• Clinical and Experimental Pediatrics
• /
• v.46 no.2
• /
• pp.154-161
• /
• 2003

Purpose : The prognosis of patients with corrected transposition of the great arteries(C-TGA) is variably affected by associated intracardiac defects, systemic right ventricular function, tricuspid valve competence, and conduction disturbances. This study aims to evaluate the importance of those factors at mid-term follow-up. Methods : Medical records of 94 patients(males 58, females 36; mean age at last follow-up, $12{\pm}9$ years; mean follow-up duration, $9{\pm}6.4$ years) diagnosed between January 1980 and May 2002 at Seoul National University Children's Hospital were studied retrospectively. Results : Among 94 patients, operations were performed in 72 patients(classic operations in 55; double switch operations in 17). Among prognostic factors including associated intracardiac anomalies(at least moderately severe tricuspid insufficiency(TI), ventricular septal defect, pulmonary stenosis and pulmonary atresia), intracardiac operation and complete atrioventricular block, TI was the only significant factor for death(P=0.001), and in turn, Ebstein anomaly and high grade atrioventricular block predicted TI. 20-year survival without TI was 77%, but only 35% with TI(P=0.0002); excluding perioperative death, the 20-year survival rates with and without TI were 48% and 87% respectively(P=0.008). There was no statistical difference in 20-year survival rate or association with TI between classic and double switch operation. Conclusion : TI was the major prognostic factor for C-TGA and was associated with Ebstein anomaly and high grade atrioventricular block at mid-term follow-up. Long-term follow-up is required to evaluate other factors, including double switch operations and associated intracardiac defects more exactly.

• Economic and Environmental Geology
• /
• v.44 no.1
• /
• pp.37-48
• /
• 2011

Some industrial minerals used in domestic industries such as monazite, apatite, bauxite, and ilmenite belong to NORM (Naturally Occurring Radioactive Materials) because they show a high radioactivity. Products, semi-products, wastes, and by-products which show higher radioactivity than NORM belong to TENORM (Technologically Enhanced Naturally Occurring Radioactive Materials). Apatite used for manufacturing phosphate fertilizer in Namhae Chemical company belongs to NORM, and its by-product, phospo-gypsum, belongs to TENORM. A geological investigation is needed for the future environmental impact assessment of the Namhae Chemical company's site. According to survey results of the Namhae Chemical company's site, soil mineral composition indicated the mixture of minerals derived from the country rock (quartz, feldspar, mica, $l4{\AA}$ mineral, kaolin and amphibole) and minerals from the gypsum open-air storage yard (gypsum and apatite). Soil samples showed average content of U 4.6 ppm and Th 10 ppm, which are similar to average crustal abundances. They also show average contents of $^{40}K$ 191-1,166 Bq/kg, $^{226}Ra$ 15.6-710 Bq/kg, and $^{232}Th$ 17.4-72.7 Bq/kg, which indicate moderate levels of radio nuclide. But $^{226}Ra$ anomaly in the gypsum open storage yard is clearly confirmed and $^{232}Th$ anomaly is also confirmed in the east road side of the factory and nearby mountain areas. Soil external hazard indices ranged 0.24-2.01 with the average 0.54. Although most external hazard indices were lower than 1, which means radiation hazard index to be negligible, 5 samples out of total 40 samples showed higher values than 1, and further detailed investigation is needed.

• Clinical and Experimental Pediatrics
• /
• v.46 no.5
• /
• pp.447-453
• /
• 2003

Purpose : This study was performed to compare complications and perinatal factors according to the birth weight groups in the infants of diabetic mothers(IDM). Methods : Three hundred and one singleton diabetic mothers and their babies of more than 30 weeks' gestational age admitted in the department of Pediatrics, Chonnam University Hospital from January 1996 to March 2002 were enrolled. Complications and perinatal factors were compared between large for gestational age(LGA) and appropriated for gestational age(AGA) infants. Results : Hypomagnesemia was observed in 37.5%, jaundice in 21.3%, hypoglycemia in 11.1%, hypocalcemia in 7.0%, and birth injury in 19.6%. Congenital anomaly was noted in 24.9% with cardiovascular anomaly most commonly. In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, Cesarean section rate, maternal height, weight before pregnancy, weight gain during pregnancy, and the incidence of unawareness of gestational DM were significant compared with the AGA group. Conclusion : In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, maternal height, weight before pregnancy and weight gain during pregnancy were larger, and the incidence of unawareness of gestational DM was higher compared with the AGA group. These results suggest that careful examination and management are needed to detect the high risk, pregnant DM mothers with possible LGA babies.

• Clinical and Experimental Pediatrics
• /
• v.52 no.8
• /
• pp.910-916
• /
• 2009

Purpose : The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January 2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation. Methods : Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in 2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies. Median follow-up time was 44 months (3-63 months). Results : Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig- Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series. On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD, side-by-side positioned great arteries, or associated coronary anomalies. Conclusion : The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, as well as ventricular outflow tract obstructions.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.36 no.1
• /
• pp.49-63
• /
• 2016

In this study, we analyzed the effects of regional hydrologic variability during warm season (June-September) in South Korea due to ENSO (El $Ni{\tilde{n}}o$-Southern Oscillation) pattern changes over the Tropical Pacific Ocean (TPO). We performed composite analysis (CA) and statistical significance test by Student's t-test using observed hydrologic data (such as, precipitation and streamflow) in the 113 sub-watershed areas over the 5-Major River basin, in South Korea. As a result of this study, during the warm-pool (WP) El $Ni{\tilde{n}}o$ year shows a significant increasing tendency than normal years. Particularly, during the cold-tongue (CT) El $Ni{\tilde{n}}o$ decaying years clearly decreasing tendency compared to the normal years was appeared. In addition, the La $Ni{\tilde{n}}a$ years tended to show a slightly increasing tendency and maintain the average year state. In addition, from the result of scatter plot of the percentage anomaly of hydrologic variables during warm season, it is possible to identify the linear increasing tendency. Also the center of the scatter plot shows during the WP El $Ni{\tilde{n}}o$ year (+17.93%, +26.99%), the CT El $Ni{\tilde{n}}a$ year (-8.20%, -15.73%), and the La $Ni{\tilde{n}}a$ year (+8.89%, +15.85%), respectively. This result shows a methodology of the tele-connection based long-range water resources prediction for reducing climate forecasting uncertainty, when occurs the abnormal SSTA (such as, El $Ni{\tilde{n}}o$ and La $Ni{\tilde{n}}a$) phenomenon in the TPO region. Furthermore, it can be a useful data for water managers and end-users to support long-range water-related policy making.

• Childhood Kidney Diseases
• /
• v.9 no.2
• /
• pp.213-221
• /
• 2005

Purpose : Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management. Methods : We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital. Results : The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diver ticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus. Conclusion : All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection. (J Korean Soc Pediatr Nephrol 2005;9:213-221)

• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.175-183
• /
• 2009

Background: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement or pediatric mitral lesions can cause problems such as a lack of growth potential. There re only limited experiences with mitral valve repair at any institution, so the purpose of his study is to evaluate the outcomes of mitral valve repair n pediatric patients. Material and Method: Sixty-four consecutive children (28 males and 36 females) with a mean age of $5.5{\pm}4.7$ years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without trial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). Result: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there as no significant difference among the groups. The median follow-up was 4.6 years range: $0.5{\sim}12.2$ years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of $2.1{\pm}1.1$ procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there ere significant differences according to the repair strategies. Conclusion: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.

• Clinical and Experimental Reproductive Medicine
• /
• v.25 no.3
• /
• pp.323-329
• /
• 1998

The safety of ICSI as a novel procedure of assisted fertilization may be assessed by the health of the baby born. In order to evaluate the safety of ICSI, perinatal outcome and congenital anomaly of the babies born after ICSI were compared with those of babies born after IVF (control group). We analysed the clinical data from the obstetric and pediatric records, including the information obtained through telephone. The results are as follows; Mean gestational age $({\pm}SEM)$ and birth weight in singleton pregnancy were $38.8{\pm}1.9$ weeks and $3209.7{\pm}501.9gm$ in IVF group, $39.0{\pm}2.2$ weeks and $3289.9{\pm}479.5gm$ in ICSI group, respectively. Mean gestational age and birth weight in twins were $36.8{\pm}2.1$ weeks and $2512.8{\pm}468.0gm$ in IVF group, $36.5{\pm}2.8$ weeks and $2492.7{\pm}537.1gm$ in ICSI group. In IVF group, perinatal mortality rates were 8.5 in singletons and 56.6 in twins; for the ICSI singletons and ICSI twins, the perinatal mortality rates were 11.6 and 49.0, respectively. The incidence of congenital malformations was 3.6% (8/224) in IVF group and 2.1% (4/188) in ICSI group, there was no statistical difference (p>0.05, Fisher's exact test). The incidence of major congenital anomalies was 0.9% (2/224; pulmonary artery hypoplasia, renal cystic dysplasia) in IVF group and 1.1% (2/188; holoprosencephaly, Cri du chat syndrome) in ICSI groups (p>0.05, Fisher's exact test). Similarly, there was no significant difference in incidence of minor congenital anormalies 2.7% (6/224) in IVF group and 1.1% (2/188) in ICSI group respectively (p>0.05, Fisher's exact test). In conclusion, there was no difference in the perinatal outcome and the incidence of congenital anomalies between the babies born after ICSI and those after conventional IVF.

• The Korean Nurse
• /
• v.30 no.3
• /
• pp.49-65
• /
• 1991

This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situaition. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, $x^2$-test, F-test, Pearsons correation, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants(42.7%) were born to mothers with risk-scores > 7, and 753 infants(57.3%) were born to mothers risk-scores <7. 2. Maternal age" parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies($X^2$=20.88, 42.87, 15.60 P < 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infanl, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. ($X^2$ = 175.96, 87.5, 16.28, 21.78, 9.46, 8. 10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P < 0.01). 4. Abnormal nutrition, anemia, UTI, other medicalcondition(pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 '||'&'||' 5 minute after birth and neonatal body weight. 6. Apgar score at 1 '||'&'||' 5 minute after, birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 '||'&'||' 5 minute after birth, 3 group(0-3, 4-6, above 7), and neonatal body weight, 2 group(below 2.5kg, the other group) (F=104.65, 96.61, 284.92, P<0.01). 8. Apgar score at 1 '||'&'||' 5 minute after birth(below 7), and neonatal body weight(below 2.5kg), were significant relation statistically with risk score.($x^2$=65.99, 60.88, 177.07, P<0.01) were 60.8 %, 60% . 9. Correct classifications of morbid infants(l '||'&'||' 5 minute Apgar score < 7) were 77.8%, 83.8% and that of nonmorbid infants(l '||'&'||' 5 minute Apgar score > 7) were 60.8%, 60%. 10. There were statistically significant difference between dislribution of maternal risk-score among the morbid infants(l '||'&'||' 5 minute Apgar score < 7) and non morbid infants(l '||'&'||' 5 minute Apgar score> 7) ($x^2$=64.8, 58.8, P < 0.001). 11. There were statistically significant difference between distribution of morbid infants(l '||'&'||' 5 minute Apgar score < 7) and fetal death. 12. The predictivity for classifying high.risk cases was 12 % and for classifying low-risk cases was 98.3 % in 5 minute Apgar score. Suggestions for further studies are as follows; 1. Contineous prospective studies, using this newly revised scoring system are strongly recommended in the stetric service. 2. Besides risk facto~s used in this study, assessmenl of risks by factors in another scoring system and paralled studies related to perinatal outcome are strongly recommended.

• Journal of the Korean earth science society
• /
• v.21 no.2
• /
• pp.137-158
• /
• 2000

The correlation and Empirical Orthogonal Function (EOF) analyses over the globe have been applied to intercompare lower-stratospheric (${\sim}$70hPa) temperature obtained from satellite data and two model reanalyses. The data is the19 years (1980-98) Microwave Sounding Unit (MSU) channel 4 (Ch4) brightness temperature, and the reanalyses are GCM (NCEP, 1980-97; GEOS, 1981-94) outputs. In MSU monthly climatological anomaly, the temperature substantially decreases by ${\sim}$21k in winter over southern polar regions, and its annual cycle over tropics is weak. In October the temperature and total ozone over the area south of Australia remarkably increase together. High correlations (r${\ge}$0.95) between MSU and reanalyses occur in most global areas, but they are lower (r${\sim}$O.75) over the 20-3ON latitudes, northern America and southern Andes mountains. The first mode of MSU and reanalyses for monthly-mean Ch4 temperature shows annual cycle, and the lower-stratospheric warming due to volcanic eruptions. The analyses near the Korean peninsula show that lower-stratospheric temperature, out of phase with that for troposphere, increases in winter and decreases in summer. In the first mode for anomaly over the tropical Pacific, MSU and reanalyses indicate lower-stratospheric warming due to volcanic eruptions. In the second mode MSU and GEOS present Quasi-Biennial Oscillation (QBO) while NCEP, El Ni${\tilde{n}}$o. Volcanic eruption and QBO have more impact on lower-stratospheric thermal state than El Ni${\tilde{n}}$o. The EOF over the tropical Atlantic is similar to that over the Pacific, except a negligible effect of El Ni${\tilde{n}}$o. This study suggests that intercomparison of satellite data with model reanalyses may estimate relative accuracy of both data.