• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.391-395
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• 2008

Purpose : This study was performed evaluate optimal dose for disimpaction, efficacy and safety of PEG 4000 in children with chronic functional constipation. Methods : Eighty six children with chronic functional constipation were enrolled in this prospective study at Konkuk university hospital March, 2003 through August, 2006. Success in disimpaction with PEG 4000 was defined as meeting at least two out of three criteria; resolution of chief complaint, getting easiness of defecation with respect to frequency of bowel movement and hardness of stool based on defecation diary, and decrease in fecal impaction on simple abdominal X-ray test. Adverse effects of PEG 4000 were monitored clinically and biochemically. Results : Eighty three out of 86 children completed the study, and success rate of disimpaction was 99% (82/83). The mean dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max.: 30 g/day). Frequency of bowel movement increased ($5.02{\pm}2.71/wk$ vs. $11.25{\pm}5.43/wk$) in most children (79/83). Fecal impaction on simple abdominal X-ray test improved with statistical significance in 25 children (P=0.0007). Because of adverse effect of PEG 4000, 3 children did not complete the study; urticaria, severe diarrhea, diarrhea and abdominal pain. One 6-year-old girl who completed the study complained tingling sensation in the hand and foot without laboratory abnormality (4/86, 4.7%). Laboratory test revealed hyperosmolality without clinical symptom in 1 child, and eosinophilia in 6 children. Conclusion : The average safe and effective dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max : 30 g/day) in children with chronic functional constipation.

• The Journal of the Korea Contents Association
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• v.18 no.5
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• pp.191-214
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• 2018

This research empirically analyzed the selection factors and the locational selection factors of the medical service facilities according to the gradual increase of the importance of the selection factors and the locational selection factors regarding the establishments of the small- and medium-sized hospitals according to the rapid changes of the socio-economic conditions. By analyzing the priority order according to the levels of the importance of each evaluation item factor through a research related to the selection factors and the locational selection factors of the small- and medium-sized hospitals and by drawing what the important factors that have the influences on the competitiveness of the pre-existent small- and medium-sized hospitals are through the classification of the real estate locational factors and the non-locational factors, the purpose lies in utilizing them as the basic data and materials for the opening strategies of the small- and medium-sized hospitals considering the special, locational characteristics according to the important factors of the selection factors of the small- and medium-sized hospitals, regarding the medical suppliers that have been preparing, for opening the new, small- and medium-sized hospitals. Based on the results of the preceding researches and the researches on the case examples, 28 evaluation factors were arrived at in terms of the level of the medical treatment, the medical services, the accessibilities of the hospitals, the conveniences of the hospitals, and the physical environment. And, regarding the 28 detailed evaluation factors that had been collected, through the interviews with the related experts, the 5 factors of the medical level, the medical service, the expertise of the hospital, the convenience of the hospital, and the physical environment were selected as the upper class evaluation factors. And, according to each upper class, a total of 28 low-part evaluation factors were selected. Regarding the optimal evaluation factors that were selected, the optimal locational factors were selected by carrying out an AHP questionnaire survey investigation with 200 medical experts as the subjects. Regarding the AHP analysis results, similarly with the case examples of the precedent researches, the levels of the importance appeared in the order of the medical level, the medical services, the accessibility of the hospital, the physical environment, and the convenience. And the factors that were related to the facilities of a hospital appeared low. The results of this research can be applied in providing the basis for the decision-makings regarding the selections of the locations of the small- and medium-sized hospitals in the future.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.276-282
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• 2003

Purpose: Although high-dose-rate intracavitary radiotherapy (HDR ICR) has been used in the treatment of cervical cancer, the potential for increased risk of late complication, most commonly in the rectum, is a major concern. We have previously reported on 136 patients treated with HDR brachytherapy between 1995 and 1999. The purpose of this study is to upgrade the previous data and confirm the correlation between late rectal complication and rectal dose in cervix cancer patients treated with HDR ICR. Materials and Methods: A retrospective analysis was peformed for 222 patients with cevix cancer who were treated for curative intent with external beam radiotherapy (EBRT) and HDR ICR from July 1995 to December 2001. The median dose of EBRT was 50.4 (30.6$\~$56.4) Gy with a daily fraction size 1.8 Gy. A total of six fractions of HDR ICR were given twice weekly with fraction size of 4 (3$\~$5.5) Gy to A point by Iridium-192 source. The rectal dose was calculated at the rectal reference point using the barium contrast criteria. in vivo measurement of the rectal dose was peformed with thermoluminescent dosimeter (TLD) during HDR ICR. The median follow-up period was 39 months, ranging from 6 to 90 months. Results: Twenty-one patients (9.5$\%$) experienced late rectal bleeding, from 3 to 44 months (median, 13 months) after the completion of RT. The calculated rectal doses were not different between the patients with rectal bleeding and those without, but the measured rectal doses were higher in the complicated patients. The differences of the measured ICR rectal fractional dose, ICR total rectal dose, and total rectal biologically equivalent dose (BED) were statistically significant. When the measured ICR total rectal dose was beyond 16 Gy, when the ratio of the measured rectal dose to A point dose was beyond 70$\%$, or when the measured rectal BED was over 110 Gy$_{3}$, a high possibility of late rectal complication was found. Conclusion: Late rectal complication was closely correlated with measured rectal dose by in vivo dosimetry using TLD during HDR ICR. If data from in vivo dosimetry shows any possibility of rectal bleeding, efforts should be made to reduce the rectal dose.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.115-124
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• 2001

Objective：The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method：Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results：Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion：These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

• Progress in Medical Physics
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• v.22 no.2
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• pp.99-105
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• 2011

The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.606-612
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• 2005

Background : It has been reported that nontuberculosis mycobacterium(NTM) isolates account for approximately 10% of patients with a positive Acid-Fast Bacilli(AFB) smear. Therefore, it is necessary to consider NTM pulmonary disease when such a positive test is encountered. The aim of this study was to evaluate the etiologies and clinical characteristics of patients with NTM pulmonary disease who had been treated at a national tuberculosis hospital. Methods : The NTM isolates were recovered from the sputum or bronchial washing specimens submitted to a clinical laboratory of National Masan TB Hospital from August 2002 to July 2003. All samples were identified using a polymerase chain reaction-restriction fragment length polymorphism analysis method, which amplifies the rpoB gene. The patients were diagnosed with NTM disease according to the American Thoracic Society diagnostic criteria. Results : One hundred NTM isolates were recovered from 57 patients. Of the 100 isolates, M. avium complex(MAC) was the most common species, which was found 55%(n=55) of patients, followed by M. abscessus(n=25), and M. fortuitum( n=9). 26(45.6%) patients had NTM disease. Twenty-six (45.6%) patients had NTM disease according to The American Thoracic Society classification. The main organisms involved in NTM disease were MAC(n=19, 73.1%) and M. abscessus(n=5, 19.2%). The pathogenic potential was 67.9% in M. intracellulare and 41.7% in M. abscessus. The predictive factors related to NTM disease were a positive sputum smear (OR 6.4, p=0.02) and the isolation of either MAC or M. abscessus(OR 6.9, p=0.007). Fifteen patients(57.7%) were cured. There were no significant factors associated with the treatment success. Conclusion : There was a relatively high proportion of NTM disease in NTM isolates and the common species were MAC and M. abscessus. The predictive factors for NTM disease were a positive sputum smear and the isolation of either MAC or M. abscessus.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.40-46
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• 2008

Purpose: We wanted to evaluate the efficacy and toxicity of modified FOLFOX-6 chemotherapy for treating recurrent or inoperable gastric cancer patients. Materials and Methods: From April 2006 to August 2007, 35 patients with recurrent gastric cancer after curative resection and 43 patients with inoperable gastric cancer underwent chemotherapy, and the results were retrospectively investigated. Results: 78 patients were assessable for response and toxicity, and they underwent an average of 7.1 cycles of chemotherapy. The response was evaluated according to the RECIST criteria. 11 partial responses (14.1%), 35 cases of stable disease (44.9%), and 32 cases of progressive disease (41%) were observed. The median time to progression was 6 months, and the average overall survival was 13 months. CTCAE grade 1 or 2 anemia (52.6%) was the most prevalent toxicity. Other common toxicities included thrombocytopenia (17.9%) and peripheral neuropathy (30.8%). There were 13 changes in the chemotherapy regimen to S1-cisplatin due to disease progression, but only an average of 1.76 cycles of S1-cisplatin were delivered due to severe toxicities and poor compliance. Conclusion: Acceptable efficacy and toxicity were seen as 59% of the patients showed non-progression, and no grade 3 or 4 toxicities were observed. In conclusion, the modified FOLFOX-6 chemotherapy is considered to be the proper 1st-line choice as a palliative treatment for recurrent or inoperable gastric cancer patients.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1126-1133
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• 2002

Purpose : Prader-Willi syndrome(PWS) is a complex disorder affecting multisystems with characteristic clinical features. Its genetic basis is an expression defect in the paternally derived chromosome 15q11-q13. We analyzed the clinical features and genetic basis of PWS patients for early detection and treatment. Methods : We retrospectively studied 24 patients with PWS in Department of Pediatrics, Samsung Medical Center, from September 1997 to September 2001. We performed cytogenetic and molecular genetic techniques using high resolution GTG banding techniques, fluorescent in situ hybridization and methylation-specific PCR for CpG island of SNRPN gene region. Results : The average birth weight of PWS patients was $2.67{\pm}0.47kg$ and median age at diagnosis was 1.3 years. The average height and weight of PWS patients under one year at diagnostic time were located in a 3-10 percentile relatively, and a rapid weight gain was seen between two and six years. Feeding problems in infancy and neonatal hypotonia were the two most consistently positive major criteria in over 95% of the patients. In 18 of the 24 cases(75%), deletion of chromosome 15q11-q13 was demonstrated and one case among 18 had an unbalanced 14;15 translocation. In four cases without any cytogenetic abnormality, it may be considered as maternal uniparental disomy and the rest showed another findings. Conclusion : We suggest diagnostic testing for PWS in all infants/neonates with unexplained feeding problems and hypotonia. It is necessary for clinically suspicious patients to undergo an early genetic test. As the genetic basis of PWS was heterogenous and complex, further study is required.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.162-166
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• 2008

Purpose : It has been previously reported that for patients with Mycoplasma pneumoniae pneumonia was previously recognized that overt illness is unusual under the age of three and the peak incidence of illness occurs in school-aged children. However, a higher incidence of this illness in younger children has been recently noted. Thus we investigated the incidence of M. pneumoniae pneumonia. Methods : The study subjects were 414 children who were diagnosed with M. pneumoniae pneumonia from January 2004 to December 2006 at Myong Ji Hospital were enrolled. The diagnostic criteria consisted of an anti-mycoplasma antibody (AMA) titer greater than 1: 320 or a four-fold rise in the titer at follow up. Results : The age distribution was as follows: before 2 years of age: 58 patients (14%), 2-4 years of age 157 patients (37.9%) and 5-15 years of age 199 patients (48.1%). The yearly incidence for the children before 5 years of age was 52 (44%), 49 (44.6%) and 114 (61.3%), respectively. The distribution according to the antibody titer was as follows; 1: 320 in 130 patients, 1:640 in 63 patients and greater than 1:1,280 in 221 patients. The hospital stay according to the antibody titer was not significant according to either age or the AMA titers. Conclusion : M. pneumoniae pneumonia showed a peak incidence in preschool children with a higher prevalence in children under the age of three than was previously recognized. The emergence of M. pneumoniae pneumonia as a cause of community acquired pneumonia in younger children calls for an epidemiologic study to investigate the changes of the pathogens in this age group and to recommend the proper treatment.

• Korean Journal of Ecology and Environment
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• v.38 no.3 s.113
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• pp.341-351
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• 2005

Ecological stream health, based on the index of biological integrity (IBI) , was evaluated at five sampling locations of Youdeung Stream during August-October 2004. For the study, we also analyzed spatial and temporal patterns of conventional water quality over tine period of 1995 ${\sim}$ 2004, using the water chemistry dataset, obtained from the Ministry of Environment, Korea. The water quality parameters used here were conductivity, total suspended solids (TSS), biochemical oxygen demand $(BOD_5)$, chemical oxygen demand $(COD_{mn})$, total nitrogen (TN), and total phosphorus (TP). The multi-metric model values averaged 27.8 in the stream and ranged 24 ${\sim}$ 32. The health condition was judged as 'Fair' to 'Poor' conditions, according to the stream health criteria of US EPA (1993). Longitudinal variation occurred from the upstream to downstream reach; largest differences in all water quality variables occurred between Site 5 and the other sites. This was mainly attributed to the impacts of wastewater treatment plants near the locations. Also, relative proportions of tolerance and omnivore species increased in downstream reaches. The model values, however, did not match the values, based on water quality parameters. We assume that this may be associated with primarily reduced water volumn during dry season in the stream along with modified physical habitat conditions.