• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.1
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• pp.46-58
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• 1999

Purpose: The aim of the present study was to evaluate the long-term clinical profile including the underlying etioligy and the prognostic factors of the neonatal cholestasis. Method: We studied the 190 infants presented with neonatal cholestasis for the last 12 years (from 1981 to 1992). The underlying causes, clinical findings and long-term outcomes were evaluated. And the prognostic factors were also analyzed. Result: Underlying disease were neonatal hepatitis in 101 (idiopathic in 77 and infectious in 24), intrahepatic bile duct paucity in 5, biliary atresia in 79, choledochal cyst in 5. Metabolic disease was not observed in this study. The important clinical problems during follow-up were persistent high fever, gastrointestinal bleeding, hepatic encephalopathy and ascites. The main causes of the death were hepatic encephalopathy and gastrointestinal bleeding. While three fourth of infants with idiopathic and infectious neonatal hepatitis recovered usually within a year, five-year survival rate for biliary atresia was just 40%, the mortality observed usually within the first year after Kasai operation and prognostic factor was the time of operation. Underlying disease was the most important prognostic factor of neonatal cholestasis. Conclusion: This study showed that most common causes of neonatal cholestasis were biliary atresia and idiopathic neonatal hepatitis, infectious neonatal hepatitis, choledochal cyst and Alagille syndrome, but few neonatal cholestasis of genetic or metabolic liver disease was observed. The most important long-term prognostic factor of neonatal cholestasis was the underlying disease.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.355-361
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• 1993

Since May 1991, authors have conducted a pilot study to determine the feasibility and evaluate the effect of concurrent radiation therapy and chemotherapy with 5-FU and Cis-platinum for locally advanced cervical cancer (stage IIB-IVA). Radiation therapy consisted of external irradiation to whole pelvis (4140 cGy/23 fx) in 4.5 weeks followed by high dose rate intracavitary radiation therapy (HDR ICRT) to deliver a dose of 30 to 35 Gy to A point in 6 to 7 fractions. After the intracavitary radiation therapy, parametrial boost was delivered for B point dose of 60 Gy in Stage IIB and 65 Gy in stage IIIB. 5-FU (1000 $mg/m^2/24hr$ for 96 hour iv infusion) and Cis-platinum (20 $mg/m^2/day$ IV bolus for 3 days) were given during the second week of external RT and the second course chemotherapy administered at the first HDR ICRT with the same method as the first chemotherapy. Sixteen patients (10 stage IIB,4 stage IIIB,2 stage IVA) were registered to this protocol. Among these 16 patients, two refused treatment after 2 fractions of external irradiation, and one could not continue intracavitary irradiation because of treatment related genitourinary toxicity. So 14 patients were evaluated for toxicity and 13 patients were evaluated for response analysis. Five of 14 patients developed grade 3 gastrointestinal toxicity but 4 of them recovered at the completion of treatment. One stage IIIB patient with inguinal lymph node metastasis who received higher dose of radiation in spite of initial poor performance status did not recover from gastrointestinal toxicity at the completion of treatment. And she died of distant metastasis at one month after the completion of treatment. Two of 14 evaluable patients showed weight loss, more than $10\%$ of initial weight. One patient developed grade 3 leukopenia. In this study, the average total treatment period of completely treated patients was 75 days and three of them took more than 80 days (84, 84, 89 days). Toxicities were generally acceptable and there were no treatment related death. At the last follow-up, complete response was achieved in $62\%(8/13)$ and especially of nine patients with stage IIB, eight patients showed complete response. This study suggests that concurrent radiation therapy and chemotherapy (5-FU and Cis-platinum) is tolerable and effective. Further follow-up is needed to determine whether this protocol will have a favorable impact on survival and to evaluate the late effect on normal tissues. In future, prospective randomized trials are needed to compare the standard radiation therapy alone with concurrent chemotherapy and radiation therapy for locally advanced cervical carcinoma.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.82-88
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• 2008

Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.

• The Korean Journal of Pain
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• v.2 no.2
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• pp.135-144
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• 1989

Celiac plexus block is recommended in patients with intractable upper abdominal cancer pain. The success rate of a celiac plexus block is variable among the authors. One of the causes of this is the anatomical variations of the celiac plexus. There has not been a study concerning anatomical observations of the celiac plexus in Korean cadavers. So, anatomical dissections were performed and observations were made of the celiac plexus and related structures in Korean cadavers. The results were as follows: 1) The subjects were 21 male bodies and 5 female bodies. The mean age at death was $69.9{\pm}15.5$ years (range 37~93). The mean height was $155.5{\pm}8.3\;cm$ (range 143~172). 2) The number of celiac ganglia ranged from 1~4. The mean numbers were $2.3{\pm}1.9$ in the right plexus and $1.9{\pm}0.8$ in the left, and the mean sizes were $18.9{\pm}7.7{\times}8.0{\pm}3.8\;mm^2$ and $18.5{\pm}8.3{\times}9.5{\pm}3.9\;mm^2$ respectively. 3) Celiac ganglia were most frequently located at the level of the upper third and middle third of L1 in both sides (65.5% in right, 64.0% in left). The vertical range of celiac ganglia ranged from 1 space, which is one third the height of one vertebral body, to 4 spaces. Mean vertical ranges were $1.5{\pm}0.6$ spaces in the right plexus and $1.6{\pm}0.7$ spaces in the left. The celiac ganglia located at the level of the upper third of L1 in the right and the lower third of L1 in the left side, had the largest vertical ranges respectively ($1.8{\pm}0.5$ spaces in right, $2.3{\pm}0.6$ spaces in left) 4) Right side celiac ganglia were located near the midline of the vertebrae compared to the left ones (mean 5.0 mm) The horizontal dimension was greater in the right ganglia ($24.2{\pm}9.2\;mm$) than in the left ganglia ($l8.8{\pm}7.0\;mm$). 5) There was no vertebral level difference between both celiac ganglia in most cases (60%). However, of the 40% of cases at different levels, in half of these (20%) the right ganglia were located higher than the left ganglia; and in the other 20%, this was reversed. 6) The origin sites of the celiac artery were most frequently in the upper third and middle third of L1 (61.6%). The celiac ganglia were usually located at the same level as the site of origin of the celiac artery (61.6% in right, 52.0% in left). 7) The vertebral level of the splanchnic nerves piercing the abdominal surface of the diaphragm was most frequently in the upper third and middle third of L1 (66.6% in right, 66.7% in left). 8) The level of the origin of diaphragmatic crura from the anterior surface of the vertebral bodies varied from the L1-L2 interspace to the L3-L4 interspace. Right crura most frequently originated at the level of the lower third of L2 to the upper third of L3 (57.6%), while left crura originated from the level of the L2-L3 interspace to the middle third of L3 (69.3%). From the above results, we realized that there were some anatomical variations of the celiac plexus and its relations to adjacent structures in Korean bodies. However, when the needle point is behind the anterior margin of the upper third of L1, it is possible to perform a successful retrocrural splanchnic nerve block.

• Journal of The Korean Society of Grassland and Forage Science
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• v.3 no.2
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• pp.67-76
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• 1983

This experiment was carried out to investigate the effects of the different nitrogen rates and cutting heights on the dead stubble after cutting, and the carbohydrate reserved in stubble of sorghum-sudangrass hybrid (Sorghum bicolor (L.) Moench) Pioneer 988. The experiment was undertaken in the Experimental Livestock Farm of Agriculture Coll., Seoul Nat'l Univ. In Suweon, 1981 and 1982. The results obtained are summarized as follows: 1. The dead stubble after cutting was found to be great with high rate of nitrogen fertilizer and low cutting height. It was also learned that the rainfall during forage cutting period made the dead stubble increased. 2. A significant higher (p<0.05) carbohydrate reserves in the stubble was observed in the high stubble height at the first cutting time and 6th through 7th day after the first cutting. The results indicate that the high stubble height reserves more carbohydrate for the early regrwoth stage after the first cutting when comparing with the low stubble. 3. The content of carbohydrate reserves was influenced by climete. Drought is caused to high content of carbohydrate, whereas, rain is caused to low content of that. The critical soluble carbohydrate content causing the death of stubble supposed to be 3 to 6% at least. 4. It is suggest that carbohydrate reserves in plant do not play a distinctive role for the regrowth in a summer annual forage like sorghum-sudangrass hybrid, but it might be rather influenced by the other factors, for example, environmental conditions at harvest and new bud.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.5 no.1
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• pp.33-43
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• 2005

Purpose: X-linked adrenoleukodystrophy(ALD) is a rare disorder that shows a great deal of phenotypic variability. We subdivided chidhood X-linked ALD patients into several phenotypes by the age at onset, the sites of most severe clinical involvement and the rate of progression of neurologic symptoms. Methods: Thirteen patients who had been diagnosed as X-linked ALD and followed up for at least one year were enrolled from 1996 to 2003. Results: 1. Ten had childhood cerebral ALD, who showed first neurologic symptoms at 7.02 years and progressed rapidly: interval between first symptoms and vegetative state was 1.35 years, and interval from initial symptoms to death was 3.35 years. Treatment with Lorenzo's oil did not prevent neurologic progression. Two patients who underwent umbilical cord blood transplantation died. 2. Two had adolescent cerebral ALD. They had first symptoms at 11.5 years, and showed tendency to progress less rapidly than childhood cerebral form patients. 3. One "Addison only" patient who had adrenal insufficiency without nervous system involvement remained asymptomatic during Lorenzo's oil treatment. 4. All cerebral form patients except one showed the lesions in both parieto-ocipital white matter in brain magnetic resonance imaging. Conclusion: The cerebral ALD was the most common form in childhood and was asoociated with a serious prognosis.

• Tuberculosis and Respiratory Diseases
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• v.64 no.6
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• pp.445-450
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• 2008

Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

• Korean journal of applied entomology
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• v.41 no.4
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• pp.269-277
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• 2002

Ecological studies on entomopathogenic nematodes are required to increase control efficacy against target insect pests and to obtain basic information for mass production. Thus, effect of temperature and nematode concentration on infectivity and reproduction of Steinernema carpocapsae Pocheon and that of exposure time and soil depth on infectivity were examined using Galleria mellonella larvae. Infectivity and reproduction were examined at five temperatures, 13, 18, 24, 30 and 35$^{\circ}C$ with seven concentrations, 0, 5, 10, 20, 40, 80 and 160 infective juveniles (IJs)/larva. Temperature and nematode concentration influenced infectivity and reproduction of S. carpocapsae Pocheon. Although G. mellonella larvae were killed by S. carpocapsae Pocheon at all given temperatures and nematode concentrations, mortality was higher at 24$^{\circ}C$ than other temperatures. Lethal time of G. mellonella by S. carpocapsae Pocheon was shorter with increasing temperature and nematode concentrations. S. carpocapsae Pocheon was not established in G. mellonella at 13 and $35^{\circ}C$. Time for the first emergence from G. mellonella cadaver was longer $18^{\circ}C$ (about 20 days) than 24 and $30^{\circ}C$ (about 5 days). The highest number of progenies was obtained at $24^{\circ}C$ with 80IJs/1arva, i.e., $18.8$\times$10^4$IJs were produced from a larva. In the exposure time assay, G. mellonella death was recorded in 10 minutes when 300 IJs were inoculated per larva. When S. carpocapsae Pocheon was inoculated at the rate of $10^{9}$ IJs/ha to G. mellonella at the depth of 0, 2, 5 and 10 cm of sand columns, 100% mortality and similar sex ratio were observed but number of established IJs in cadaver was decreased with deepening the soil depth. The results indicated that optimum temperature for infectivity and reproduction of S. carpocapsae Pocheon was $24^{\circ}C$ In addition, S. carpocapsae Pocheon was effective to target insects within 5 cm from the soil surface.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.8
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• pp.960-964
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• 2007

This study was performed to examine the toxicity of Psoralea corylifolia L. by the single-dose oral toxicity tests in rat and bacterial reverse mutation assay. In single-dose oral toxicity tests, 5 mL ethanol extract of P. corylifolia L. were directly injected into 10 rats (5 males and 5 females) at a dosage of 2 g/kg. Death practice was not detected during breeding periods (14 days), and $LD_{50}$ was calculated over 2 g/kg. No difference were observed with control group in the growth rate and histological observations. In bacterial reverse mutation assay, his(-) Salmonella Typhimurium TA98, TA100, TA1535, TA1537 and trp(-) Escherichia coli WP2uvrA (pKM101) were used for assessing the toxicity of ethanol extracts of P. corylifolia L.. No significant difference in formation of the colonies and no dose-dependent increase was observed regardless of the addition of S9 mix. The results showed that ethanol extracts of P. corylifolia L. did not have single-dose oral toxicity and mutagenic toxicity.

• Korean journal of applied entomology
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• v.47 no.2
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• pp.155-162
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• 2008

The Welsh onion beet armyworm, Spodoptera exigua (Hubner), has attacked Welsh onion and is now the most important pest of Welsh onion in southwestern Korea. The beet armyworm has a wide host range, occurring as a serious pest of vegetable and fields. The relatively high abundance of beet armyworm has stimulated frequent application of insecticides to foliage. Insecticide resistance is a major problem in management of this insect. Accordingly, pesticide application for the control of beet armyworm was tried in both the open field and in laboratory, using 4 synthetic compounds such as metaflumizone and chlorfenapyr, indoxacarb, flufenoxuron, emamectin benzoate. In the laboratory, each developmental stages from eggs, larva to pupa was tested against 4 insecticides. Against the eggs of welsh onion beet armyworm, there was no significantly different with each other. These tested chemicals no killing effect to eggs. However, the population of 1st larva hatched from eggs were reduced because they eaten the egg shell with residual insecticides. The tested insecticides were taken very high mortalities to 1st to 3rd larva of Welsh onion beet armyworm. Otherwise, there were decreased the death rate from 4th to 6th larva. On the other hand, their value of control effects were relatively good against Welsh onion beet armyworms in the field between 87.2 and 90.5% on 10 days after insecticide application.