• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.392-396
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• 2010

Purpose : The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. Methods : In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. Results : The mean ages of the febrile convulsion and control group were $16.3{\pm}7.4$ and $15.8{\pm}6.1$ months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb <10.5 gm/dL) was more frequent in the febrile convulsion group than in the control group, although there was no statistical significance. Unexpectably, the RDW (red blood cell distribution width) was significantly lower and the MCNC (mean corpuscular hemoglobin concentration) was significantly higher among seizure cases than among the controls (P <0.05). There is no statistical difference between simple and complex febrile groups in the clinical and laboratory profiles. On multiple logistic regression analysis, iron deficiency anemia was more frequent, but the RDW was lower, among the cases with febrile convulsion, compared with the controls. Conclusions : Our study suggests that the iron deficiency anemia is associated with febrile convulsion, and screening for iron deficiency anemia should be considered in children with febrile convulsions.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.152-157
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• 2005

Purpose: A total gastrectomy is generally peformed for the treatment of upper third gastric cancer. However, the optimal extent of resection for early-stage upper third gastric cancer is still controversial. In this research, we compared the nutritional status and the quality of life in patients who underwent a total gastrectomy with uncut Roux en Y esophagojejunostomy with those in patients who underwent a proximal gastrectomy with esophagogastrostomy for treatment of upper third gastric cancer. Materials and Methods: We reviewed 50 patients with no evidence of recurrent disease following curative surgery for upper third gastric cancer. Among this group, 25 patients underwent a total gastrectomy (TG) and 25 patients a proximal gastrectomy (PG). 8 TG and 4 PG patients were excluded from this study because of death, refusal to interview etc. The nutritional status was assessed by measuring body weight, serum albumin, serum hemoglobin, and serum total protein. The gastrointestinal function and the quality of life were assessed by Cuschieri grading and modified Visick qrading. Results: In analysis of covariance of age and preoperative serum albumin, PG patients demonstrated lower weight loss (P=0.038), elevated serum albumin (P=0.049), and better outcome based on modified Visick grading (P=0.016) than TG, but there were no significant differences in the serum hemoglobin change (P=0.165), serum total protein change (P=0.435), and Cuschieri grading (P=0.064) between the preoperative and the postoperative data. Conclusion: In this study, a proximal gastrectomy led to a better nutritional status and quality of life than a total gastrectomy, as judged from the low weight loss, elevated serum albumin and better modified Visick grade.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.137-144
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• 2002

Background: Hemoptysis is an often alarming presenting symptom and VEGF is a major regulator of both normal and abnormal angiogenesis, including many inflarrunatory diseases. In this report the clinical significance of the serum VEGF level in patients with hemoptysis was investigated. Methods: Thirty-two patients with hemoptysis were evaluated. The estimated amount of hemoptysis, etiology and serum VEGF level was examined at admission and bronchial angiography was performed in 22 patients. In order to objectify the neovascularization status, one point for the presence of the A-V shunt, hypervascularity, vascular tortuosity was designated for a total of 0-3 points. Results: Mean quantity of hemoptysis was $172.4{\pm}270.4ml$. The mean angiographic neovascularization score was $1.23{\pm}0.75$. The serum VEGF level correlated with the quantity of hemoptysis(r=0.524, p=0.002) and with the angiographic neovascularization score(r=0.441, p=0.04). Using the standard diagnostic criterion for massive hemoptysis, the serum VEGF level of patients with massive hemoptysis($642.4{\pm}545.6$ pg/ml, n=13) was found to be higher than that of patients with non-massive hemoptysis($394.6{\pm}225.8$ pg/ml, n=19) (p=0.069). Conclusion: Regardless of the etiology, the serum VEGF may contribute to abnormal neovascularization in patients with hemoptysis. Therefore, it is suggested that serum VEGF measurements may help in predicting a massive hemoptysis.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.151-158
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• 1994

Since Jan. 1992, authors have conducted a pilot study to treat malignant glioma with multiple daily fractionated(MDF) radiation therapy and this paper presents the outcome compared MDF to conventional factionated(CF) radiation therapy Between Sep. 1989 and Jan. 1993, forty three patients with high grade glioma of brain except brain stem glioma were treated: nineteen patients were treated with CF radiation therapy and 24 patients were treated with MDF radiation therapy. In CF radiation therapy, total dose was 6300cGy/35fx in 7 weeks, which 5040cGy was delivered to the initial target volume and 1260cGy to reduced target volume. And in MDF radiation therapy, total dose was 6400cGy/40fx in 4 weeks, which 3200cGy was delivered to the initial target volume as 160cGy 2 times daily 6hr apart. All patients had histologically confirmed anaplastic astrocytoma(AA) of glioblastoma multiforme (GBM) with stereotactic biopsy or craniotomy for subtotal or gross tumor resection. The range of follow-up was 7 months to 4 years with a median follow-up of 9 months. The Median survival from surgery was 9 months for all patients. The median survival was 9 months and 10 months for MDF group and CF group and 10 months and 9.5 months for glioblastoma multiforme and anaplastic astrocytoma, respectively. In 36 patients with follow-up CT scan or MRI scan, disease status was evaluated according to treatment groups, Four patients(GBM:3, AA:1) of 21 patients in MDF group, were alive with no evidence of disease, while none of patient was alive with no evidence of disease in CF group. The progression of disease had occurred in 20 patients, 11 patients and 9 patients in MDF group and CF group, respectively All of these patients showed in-field progression of disease, Four of 11 patients($27\%$) in MDF group showed the new leasion outside of the treatment field, while 5 of 9 patients($56\%$) in CF group. In our study the prognosis was not influenced by age, KPS, grade, extent of surgery and different fractional scheduled radiation therapy. Authors concluded that MDF regimen was well tolerated and shortened the treatment period from 7 weeks to 4 weeks without compromising results. We believe that further follow-up is needed to assess the role of MDF.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.23-29
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• 1999

Purpose : To evaluate the efficacy of radiation therapy and extrafascial hysterectomy in bulky stage IB, IIA-B uterine cervix cancers. Methods and Materials : Twenty four patients with bulky stage IB and IIA-B carcinoma of the uterine cervix were treated with extrafascial hysterectomy following radiation therapy due to doubts of residual disease at Department of therapeutic radiology, Keimyung University, Dongsan Hospital, from April 1986 to December 1997 According to FIGO staging system, there were 7 patients with stage IB, 9 patients with IIA and 8 patients with IIB stage whose median age was 45. Pathologic distribution showed 16 patients with squamous cell carcinoma and 8 patients with adenocarcinoma. Seven patients had tumors that are less than 5cm in size and 17 patients had tumors with larger than 5cm. The mean interval between radiation therapy and extrafascial hysterectomy was 57 days. The radiation therapy consisted of external irradition to the whole pelvis (180 cGy/fraction, mean 4100 cGy) and parametrial boost (for a mean total dose of 5000 cGy) with midline shield (4H 10 cm), followed by intracavitary irradiation up to 7500 cGy to point A (maximum 8500 cGy). The maximum follow up duration was 107 months and mean follow up duration was 42 months. Results :Ten out of 24 patients (41.7%) had residual disease found at the time of extrafascial hysterectomies. Five year overall survival rate (5Y OSR) and five year disease free survival rate (5Y DFSR) were 63.6% and 62.5% respectively. Five year overall survival rate for stage IB and IIA was 71.4% and 50% for stage IIB. There was a significant difference in 5Y OSR and 5Y DFSR between patients with and those without residual disease (negative vs positive, 83.3% vs. 40% (P=0.01), 83.3% vs 36% (P=0.01) respectively). There was a notable tendency of better survival with adenocarcinoma than with squamous cell carcinoma (adenocarcinoma vs squamous cell carcinoma, 85.7% vs. 53.3% (P=0.1), 85.7% vs. 50.9% (P=0.1) of 5Y OSR and 5Y DFS respectivey). Total dose to A point did not make a significant difference in survival rate or the existence of residual lesion (< 7500 cGy, ${\geq}$ 7500 cOy). It was also noted that significantly more frequent local failures have occurred in patients with positive residual disease compared with negative residual disease (5/10 vs. 0/14, p=0.003), There was no death related to the treatment. Conclusion : There was no improvement of residual disease and to the overall survival rate in spite of increased total dose to point A. We conclude that there is a possible beneficial effect of radiation therapy followed by extrafaseial hysterectomy in survival for adenocarcinoma of bulky stage IB and IIA-B uterine cervix. We need to confirm this with longer follow up and with large number of patients.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.199-206
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• 2003

Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.

• Korean Journal of Weed Science
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• v.4 no.1
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• pp.26-38
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• 1984

To investigate the varietal differences of weed competitive functions under the four different seeding and transplanting methods, rice cultivars, Milyang 23 and Sadominori, were used with the seven weeding methods, namely, weedy check, weed-free, once weeding at 3, 6, 9, and 12 weeks and two times weeding at 3 and 9 weeks after seeding/transplanting, respectively. As a result, the proper and reasonable weeding stages and times by total and respective weed group were estimated. Also the constructive characteristics for yield formations were evaluated under the different competitive conditions as affected by various cropping patterns.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.197-203
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• 2005

Homograft aortic valve replacement (AVR) has many advantages such as excellent hemodynamic performance, faster left ventricular hypertrophy regression, resistance to infection and excellent freedom of thromboembolism. To find out the results of homograft AVR, we reviewed our surgical experiences. Material and Method: Eighteen patients (male female=16 : 2, mean age=39.3$\pm$16.2 years, range: 14$\~$68 years) who underwent homo-graft aortic valve replacement between May 1995 and May 2004 were reviewed. The number of homografts was 20 (17 aortic and 3 pulmonic homografts) including two re-operations. Ten patients had a history of previous aortic valve surgery. Indications for the use of a homograft were native valve endocarditis (n=7), prosthetic valve endocarditis (n=5), or Behcet's disease (n=8). The homograft had been implanted predominantly as a full root except in one patient in the subcoronary position. Result: Mean follow-up was 41.3 $\pm$ 26.2 months. There was one operative mortality. Postoperative complications included postoperative bleeding in 3 patients, and wound infection in 1. There was no late death. Three patients underwent redo-AVR. The etiology of the three reoperated patients was Behcet's disease (p=0.025). Freedom from reoperation was $87.5\pm8.3\%$, $78.8\pm11.2\%$ at 1, 5 years respectively, In patients with infective endocarditis, there was no recurrence of endocarditis. There was no thromboembolic complication. Conclusion: Although longer term follow-up with larger numbers of patients is necessary, the operative and mid-term results for homograft AVR was good when we took into account the operative risks of Behcet's disease or infective endocarditis. Behest's disease was a risk factor for reoperation after the homograft AVR. We think homograft AVR is the procedure of choice, particularly in patients with infective endocarditis.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.63-71
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• 2009

Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

• Clinical and Experimental Pediatrics
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• v.46 no.4
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• pp.351-357
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• 2003

Purpose : To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies. Methods : From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a control group, 22 UTI patients with no radiologic abnormalities were selected and matched by age and sex. Results : The incidence of AFBN was more common in boys than in girls. Since both groups had similar symptoms, it was difficult to diagnose AFBN by clinical presentations alone. ESR and CRP were significantly higher in AFBN patients. The most common causative organism was E. coli in both groups. On the sonographic findings, the most lesions were seen on the upper lobe of the kidney; more frequently, on left kidney. The lesions showed globular or wedge-shaped increased echogenecity. $^{99m}Tc-DMSA$ scan showed the complete coincidence of the location, size and shape in all cases compared to the findings of renal sonography. Conclusion : The roles of renal sonography and DMSA scan were very important, and ultrasonography was an excellent initial tool in diagnosing AFBN. Since the degree of infection in AFBN is more severe than other urinary tract infections and evollution into a renal abscess is possible, early diagnosis and appropriate antibiotics therapy is essential.