The Journal of the Korean bone and joint tumor society
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v.20
no.1
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pp.14-21
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2014
Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.
Purpose : To investigate the signal enhancement ratio by NOE effect on in vivo $^{31}P$ MRS in human heart muscle and liver. we also evaluated the enhancement ratios of different phosphorus metabolites, which are important in 31P MRS for each organ. Materials and Methods : Ten normal subjects (M:F = 8:2, age range = 24-32 yrs) were included for in vivo $^{31}P$ MRS measurements on a 1.5 T whole-body MRI/MRS system using $^1H-^{31}P$ dual tuned surface coil. Two-dimensional Chemical Shift Imaging (2D CSI) pulse sequence for $^{31}P$ MRS was employed in all $^{31}P$ MRS measurements. First, $^{31}P$ MRS performed without NOE effect and then the same 2D CSI data acquisitions were repeated with NOE effect. After postprocessing the MRS raw data in the time domain, the signal enhancements in percent were estimated from the major metabolites. Results : The calculated NOE enhancement for liver $^{31}P$ MRS were $\alpha-ATP\;(7\%),\;\beta-ATP\;(9\%),\;\gamma-ATP\;(17\%),\;Pi\;(1\%),\;PDE\;(19\%)$ and $PME\;(31\%)$. Because there is no creatine kinase activity in liver, PCr signal is absent. For cardiac $^{31}P$ MRS, whole body coil gave better scout images and thus better localization than surface coil. In $^{31}P$cardiac multi-voxel spectra, DPG signal increased from left to right according to the amount of blood included. The calculated enhancement for cardiac $^{31}P$ MRS were : $\alpha-ATP\;(12\%),\;\beta-ATP\;(19\%),\;\gamma-ATP\;(30\%),\;PCr\;(34\%),\;Pi\;(20\%),\;(PDE)\;(51\%),\;and\;DPG\;(72\%)$. Conclusion : Our results revealed that the NOE effect was more pronounced in heart muscle than in liver with different coupling to 1H spin system and thus different heteronuclear cross-relaxation.
This study was conducted to investigate the relationship of development of root and soil condition and also to elucidate the difference between stands for mechanical and physical stability according to distribution of roots in the Norway Spruce (Picea abies [L.] Karst.) stands of 30 to 40 year of ages with different soil condition. In the root structure, remarkably different root pattern was shown among the three stands; Eberg$\ddot{o}$tzen stand showed large number f roots with much fine roots which deeply in vertical direction while Barbis stands had thicker root and small number of root than Eberg$\ddot{o}$tzen stand. The Weidenbrunnen stand showed differently half-vertical and plate root structure and the root developed not to be deeply compared to the other two stands. In the total number of root, Eberg$\ddot{o}$tzen stand had the most number of 74 and Barbis stand 33, Weidenbrunnen stand 57 respectively. Eberg$\ddot{o}$tzen stand had much more number of vertical root with 57 than the other two stand; Barbis 21 and Weidenbrunnen 36. In the total length of root, Weidenbrunnen stand showed to be longer than the other two stands and the length of horizontal root also showed longer. Regarding to the rates of horizontal root against vertical root, Eberg$\ddot{o}$tzen stand showed comparatively higher value as 1,2 than other two stands(0.5). In the total weight of root, Weidenbrunnen stand showed very high value compared with the other stands and ratio of vertical root against horizontal root was 0,16 which is very lower than the other two stands(0,4). The remarkable differences of root pattern of Norway spruce stands appeared in this study are through to be caused more by chemical property of soil such as acidity den the mechanical or physical factor of soil conditions.
This study was conducted to effect a complex fertilizer treatment on a recovery of damaged turfgrass caused by competing with tree at area under trees, and to seek for effective management system on damaged areas under trees in golf courses. Available phosphorous and potassium were enough to grow up turfgrass in plots of East valley and Ji San Golf Club. But these plots were acid soil ranged from pH 5.3 to pH 5.5, so that lime fertilizer was required for improving the chemical of soil. The effect on complex fertilizer showed significant f3r the recovery of damaged turfgrass. Turfgrass recovery ratio by complex fertilizer was better in low-density(LD) section of fertilizer than in high-density(HD) section of control. As the result of surveying turfgrass characters according to dates, dry matters in HD sections of control plots were higher than these in LD sections of fertilizer plots in 6 Aug. before sprinkling a complex fertilizer. But dry matters in LD section of fertilizer were, on the contrary, higher than in 6 Sep. after sprinkling complex fertilizer. In view of the result so far conducted, a turfgrass recovery to LD sections of complex fertilizer was batter than that of HD sections of control. Sprinkling complex fertilizer on turfgrass damaged by competing with trees will maintain the turfgrass growth, even though happen to compete between trees and turfgrass.
Jang, Sun Hwa;Kim, Jae Hui;Yeom, Jung Sook;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
Clinical and Experimental Pediatrics
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v.51
no.8
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pp.848-855
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2008
Purpose : The objective of this study was to ascertain the incidence of congenital heart disease in the western part of Gyeongnam Province in Korea. Methods : We enrolled 849 children (M:F=390:459) who were diagnosed with congenital heart disease (CHD) and received echocardiography during January 1997 to December 2005 in Gyeongsang National University Hospital. The subjects were limited to patients born from 1997 to 2004. The CHDs were classified into acyanotic types and cyanotic type. Further, acyanotic type CHDs were divided into shunt type and valvular types. Results : Numbers of initially diagnosed patients from 1997 to 2004 were as follows: 113, 128, 116, 104, 129, 97, 84, and 78. The median age of initially diagnosed CHD patients was 1 month in the acyanotic type and 0.5 months in cyanotic type. Also, an annual frequency among CHD types and gender ratio were no significant difference in every year. Incidences of CHD from 2000 to 2004 in the western part of Gyeongnam Province were 8.9, 12.7, 10.9, 10.0, and 9.7 per 1,000 live births, respectively. Conclusion : From 1997 to 2001, 100-130, and from 2002 to 2004, less than 100 patients were diagnosed with CHD. This showed a decrease in the numbers of CHD patients in the last three years. However, the Incidence of CHD was 0.89-1.24% during the last five years. Therefore, the decrease in the annual frequency of CHD was due to the recent decline in birth rate in Korea.
Kim, Pil-Geun;Sung, Kyu-Youl;Jang, Young-Nam;Park, Maeng-Eon
Journal of the Mineralogical Society of Korea
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v.19
no.4
s.50
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pp.277-289
/
2006
This study was carried out to find a new material having high removal efficiency for the harmful red tide. C. polykrikoides grow very fast and accumulate into dense and visible patches near the surface of the seawater ('Water bloom'). Some mineral medicines and Hwangto (reddish soil consist of clay minerals and Fe-oxides) were used in this study to remove C. polykrikoides. The pre-determined sprinkling ratio of mineral vs. seawater which contains approximately 5,000 cells/mL of C. polykrikoides was 10 g/L. In order to quantify the removal efficiency, the density of living cells was measured by counting with the Intervals of 0, 10, 30, and 60 minutes after sprinkling. Five Hwangtos feom different localities were examined in this study. It is found that a material with a high concentration of Fe and Al was the most effective to remove C. polykrikoides. After the sprinkling of the Hwangto showing the best removal efficiency in the test, 99% of total algaes were found to be eliminated within 60 minutes. Jeokeokji showed the highest removal efficiency among clay mineral medicines(92% removal efficiency after 60 minutes), and the rests in decreasing order are as follows: Gamto (91%) > Baekseokji (89%) > Hydromica (81%). In addition, Fe-oxide mineral medicine similarly looking as fine-grained earthy Daejaseok showed 100% removal efficiencyafter 30 minutes, and Wooyoeryang, 95% after 60 minutes. It is noted that even little addition (1 g/L) of Daejaseok, 10% of Hwangto concentration into seawater showed the removal efficiency of 100% after 60 minutes. From the results, it could be concluded that the fine-grained earthy Daejaseok was the most effective natural mineral medicine to remove the C. polykrikoides from seawater. Under the microscope the removal mechanism was found to be activated in the following order: adsorption, swelling of chain colony, chain colony crisis and algaecide.
Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.
Kang Byoung-Chul;Ha Il-Soo;Kim In-One;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook
Childhood Kidney Diseases
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v.1
no.2
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pp.101-108
/
1997
Purpose : The clinical characteristics of renovascular hypertension (RVHT) in children were analyzed. Methods : Medical records of 16 children diagnosed as RVHT on the basis of angiography during Jan. '86 to Jun. 94 in our hospital were reviewed retrospectively. Results : The mean age at the onset was 8.5 yrs and the sex ratio(M:F) was 7:9. The causes of RVHT were Takayasu arteritis in 6, Moyamoya disease in 5, and fibromuscular dysplasia in 3 patients. Abdominal bruit was noted in 6 patients (38%). Peripheral renin activity was raised in all tested patients. Bilateral renal arterial involvemnent was found in 9 patients (56%). Captopril renal scans showed good correlation with angiographic findings. Five patients were treated with antihypertensives only, and blood pressure was controlled completely in 2 and incompletely in 3. Percutaneous transluminal angioplasty was performed in 10 patients with 50% of success rate. However, hypertension was recurred due to restenosis or accompaning aortic stenosis in 3 patients. Surgical treatment was performed in 4 patients, and the blood pressure was controlled partially in 1 and poorly in the remaining 3. Conclusions : Takayasu arteritis, Moyamoya disease and fibromuscular dysplasia are the major causes of childhood RVHT in our country. The diagnosis of RVHT in children should be based on a set of tests individually selected for case by case. For the low curability of the current treatment modalities available, RVHT in children should not be regarded as 'curable' so far. We expect, however, that the outcome will be improved by more extensive application of the newly developed surgical technique.
Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.
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