• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.2
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• pp.155-160
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• 2011

Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.90-96
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• 1997

Purpose : Recently a shift in hepatitis A incidence from children to adults has been well noted. We experienced under 15-years old 31 patients who presented hepatitis A infection. In order to prepare for the prevention on hepatitis A outbreak in the future, we studied the clinical and epidemiologic manifestations of these patients. Methods : We enrolled patients from July to December in 1996 (6 months) and evaluated the monthly incidence, geographical distribution, age and sex, and clinical manfestations, including laboratory fadings. Results : Many cases of hepatitis A occured in the summer months, especially August (16/31 cases). Most of patients (87%) were living in the Seo-Ku area (northwest district of the city). In age distribution, there were no cases under 3 years of age, 3 cases from 4~5 years, 13 cases from 6~10 years, 15 cases from 11~15 years. Clinical profiles showed that dark urine, nausea and vomiting, anorexia, abdominal pain, fever, and fatigue were the common presenting symptoms. The initial presenting laboratory tests included total bilirubin 3.3mg/dl, alkaline phosphatase of 856units/L, and serum asparate aminotransferase and alanine aminolransferase levels of 910IU/L and 1239IU/L, respectively. No patient presented atypical clinical courses or complications. Conclusions : Hepatitis A in children shows benign clinical features. This study showed that the possibility of another outbreak of Hepatitis A in the TaeJon area or elsewhere in the near future Korea will be possible. To prevent an outbreak we will be concerned about the anti-HAV IgG prevalance rate in children and preventive modalities including vaccination against hepatitis A.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.116-125
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• 1997

Purpose : Studies on the duration of immune response against Japanese encephalitis virus from recipients with JE vaccine (Nakayama-NIH strain) in Korea. Methods : To determinate the immune response and the duration of antibody against JE vaccine, 213 students were examined since 1994 using hemmaglutination inhibition test and plaque reduction neutralization test (PRNT). Results : 24 months after the first vaccination, haemmaglutination inhibition and neutralizing antibody maintained from the recipients 63.4% (>1:20) and 100% (>1:20), respectively. In April 1996, one dose booster to the same recipients those who were vaccinated in 1994, the GMT antibody for HI and PRNT titer were both increased from 1:11.6 to 1:13.2 and 1:275.7 to 1:348.1, respectively, after 6 months booster (after 30 months from the initial vaccination). This results showed that the antibody from the active immunity could be maintained more than 12 months after the initial vaccination. On the basis of these results, inactivated killed JE vaccine (Nakayama-NIH strain) using for preventing against JE purpose seems to produce antibody enough to protect against JE at present. Conclusions : Along with the results of this study demonstrating duration of antibody, the active immunization could be maintained as long as by initial vaccination of 2 doses, a single dose of booster vaccination made during a period of 1 month to 12 months and the successive booster vaccination by 2 or 3 year intervals. However, the immunization schedule should be concerned with both epidemiology of disease and the immune response of vaccinated individuals.

• Korean Journal of Soil Science and Fertilizer
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• v.32 no.2
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• pp.182-191
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• 1999

A study was conducted for the determination of application rate of pig-dung composted with sawdust (referred as pig manure hereafter) for wetland rice. The study involved the field experiments with the cultivation of rice under different rates of application of pig manure in combination of different rates of chemical fertilizers, in a wetland rice soil. The field experiment involved following treatments : (I) Without fertilizer, (II) Standard rate of chemical fertilizers based on soil testing($98-73-71kg\;ha^{-1}$ as $N-P_2O_5-K_2O$), (III) $2.1Mg\;ha^{-1}$ of pig manure $>+80-37kg\;ha^{-1}$ of $N- K_2O$ as chemical fertilizer(Less $N-P_2O_5-K_2O$ contained in the compost), (IV) $4.2Mg\;ha^{-1}$ of pig manure+ $62-3kg\;ha^{-1}$ of $N-K_2O$as chemical fertilizer(Less $N-P_2O_5-K_2O$ contained in the compost), (V) $10Mg\;ha^{-1}$ of pig manure+ Treatment(II), (VI) $20Mg\;ha^{-1}$ of pig manure +Treatment(II). Number of tillers in treatment (I) were higher than other treatments in tillering and panicle formation stage. After heading stage, treatments (V) and (VI) have higher number of tillers, but treatment (III) and (IV) have fewer number of tillers during all growing stage. Uptake of NPK in rice plants was higher in treatment (VI), but the efficiency of N, P and K was higher in treatment (I), (III) and (IV). The yield of unhulled rice were in order of tretments (VI)>(V)>(IV)>(II)>(III), although the difference was not statistically significant. Inorganic nitrogen, available P and exchangable K contents in soil were highest at tillering stage in all treatments and became low from panicle formation to harvest stage. Available P in soil was increased by the application of pig manure upto 20 cm depth. Exchangeable cation contents in 40 to 60 cm soil depth was much higher in treatment (VI) than in other treatments. Treatment (V) and (VI) showed much higher losses of N. $P_2O_5 $ and $K_2O$ than other treatment. Though treatment (VI) tended yield higher than in other treatments, showed lodging and occurrence of leaf and neck blast in this treatment. Yield of unhulled rice in treatment (IV) was not significant statistically and reduced nutritional losses. It is conclude that treatment (IV) seems to be the most reasonable one for the application of pig manure in combination of chemical fertilizers.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.49-54
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• 2009

Purpose: To report on the clinical outcome of patients with stage I testicular seminoma by postoperative radiotherapy (PORT) or surveillance after radical inguinal orchiectomy. Materials and Methods: This study is a retrospective review of 32 stage I pure seminoma patients treated between 1996 and 2005 at the Samsung Medical Center. Twenty two of the patients were treated by PORT, which was directed at the paraaortic lymphatics with a median dose of 25.2 Gy in 14 fractions for 3 weeks. The 10 remaining patients were managed by surveillance. The median follow-up period was 96 months with a range of 24 to 155 months. Results: Clinically, most patients presented with a testicular mass or discomfort. Two of the patients had a history of undescended testes. Pathologically, 23 of the patients had intratubular germ cell neoplasia with seminoma. Both recurrence-free survival (RFS) and overall survival (OS) rates of patients treated by PORT were 100%. In the control group, 1 of the 10 patients suffered a para-aortic lymph node relapse. The RFS and OS rates of the surveillance group were 88.9% and 100%, respectively. Conclusion: No difference in survival was observed between the two groups. Moreover, symptom recurrence was only observed in 1 patient in the control group. The use of PORT may reduce the risk of relapse. With the availability of effective diagnostic and salvage modalities, surveillance monitoring may be considered for patients in good compliance.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.573-579
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• 2002

Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.961-969
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• 2003

The purpose of this study was to evaluate the fate of left atrioventricular valve regurgitation(LAVVR) following repair of complete atrioventricular septal defects (AVSDs). Material and Method: Between July 1984 and March 2002, repair of complete AV defects were performed in 77 patients. Mean age at surgery was 30.23$\pm$69.11 months (range 1 to 456). Echocardiograms of all survivors after isolated AVSDs correction were reviewed. LAVVR were evaluated with color doppler echocardiography in 64 survival periodically. On each study, LAVVR severity was graded on a 1 to 4 scale, based upon the size of the regurgitated jet. Result: Mild deterioration of LAVV function was fairly common. LAVVR severity increased by >1 grade in 19 patients (30.2%) during the course of the study. However, the deterioration in LAVVR function occurred primarily between 12 and 24 months postoperatively. After the initial 24 postoperative months, LAVVR worsened on only 8 occasions and in each instance worsened by only 1 grade. Deterioration more than 3+ LAVVR occurred in only 3 patients. And deterioration to 4+ LAVVR was not observed after the initial 24 postoperative months but one. Survival curve analysis predicted a 88.2% of ten-year freedom rate from development of 4+ LAVVR after initial operation of complete AVSDs. Conclusion: Postoperative LAVVR remains fairly stable following AVSDs repair, Serious deterioration is rare after 24 postoperative months, especially after the initial 48 postoperative months. But serial follow-up study with echocariogram was need till 24 postoperative months after repair of complete AVSDs.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.350-354
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• 2009

Background: Complicated pleural space occupying lesions (SOL) have been treated by thoracentesis, closed thoracotomy drainage (CTD) or surgical intervention with using a video thoracosocpe or open thoracotomy depending on the extent of the disease. With the development of video assisted thoracoscopic surgery (VATS), VATS pleural adhesiolysis and decortication have revealed good results as compared to those for open thorcotomy. To assess the effectiveness of VATS pleural adhesiolysis and decortication, we retrospectively analyzed the medical record and radiologic findings of the patients with complicated pleural SOL and who were treated by this surgery. Material and Method: From May 1996 to April 2006, 64 patients (mean age: 41.8 years) with complicated pleural SOL underwent 65 VATS. To analyze the surgical outcome, we classified the postoperative findings on the simple chest X-rays into 4 classes as Class I: no or minimal pleural lesion, Class II: blunting of the cardiophrenic angle and mild pleural thickening, Class III: an elevated diaphgram or persistent lung collapse and Class IV: complicated or recurrent effusion. Result: Before VATS, the patients underwent the diagnostic or therapeutic procedures: single or repeat diagnostic tapping for 41, thoracoscotomy drainage for 11, pigtail catheter drainage for 10 and intrapleural fibrinolytics for 10. The mean duration between the onset of symptom and surgery was 18.4 days. There was neither mortality nor severe complications. The surgical outcomes were class 1 for 28, class 2 for 13, class 3 for 19 and class 4 for 5. There were statistically significant differences between the symptom duration and the classes, and between the operation time and the classes. Conclusion: VATS pleural adhesiolysis and decortication are effective, safe treatments for managing complicated pleural SOL, and an earlier operation is needed for obtaining a better surgical outcome.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.344-349
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• 2009

Background: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and. so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. Material and Method: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients Should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1cm) seen on the computed tomography. Result: There were 50 men and 8 women with a mean age of 28.2 years (range: $14\sim54$ years). The mean length of hospitalization was 5.3 days (range: $2\sim10$ days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: $10\sim58$ months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intra-operative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1 % for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. Conclusion: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.

• Korean Journal of Ecology and Environment
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• v.39 no.3 s.117
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• pp.352-365
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• 2006

In order to evaluate the change of aquatic environment in the reclaimed Hwaong Reservoir, situated in the early stage after construction, this study was conducted to measure the change of precipitation, temperature, and salinity from June 2002 to January 2006. The range and mean of temperature was $-0.7{\sim}33.4^{\circ}C$ and $13.6^{\circ}C$, respectively. Temperature of upstream part rapidly changed during the transitional period; from spring to summer and from fall to winter. It showed abrupt decrease with high discharge from the streams temporarily. While, hypolimnetic temperature of upstream happened to be somewhat higher than that of surface or downstream. The range and mean of salinity was 0.3${\sim}$32.3 psu and 25.3 psu, respectively. Vertical difference of salinity was marked, and the change in the surface water was much higher than middle or bottom layers. It showed the marked difference at all stations, except for the bottom layer of upstream into which Namyang Stream flows, indicating that vertical gradient of salinity is strongly sustained in the reservoir. Salinity was changed markedly during the storm period (June${\sim}$October), and freshwater with low salinity was expanded from upstream to downstream along the surface layer. The surface of the reservoir was totally covered by the stream discharged water with a large amount of silt and low salinity during this period. The difference of temperature and salinity between the surface and bottom layer ranged $-10.6{\sim}9.7^{\circ}C$ and $-27.1{\sim}30.0$ psu, respectively. The big difference of salinity appeared with a large discharge of freshwater from the streams or large input of seawater through the gate. Salinity was negatively correlated with temperature, indicating the influence of monsoon storm events on the salinity under the whole watershed scale of this brackish reclaimed reservoir.