• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.36-43
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• 2010

Purpose: The aim of this study was to evaluate the clinical features and factors contributing to treatment outcome for chronic functional constipation in children. Methods: We analyzed the medical records of patients with constipation, who visited the inpatient or outpatient clinic of the Department of Pediatrics of Pusan National University Hospital, between January 1998 and December 2007. The clinical features, outcomes, and factors affecting the treatment response according to the main drug (lactulose vs. PEG 4000) were analyzed retrospectively. Results: Two hundred forty children (142 males and 98 females) were enrolled in this study. The mean age was 51.2${\pm}$37.9 months. The duration of symptoms was 32.6${\pm}$33.7 months. The accompanying symptoms were as follows: encopresis, 91 (30.4%); abdominal pain, 76 (31.6%); and blood-tinged stool, 37 (15.4%). The treatment response was achieved earlier in females (p<0.001), patients with accompanying symptoms (p<0.05), and patients treated with PEG 4000 (p=0.001). The duration of symptoms (p<0.05) and stool frequency before treatment (p<0.05) were related to a delayed treatment response. Relapse occurred in 7 children, all of whom were treated successfully later. Conclusion: Factors contributing to treatment response are female gender, accompanying symptoms, duration of symptoms, and stool frequency before treatment. PEG 4000 is superior to lactulose in response time and taken into consideration as a primary drug for the treatment of functional constipation of children. Early treatment and sufficient treatment time may also be important factors to achieve an early response and prevent relapse.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.69-78
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• 1998

Purpose : The risk of severe tuberculous disease such as meningitis or miliary tuberculosis increases as younger is the child at the time of infection. Therefore, the early diagnosis and prompt treatment is mandatory for infants with tuberculosis. This study was undertaken to describe the epidemiology, clinical and radiographic manifestations, and response to therapy in infants with tuberculous disease. Methods : Medical records of 29 infants with tuberculosis diagnosed at the Seoul National University Children's Hospital from July, 1985, to April, 1997, were reviewed, retrospectively. A case of tuberculosis was confirmed if M. tuberculosis was isolated from any body site or if there was histologic proof of tuberculosis. Otherwise, the diagnoses were individualized considering history of contact with contagious adult case, clinical manifestations, chest X-ray findings, result of a Mantoux test reaction with 5 tuberculin unit of PPD, and the response to therapy. Results : The mean age at diagnosis was $7.00{\pm}2.65$ months (range, 3 to 12 months). Twelve cases had isolated pulmonary diseases, and the rest had pulmonary disease and meningitis, 5 cases; pulmonary disease and cervical lymphadenitis, 3; isolated meningitis, 3; and miliary tuberculosis, 6. Source case was identified in 19 cases, 7 of which were detected with retrograde manner. Twenty seven of 29 were symptomatic at their initial visit. The presenting symptoms were mainly respiratory or neurologic, and respiratory difficulty was accompanied in 7 cases. Physical examination revealed wheezing in 7 cases and decreased breath sounds in 9. Hepatomegaly or hepatosplenomegaly were frequent. Chest radiographs showed lung parenchymal disease with hilar lymphadenopathy in 18 cases, and focal or generalized emphysematous change in 7 cases. Conclusion : Most of the infants with tuberculosis are symptomatic at diagnosis, and many of infants with intrathoracic tuberculosis presented with symptoms of bronchial obstruction. When tuberculosis is suspected in an infant, the adult source case should be vigorously investigated to aid in diagnosis and for the prevention of further transmission of tuberculous disease. Almost half of infant tuberculosis are preventable if prophylaxis were given when adult cases were diagnosed.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.29-35
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• 2014

Introduction: Persistent vesicoureteral reflux (VUR), a major cause of urinary tract infection (UTI) in children, can result in serious renal complications, such as reflux nephropathy and chronic renal failure. We evaluated the clinical characteristics and prognostic factors of VUR. Methods: From December 1993 to May 2011, we examined 117 children with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Chungbuk National University hospital for a UTI. The patients were managed medically or surgically. Results: Male patients had a slightly higher prevalence of VUR than female patients (55%). The degrees of the 161 refluxing ureters, as classified by the International Reflux Study Committee, were as follows: grade I, 15 ureters; grade II, 32 ureters; grade III, 54 ureters; grade IV, 26 ureters; grade V, 34 ureters. One hundred and sixty-one renal units (115 cases) underwent a 99m TC-DMSA renal scan, and 62% showed abnormal findings. The incidence of renal cortical defects showed a direct correlation with the severity of VUR. Ninety-four refluxing ureters were followed up medically, and 66 ureters (67%) either disappeared or improved. However, 9 refluxing ureters persisted. The spontaneous resolution rate of VUR seemed to be higher in younger patients with lower grades of reflux, and without renal cortical defects. Sixty-seven refluxing ureters (41%) were treated surgically, 62 refluxing ureters (92%) disappeared, and 5 refluxing ureters (8%) persisted. Conclusion: The incidence of renal cortical defects in patients with UTIs was 62% (in a 99m TC-DMSA renal scan), and showed a direct correlation with the severity of VUR. The spontaneous resolution rate seemed to be lower in the patients with higher grades of VUR, older age (over 4 years old) and diffuse renal cortical defects.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.58-64
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• 2011

Objective: The 3-dimensional reconstruction method with resolution recovery modeling has advantages of high spatial resolution and contrast because of its precise modeling of spatial blurring according to the distance from detector plane. The aim of this study was to evaluate one of the resolution recovery reconstruction methods (Astonish, Philips Medical), compare it to other iterative reconstructions, and verify its clinical usefulness. Materials and Methods: NEMA IEC PET body phantom and Flanges Jaszczak ECT phantom (Data Spectrum Corp., USA) studies were performed using Skylight SPECT (Philips) system under four different conditions; short or long (2 times of short) radius, and half or full (40 kcts/frame) acquisition counts. Astonish reconstruction method was compared with two other iterative reconstructions; MLEM and 3D-OSEM which vendor supplied. For quantitative analysis, the contrast ratios obtained from IEC phantom test were compared. Reconstruction parameters were determined by optimization study using graph of contrast ratio versus background variability. The qualitative comparison was performed with Jaszczak ECT phantom and human myocardial data. Results: The overall contrast ratio was higher with Astonish than the others. For the largest hot sphere of 37 mm diameter, Astonish showed about 27.1% and 17.4% higher contrast ratio than MLEM and 3D-OSEM, in short radius study. For long radius, Astonish showed about 40.5% and 32.6% higher contrast ratio than MLEM and 3D-OSEM. The effect of acquired counts was insignificant. In the qualitative studies with Jaszczak phantom and human myocardial data, Astonish showed the best image quality. Conclusion: In this study, we have found out that Astonish can provide more reliable clinical results by better image quality compared to other iterative reconstruction methods. Although further clinical studies are required, Astonish would be used in clinics with confidence for enhancement of images.

• Journal of Veterinary Clinics
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• v.32 no.2
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• pp.141-147
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• 2015

Based on the results of previous studies, endoscopic biopsy sample's quality has a major impact on its adequacy for histopathology, and that the nature of the biopsy forceps can influence the specimen quality. The present study compared the effects of three different types of endoscopic biopsy forceps and two different operators on sample quality and adequacy for histopathology in three healthy cats. Every biopsy was performed between the major papilla and caudal duodenal flexure, and each operator performed five biopsies with each type of forceps on each cat, for a total of 90 biopsies. One pathologist evaluated the quality and adequacy of the obtained samples. Biopsies performed with large-cup forceps provided heavier and longer samples than the standard round forceps. With the same size forceps, the presence of alligator teeth had no effect on sample quality or adequacy for histopathological examination and assessment. Based on the results of the present study, although the standard round forceps could be used to obtain adequate samples for histopathology, large-cup forceps such as the standard oval and alligator jaw type have the advantage of obtaining high quality endoscopic samples.

• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.73-78
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• 1995

[ $^{99m}Tc$ ]-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were cor related with scan findings in 22 patients with osteogenic sarcoma. The results were as follows 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope Intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients.. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and $^{99m}Tc$-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.134-140
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• 2012

This retrospective study was performed to describe and evaluate ultrasonographic characteristics of splenic disorders and to pursue any relationship with cytologic or histopathologic diagnoses. Medical records were reviewed for patients that had undergone both abdominal ultrasonographic procedures and ultrasound-guided fine-needle aspiration (FNA) or surgical biopsy of splenic lesions or necropsy from January 2002 to July 2011 at Seoul National University Hospital for Animals. Total 124 dogs, 76 cases with FNA and 48 cases with biopsy, were available for this investigation. The age of dogs ranged from 2 to 17 years ($mean{\pm}SD$ = $9.54{\pm}3.34$ years), with the gender distribution of 61 females (26 spayed) and 63 males (40 neutered). In breed distribution, 114 were purebred dogs and 10 were mixed breed dogs. The dogs represented 26 breeds, with 113 dogs categorized into small-sized breeds. The ultrasonographic appearances of splenic disorders could be classified into 10 types including normal appearance, depending on the distribution and echogenicity of splenic lesions as well as the increase in spleen size and diffuse parenchymal changes. Among 124 cases, 44 (35.4%) had hypoechoic nodules/masses with the highest frequency, followed by 23 (18.5%) with multiple small hypoechoic nodules. Of 124 cases, 70 (56.5%) were benign and 54 (43.5%) were malignant lesions at cytologic or histopathologic results. Each ultrasonographic appearance had variable cytologic or histopathologic diagnoses. However, diffuse heterogenicity and diffuse hypoechogenicity were significantly associated with malignancy (p < 0.05), whereas hyperechoic nodules/masses were more often associated with benignity (p < 0.05). Based on our results, it may be considered that the ultrasonographic examination for spleen could be able to provide the least information necessary for benign and malignant lesions in prioritizing differential diagnoses.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.172-180
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• 1997

Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

• Tuberculosis and Respiratory Diseases
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• v.50 no.5
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• pp.591-598
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• 2001

Background : Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease that is histologically and ultrastructurally identical to the salivary gland tumor of the same name and regarded as a slow growing low-grade malignancy. We examined its clinical characteristics. Method : We collected 13 Korean cases of primary adenoid cystic carcinoma arising in the bronchus including 5 cases of our own and 8 cases from the literature. Result : The patients ages ranged from 20 to 74. Men numbered 9 and women 4. The presenting symptoms were cough, dyspnea, and hemoptysis. The fiberoptic bronchoscopic findings were primarily hypervascular polypoid mass with a smooth surface that obstructed airway totally or near totally. There were three inoperable cases including two cases with distant metastasis to bone or cervical lymph node and one case with mediastinal invasion. The remaining 10 patients underwent surgical resection. Among them, two patients received postoperative radiotherapy. The median survival was 21 months in the 8 surgical and evaluable cases. One patient lived 13 years without recurrence. The prognosis was relatively favorable in operable cases. Conclusion : It was not common for primary adenoid cystic carcinoma arising in the bronchus to have distant metastasis or invasion to the mediastinum on presentation. The prognosis was relatively favorable in operable cases. It would be important to perform flexible bronchoscopy for early diagnosis and to do surgical treatment if possible.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.107-119
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• 2005

Temporomandibular joint arthritides is divided into osteoarthritis, osteoarthrosis and polyarthritis. Because the signs, symptoms and radiographical features of osteoarthritis and osteoarthrosis are similar without arthralgia, diffenential diagnosis is difficult. Also non-radiographically change in early Osteoarthritis leads to misdiagnose. Planar bone scan and SPECT are useful to detect bone change early. This study was carried out in order to make diagnostic criteria of planar bone scan and SPECT. Three hundred and four temporomandibular joints were examined with clinical examination, computerized tomograph, planar bone scan, and SPECT. The obtained results were as follows. 1. If temporomandibular joint simple uptake ratio of patient in twenties is over 1.397%, it's condition may be osteoarthritis. And simple uptake ratio over in thirties-fourties may mean osteoarthritis. 2. It may mean osteoarthritis of temporomandibular joint that the number of coronal and transverse SPECT frame with hot spot is over four. 3. Destructive stage may goes on, if simple uptake ratio is over 1.370% in tweenties and over 1.104% in thirties-fourties. 4. If the number of coronal SPECT frame with hot spot is over four, temporomandibular joint may be on destructive stage in tweenties, thirties-fourties. And if the number of transverse SPECT frame with hot spot is over three, it may be on destructive stage in all ages. 5. When patient complains subjective arthralgia and palpation arthralgia, bone change may be more active than each arthralgia. 6. Osteoarthritis may progress gradually worse in 4.5 anamnesis. And then it may be stable gradually and turn to osteoarthrosis.