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The Photocatalytic Degradation of Humic Acid by TiO2 Sol-Gel Coating -Characterization of Humic Acid in the Chemical Oxidation Treatment (II)- (TiO2 졸-겔 코팅 막에 의한 Humic Acid의 광분해 -화학적 산화법에 의한 부식산의 분해처리 기술에 관한 연구 (II)-)

  • Seok, Sang Il;Ahn, Bok Yeop;Suh, Tae Soo;Rhee, Dong Seok
    • Journal of Korean Society of Environmental Engineers
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    • v.22 no.4
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    • pp.765-773
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    • 2000
  • The degradation of humic acid using $TiO_2$ coatings was studied, $TiO_2$ coatings were prepared by dip-coating method. Sol solutions for coating were prepared by mixing the gel, which can be produced by the reaction of $TiOCl_2$ and $NH_4OH$ solution, and hydrogen peroxide solution, and hydrolysis of titanium tetraisopropoxide (TTIP). It was shown from XRD that coatings from sol aged at $100^{\circ}C$ for 18h with titanium peroxo solution were crystallized to anatase in the range of temperatures of $25^{\circ}C$ to $500^{\circ}C$. In contrast, those coated from TTIP were crystallized to anatase at temperature above $400^{\circ}C$. So the sols originated from $TiCl_4$ can be applied for not only on the heat-resistance substrates but on the plastic substrates. Thickness and the quality of the films were dependent on the withdrawing speed, the concentration of sol, and the number of coating. The films showed various interference colors depending on the thickness of them. In the case that the films coated 2 times at withdrawing speed of 2.5cm per minute by 0.2M sol, the films had a transparent light blue color with thickness of around 50nm. It was known from the result of photo-degradation by $TiO_2$ coatings using humic acid that the removal efficiency of $COD_{cr}$ was over 85% after illumination of $UV/H_2O_2$ for 40min. and that of UV/VIS absorbable materials was over 95%.

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PROPAGATION OF GRASS CARP AND SILVIR CARP, 1971 (초어 및 백련의 종묘 생산에 관한 연구, 1971)

  • KIM In-Bae;PAIk Eui In
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.4 no.3_4
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    • pp.113-120
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    • 1971
  • In 1971, about 150,000 fingerlings of grass and silver carps were produced and distributed from the Fishculture Laboratory of Pusan fisheries College. The adults Were those transplanted from Japan in 1963. Findings during the process of this production are summarized as following : 1. Brood fish must be handled with a great care during the catching, hormone injection and maturity inspection so as the fish are not injured, otherwise, the eggs would not mature perfectly. Scale fall also affects significantly. 2. The amount of pituitary to be injected is preferable to be 2 to 3 times or more in donor's body weight to obtain good results. 3. The eggs should be spawned or stripped and inseminated as soon as mature. If the spawning is delayed the eggs become overmature and the hatching rate decreases significantly. 4. The water once used for the incubation of eggs should not be reused. The eggs under hatching process were melted away when water once used for incubation was reused. 5. A great care must be paid to keep water in quality when the net cage culture system is employed for raising fry or early fingerlings of Chinese carps. The best method to keep water in quality is to supply water in the cage continuously through a pipe or hose. 6. Heavy outbreaks of Spirogyra occured when clear well water was supplied into the cage, and a great number of fry or fingerlings were trapped or entangled resulting in a significant decrease of fish under rearing. It was prevented when moderately bloom-ed pond water was supplied into the cage. 7. Silver carp fry are usually captured and transported in the cool season because they can not be handled in the warm season owing to a high mortality, but cage cultured small size fingerlings ranging from 1.5 to 2 cm in total length are easily handled and transported even in the hot summer season, thus it enables the fish farmers to start growing them one season earlier.

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Polymerization of dual cured composites by different thickness (두께에 따른 이중 중합형 복합레진의 중합)

  • Kim, Yun-Ju;Jin, Myoung-Uk;Kim, Sung-Kyo;Kwon, Tae-Yub;Kim, Young-Kyung
    • Restorative Dentistry and Endodontics
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    • v.33 no.3
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    • pp.169-176
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    • 2008
  • The purpose of this study was to evaluate the effect of thickness, filling methods and curing methods on the polymerization of dual cured core materials by means of microhardness test. Two dual cured core materials, MultiCore Flow (Ivoclar Vivadent AG, Schaan, Liechtenstein) and Bis-Core (Bisco Inc., Schaumburg, IL, USA) were used in this study. 2 mm (bulky filled), 4 mm (bulky filled), 6 mm (bulky and incrementally filled) and 8 mm (bulky and incrementally filled)-thickness specimens were prepared with light cure or self cure mode. After storage at $37{\circ}C$ for 24 hours, the Knoop hardness values (KHN) of top and bottom surfaces were measured and the microhardness ratio of top and bottom surfaces was calculated. The data were analyzed using one-way ANOVA and Scheffe multiple comparison test, with ${\alpha}$= 0.05. The effect of thickness on the polymerization of dual cured composites showed material specific results. In 2, 4 and 6 mm groups, the KHN of two materials were not affected by thickness. However, in 8 mm group of MultiCore Flow, the KHN of the bottom surface was lower than those of other groups (p < 0.05). The effect of filling methods on the polymerization of dual cured composites was different by their thickness or materials. In 6 mm thickness, there was no significant difference between bulk and incremental filling groups. In 8 mm thickness, Bis-Core showed no significant difference between groups. However, in MultiCore Flow, the microhardness ratio of bulk filling group was lower than that of incremental filling group (p < 0.05). The effect of curing methods on the polymerization of dual cured composites showed material specific results. In Bis-Core, the KHN of dual cured group were higher than those of self cured group at both surfaces (p < 0.05). However, in MultiCore Flow, the results were not similar at both surfaces. At the top surface, dual cured group showed higher KHN than that of self cured group (p < 0.05). However, in the bottom surface, dual cured group showed lower value than that of self cured group (p < 0.05).

Yongdoseo(龍圖墅) and Guimunwon(龜文園) which Applied a Sangsu(象數) Principle on Garden Composition (상수(象數) 원리를 정원구성에 적용한 용도서(龍圖墅)와 귀문원(龜文園))

  • Hong, Hyoung-Soon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.2
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    • pp.119-129
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    • 2012
  • Yongdoseo and Guimunwon are described in "Bokgeo(卜居, fixabode)" of "Sanlimkyengje(山林經濟)" written by Manseon Hong. This record is a unique garden conceptual idea applying the principles of Hetu(河圖) and Luoshu(洛書), fanciful gardens which have not been actually constructed. Here, two garden types were concretely described respectively, however the underlying meaning therein cannot be apprehended without exact understanding about Sangsu studies. Therefore, the purpose of this study is to illuminate the meaning contained in Garden illustration and the historical meaning of landscape therein through considering this text. To achieve the purpose of this study, the writer and the compiler who are the background of this writing and the outline of Sangsu studies were investigated. Also, the principles of Saengsu(生數), Seongsu(成數), Yin Yang(陰陽), Four Bodies(四象), Palgwedo(八卦圖), etc. which are in Hetu and Luoshu were considered. The result of this study went through this research process is summarized as follows. First, Hetu Luoshu are conceptual definitions which wholly abstracted the basic propositions of Sangsu philosophy such as the universe change principle, etc., while Yongdoseo and Guimunwon can be said to be operational definitions which apply those as garden composition principle, enabling to experience the meaning contained therein concretely and explain it in a replicable way. This attempt is a unique example, unprecedented in Chinaas well. Second, as a livingspace, garden was selected as a means to concretize operational definitions about the meaning of Hetu Luoshu, and as the property to reproduce the bearings concept, the location and the number, etc. of Hetu Luoshu, Taegukjeong(太極亭), Shipjagak(十字閣), Dondae(墩臺), well, pond as well as various kinds of trees were used. Third, the main motif of Yongdoseo and Guimunwon is the relation between Apriority(先天) and Posterior(後天), and the relation between Constitution(體) and Use(用) of Hetu and Luoshu respectively. That is, Yongdoseo planted evergreen trees such as Shipjangcheong(十長靑) in order to symbolize the universe creation principle which Hetu stands for, i.e. silent, harmonious, orderly and win-win image. In Guimunwon, flowering trees(花木) and fruit trees(果木) were planted freely to express the change of Posterior which Luoshu stands for, thatis, dynamic, disharmonious, disorderly, incompatible(相剋) and changing image. The effects intended to be attained through such planting were, 'freshness and cheerfulness(淸爽)' of Yongdoseo and 'splendidness' of Guimunwon respectively. Sangsu studies based on Hetu and Luoshu is a unique thinking system to the Orient which came from the accumulated wisdom of several scholars from various schools through a long period since ancient times. Therefore, the concept and the theory thereof are profound and huge, and its viewpoints of interpretation are diverse. It is a limit of this study that more in-depth and various consideration was not performed. As a further research project, more empirical study of Orientalism such as Sangsu studies, etc. inherent in Traditional Garden is necessary.

Interpretation of Soil Catena for Agricultural Soils derived from Sedimentary Rocks (퇴적암 유래 농경지 토양에 대한 카테나 해석)

  • SONN, Yeon-Kyu;LEE, Dong-Sung;KIM, Keun-Tae;HYUN, Byung-Keun;JUN, Hye-Weon;JEON, Sang-Ho
    • Journal of the Korean Association of Geographic Information Studies
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    • v.20 no.4
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    • pp.1-14
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    • 2017
  • In Korea, the soil series derived from sedimentary rocks are classified into seven soil series of coarse loamy soil such as Dain, Danbug, Dongam, Imdong, Jeomgog, Maryeong, and Yonggog; seventeen soil series of fine loamy soil such as Angye, Anmi, Banho, Bigog, Deoggog, Dogye, Dojeon, Gamgog, Gugog, Jincheon, Maji, Mungyeong, Oggye, Samam, Yanggog, Yeongwol, and Yulgog; six soil series of fine silty soil such as Goryeong, Bonggog, Juggog, Gyeongsan, Yuga, and Yugog; and four soil series of clayey soil such as Mitan, Pyeongan, Pyeongjeon, and Uji. All thirty-four soil series have different drainage rates and topography. However, the soil texture depends on the parent rock. The buffer functions in GIS (Geographic Information System) techniques were used to calculate adjacent soil series from a soil series. The length of the adjacent soil series was adjusted because a side of the buffer area was one meter long. The cluster analysis was conducted using the CCC (Cubic Clustering Criterion) method, in which the number of clusters is calculated based on the individual soil series ratio. Soil survey has been carried out since 1964 as "The reconnaissance soil survey", and 1:5,000 detailed soil survey was completed in 1999 with a five-years plan in Korea. Today, all the soil survey information has been computerized. GIS techniques were used to establish a digital soil map; however, there have not been any studies to interpret pedogenesis using the GIS technique. In this study, the area of the adjacent soil series were obtained using the GIS technique. The area of the adjacent soil series can be calculated based on the information area. The similarities of soil originated from sedimentary rocks were estimated using the length. As a result, the distribution of grain size was different based on the types of sedimentary rocks and the location. The clusters were distinguished into limestone, sandstone, and shale. In addition, the soil derived from shale was divided into red shale and gray shale. This means that quantitative interpretation of the catena and this established method can be used to interpret the relationship between soil series.

Numerical Analysis of Unstable Combustion Flows in Normal Injection Supersonic Combustor with a Cavity (공동이 있는 수직 분사 초음속 연소기 내의 불안정 연소유동 해석)

  • Jeong-Yeol Choi;Vigor Yang
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2003.05a
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    • pp.91-93
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    • 2003
  • A comprehensive numerical study is carried out to investigate for the understanding of the flow evolution and flame development in a supersonic combustor with normal injection of ncumally injecting hydrogen in airsupersonic flows. The formulation treats the complete conservation equations of mass, momentum, energy, and species concentration for a multi-component chemically reacting system. For the numerical simulation of supersonic combustion, multi-species Navier-Stokes equations and detailed chemistry of H2-Air is considered. It also accommodates a finite-rate chemical kinetics mechanism of hydrogen-air combustion GRI-Mech. 2.11[1], which consists of nine species and twenty-five reaction steps. Turbulence closure is achieved by means of a k-two-equation model (2). The governing equations are spatially discretized using a finite-volume approach, and temporally integrated by means of a second-order accurate implicit scheme (3-5).The supersonic combustor consists of a flat channel of 10 cm height and a fuel-injection slit of 0.1 cm width located at 10 cm downstream of the inlet. A cavity of 5 cm height and 20 cm width is installed at 15 cm downstream of the injection slit. A total of 936160 grids are used for the main-combustor flow passage, and 159161 grids for the cavity. The grids are clustered in the flow direction near the fuel injector and cavity, as well as in the vertical direction near the bottom wall. The no-slip and adiabatic conditions are assumed throughout the entire wall boundary. As a specific example, the inflow Mach number is assumed to be 3, and the temperature and pressure are 600 K and 0.1 MPa, respectively. Gaseous hydrogen at a temperature of 151.5 K is injected normal to the wall from a choked injector.A series of calculations were carried out by varying the fuel injection pressure from 0.5 to 1.5MPa. This amounts to changing the fuel mass flow rate or the overall equivalence ratio for different operating regimes. Figure 1 shows the instantaneous temperature fields in the supersonic combustor at four different conditions. The dark blue region represents the hot burned gases. At the fuel injection pressure of 0.5 MPa, the flame is stably anchored, but the flow field exhibits a high-amplitude oscillation. At the fuel injection pressure of 1.0 MPa, the Mach reflection occurs ahead of the injector. The interaction between the incoming air and the injection flow becomes much more complex, and the fuel/air mixing is strongly enhanced. The Mach reflection oscillates and results in a strong fluctuation in the combustor wall pressure. At the fuel injection pressure of 1.5MPa, the flow inside the combustor becomes nearly choked and the Mach reflection is displaced forward. The leading shock wave moves slowly toward the inlet, and eventually causes the combustor-upstart due to the thermal choking. The cavity appears to play a secondary role in driving the flow unsteadiness, in spite of its influence on the fuel/air mixing and flame evolution. Further investigation is necessary on this issue. The present study features detailed resolution of the flow and flame dynamics in the combustor, which was not typically available in most of the previous works. In particular, the oscillatory flow characteristics are captured at a scale sufficient to identify the underlying physical mechanisms. Much of the flow unsteadiness is not related to the cavity, but rather to the intrinsic unsteadiness in the flowfield, as also shown experimentally by Ben-Yakar et al. [6], The interactions between the unsteady flow and flame evolution may cause a large excursion of flow oscillation. The work appears to be the first of its kind in the numerical study of combustion oscillations in a supersonic combustor, although a similar phenomenon was previously reported experimentally. A more comprehensive discussion will be given in the final paper presented at the colloquium.

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THE PREVALENCE OF CLEFT LIP AND/OR CLEFT PALATE IN KOREAN MALE ADULT (한국인 성인 남자에게 구순열 및 구개열의 유병률에 관한 연구)

  • Baik, Hyoung-Seon;Keem, Jae-Hoon;Kim, Dong-Jun
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.63-69
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    • 2001
  • Cleft lip and/or palate(CLP) is the most common congenital deformity in the craniofacial region. For a practical public health system for these patients it is necessary to have an understanding on the prevalence of CLP. However, it was difficult to estimate the exact number of CLP patients due to problems in sample selection, higher miscarriage and still birth rate, difficulty in classification, and adoptions to foreign countries. Therefore this study was to estimate the prevalence of CLP and the rate of orthodontic treatment, which is usually necessary in cleft lip and/or palate patients. The samples consisted of 218,322 Korean male adults from Seoul, Kwangju, Taegu and Pusan, all born in 1979. The screening method for recognizing the CLP patients was proceeded in steps and the results are as follows. 1. The prevalence of cleft lip and/or palate in Korean male adults born in 1979 was 0.65 out of the 1000 samples. 2. In the anteroposterior aspect of the 1000 samples, the prevalence of cleft lip, cleft lip and palate, and cleft palate was 0.26, 0.36 and 0.03 respectively. 3. In the transverse aspect of the 1000 samples, the prevalence of left, right and bilateral cleft was 0.35, 0.16, 0.12 respectively. The cleft in the left showed a much higher prevalence than in the rirht, while bilateral cleft showed a lower prevalence than unilateral cleft. 4. The orthodontic treatment rate of Korean male adults among cleft lip and/or palate Patients was $35\%$, and it was in the order of cleft lip and Palate, cleft lip, and cleft Palate, being $67\%,\;29\%\;and\;29\%$ respectively. The orthodontic treatment rate in patients with the more severe cleft lip and palate was higher than in patients solely having cleft lip or cleft palate.

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THE EFFECT OF LOW DIETARY CALCIUM AND IRRADIATION ON MANDIBLE IN RATS (저칼슘식이와 방사선조사가 백서 악골에 미치는 영향의 실험적 연구)

  • Lee Sun-Ki;Lee Sang-Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.2
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    • pp.229-250
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    • 1993
  • This study was performed to investigate the morphological and structural changes of bone tissues and the effects of irradiation on the mandibular bodies of rats which were fed low calcium diets. In order to carry out this experiment, 160 seven-week old Sprague-Dawley strain rats weighing about 150 gm were selected and equally divided into one normal diet group of 80 rats and one low calcium diet group with the remainder. These groups were then subdivided into two groups, 40 were assigned rats for each subdivided group, exposed to radiation. The Group 1 was composed of forty non-irradiated rats with normal diet, Group 2 of forty irradiated rats with normal diet, Group 3 forty non-irradiated rats with low calcium diet, and Group 4 forty irradiated rats with low calcium diet. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-50 teletherapy unit. The rats with normal and low calcium diet groups were serially terminated by ten on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandible were removed and fixed with 10% neutral formalin. The bone density of mandibular body was measured by use of bone mineral densitometer(Model DPX -alpha, Lunar Corp., U.SA). Triga Mark ill nuclear reactor in Korea Atomic Research Institute was used for neutron activation and then calcium contents of mandibular body were measured by using a 4096 multichannel analyzer (EG and G ORTEC 919 MCA, U.SA). Also the mandibular body was radiographed with a soft X-ray apparatus(Hitex Co., Ltd., Japan). Thereafter, the obtained microradiograms were observed by a light microscope and were used for the morphometric analysis using a image analyzer(Leco 2001 System, Leco Co., Canada). The morphometric analysis was performed for parameters such as the total area, the bone area, the inner and outer perimeters of the bone. The obtained results were as follows: 1. In the morphometric analysis, total area and outer perimeter of the mandibular bodies of Group 3 were a little smaller than that of Group 1. The mean bone width and bone area were much smaller than that of Group 1 and the inner perimeter of Group 3 was much longer than that of Group 1. The total area and outer perimeter of Group 2 and Group 4 showed little difference. The mean bone width and bone area of Group 4 were smaller than that of Group 2 and the inner perimeter of Group 4 was longer than that of Group 2. 2. The remarkable decreases of the number and thickness of trabeculae and also the resorption of endosteal surface of cortical bone could be seen in the microradiogram of Group 3, Group 4 since the 3rd day of experiment. On the 21st day of experiment, the above findings could be more clearly seen in Group 4 than in Group 3. 3. The bone mineral density of Group 3 was lesser than that of Group 1 and the bone mineral density of Group 4 was lesser than that of Group 2 on the 7th, 14th, 21st days. The irradiation caused the bone mineral density to be decreased regardless of diet. In the case of Groups with low calcium diet, the bone mineral density was much decreased on the 21st day than on the 3rd day of experiment. 4. The calcium content in mandible of Group 3 was smaller than that of Group 1 throughout the experiment. roup 4 showed the least amount of calcium content. The irradiation caused the calcium content to be decreased regardless of diet. In the case of Groups with low calcium diet, the calcium content was much decreased on the 21st day than on the 3rd day of experiment. In conclusion, the present study demonstrated that morphological changs and decrease of bone mass due to resorption of bone by low calcium diet, and that the resorption of bone could be found in the spongeous bone and endosteal surface of cortical bone. So the problem of resorption of bone must be considered when the old and the postmenopausal women are taken radiotherapy because the irradiation seems to be accelerated the resorption of osteoporotic bone.

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LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA (국내에서 제작된 고정성 보철물의 수명과 실패 요인 및 양상)

  • Shin Woo-Jin;Jeon Young-Sik;Lee Keun-Woo;Lee Ho-Yong;Han Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.158-175
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    • 2005
  • Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.

Choledochal Cyst in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담관낭종 -대한소아외과학회회원 대상 전국조사-)

  • Choi, Kum-Ja;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.J.;Park, K.W.;Park, W.H.;Park, J.Y.;Paek, H.K.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Park, Y.S.;Lee, T.H.;Chung, S.Y.
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • A nationwide survey on choledochal cyst was undertaken among 39 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the five year period of 1997 to 2001. Three hundred and forty eight patients were registered from 32 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:3.4. The age of patients on diagnosis was $49.0{\pm}44.4$ months. The geographic distribution was 34.8% in Seoul and Kyoungki-do, 33.3% in Kyoungsang-do, 17.9% in Cholla-do, and 8.5% in Choongchung-do, in order of frequency. The three common clinical presentations were abdominal pain (63.8%), vomiting (35.3%), and jaundice (29.1%). Only seven patients (2%) presented with classic triad, and 25 patients were diagnosed by antenatal ultrasonographic examination. According to the Todani Classification, 238 patients (7l.3%) were type 1, 3 (0.9%) type 11, and 93 (27.8%) type IV. At the time of the operation, three important associated conditions were choledocholithiasis in 45 patients (15.1%), liver fibrosis (Grade 1-4) in 35, and previous operative procedure for biliary diseases in 10. Associated anomalies were observed in 13 patients (3.8%). Three hundred thirty nine (98.8%) of 343 lesions were treated by Cyst excision and Roux-Y hepaticoiejunostomy. One hundred seventy-six patients had an anomalous arrangement of the pancreatobiliary ductal system (APBD): APBD was not in 92 patients, biliary duct joined to the pancreatic duct in 51, and pancreatic duct joined to the biliary duct in 26. There were 8.5% early, and 7.7% late phase operative complications. The major complications were bleeding, anastomotic leakage, and acute pancreatitis. The combination of acute abdomen and choledochal cyst may suggest spontaneous rupture. Because of the development of late intrahepatic bile duct stones, long term follow up after cyst excision and hepaticojejunostomy is required. The optimal time of surgical intervention should also be considered in the situation of routine use of antenatal ultrasonographic examination. This is the first review of the choledochal cyst in Korea and provides baseline data for future comparisons.

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