (5.3%) and complete molecular response (CMR) in 55 patients (72.4%). In the case of initial therapy, CCyR was achieved in 95 patients (79.1%) who received imatinib and in both patients who received dasatinib (100%). For the second line treatment, nilotinib were used in 30 patients and in 19 of them (63.3%) CCyR was achieved. In half of the 6 patients (50%) who received dasatinib as second line or third line treatment CCyR was also achieved. Conclusions: CML patients had a good response to TKI treatment. FISH could be useful for diagnosis in cases where CC analysis failed to detect the Ph chromosome. RQ-PCR was helpful in detecting any residual disease and determining the depth of the treatment response at levels greater than the CC methods.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.184-189
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• 2010

Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1555-1562
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• 2000

Objects : Surgical management of the distal anterior cerebral artery(DACA) aneurysms presents several unique problems to surgeons, such as difficulty in early identification of parent arteries, high incidence of rebleeding and premature rupture, and requirement of unfamiliar approach other than conventional frontotemporal craniotomy. Therefore, preoperative anatomical knowledge of anterior interhemispheric fissure and entry point of dissection is prerequisite. Authors utilized a frontobasal approach for DACA aneurysms by using consistent external landmark for guidance to the deep structure. Materials and Methods : From Nov. 1995 to Jun. 1999, a surgical clipping of DACA aneurysms was carried out in 9 patients among a total 131 patients with intracranial aneurysms. In each case, the clinical and aneurysmal features were carefully reviewed through the angiograms, medical records, and intraoperative findings. Results : The incidence of DACA aneurysms was 6.9% from our series. All cases were arisen from juxtacallosal por-tion ; 6 cases from pericallosal-callosomarginal(PC-CM) junction and 3 from pericallosal-frontopolar(PC-FP) junction. Associated vascular anomalies were noted in 3 cases and multiple aneurysms in 3 cases, respectively. The preoperative clinical grades were generally poor. An early surgery was performed in 7 cases and frontobasal interhemispheric approaches in 7 cases. Postoperatively, two patients died of complications ; one delayed ischemic vasospasm and one aspiration pneumonia but remaining patients recovered well. Conclusion : The frontobasal interhemispheric approach was useful for DACA aneurysms in early surgery. Division of superior sagittal sinus(SSS) enabled a minimal retraction of brain on both sides, and prevention of intraoperative rupture was possible. Authors suggest the frontopolar(first frontal bridging) vein as a constant external landmark for approaching the genu of the corpus callosum and juxtacallosal DACA aneurysms.

• Korean Journal of Oriental Medicine
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• v.9 no.1
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• pp.1-33
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• 2003

From the study on Doo-Jong Kims view of history about the early Korea$(Korea\;herewith\;stands\;for\;Korea\;dynasty\;A.D.918{\sim}1392)s$ Medicine, I came to a conclusion as follows. 1. Doo-Jong Kim is stressing on the fact that Early Koreas Medicine inherited from Shilla dynasty and seemingly expressing the pride of national medical science. But actually he distorted the Koreas independent growth with flunkeyism and insisted that Koreas medicine only took over Shilla dynastys which based on Chinese Tang dynastys medical science. As a result, Koreas medicine was blurred and evaluated as nothing but Tangs medicine. But, the reasons of Doo-Jong Kims viewpoints were not based on the fact, but on his speculation. 2. About the medical system, Doo-Jong Kim viewed that Korea copied Chinese Soo & Tangs medical system, But the fact is that Korea only borrowed a part of Chinese medical systems name, for examples, Tae-I-Gam, Sang-Yak-Kook, Sang-Sik-Kook, etc., and its actual functions were different and grew in Koreas own way, As a result, the titles or roles in the system were very different from those of Chinas. Especially, Korea saw much development in Science of Acupuncture and Moxibustion that there was a specialist on Acupuncture, called I-Chim-Sa, and even had much influences on Chinese Acupuncture and Moxibustions growth, exporting Hwang-Je-Ne-Kyong to Chinese Song dynasty. 3. About the education system of medicine, Doo-Jong Kim viewed that Koreas medicine was only a copy of Shilla dynastys which was based on Chinese Tang dynastys, taking the medical examination curriculum as an example. The fact is that Tangs medical curriculum was three, Bon-Cho, Kab-Ul, Maek-Kyong, Shilla had seven, Bon-Cho-Kyong, Kab-Ul-Kyong, So-Moon-Kyong, Chim-Kyong, Maek-Kyong, Myong-Dang-Kyong, Nan-Kyong, and Korea had ten, So-Moon-Kyong, Kab-Ul-Kyong, Bon-Cho-Kyong, Myong-Dang-Kyong, Maek-Kyong, Dae-Kyong-Chim-Kyong, Nan-Kyong, Ku-Kyong, Ryu-Yon-Ja-Bang, So-Kyong-Chang-Jeo-Ron. Simply considering this, it is so clear that Koreas medical curriculum was much more upgraded one than that of China. 4. About the examination system for civil service, Doo-Jong Kim expressed that Shilla dynasty did not have such system, and only expounded knowledge of Shilla medicine, In case of China, Tang danasty Hyang-Kong was only a qualification test for civil service, which the result was completely dependent on applicants social status, Song danasty examination system was composed of three steps of Hyang-Si, Sung-Si, Jeon-Si (See Note1), but it stuck to formality by having Jeon-Si of anti-fraudulence use. On the other hand, examination system for civil service in Korea dynasty started in 958 by an advice of Ssang-Ki, Chin-Si in 977 and K대-Ja-Si (See Note 1), a kind of Hyang-Si, in 1024., Three steps of examination system made employment for civil service strictly fair, Moreover, it was possible for offsprings of concubine to be an applicant. These easily explain that the examination system of Korea dynasty was more upgraded one than that of China, Tang ＆ Song dynasty. Hyang-Si : Exam in local area Sung-Si : Exam in province for those who passed Hyang-Si Jeon-Si : Exam held with Koea Kings supervision for those who passed Hyang-Si Keo-Ja-Si : Selective exam in local area like Hyang-Si. From the reasons above, it is clear that Doo-Jong Kim was much biased by flunkeyism through Japanese colonialisam and expressed his view on Korea Medical History based on such theory of heteronomy and stasis. Moreover, without rigid historical evidence on records, he distored the fact by translating incorrectly on his purpose. Therefore, Doo-Jong Kims Korean Medical History must be reevaluated through rigid historical research and his mistranslation should be corrected.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.31 no.2
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• pp.70-81
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• 2013

In this study, the locational and constructional characteristics of Jukrimseowon, pavilion Imrijeong, and Palgwaejeong located in Nonsan, Ganggyung-eup were reviewed and the interrelation of these three places were studied through references including records of those days; Sagyeyonbo(沙溪年譜), Jukrimseowon dorok(竹林書院都錄), Imrijeonggi(臨履亭記), Jukrimseowon Myojeongbi(竹林書院廟庭碑), Namyurok(南遊錄). The result is as follows. Jukrimseowon enshrining Yukhyeon(六賢) is arranged as 'Hongsalmoon-Woisalmoon-Dongjae(憲章堂; Heonjangdang)' and 'LIbrary-Naesammoon(神門; shin moon)-Sau(竹林祠: Jukimsa)', excluding a lecture hall. In case of Sagye Jangsang Kim's Imrijeong(沙溪金長生) and Uam Shiyoel Song(尤庵宋時烈)'s Palgwaejeong respectively constructed 50 meters and 10 meters each away from Jurimseowon, detail designs such as scale, roofs, surface, windows, doors, and tablets as well as its prospect are nearly identified. Especially Taking Imrijeong and Palgwaejeong's locational conditions composed of rocks centered on Jukrimseowon, those are maintain the bilateral symmetry as much as possible and surround the shrine. It appeared that the Jukrimseowon's shrine enshrining Yulgok(栗谷) and Ugye(牛溪) was rebuilt during the reconstruction of auditoriums because of political conditions after the renovation of Kiing Injo and it was called as 'Hwangsanseowon(黃山書院)' with Imrijeong which was a lecture hall. It was an inevitable consequence to keep the bilateral symmetry which is a basic order of auditorium structure by maintaining and using Imrijeong and Palgwaejeong as a lecture hall of the auditorium after the reconstruction at least. Consequently, the desperate attempt to adjust the arrangement and visual imbalance of Imrijeong built with periodical differences and Hwangsanseowon resulted from the construction of shrine was Palgwaejeong built under Monggoibyuk of Hwansan Taken these circumstances together, Jukrimseowon is a 'shrine-centered auditorium' with characteristics of auditorium, constructed by integrating Imrijeong which was used as a lecture hall after the construction of shrine and Palgwaejeong repaired through the reconstruction. The construction of Palgwaejeong and the formative conformity with Imrijeong are assumed as an consequence intended for the compensation of Jukrimseowon's function and role as an auditorium. This study will provide an opportunity to focus on the auditorium and pavilion's complementary function as well as the Confucian and constructional functions by revealing the fact that pavilions were established as a complementary facility for the lecture hall of auditorium.

• The KIPS Transactions:PartD
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• v.13D no.7 s.110
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• pp.985-996
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• 2006

As the internet technologies develop, the geographic information system environment is changing to the web-based service. Since geospatial information of the existing Web-GIS services were developed independently, there is no interoperability to support diverse map formats. In spite of the same geospatial information object it can be used for various proposes that is duplicated in GIS separately. It needs intelligent strategies for optimal replica selection, which is identification of replication geospatial information objects. And for management of replication objects, OMG, GLOBE and GRID computing suggested related frameworks. But these researches are not thorough going enough in case of geospatial information object. This paper presents a model of location service, which is supported for optimal selection among replication and management of replication objects. It is consist of tree main services. The first is binding service which can save names and properties of object defined by users according to service offers and enable clients to search them on the service of offers. The second is location service which can manage location information with contact records. And obtains performance information by the Load Sharing Facility on system independently with contact address. The third is intelligent selection service which can obtain basic/performance information from the binding service/location service and provide both faster access and better performance characteristics by rules as intelligent model based on rough sets. For the validity of location service model, this research presents the processes of location service execution with Graphic User Interface.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1172-1178
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• 2008

Purpose : Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment. Methods : We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007. The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding. Results : Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy. Conclusion : In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.211-217
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• 2000

Purpose : Salmonellosis including typhoid fever is still prevalent in Korea. Recently it has been reported that the incidence of salmonella gastroenteritis is increasing with a reduction of typhoid fever. We studied the clinical and laboratory features of salmonellosis. Methods : We evaluated the clinical records of 83 patients with salmonellosis who had been confirmed by stool culture from 1994 to 1999. Results : Annual incidence of salmonellosis showed an increasing tendency during recent 4 years. Seasonally, summer(45.8%) was the most prevalent, followed by fall(32.5%). Male to female ratio was 1.4 : 1. In age distribution, 64 cases(77.1%) were under 5 year-old, and 18 cases(21.7%) were younger than 1 year-old. Clinical features included diarrhea(96.4%), fever(91.6%), vomiting(49.4%), bloody stool(42.1%), abdominal pain(40.1%) and tenesmus(12.0%). In serogroups, there was no group A and group B, group C, group D(including 2 cases of S.typhi) and group E were in 41.0%(34 cases), 3.6%(3 csaes), 51.8%(43cases) and 3.6%(3 cases), respectively. In Widal test, 5 cases(13.5%) and 1 case(2.7%) of group B, C and E(total 37 cases) were observed the O titer above 1 : 80 and 1 : 320, respectively. However, in 36 cases of group D, 19 cases(52.7%) and 9 cases(25.0%) were above the O titer 1 : 80 and 1 : 320, respectively. Antibiotics resistant rates to ampicillin, trimethoprim/sulfamethoxazole and chloramphenicol were 23.2%, 10.1% and 51.4%, respectively. Conclusion : Salmonellosis has become a common cause of gastroenteritis in children, especially under the pre-school age. Isolation of salmonella is neccessary for accurate diagnosis of gastroenteritis and typhoid fever. A careful attention of the use of antibiotics is needed to reduce the muilti-drug resistant strains.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.155-160
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• 1997

Purpose : Tethered cord syndrome is characterized by progressive motor and sensory disturbances in lower extremities, foot deformities caused by a pathologic fixation of spinal cord resulting in excessive stretching of the spinal cord. It is also frequently associated with urological symptoms include urinary frequency, incontinence, enuresis, urgency and recurrent urinary tract infection. Because there is few report in the literature about urological manifestations of theterd cord syndrome, we conducted a retrospective study on the patients diagnosed as tethered cord syndrome to delineate the characteristics of urologic manifestations in tethered cord syndrome and to establish the policy to evaluate patients who is suspected of tethered cord syndrome. Method : A retrospective study was conducted by reviewing the medical records of nine patients who was diagnosed as tethered cord syndrome from November 1991 to July 1996 in Yeungnam University Hospital. Result : 1) The age distribution of nine patients was as follows; 5 patients were under 2 years, 1 case from 2 to 6 years and 3 cases from 6 to 10 years. 2) Of 9 patients 6 had voiding frequency, urinary incontinence, enuresis, urgency and loss of micturation sense. Radiologic urodynamic studies revealed neurogenic bladder in 5 patients, hydronephrosis and hydroureter in 3, vesicoureteral reflux in 3. 3) Of 6 patients with urological abnormal manifestations 4 underwent spinal cord surgery (detethering). In spite of surgical intervention, the urological manifestations improved in only one patient. Conclusion : Urological abnormalities were common in tethered cord syndrome. Abnormal laboratory findings including urodynamic study were found even before the onset of urological symptoms. We have to concern tethered cord syndrome as one of common causes of voiding frequency and enuresis and to evaluate urological abnormalities as thetered cord syndrome is diagnosed.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.137-146
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• 2006

Purpose : A regional lymphadenitis is the most frequent adverse reaction of BCG. In order to find out developmental factors and establish a strategy of management, we investigated the clinical courses of children with lymphadenitis following BCG on the aspect of BCG strains, suppurative rates according to the sizes of lymph node and the clinical difference with or without treatment. Methods : From January 1997 to June 2004, 52 children less than 24 month-age-old diagnosed as BCG lymphadenitis in Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea were enrolled. The type of BCG strain, place of vaccination, location and size of lymphadenitis were assessed with medical records, retrospectively. Finally, we analysed the correlations between BCG strains or the sizes of lymph node and natural remission or suppuration. Results : The first detected mean age of BCG lymphadenitis was 5.5 month-age. The larger of the measurement was at the first visiting, the younger of age that was first presented. The most frequent location was the same sided axillary region of BCG injection. Among 52 subjects, 46 cases(88.5%) were vaccinated with intradermal Pastuer strain, and only 5 cases(9.6%) were done with percutaneous multipunctured Tokyo strain. Twenty eight cases(53.8%) were regressed naturally, otherwise 24 cases(46.2%) were suppurated. The larger those were sized, the higher freqeuncies those were suppurated on, significantly. Treatment with medications could not prevent the suppuration and could not shorten the healing periods. Conclusion : We predict that there are differences between the occurrent rate of BCG lymphadenitis and BCG strains or methods. Treatment with medication is not recommended owing to its ineffectiveness. Especially, in case of non-suppurative lymphadenitis should be onlyless influence on the tuberculin skin test, cause less adverse reactions, and is inexpensive. observed without treatment, because it could be regressed naturally. An ideal BCG makes a scar, We should make an effort to choose the best BCG strain that can fulfill such requirements.