• Neonatal Medicine
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• v.18 no.1
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• pp.14-22
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• 2011

Neonatal bleeding is a common problem encountered in nursery rooms or neonatal intensive care units, especially among premature infants. Furthermore, owing to recent remarkable improvement of neonatology, survival rates of preterm neonates have increased; hence, neonatal bleeding cannot be emphasized enough. Since the total blood volume of neonates is small, bleeding can be one of the causes of morbidities and mortalities. Therefore, rapid diagnosis and immediate therapy is urgently needed. The patient's medical history including a familial history of a bleeding disorder or of a previously affected infant who suffered from bleeding along with maternal and neonatal drugs can provide important diagnostic clues. Presence of bleeding with or without petechiae and ecchymoses in a healthy term or late preterm infant with thrombocytopenia but normal prothrombin time and activated partial thromboplastin time strongly suggests a congenital bleeding disorder. For a sick infant who is bleeding from multiple sites, an acquired disorder such as disseminated intravascular coagulation is suspected. Intracranial hemorrhage in term or late preterm infants without a history of birth trauma is highly suggestive of coagulation disorders. The purpose of this review is to summarize recent advances in diagnostic methods is as well as basic concepts of neonatal hemostatic disorders. First, an outline of background information will be presented followed by a discussion of primary and secondary hemostatic disorders as well as inherited and acquired disorders.

• Neonatal Medicine
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• v.18 no.1
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• pp.153-157
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• 2011

Pneumopericardium is a rare form of neonatal air leakage. Tension pneumopericardium is much more infrequent, but can cause a cardiovascular deterioration with high mortality up to 80% and neurodevelopmental morbidity in half of the cases. We report two cases of preterm infants who successfully recovered from tension pneumopericardium that developed during mechanical ventilator assistance. The patients displayed a sudden increase in oxygen demand and subsequent cardiovascular deterioration. Immediate needle aspiration of the pneumopericardium performed after checking X-ray images rescued each of patient. Since the clinical symptoms are non-specific, clinicians' suspicion is most important when patients show sudden refractory cardiovascular collapse, especially in ventilator-assisted neonates. This life threatening complication demands instant diagnosis and intervention.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.751-756
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• 2006

Purpose : Our goals were to determine the frequency of headaches and backaches occurring as a side effect following lumbar puncture in children, and to investigate various factors that might influence the frequency of headaches and backaches. Methods : From October 2004 to February 2006, we enrolled 148 patients aged 2 to 15 years who received diagnostic lumbar puncture at the Presbyterian Medical Center, Chonju, Korea. Patient data were collected for age, sex, number of puncture attempts, volume of cerebrospinal fluid(CSF), bevel orientation of puncture needle, cell count in CSF, periods of absolute bed rest, and the frequency and duration of headaches and backaches. Results : Headaches occurred in 8 patients and backaches occurred in 40 patients. Headaches were found both to occur significantly more frequently in patients over age 10 and to last longer when the bevel orientation of the puncture needle was inserted toward the cranium rather than laterally. Backaches lasted longer in males than in females. The other factors evaluated showed no relationship at all to the frequency and duration of headaches and backaches. Conclusion : Following lumbar puncture, headaches were common in patients over age 10, and lasted longer when the bevel orientation was toward the cranium. Backaches lasted longer in males than in females. In light of these findings, we recommend taking special care when performing lumbar puncture for CSF examination in patients over age 10.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.39-45
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• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1397-1402
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• 2002

Purpose : One of the major complication of arterial catheterization is the thrombosis of the iliac or femoral arteries. Tissue loss following femoral artery catheterization is rare. However longterm sequelae such as impaired limb growth and future impairment of vascular access, are also important in pediatric cardiac patients. But standard methods to treat thrombotic complication of arterial catheterization in infants and children is not established. The present study was performed to assess the efficacy of intraarterial catheter-directed urokinase infusion in infants and children with limb ischemia due to arterial thrombosis after cardiac catheterization. Methods : From January 1994 to August 2002, 12 patients with thrombotic femoral artery occlusion after arterial catheterization were treated with catheter-directed urokinase infusion in Dong-A University Hospital. Retrospective analysis of the medical records and angiograms was conducted. Results : The incidence of femoral artery thrombosis after retrograde arterial catheterization, which had not responded to systemic infusion of heparin and/or urokinase, was 2.8 percent. The doses of urokinase were 1,000-4,400 unit/kg/hr and duration of infusion was $50.6{\pm}29.2$ hours(18-110 hours). Clot resolution was complete in all patients who started to receive the intraarterial urokinase infusion within four days after catheterization. Only partial thrombolysis was seen in two patients who were treated with intraarterial urokinase on the 12th and 19th days after thrombus formation. Balloon angioplasty was done for these two patients with partial success. Bleeding complications were seen in two cases. Conclusion : Early use of catheter-directed intraarterial infusion of urokinase is safe and effective in thrombolysis of femoral artery occlusion after cardiac catheterization in infants and children.

• Korean Journal of Veterinary Research
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• v.30 no.4
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• pp.373-381
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• 1990

Endocrine cells in the cardiac and fundic regions of the Korean hedgehog were studied ultrastructurally. Five types of endocrine cells classified as EC, ECL, $D_1$. G and A-like cells were identified in these regions. EC cells contained pleomorphic granules, 170~500nm in diameter, with high electron density and highly dense bodies in a dense matrix. ECL cells were characterized by the presence of round or oval granules, 220~450nm in diameter, with high electron density. Some granules of ECL cells showed a small amounts of contents or empty. $D_1$ cells contained round and relatively small granules, 140~400nm in diameter, with low to moderate electron density. G cells were characterized by the presence of round or oval granules, 200~400nm in diameter, with moderate electron density. Some granules of these cells showed a narrow halo between the limiting membrane and the granular matrix. A-like cells contained round granules, 170~260nm in diameter, With high electron density. The granules of these cells showed homogeneous matrix surrounded by the tight membrane.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.313-316
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• 1994

Usually the persistence of ventricular activity in Tc-99m DTPA cisternography is deter mined using 24 hour images in our country. However, the 24 hour image is regarded as an in-sufficient data by many investigators. They prefer 48 hour image. The aim of the present study was to evaluate the feasibility and usefulness of 48 hour delayed imaging in Tc-99m DTPA cisternography. We performed 48 hour cisternography using Tc-99m DTPA in 38 patients with known hydrocephalus. 37-111 MBq (1-3mCi) of Tc-99m DTPA were injected by lumbar puncture. Anterior and both lateral Images were obtained at 2, 6, 24 and 48 hours. The classification of hydrocephalus was done at 24 and 48 hours by two independent nuclear medicine physicians. The 48 hour images were interpretable in all cases. In seven patients, the clearance of ventricular activity was noted only on 48 hours images. Therefore, their classification was changed from type W to type III. Sixteen of 38 patients were underwent shunt operations. Clinical improvement was noted in 13 patients(1/1 of type II, 3/6 of type III 8/9 of type IV). One case who showed a changing pattern from IV to IIIa showed no clinical improvement after shunt operation. In conclusion, the 48 hour delayed imaging was feasible and useful technique in Tc-99m DTPA cisternography.

• Proceedings of the Korea Water Resources Association Conference
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• 2007.05a
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• pp.774-779
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• 2007

IDF 곡선은 전통적으로 지점에서의 과거 관측 강우량 시계열 자료를 수집하여 작성하여 왔으며, 이때 과거 강우량 자료는 정상성을 지니고 있고 미래를 대변한다는 가정을 전제로 한다. 그러나 이미 많은 연구자들에 의해 기후변화가 전구적으로 발생하고 있으며 우리나라에서도 더 이상 기후변화의 사실여부는 이제 더이상 논란 꺼리가 아니다. 특히, 기후변화의 영향을 직접적으로 받을 수밖에 없는 수자원 분야에서는 1990년대부터 잦은 홍수와 가뭄의 반복으로 곤란을 겪고 있다. 특히, 우리나라는 협소한 국토면적과 과다한 인구로 토지나 수자원 등 국토자원 이용의 강도가 다른 나라에 비하여 현저하게 높기 때문에 지구온난화에 따른 기후변화와 같은 약간의 기후변동으로도 심각한 문제가 발생할 가능성이 내포되어 있다. 특히, 기후변화는 유역 규모의 강우 발생 패턴과 강우량의 증가 및 감소에 영향을 미치게 되며 이로 인해 강우 시계열 자료는 비정상성과 경향성을 지니게 된다. 그러나 지금까지는 IDF 곡선의 작성시 강우의 경향성을 무시해 왔다. 본 연구에서는 기후변화가 IDF 곡선에 미치는 영향을 분석하기 위하여 GCM 기후변화 시나리오를 이용하여 IDF 곡선을 작성하였다. 이를 위하여 먼저, YONU CGCM의 제한실험과 점증실험을 실시하여 전구적 규모의 기후변화 시나리오를 작성하였으며, 통계학적 축소기법과 추계학적 일기발생기법을 이용하여 대상지점의 일 수문기상 시계열을 모의하였다. 그리고 BLRP(Bartlett Lewis Rectangular Pulse) 모형과 분해(koutsoyiannis, 2000) 기법을 이용하여 모의된 일 강우 자료를 시자료로 분해하였으며 이를 이용하여 IDF 곡선을 작성하였다. 그 결과, 기후변화 시 지속기간별 재현기간별 강우량이 현재에 크게 비해 증가됨을 확인할 수 있었다.으며 여러명이 동시에 서버에 접속을 하기 때문에 컴퓨터에 부하가 많이 걸리는 모델링이나 복잡한 분석은 실시하기 어려우며, 대용량 데이터를 전송할 수 있는 대역폭이 확보 되어야 한다. 또한, Internet 환경으로 개발을 해야되기 때문에 데스크탑용 GIS에 비해 개발속도가 느리며 개발 초기비용이 많이 들게 된다. 하지만, 네트워크 기술의 발달과 모바일과의 연계 등으로 이러한 약점을 극복할 수 있을 것으로 판단된다. 따라서 본 논문에서는 인터넷 GIS를 이용하여 홍수재해 정보를 검색, 처리, 분석, 예경보할 수 있는 홍수방재정보 시스템을 구축토록 하였다.비해 초음파 감시하 치골상부 방광천자가 정확하고 안전한 채뇨법으로 권장되어야 한다고 생각한다.應裝置) 및 운용(運用)에 별다른 어려움이 없고, 내열성(耐熱性)이 강(强)하므로 쉬운 조건하(條件下)에서 경제적(經濟的)으로 공업적(工業的) 이용(利用)에 유리(有利)하다고 판단(判斷)되어진다.reatinine은 함량이 적었다. 관능검사결과(官能檢査結果) 자가소화(自家消化)시킨 크릴간장은 효소(酵素)처리한 것이나 재래식 콩간장에 비하여 품질 면에서 손색이 없고 저장성(貯藏性)이 좋은 크릴간장을 제조(製造)할 수 있다는 결론을 얻었다.이 있음을 확인할 수 있었다.에 착안하여 침전시 슬러지층과 상등액의 온도차를 측정하여 대사열량의 발생량을 측정하고 슬러지의 활성을 측정할 수 있는 방법을 개발하였다.enin과 Rhaponticin의 작용(作用)에 의(依)한 것이며, 이는 한의학(韓醫學) 방제(方劑) 원리(原理)인 군신좌사(君臣佐使) 이론(理論)에서 군약(君藥)이 주증(主症)에 주(主)로 작용(作用)하는 약물(藥物)이라는 것을 밝혀주는 것이라고 사료(思料)된다.일전 $13.447\;{\mu}g/hr/g$, 섭취 7일중 $8.123

• Journal of Chest Surgery
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• v.40 no.10
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• pp.691-695
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• 2007

Background: The introduction of central venous catheters in 1979 has aided the administration of chemotherapy to oncologic patients. We analyzed the clinical reviews and complications of totally implantable venous catheters in an effort to achieve optimal management. Material and Method: We retrospectively studied 100 cases with totally implantable venous catheter at our hospital and we report the results. Result: 100 totally implantable venous catheters were placed in the right subclavian vein in 74 cases (74%), the left subclavian vein in 21 cases, the right jugular vein in 3 cases, the left jugular vein in 1 case and the right femoral vein in 1 case. The immediate complications were 5 cases in malposition of the catheter and 5 cases of arterial puncture. The late complications were 1 case of subclavian vein thrombosis, which was treated with anticoagulation, and 2 cases of pinch-of syndrome. There were no other early or late complications. Conclusion: The low rate of complications in this study confirms the safety and convenience of using totally implantable venous catheter in patients undergoing prolonged chemotherapy. Yet because Infection, thrombosis, and catheter fracture are the most common long term complications of totally implantable venous catheters, early diagnosis and management of these problems can prevent severe complications.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.49-56
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• 2006

배경 : 급성 폐손상은 폐내, 외의 원인질환들에 의해 폐포-모세혈관의 투과성이 증가하며, 폐부종에 의해 급성 저산소성 호흡곤란이 유발되는 증후군이다. 헤파린은 항응고작용 외에 자체적으로 항염증효과를 가지고 있으나, 염증성질환에 헤파린을 투여하면 출혈성 합병증이 발생하기 때문에 실제로 임상에서 이용하는데 제약이 있다. 하지만 헤파린에서 2-O와 3-O sulfate를 제거하면, 항응고 효과가 제거되고 항염증효과는 지니고 있는 비항응고성 헤파린 (nonanticoagulant heparin)으로 변화한다. 본 연구에서는 흰쥐에게 내독소 (LPS)를 투여하거나, 출혈성 쇼크를 일으켜서 유발된 급성폐손상에서 비항응고성 헤파린의 치료효과를 살펴보았다. 방법 : 각 군당 5 마리 이상의 흰쥐 (Balb/c mouse)를 이용하였다. 미정맥 (tail vein)을 통해 생리식염수 또는 비항응고성 헤파린 (50 mg/kg)을 투여한 직후에 내독소를 복강으로 투여하거나 (1 mg/kg), 심장천자를 통해 총 혈액의 1/3 정도로 제거하여 출혈성 쇼크를 유도하여 급성폐손상을 유발하였다. 내독소 투여 또는 출혈성 쇼크 유발 1 시간 후에 흰쥐를 희생시키고 폐를 적출하였고, 폐의 염증성 변화는 사이토카인 ($TNF-{\alpha}$, MIP-2, $IL-1{\beta}$)을 측정하여 살펴보았고, 폐손상의 정도는 myeloperoxidase (MPO) assay와 wet-to-dry weight ratio를 측정하여 알아보았다. 결 과 : 내독소를 투여한 흰쥐의 폐에서 대조군의 폐에 비해 사이토카인의 발현이 증가하고 ($TNF-{\alpha}$; $196.1{\pm}10.8$ vs $83.7{\pm}18.4pg/ml$, MIP-2; $3,000{\pm}725$ vs $187{\pm}26pg/ml$, $IL-1{\beta}$; $6,500{\pm}1167$ vs $266{\pm}25pg/ml$, p<0.05, respectively), 폐의 MPO 활성이 증가하였다 ($27.9{\pm}6.2$ vs $10.5{\pm}2.3U/g$ of lung protein, p<0.05). 출혈성 쇼크를 일으킨 흰쥐의 폐에서 대조군의 폐에 비해 사이토카인의 발현은 증가되지 않았으나, MPO 발현은 증가되었다 ($16.5{\pm}3.2$ vs $10.5{\pm}2.3U/g$ of lung protein, p<0.05). 내독소 투여 또는 출혈성 쇼크에 의해 급성폐손상이 유발된 흰쥐에서 생리적 식염수를 투여하거나 비항응고성 헤파린을 투여한 군 사이에 사이토카인의 발현이나 MPO 활성에 의미있는 차이는 관찰되지 않았다. 결론 : 이상의 결과로 비항응고성 헤파린은 내독소를 투여하거나 출혈성 쇼크를 일으키고 한 시간 뒤에 측정한 흰쥐의 급성폐손상에서 의미있는 치료효과를 보이지 않았다.