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Antioxidant capacity and Raw 264.7 macrophage anti-inflammatory effect of the Tenebrio Molitor (갈색거저리(Tenebrio Molitor)의 항산화능과 Raw 264.7 대식세포의 항염증 효과)

  • Yu, Jae-Myo;Jang, Jae-Yoon;Kim, Hyeon-Jeong;Cho, Yong-Hun;Kim, Dong-in;Kwon, O-jun;Cho, Yeong-Je;An, Bong-Jeun
    • Food Science and Preservation
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    • v.23 no.6
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    • pp.890-898
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    • 2016
  • The purpose of this paper is to investigate potential anti-inflammatory and anti-oxidant effects of Tenebrio molitor. Macrophage cell response by outside stimulation leads expression of pro-inflammatory cytokines, such as tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), interleukin-6 (IL-6), $interleukin-1{\beta}$ ($IL-1{\beta}$), and trigger expression of genes which are affected by inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), resulting in formation of inflammatory factors like nitric oxide (NO) and Prostaglandin $E_2$ (PGE2). Cell viability was determined by MTT assay. In order to investigate anti-inflammatory agents, the inhibitory effects on the production of lipopolysaccharide (LPS)-induced NO in RAW 264.7 cells were examined. T. Molitor significantly decreased the production of NO in a dose-dependent manner, and also reduced the expression of iNOS, a COX-2 protein. As a result, the levels of protein such as $PGE_2$, iNOS, COX-2 and MARKs were significantly reduced compared to non-treated group in T. Molitor water extract (TDW) treated group. Also, antioxidant effect of T. Molitor were investigated using DPPH, ABTS+ and superoxide anion radical scavenging activity tests in cell-free system. Antioxidant activity of T. molitor was found low in the DPPH radical scavenging test while high in the ABTS+ and superoxide anion radical scavenging activity tests. These results show that TDW could be an effective anti-pro-inflammatory and anti-oxidant agent.

A Study on the Hydraulic Characteristics of Rashig Super-Ring Random Packing in a Counter-Current Packed Tower (역류식 충전탑에서 Raschig Super-ring Random Packing의 수력학적 특성에 대한 연구)

  • Kang, Sung Jin;Lim, Dong-Ha
    • Clean Technology
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    • v.26 no.2
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    • pp.102-108
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    • 2020
  • In recent years, packed column has been widely used in separation processes, such as absorption, desorption, distillation, and extraction, in the petrochemical, fine chemistry, and environmental industries. Packed column is used as a contacting facility for gas-liquid and liquid-liquid systems filled with random packed materials in the column. Packed column has various advantages such as low pressure drop, economical efficiency, thermally sensitive liquids, easy repairing restoration, and noxious gas treatment. The performance of a packed column is highly dependent on the maintenance of good gas and liquid distribution throughout a packed bed; thus, this is an important consideration in a design of packed column. In this study, hydraulic pressure drop, hold-up as a function of liquid load, and mass transfer in the air, air/water, and air-NH3/water systems were studied to find the geometrical characteristic for raschig super-ring experiment dry pressure drop. Based on the results, design factors and operating conditions to handle noxious gases were obtained. The dry pressure drop of the random packing raschig super-ring was linearly increased as a function of gas capacity factor with various liquid loads in the Air/Water system. This result is lower than that of 35 mm Pall-ring, which is most commonly used in the industrial field. Also, it can be found that the hydraulic pressure drop of raschig super-ring is consistently increased by gas capacity factor with various liquid loads. When gas capacity factor with various liquid loads is increased from 1.855 to 2.323 kg-1/2 m-1/2 S-1, hydraulic pressure drop increases around 17%. Finally, the liquid hold-up related to packing volume, which is a parameter of specific liquid load depending on gas capacity factor, shows consistent increase by around 3.84 kg-1/2 m-1/2 S-1 of the gas capacity factor. However, liquid hold-up significantly increases above it.

Properties of the interfacial oxide and high-k dielectrics in $HfO_2/Si$ system ($HfO_2/Si$시스템의 계면산화막 및 고유전박막의 특성연구)

  • 남서은;남석우;유정호;고대홍
    • Proceedings of the Korea Crystallographic Association Conference
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    • 2002.11a
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    • pp.45-47
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    • 2002
  • 반도체 소자의 고집적화 및 고속화가 요구됨에 따라 MOSFET 구조의 게이트 절연막으로 사용되고 있는 SiO₂ 박막의 두께를 감소시키려는 노력이 이루어지고 있다. 0.1㎛ 이하의 소자를 위해서는 15Å 이하의 두께를 갖는 SiO₂가 요구된다. 하지만 두께감소는 절연체의 두께와 지수적인 관계가 있는 누설전류를 증가시킨다[1-3]. 따라서 같은 게이트 개패시턴스를 유지하면서 누설전류를 감소시키기 위해서는 높은 유전상수를 갖는 두꺼운 박막이 요구되는 것이다. 그러므로 약 25정도의 높은 유전상수를 갖고 5.2~7.8 eV 정도의 비교적 높은 bandgap을 갖으며, 실리콘과 열역학적으로 안정한 물질로 알려진 HfO2[4-5]가 최근 큰 관심을 끌고 있다. 본 연구에서는 HfO₂ 박막을 실제 소자에 적용하기 위하여 전극 및 열처리에 따른 HfO₂ 박막의 미세구조 및 전기적 특성에 관한 연구를 수행하였다. 이를 위해, HfO₂ 박막을 reactive DC magnetron sputtering 방법으로 증착하고, XRD, TEM, XPS를 사용하여 ZrO₂ 박막의 미세구조를 관찰하였으며, MOS 캐패시터 구조의 C-V 및 I-V 특성을 측정하여 HfO₂ 박막의 전기적 특성을 관찰하였다. HfO₂ 타겟을 스퍼터링하면 Ar 스퍼터링에 의해 에너지를 가진 산소가 기판에 스퍼터링되어 Si 기판과 반응하기 때문에 HfO₂ 박막 형성과 더불어 Si 기판이 산화된다[6]. 그래서 HfO₂같은 금속 산화물 타겟 대신에 순수 금속인 Hf 타겟을 사용하고 반응성 기체로 O₂를 유입시켜 타겟이나 시편위에서 high-k 산화물을 만들면 SiO/sub X/ 계면층을 제어할 수 있다. 이때 저유전율을 갖는 계면층은 증착과 열처리 과정에서 형성되고 특히 500℃ 이상에서 high-k/Si를 열처리하면 계면 SiO₂층은 증가하는 데, 이것은 산소가 HfO₂의 high-k 박막층을 뚫고 확산하여 Si 기판을 급속히 산화시키기 때문이다. 본 방법은 증착에 앞서 Si 표면을 희석된 HF를 이용해 자연 산화막과 오염원을 제거한 후 Hf 금속층과 HfO₂ 박막을 직류 스퍼터링으로 증착하였다. 우선 Hf 긍속층이 Ar 가스 만의 분위기에서 증착되고 난 후 공기중에 노출되지 않고 연속으로 Ar/O₂ 가스 혼합 분위기에서 반응 스퍼터링 방법으로 HfO₂를 형성하였다. 일반적으로 Si 기판의 표면 위에 자연적으로 생기는 비정질 자연 산화막의 두께는 10~15Å이다. 그러나 Hf을 증착한 후 단면 TEM으로 HfO₂/Si 계면을 관찰하면 자연 산화막이 Hf 환원으로 제거되기 때문에 비정질 SiO₂ 층은 관찰되지 않았다. 본 실험에서는 HfO2의 두께를 고정하고 Hf층의 두께를 변수로 한 게이트 stack의 물리적 특성을 살펴보았다. 선증착되는 Hf 금속층을 0, 10, 25Å의 두께 (TEM 기준으로 한 실제 물리적 두께) 로 증착시키고 미세구조를 관찰하였다. Fig. 1(a)에서 볼 수 있듯이 Hf 금속층의 두께가 0Å일때 13Å의 HfO₂를 반응성 스퍼터링 방법으로 증착하면 HfO₂와 Si 기판 사이에는 25Å의 계면층이 생기며, 이것은 Ar/O₂의 혼합 분위기에서의 스퍼터링으로 인한 Si-rich 산화막 또는 SiO₂ 박막일 것이다. Hf 금속층의 두께를 증가시키면 계면층의 성장은 억제되는데 25Å의 Hf 금속을 증착시키면 HfO₂ 계면층은 10Å미만으로 관찰된다. 그러므로 Hf 금속층이 충분히 얇으면 플라즈마내 산소 라디칼, 이온, 그리고 분자가 HfO₂ 층을 뚫고 Si 기판으로 확산되어 SiO₂의 계면층을 성장시키고 Hf 금속층이 두꺼우면 SiO/sub X/ 계면층을 환원시키면서 Si 기판으로의 산소의 확산은 막기 때문에 계면층의 성장은 억제된다. 따라서 HfO₂/Hf(Variable)/Si 계에서 HfO₂ 박막이 Si 기판위에 직접 증착되면, 순수 HfO₂ 박막의 두께보다 높은 CET값을 보이고 Hf 금속층의 두께를 증가시키면 CET는 급격하게 감소한다. 그러므로 HfO₂/Hf 박막의 유효 유전율은 단순 반응성 스퍼터링에 의해 형성된 HfO₂ 박막의 유전율보다 크다. Fig. 2에서 볼 수 있듯이 Hf 금속층이 너무 얇으면 계면층의 두께가 두꺼워 지고 Hf 금속층이 두꺼우면 HfO₂층의 물리적 두께가 두꺼워지므로 CET나 EOT 곡선은 U자 형태를 그린다. Fig. 3에서 Hf 10초 (THf=25Å) 에서 정전 용량이 최대가 되고 CET가 20Å 이상일 때는 high-k 두께를 제어해야 하지만 20Å 미만의 두께를 유지하려면 계면층의 두께를 제어해야 한다.

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Potentials of Synbiotics for Pediatric Nutrition and Baby Food Applications: A Review (소아 영양 및 유아식 응용을 위한 신바이오틱스의 잠재력: 총설)

  • Jung, Hoo Kil;Kim, Sun Jin;Seok, Min Jeong;Cha, Hyun Ah;Yoon, Seul Ki;Lee, Nah Hyun;Kang, Kyung Jin
    • Journal of Dairy Science and Biotechnology
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    • v.33 no.2
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    • pp.111-118
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    • 2015
  • Probiotic, prebiotic, and synbiotic substances as well as microorganisms were added to infant formula in an attempt to influence the intestinal microflora with an aim to stimulate the growth of lactic acid bacteria, especially bifidobacteria and lactobacilli. Over the last 10 years, new synbiotic infant formulas containing probiotics and prebiotics have been proposed in order to simulate the effect of breast-feeding on the intestinal microflora. Owing to their synergistic effect, the new synbiotics are expected to be more helpful than using probiotics and prebiotics individually. Maintenance of the viability of the probiotics during food processing and the passage through the gastrointestinal tract should be the most important consideration, since a sufficient number of bacteria ($10^8cfu/g$) should reach the intended location to have a positive effect on the host. Storage conditions and the processing technology used for the manufacture of products such as infant formula adversely affect the viability of the probiotics. When an appropriate and cost-effective microencapsulation methodology using the generally recognized as safe (GRAS) status and substances with high biological value are developed, the quality of infant formulas would improve. The effect of probiotics may be called a double-effect, where one is an immunomodulatory effect, induced by live probiotics that advantageously alter the gastrointestinal microflora, and the other comprises anti-inflammatory responses elicited by dead cells. At present, a new terminology is required to define the dead microorganisms or crude microbial fractions that positively affect health. The term "paraprobiotics" (or ghost probiotics) has been proposed to define dead microbial cells (not damaged or broken) or crude cell extracts (i.e., cell extracts with complex chemical composition) that are beneficial to humans and animals when a sufficient amount is orally or topically administered. The fecal microflora of bottle-fed infants is altered when the milk-based infant formula is supplemented with probiotics or prebiotics. Thus, by increasing the proportion of beneficial bacteria such as bifidobacteria and lactobacilli, prebiotics modify the fecal microbial composition and accordingly regulate the activity of the immune system. Therefore, considerable attention has been focused on the improvement of infant formula quality such that its beneficial effects are comparable to those of human milk, using prebiotics such as inulin and oligosaccharides and potential specific probiotics such as bifidobacteria, which selectively stimulate the proliferation of beneficial bacteria in the microflora and the indigenous intestinal metabolic activity of the microflora.

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Potentiation of Antitumor Effect of Radiotherapy by Recombinant Tumor Necrosis Factor-$\alpha$ (방사선의 항암작용에 대한 재조합 TNF-$\alpha$의 효과)

  • Seong Jinsil;Shin Hang Chul;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.225-231
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    • 1998
  • Purpose : To determine whether TNF-$\alpha$ increases the antitumor effect of radiotherapy in murine syngeneic tumor system. Materials and Methods : Syngeneic murine tumors of MCa-K or MCa-4 (mammary carcinoma), OCa-I (ovarian carcinoma), or HCa-I(hepatocarcinoma were grown in hind legs of C3Hf/HeJ mice. When tumors were grown to 6 mm in mean diameter mice were treated with TNF-$\alpha$, radiation, or combination of the both. Gamma-radiation was given as a single dose of 30 Gy for HCa-I and 15 Gy for other tumors using Cobalt-60 teletherapy unit. A novel TNF-$\alpha$ mutein developed in Korea, was intraperitoneally administered daily at a dose of 10 ug per mouse for 7 days. In combination of radiation and TNF-$\alpha$, the drug was started 1 hour after radiation. Tumor growth delay assay was used to measure the tumor response to the treatment. Results : Among 4 tested tumors, TNF-$\alpha$ alone showed significant antitumor activity in MCa-K and OCa-I tumors, which showed absolute growth delay (AGD) of 5.0 days and 6.5 days, respectively. In combination with radiation, TNF-$\alpha$ showed significant delay of AGD (41.1 days) in OCA-I compared to AGDs of TNF-$\alpha$ alone and radiation, i.e., 6.5 days and 26.9 days, respectively(p<0.05). Enhancement factor was 1.29 in OCa-I, which showed supraadditive effect. TNF-$\alpha$ did not show significant delay of AGDs in the remaining 3 tumors compared to AGDs of TNF-$\alpha$ alone and radiation. Conclusions: TNF-$\alpha$ alone showed antitumor effects in MCa-K and OCa-I. In combination with radiation, TNF-$\alpha$ acted in supraadditive way in OCa-I only. The results of this study imply that the combination of TNF-$\alpha$ and radiation has different therapeutic potential depending on tumor model and further study is advocated.

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EFFECT OF LIGHT IRRADIATION MODES ON THE MARGINAL LEAKAGE OF COMPOSITE RESIN RESTORATION (광조사 방식이 복합레진 수복물의 변연누출에 미치는 영향)

  • 박은숙;김기옥;김성교
    • Restorative Dentistry and Endodontics
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    • v.26 no.4
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    • pp.263-272
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    • 2001
  • The aim of this study was to investigate the influence of four different light curing modes on the marginal leakage of Class V composite resin restoration. Eighty extracted human premolars were used. Wedge-shaped class Y cavities were prepared on the buccal surface of the tooth with high-speed diamond bur without bevel. The cavities were positioned half of the cavity above and half beyond the cemento-enamel junction. The depth, height, and width of the cavity were 2 mm, 3 mm and 2 mm respectively. The specimens were divided into 4 groups of 20 teeth each. All the specimen cavities were treated with Prime & Bond$^{R}$ NT dental adhesive system (Dentsply DeTrey GmbH, Germany) according to the manufacturer's instructions and cured for 10 seconds except group VI which were cured for 3 seconds. All the cavities were restored with resin composite Spectrum$^{TM}$ TPH A2 (Dentsply DeTrey GmbH, Germany) in a bulk. Resin composites were light-cured under 4 different modes. A regular intensity group (600 mW/${cm}^2$, group I) was irradiated for 30 s, a low intensity group (300 mW/${cm}^2$, group II) for 60 s and a ultra-high intensity group (1930 mW/${cm}^2$, group IV) for 3 s. A pulse-delay group (group III) was irradiated with 400 mW/${cm}^2$ for 2 s followed by 800 mW/${cm}^2$ for 10 s after 5 minutes delay. The Spectrum$^{TM}$ 800 (Dentsply DeTrey GmbH, Germany) light-curing units were used for groups I, II and III and Apollo 95E (DMD, U.S.A.) was used for group IV. The composite resin specimens were finished and polished immediately after light curing except group III which were finished and polished during delaying time. Specimens were stored in a physiologic saline solution at 37$^{\circ}C$ for 24 hours. After thermocycling (500$\times$, 5-55$^{\circ}C$), all teeth were covered with nail varnish up to 0.5 mm from the margins of the restorations, immersed in 37$^{\circ}C$, 2% methylene blue solution for 24 hours, and rinsed with tap water for 24 hours. After embedding in clear resin, the specimens were sectioned with a water-cooled diamond saw (Isomet$^{TM}$, Buehler Co., Lake Bluff, IL, U.S.A.) along the longitudinal axis of the tooth so as to pass the center of the restorations. The cut surfaces were examined under a stereomicroscope (SZ-PT Olympus, Japan) at ${\times}$25 magnification, and the images were captured with a CCD camera (GP-KR222, Panasonic, Japan) and stored in a computer with Studio Grabber program. Dye penetration depth at the restoration/dentin and the restoration/enamel interfaces was measured as a rate of the entire depth of the restoration using a software (Scion image, Scion Corp., U.S.A.) The data were analysed statistically using One-way ANOVA and Tukey's method. The results were as follows : 1. Pulse-Delay group did not show any significant difference in dye penetration rate from other groups at enamel and dentin margins (p>0.05) 2. At dentin margin, ultra-high intensity group showed significantly higher dye penetration rate than both regular intensity group and low intensity group (p<0.05). 3. At enamel margin, there were no statistically significant difference among four groups (p>0.05). 4. Dentin margin showed significantly higher dye penetration rate than enamel margin in all groups (p<0.05).

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Yongdoseo(龍圖墅) and Guimunwon(龜文園) which Applied a Sangsu(象數) Principle on Garden Composition (상수(象數) 원리를 정원구성에 적용한 용도서(龍圖墅)와 귀문원(龜文園))

  • Hong, Hyoung-Soon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.2
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    • pp.119-129
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    • 2012
  • Yongdoseo and Guimunwon are described in "Bokgeo(卜居, fixabode)" of "Sanlimkyengje(山林經濟)" written by Manseon Hong. This record is a unique garden conceptual idea applying the principles of Hetu(河圖) and Luoshu(洛書), fanciful gardens which have not been actually constructed. Here, two garden types were concretely described respectively, however the underlying meaning therein cannot be apprehended without exact understanding about Sangsu studies. Therefore, the purpose of this study is to illuminate the meaning contained in Garden illustration and the historical meaning of landscape therein through considering this text. To achieve the purpose of this study, the writer and the compiler who are the background of this writing and the outline of Sangsu studies were investigated. Also, the principles of Saengsu(生數), Seongsu(成數), Yin Yang(陰陽), Four Bodies(四象), Palgwedo(八卦圖), etc. which are in Hetu and Luoshu were considered. The result of this study went through this research process is summarized as follows. First, Hetu Luoshu are conceptual definitions which wholly abstracted the basic propositions of Sangsu philosophy such as the universe change principle, etc., while Yongdoseo and Guimunwon can be said to be operational definitions which apply those as garden composition principle, enabling to experience the meaning contained therein concretely and explain it in a replicable way. This attempt is a unique example, unprecedented in Chinaas well. Second, as a livingspace, garden was selected as a means to concretize operational definitions about the meaning of Hetu Luoshu, and as the property to reproduce the bearings concept, the location and the number, etc. of Hetu Luoshu, Taegukjeong(太極亭), Shipjagak(十字閣), Dondae(墩臺), well, pond as well as various kinds of trees were used. Third, the main motif of Yongdoseo and Guimunwon is the relation between Apriority(先天) and Posterior(後天), and the relation between Constitution(體) and Use(用) of Hetu and Luoshu respectively. That is, Yongdoseo planted evergreen trees such as Shipjangcheong(十長靑) in order to symbolize the universe creation principle which Hetu stands for, i.e. silent, harmonious, orderly and win-win image. In Guimunwon, flowering trees(花木) and fruit trees(果木) were planted freely to express the change of Posterior which Luoshu stands for, thatis, dynamic, disharmonious, disorderly, incompatible(相剋) and changing image. The effects intended to be attained through such planting were, 'freshness and cheerfulness(淸爽)' of Yongdoseo and 'splendidness' of Guimunwon respectively. Sangsu studies based on Hetu and Luoshu is a unique thinking system to the Orient which came from the accumulated wisdom of several scholars from various schools through a long period since ancient times. Therefore, the concept and the theory thereof are profound and huge, and its viewpoints of interpretation are diverse. It is a limit of this study that more in-depth and various consideration was not performed. As a further research project, more empirical study of Orientalism such as Sangsu studies, etc. inherent in Traditional Garden is necessary.

Effects of Various Diets on Growth and Body Composition of Juvenile Parrot Fish, Oplegnathus fasciatus (먹이 종류가 돌돔 Oplegnathus fasciatus 치어의 성장 및 체성분에 미치는 영향)

  • Moon Lee, HaeYoung;Nam, Myung-Mo
    • Korean Journal of Ichthyology
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    • v.27 no.4
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    • pp.293-299
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    • 2015
  • The feeding experiment was conducted to investigate the effects of one experimental diet (EDP) and five different commercial diets (CEPs) on growth and body composition for juvenile parrot fish, Oplegnathus fasciatus. An EDP was formulated to contain 50% crude protein (CP) from fishmeal, casein, zein and wheat flour and 15% crude lipid (CL) from squid liver oil. Five CEPs for seawater fish were two domestic E commercial diet (DECD) and C commercial diet (DCCD), three imported H commercial diet (IHCD), L commercial diet (ILCD) and O commercial diet (IOCD) containing 53.1~66.6% CP and 10.7~14.6% CL, respectively. Each diet was fed to triplicate groups of juvenile parrot fish initially weighing $1.14{\pm}.01g/fish$ (mean${\pm}$SD) in a flow-through seawater system with a water temperature of $19.0{\sim}25.0^{\circ}C$. Weight gain (WG) and feed efficiency (FE) were significantly greatest in fish fed the DCCD and IOCD; intermediate responses were observed for fish fed the ILCD, while the IECD, IHCD, and the EDP produced the lowest WG and FE values. Survival with no significant difference approached 100% for fish fed the all six diets in this experiment. Whole-body moisture, protein, lipid and ash contents were not affected by the different type of diets. Therefore, type of diets appeared to be important factor in influencing WG and FE of juvenile parrot fish; the best diets for juvenile parrot fish was determined to be the domestic commercial C and the imported commercial O diets containing high protein (61.3, 66.6%) and lipid (14.6, 13.0%) in natural seawater based on highest WG, and FE, respectively. This study indicates that the two commercially formulated diets containing two highest proteins and lipids used in this experiment could be practical diets for juvenile parrot fish; these differences of growth performance between experimental diet and commercial diets may be reason for different dietary protein and lipid levels.

Correlation of Consumer Evaluation on Restaurants in Social Network System (SNS) with Food Hygiene (식품접객업소에 대한 사회관계망서비스(SNS) 상의 소비자 평가와 위생상태의 연관성 분석)

  • Kim, Kyungmi;Kim, Sejeong;Lee, Soomin;Lee, Jeeyeon;Lee, Heeyoung;Choi, Yukyung;Yoon, Yohan
    • Journal of the East Asian Society of Dietary Life
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    • v.27 no.4
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    • pp.473-476
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    • 2017
  • Social network service (SNS) plays an important role in food service industry consumers SNS restaurants, and other consumers review the reputations. It was assumed that bad reputation could have poor food hygiene. Therefore, this study evaluated the relation between reputations SNS and food hygiene. Restaurants were searched using web portals and 12 restaurants (six for good and six for bad reputation) were selected. Microbiological analysis (total aerobic bacteria, coliform, and Escherichia coli) for main and side dish was performed. Detection frequencies for total aerobic bacteria were not different between good and bad restaurants. However, bad restaurants had higher detection frequencies (70.8%) with mean of 3.2 log CFU/g for coliform than good restaurants (62.5%; mean of 2.3 log CFU/g). In addition, bad restaurants had higher detection frequencies (25%) of E. coli with mean of 0.8 log CFU/g than good restaurants (8.3%; mean of 0.5 log CFU/g). This result indicates that consumer reputations SNS are related to food hygiene, and the reputation data can be used for food hygiene inspection by food safety agencies.

Choledochal Cyst in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담관낭종 -대한소아외과학회회원 대상 전국조사-)

  • Choi, Kum-Ja;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.J.;Park, K.W.;Park, W.H.;Park, J.Y.;Paek, H.K.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Park, Y.S.;Lee, T.H.;Chung, S.Y.
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • A nationwide survey on choledochal cyst was undertaken among 39 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the five year period of 1997 to 2001. Three hundred and forty eight patients were registered from 32 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:3.4. The age of patients on diagnosis was $49.0{\pm}44.4$ months. The geographic distribution was 34.8% in Seoul and Kyoungki-do, 33.3% in Kyoungsang-do, 17.9% in Cholla-do, and 8.5% in Choongchung-do, in order of frequency. The three common clinical presentations were abdominal pain (63.8%), vomiting (35.3%), and jaundice (29.1%). Only seven patients (2%) presented with classic triad, and 25 patients were diagnosed by antenatal ultrasonographic examination. According to the Todani Classification, 238 patients (7l.3%) were type 1, 3 (0.9%) type 11, and 93 (27.8%) type IV. At the time of the operation, three important associated conditions were choledocholithiasis in 45 patients (15.1%), liver fibrosis (Grade 1-4) in 35, and previous operative procedure for biliary diseases in 10. Associated anomalies were observed in 13 patients (3.8%). Three hundred thirty nine (98.8%) of 343 lesions were treated by Cyst excision and Roux-Y hepaticoiejunostomy. One hundred seventy-six patients had an anomalous arrangement of the pancreatobiliary ductal system (APBD): APBD was not in 92 patients, biliary duct joined to the pancreatic duct in 51, and pancreatic duct joined to the biliary duct in 26. There were 8.5% early, and 7.7% late phase operative complications. The major complications were bleeding, anastomotic leakage, and acute pancreatitis. The combination of acute abdomen and choledochal cyst may suggest spontaneous rupture. Because of the development of late intrahepatic bile duct stones, long term follow up after cyst excision and hepaticojejunostomy is required. The optimal time of surgical intervention should also be considered in the situation of routine use of antenatal ultrasonographic examination. This is the first review of the choledochal cyst in Korea and provides baseline data for future comparisons.

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