• Journal of Chest Surgery
• /
• v.30 no.12
• /
• pp.1167-1174
• /
• 1997

We retrospectively reviewed a series of 20 patients treated with delayed sternal closure during a 5-year period from 1991 to 1996. Of the 2675 patients with cardiovascular su gery 20 underwent this procedure. Male and female ratio was 11:9, mean age was 6.4 months(range 7 days to 5 years). The indications included unstable hemodynamic profiles after open heart surgery due to myocardial edema and poor lung compliance(15), necessity of mechanical ventricular assist device due to weaning failure(3), and hypoxia after PAB(2). Sternum was closed at a mean interval of 102(range 4 to 213) hours after operation. During delayed sternal closure, central venous pressure was elevated(p<0.05). Mediastinitis and other wound problems did not occur. Sepsis developed in 2 patients and microorganism was confirmed in one of the two patients. Five patients died(mortality 25%). And two of 15 discharged patients died during follow-up period. Cumulative survival rate was 65.0% at 12 months and also 65.0% at 24 months.(Standard error was 10.7%) Delayed sternal closure Is considered to be a good method to decompress the hemodynamically compromised heart. Without that, it is not f asible to come off bypass or to decompress the heart. Of course. careful selection of the indication is imperative.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.1
• /
• pp.37-41
• /
• 2012

Objective : The aim of this study was to describe a single center's experience in the management of craniopharyngiomas in children over a 15-year period. Methods : The clinical records of pediatric patients treated for craniopharyngiomas between December 1995 and February 2011 were reviewed. Thirty-five pediatric patients diagnosed with craniopharyngioma were treated, and their medical records and imaging data were analyzed retrospectively. Results : The mean follow-up duration was 76 months (range, 10-195). Overall survival and local control rates at 10 years were $94.7{\pm}5.1%$ and $37.1{\pm}11.9%$, respectively. The female-to-male ratio was 16 : 19, and the mean age was 8.6 years (range, 1-17). Initially, gross total resection (GTR) was performed in 30 patients; subtotal resection (STR) followed by radiotherapy was performed in 5 patients. Of the 14 cases that showed recurrence after GTR, 5 patients were treated with GTR, 1 with radiation therapy (RT), 4 with gamma knife radiosurgery (GKRS), and 4 with subtotal resection followed by RT. No patients who underwent RT or GKRS had recurrences. Two cases with recurrence after STR followed by RT were treated with GTR. One patient died of hormonal insufficiency 64 months after the first surgery. The overall median time progression was 51.2 months (range, 3-182) : 49.7 months in the patients who underwent GTR and 60.2 months in the patients who underwent STR followed by RT. Conclusion : If safe resection is possible, GTR at the initial treatment should be attempted to reduce the tumor recurrence. However, if the tumor recurs after the first surgery, RT or GKRS with/without reoperation may be an effective salvage treatment for recurrent craniopharyngioma.

• Clinical and Experimental Pediatrics
• /
• v.62 no.11
• /
• pp.422-427
• /
• 2019

Background: Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. Purpose: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods: This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction. Results: The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction. Conclusion: BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.

• The Journal of Korean Medical History
• /
• v.32 no.1
• /
• pp.11-20
• /
• 2019

Queen Myeongseong was the wife of King Hyeonjong, the 18th king of the Joseon Dynasty, and the mother of King Sukjong. The clinical records of Queen Myeongseong are summarized on the basis of the Seungjeongwon Ilgi (The Daily Records of Royal Secretariat of Joseon Dynasty 承政院日記) and reviewed through Donguibogam. Queen Myeongseong gave birth to one male and three female children in the time of the queen. She took Geumgaedangguihwan (金櫃當歸丸), Dalsaengsan (達生散), Antaeum (安胎飮) during her pregnancy and Gungguitang (芎歸湯) during postnatal care. Since 1669, chest tightness, sleeplessness, arm pain and numbness of arms had been appeared. Ondamtang (溫膽湯) and Dodamtang (導痰湯) were used but they were not effective. However, when her symptoms were regarded as a benign tumor due to cold and wetness, there was a difference in the use of Ohjuksan (五積散). In 1683, when king Sukjong was caught in a smallpox, she took care of him. She exorcised in the middle of winter to pray for her son's recovery, and died of the flu.

• Journal of Yeungnam Medical Science
• /
• v.4 no.2
• /
• pp.131-138
• /
• 1987

In 1814, Giovanni Battista Monteggia first described two cases of fracture of proximal third of ulna with a dislocation of radial head, and this combined injury is now known as the Monteggia fracture. Despite its rarity, the importance of early recognition of dislocated radial head and correct treatment bas been emphasized. Eight cases of Monteggia fracture were studied from March, 1984 to June, 1987. The results are as follows 1. Male patients were six and female were two. 2. The frequent cause of injury was fall down in four cases. 3. Bado type I accounted for 50%, type II for 12.5% and type III for 37.5%. 4. The level of ulna fracture was above upper one third of ulna in seven. 5. The common direction of dislocated radial head was anterior. 6. Two children and two adults were managed by closed reduction. Four ulna fractures in adult were treated by open reduction and internal fixation using a semitubular plate. 7. The results (by Bruce et al. criteria) were 3 excellent, 2 good, 1 fair and 2 poor.

• Korean Journal of Child Studies
• /
• v.36 no.6
• /
• pp.165-188
• /
• 2015

The purpose of this study was to examine the relationships among Korean early adolescents' perceived negative parenting practices, trajectories of mobile phone dependency(MPD), and self-regulated learning(SRL), while taking into account gender differences. Early adolescents are required to acquire self-regulation in Korean cultural contexts of a strong emphasis on academic achievement and recent technological advancements. The study made use of data from the Korean Children and Youth Panel Study(KCYPS), and three waves of data collected from 1,953 adolescents in $7^{th}$, $8^{th}$ and $9^{th}$ grade were analyzed. The results can be summarized as follows. Growth-curve longitudinal analysis indicates that their initial value of MPD through $7^{th}$ to $9^{th}$ grade had increased, but the initial value and rate of change were significantly different according to gender. Furthermore, the results of multiple group analysis revealed that some path weights appeared different according to gender. For male students, the rate of change in MPD did not have a significant effect on either SRL in $7^{th}$ or $9^{th}$ grade, whereas for female students, it predicted the existence of significant relationships with them. The implications of these findings were also discussed.

• Journal of Chest Surgery
• /
• v.25 no.11
• /
• pp.1327-1336
• /
• 1992

Between Jan. 1986 and Aug. 1992. 72 patients underwent Rastelli procedure. There were 43 male and 29 female, aged 46 days to 16 years [mean age, 5.2 years] with 18 patients less than 2 years of age. All patients had complex defect, 27 pulmonary atresia with ventricular septal defect, 18 corrected transposition of great arteries with pulmonary atresia or punmonary stenosis, 10 truncus arteriosus, 10 double outlet right ventricle with pulmonary atresia or stenosis, 7 complete transposition of great artersia with pulmonary atresia or pulmonary stenosis. The types of extracardiac valved conduit used were prosthetic valve[n=47, 24 car-bomedics, 19 Ionescu-Shiley, 4 Bjork-shiley] and hand-made trileaflet valve using pericardium. [n=23, 20 bovine pericardium, Z autologous pericardium, 1 equine pericardium] The mean size of valved cinduit was 5.25mm larger in diameter than the size of main pulmonary artery. [normalized to the patient`s body surface area] There were 17 hospital death[24%] and 4 late deaths[5.6%]. Postoperative complication rate was 38.9%a, none of which was conduit-related. All patients were followed pos-toperatively for 1 to 73 months. [mean 25.8 months] During follow-up period, reoperation was done in 6 patients due to stenosis of valved conduit. Mean interval between intial repair and reoperation was 20.3 months. In our experience, li recently extracardaic valved conduits between right ventricle [or pulmonary ventricle] and pulmonary artery were inserted with increasing frequency in infants less than 2 year, but hospital mortality was decreased, 2] Risk of reoperation due to conduit stenosis is low, so that the effect of graft failure on overall survival is minimized. 3] Nevertheless, because any type of extracardaic valved conduit is not ideal in children, we recommended that Lecompte should be done if cardiac anatomy is permitted.

• Korean Journal of Bronchoesophagology
• /
• v.12 no.2
• /
• pp.26-30
• /
• 2006

Backgroud and Objectives: Inhalation of foreign bodies in respiratory tract can be fatal to infants and child. After ventilating bronchoscopy technique was widelyused, most of the pediatric airway foreign bodies could be managed effectively. In this study, we aimed to analyze clinicalfeatures and outcomes of ventilating bronchoscopic removal of pediatric airway foreign bodies. Materials and Methods: One hundred twenty cases of ventilating bronchoscopy for pediatric airway foreign bodies at Seoul National University Hospital for the past 15 years were analyzed retrospectively. Results: In 120 cases, sex ratio (male: female) was 2.2:1 and mean age was 27.0 months. Most frequent type of airway foreign was peanut (60.2%). One hundred thirteen patients, in whom a foreign body was confirmed in the airway, were successfully managed by ventilating bronchoscopy. Delayed diagnosis and management made a significantly long postoperative hospital stay. Conclusion: Great care must be given when feeding young children, especially younger than 36 months, with nuts. Early intervention with ventilating bronchoscopy following a clinical suspicion is critical to successful treatment.

• Research in Community and Public Health Nursing
• /
• v.20 no.2
• /
• pp.225-233
• /
• 2009

Purpose: This study was to analyse the factors affecting youth smoking, especially self-efficacy and perceived social norm, based on the stage of change. Methods: A self-reported survey was conducted during the period from the 21 st of April to the 17th of May, 2008. Data were collected from 10,707 students of 12 middle schools in Seoul, Gyeonggi-do, and Incheon. The data were analysed with SPSS/WIN 15.0. Results: The smoking possibility was 2.18 times higher in the male students than in female students, and 1.76 times higher in 8th-grade students and 2.48 times higher in 9th-grade students than in 7th-grade ones. Smoking possibility increased when students had more experience in alcohol, more friends who smoke, or worse relationship with their parents. Also this study showed that high-level self-efficacy and perceived social norm were acting as inhibiting factors of smoking. Conclusion: To reduce the youth's smoking rate, smoking prevention programs should provide educational chances to learn knowledge and skills on how to reject smoking temptation. Also, someone significant like parents should make it clear to the youth that they do not want their children to smoke.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.1
• /
• pp.407-412
• /
• 2016

Background: Considering the rising incidence of thyroid cancer worldwide, the aim of our study was to investigate the temporal trends in the incidence of this cancer in a large population of Iranian patients. Materials and Methods: We used the Iran Cancer Data System (ICDS) Registry to assess the thyroid cancer trend from 2004 to 2010 with regard to different genders, age groups, and morphologies. To do this we analyzed the data of 10,913 new cases of thyroid cancer that occurred during these years. Results: The incidence rate (per one year) of thyroid cancer was 2.20 per 100,000 persons between 2004 and 2010 in Iran. Papillary thyroid cancer was the most common histology type, with an annual rate of 0.29 in Iran. The highest rate of prevalence in thyroid cancer was observed at the age of 45 years at the time of diagnosis. We found a female-to-male ratio of 2 in Iran. A significant decrease was detected in the trend of thyroid cancer in children <19y, which was not correlated to the trend of older patients. Conclusions: As expected, the trend of thyroid cancer increased over the 7 years, primarily contributed by papillary thyroid cancer. A rising pattern of incidence was seen in all the age groups except patients aged under 19 years.