• Clinical and Experimental Pediatrics
• /
• v.46 no.1
• /
• pp.76-82
• /
• 2003

Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.

• Journal of Veterinary Clinics
• /
• v.20 no.2
• /
• pp.237-241
• /
• 2003

A case of juvenile onset generalized demodicosis of one year old, intact female Japanese Chin dog weighing 3.1kg was presented to the Small Animal Clinic of the College of Veterinary Medicine of Kyungpook National University. The diagnosis was made based on the physical examination, deep skin scrapings, hematology, serum chemistry, endocrinologic evaluation and bacterial culture. Numerous D. canis mites of various stages were observed in multiple skin scraping samples. CBC, serum chemistry, $T_3$, $T_4$ and free $T_4$ values were within normal range and Staphylococcus intermedius was isolated in bacterial culture of pustules. The dog was healthy other than skin lesions at the presentation. The three different treatment protocols were tried for the case. No clinical improvement was observed during 13 weeks of orally given daily basis ivermectin therapy at 600ug/kg and 2 weeks of spot-on weekly basis selamectin therapy at 30 mg/kg with cephalexin given orally twice a day at 25 mg/kg. However, a remarkable remission was seen by 0.1% amitraz dip on weekly basis with 4% chlorhexidine bath given twice a week. The secondary staphylococcal infection and accompanied pruritus was almost disappeared in two weeks and she was recovered clinically normal in 9 weeks of therapy. The therapy was continued for 4 more weeks to prevent relapse. The dog is clinically normal and being monitored for development of any abnormal dermatological signs for the time being.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.2
• /
• pp.175-184
• /
• 2011

With a development of implant restoration technique, there are increasing use of computer-guided system for edentulous patients. It was carried out simulated operation based on CT information about patient's bone quantity, quality and anatomical landmark. However, there are some difference between the programmed implant and post-operative implant about it's position. If the deviation was severe, it could happen a failure of 'passive fit' and not suited for path of implant restoration. The aim of this presentation is to evaluate about a degree of deviations between programmed implant and post-operative implant. Five patients treated by 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden) in Department of Prosthodontics, Inha University were included in this study. The patients were performed CT radiograph taking and intra-oral impression taking at pre-operation. Based on CT images and study model, surgical stent was produced by NobelBiocareTM. To fabricated a pre-operative study model, after connected lab analog to surgical template, accomplished a pre-operative model using type 4 dental stone. At final impression, a post-operative study model was fabricated in the conventional procedures. Each study model was performed CT radiograph taking. Based on CT images, each implant was simulated in three dimensional position using $Procera^{(R)}$ software (Procera Software Clinical Design Premium, version 1.5; Nobel Biocare AB). In 3D simulated model, length and angulation between each implant of both pre- and post-operative implants were measured and recorded about linear and angular deviation between pre-and post-operative implants. A total of 24 implants were included in this study and 58 inter-implant sites between each implant were measured about linear and angular deviations. In the linear deviation a mean deviation of 0.41 mm (range 0~1.7 mm) was reported. In the angular deviation, a mean deviation was $1.99^{\circ}$ (range $0^{\circ}{\sim}6.7^{\circ}$). It appears that the both linear and angular mean deviation value were well acceptable to application of computer-guided implant system.

• Advances in pediatric surgery
• /
• v.8 no.2
• /
• pp.143-155
• /
• 2002

A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

• Childhood Kidney Diseases
• /
• v.5 no.2
• /
• pp.136-146
• /
• 2001

Purpose : One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. Methods . We analyzed the Medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient's urine becomes protein free. Results : There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone $60mg/m^2$ daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased a]id proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein Al (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). Conclusions : This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed. (J Korean Soc Pediatr Nephrol 2001;5 : 136-46)