• Korean Journal of Radiology
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• v.23 no.9
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• pp.889-900
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• 2022

Objective: To investigate the long-term outcomes of percutaneous treatment of benign biliary strictures using temporary placement of a retrievable expanded polytetrafluoroethylene (PTFE) covered stent. Materials and Methods: We retrospectively analyzed the outcomes of 148 patients (84 male and 64 female; age range, 11-92 years) who underwent percutaneous transhepatic placement and removal of a retrievable PTFE-covered stent for the treatment of benign biliary strictures between March 2007 and August 2019 through long-term follow-up. Ninety-two patients had treatment-naïve strictures and 56 had recurrent/refractory strictures. Results: Stent placement was technically successful in all 148 patients. The mean indwelling period of the stent was 2.4 months (median period, 2.3 months; range, 0.2-7.7 months). Stent migration, either early or late, occurred in 28 (18.9%) patients. Clinical success, defined as resolution of stricture after completing stent placement and removal, was achieved in 94.2% (131 of 139 patients). The overall complication rate was 15.5% (23 of 148 patients). During the mean follow-up of 60.2 months (median period, 52.7 months; range, 1.6-146.1 months), 37 patients had a recurrence of clinically significant strictures at 0.5-124.5 months after removal of biliary stent and catheter (median, 16.1 months). The primary patency rates at 1, 3, 5, 7, and 10 years after removal of biliary stent and catheter were 88.2%, 70.0%, 66.2%, 60.5%, and 54.5%, respectively. In the multivariable Cox proportional hazard regression analysis, sex, age, underlying disease, relation to surgery, stricture type, biliary stones, history of previous treatment, and stricture site were not significantly associated with the primary patency. Conclusion: Long-term outcomes suggest that percutaneous treatment of benign biliary strictures using temporary placement of retrievable PTFE-covered stents may be a clinically effective method.

• 한국노년학
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• v.39 no.4
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• pp.723-739
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• 2019

This study is to verify the mediated effects of attitudes toward old people and dementia in the influence of elderly couples in the aging society amid the rapidly changing family structure and functions due to the combination of individualization, marital status and divorce rate. In order to carry out such research purposes, data were collected from students of elementary, middle and high schools in Gwangju, through self-subscribed questionnaire. For statistical analysis, the SPSS 20.0 and AMOS 18.0 programs were used and frequency, percentages, technical statistics, correlation, factor analysis, structural model validation, and the Sobel-Test were performed. The results of this study are as follows. First, family intimacy, elderly awareness, and elderly care were the highest among elementary school students, followed by middle school and high school students (P.<.001). Also, in religion, the family intimacy of teenagers with religion was higher than those without religion (p.001). Second, family intimacy directly affected elderly people's attitudes toward dementia and elderly care, old people's attitudes toward dementia and attitudes toward dementia directly affected elderly care. Third, family intimacy (parent-child) was found to be 7.8% for older adults, 20.2% for family intimacy and attitudes toward dementia, and 34.1% for elderly care (p.<.001). Fourth, it has been verified that the absolute value of attitudes toward dementia and elderly people's awareness of elderly people and attitudes between family intimacy and elderly care has been higher than 1.96 and thus acts as a mediating role. These findings are intended to contribute to the welfare of senior citizens' education to improve the quality of life for senior citizens through the resolution of conflicts between generations, as well as the resolution of positive stimulus, by developing various programs such as family friendship, elderly awareness, culture with parents, and various experiences to improve attitudes toward dementia in early adolescence.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.187-195
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• 1999

Purpose : VUR is state where urine regurge from bladder to ureter and kidney. It is shown in about 1/3 of urinary tract infection patients and it is classified as grade I to V. We compared results from RI VCUG(Radiisotope voiding cystourethrography) and X-ray VCUG which used in diagnosing VUR in children, to evaluate which is better in diagnosing VUR in children. Methods : 41 Patients(19 males, 21 females), who visited Pediatric department, Soonchunhyang university Hospital from peroid of 1991. January to 1998. July for recurrent urinary tract infection or abnormalities in ultrasonogams, were enrolled in the study. The age ranged from 9 months to 17 years and mean age was 5 1/2 years. Both RI VCUG and X-ray VCUG were done and follow-up test of urine culture, renal ultrasonogram and RI VCUG were done every month, every 3 month and every 6 month, respectively to observe the disappearance of VUR and evaluated the prognosis. Results : 24 patients had taken RI VCUG and 17(70.1%) patients showed positive result. 22 patients had taken X-ray VCUG and 9(40.1%) patients showed findings of VUR. 17 patients had taken both tests and 14 patients showed positive result in RI VCUG and 6 of these patients also showed reflux in X-ray VCUG. 3 patients who showed negative in RI VCUG, showed negative also in X-ray VCUG. For prognosis, resolution and scar formation was shown in 8 patients each. Persistent VUR was shown in 6 patients and 2 of these patients VUR was corrected by operation, 1 patient showed decreased renal function, and 1 patient was not follwed up. 8 of 9 patients who showed findings of VUR on DMSA scan formed a scar and 8 patients who showed no findings of VUR didn't form a scar. Urine culture was positive in 17 of 19 patients with VUR. Positive rate in urine culture was higher than that of patients with no VUR who showed positivity in 15 of 21 patients for urine culture. E. coli was most common organism and the period free of UTI was 14 months in VUR patients and it was shorter compared to patients without VUR which was 26 months. Conclusion : In diagnosing VUR in children, the positive rate was higher in RI VCUG than X-ray VCUG. Therefore, in early diagnosis when VUR is suspicious but not shown in X-ray VCUG, RI VCUG should be done and it will help to make accurate diagnosis.

• Journal of Environmental Health Sciences
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• v.43 no.1
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• pp.1-22
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• 2017

'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.24-27
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• 2010

Purpose: Early diagnosis of breast is of the utmost importance to improve prognosis. We have a limitation for mammography and sonography detecting small cancer. Clinical importance of Breast Specific Gamma Imaging (BSGI) has improved for that reason. So We studied performance evaluation test of count rate and resolution with high sensitivity to the low dose of BSGI. Materials and Methods: BSGI of Dilon 6800, point source of $^{99m}Tc$ from 1.85~148 MBq (0.05~4 mCi) at the intervals of 1.85~37 MBq (0.05~1 mCi) was used for the test. Performance evaluation method was performed for measuring deadtime for choosing at the 5 different point in the useful field of view (UFOV), acquired image for 60 seconds. Compared with reference of clinical uptake distribution of breast, activity increased according to the distance change 10, 20, 30, 40, 50 mm in the useful field of view. Results: Counting curve increased according to the activity from 1.85 MBq (0.05 mCi) to the 74 MBq (2 mCi), and it change flat shape over 74 MBq (2 mCi). The variation of the full width of half maximum (FWHM) to the distance is 4.05, 4.73, 5.77, 6.90, 8.00, 9.32 mm in 1.85 MBq (0.05 mCi), 4.30, 4.80, 5.90, 7.00, 8.10, 9.07 mm in 3.7 MBq (0.1 mCi), 4.90, 5.60, 6.20, 7.20, 8.20, 9.10 mm in 5.55 MBq (0.15 mCi), 5.30, 6.10, 6.60, 7.00, 7.90, 8.70 mm in 7.40 MBq (0.2 mCi). Conclusion: Distortions of image would be acquired because of the deadtime in BSGI. We found out the fact that specification of $^{99m}Tc$ reaction under 74 MBq (2 mCi) for BSGI. Second, FWHM distribution change from varied distance from the detector, clearly distinguished the location of the lesion.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

• Korean Journal of Agricultural and Forest Meteorology
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• v.14 no.3
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• pp.124-131
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• 2012

This study was carried out to evaluate a possible change in freeze risk for 'Changhowon Hwangdo' peach buds in three major peach growing areas under the future climate projected by RCP8.5 emission scenario. Mean values of the monthly temperature data for the present decade (2000s) and the future decades (2020s, 2050s, 2080s) were extracted for farm lands in Icheon, Chungju, and Yeongcheon-Gyeongsan region at 1km resolution and 30 sets of daily temperature data were generated randomly by a stochastic process for each decade. The daily data were used to calculate a thermal time-based dormancy depth index which is closely related to the cold tolerance of peach buds. Combined with daily minimum temperature, dormancy depth can be used to estimate the potential risk of freezing damage on peach buds. When the freeze risk was calculated daily for the winter period (from 1 November to 15 March) in the present decade, Icheon and Chungju regions had high values across the whole period, but Yeongcheon-Gyeongsan regions had low values from mid-December to the end of January. In the future decades, the frequency of freezing damage would be reduced in all 3 regions and the reduction rate could be as high as 75 to 90% by 2080's. However, the severe class risk (over 80% damage) will not disappear in the future and most occurrences will be limited to December to early January according to the calculation. This phenomenon might be explained by shortened cold hardiness period caused by winter warming as well as sudden cold waves resulting from the higher inter-annual climate variability projected by the RCP8.5 scenario.

• Journal of Korean Society of Forest Science
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• v.19 no.1
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• pp.1-23
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• 1973

The results of ground vegetation experiment conducted at completely denuded forestland in the mudstone region are summerized as follows: On the reaults of soiling quantity the effect of soiling was observed where depth of soiling over 10 cm was practiced, and a plot where treated with 15cm soiling and without fertilizer showed poor growth and it was even worser than the plot where soiling was practiced only 1 cm in thikness but applied adequate amount of fertilizers. The depth of slits between 30cm and 40cm showed no significant difference in the effect. A plot where covered with vegetation bag showed somewhat better results in seed loss and early growth but no differences observed in the fall result over the none covered plot. And then, it is recommendable to have soiling over 10cm in thikness with slit of 30cm and 30cm in depth and to apply 30 gram of fertilizer (22;22:11, 50 gram) per slit. On various soiling materials trial there were no striking differences in the effect of soiling between weathered granite soil, wheathered tuffs soil and weathered mudstone soil. In the treatment with various green materials, a plot treated with straw mat showed a significant difference at 1 percent. The results show that weathered mudstone soil is effective to use as soiling materials and straw mat treatment was better. On forest fertilization trial, in the mudstone region where red and black pine trees already existing at a rate of 2,000-3,000 trees per hectare had applied 110kg of compound fertilizers (9:12:3 and 22:22:11) per hectare basis in terms of plant nutrient. As a result, the difference in effect between the compound fertilizers was not found however the leaf color and leaf length of the fertilizer added plot showed darker and longer at 30 percent over the no fertilizer received plot. Compound fertilizers, 14:37:12 and 9:12:3 were applied to alder trees at a rate of 20 gram and 40 gram per tree in terms of plant nutrient and a remarkable growth accelerantion was observed where 40 grams of plant nutrient applied. The effect difference between the compound fertilizers was not found. On investigation of tree root elongation, forty years old red pine trees showed only 15cm tap root elongation through mudstone while black pine had 23 cm tap root elongation. The total length of supporting root elongtion of red and black pines showed 20 and 13 meters, respectively. The tap roots of Black locusts were not able to elongate through mudstone, however, the supporting roots tended to develop to the underneath of pine tree where some moisture content is available. Black locusts And grown on the residual soil of mudstone normally die between 8 to 10 years. The red pine trees show flat in tree shape while black pine had triangle in the shape. With the results it can be said that in an artificial reforestation in denuded forest land of the mudstone region the adequate slit and enough amount of fertiliizer application must be provided for the succesful performance of the program. On integrated experimental results of 1972. for the establishment of ground vegetation on the completely denuded forest land in mudstone region, soiling could be effectively practiced with weathered mudstone soil and it would not specially necessiate to have either weathered granite or tuffssoil for the soiling. And the soiling depth should be more than 10 cm in thickness. Among green materials used the straw mat proved to be the most effective reatment. Three major factors which enable to establish ground vegetation by the shortest period of time: A. Physical improvement of soil is necessary to breakdown of the horizontal cracks sushas Slit, contour line plot, seeding hole and etc., and soiling with weathered mudstone soil. B. Chemical improvement of soil: is needed sufficient amount of fertilizer application 300~400kg ha, $N+P_2O_5+K_2O$), and increased production of ground covering and expedite resolution of the vegetation (ground vegetation, fallen leaves and twigs). C. Complete establishment of the basic structure for the erosion control (Prevention of surface soil erosion)