• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.858-864
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• 2003

Purpose : There was a outbreak of aseptic meningitis in Busan, 2002. We report the clinical features and causative viruses. Methods : Two hundred seventy six children with aseptic meningitis who were admitted to the Department of Pediatrics, Maryknoll Hospital between January and December, 2002 were included. CSF, stool and throat swab viral cultures were done in 244 of these children. Results : The male to female ratio was 1.4 : 1. Age of patients varied from five months to fourteen years old. Average age was $5.7{\pm}6.2years$ old and mostly between one and four years.(41.3%) Monthly distribution revealed that the number of patients increased from May to July. The main symptoms were fever, headache and vomiting in this order. Respiratory tract infection symptom was associated from June to July and headache and nausea without fever were characteristically observed in children more than 10 years old from November to December. In peripheral blood examination, leukocytosis(WBC>$10,000/mm^3$) showed in 34.8%, ESR was increased in 56.1%, and CRP was positive value in 61%. Therefore differential diagnosis was difficult through peripheral blood examination. CSF findings revealed mean leukocyte count $86.5{\pm}180.2/mm^3$, protein $41.7{\pm}32.9mg/dL$, glucose $56.4{\pm}9.9mg/dL$. Median hospitalized period was $4.7{\pm}7.2days$ and compared with non-tapping group, hospitalized period was shorter and subsidance of symptoms was faster, therefore antibiotics injection period was shorter in the spinal tapping group. Virus was isolated in 31 cases of 244. The causative agents were echovirus 6, echovirus 9, echovirus 25, coxsakie virus B3, B4. Conclusion : There was an epidemics of aseptic meningitis in Busan, 2002; the causative agent was echovirus 6, 9, 25, coxsakie virus B3, B4.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.883-888
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• 2003

Purpose : The etiology of hemolytic anemia can be classified as either cellular or extracellular defects of red blood cells. The aim of this study was to investigate the clinical and laboratory findings of hemolytic anemia concerning its etiological classification. Methods : Clinical and laboratory findings of the patients with hemolytic anemia treated from January 1987 to May 2002 at Severance Hospital were analyzed retrospectively. They were divided into two groups based on the types of red cell defects(group I : erythrocytic defect, group II : extraerythrocytic defect). Results : Twenty one cases were included in group I, thirty four cases in group II, and three cases were unclassified. In group I, nineteen cases(90.5%) were diagnosed as hereditary spherocytosis and were proved to have red cell membrane disorders while two cases(9.5%) were shown to have red cell enzyme deficiencies. In group II, thirteen cases(38.2%) were noted as autoimmune hemolytic anemia, eleven cases(32.4%) as traumatic or microangiopathic hemolytic anemia, four cases(11.8%) as drug induced hemolytic anemia, two cases(5.9%) were related with systemic lupus erythematosus and one case(2.9%) with malignancy. Hemoglobin at the time of diagnosis(7.5 g/dL vs. 6.2 g/dL, P<0.05) and the incidence of splenomegaly(85.7% vs. 18.2%, P<0.05) were higher in group I though blood urea nitrogen(9.0/0.4 mg/dL vs. 27.8/1.6 mg/dL, P<0.05) was higher in group II. Conclusion : Comparing the clinical features of pediatric hemolytic anemia, we concluded as following : In cases associated with extraerythrocytic defect, blood tests revealed significant initial lower hematocrit with higher level of BUN and Cr while cases with erythrocytic defect, splenomegaly were more common noted.

• Radiation Oncology Journal
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• v.17 no.4
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• pp.281-286
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• 1999

Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.291-298
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• 2003

Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

• The Journal of the Petrological Society of Korea
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• v.13 no.1
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• pp.34-45
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• 2004

This paper describes the textural relations of mantle xenoliths and fluid inclusions in mantle-derived rocks found in alkaline basalts from Jeju Island which contain abundant ultramafic, felsic, and cumulate xenoliths. Most of the ultramafic xenoliths are spinel-lherzolites, composed of olivine, orthopyroxene, clinopyroxene and spinel. The felsic xenoliths considered as partially molten buchites consist of quartz and plagioclase with black veinlets, which are the product of ultrahigh-temperature metamorphism of lower crustal materials. The cumulate xenoliths, clinopyroxene-rich or clinopyroxene megacrysts, are also present. Textural examination of these xenoliths reveals that the xenoliths are typically coarse grained with metamorphic characteristics, testifying to a complex history of evolution of the lower crust/upper mantle source region. The ultramafic xenoliths contain protogranular, porphyroclastic and equigranular textures with annealing features, indicating the presence of shear regime in upper mantle of the Island. The preferential associations of spinel and olivine with large orthopyroxenes suggest a previous high temperature equilibrium in the high-Al field and the original rock-type was a Al-rich orthopyroxene-bearing peridotite without garnet. Three types of fluid inclusions trapped in mantle-derived xenoliths include CO$_2$-rich fluid (Type I), multiphase silicate melt (glass ${\pm}$ devitrified crystals ${\pm}$ one or more daughter crystals ＋ one or more vapor bubbles) (Type II), and sulfide (melt) inclusions (Type III). C$_2$-rich inclusions are the most abundant volatile species in mantle xenoliths, supporting the presence of a separate CO$_2$-rich phase. These CO$_2$-rich inclusions are spatially associated with silicate and sulfide melts, suggesting immiscibility between them. Most multiphase silicate melt inclusions contain considerable amount of silicic glass. reflecting the formation of silicic melts in the lower crust/upper mantle. Combining fluid and melt inclusion data with conventional petrological and geochemical information will help to constrain the fluid regime, fluid-melt-mineral interaction processes in the mantle of the Korean Peninsula and pressure-temperature history of the host xenoliths in future studies.

• The Journal of the Petrological Society of Korea
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• v.21 no.2
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• pp.151-171
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• 2012

The Permo-Triassic Songrim orogeny in the Korean peninsula was a major tectonic event involving complicated continental collisions at the eastern margin of Eurasia. Based on the previous studies on the metamorphic and deformations features of the Songrim orogeny, this paper presents metamorphic and structural characteristics and timing of the Songrim orogeny in the Taebaeksan basin, and discuss about correlation of the tectono-metamorphic evolution of the Taebaeksan basin with the Okcheon basin and the Imjingang belt with a combined analysis of bulk crustal shortening direction, metamorphic P-T and T-t (time) paths. The metapelites in the Pyeongan Supergroup in the northeastern margin of the Taebaeksan basin have experienced lower-temperature/medium-pressure (LT/MP) regional metamorphism followed by high-temperature contact metamorphism due to the Jurassic granite intrusion. The earlier LT/MP regional metamorphism produced two loops of clockwise P-T-d (deformation) paths combined with four deformation events ($D_1-D_4$). The first loop concomitant with $D_1$ and $D_2$ occurred at $400-500^{\circ}C$, 1.5-3.0 kbar, and related with growth of syn-$D_1$ chloritoid and andalusite, post-$D_1$ margarite, Ca-rich syn-$D_2$ or post-$D_2$ plagioclase. The second loop accompanying $D_3$ and $D_4$ occurred at $520-580^{\circ}C$, 2.0-6.0 kbar, and associated with the growth of syn-$D_3$ garnet and staurolite, and syn-$D_4$ and/or post-$D_4$ andalusite porphyroblasts. Furthermore the syn-$D_1$ chloritoid and andalusite porphyroblasts grew during E-W bulk crustal shortening, whereas the syn-$D_3$ garnet and staurolite, and the syn-$D_4$ and/or post-$D_4$ andalusite porphyroblasts have grown under N-S bulk crustal shortening. The similarity in the characteristics and timing of the metamorphism and bulk crustal shortening directions between the Okcheon and Imjingang belts suggest that the peak metamorphic conditions tend to increase toward the western part (Imjingang belt and southwestern part of the Gyeonggi Massif) from the eastern part (Taebaeksan basin). The E-W bulk crustal shortening influenced the eastern part of the Okcheon belt, whereas the N-S bulk crustal shortening resulted in strong deformation in the Imjingang and Okcheon belts. Consequently, the Permo-Triassic Songrim orogeny in the Korean peninsula is probably not only related to collision of the North and South China blocks, but also to the amalgamation of terrane fragments at the eastern Eurasia margin (e.g., collision of the Sino-Korean continent and the Hida-Oki terrane).

• Journal of Gastric Cancer
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• v.8 no.3
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• pp.129-135
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• 2008

Purpose: The usefulness of serum tumor markers for assessing gastric carcinoma is very limited compared to that for neoplasms in other digestive organs. Many reports have shown that serum tumor markers are closely associated with the prognosis and tumor recurrence in gastric cancer patients. However, little is known about the usefulness of serum tumor markers as a predictor of distant metastasis for gastric carcinoma. Materials and Methods: With excluding the non-specific causes of elevated tumor markers, a total of 788 patients with gastric carcinoma and who were seen at our hospitals between 2004 and 2006 were included in this study. The correlation between the preoperative level of tumor makers and the clinicopathological features was analyzed. Results: CEA was significantly correlated with age, gender and nodal metastasis, but not with the depth of tumor. The CEA level was not correlated with distant metastasis, such as peritoneal or hematogenous metastasis. In contrast, the CA 19-9 level was significantly correlated not only with the depth of tumor and nodal metastasis, but also with peritoneal metastasis. Especially, the patients with over 500% elevation of the CA 19-9 level had a significant risk of peritoneal metastasis. Conclusion: CA 19-9 is useful for predicting peritoneal metastasis in gastric cancer patients. It can be used efficiently in making the diagnostic and the treatment plan, in combination with other diagnostic tools, for gastric cancer patients.

• Journal of Environmental Policy
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• v.8 no.2
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• pp.25-61
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• 2009

These days, environmental policies have changed from being command and control systems toward economic incentive systems, with various incentives having been established by OECD countries. In Korea, many environmental charges have been established in order to diminish activities which damage natural resources. Among them, the Ecosystem Conservation Cooperation Charge and the Replacement Charge for Forest Resources Creation are considered to be representative environmental charges. These charges, along with a few others, were designed to encourage efforts to protect natural resources. The charges include a number of different features, utilize varying methods, and altered ranges of jurisdiction. However, the charges may pose serious inequity problems in terms of their estimated values and their conditions of reduction and exemption. For instance, although the Ecosystem Conservation Cooperation Charge is a primary charge applied to natural resource damage, the charge does not fully secure its original objectives due to its low levy and limited range of provisions. Moreover, the Replacement Charge for Forest Resources Creation has been criticized because of similar reduction and exemption provisions. Therefore, this study analyzes the inequity problems associated with the charges and proposes solutions. First of all, the Ecosystem Conservation Cooperation Charge should be redesigned in such a way that it reflects the substantial value of natural resource damage through either abrogate or increased maximum limits of the charge. With regard to the Replacement Charge for Forest Resources Creation, the cases and ranges of reduction and exemption provisions should be narrowed. Finally, the charges collected should be expended in conformity with their original objectives, and their expenditure should be restricted to either restoration activities or activities directly related to compensation and mitigation of damaged natural resources.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.273-280
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• 2005

Purpose: Cyclin G2 has been reported to be a negative cell-cycle regulator in various cancer tissues. However, the pattern of cyclin G2 expression in gastric cancer is relatively unknown. We investigated the expression of cyclin G2 in gastric cancer tissues and evaluated the clinical significance of its expression. Materials and Methods: Well-preserved gastric cancer tissues were consecutively obtained from 172 patients who underwent gastric cancer operations at Samsung Medical Center between November 1994 and December 1997. Cyclin G2 expression in the tissues was examined immunohistochemically, and the clinicopathological features and prognostic significance according to the expression were analyzed. Results: Of the 172 gastric cancer tissues, cyclin G2 expression was positive in 43 tissues (25.0%). According to the stage, cyclin G2 expression was lower in more advanced stages (P<0.001). Negative expression of cyclin G2 was positively correlated with more advanced depth of tumor invasion (P<0.05), presence of lymph-node metastasis (P<0.05) and presence of lymphatic invasion (P<0.05). The prognosis of the cyclin G2(+) group was significantly better than that of the cyclin G2(-) group (P<0.001). Multivariate analysis revealed that T stage, lymph-node metastasis, distant metastasis, and lymphatic invasion were independent prognostic factors, but the expression of cyclin G2 was not. Conclusion: Cyclin G2 was expressed in 25% of the gastric cancer tissues, and negative expression of cyclin G2 was associated with more advanced tumor progression. Cyclin G2 may be a negative cell-cycle regulator in gastric cancer, and further studies are necessary to elucidate its exact role in the mechanism of carcinogenesis.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.193-199
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• 2007

Purpose: Combined resection of an invaded organ in advanced gastric cancer (AGC) with infiltration of adjacent organs is essential to achieve R0 resection. However, when the tumor invades the head of the pancreas or duodenum, R0 resection interferes with the lower resectability and results in a higher morbidity. Wereviewed these cases retrospectively and considered the proper extent of the surgical resection. Materials and Methods: We retrospectively analyzed cases where patients underwent surgery for gastric adenocarcinoma at the Department of Surgery, Presbyterian Medical Center, between January 1998 and December 2003. Among the 45 patients who were suspected to have pancreatic head or duodenum invasion by a primary tumor or metastatic lymph nodes based on the operative findings, we included 22 patients without incurable factors. The patients were classified into three groups: 4 patients that underwent a combined resection (PD group), 12 patients that underwent a palliative subtotal gastrectomy (STG group) and 6 patients that underwent bypass surgery only (GJ group). We analyzed the clinicopathological features, operative data and results. Results: The patients of the PD group achieved R0 resection by PD with D3 Dissection in all Patients. A pancreatic fistula was observed in one patient (morbidity 25%). There was no surgery-associated mortality (mortality 0%). All patients of the PD group were in stage IV. However, the 2-year survival rate (SR) was 75% and the 5-year SR was 50%. Six patients of the STG group underwent surgery with marginal resection and the other six patients of the STG group had a positive distal resection margin. The 2-year SR was 41.7% and the 5-year SR was 16.7%. Most of the patients of group GJ were of old age (mean age: $72.7{\pm}8.6$ years) or had chronic diseases. The 2-year SR was 0%. Conclusion: Combined resection of the pancreas and duodenum in AGC with pancreatic head invasion is relatively safe with moderate morbidity and a lower mortality. One can expect long-term survival if combined resectionis performed in cases without incurable factors.