• Childhood Kidney Diseases
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• v.13 no.2
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• pp.215-221
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• 2009

Purpose : Thymus is a lymphoproliferative organ that changes size in various physiological states in addition to some pathological conditions. Thymus is susceptible to involution, and shows a dramatic response to severe stress. Thymic measurements may be helpful in various diseases. UTI (urinary tract infection) is most common bacterial infection in infants and VUR (vesicoureteral reflux) is a common abnormality associated with UTI. In our study, the size of thymus was compared on the premise that a greater stress is exerted on the body when UTI is accompanied by VUR, than when occurs on its own. Methods : Thymic size was measured on standard chest anteroposterior radiographs and expressed as the ratio between the transverse diameter of the cardiothymic image at the level of the carina and that of the thorax (CT/T). The medical records of 99 febrile urinary tract infection infants without other genitourinary anomalies except VUR were reviewed retrospectively. Results : Among 99 patients with febrile UTIs, 25 were febrile UTI without VUR and 74 with VUR. For the UTI with VUR group, there was a significant decrease in the thymic size compared to the those without VUR group ($0.382{\pm}0.048$ vs $0.439{\pm}0.079$, P<0.05). However, there were no differences in the duration of fever and WBC, CRP between the UTI with VUR and UTI without VUR. In addition, there were no differences in the cardiothymic/thoracic ratios between renal defects and renal scars in febrile UTI patients. Conclusion : The results of this study show that the shirinkage of thymus was more frequently found in the UTI patients with VUR. Therefore, awareness of the risks associated with thymic size is important for the appropriate work up and management of UTI patients.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.979-985
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• 1997

Between October 1991 and May 1995, 256 "New Duromedics Valve"(Edward TEKNA Bileaflet Valve) were implanted in 208 adult patients(171 mitral, 82 aortic and 3 tricuspid) with age ranging from 18 years to 70 years(mean 48.2$\pm$ 11.6 years). Postoperative complication rates were 12.2%, but there was none valve related one. Overall early mortality rate were 1.4%(1.6% for MVR, 2.1% for DVR, and none for AVR or TVR) respectively. Follow-up was 99% completed ranging in duration from 2 months to 46 months. There were 6 valve-related late complications(2.9%) with 2 patients with upper gastrointestinal bleeding, 2 with cerebral thxomtioembolism, 1 with valve thrombosis and 1 with valve endocarditis. Freedom from these valve-related major complications were 89.9% at 40 months. There were 5 late deaths(2.4%). one of these late deaths was considered valve-related. Overall actuarial survival rates at 40 months were 95.5%, 96.8% for mitral, 97.1% for aortic, 100% for tricuspid, and 92.0% for double valve replacement respectively. Preoperative New York Heart Association functional class were 2.9, and 1.3 in post-operative state. We have been trying to keep the international normalized ratio(INR) with range of 2.5 to 3.0. The INR of 4 patients of 5 with anticoagulant ralated complications was beyond the range. To reduce the rate of anticoagulant related complications, we felt very strongly that the INR should be kept between 2.5 and 3.0. In our cases, there was no structural failure or significant hemolysis in the absence of periprosthetic leak. This experience encourages us to continue using the "New Duromedics Valve".omedics Valve".uot;.

• The Korean Journal of Pharmacology
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• v.30 no.1
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• pp.67-73
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• 1994

Na-Ca exchange transports calcium ion either into (reverse mode Na-Ca exchange) or out of the cell (forward mode Na-Ca exchange) according to the direction of driving force produced by the changes in ratio of intra- and extra-cellular Na concentrations. Thus, Na-Ca exchange is regarded as the regulator of myocardial contraction. However, the existence of reverse mode Na-Ca exchange and its role in myocardial contraction is still questioned. Present study was performed to identify the presence of reverse mode Na-Ca exchange and its possible involvement in the regulation of myocardial contraction in rat heart. Using the left atria of rat, contraction was induced by electrical field stimulation (EFS, 0.5 msec duration and supramaximal voltage). Changing of the stimulation frequencies from resting 4 Hz to 0.4, 1 or 8 Hz caused typical negative staircase effect in twitch tension, but $^{45}Ca$ uptake showed bimodal increase. When the stimulation frequency was abruptly changed from 4 Hz to 0.4 Hz the atrial twitch tension showed three phased-enhancement, that is, the initial rapid increase (the first phase) followed by rapid decrease (the second phase) and stabilization (the third phase). $^{45}Ca$ uptake was equivalent to tension, i.e. initial significant increase in first 30 second and then decrease. Benzamil treatment abolished the first phase of increase in a dose dependent manner from $10^{-5}\;to\;3{\times}10^{-4}M.$ Bay k 8644 $(3{\times}10^{-5}M)$ treatment enhanced the inotropy induced by frequency reduction and abolished the second and third phase decreases. Benzamil treatment also suppressed the contraction stimulated by Bay K 8644. Although the contraction at 4 Hz stimulation was completely abolished by verapamil $3{\times}10^{-5}\;M$ pretreatment, the contraction reappeared as soon as the stimulation frequency was changed into 0.4 or 1 Hz and interstingly,$^{45}Ca$ uptake were significantly higher than no treatment. From these results, it is concluded that reduction of stimulation frequency causes calcium influx by the reverse mode Na-Ca exchange, resulting in initial rapid increase of twitch tension. then it turns into forward mode exchange to efflux the calcium, resulting in decrease of the twitch tension in left atria of rat.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.293-298
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• 2008

Purpose : The aim of our study was to evaluate the therapeutic response to cyclosporine, time to remission and side effects in steroid resistant nephrotic syndrome (SRNS). Methods : This study included 22 children with idiopathic SRNS who were treated with cyclosporine between June 1989 and August 2006. Medical records were reviewed retrospectively. Results : The mean age of patients at diagnosis was $5.2{\pm}3.3\;years$. The male to female ratio was 1.2:1. Pre-treatment renal biopsies showed minimal change (MCD) in 12 (54.5%), focal segmental glomerulosclerosis (FSGS) in 8 (36.4%), membranous nephropathy (MGN) in one (4.5%) and mesangioproliferative glomerulonephritis in one (4.5%). 15 (68.2%) patients responded to cyclosporine, of whom 11 (91.6%) patients were MCD, 3 (37.5%) patients FSGS, and 1 patient MGN (MCD vs FSGS, P<0.05). The time to remission in patients who responded to cyclosporine was $31.5{\pm}15.2\;days$. Four of the 15 cyclosporine responders maintained complete remission even after cessation of the medication Seven still received cyclosporine, 2 were intermittently treated with steroids after discontinuation of cyclosporine, and two were treated with cyclosporine and steroids. The mean duration of cyclosporine therapy was $546.5{\pm}346.2$, $1,392.9{\pm}439.7$, $439.5{\pm}84.1$, and $433.5{\pm}74.2$ days, respectively. We performed post-treatment biopsies in 8 patients and partial interstitial fibrosis and tubular atrophy were found in two. Conclusion : The thrapeutic response of cyclosporine is good in steroid resistant nephrotic syndrome, especially in minimal change. But, there is a problem of long term cyclosporine dependency.

• The Korean Journal of Physiology
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• v.24 no.1
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• pp.27-37
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• 1990

The extrafetal transfer of $Li^{+}$ in amniotic fluid was studied in 45 pregnant rabbits. LiCl solution was administered either intravenously to mother or directly into the amniotic sac and monitored the appearance and disappearance of $Li^{+}$ in the amniotic fluid, then calculated the transfer rate of $Li^{+}$ of extrafetal origin. To study the transplacental $Li^{+}$ transfer, a solution of 150 mM LiCl was infused continuously via maternal vein (initial dose: 0.7 mmol/kg, maintaining dose: 0.03 mmol/kg/min) and the $Li^{+}$ concentration was measured in maternal blood and amniotic fluid after 60 and 120 minutes of infusion. Change in the volume of aminotic fluid was determined by Congo red dilution method at the same time. Effects of duration of gestation was not considered in this study. Extrafetal transport of $Li^{+}$ into the amniotic fluid was estimated by comparing the $Li^{+}$ concentration and volume of amniotic fluid determined before and after ligating the placental vessels. Extrafetal $Li^{+}$ transport from the amniotic fluid was determined by observing the time dependent disappearance of $Li^{+}$ and Congo red in amniotic fluid after injecting 0.5 ml solution of 15 mM or 90 mM LiCl and 50 mg/ml Congo red. Following are the results obtained: 1) During infusion of LiCl through maternal vein the ratio of the aminotic $Li^{+}$/maternal plasma $Li^{+}$ increased significantly along with the increment of fetal weight. 2) The volume of amniotic fluid of larger fetuses than 20.5 gm increased significantly during administration of LiCl while that of smaller fetuses did not change. 3) After umbilical cord ligation the $Li^{+}$ concentration of amniotic fluid of larger fetuses than 20.5 gm was decreased to $59.9{\pm}10.3%$ and $56.9{\pm}42.9%$ $(mean{\pm}S.D.)$ of those of control group after 60 and 120 minutes of LiCl infusion respectively. In amniotic fluid of smaller fetuses than 20.5 gm, there was no significant difference between control and ligation groups. 4) The disappearance rate of Congo red in the amniotic fluid was $45.2{\pm}8.2%/hr$. 5) The disappearance rate of $Li^{+}$ after intraamniotic injection of LiCl depended on the amount injected. On injecting $7.5\;{\mu}mol$ LiCl, $Li^{+}$ disappeared rapidly from the amniotic fluid and the rates after 60 min and 90 min were $97.0{\pm}2.8,\;98.5{\pm}2.0%$ respectively. On injecting $45\;{\mu}mol$ LiCl, the rates were $56.0{\pm}15.4,\;78.9{\pm}14.5%$ at 60 and 90 min. 6) From the above results it was concluded: a) $Li^{+}$ transfer into the amniotic fluid increased along with the fetal growth and one half of $Li^{+}$ influx is through the extrafetal route even after the maturation of fetal kidney. b) One half of the $Li^{+}$ transfer from the amniotic fluid was through swallowing of fetus, while the remaining half was transfered rapidly through amniotic membrane, which was concentration limited.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.252-256
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• 2004

Purpose: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. Materials and Methods: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. Results: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3：1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in $14\%$ (32/228) of the total gastrectomy cases, in$15.9\%$ (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in $13.2\%$ (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases ($12.5\%$) and 25 of the remaining 172 cases ($14.5\%$) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. Conclusion: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.1
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• pp.183-192
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• 2001

The purpose of this study is to verify the relation between vegetarian diet and the risk factors of cardiovascular disease. To do the present study the vegetarians were selected; 127 Buddhist nuns (age : 23 ~ 79 yrs) from Oonmoon Temple in Choungdo District, Gyeongsang Book-do. For control subjects, 235 healthy female adults (age : 23~79yrs) were selected. They were the teachers, the nurses of the hospital of Gyeongsang National University and the housekeepers living in Chinju Gyeongsang Nam-do. This study was conducted from October 1996 to February 1997. The contents are consisted of anthropometric measurement, questionnaries about eating behavior and intake frequency of food group and clinical examination. The results were summarized as follows. The average ages of vegetarians and non-vegetarians were 44.2 yrs and 40.5 yrs respectively. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.4 and 21.0, WHR were 0.8 and 0.8, percentage of body fat were 28.7 and 26.5 and the average duration of vegetarian diet of the vegetarians was 13.1 years. Eating behavior score of vegetarian was significantly higher than those of non-vegetarians. Eating behavior score was negatively of correlated with levels of serum total-cholesterol, LDL-cholesterol and atherogenic index (AI). In intake frequency of green vegetable, lemon-yellow vegetable, bumb and seaweeds of the vegetarians more than those of non-vegetarians. Levels of total cholesterol, LDL-cholesterol, AI, diastolic blood pressure, blood sugar and HDL cholesterol of non-vegetarians were significantly higher (p<0.01) than those of vegetarians, but ratio of HDL cholesterol/total-cholesterol was lower in non-vegetarians. Consequently, vegetable diet can be considerably diet help to decrease the risk of cardiovascular disease.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.636-652
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• 1992

This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.175-183
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• 1995

Background: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. Method: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 and a single cold agglutinin titer of $\geq$ 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of $\geq$ 1:40 or a single cold agglutinin titer of $\geq$ 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. Results: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(${\geq}38.9^{\circ}C$) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. Conclusion: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.720-729
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• 2000

Background : Histological analysis of tuberculosis shows a spectrum of findings, from well formed granulomatous inflammation with few bacilli in patient with normal immune response to M. tuberculosis to poorly formed granulomatous inflammation with many bacilli in patient with defective immune response. To evaluate the degree of immune response to M. tuberculosis, we studied the histologic features, including the presence of acid fast bacilli(AFB) in lymph node of patients with cervical tuberculous lymphadenitis, and compared them with clinical characteristics. Methods : We reviewed the histologic features of 33 cases of cervical tuberculous lymphadenitis and processed the excised nodes for auramine-rhodamine staining to detect AFB. The AFB positivity in tissue was compared with the histologic features(degree of granuloma formation, presence of caseation necrosis, presence of neutrophilic infiltration) and clinical characteristics(lymph node size, duration of symptom, presence of local symptom or radiologic evidence of pulmonary tuberculosis). Results : 1) The mean age at diagnosis was 42.4 years, and male to female ratio was 1:4.5. 2) Histologically, all cases showed well formed granuloma and variable degrees of caseation necrosis, and 39% of the cases showed neutrophilic infiltration in the granulomatous inflammation. 3) AFB were confirmed in 52% of the cases, and they were found extracellularly and at the periphery of caseation necrosis. 4) There was no association between AFB positivity and histological features or clinical characteristics. Conclusion : Cervical tuberculous lymphadenitis showed well formed granulomatous inflammation with caseation necrosis, and there was no association between AFB positivity in the tissue and histological or clinical characteristics.