• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.420-427
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• 2010

Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.444-453
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• 2005

Sometimes the dentists encounter a child who can not be treated with traditional behavior management techniques (for example, reward, restraint, Tell-Show-Do, familialization). In such a case, the dentists use sedation technique. Recently, in Korea, the use of sedation by pediatric dentists is increased. But, the guideline and survey of sedation is very insufficient. Now, we need a survey of sedation practice in Korea. We carried out research on the actual condition about sedation with a questionaire to pediatric dentists in Korea. Followings are the conclusions 1. Sixty six percent of pediatric dentists use sedative agents in their practice. In this study, using sedation shows an increase as compared with the past. 2. Determinative factors of using sedation were orderly behavior management, number of visiting, guidian's opinion, amount of treatment, general condition. 3. Distribution of ages in patients sedated with agents was orderly 3 years, 4-5 years, under 2 years, 6-10 years, more than 10 years. 4. Particular sedative drugs were chloral hydrate 60-70mg/kg, hydroxyzine 10-40mg/kg(25mg/kg), and oral route was the most favorable route. 5. Observation of skin and nail color, pulse oximeter were the most frequently utillized monitoring method during sedation. 6. Only fifty six percent of pediatric dentists complete the cardiopulmonary resuscitation course.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.324-330
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• 2020

Purpose: Korean studies on the prevalence of a tarsal coalition are quite rare, and there are very few reports on the prevalence of multiple tarsal coalitions among adults in the foreign literature. Therefore, this study examined the characteristics and prevalence of tarsal coalition in the Korean population based on imaging tests. Materials and Methods: The prevalence of tarsal coalition and its anatomical location and histological classification were reviewed retrospectively among 4,711 patients (4,454 males and 257 females) with an ankle sprain or ankle fracture who underwent foot and ankle computed tomography and magnetic resonance imaging between March 2009 and February 2019 at the authors' institution. Results: Over a period of 10 years, 78 patients (1.7%) had a tarsal coalition, among whom 53 patients (67.9%) had an isolated tarsal coalition and 25 patients (32.1%) had multiple tarsal coalitions. Regarding the anatomical location, a talocalcaneal coalition was the most common type in both isolated (31 patients, 37 cases [62.7%]) and multiple (22 patients, 23 cases [45.1%]) tarsal coalitions. In the isolated coalition group, the second-most common type was calcaneonavicular coalition (10 patients, 16.9%), followed by naviculocuneiform (nine patients, 15.3%) and cuboidonavicular coalitions (three patients, 5.1%). In the multiple coalition group, the second-most common coalition type was calcaneonavicular coalition (14 patients, 14 cases [27.5%]), followed by talonavicular coalition (six patients, six cases [11.8%]). From a total of 60 cases of talocalcaneal coalition, 24 cases (40.0%) were in the posterior facet, 18 cases (30.0%) in the middle facet, and four cases (6.7%) in the anterior facet. Regarding the histological classification, cartilaginous coalition was the most common in both single (32 patients, 35 cases [59.3%]) and multiple (20 patients, 37 cases [72.5%]) coalition groups. Conclusion: The present study found that talocalcaneal coalition was the most common type of tarsal coalition. In contrast to previous reports that a talocalcaneal coalition generally occurs in the middle facet, it was usually observed in the posterior facet in the present study. In addition, although multiple tarsal coalitions have been reported to be quite rare, this study confirmed that they are not rare and can occur in a range of patterns.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.5.3-6
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• 1981

There are too many kinds of esophageal corrosive agents, such as sodium hydrochloride, acetic acid, hydrochloric acid, etc. Esophageal burn due to above chemical agents are decreasing recently, but still many patients visited to the hospital because of swallowing corrosive agents for the purpose of suicide or accidentally. Among the treatment of corrosive injury of the esophagus, prevention of esophageal stricture is the key point. Recently various methods are using as the treatment of corrosive esophagitis and prevention of esophageal stricture. 51 cases of corrosive injury of the esophagus who had been admitted and treated at the Dept. of Otolaryngology, Han Yang University Hospital during past 9 years (from May 1972 to Dec. 1980) were evaluated and report the result about age distribution, sex incidence, monthly distribution, cause of swallowing, swallowing agents, arriving time at hospital after swallowing, changes on oral and pharyngeal mucosa, laboratory findings, emergency treatment and treatment during admission, treatment follow up results and complications with review of liter ature. Following results were obtained; 1. Female patients 27 cases (52.9%) were more than male patients 24 cases (47.1%) and its ratio was 1.13 : 1. 2. Age distribution showed predilection for age of 21-30 with 20 cases(39.2%), and 11-20 with 11 cases (21.6%), 31-40 with 7 cases(13.7%), over 50 with 7 cases (13.7%) were following. 3. Monthly distribution showed predilection for March with 8 cases(15.7%), and April, July with 7 cases (13.7%), September with 6 cases(l1.8%), October 5 cases(9.8%) were following. 4. For the purpose of suicide was the most cause of swallowing with 40 cases(78.4%), and accidentally swallowing 11 cases(21.6%). 5. Acetic acid was the most swallowing agent with 24 cases (47.0%), and hydrochloric acid 11 cases (21.5%), lye 8 cases(15.7%), iodine 2 cases(3.9%) were following. 6. Arriving time at the hospital after swallowing showed predilection for within 12 hours with 42 cases (82.4%), and from 12 hours to 24 hours with 4 cases(7.8%) was next. 7. Moderate change with injection and swelling was the prevalent change on oral and pharyngeal mucosa with 20 cases(39.2%) and severe cases with ulceration 18 cases (35.3%), mild cases with injection 10 cases (19.6%) were following. 8. Leukocytosis was seen on 40 cases (78.4%), and increased Hct. was seen 31 cases (60.8%). On urine analysis, 14 cases(27.5%) showed over 1.030 S.G., and proteinuria was seen on 25 cases(49.0%), glycosuria was seen on 5 cases(9.8%) and hematuria was seen on 6 cases(11.8). 9. Gastric lavage was done on 30 cases (58.8%) as emergency treatment and on 3 cases(5.9%) tracheostomy was done for the airway keeping. 10. As methods of treatment during admission, L-tube insertion was done on 50 cases (98.0%), antibiotics was given to 49 cases (96.1%), steroid and antacid were given to 46 cases(90.2%). 11. 36 cases(70.6%) were in favorable condition after proper treatment, but 2 cases (3.9%) were expired during admission, 4 cases (7.8%) showed esophageal stricture in-spite of treatment, and 1 case(2.0%) showed pyloric stenosis. 12. Complications were observed in 8 cases (17.7%). Renal failure (4 cases), aspiration pneumonia (2 cases), upper G-I bleeding (1 cases), and diabetic coma (1 cases) were seen in order of frequency.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.283-295
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• 1999

Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.653-662
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• 2006

Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.1
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• pp.19-25
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• 2015

Nowadays, CAD/CAM is broadly used in dentistry for inlays, crowns, implant abutments and its spectrum is expanding to complete dentures. Utilizing CAD/CAM to fabricate complete dentures is expected to decrease chair time and the number of visits, thus decreasing total fabrication time, expenses and errors caused during fabrication processes. One of the systems using CAD/CAM, DENTCA$^{TM}$ CAD/CAM denture (DENTCA Inc. Los Angeles, USA) scans edentulous impressions, designs dentures digitally, fabricates try-in dentures by 3D printing and converts them into final dentures. Patients can wear final dentures after only 2 - 3 visits with satisfying adaptation. This case report introduces a 71-year-old male patient who visited to consult remaking of existing old dentures. Residual teeth with bad prognosis and root remnants were extracted and the patient used reformed existing mandibular denture for 2 months. And then DENTCA system started. One-step border molding was done using conventional tray of adequate size provided by DENTCA system and wash impression was taken. Gothic arch tracing was completed based on the vertical dimension of existing dentures. Both maxillary and mandibular trays were placed to the resultant centric relation and bite registration was taken. Then DENTCA scanned the bite registration, arranged the teeth, completed the festooning and fabricated the try-in dentures by 3D printing. The try-in dentures were positioned, occlusal plane and occlusal relations were evaluated. The try-in dentures were converted to final dentures. To create bilateral balanced occlusion, occlusal adjustment was done after clinical remounting using facebow transfer. The result was satisfactory and it was confirmed by patient and operator.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.361-374
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• 1999

Intraoral filled type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis, enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase causes gingival inflammation and enamel decalcification. The purpose of this study is to get klowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36 males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their ,menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. For control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks after appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.229-238
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• 2004

Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.251-261
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• 2014

Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.