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Twelve Years of Experience with Vascular Ring Surgery (혈관륜 수술의 12년 경험 보고)

  • Kim, Yun-Seok;Goo, Hyun-Woo;Jhang, Won-Kyoung;Yun, Tae-Jin;Seo, Dong-Man;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.749-756
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    • 2009
  • Background: Vascular ring is a rare anomaly of the aortic arch. We did surgical repair procedures on 16 cases of vascular ring over the past 12 years. This article reviews our results. Material and Method: Between 1995 and 2007, 16 patients (5 with double aortic arch, 7 with right aortic arch-left ligamentum, 4 with pulmonary artery sling) underwent surgical repair. Mean age at the time of the operation were as follows: double aortic arch, $5.7{\pm}5.5$ years; right aortic arch-left ligamentum, $6.1{\pm}13.4$ years; pulmonary artery sling, $2.9{\pm}2.6$ years. Five patients (71%) with right aortic arch-left ligamentum had an associated Kommerell's diverticulum. Two patients (40%) with double aortic arch, 2 patients (28.6%) with right aortic arch-left ligament and 4 patients (100%) with pulmonary artery sling had associated airway stenosis. Cardiac anomalies were present in 8 of 16 patients. Result: There was no peri-operative or post-operative mortality. The mean hospital stay was $27.1{\pm}38.2$ days. None of our patients underwent reoperation. Conclusion: Vascular ring is rare, but, it needs surgical correction. It is important to suspect the diagnosis and to validate with echocardiography. Preoperative and postoperative computed tomography and bronchoscopy are useful to evaluate the airway and surrounding structures.

A Proposal to Control System and the Problems of the Problems of the Report about Supply and Demand for Medical Technicians and Management Policy ("의료기사인력수급에 관한 보고서"의 문제점과 관리제도의 개선방안)

  • Kim, Sang-Hyun;Lim, Yongmoo
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.4
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    • pp.25-30
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    • 2008
  • Purpose: In this paper, we have analyzed the problems of the Oh's report which is used to the basic data for supply and demand of medical technicians and studied a proposal for improvement to control system and supply and demand of korean optometrists. Methods: We have analyzed errors of Oh's report including supply and demand for medical technicians and management policy, expecting number for future optician, inaccurate estimation by limited data (employment rate, retirement rate, mortality rate) and an incorrect method of measurement for future supply and demand. Results: Oh's report showed the 18% error for estimation of supply which exclude the irregular entrance students. The estimation of supply was calculated by graduation rate 62.6% (college and University of Technology are 78.9% and 85.98% respectively), employment rate 65.8% (the average employment between 2002 and 2007 is 73.96%) and retirement rate is 2.3% (the retirement of pharmacists is 1.3%) but it showed the significant differences to objective data. For estimate the suitable ratio of optometrists to the population, the ratio use of medical facilities by an age group was used, and suggested spectacle wearers 1,280 persons (populations 2,928 persons) per optometrist but the different from reference of Germany (4,706 persons), America (1,789 persons) and Korea (1,825 persons/an optometrist) are applied to estimation on supply. This report applied the low employment rate and argued that maintain the present situation, but claimed that utilize unemployment persons. The above result has induced double weighting effect on estimation of supply. Conclusions: To solve the related problems of supply and demand, we have to make a search for exact data and optimum application model, have to take an example of nation similar job category as Germany and the research result of the job satisfaction into consideration. After we get the integrated research result, we must carried out the policy with fairness and balance for the estimation of supply and demand. Therefore exact research is required prior to beginning policy establishment, government and related group have to make a clear long-term plan and permanent organization for medical technician to establish supply and demand of medical technician.

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Factors for Delayed Diagnosis of Acute Appendicitis in Children (소아 급성 충수돌기염 진단에 지연을 일으키는 요인에 관한 연구)

  • Han, Myung-Ki;Kim, Kyoung-Soo;Park, Yu-In;Kim, Jeong-Ho;Lee, Jung-Joo;Kim, Bong-Seong;Kang, Hye-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.158-165
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    • 2002
  • Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

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Post-Exposure Prophylaxis of Varicella in Family Contact by Oral Acyclovir (가족 내 수두 환자와 접촉 후 경구 Acyclovir의 예방효과)

  • Kim, Sang Hee;Kim, Jong Hyun;Oh, Jin Hee;Hur, Jae Kyun;Kang, Jin Han;Koh, Dae Kyun
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.61-66
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    • 2002
  • Purpose : To determine wether varicella can be prevented by administration of oral acyclovir(ACV) during the incubation period of the disease. Methods : Starting 9 days after exposure to the index case in their families, ACV(40 mg/kg/day in four divided doses) was given orally to 20 exposed children for 5 days. Their clinical features was compared with those of 20 control subjects. Antibody titers to VZV were measured in both group 1 week and 4 weeks after finishing the oral ACV administration. Results : The mean age of family members with varicella(51.4 months) were significantly high compared to that of ACV prophylaxis group(28.5 months) and control group(31 months) (P<0.05). Among the 12 children with ACV prophylaxis who completed follow up blood sampling, nine children were diagnosed as VZV infection on the serologic test(75%). Among them six children showed positive VZV IgM on the first blood sample and two children showed serocoversion to positive IgM on the second test after ACV prophylaxis. One child who was negative on both IgM and IgG, showed positive IgG on the second test. The incidence of fever and severity of skin rashes were significantly low in children received oral ACV than in the control group. No or reduced number of maculopapular eruption were observed in the oral ACV group compared to multiple vesicles of the control group. Conclusion : In the present study, we observed that oral ACV prophylaxis to the family contacts is effective in reducing severity of skin lesion. It is likely that oral ACV 9 days after contact prevents or reduces blood dissemination of VZV. Little is known about clinical effect and immunity to the virus in exposed children with no varicella symptom after treatment. We propose the checking up antibody to VZV some period after oral ACV, and considering vaccination to whom with no antibody. But further more studies are needed to practical application of oral ACV for the postexposure prophylaxis of varicella.

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Clinical Outcome of Multicystic Dysplastic Kidney in 46 Children (다낭성 이형성 신 환아 46명의 예후와 관련한 임상적 고찰)

  • Jeong Il-Cheon;Hwang You-Sik;Ahn Sun-Young;Han Sang-Won;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.27-32
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    • 2006
  • Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.

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Clinical Characteristics and Associated Anomalies in Children with Solitary Kidney (단일신을 가진 소아의 임상적 특징과 동반기형)

  • Kim, Joo-Whee;Lee, Se-Eun;Jung, Yun-Hye;Han, Kyung-Hee;Lee, Hyun-Kyung;Kang, Hee-Gyung;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.42-50
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    • 2010
  • Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.

Isolation and Characterization of Lactobacillus Strains Isolated from Korean Feces (한국인에서 분리된 Lactobacillus 속 젖산균의 동정 및 생리적 특성)

  • Kang, Dong-Gyu;Kang, Seog-Pil;Chang, Dong-Hoon;Kim, Sang-Ho;Yoon, Sung-Sik
    • Korean Journal of Food Science and Technology
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    • v.33 no.5
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    • pp.567-573
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    • 2001
  • Lactobacilli have been generally recognized as an important lactic acid bacteria present in the normal human intestinal flora. Fifty two Lactobacillus isolates were recovered from the feces of healthy Koreans whose age ranged from thirteen days after birth to 37 years. Among the isolates above, 17 isolates were tentatively identified as strains of Lactobacillus acidophilus and 3 isolates as strains of Lactobacillus casei. For their characterization, these twenty isolates were subjected to the experiments for the resistance to the artificial gastric juice, pH2.5 and bile salt. Interestingly, 3 strains survived pH 2.5 after 3 hour incubation in the artificial gastric juice with more than 75% of survival rate. L. acidophilus a-4 had the highest survival rate of 100%. Four strains including L. acidophilus a-3 grew gradually in MRS broth in the presence of the artificial bile salt. Cholesterol assimilation was also tested for the 20 isolates. The result showed that cholesterol concentration of the medium was reduced by 10 Lactobacillus isolates with more than 60%, as compared to the control. L. acidophilus a-2 had the highest reduction rate of 77%. Judging from these data obtained in vitro, some isolates ware likely to reach the lower small intestine after consumption without a significant loss of viability, suggesting that they had the potential to be developed as a probiotic culture which might lower the cholesterol level in human.

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Pueraria lobata Ohwi as an Osteoporosis Therapeutics (칡의 부위별 골다공증 치료효과)

  • Kim, Chung-Sook;Ha, Hye-Kyung;Kim, Hye-Jin;Lee, Je-Hyun;Song, Kye-Yong
    • Korean Journal of Food Science and Technology
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    • v.34 no.4
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    • pp.710-718
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    • 2002
  • It is reported that Pueraria Radix contains phtoestrogens whereas flower, and bud of Pueraria lobata Ohwi were not known. In the present study, we determined the amount of phytoestrogen in each portion of P. lobata Ohwi and carried out therapeutic effects of osteoporosis. The amounts of genistein, daidzein, and formononetin in Pueraria Radix (PR), Pueraria Flos (PF), and young Pueratia Folium (PL) were quantitated using a HPLC system. Proliferation of osteoblast and growth inhibitory effect on osteoclast were measured in order to screen their effects on osteoporosis. Proliferation of osteoblast-like cells (Saos-2) was analyzed by both MTT methods and alkaline phosphatase (ALP) assays. Growth inhibitory effect on osteoclast was also detected as Tartrate resistant acid phosphatase (TRAP) assay. Ovariectomized rat as an in vivo animal model was selected and administrations of PR were 1 g/kg/day (PR-1) and 5 g/kg/day (PR-5) for 9 weeks, respectively. Trabecular bone areas (TBAs) of tibia and lumbar were analyzed usibg histomorphological methods. Results show that PR contains the highest level of daidzein ($10435{\pm}2143\;mg/kg$ of dried herb) and stimulated ALP activity, approximately 160% of the control. Growth inhibitory effect on osteoclast by both PR and daidzein were almost identical with control although $IC_{50}$ of genistein was $5.81{\times}10^{-7}$ M. Increases in body weight of OVX rats were suppressed by administration of PR but wet weights of uterus in PR-5 group were increased (p<0.05). Plasma ALP and HDL-cholesterol levels were decreased following ages (p<0.01), and LDL-cholesterol level was also decreased in PR-5 group at 20 week of age (p<0.01). TBAs of tibia and lumbar in PR-1 and PR-5 groups were higher than those of the control although the values were less than those of the sham group (each p<0.01) In conclusion, administrations of PR prevented loss of TBAs of tibia and lumber in OVX rats, while PL and PF did not (p<0.01).

A Study on the Brand Characteristics According to Trends in the Children's Apparel Market

  • Han, Gyung-Hee
    • Journal of Fashion Business
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    • v.9 no.6
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    • pp.160-174
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    • 2005
  • Despite the decrease in the number of children due to low birth rate, the domestic children's apparel market has been achieving steady growth as family income is rising thanks to more opportunities for working women, parents spend more on their children, and they prefer brand products that make their children look special. In addition, the market is suffering from hard competition as large enterprises have joined the race. The present study purposed to survey the children's apparel market in Korea, which is in a transitional period, and to contribute to the development of the market with Korean brands. For this purpose, we analyzed the characteristics of children's apparel brands in the 21st century based on the current state of the domestic children's apparel market and, based on the findings, forecasted the future trend of children's apparel brands, suggested improvements for expected problems, proposed standards for coping with changes such as diversification, high quality and differentiation in the children's apparel market, and provided consumers with information on how to purchase products. According to the result of analyzing the characteristics of children's apparel brands in the 21st century, brands are categorized largely into four types - life cultural brands, functional product brands, character brands and brands advancing to China. Life cultural brands equipped with all necessities for children are expanding, and with the deepening social problems of environmental pollution and the reduction of the child population, functional products made of environment-friendly materials are spreading widely, targeting infants and children. Furthermore, for extending age targets and diversifying products, children's apparel is using characters. The use of characters is expected to have a considerable effect on the growth of brands because children are more subjective as consumers than before and they are more easily persuaded with characters. Domestic children's apparel brands advancing to China have a high expectation of success in overcoming the limitation of the local market that has reached its peak and growing into global brands. Korean apparel makers are struggling to overcome the depressed domestic market, to recover consumers' consumption, to cope with market opening, to pursue high value of sensibility and to expand the seniors' market, etc. In this situation, future trends of children's apparel brands will be the expansion of family brands, brand totalization, quality price, niche market (pre-teen market), etc. In response to these trends, we made the following suggestions for improvement. 1. Children's apparel brands are evolving into family brands as well as into total brands through voluming. Today, however, apparel makers are advancing to the children's apparel market with the concept of adults' apparel and, as a result, children's apparel is merely adults' apparel of reduced size, having problems in design, color and materials. Thus, apparel makers must develop design considering the wide range of size and the characteristics of children's apparel, strengthen sourcing abilities to create revenues, and make thorough survey of customers to find common denominators between adults' apparel and children's apparel considering that characteristic that the target class is different from the buyer class. Furthermore, they must make active investments in human resources, develop outstanding products through advanced planning and design, and support marketing techniques and management systems to stores. 2. As the declining birth rate will continue to have a negative effect on the market, it may be difficult to expand the market size but there is still a margin for growth through high-sensibility and high-quality products. The competitiveness of brands is determined by their market shares. Accordingly, concepts should be specialized according to lifestyle, customers' diverse needs should be satisfied, and cross-coordination should be achieved within a brand. 3. Considering Korean parents who do not spare investment in their children despite shrinking consumption, functional products must be high value-added goods that can enhance efficiency. However, in the current situation of the infants' apparel industry where a textile manufacturer supply its products to multiple brands, it is difficult to develop unique products only based on materials. Thus, it is considered urgent to appeal to consumers not by relying on materials only but by finding methods of applying their own characters to children's dress.

Analysis of the types of eating behavior affecting the nutrition of preschool children: using the Dietary Behavior Test (DBT) and the Nutrition Quotient (NQ) (유아의 영양상태에 영향을 미치는 식행동 유형 분석 : 어린이 식행동 검사 (DBT)와 어린이 영양지수 (NQ) 활용)

  • Sim, Hyeon Mi;Han, Youngshin;Lee, Kyung A
    • Journal of Nutrition and Health
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    • v.52 no.6
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    • pp.604-617
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    • 2019
  • Purpose: To investigate the effect of eating behavior on nutritional status according to temperament type. Methods: One thousand one hundred three preschool children aged 2 to 6 years in Gyeongsan, Gyeongsangbuk-do from April to June 2018 were surveyed about their eating behavior and nutritional status using DBT (Dietary Behavior Test) and NQ (Nutrition Quotient) which are proven tests. The dietary behaviors of the children were classified into four categories: approach avoidance, sensory sensitivity, hyperactivity, and irregularity. NQ scores were divided into five categories: balance, diversity, moderation, regularity, and practice. Results: The mean of the children's age was 3.42 ± 1.4 (596 boys and 507 girls). The percentage distribution of the NQ grade was as follows: 5.5% (highest), 12.5% (high), 47.1% (medium), 22.2% (low), and 12.6% (lowest). The risk group of approach avoidance and sensory sensitivity had significantly (p < 0.001) lower scores than the normal group in balance factor (51.9 ± 12.0 vs. 57.8 ± 15.9 in approach avoidance type, 52.6 ± 17.6 vs. 57.7 ± 15.9 in sensory sensitivity type) and diversity factor (32.5 ± 24.4 vs. 50.1 ± 22.4 in approach avoidance type, and 32.5 ± 24.0 vs. 50.7 ± 22.2 in sensory sensitivity type). The scores of the hyperactivity risk group were significantly lower in moderation factor (78.2 ± 12.1 vs. 81.2 ± 11.9), and those of the irregular risk group were significantly lower in variety (35.9 ± 24.5 vs. 48.8 ± 23.2), regularity (57.6 ± 37.1 vs. 66.1 ± 17.6), and practice (57.1 ± 19.4 vs. 65.1 ± 22.5) factors than the normal group (p < 0.001). Especially, the risk group of approach avoidance and sensitivity type had significantly (p < 0.001) lower intakes of whole grain, fruit, bean and bean products, vegetables, and Kimchi. Conclusion: This present study suggested that the eating behavior based on temperament of demanding preschool children affected food choice resulting in food consumption diversity of children. Therefore, it is important to provide customized nutrition education programs based on temperament type.