• Journal of Chest Surgery
• /
• v.30 no.4
• /
• pp.363-372
• /
• 1997

One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.

• Korean Journal of Heritage: History & Science
• /
• v.42 no.1
• /
• pp.88-99
• /
• 2009

This study was conducted to formulate management guidelines for Natural monumental old trees in Korea through survey of tree vigor and analysis of growing environments. A total of 20 old trees designated as natural monuments in Seoul, Incheon, and Gyeonggi Province were surveyed. The biological characteristics were surveyed with 4 items of species, ages and height of trees. The surrounding environments were surveyed with 2 items of location types and surroundings. The root conditions were surveyed with 2 items of denudation and molding depth. The health conditions were surveyed with 5 items of withering rate, cavity size, bark breakaway rate, damages by blight and insects, and growing tips. The soil conditions were surveyed with 6 items of PH, organic contents, valid phosphoric acid, transposal cations(K, Ca) and soil compaction. On the basis of outcomes of these research items, mutual relations among locations, growings and soil conditions of old trees were analyzed by carring out cross tabulation, correlation, and simple and multiple regression. Management guidelines were presented searching the factors effecting on the health of the monumental old trees. On the biological characteristics, the old trees designated as natural monuments were Pinus bungeana(4 trees), Juniperus chinensis(3 trees), Ginkgo biloba(3 trees), Poncirus trifoliata(2 trees). Actinidia arguta, Wisteria floribunda, Thuja orientalis, Quercus mongolica, Sophora japonica, Fraxinus rhynchophylla, Zelkova serrata, and Pinus densiflora. The tree height ranged from 4.2 to 39.2m, and root collar rounds ranged from 1.01 to 15.2m. On the surrounding environments, The location types ; Gardens(4), historical sites(5), residental sections(3) open agricultural fields(3), mountain hills(3), and near ocean beaches(1) and stream site(1). The surroundings ; 75% denudation of roots, molded more than 10cm except 4 trees(25%). On the health conditions, 1)Withering rate ; Ginkgo biloba(20%) in Yongmoon temple, (5%) in Saki-ri, kanwha-gun, and others had no withering rate. 2) Cavity size ; all subject had $5{\sim}100cm^3$ of cavity. 3) Bark breakaway rate ; Pinus bungeana in Soosong-dong, in the shrine of Confucius, in Samchung-dong, especially high rate of cavity(5~50%) in Seoul area and in Saki-ri, Kangwha-gun were high 45% brakeaway rate. 4) Damages by blight and insects was slight due to managements. 5Growing tips ; In cases of Juniperus chinensis in Changdeok palace and SunnogDang, seoul, growing tips were 1/2, presumably cause by air pollution, and in cases of Fraxinus rhynchophylla in Paju city and Pinus densiflora in BacksaDorip-ri, Icheon city, growing tips were fine, presumably because there were no moldings. On the Soil conditions, Soil pH ranged from 5.2 to 8.3, organic matter contents from 12% to 56%, phosphorus contents from 104 to 618ppm, soil compaction ranged from 7 to 28mm( among them, Denudation was severe with 21~28mm soil compactions in cases of Pinus bungeana in Soosong -dong, Thuja orientalis in Samchung -dong, Ginkgo biloba in the shrine of Confucius and in Yongmoon temple.) Results of cross tabulation, correlation, and regression analysis showed that molding depth was the most serious factor to deteriorate the tree vigor and cambium conductivity. In addition, soil acidity, organic matter contents, disease and insect damages and cambial detachment were also related to the tree vigor. Additional research of these relationships will be needed to conduct more detailed studies. Based on the relationships between the tree vigor and growing environments, it is considered that old trees should be managed to give them more growing spaces and less abuses. Also, molded soils should be removed and further soil-molding around the tree collar should be prohibited. For the construction of systematic management and removal of harmful factors, appropriative management according to spices, persistent monitering of damaged cases and construction of management system through the accumulation of data on the relationships of soil conditions are required.

• 한국산학경영학회:학술대회논문집
• /
• 2004.11a
• /
• pp.101-123
• /
• 2004

This study examines empirically the significant changes in tax payments when the consolidated tax return is introduced in the future. We estimate the consolidated tax payments under the eight cases which are classified as such : whether only 100% ownership subsidiaries should be included or 80% and over, whether all subsidiaries should be included or only subsidiaries with loss, and whether unrealized profits from intercompany transactions should be excluded or not. After estimating the consolidated tax payments, we test the difference between the consolidated tax payments and the sum of the individual tax payments of the subsidiaries. The results of the test show that the consolidated tax payments are significantly less than the sum of the individual tax payments of the subsidiaries. We interpret that the inclusion of the losses of the subsidiaries in the consolidated tax base makes the tax payment decrease. Based on our analysis about 3.8 billion Won per each parent company would decrease due to the introduction of the consolidated tax return. And we find that under the mandatory consolidated tax return system the significant difference between the consolidated and individual tax payment exists except that the only 100% ownership subsidiaries are included and unrealized profits from intercompany transactions are not excluded. However, when the parent companies have the discretion to select the consolidated subsidiaries, the consolidated tax payments are significantly less than the sum of the individual tax payments of the subsidiaries regardless of the ownership percentage, inclusion of the loss of the subsidiaries and exclusion of the unrealized profits.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.16 no.2
• /
• pp.239-250
• /
• 2005

Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.13 no.2
• /
• pp.128-133
• /
• 2010

Purpose: Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children. Methods: We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010. Results: The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6${\pm}$0.7 and 1.7${\pm}$1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups. Conclusion: Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

• Radiation Oncology Journal
• /
• v.23 no.3
• /
• pp.131-136
• /
• 2005

Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.4
• /
• pp.354-363
• /
• 2001

Background : Although lung involvement has been reported in 5 to 46% of dermatomyositis/polymyositis(DM/PM) patients, reports of the condition in Korea are rare. This study evaluated the clinical features of lung involvement in DM/PM patients. Methods : The medical records, laboratory results and radiologic findings of 79 DM/pM patients, who attended the Seoul National University Hospital (SNUH) between 1989 and 1999, were reviewed retrospectively. Results : A total 79 patients of whom 24 patients(33%) showed lung involvement, were enrolled in this study. More patients with lung involvement were female(F:M=11:1), and older compared with those without lung involvement. Patients with lung involvement presented with dyspnea(79%), coughing(67%), an elevated ESR, and CK/LD. Anti-Jo 1 antibody test was positive in 30%, which is significantly higher in patients with lung involvement. A simple chest X-ray of the patients with lung involvement exhibited reticular opacity(50%), reticulonodular opacity(30%), patchy opacity(29%), nodular opacity(13%) and linear opacity(4%). HRCT(n=24) showed ground glass opacity(75%), linear or septal thickening(50%), patchy consolidation(42%), honey-combing(33%) and nodular opacity(17%). The pulmonary function test showed a restrictive ventilatory pattern(77%) and a lower diffusing capacity(62%). The patients were followed up during a mean duration of $30{\pm}28$ months. They were treated with steroid only(50%) or a combination of steroids and cytotoxic agents(46%). Muscle symptoms were improved in 89% with treatment, but an improvement in the respiratory symptoms or in the pulmonary function test was rare. Patients with lung involvement had a higher mortality rate(21%) than those without lung involvement(10%) during the follow-up periods. Conclusion : DM/PM patients with lung involvement were mostly female, older and had a higher positive rate Anti-Jo 1 antibodies, but there was no significant difference in prognosis.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.2
• /
• pp.209-217
• /
• 2003

Object：This study examined the diagnostic validity of the K-ABC and the K-LDES for identifying the cognitive deficits and the learning difficulty of children with learning disorder and to diagnose the learning disorder. Method：The clinical group consisted of 15 children with learning disorder or attention deficit hyperactivity disorder accompanying learning problem(LP) and 14 children with attention deficit hyperactivity disorder. They were diagnosed either learning disorder or attention deficit hyperactivity disorder based on DSM-IV criteria by child psychiatrists and clinical psychologists visiting Seoul National University Children’s Hospital. The normal group was composed of 15 children be going to an elementary school. All groups were between the age of 7 and 12. The K-ABC was administered to the clinical and the normal group. The K-LDES was also administered to mothers of all groups. Result：There were no significant differences on sequential, simultaneous, mental processing subscales of the K-ABC in three groups. However, The LP group showed slightly lower scores on Achievement scale and significant low scores on Reading/Decoding than the other groups. On K-LDES, LP group showed significant low scores on Listing, Thinking, Reading, Writing, Spelling, Mathematical calculation, Learning quotient(LQ) than the other groups. Also there were significant correlations between K-ABC and K-LDES subscales. Conclusion：The result of present study showed that the K-ABC and the K-LDES are a valid and effective instruments for evaluating and diagnose the learning disorder.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.6 no.2
• /
• pp.129-139
• /
• 2003

Purpose: The aim of the study was to evaluate the long-term outcome of glycogen storage disease (GSD) type 1 with particular reference to hepatic adenoma and hepatocellular carcinoma, and to analyze risk factors affecting the development of hepatic adenoma in GSD type 1. Methods: Forty-three GSD type 1 patients (31 males and 12 females, mean age $13.9{\pm}6.4$ years) were analyzed retrospectively. Hepatic adenoma was detected on abdominal USG and diagnosed on histologic examination. Clinical profiles were compared between patients with hepatic adenoma (n=16) and age-matched controls without hepatic adenoma (n=16). Results: 1) Of 43 GSD type 1 patients, 16 (37.2%) had hepatic adeoma. Hepatic adenoma was detected at the age of mean $14.2{\pm}4.1$ years (range: 7.9~25.7 years). Fourteen (87.5%) adenomas were multiple at detection. 2) Comparison of the clinical profiles between adenoma group and non-adenoma group revealed that age at first introduction of uncooked cornstarch treatment was significantly late in adenoma group compared with non-adenoma group ($9.1{\pm}5.2$ years vs. $3.0{\pm}1.8$ years, p=0.003). Portocaval shunt surgery was performed in 11 (68.8%) patients in adenoma group and 3 (18.8%) in non-adenoma group (p=0.004). Hepatic adenoma developed mean $5.8{\pm}4.2$ years after shunt operation. 3) One patient was diagnosed as hepatocellular carcinoma at the age of 25.7 years. Conclusion: Hepatic adenoma is an important late complication of GSD type 1 with the risk of malignant transformation. Early introduction of cornstarch therapy with strict metabolic control is needed to prevent the development of hepatic adenoma in GSD type 1.

• Clinical and Experimental Pediatrics
• /
• v.50 no.2
• /
• pp.190-197
• /
• 2007

Purpose : Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. Methods : We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. Results : Final height SDS was $-0.11{\pm}1.15$ ($-0.26{\pm}1.33$ in females, $0.04{\pm}0.91$ in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average $HbA_{1C}$. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average $HbA_{1C}$ than patients without complications. Patients whose microalbuminuria regressed had lower levels of average $HbA_{1C}$, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. Conclusion : The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.