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Type 2 Diabetes Mellitus in Children (소아연령에서의 2형 당뇨병의 임상적 고찰)

  • Park, Jee Min;Yoo, Eun Gyong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.646-653
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    • 2002
  • Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

The Prognostic Factors Affecting the Occurrence of Subsequent Unprovoked Seizure in Patients Who Present with Febrile Seizure after 6 Years of Age (6세 이후 열경련 환자의 비열성발작으로 진행되는 위험 인자)

  • Lee, Hyeon Ju;Kim, Seung Hyo
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.215-220
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    • 2018
  • Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.

Factors Affecting the Registration and Access Levels of the Pilot Project for the General Physician System among People with Disabilities (장애인 건강주치의 시범사업 수요자의 등록 및 이용수준 영향 요인 분석)

  • Eunhee Choe;Yeojeong Gu;Seungji Lim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.185-195
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    • 2024
  • Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

Seed Production Studies in Italian Ryegrass ( Lolium multiflorum Lam. Itailcum ) I. Effect of seeding time and seed rates of Italian ryegrass, cv. Tetrone on seed production (이탈리안 라이그라스의 종자생산에 관한 연구. 제1보. 파종기와 파종량이 종자에 미치는 영향)

  • 박병훈;이남종
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.4 no.3
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    • pp.226-234
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    • 1984
  • In order ti find out the optimum seeding time(OST) and optimum seed rate(OSR) of Italian ryegrass on seed production, this studies with tetraploid cv. Tetrone were carried out on the experimental field of Livestock Experiment Station. Treatments included seed rates of 1, 2, 3 and 4 kg per 10a and combined with seeding time on 20, 30 Aug, 9, 19 and 29, September 1983. Seeds were sown in rows 50 cm apart and were spaced in a continuous line with width of 15 cm within the rows. The results are summarized as follows: 1. Autumn tillers could be classified into three groups from winter-killing point of view, namely winter-killing completely, damaged growing point only and living tillers. 2. The young inflorescence-bearing stem in Italian ryegrass which were sown earlier than 9. September were more susceptible to winter killing. Tiller buds in those stems which originated from an axillary buds at the stem base within senescent leaf-sheaths emerged lately in spring, and consequently heading was delayed, culm length shortened and seed yield reduced. 3. Tiller buds which originated from damaged growing point only and living tillers in moderate shoots emerged early in spring and those tillers became mainly spike-bearing culm. 4. The emergence-time of tillers influenced on culm-, spike- length and ripenness more than seeding time and seed rate. 5. Seed yield was mostly affected by the number of spikes per unit area. 6. For the safety of over-wintering and enough spikes on seed production, OST and OSR at Suweon were the last part of September and 2-3 kg per 10a, respectively. Especially OSR was 2 kg per 10a for early and 3 kg per 10a for late OST.

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Parents' Satisfaction on Foodservice Quality of Kindergartens in Chungbuk Province (충북지역 유치원 급식품질에 대한 학부모 만족도)

  • Lee, Joo-Young;Lee, Young-Eun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.613-623
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    • 2010
  • The purpose of this study was to examine parents' perceptions towards the importance and performance levels of foodservices quality at kindergartens. The questionnaire was developed to measure the thirty-one quality attributes of foodservice operations. A questionnaire survey was conducted to 500 parents and the return rates were 62.4%. The survey period was from July 15 to August 8, 2008. The parents had a high level of perception toward the need for foodservice, earning 4.46 points out of 5 point. Their perceptions of foodservice quality were examined by six dimensions of importance and performance level. While the parents gave 4 points or greater of 5 points to most quality attributes of importance level, they gave 4 points or less out of 5 points to most quality attributes of performance level. As for the importance and performance level of the quality dimensions of foodservice, parents regarded sanitation as the most important dimension. IPA showed that 'ventilation', 'sanitation of tableware' and 'sanitation of dining tables and chairs' were included as 'focus' areas. The overall satisfaction level for foodservice was 3.74 out of 5 points A higher level of satisfaction was shown at self-operated foodservice system of kindergartens. According to multiple regression analysis, 46.3% of the variance in the respondents' overall satisfaction scores was explained by factors such as food, menu and price, facilities, sanitation, atmosphere and foodservice effects.

무령왕릉보존에 있어서의 지질공학적 고찰

  • 서만철;최석원;구민호
    • Proceedings of the KSEEG Conference
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    • 2001.05b
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    • pp.42-63
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    • 2001
  • The detail survey on the Songsanri tomb site including the Muryong royal tomb was carried out during the period from May 1 , 1996 to April 30, 1997. A quantitative analysis was tried to find changes of tomb itself since the excavation. Main subjects of the survey are to find out the cause of infiltration of rain water and groundwater into the tomb and the tomb site, monitoring of the movement of tomb structure and safety, removal method of the algae inside the tomb, and air controlling system to solve high humidity condition and dew inside the tomb. For these purposes, detail survery inside and outside the tombs using a electronic distance meter and small airplane, monitoring of temperature and humidity, geophysical exploration including electrical resistivity, geomagnetic, gravity and georadar methods, drilling, measurement of physical and chemical properties of drill core and measurement of groundwater permeability were conducted. We found that the center of the subsurface tomb and the center of soil mound on ground are different 4.5 meter and 5 meter for the 5th tomb and 7th tomb, respectively. The fact has caused unequal stress on the tomb structure. In the 7th tomb (the Muryong royal tomb), 435 bricks were broken out of 6025 bricks in 1972, but 1072 bricks are broken in 1996. The break rate has been increased about 250% for just 24 years. The break rate increased about 290% in the 6th tomb. The situation in 1996 is the result for just 24 years while the situation in 1972 was the result for about 1450 years. Status of breaking of bircks represents that a severe problem is undergoing. The eastern wall of the Muryong royal tomb is moving toward inside the tomb with the rate of 2.95 mm/myr in rainy season and 1.52 mm/myr in dry season. The frontal wall shows biggest movement in the 7th tomb having a rate of 2.05 mm/myr toward the passage way. The 6th tomb shows biggest movement among the three tombs having the rate of 7.44mm/myr and 3.61mm/myr toward east for the high break rate of bricks in the 6th tomb. Georadar section of the shallow soil layer represents several faults in the top soil layer of the 5th tomb and 7th tomb. Raninwater flew through faults tnto the tomb and nearby ground and high water content in nearby ground resulted in low resistance and high humidity inside tombs. High humidity inside tomb made a good condition for algae living with high temperature and moderate light source. The 6th tomb is most severe situation and the 7th tomb is the second in terms of algae living. Artificial change of the tomb environment since the excavation, infiltration of rain water and groundwater into the tombsite and bad drainage system had resulted in dangerous status for the tomb structure. Main cause for many problems including breaking of bricks, movement of tomb walls and algae living is infiltration of rainwater and groundwater into the tomb site. Therefore, protection of the tomb site from high water content should be carried out at first. Waterproofing method includes a cover system over the tomvsith using geotextile, clay layer and geomembrane and a deep trench which is 2 meter down to the base of the 5th tomb at the north of the tomv site. Decrease and balancing of soil weight above the tomb are also needed for the sfety of tomb structures. For the algae living inside tombs, we recommend to spray K101 which developed in this study on the surface of wall and then, exposure to ultraviolet light sources for 24 hours. Air controlling system should be changed to a constant temperature and humidity system for the 6th tomb and the 7th tomb. It seems to much better to place the system at frontal room and to ciculate cold air inside tombs to solve dew problem. Above mentioned preservation methods are suggested to give least changes to tomb site and to solve the most fundmental problems. Repairing should be planned in order and some special cares are needed for the safety of tombs in reparing work. Finally, a monitoring system measuring tilting of tomb walls, water content, groundwater level, temperature and humidity is required to monitor and to evaluate the repairing work.

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The Changes of Pulmonary Function and Systemic Blood Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증후군 환자에서 혈압 및 폐기능의 변화에 관한 연구)

  • Moon, Hwa-Sik;Lee, Sook-Young;Choi, Young-Mee;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.206-217
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    • 1995
  • Background: In patients with obstructive sleep apnea syndrome(OSAS), there are several factors increasing upper airway resistance and there is a predisposition to compromised respiratory function during waking and sleep related to constitutional factors including a tendency to obesity. Several recent studies have suggested a possible relationship between sleep apnea(SA) and systemic hypertension. But the possible pathophysiologic link between SA and hypertension is still unclear. In this study, we have examined the relationship among age, body mass index(BMI), pulmonary function parameters and polysomnographic data in patients with OSAS. And also we tried to know the difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Methods: Patients underwent a full night of polysomnography and measured pulmonary function during waking. OSAS was diagnosed if patients had more than 5 apneas per hour(apnea index, AI). A careful history of previously known or present hypertension was obtained from each patient, and patients with systolic blood pressure $\geq$ 160mmHg and/or diastolic blood pressure $\geq$ 95mmHg were classified as hypertensives. Results: The noctural nadir of arterial oxygen saturation($SaO_2$ nadir) was negatively related to AI and respiratory disturbance index(RDI), and the degree of noctural oxygen desaturation(DOD) was positively related to AI and RDI. BMI contributed to AI, RDI, $SaO_2$ nadir and DOD values. And also BMI contributed to $FEV_1,\;FEV_1/FVC$ and DLco values. There was a correlation between airway resistance(Raw) and AI, and there was a inverse correlation between DLco and DOD. But there was no difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Conclusion: The obesity contributed to the compromised respiratory function and the severity of OSAS. AI and RDI were important factors in the severity of hypoxia during sleep. The measurement of pulmonary function parameters including Raw and DLco may be helpful in the prediction and assessment of OSAS patients. But we could not find clear difference between hypertensive and normotensive OSAS patients.

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TNF-$\alpha$ TGF-$\beta$ and Fibrinolytic Parameters in Tuberculous and Malignant Pleural Effusions (결핵성 및 악성 흉막염에서 TNF-$\alpha$, TGF-$\beta$ 및 섬유소용해계의 역할)

  • Shim, Tae-Sun;Yang, Sung-Eun;Chi, Hyun-Sook;Kim, Mi-Jung;Chung, Hun;JeGal, Yang-Jin;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.149-161
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    • 2000
  • Background : Residual pleural thickening (RPT) develops in about 50% of tuberculous pleurisy ($PL_{TB}$). Some reports have suggested that elevated TNF-$\alpha$ and impaired fibrinolysis could be the cause of RPT, but until now, the mechanism and predictors of RPT have not been well known. TGF-$\beta$ has been known to promote fibrogenesis and is increased in tuberculous pleural fluid (PF). $PL_{TB}$ and malignant pleurisy ($PL_{MAL}$) manifest lymphocyte-dominant exudative pleural effusion, and it has clinical implications in the differentiation of the two diseases based on the findings of pleural effusion. We performed this study to compare pleural fluid TNF-$\alpha$ TGF-$\beta$, and fibrinolytic parameters between $PL_{TB}$ and $PL_{MAL}$, and to find the predictors of RPT in $PL_{TB}$. Methods : Thirty-five $PL_{TB}$ and 14 $PL_{MAL}$ patients who were admitted to the Asan Medical Center from February 1997 to August 1999 were enrolled. All $PL_{TB}$ patients were prescribed a primary, short-course, anti-tuberculosis regimen. INF-$\alpha$ tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), plasminogen, $\alpha$2-antiplasmin, and D-dimer were measured in both PF and PB. TGF-$\beta$was measured only in PF. Clinical characteristics, TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters were compared between patients with RPT less than 2 mm and patients with more than 2 mm of the thirty patients who completed the anti-tuberculosis treatment. Results : The levels of TNF-$\alpha$ tPA, PAI-1, plasminogen, $\alpha$2-antiplasmin, and D-dimer in PF were higher than those in peripheral blood (PB) in $PL_{TB}$, whereas only plasminogen, $\alpha$2-antiplasmin, and D-dimer were higher in PF than in PB in $PL_{MAL}$. Pleural fluid TNF-$\alpha$ TGF-$\beta$, PAI-1, plasminogen, $\alpha$2-antiplasmin were increased in $PL_{TB}$ compared with $PL_{MAL}$, but these factors did not show any further advantages over ADA in differentiation between $PL_{TB}$ and $PL_{MAL}$. TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters did not show any differences between patients with RPT less than 2 mm and patients with RPT more than 2 mm. Conclusion : Our data suggest that TNF-$\alpha$, TGF-$\beta$ and fibrinolytic parameters may play some role for the development of RPT in $PL_{TB}$, but they failed to predict the occurrence of RPT in $PL_{TB}$. Also these parameters did not seem to have any advantages over ADA in differentiating between two diseases.

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Studies on the soybean varieties in Korea. -IV relationships between the seed yields and some characteristics on the several sowing dates- (대두의 품종에 관한 연구 -제4보 파종기별 수량과 제특성과의 관계-)

  • Kwon-Yawl Chang
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.2
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    • pp.30-37
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    • 1964
  • Experiments were carried out to clarify the relationships between seed yields and some ecological characteristics, seed yields and some morphological characteristics, and the relationships among the varietal yields on the several sowing plots when grown under different climatic conditions. Twenty-four soybean varieties were used as the material, selected at random from 138 varieties which were cultivated the year before. These varieties were grown in the Experimental Farm, Chinju Agricultural College, Kyung Sang Namdo, Korea, and seed sowing was conducted at 5 times, from April to July, in 1962 and 1963. The results obtained are summarized as follows: 1. Correlations between seed yields and some ecological characteristics on the sowing date bases are shown in Table 1. Among some ecological characteristics, it was observed that there wert close relationships between seed yields and days to flowering, and between seed yields and the total growing length, except on the late sowing, i.e. July sowing plots, However, there was no clear correlation between seed yields and durations of flowering, and between seed yields and days from flowering to maturity. 2. Correlations between seed yields and some morphological characteristics on the sowing date bases are shown in Table 2. From this table, it was also observed that there were some close relationships between seed yields and branch number for plant, stem diameter, plant weight, pod number per plant, and grain number per plant, but there was no clear relationship between seed yields and stem length, and between seed yields and 100 grain weight, on every sowing plot. 3. Relations between varietal yields and the sowing dates are shown in Table 3. Our leading varieties such as Ulsan, Sangdoo, Changdan Backmok, Iksan, Haman, Barchongdeo, and Anion Daerip, which belong to the maturity groups of IV, V, and VI, have been significantly high in yield at each sowing date plot, but the extreme early varieties, that frequently are damaged by insects, moisture and diseases, and the extreme late varieties, that frequently are caught by frost suffering reduced yield, are showed a lower yield than the others. However, extreme early varieties, for instance, Black Hawk, an American variety, and Chung Buk Baek, a Korean early variety, showed high productivity on the late sowing, June and July sowing plots, and Do san No. 6, which is late Japanese variety, showed a high yield on the extreme early sowing, i.e. April sowing plots. 4. Relations between seed yields and the sowing dates on the varietal bases are shown in Table 4. It was observed that, the early varieties did not differ much in yields at the various sowing dates while the yields of late varieties decreased progressively with subsequent dates. However, the extreme late varieties, such as Tamanishiki, that frequently are caught by frost suffering reduced yield, may be difficult to harvest at this location. The results in these experiments showed that in most cases maximum yields were obtained when leading varieties, which are medium or late varieties, were shown in Mid-May, and progressively lower yields were produced from June and July sowings. On the other hand, the late sowings of the early varieties, such as Black Hawk and Chung Buk Baek, in these experiments showed favorable yields compared with the others. From these results, we can predict that our local medium or late varieties produce higher yields at this location than was produced by early varieties in most of the sowing dates, especially the May sowing, and early varieties such as Black Hawk and Chung Buk Baek should be used in the late sowing, June sowing time.

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A Study on the Measurement of the Pollution Level of Bacteria and Disinfection of Table and IP Cassette (촬영 테이블과 IP Cassette의 세균 오염도 측정 및 소독에 관한 연구)

  • Bae, Seok-Hwan;Lee, Moo-Sik;Lim, Chang-Seon;Kim, Gha-Jung
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.229-237
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    • 2008
  • Purpose : For the number of microbes and the pollution level of bacteriology of IP Cassette and Table by laboratories, after identifying the bacteria before and after using alcohol and tissue including disinfectant and statistically testing, this research was intended to provide the basic data for the prevention and the right disinfection guideline for infection management of hospitals in diagnostic radiology. Subject and Method : The subject of this research was the general room of diagnostic radiology of a university hospital in Daejeon City. The research was conducted from Apr 5 to Apr 12, 2007. The number of microbes and the pollution level of bacteriology of IP Cassette and Table by laboratories were tested before and after using alcohol and tissue for disinfection including disinfectant. In order to collect specimens exactly, they were collected with the nurse who specialized in infection management of the hospital, and statistical processing was done with SPSS V13.0. To compare the results before and after using alcohol and tissue, T-test was implemented, and post-hoc test was conducted. Results : Bacteria were detected in 19 cases of 24 subjects(79.2%), however, they were not detected in 5 cases(20.8%). 7kinds of bacteria were detected as isolated bacteria, of which Methicillin Resistant coagulase-negative Staphylococci(MRCNS) were detected in 15 cases(62.5%), which was most, Methicillin Resistant Staphylococcus Aureus(MRSA) in 6 cases(16.7%), Enterococcus Faecium(EFM) in 5 cases(20.8%), Acinetobacter baumannii(ABA) in 2 cases(8.3%), and Bacillus sp, Coagulase-negative Staphylococci(CNS), and Enterococcus sp(ENT) in 1 case, respectively(4.2%). In all bacteria except ABA, Gram positive bacillia were detected in 30 cases(97%), and Gram negative bacilli were detected only in 1 case(3%). As for the kinds of bacteria and the number of groups before and after using 70% Alcohol by Groups, when the bacteria were identified after disinfecting IP Cassette and Table with 70% Alcohol, all the bacteria became extinct in both IP Cassette and Table Group(100%). As for the kinds and number of bacteria before and after using Tissue Cleaner by Groups, the bacteria in Tissue Cleaner Group became completely extinct only in 10 Groups(71.2%), and in 4 Groups, there was much decrease in bacteria, however, they were still detected. The extinction rate of all the bacteria was 91.5%. That is, though the other bacteria became extinct(100%), that of MRCNS bacteria was lowest(83.6%), followed by MRSA(95%). Conclusion : As a result of comparing the mean of the bacteria which were detected before and after using 70% Alcohol and Tissue Cleaner, there was statistically significant in the significant level of 5% in both of them.

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