• Tuberculosis and Respiratory Diseases
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• v.38 no.3
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• pp.236-244
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• 1991

The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway, its treatment needs such special measures as steroid therapy, surgical intervention and/or laser therapy, but the therapeutic result is often disappointing. To exploit a new treatment modality for bronchial stenosis, balloon dilatation was carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under fluoroscopic guide in two others. Endobronchial tuberculoses were subdivided into two(16.7%) with actively caseating type, seven (58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four (57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with actively-caseating type and three with stenotic type without fibrosis) were improved with this method. $FEV_{1.0}$ or FVC increased 10% or more after procedure in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of twelve, in whom follow-up examination was done after the procedure. Balloon dilatation of bronchial stenosis is more effective, when endobronchial tuberculosis is in active stage than in healed fibrotic stage. It is suggested that bronchial stenosis can be minimized by early diagnosis and early application of balloon dilatation in the course of disease.

• Journal of Genetic Medicine
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• v.6 no.1
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• pp.81-86
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• 2009

Multiple epiphyseal dysplasia (MED) is a clinically and genetically heterogeneous chondroplasia, characterized by delayed development of the ossification centers and, deformities of the extremities that involve only the epiphysis and result in mild short stature. Mutations in the cartilage oligomeric matrix protein (COMP) gene are most commonly found, and most of the mutations are located in the calmodulin-like repeats and the C-terminal domain. We report a Korean kindred of 12 family members with MED in four generations who were found to have a novel mutation in the COMP gene. A pedigree showed early onset osteoarthritis requiring arthroplasty that was an autosomal dominant inherited trait. Radiological examinations demonstrated the presence of osteochondral defects in the medial femoral condyles, and the knee and hip joints showed variable degrees of precocious degenerative changes. Mutation analysis of the COMP gene in the proband and five other affected family members identified a novel missense mutation, c.1280G>C (p.Gly427Ala) in exon 12, which was not found in three unaffected family members. Direct sequencing of the COMP gene may yield pathogenic mutations in dominantly inherited MED cases, and may provide opportunities of carrier detection among high-risk family members, leading to genetic counseling for early diagnosis and intervention before the onset of complications.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.63-67
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• 2000

Purpose: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. Methods: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. Results: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. Conclusion: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5385-5388
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• 2015

Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.1
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• pp.79-86
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• 2016

Objectives The purpose of this study was to compare the effects of MSAT (Motion style acupuncture treatment) using Sandbag regarding low back pain with HIVD of L-SPINE. Methods Forty patients received inpatient treatment from March 16 to May 16, 2015 in the Daejon-Jaseng oriental medicine hospital were divided into 2 groups by blocked randomization: Group A (n=20) is routine treatment on HIVD of L-SPINE with MSAT using Sandbag and Group B (n=20) is routine treatment on HIVD of L-SPINE (acupuncture, Shinbaro pharmacopuncture, herb medication, chuna treatment and physiotherapy). The MSAT (Motion style acupuncture treatment) using Sandbag was administered each day and both groups were received routine treatment each day. Evaluations were made before treatment, after 3 days and 7 days, and before discharge using the NRS (numeric rating scale) and ODI (oswestry disability index). The statistically significance was evaluated by SPSS 22.0 for windows. Results The NRS (numeric rating scale) and ODI (oswestry disability index) of both A and B groups after 3, 7 days and before discharge of treatment significantly decreased (p<0.05). Regarding group comparison, the NRS (numeric rating scale) and ODI (oswestry disability index) of A group was significantly lower than the B group at 3, 7 days, before discharge (p<0.05). Regarding improvement of the NRS (numeric rating scale) and ODI (oswestry disability index), A group was significantly lower than the B group at 3 day (NRS), 7 day (ODI) (p<0.05). There was significant difference between two groups at 7 days (NRS) and before discharge (p<0.05). Conclusions Compared to routine treatment, the MSAT (Mostion style acuputure treatment) using Sandbag significantly improved the NRS (numeric rating scale) and ODI (oswestry disability index) after 3, 7 days, and before discharge. Because early intervention determines the grade of Low back pain with HIVD of L-SPINE, the MSAT (Motion style acupuncture treatment) using Sandbag will be clinically helpful to patients at the early stage.

• Journal of Music and Human Behavior
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• v.11 no.1
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• pp.21-37
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• 2014

The significant role of joint attention in the development of children with autism spectrum disorder (ASD) has highlighted the importance of early intervention. With the emphasis on the effective cueing and reinforcer for orienting to social stimuli in improving responding to joint attention (RJA) of children with ASD, the use of musical cue was hypothesized. This study aimed to examine the occurrence of RJA behaviors depending on the attentional cue, which differed in the level of information and type of auditory modality. Nine children with ASD participated in this study. The use of eight different joint attention cues were analyzed in terms of the frequency and accuracy of RJA behaviors elicited. The results of the study showed that RJA behaviors occurred more frequently with musical cues than with verbal cues and the mean accuracy rate of RJA was higher with musical cues (p = .047). Musically delivered eliciting and directing cues accompanied with pointing elicited the highest attentional shift and RJA accuracy. The significant increases in RJA with the use of musical cues indicated that incorporating musical elements into an attentional cue may provide more accurate cue information, enough to improve RJA behaviors of children with autism.

• The Journal of the Korea Contents Association
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• v.16 no.12
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• pp.132-142
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• 2016

The study aimed to examine the state of visual acuity tests in preschoolers and determine the factors affecting the deterioration of their vision. A total of 172 pair, child aged 5-7 years and either one of their parents, were recruited from childcare centers or kindergarten between August 2015 and January 2016. Questionnaires were administered to the parents, and the children's visual acuities were measured. Using forward selection in logistics regression analysis, factors affecting vision deterioration were elucidated. Of 172 children, 128 (74.4%) had undergone a visual acuity test previously and 77 (44.8%) showed a deterioration in their vision. Children who had undergone their first visual acuity test after the age of 7 years (OR=7.425, CI=2.844- 19.385) and showed more abnormal eye symptoms, such as squinting or tilting the head to see or falling down frequently (OR=3.084, CI=1.202-7.914) and whose age was younger (OR=10.335, CI=3.252-32.848), were more likely to develop deterioration of vision. Children who had a posture such that they looked up at the computer monitor from below (OR=.075, CI=.022-.255), were less likely to show deterioration of vision. It can be inferred that early visual acuity tests is essential to detect deteriorated vision of preschoolers. Therefore, it is necessary to educate parents, personnels in day care center, and health clinics about the importance of early visual acuity tests and close observation of specific behaviors related to vision deterioration. Development of precautionary intervention program of vision deterioration in preschoolers and examination of its effects are needed.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.1008-1018
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• 1996

Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recwrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.2
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• pp.87-94
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• 2010

Objectives : This study was aimed at investigating the relationship between internet game addiction and emotional and behavioral characteristics of students both in the 5th and 6th grade of elementary school and in middle school. Methods : Two elementary schools and two middle schools were chosen to participate. The students completed selfreport questionnaires designed by the authors, called the Internet Game Addiction Scale, Korean youth self-report (K-YSR). Results : Compared to previous studies, the rates of those in the obvious game addiction group were much lower in this study. We defined the upper 10% of internet game addiction scores as a high risk user group and the lower 10% as a control group. There were significant differences between the groups with respect to the the ages at which internet gaming began, the frequency of game play per week, and the average length of each game playing session. Significant associations were also found between the level of internet game addiction and the withdrawn and delinquency subscales of the K-YSR. However, the association between game addiction and the withdrawn subscale was found only in middle school students. Conclusion : The findings from this study suggested that withdrawn and delinquent behaviors could be predictors of internet game addiction. Results also suggested the importance of early childhood intervention for preventing the development of more severe psychopathology in early adolescence.

• Journal of Cadastre & Land InformatiX
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• v.50 no.1
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• pp.201-214
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• 2020

This study aimed to early detect damaged trees by pine wilt disease using the vegetation indices of UAV images. The location data of 193 pine wilt disease trees were constructed through field surveys and vegetation index analyses of NDVI, GNDVI, NDRE and SAVI were performed using multi-spectral UAV images at the same time. K-Means algorithm was adopted to classify damaged trees and confusion matrix was used to compare and analyze the classification accuracy. The results of the study are summarized as follows. First, the overall accuracy of the classification was analyzed in order of NDVI (88.04%, Kappa coefficient 0.76) > GNDVI (86.01%, Kappa coefficient 0.72) > NDRE (77.35%, Kappa coefficient 0.55) > SAVI (76.84%, Kappa coefficient 0.54) and showed the highest accuracy of NDVI. Second, K-Means unsupervised classification method using NDVI or GNDVI is possible to some extent to find out the damaged trees. In particular, this technique is to help early detection of damaged trees due to its intensive operation, low user intervention and relatively simple analysis process. In the future, it is expected that the utilization of time series images or the application of deep learning techniques will increase the accuracy of classification.