• Journal of radiological science and technology
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• v.28 no.2
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• pp.105-110
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• 2005

Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

• Korean Security Journal
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• no.42
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• pp.7-36
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• 2015

This study aims at analyzing difference of social Security network, Community unity and local government trust according to socio-demographical features, exploring the relation of social Security network, Community unity and local government trust according to socio-demographical features, presenting results between each variable as a model and verifying the property of mutual ones. This study sampled general citizens in Gwangju for about 15 days Aug. 15 through Aug. 30, 2014, distributed total 450 copies using cluster random sampling, gathered 438 persons, 412 persons of whom were used for analysis. This study verified the validity and credibility of the questionnaire through an experts' meeting, preliminary test, factor analysis and credibility analysis. The credibility of questionnaire was ${\alpha}=.809{\sim}{\alpha}=.890$. The inout data were analyzed by study purpose using SPSSWIN 18.0, as statistical techniques, factor analysis, credibility analysis, correlation analysis, independent sample t verification, ANOVA, multi-regression analysis, path analysis etc. were used. the findings obtained through the above study methods are as follows. First, building a social Security network has an effect on Community institution. That is, the more activated a, the higher awareness on institution. the more activated street CCTV facilities, anti-crime design, local government Security education, the higher the stability. Second, building a social Security network has an effect on trust of local government. That is, the activated local autonomous anti-crime activity, anti-crime design. local government's Security education, police public oder service, the more increased trust of policy, service management, busines performance. Third, Community unity has an effect on trust of local government. That is, the better Community institution is achieved, the higher trust of policy. Also the stabler Community institution, the higher trust of business performance. Fourth, building a social Security network has a direct or indirect effect on Community unity and local government trust. That is, social Security network has a direct effect on trust of local government, but it has a higher effect through Community unity of parameter. Such results showed that Community unity in Gwangju Region is an important factor, which means it is an important variable mediating building a social Security network and trust of local government. To win trust of local residents, we need to prepare for various cultural events and active communication space and build a social Security network for uniting them.

• Neonatal Medicine
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• v.15 no.1
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• pp.80-83
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• 2008

Purpose : Inguinal hernias are common in children and sometimes are associated with dangerous complications, such as incarceration. There are no established management guidelines for ovarian hernias. We have reviewed the clinical course of ovarian hernias in infants. Methods : We reviewed the medical records of female infants diagnosed with ovarian hernias by ultrasonogram at Kwandong University College of Medicine, Cheil General Hospital, and the Women's Healthcare Center between March 2001 and August 2007. We analyzed the patients gestational age, birth weight, age at the time of detection of the inguinal mass, the patients chief complaints, operative time, post-operative complications, and ultrasonographic findings. Results : Eight female infants had ovarian hernias, four of whom were born prematurely. Seven infants had left-sided ovarian hernias, and one infant had a right-sided ovarian hernia. Five infants underwent surgery and there were no postoperative complications or recurrences. Three girls did not have surgery, and the ovarian hernias regressed spontaneously, with no recurrences or complications. The regression time of inguinal masses ranged from 70-161 days after birth. Conclusion : Physical examination to detect movable masses within the labium major in premature female infants is important because the incidence of premature inguinal hernias is much higher than in term infants. No rational medical treatment plans for female ovarian hernias have been published to date. We cared for three girls with spontaneous regression of ovarian hernias. Pediatricians should be aware whether emergent surgery for ovarian hernias is indicated.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.291-296
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• 1995

Purpose : In general, the wedge factors which are used clinical practices are ignored of dependency on field sizes and depths. In this present, we investigated systematically the depth and field size dependency to determine the absorbed dose more accurately. Methods : The wedge factors for each wedge filter were measured at various depths (depth of Dmax, 5cm, 10cm, and 15cm) and field sizes ($5cm{\times}5cm,\;10cm{\times}10cm,\;15cm{\times}15cm, and 20cm{\times}20cm$) by using 4-, 6-, and 10-MVX rays. By convention, wedge factors are determined by taking the ratio of the central axis ionization readings when the wedge filter is in place to those of the open field in same field size and measurement depth. In this present work, we determined the wedge factors for 4-, 6-, and 10-MV X rays from Clinac 600C and 2100C linear accelerators (manufactured by Varian Associates, Inc., Palo Alto, CA). To confirm that the wedge was centered, measurements were done with the two possible wedge position and various collimator orientations. Results : The standard deviations of measured values are within $0.3\;\%$ and the depth dependence of wedge factor is greater for the lower energies. Especially, the variation of wedge factor is no less than $5\%$ for 4- and 6- MV X rays with more than $45^{\circ}$ wedge filters. But there seems to be a small dependence on field size. Conclusion : The results of this study show a dependence on the point of measurement. There also seems to be a small dependence on field size. And so, we should consider the depth and field size dependence in determining the wedge factors. If one wedge factor were to be used for each wedge filter it seems that the measurement for a 10cm x 10cm field size at a depth of loom would be a reasonable choice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.1
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• pp.1-10
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• 2002

Purpose; Dysregulation of gastric epithelial cell proliferation and apoptosis are important in development of ulcer, atrophy and neoplasia in Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the effect of infection of H. pylori on gastric epithelial cell proliferation and apoptosis in children. Methods: Histological grading by updated Sydney system, PCNA immunostaining and TUNEL method were performed in H. pylori positive (N=58) and negative (N=40) gastric biopsy specimens. Results: In H. pylori positive children, there were significantly higher grade of polymorphonuclear neutrophil activity (P=0.000), chronic inflammation (P=0.000), epithelial damage (P=0.000) and lymphoid follicles (P=0.000) than in H. pylori negative children. Intestinal metaplasia was not seen in H. pylori positive children. PCNA index was significantly different between H. pylori positive children ($67.8{\pm}18.13$) and H. pylori negative children ($54.8{\pm}14.46$, P=0.000). There was positive correlation between PCNA index and H. pylori density (r=0.277, P=0.007), polymorphonuclear neutrophil activity (r=0.280, P=0.007) and chronic inflammation (r=0.284, P=0.006). Apoptosis index of H. pylori positive children ($0.44{\pm}0.447$) was significantly higher than of H. pylori negative children ($0.14{\pm}0.196$, P=0.000). There was positive correlation between apoptosis index and H. pylori density (r=0.472, P=0.000), polymorphonuclear neutrophil activity (r=0.370, P=0.001) and chronic inflammation (r=0.483, P=0.000). There was positive correlation between PCNA index and apoptosis index (r=0.353, P=0.003). Conclusion: The PCNA and apoptosis index in H. pylori positive children were significantly higher than in H. pylori negative children. This study suggested that gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.129-135
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• 2002

Objective : The primary objective of this study was to estimate the prevalence of HBsAg-positives in the late 1990's among Korean adults. In addition, we evaluated the association of age, a residential area, a vaccination rate, a family history of chronic liver diseases and a past history of acute liver disease with the seropositivity of HBsAg, and estimated the prevalence of chronic HBV infection by follow-up for 6 month or more. Methods : A total of 10 areas, six metropolitan and four small cities, were selected. In each cities, one health screening center was selected for recruitment of study subjects. The study subjects were enrolled from a general health examination program that is provided by medical insurance companies. Questionnaires on various risk factors were administered to the study subjects. Sera was drawn and tested for HBsAg by radioimmunoassay. HBeAg and ALT were also tested for those of HBsAg positive. The HBsAg positives was retest for HBsAg 6 months later Results : Among the study subjects (n= 1816), the seroprevalence of HBsAg was 5.5% (95% CI=4.5%-6.6%), 7.4% in men (95% CI=5.8-9.4) and 3.6% in women (95% CI=2.5-5.0). A past history of acute liver disease and a family history of chronic liver diseases was shown to be risk factors for HBsAg positivity. Among the 31 HBsAg-positives, negative seroconversion rate was estimated to be 3.2%, Thus, prevalence of chronic HBV infection was estimated to be 5.3% (95% CI=3.7-6.6). Conclusion : In this study, the HBsAg seroprevalence rate was lower than that of the other studies in 1980's, particularly in young adult and women. Considering the public health importance of liver cancer and chronic liver diseases, the further effort is needed to prevent and reduce the HBV infection.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.18-26
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• 2006

Purpose : Empirical antimicrobial treatment is indicated before bacteriological results are available for young children with febrile UTI to minimize renal scarring. To ensure appropriate therapy, knowledge of the prevalence of causative organisms and their susceptibility patterns to antimicrobials is mandatory. We performed a retrospective analysis investigating the local prevalence and resistance patterns of uropathogens, primarily E. coli, isolated from community-acquired UTIs. Methods : A total of 103 positive urine cultures from children with febrile UTI collected at Bundang CHA General Hospital from February 2004 to February 2005 were analyzed. Inclusion criteria were fever higher than $37.5^{\circ}C$, significant bacteriuria with single strain growth of at least 10s colony forming units/mL urine, and leukocyturia >5/HPF. Results : E. coli(89.3%) was the leading uropathogen followed by Enterococcus spp.(3.9%) Klebsiella spp.(2.9%), Citrobctcter spp.(1.9%) and Enterobacter spp.(1.9%). E. coli strains revealed a low proportion of antimicrobial susceptibility to ampicillin(AMP; 27.2%) ampicillinsulbactam(AMS; 34.8%) and trimethoprim-sulfamethoxazole(SXT; 65.2%). Susceptibility patterns to cephalosporins were as follows; cefazolin(1st generation; 91.3%), cefoxitin(2nd; 100%), ceftriaxone(3rd; 97.8%) and cefepime(4th; 97.8%). Three E. coli isolates produced ex tended - spectrum beta-lactamase(ESBL). Conclusion : Empirical treatment with AMP, AMS and SXT, which are commonly used in pediatric clinics, is not recommended for childhood UTI due to high incidence of resistance. The high level of susceptibility to cephalosporins makes these drugs reasonable alternatives. However the emergence of ESBL-producers, even though they are quite few, may have an impact on cephalosporin treatment in the future. (J Korean Soc Pediatr Nephrol 2006;10:18-26)

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.285-293
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• 2000

Purpose: A prospective comparison was made between imaging with Tc-99m pertechnetate (Tc-99m) and Ioine-131 (I-131) for the detection of residual and metastatic tissue after total thyroidectomy in patients with well-differentiated thyroid carcinoma. Materials and Methods: Initially our patients had imaging with Tc-99m, followed by I-131 within 3 days. The study included 21 patients who had ablation with high dose of I-131 ranging from 100 mCi to 150 mCi. Planar and pinhole images were acquired for both Tc-99m and I-131. Diagnostic images of Tc-99m and I-131 were compared with post-therapy images. Degree of uptake on Tc-99m and I-131 images was scored by four point scale and compared. Results: The results of the Tc-99m study were: 16 of 19 studies (84%) were positive on simple planar images, but 19 of 20 studies (95%) were positive on pinhole images. Conventional I-131 diagnostic imaging on the other hand showed that all studies (100%) were positive on both planar and pinhole images. There was a significant difference in degree of uptake between Tc-99m and I-131 planar images (p<0.05). Only one case of Tc-99m scintigraphy was negative on both planar and pinhole studies (false negative). There was no distant metastasis on the therapeutic I-131 images. Conclusion: Tc-99m scan using pinhole in certain clinical situations is an alternative to the I-131 scan in detecting thyroid or lymph node metastasis prior to the first ablative treatment after thyroidectomy for well-differentiated thyroid carcinoma.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.70-75
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• 2017

Purpose Radioactive iodine thyroid uptake (RAIU) rate is an examination which determines and seeks about general functions of thyroid gland. The size of thyroid gland is normally different between each person, also patients having thyroid diseases have had a variety of size of thyroid gland compared with others. The purpose of this study will investigate about the counting rate which is effected by the geometric factors through the length and volume changes of the source in RAIU rate. Materials and Methods I-131 185 kBq ($5{\mu}Ci$) were placed in a cylindrical phantom of 0.5 cm, 1 cm, 1.5 cm, and 3 cm in diameter, respectively, and saline was added to gradually increase the length by 1 cm in the horizontal and vertical directions to give a change in volume. The source was measured 20 times for 20 seconds from a distance of 25 cm to $364.4keV{\pm}20%$ energy ROI with Captus 3000 thyroid uptake system (Capintec, NJ, USA). Results When the source was located in the transverse direction of the detector, the consequence of one-way ANOVA is that even though the length of source is increased each diameter, there is mostly no significant difference. When the source was located in the longitudinal direction and the counting rate of length 1 cm at all diameter is set to 100%, the average is 92.57% for length 2 cm, 86.1% for 3 cm, 80.69% for 4 cm, 74.82% for 5 cm, and 69.68% at 6 cm. Conclusion According to this study, it is expected that the gap of RAIU rate has been depended on the thickness of thyroid gland as well as the diameter of the beaker. We know that the change of the volume with the increase of the length of the source had less effect on the change of the counting rate. Thus, in order to reduce the error in the measurement of the counting rate with the thyroid uptake rate equipment, an accurate counting rate can be relatively measured if the counting rate which is measured is corrected by thickness or the distance between the thyroid and the thyroid uptake rate equipment is changed.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.13 no.2
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• pp.111-119
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• 2013

Purpose: Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disorder caused by deficiency of the enzyme ${\alpha}$-L-iduronidase, which leads to a broad spectrum of multisystemic manifestations. Short stature and decreased growth velocity are prominent features of MPS I. The aim of the present study was to evaluate the effect of enzyme replacement therapy (ERT) on growth of Korean MPS I patients from a single center. Methods: Height data were obtained by retrospective chart review of 10 Korean patients with MPS I who had received ERT for a minimum of 3 years. Height was expressed as standard deviation scores (SDS) based on normative data. Annual growth rates were calculated before and during ERT. A piecewise regression model was used to analyze height z-scores before and after treatment. Individual analysis was performed for impact of phenotype [(severe (Hurler) versus attenuated (Hurler-Scheie, Scheie)] on growth. Results: Annual growth was 3.3 cm (z-score= -0.21) in the year before ERT and 6.2 cm (z-score= 0.17), 5.8 cm (z-score= 0.07), and 3.8 cm (z-score= -0.4) in the first, second, and third years of ERT, respectively. Regression analysis showed improvement in the slope after ERT (difference= 0.04; P=0.022). Estimated slope differences between severe and attenuated phenotypes were statistically significant before (P=0.001) and after treatment (P<0.0001), although no significant difference was noted when stratified by phenotype. Conclusion: ERT with aldurazyme appears to have a positive impact on linear growth in patients with MPS I.