• Advances in pediatric surgery
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• v.18 no.2
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• pp.59-67
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• 2012

Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p= 0.032). Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p= 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.65-70
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• 1987

Empyema thoracis following pneumonia, pulmonary tuberculosis, trauma and surgical procedures continues to be a source of major morbidity and mortality. We retrospectively reviewed the hospital records of 330 patients [child:87, adult243] treated for empyema thoracis at Catholic Medical Center between 1964 and 1986. The causes of empyema in these patients were as follows: pneumonia [C***:66%, A***:30%], pulmonary tuberculosis [C:2%, A:20%], lung abscess [C:3%, A:5%], postoperative complication [C:0%, A:13%], trauma [C:1%, A:4%] and unknown origin [C:23%, A:17%]. Three patients in this series died of sepsis from necrotizing pneumonia. Staphylococcus [29.3%], Streptococcus [8.8%], E. coli [8%], Mycobacterium tuberculosis [7.9%], Klebsiella [7.4%], Pseudomonas [6.4%], Bacteroides [3.4%] were the organisms most commonly isolated. Bacterial isolates were single in 68.3%, multiple 7.5% and absent 24.2%. The type of organism did not correlate with severity of disease or eventual requirement for closed thoracotomy drainage, open thoracotomy drainage [Modified Eloesser*s procedure], thoracoplasty, decortication or pleuropneumonectomy. Successful methods of treatment included aspiration in 44%, tube thoracotomy in 66%, open thoracotomy drainage in 98.7%, thoracoplasty in 98%, decortication in 96% and pleuropneumonectomy in 73%. Initial mode of management in empyema thoracis are thoracentesis and closed thoracotomy drainage. If the initial management was failed, we performed another surgical procedures. Before 1973, we manage with Schede`s thoracoplasty in the postpneumonectomy empyema patients. But thoracoplasty, with or without the use of muscle flaps, is a hazardous operation in the poor-risk patients. The permanent, open thoracotomy drainage is a relatively minor operation which is well tolerated even by cachexic, septic patients. It controls infection, and sometimes results in the bronchopleural fistula closing spontaneously.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.627-632
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• 1993

A clinical study was performed on 64 cases of the esophageal diseases experienced at the Department of Thoracic & Cardiovascular Surgery of Kyungpook University Hospital from Jan. 1988 through Dec. 1992. The results were as follows: The most common esophageal disease was cancer which occurred in 37.5% of the total. In esophageal cancer patients, 24 cases were operated on and cancer resection was feasible in 19 cases with 2 cases of hospital death. The overall 1 year survival rate was 41.6% and the most favorable follow up result was revealed in stage I group. Esophageal stricture occurred in 22 cases and its causes were alkali and acid. The most common stricture site was mid-esphagus. Colon interposition was performed on 15 cases. Achalasia occured in 8 cases and was treated with modified Heller`s myotomy. Esophageal perforation occurred in 6 cases and its operative mortality rate was 16.6%. Two patients with congenital bronchoesophageal fistula were treated with surgical division. The first case, which occurred in an adult, is of Braimbridge,s typeII classification. The second one which occured in an child with sequestration, is of Braimbridge,s type IV classification. Diverticulectomy was performed in 1 case of esophageal diverticulum. Enucleation of tumor was performed in 1 case of esophageal leiomyoma.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.339-342
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• 2008

The Korean Health Insurance (KHI) has been introduced since 1977 and it took only 12 years that KHI had accomplished the total coverage of Korean population. The remarkable success of KHI can be compared with other OECD countries which had taken some 30 years to over 100 years to establish the total coverage of the population. Life expectancy at birth and the infant mortality rate in Korea in 2005 both surpassed the average figures of the OECD countries, The main reason for the success of KHI can be delineated with the three characteristics in KHI development; low premiums, low benefits, and low fee-schedule charges. However, these three characteristics of KHI, which had been the key for the rapid development of the system, have become terrible disadvantages for the stable development of KHI. The dissatisfaction and discontent of health care providers are ever increasing. The population is reluctant to pay more premiums though it seems essential for the better care coverage. The health care system has been heavily distorted toward high technology-oriented expensive care. There should be several factors seriously tackled for the secure development of KHI in the future. This paper will review a brief history of KHI development, and I would like to make a suggestion of health insurance for children.

• Clinical and Experimental Pediatrics
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• v.60 no.5
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• pp.129-137
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• 2017

The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.

• Nutrition Research and Practice
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• v.5 no.1
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• pp.3-10
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• 2011

Women's nutrition has received little attention in nutrition programming, even though clinical trials and intervention trials have suggested that dietary improvement or supplementation with several nutrients may improve their health, especially in low-income settings, the main focus of this paper. Most attention so far has focused on how improvements in maternal nutrition can improve health outcomes for infants and young children. Adequate vitamin D and calcium nutrition throughout life may reduce the risk of osteoporosis, and calcium supplementation during pregnancy may reduce preeclampsia and low birth weight. To reduce neural tube defects, additional folic acid and possibly vitamin $B_{12}$ need to be provided to non-deficient women before they know they are pregnant. This is best achieved by fortifying a staple food. It is unclear whether maternal vitamin A supplementation will lead to improved health outcomes for mother or child. Iron, iodine and zinc supplementation are widely needed for deficient women. Multimicronutrient supplementation (MMS) in place of the more common iron-folate supplements given in pregnancy in low-income countries may slightly increase birth weight, but its impact on neonatal mortality and other outcomes is unclear. More sustainable alternative approaches deserve greater research attention.

• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.1
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• pp.15-26
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• 2014

Purpose: The objective of this study was to analyse the content of health-textbooks in elementary school in order to offer the basic data required for development or revision of health-textbook for elementary school. Methods: This study was methodological study of the content of health-textbooks. The study sample consisted of 10 health-textbooks of elementary school which were edited in 2009~2010. The components of contents divides into holistic analysis and specific areas. Results: One textbook was no introductory remarks and 2 textbooks were no preface. The health-textbooks consisted of 7 areas and were comprehensive for school education. The proportion of each was different in 10 textbooks. Sexuality and health was accounted for the largest portion of the seven areas in both the fifth and sixth grade. However, given that the mortality rate for the child's safety accidents is higher than in developed countries, the proportion of accident prevention and first aid can be relatively weak area. Conclusion: It is essential that health-textbooks empower schoolers to make healthy decisions through the promotion of useful life skills that provide a more integrated concept of health. Therefore, there is a need for approaches to health textbook to integrate more values of health.

• Advances in pediatric surgery
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• v.7 no.1
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• pp.26-30
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• 2001

Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6023-6026
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• 2012

The incidence of hepatocellular carcinoma (HCC) in Malaysia for the year 2001 was 2.8 per 100,000 people. The mortality rate is increasing. A retrospective cohort study measuring the survival of HCC patients who received treatment in Selayang Hospital was conducted from 1 January 2003 to 31 December 2006. The main objectives of the study were to measure the survival of the patients and to understand the influencing factors, especially ethnicity. The subjects were newly diagnosed cases of HCC by CT scan and histopathological assessment who underwent futher investigations and treatments in Hospital Selayang (inception cohort). The survival time was measured from the date of diagnosis until the subjects died, or failed to follow-up at the end of the study period (31 December 2007). A total of 299 patients were selected with 95 patients dying, the majority among Chinese (39.1%). Subgroup analysis according to ethnicity proved significantly that Chinese patients who had smaller tumor, less number of nodules, low AFP level, Child Pugh Class A and received surgical treatment had a better median survival rate compared to other ethnic groups. Malay (cHR: 1.3, 95%CI; 0.89-1.85) and Indian (cHR: 1.3, 95%CI; 0.74-2.26) patients had a poor survival compared to Chinese patients, but not in the final model. Therefore ethnicity may play a role in survival of HCC patients, but not as a main hazard prognostic factor.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1767-1769
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• 2014

Purpose: Lung cancer, one of the most frequently diagnosed cancers in the world, is characterized by relatively high morbidity and mortality. Berbamine (BER) has been initially reported to exert anti-proliferative effects against a series of cancers. Methods: In this study the in vitro cytotoxicity of BER was measured by MTT assay. In vivo anti-cancer efficacy of BER was assessed in A549 xenografts. Results: Cytotoxicity tests showed dose-dependent cell growth inhibition effects of BER against A549 cells. Moreover, BER significantly reduced the growth of lung cancer in a dose-dependent manner in nude mice with prolonged survival time. Conclusion: Therefore, BER might be in herbal medicine for cancer therapy and further efforts are needed to explore therapeutic strategies.