• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.140-148
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• 2005

Purpose : To characterize the epidemiology and clinical features of invasive pneumococcal infections in Korean children. Methods : One hundred ninety four cases of invasive pneumococcal infections diagnosed at the Seoul National University Children's Hospital from October 1985 to December 2003 were analysed retrospectively. All isolates were screened for resistance to penicillin by oxacillin disc diffusion test. Serotypes were determined for 125 isolates. Results : The types of infection were bacteremia without focus 84/194(43%), meningitis 36/194(19%), pneumonia with bacteremia 36/194(19%), peritonitis 24/194(12%), other focal infections 3/194(2%). Fifty seven percent(110/194) of the episodes developed in the immunocompromised and 20%(37/194) were nosocomially acquired. The patients younger than 2 years of age was 60% in the immunocompetent patients and 25% in the immunocompromised patients. The overall case fatality rate was 7%. All the isolates by 1988 were susceptible to penicillin screened by oxacillin disk. Penicillin resistance was first detected in 1989(20%), and then increased rapidly; 89% in 1995, 69% in 1996, and 80~100% thereafter. The seven most frequently isolated serotypes were 23F, 19F, 14, 6B, 6A, 9V and 19A, which accounted for 70% of total isolates. Conclusion : S. pneumoniaeis an important cause of morbidity and mortality in children. Invasive infections caused by S. pneumoniae most often occurred in infants and young children, while they are frequent in older immunocompromised children as well. This is the largest case series on invasive pneumococcal infections in Korean children.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.174-180
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• 2014

Purpose: This study was performed to assess the clinical and epidemiological changes after the introduction of the rotavirus vaccine in Korea, as well as to determine the efficacy of the rotavirus vaccine among hospitalized rotaviral gastroenteritis patients over the past two years. Methods: We analyzed yearly and seasonal patterns of 1,165 inpatients who were hospitalized for rotaviral gastroenteritis under the age of 5 years between 2006 and 2013. We also conducted a survey among 460 gastroenteritis patients who were hospitalized between 2012 and 2013 regarding the rotavirus vaccination and the symptoms of gastroenteritis. Among those individuals surveyed, clinical indices were analyzed for 124 patients who were tested positive for the rotavirus antigen. Results: The incidence of Rotaviral gastroenteritis have decreased significantly by year 2010. After the introduction and widespread dissemination of the rotavirus vaccine, the onset of the disease and the seasonal peak have been delayed. Overall, the vaccinated group showed a lower rate of positivity than the unvaccinated group. Among the hospitalized rotaviral gastroenteritis patients, the vaccinated group had a shorter hospitalization period, less severe clinical symptoms of gastroenteritis, and better laboratory test results. Conclusions: After introduction of the rotavirus vaccine in Korea, there were two main trends observed: 1) the overall level of disease incidence was reduced; 2) the severity of rotaviral gastroenteritis cases also decreased. Based on this data, more children should receive vaccination in order to prevent the rotavirus infection and decrease the severity of rotaviral gastroenteritis.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.261-267
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• 2017

The study has attempted to evaluate and compare the image evaluation and exposure dose by respectively applying filter back projection (FBP), the existing test method, and adaptive statistical iterative reconstruction (ASIR) with different values of tube voltage during the low dose computed tomography (LDCT). With the image reconstruction method as basis, chest phantom was utilized with the FBP and ASIR set at 10%, 20% respectively, and the change of tube voltage (100 kVp, 120 kVp). For image evaluation, back ground noise, signal-noise ratio (SNR) and contrast-noise ratio (CNR) were measured, and, for dose assessment, CTDIvol and DLP were measured respectively. In terms of image evaluation, there was significant difference in ascending aorta (AA) SNR and inpraspinatus muscle (IM) SNR with the different amount of tube voltage (p < 0.05). In terms of CTDIvol, the measured values with the same tube voltage of 120 kVp were 2.6 mGy with no-ASIR and 2.17 mGy with 20%-ASIR respectively, decreased by 0.43 mGy, and the values with 100 kVp were 1.61 mGy with no-ASIR and 1.34 mGy with 20%-ASIR, decreased by 0.27 mGy. In terms of DLP, the measured values with 120 kVp were $103.21mGy{\cdot}cm$ with no-ASIR and $85.94mGy{\cdot}cm$ with 20%-ASIR, decreased by $17.27mGy{\cdot}cm$ (about 16.7%), and the values with 100 kVp were $63.84mGy{\cdot}cm$ with no-ASIR and $53.25mGy{\cdot}cm$ with 20%-ASIR, a decrease by $10.62mGy{\cdot}cm$ (about 16.7%). At lower tube voltage, the rate of dose significantly decreased, but the negative effects on image evaluation was shown due to the increase of noise.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.110-115
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• 2006

Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.64-70
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• 2009

Purpose: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. Materials and Methods: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/$m^2$). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/$m^2$) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. Results: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. Conclusion: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.

• Journal of the Korean Wood Science and Technology
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• v.13 no.2
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• pp.14-34
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• 1985

One of the techniques for altering the properties of wood that has received considerable attention in the last twenty years is the formation of a wood-polymer composite (WPC) by irradiation and heat-catalyst polymerization of a monomer incorporated into the wood matrix. Wood-polymer composites are the new products having the superior mechanical and physical properties and the combinated characteristics of wood and plastic. The purpose of this experiment was to obtain the basic data for the improvement of wooden materials by manufacturing WPC and Staypak. The species examined was Hyunsasi-Namoo (Populus alba ${\times}$ P. glandulosa) which had not been utilized yet. Methylmethacrylate (MMA) as monomer, benzoyl peroxide (BPO) as initiator and methyl alcohol as bulking agent were used. The monomer containing BPO was impregnated into wood pieces by the dipping and the vacuum process for 2 hours. After impregnation, the treated samples were polymerized on the hot press with pressure and heat-catalyst methods. The results obtained were summarized as follows 1. The monomer loading into wood by the dipping process was 12.13 percent and 29.99 percent by the vacuum. The polymer loading into wood by the dipping process was 6.79 percent and 15.44 percent by the vacuum. 2. Comparing with Staypak, antishrink efficiency (ASE) of WPC was 12.5 to 13.6 percent on the radial direction and 14.70 to 18.63 percent on the tangential. Antiswelling efficiency (AE) was 14.40 to 17.22 percent on the radial direction and 17.18 to 42.1 8 to 42.14 percent on the tangential. Reduction in water absorptivity (RWA) was 8.19 to 15.5 percent. As a whole, the vacuum process was better than the dipping. 3. The specific gravity of control, Staypak and WPC were 0.44, 0.66 and 0.61 to 0.62, respectively. 4. In the bending strength test, the strength in case that the load direction is on the radial surface was greater than that which the load direction is on the tangential. 5. Increasing rate of stress at proportional limit in compression perpendicular to grain was 72.26 percent in case of WPC by the dipping process, 78.93 percent by the vacuum and 99.09 percent in case of Staypak.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.267-273
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• 2002

Background: We performed a phase IV clinical trial to examine the usefulness of a continuous infusion of nicardipine hydrochloride to control hypertension in patients with acute aortic dissection. material and Method: Systolic/diastolic blood pressure, and heart rate were monitored before and after the intravenous administration of nicardipine in 31 patients with aortic diseases. The period of nicardipine administration in each patient was from 3 to 14 days. Efficacy was evaluated by determining the average amount of blood pressure reduction on the 3rd day of drug administration. The dosage of another antihypertensive agent was slowly tapered down, and ultimately replaced by the test drug. Result: 28 patients were diagnosed as acute aortic dissection, 2 patients as rupture of the aortic arch aneurysm, and 1 patient as traumatic aortic rupture. Mean age was 53.9 $\pm$ 14.9(29~89) years, and 21 patients(67.7%) were male. 14 patients(32.3%) had complications associated with underlying aortic disease: aortic insufficiency in 7, hemopericardium in 6, acute renal failure in 1, paraplegia in 1, lower extremity ischemia in 1, and hemothorax in 1. The time needed to reach the target blood pressure was within 15 minutes in 16, from 15 to 30 minutes in 10, from 30 to 45 minutes in 3 and from 45 to 60 minutes in 2, and their baseline average systolic, diastolic, and mean arterial blood pressures(mmHg) were 147$\pm$23, 82.3$\pm$ 18.6, and 104 $\pm$ 18, respectively. Average systolic, diastolic, and mean arterial blood pressures(mmHg) on the third day of nicardipine infusion were 119$\pm$ 12, 69$\pm$9, and 86$\pm$8, and they all showed statistically significant decrease(p<0.05). The average systolic, diastolic, and mean arterial blood pressure(mmHg) after the discontinuation of the nicardipine infusion were 119 $\pm$ 15, 71 $\pm$ 14, and 86$\pm$ 13, respectively. No significant difference was observed between the average pressures measured on the third day and those measured after the discontinuation of the nicardipine infusion, and no definite side effects were observed during the study period. Conclusion: Nicardipine hydrochloride was both effective and safe at controlling blood pressure in patients with acute aortic dissection.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.131-136
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• 1997

The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prosnosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively: The results were as follows : 1. Serum triiodothyronine(73) reached to its nadir(30.05 $\pm$ 17.5ng/dl, p(0.001) at 10 minutes after the start of CPB and remained low(p(0.05) throughout the study period. 2. Serum thyroxine(74) concentr tion slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(W4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37 $\pm$ 0.81u1U/m1, p(0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum 73 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum 73 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.465-473
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• 2004

Purpose : The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. Materials and methods : Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNF-Adenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. Results : Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was $-53.66{\pm}13.43$ which was the best among three groups. The threshold of compound action potential was between 800 to $1000{\mu}A$ in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. Conclusion : BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.152-155
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• 2009

Purpose: The most widely accepted tool for follow up management of thyroid cancer patients is serum thyroglobulin (Tg) measurement, but its value is limited by the interference of anti-thyroglobulin antibodies (anti-Tg Ab). Recently thyroglobulin measurement in the wash out of fine-needle aspiration biopsy specimens (Tg-FNAB) is frequently used for differential diagnosis of recurrences/metastases. The aim of this study was the investigation of the diagnostic utility of Tg-FNAB compared with serum Tg. Materials and Methods: We enrolled 41 consecutive patients with thyroid cancer who were evaluated for Tg-FNAB between January 2007 and February 2008 retrospectively. We ruled out 6 patients who anti-Tg Ab positive (${\geq}$100 U/mL) in the RIA (BRAHMS anti-Tgn RIA 100Det; BRAHMS Aktiengesell schaft, Berlin, Germany). Serum Tg and Tg-FNAB were measured by immunoradiometric assay (BRAHMS Tg pluS RIA 100 Det; BRAHMS Aktienge sellschaft, Berlin, Germany). We evaluated for Tg-FNAB compared with serum Tg and corresponding cytological smear. To compare the values of the two the t-test was used. Results: Tg-FNAB values were significantly higher (median 1,060 ng/mL, range 0.2~434,000 ng/mL) than serum Tg (median 2.5 ng/mL, range 0.9~131 ng/mL) (p=0.0394). The rate of correspondence with Tg-FNAB between cytological result was 87.9% and 65.9% in the case of serum Tg. Tg-FNAB was positive in 28 (24 with positive and 4 with suspicious cytology). Of the remaining 13 patients with negative Tg-FNAB, 1 had suspicious and 12 had unsuspicious cytology. serum Tg was positive in 26 (17 with positive and 3 with suspicious and 6 with unsuspicious cytology), Of the remaining 15 patients with negative serum Tg, 8 was positive in cytological result and 1 had suspicious and 6 had unsuspicious cytology. Conclusions: Tg-FNAB measurement is more accurate with high sensitivity (87.9%) than serum Tg (65.9%). The Tg-FNAB was a useful predictor for detecting recurrences/metastases with serum Tg.