• Childhood Kidney Diseases
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• v.2 no.2
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• pp.152-160
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• 1998

Purpose : Vesicoureteral reflux (VUR), which can result in renal failure in children, is expected to resolve spontaneously in mild cases, but severe cases require surgical correction, posing dilemma in deciding the right measures in some cases. Therefore, to delineate the factors affecting spontaneous resolution of VUR and to apply them in assessing the prognosis, we reviewed the patients with VUR who had been treated medically. Patients and Methods : 32 children (49 renal units) with reflux who had been admitted during the 5-year period from Jan '92 to Dec '96 were classified into 4 groups (Resolved, Improved, Unchanged, and Worsened) and analyzed. Results : 1) 25 were boys and 7 girls. The age at diagnosis ranged from 13 days to 9 years (mean $24.6{\pm}11.4$ mo) 2) Among 49 refluxing ureters, 4 were below 1 me of age,21 between 1 me to 1 yr, 16 between 1 yr to 6 yr, 8 beyond 6 yr. Two belonged to Grade I, 16 to Crade II, 17 to Grade III, 12 to Grade IV, and 2 to Grade V. 3) Spontaneous resolution rates of reflux were 100, 81, 47, 8, 0$\%$ for each Grade, respectively. Resolution plus improvement rates in Grade III and IV were 71 and $50\%$, each. 4) Resolution rates in relation to the age at diagnosis were $100\%$ for below 1 mo, $48\%$ between 1 mo to 1 yr, $56\%$ between 1 to 6 yr, and $13\%$ beyond 6 yr. 5) Of 15 unilateral refluxing ureters, 14 ($93\%$) resulted in resolution. Of 34 bilateral refluxing ureters, 11 ($32\%$) resolved spontaneously 6) Resolution occurred within 1 year in 20 units of 24 renal units in regular follow-up. Conclusion: The lower the initial grade and the younger the patient, the sooner the reflux resolved. Resolution was better when VUR was unilateral than bilateral. Long-term regular follow-up is essential because even the cases falling in Grades III and IV have high rates of spontaneous resolution and improvement with medical treatment.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.95-103
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• 1998

Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea. Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea. Results : CAPD was performed in 114 cases. The mean age of the patients was $10.5{\pm}6.6$ years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases($80\%$). The common renal disease of ESRD were FSGS($17\%$), reflux nephropathy ($11\%$), chronic glomerulonephritis($9.6\%$). Mean duration of CAPD was $20{\pm}16.9$ months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was $10.3{\pm}11.3$ days. The most common complication was peritonitis($20.6\%$). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas. Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly($7\%$) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

• Journal of radiological science and technology
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• v.33 no.3
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• pp.277-282
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• 2010

The study is to verify non-uniform dose distribution in Field-In-Field (FIF) technique using two-dimensional ionization chamber (MatriXX, Wellhofer Dosimetrie, Germany) for breast tangential irradiation. The MatriXX and an inverse planning system (Eclipse, ver 6.5, Varian, Palo Alto, USA) were used. Hybrid plans were made from the original twenty patients plans. To verify the non-uniform dose distribution in FIF technique, each portal prescribed doses (90 cGy) was delivered to the MatriXX. The measured doses on the MatriXX were compared to the planned doses. The quantitative analyses were done with a commercial analyzing tool (OmniPro IMRT, ver. 1.4, Wellhofer Dosimetrie, Germany). The delivered doses at the normalization points were different to average 1.6% between the calculated and the measured. In analysis of line profiles, there were some differences of 1.3-5.5% (Avg: 2.4%), 0.9-3.9% (Avg: 2.5%) in longitudinal and transverse planes respectively. For the gamma index (criteria: 3 mm, 3%) analyses, there were shown that 90.23-99.69% (avg: 95.11%, std: 2.81) for acceptable range ($\gamma$-index $\geq$ 1) through the twenty patients cases. In conclusion, through our study, we have confirmed the availability of the FIF technique by comparing the calculated with the measured using MatriXX. In the future, various clinical applications of the FIF techniques would be good trials for better treatment results.

• The Journal of Internal Korean Medicine
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• v.31 no.1
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• pp.1-10
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• 2010

Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.47-52
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• 2018

Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.213-219
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• 2012

The recombinant bovine somatotropin (rbST) has been used for increasing milk production of dairy cows without adverse health effects. This study was conducted to compare effects of supplementation with $Boostin^{(R)}$-250 containing 250 mg of rbST on milk production with those of $Posilac^{(R)}$ and $Boostin^{(R)}$-S. And safety of rbST supplementation on target animals was also observed. Each twenty-five lactating dairy cows were assigned randomly to one of four groups. $Boostin^{(R)}$-250 and vehicle (control) were administered weekly. $Boostin^{(R)}$-S and $Posilac^{(R)}$ were administered two week intervals. Milk yield, milk components, milk somatic cell count, health status, and body condition score of cows were examined. Supplementation with $Posilac^{(R)}$, $Boostin^{(R)}$-S, and $Boostin^{(R)}$-250 induced more milk yield than control group by 2.9 kg/day (12.3%), 4.2 kg/day (17.9%), and 4.1 kg/day (17.4%), respectively. There was a significant difference in milk yield among three rbST treatment groups and control group (${\alpha}$ = 0.05). The rbST supplementation did not increase the incidence of clinical mastitis and milk somatic cell counts. Supplementation with rbST did not significantly affect milk components (milk fat, protein, and solid not fat). The rbST supplementation of the dairy cows after peak milk yield did not cause negative effect on BCS. However, some cows less than 100 days in milking had decreased BCSs after rbST supplementation. In conclusion, milk production in 250 mg of rbST administered cows every week was similar to that of 500 mg of rbST administered cows every 2 weeks. And supplementation of 250 mg of rbST every week could reduce metabolic stress in cows.

• Korean Journal of Veterinary Service
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• v.21 no.3
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• pp.285-300
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• 1998

1. The number of average milking cows, clinical forms of mastitis, mastitis-developing cows, and cows killed by mastitis a year were 25.7, 1.8(7%), 6.3(26%), and 2.7(10.1%)heads, respectively. The annual grade changes of standard plate counts(SPC) and somatic cell counts(SCC) showed the grade 1A of SPC diminished sharply from April to August, we think it was due to the lack of proper management in farming season and the grade 3 of SCC indirectly influenced increased in huge during August. 2. The average number of parturitions of farms was 2.3, but 50% of below 1 parturition were 22 farms(31%), 50% of above 3 parturitions were 16(23%) out of 71 farms. According to grades of the number of parturitions of milking cows per each farm, the farms' grades recording 3 parturitions and 50% were little bit excellent. 3. The actual situation research of foremilking CMT revealed 35 out of 74 farmer didn't do CMT Among them(35 out of 74 farmers), 80% did not test thanks to the troublesome process of the CMT. SCC grade 3, among farms who did foremilking CMT once or twice a month and who did not were 29% and 40% respectively and SPC grade 1A were 55% and 9%, respectively. 4. The research of actual situation on milking management let us know 29 farms(39%) did not do lastmilking, 37 farms(49%) usually did overmilking, and 34 farms(46%) did milking for 4 or 5 minutes. Grades according to average requiring times of milking showed SCC grade 1 of farms milking within 7 minutes was 11% and SPC grade 1A was 34%, on the other side, farms milking more than 7 minutes were 0% in SCC grade 1 and 13% in SPC grade 1A. Grades according to the starting time of milking after rubbing teats showed SPC grade 1A of farms starting milking at about 1 minute and over 2 minutes were 50% and 20%, respectively. 5. The research of actual situation on hygienic milking management uncovered 65 farms(88%) were using one towel which was used in washing teats and udders to wash more than 3 to 4 cows, and 53 farms(72%) were using one dried towel to dry udders not for each cow but for more than 3 to 4 cows after washing. Also, on milking turns disclosed 30 farms(40%) were milking cows in the order of incoming without isolation of a dominant group. According to grades of towels used in washing teats and udders, farms using a towel for each cow were 56% and a towel for over 3 cows were 31% in SPC grade 1A. According to using-or-not grades of dried towels after washing udders, farms using a towel for each cow were 79% and a towel for over 3 cows were 21% in SPC grade 1A. 6. Farms doing teat-dipping before milking were 7(10%), not doing teat-dipping after milking, or doing sometimes were 9(12%), and doing right after milking were 57(77%). And farms doing teat-dipping after dry cows and before delivery were 21(28a ). Farms using bethadine as an antiseptic solution were 70(95%), 40 farms(59%) diluted it with water as weak as 5 to 10 times, and on drying cows 64 farms(87%) slowly did it more than 2 days. Grade 1A of SPC of farms doing teat-dipping at every milking was 38%, farms doing occasionally or not was 33%, and farms doing it right after milking was 37% and doing after milking more than 5 cows was 20%. Grade 1A of SPC among farms diluting bethadine 5 times and diluting 5 to 10 times with water were 36% and 33%, respectively, and Grade 3 of SCC were 35% and 32%, respectively. 7. Studies on nonlactating period medical treatment, as the cows were on dry, 54 farms treated with their own hands.73 farms(98%) had bovine mastitis treated for themselves. And on applying medicines against mastitis, 55 farmers chose them on the basis of their own experience, 42 farms(57%) were treated more than 3 days. 41 farms(55%) dumped away the mastitis infected milk separately, 24 farms(32%) were feeding and milking at the same time. 8. Fifty-six farms(76%) always washed and disinfected milking machines after milking. Farms using the milking machines at low, or variable vacuum pressures, or at the vacuum pressure, set at the moment of its installation were 31(42%), and farms that did not know pulsation ratio were 27(37%). Farms changing liners when they were torn 8(11%), 58 farms(78%) said they checked milking system when there were wrong with them, 31 farms(42%) changed milking hoses when they found out problems, and 42 farms(57%) cleaned vacuum and milking systems when they felt dirty. The SPC grade 1A of farms washing and sterilizing milking machines was 38% and farms only washing was 28%.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.674-678
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• 1998

The conventional surgical treatment of isolated critical stenosis of the left main coronary artery restores a less physiologic perfusion of the myocardium, leads to occlusion of the left coronary ostium, and consumes an appreciable length of bypass material. From June 1994 to February 1996, eleven patients, three male and eight female, underwent patch angioplasty and additional bypass graft to left anterior descending artery (10 internal mammary artery, 1 saphenous vein) in isolated critical left main coronary artery stenosis. Their ages ranged from 34 to 62 years, mean 44 years. All had 60% to 90% stenosis of the left main coronary artery and Class III angina. The angiogram showed nine osteal lesion and three main stem stenosis. The operation was performed with conventional cardiopulmonary bypass and cold blood cardioplegia. We approached anteriorly and used bovine pericardium as onlay patch in all patients. There were one leg wound dehiscence, but no operative deaths and infarctions. All patients are free of symptoms after a mean follow-up of 15.5 months. Angiographic restudy at an average 14.4 months was obtained in five patients and showed widely patent left main coronary artery with excellent runoff. But additional graft to left anterior descending coronary artery were stenosed in two patients and showed diminutive flow in others. Our preliminary results suggest that angioplasty of the left main coronary artery can be carried out with low operative risks. But additional bypass graft to left anterior descending coronary artery may be unnecessary. The technique appears to be a promising alternative to conventional coronary artery bypass grafting in isolated left main coronary artery stenosis.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.542-547
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• 2002

Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.134-141
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• 1998

Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.