• Title/Summary/Keyword: 지속 가능

Search Result 7,450, Processing Time 0.037 seconds

The National Survey of Acute Respiratory Distress Syndrome in Korea (급성호흡곤란증후군의 전국 실태조사 보고)

  • Scientific Subcommittee for National Survey of Acute Respiratory Distress Syndrome in Korean Academy of Tuberculosis and Respiratory Disease
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.1
    • /
    • pp.25-43
    • /
    • 1997
  • Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (${\pm}17.2$ years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (${\pm}13.1$ days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, $Pa0_2$, $PaCO_2$, $Sa0_2$, alveolar-arterial oxygen differences, $PaO_2/FIO_2$, and PEEP/$FI0_2$ between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

  • PDF

Study on the Effect of Deep Fertilization on Paddy Field - Efficiency of Ball Complex Fertilizer Mixed with Zeolite - (수도(水稻)에 대(對)한 심층추비효과(深層追肥効果)에 관(關)한 연구(硏究) - Zeolite 첨가(添加) Ball complex 비료(肥料)의 비효(肥効) -)

  • Kim, Tai-Soon;U., Zang-Kual
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.10 no.1
    • /
    • pp.61-67
    • /
    • 1977
  • A study was conducted in order to compare the topdressing method of the conventional fertilizers as control and the deep application method of the ball complex fertilizer newly developed. The ball complex fertilizer consisted of 5% of nitrogen, 5% of phosphorus, and 7% of potassium. Basal application of nitrogen for the rice plant was the same for both control plots and ball complex plots. One ball complex fertilizer per four hills was applied at depth of 12~13cm 35days before heading stage while control plot received three times topdressing at different growth stages as usual practice. The results obtained were as follows. 1. The ball complex fertilizer applied in the soil was continuously utilized by the rice plants until harvest time while nitrogen and potassium uptake of control plots was reduced rapidly after heading stage. Daily uptake of nitrogen and potassium per hill at maturing stage were 0.45mg and 0.68mg in control plots, but 4.80mg and 7.0mg respectively in ball complex plots. 2. Dry matter productivity of the rice plant in control plots, well coinciding with nutrients uptake pattern, was maximum just after heading stage decreased at maturing stage. But dry matter productivity in ball complex plots was much higher at maturing stage than at heading stage. 3. Ball complex application increased effective tillering rate, causing higher panicle number per hill. 4. Ball complex application brought about 528kg/10a of hulled grain yield while the conventional practice 423kg/10a. 5. Deep application of ball complex was superior to usual practice in terms of yield components such as panicle number per hill, filled grain number per panicle, maturing rate, and 1,000 grain weight. 6. From the morphological characteristics point of view, the deep application of ball complex made the flag leaf and the 2nd leaf heavier, larger and broader as compared to control treatment. 7. It is considered that by applying the ball complex fertilizer at depth of 12~13cm sufficient amount of nitrogen and potassium could be utilized by rice plants during the maturing stage and assimilated in the leaf blade, consequently making the flag leaf and the 2nd leaf bigger and healthier. The fact can easily explain that the ball complex plots had higher capacity of photosynthesis, less discoloration of lower leaves, bigger leaf area index, and better grain yield as compared to the conventional practice. In conclusion the deep application method of the ball complex fertilizer was superior to the routine topdressing method of the usual fertilizers.

  • PDF

A Study on Foreign Air Operator Certificate in light of the Convention on International Civil Aviation (시카고협약체계에서의 외국 항공사에 대한 운항증명제도 연구)

  • Lee, Koo-Hee
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.30 no.1
    • /
    • pp.31-64
    • /
    • 2015
  • The Chicago Convention and Annexes have become the basis of aviation safety regulations for every contracting state. Generally, aviation safety regulations refer to the SARPs provided in the Annexes of the Chicago Convention. In order to properly reflect international aviation safety regulations, constant studies of the aviation fields are of paramount importance. Treaties duly concluded and promulgated under the Constitution and the generally recognized rules of international law shall have the same effect as the domestic laws of the Republic of Korea. Each contracting state to the Chicago Convention should meet ICAO SARPs about AOC and FAOC. According to ICAO SARPs, Civil Aviation Authorities shall issue AOC to air carriers of the state, but don't require to issue for foreign air carrier. However some contracting states of the Chicago Convention issue FAOC and/or Operations Specifications for the foreign operators. This FAOC is being expanded from USA to the other contracting states. Foreign operators have doubly burden to implement AOC of the ICAO SARPs because FAOC is an additional requirement other than that prescribed by the ICAO SARPs In Article 33, the Chicago Convention stipulates that each contracting state shall recognize the validity of the certificates of airworthiness and licenses issued by other contracting states as long as they are equal to or above the minimum standards of the ICAO. In ICAO Annex 6, each contracting state shall recognize as valid an air operator certificate issued by another contracting state, provided that the requirements under which the certificate was issued are at least equal to the applicable Standards specified in this Annex. States shall establish a programme with procedures for the surveillance of operations in their territory by a foreign operator and for taking appropriate action when necessary to preserve safety. Consequently, it is submitted that the unilateral action of the states issuing the FAOC to the foreign air carriers of other states is against the Convention. Hence, I make some proposals on the FAOC as an example of comprehensive problem solving after comparative study with ICAO SARPs and the contracting state's regulations. Some issues must be improved and I have made amendment proposals to meet ICAO SARPs and to strengthen aviation development. Operators should be approved by FAOC at most 190 if all states require FAOC. Hence, it is highly recommended to eliminate the FAOC or reduce the restrictions it imposes. In certain compliance-related issues, delayed process shall not be permitted to flight operations. In addition, it is necessary for the ICAO to provide more unified and standardized guidelines in order to avoid confusion or bias regarding the arbitrary expansion of the FAOC. For all the issue mentioned above, I have studied the ICAO SARPs and some state's regulation regarding FAOC, and suggested some proposals on the FAOC as an example of comprehensive problem solving. I hope that this paper is 1) to help understanding about the international issue, 2) to help the improvement of korean aviation regulations, 3) to help compliance with international standards and to contribute to the promotion of aviation safety, in addition.

Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake (어린이집 조리종사자 대상의 나트륨 저감화 행동변화단계에 따른 영양지식, 식태도, 식행동, 자아효능감 비교)

  • Ahn, Yun;Kim, Kyung Won;Kim, Kyungmin;Pyun, Jinwon;Yeo, Ikhyun;Nam, Kisun
    • Journal of Nutrition and Health
    • /
    • v.48 no.5
    • /
    • pp.429-440
    • /
    • 2015
  • Purpose: The purpose of this study was to examine sodium-related nutrition knowledge, eating attitudes, eating behaviors, and self-efficacy by stages of behavioral change in reducing sodium intake among childcare center foodservice employees. Methods: Subjects (n = 333) were categorized according to two groups based on the stages of change; Pre-action stage (PA group: precontemplation/contemplation/preparation stage), Action stage (A group: action/maintenance stage). Results: A major source of sodium-related nutrition information was TV/radio (56.6%) and only 166 people (49.8%) have experienced nutrition education specific to sodium. Although the A group showed slightly higher scores for nutrition knowledge than the PA group, the difference was not significant. The percentages of correct answers for 'daily goal of sodium intake for adults (27.0%)', 'calculation of sodium content in nutrition labeling (30.3%)' were low for both groups. The A group (total score: 40.3) had more desirable eating attitudes regarding reducing sodium intake than the PA group (36.6, p < 0.001). The total score for eating behaviors was slightly higher in the A group (49.6) than in the PA group (48.5), but without statistical significance. The A group (total score: 58.2) also received higher scores for self-efficacy regarding reducing sodium intake than the PA group (52.5, p < 0.001). Conclusion: This study suggests that nutrition education for childcare center foodservice employees should be expanded and customized education should be implemented according to the stages in reducing sodium intake. It is also suggested that food companies make efforts to develop low-sodium products.

The Pattern Analysis of Financial Distress for Non-audited Firms using Data Mining (데이터마이닝 기법을 활용한 비외감기업의 부실화 유형 분석)

  • Lee, Su Hyun;Park, Jung Min;Lee, Hyoung Yong
    • Journal of Intelligence and Information Systems
    • /
    • v.21 no.4
    • /
    • pp.111-131
    • /
    • 2015
  • There are only a handful number of research conducted on pattern analysis of corporate distress as compared with research for bankruptcy prediction. The few that exists mainly focus on audited firms because financial data collection is easier for these firms. But in reality, corporate financial distress is a far more common and critical phenomenon for non-audited firms which are mainly comprised of small and medium sized firms. The purpose of this paper is to classify non-audited firms under distress according to their financial ratio using data mining; Self-Organizing Map (SOM). SOM is a type of artificial neural network that is trained using unsupervised learning to produce a lower dimensional discretized representation of the input space of the training samples, called a map. SOM is different from other artificial neural networks as it applies competitive learning as opposed to error-correction learning such as backpropagation with gradient descent, and in the sense that it uses a neighborhood function to preserve the topological properties of the input space. It is one of the popular and successful clustering algorithm. In this study, we classify types of financial distress firms, specially, non-audited firms. In the empirical test, we collect 10 financial ratios of 100 non-audited firms under distress in 2004 for the previous two years (2002 and 2003). Using these financial ratios and the SOM algorithm, five distinct patterns were distinguished. In pattern 1, financial distress was very serious in almost all financial ratios. 12% of the firms are included in these patterns. In pattern 2, financial distress was weak in almost financial ratios. 14% of the firms are included in pattern 2. In pattern 3, growth ratio was the worst among all patterns. It is speculated that the firms of this pattern may be under distress due to severe competition in their industries. Approximately 30% of the firms fell into this group. In pattern 4, the growth ratio was higher than any other pattern but the cash ratio and profitability ratio were not at the level of the growth ratio. It is concluded that the firms of this pattern were under distress in pursuit of expanding their business. About 25% of the firms were in this pattern. Last, pattern 5 encompassed very solvent firms. Perhaps firms of this pattern were distressed due to a bad short-term strategic decision or due to problems with the enterpriser of the firms. Approximately 18% of the firms were under this pattern. This study has the academic and empirical contribution. In the perspectives of the academic contribution, non-audited companies that tend to be easily bankrupt and have the unstructured or easily manipulated financial data are classified by the data mining technology (Self-Organizing Map) rather than big sized audited firms that have the well prepared and reliable financial data. In the perspectives of the empirical one, even though the financial data of the non-audited firms are conducted to analyze, it is useful for find out the first order symptom of financial distress, which makes us to forecast the prediction of bankruptcy of the firms and to manage the early warning and alert signal. These are the academic and empirical contribution of this study. The limitation of this research is to analyze only 100 corporates due to the difficulty of collecting the financial data of the non-audited firms, which make us to be hard to proceed to the analysis by the category or size difference. Also, non-financial qualitative data is crucial for the analysis of bankruptcy. Thus, the non-financial qualitative factor is taken into account for the next study. This study sheds some light on the non-audited small and medium sized firms' distress prediction in the future.

Analysis and Implication on the International Regulations related to Unmanned Aircraft -with emphasis on ICAO, U.S.A., Germany, Australia- (세계 무인항공기 운용 관련 규제 분석과 시사점 - ICAO, 미국, 독일, 호주를 중심으로 -)

  • Kim, Dong-Uk;Kim, Ji-Hoon;Kim, Sung-Mi;Kwon, Ky-Beom
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.32 no.1
    • /
    • pp.225-285
    • /
    • 2017
  • In regard to the regulations related to the RPA(Remotely Piloted Aircraft), which is sometimes called in other countries as UA(Unmanned Aircraft), ICAO stipulates the regulations in the 'RPAS manual (2015)' in detail based on the 'Chicago Convention' in 1944, and enacts provisions for the Rules of UAS or RPAS. Other contries stipulates them such as the Federal Airline Rules (14 CFR), Public Law (112-95) in the United States, the Air Transport Act, Air Transport Order, Air Transport Authorization Order (through revision in "Regulations to operating Rules on unmanned aerial System") based on EASA Regulation (EC) No.216/2008 in the case of unmanned aircaft under 150kg in Germany, and Civil Aviation Act (CAA 1998), Civil Aviation Act 101 (CASR Part 101) in Australia. Commonly, these laws exclude the model aircraft for leisure purpose and require pilots on the ground, not onboard aricraft, capable of controlling RPA. The laws also require that all managements necessary to operate RPA and pilots safely and efficiently under the structure of the unmanned aircraft system within the scope of the regulations. Each country classifies the RPA as an aircraft less than 25kg. Australia and Germany further break down the RPA at a lower weight. ICAO stipulates all general aviation operations, including commercial operation, in accordance with Annex 6 of the Chicago Convention, and it also applies to RPAs operations. However, passenger transportation using RPAs is excluded. If the operational scope of the RPAs includes the airspace of another country, the special permission of the relevant country shall be required 7 days before the flight date with detail flight plan submitted. In accordance with Federal Aviation Regulation 107 in the United States, a small non-leisure RPA may be operated within line-of-sight of a responsible navigator or observer during the day in the speed range up to 161 km/hr (87 knots) and to the height up to 122 m (400 ft) from surface or water. RPA must yield flight path to other aircraft, and is prohibited to load dangerous materials or to operate more than two RPAs at the same time. In Germany, the regulations on UAS except for leisure and sports provide duty to avoidance of airborne collisions and other provisions related to ground safety and individual privacy. Although commercial UAS of 5 kg or less can be freely operated without approval by relaxing the existing regulatory requirements, all the UAS regardless of the weight must be operated below an altitude of 100 meters with continuous monitoring and pilot control. Australia was the first country to regulate unmanned aircraft in 2001, and its regulations have impacts on the unmanned aircraft laws of ICAO, FAA, and EASA. In order to improve the utiliity of unmanned aircraft which is considered to be low risk, the regulation conditions were relaxed through the revision in 2016 by adding the concept "Excluded RPA". In the case of excluded RPA, it can be operated without special permission even for commercial purpose. Furthermore, disscussions on a new standard manual is being conducted for further flexibility of the current regulations.

  • PDF

An Analysis of the Imported Consumer Goods Distribution Sector of Korea: From a Vertical Structure Viewpoint (수입소비재(輸入消費財) 유통구조(流通構造)의 효율화(效率化) 방안(方案))

  • Nam, Il-chong
    • KDI Journal of Economic Policy
    • /
    • v.13 no.1
    • /
    • pp.3-33
    • /
    • 1991
  • Since the early 1980's, the Korean government has gradually been widening the Korean market to foreign consumer goods. This, combined with the increased purchasing power of the Korean consumers resulting from the continued economic growth of the country, has sparked a spectacular influx of foreign consumer goods into Korea, ranging from BMW's to chopsticks. Import of foreign consumer goods amounted to more than 6 billion dollars in 1989 and is continuing to grow at a rapid rate. The increased import of foreign consumer goods doubtlessly improved the overall welfare of the Korean consumers by providing them with a wider range of options to choose from, by lowering the prices of some of the consumer goods domestically produced, and also by forcing the producers of some Korean goods to face competition with better foreign goods, thus giving them an incentive to raise the quality of their products. However, it is agreed by most economists that this increase in general welfare has been much smaller than what they had expected at the outset. Consumer prices of most imported consumer goods are easily double the import price, and in some cases, more than treble the import prices. Further, there has not been a noticeable drop in the prices of domestically produced consumer goods. Much of the blame has been attributed to the distribution sector of Korea. The objective of this paper is to analyze the imported consumer goods distribution sector of Korea, focusing on the possible sources of the poor performance of that sector, and to make policy suggestions that could potentially increase the welfare. This paper differs from all the previous research by others on this subject in that it analyzes the imported consumer goods distribution sector of Korea as a vertical structure. The distribution sector of an imported consumer good is a vertical structure since it consists of an international market, an import stage, and domestic wholesale and retail markets, in that order vertically. Our study naturally includes the analysis of the vertical restraints as well as the analysis of the industrial organization of each horizontal stage in the vertical structure. Each horizontal component of the imported consumer goods distribution sector is basically a monopolistically competitive market differentiated by characteristics of goods and by the locations and the services of firms. Further, restrictive dealership and resale price maintenance are found to be widely in use. Our main findings are the follwing; First, most consumer goods are imported monopolistically or oligopolistically through restrictive dealership contracts between foreign producers and domestic importers. Such restrictive dealership gives importers market power in the domestic market and explains many of the large discrepancies betwen the consumer prices and the import prices of many goods. Korean anti - trust law does not cover the issues arising from the market power of an importer resulting from a restrictive dealership contract. Second, some major producers of Korean goods are also importers of foreign goods that are substitutes of their products. The import of substitutes by major domestic producers is anti - competitive because it tends to raise the prices of both domestic goods and foreign goods, and also because it reduces the incentive of the domestic producers to raise the quality of their products. Third, wholesalers and retailers widely use resale price maintenance as a price fixing mechanism, and while this is against the anti- trust law, it seldom gets noticed. Fourth, the high level of rents of real estate for commercial use works as an entry barrier to the distribution sector and results in reduced competition by the firms in that sector. Finally, there are information problems. Consumers have inferior information to firms about the quality of a foreign consumer good that they have not tried before. Such information asymmetry often enables firms to raise prices. In addition, information asymmetry between importers frequently delays the import of cheaper substitutes. In order to alleviate the problems indentified above, we suggest the following policy changes. The government should strengthen the anti - trust law and its enforcement to regulate restrictive import contracts, import of competing goods by major domestic producers, and RPM by wholesalers and retailers that is aimed at price fixing. In addition, the government should loosen its tight real estate policy to encourage investment in the distribution sector. Finally, we suggest that the import price revelation policy that has been in use for some items since 1990 be expanded to most imported consumer goods that are introduced for the first time to give consumer better information and be used only for the period of time needed to inform sufficient number of consumers.

  • PDF

Environmental Management of Marine Cage Fish Farms using Numerical Modelling (수치모델을 이용한 해상어류가두리양식장의 환경관리 방안)

  • Kwon, Jung-No;Jung, Rae-Hong;Kang, Yang-Soon;An, Kyoung-Ho;Lee, Won-Chan
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
    • /
    • v.10 no.4
    • /
    • pp.181-195
    • /
    • 2005
  • To study the effects of aquaculture activity of marine cage fish farms on marine environment, field researches including hydrography, sediment, benthos and trap experiment at the marine cage fish farms(Site A) around estuaries of Tongyeong city were carried out during June $26\~27$, 2003. A simulation using numerical model-DEPOMOD was conducted to predict the solid deposition from fish cage and to assess the probable solid deposition, and the efficiency of environmental management of marine cage fish farms was studied. The marine cage fish farms cultured mainly common sea bass (Lateolabrax japonicus), red seabream (Pagrus major), striped breakperch (Oplegnathus fasciatus) and black rockfish(Sebastes schlegeli), and total amount of cultured fish of the Site A were 23.1MT. The amount of husbandry fish by unit area(and volume) of the fish cage was $43.0kg\;m^{-2}(6.1kg\;m^{-3})$. The daily mean amounts of food fed by unit biomass and cage area were $30.8g\;kg^{-1}day^{-1},\;1.32kg\;m^{-2}day^{-1},$ respectively, at the Site A. The concentration of ORP of the sediment below the center at the Site A was -334.6 mV and the concentrations of AVS, COD, Carbon and Nitrogen were $0.43mg\;g^{-1}dry,\;17.75mg\;g^{-1}dry,\;10.19mg\;g^{-1}dry\;and\;3.49mg\;g^{-1}dry$, respectively. Capitella capitata was dominant benthic species which occupied $57.8\%$ of total species, and the Infaunal Trophical Index(ITI) was marked below 20 within 20 m distance from the edge of the Site A. The result of trap experiment, the solid deposition from the Site A was $34,485g\;m^{-2}yr^{-1}$ at 0 m from the center of the cage and $18,915g\;m^{-2}yr^{-1}$ at 42 m. From a model simulation, it was estimated that using a model simulation, the proportion of unfed food was $40\%$ at the Site A and the annual total amount of solid deposition was 63,401 accounting for $24.4\%$ of the annual total food fed at the Site A. The area solid deposition settled was estimated to be $8,450m^2$, which was about 16 times of the total area of fish cage at the Site A. And concerning ITI and abundance of benthos, the model predicted that sustainable solid flux at the Site A was below $10,000gm^{-2}yr^{-1}$. The percentage of food wasted was main element of solid deposition at the marine cage fish farms, and for minimizing solid deposition it is necessary to increase the efficiency of the food uptake. Based on the result of the model simulation, if the percentage of food wasted decreases to $10\%$ from the current $40\%$, then the solid deposition could decrease to a half. In addition, it was predicted that if farmers use EP pellets as food fed instead of MP and fish trash, solid deposition could decrease by $57\%$. Also this study proposes that the cage facility ratio of the licensed area be decreased to less than $5\%$ to minimize the sediment pollution.

Analysis of Urinary Mass Screening for Elementary, Middle and High School Children Over a 3-year Period(1995-1997) in Seoul (서울지역내 초.중.고 학생들에 실시된 3년 동안의($1995{\sim}1997$) 집단뇨검사 결과 분석)

  • Kang Ho-Seok;Lee Chong-Guk
    • Childhood Kidney Diseases
    • /
    • v.3 no.2
    • /
    • pp.161-169
    • /
    • 1999
  • Purpose : The urinary mass screening program for the detection of proteinuria in school aged population has been performed in Seoul since 1981. Systematic evaluation in corporation with the Seoul School Health Center for students with proteinuria identified in the mass screening has been performed from 1987. The results of urinary mass screening up to 1994 was reported. I report here the results of urinary mass screening from 1995 to 1997 and compare them with previous results and attempt to reveal the significance of urinary mass screening. Objects and Methods : In the 3-year period between 1995 and 1997, annually about 460,000 students comprising 3 different age groups; 5th grade of elementary school, 2nd grade of middle school and 2nd grade of high school were chosen, corresponding to the approximate ages of 11, 14, and 17 years, respectively. These subjects accounted for 26% of total school aged children in Seoul. The screening program was carried out in 3 steps. The 1st test was performed with dipstick at school and the 2nd at the Seoul School Health Center. Those students who showed proteinuria in the 1st and 2nd tests were referred to the hospital. Laboratory examinations including renal biopsies were performed to those students with pathologic proteinuria to clarify the incipient renal diseases. Results : 1) The prevalence of asymptomatic proteinuria was 0.28% in the 1st test. It peaked at the group of 14 years old as 0.34%, compared with 0.26% at the group of 11 years old and 0.24% at the group of 17 years old. It reached to 0.26% in male and 0.30% in female. 2) 25 percent of those having proteinuria at the first test were positive at the second test. 3) The proportion of patients with proteinuria by 3rd test were as follows; 25% of transient proteinuria, 55% of orthostatic proteinuria, 6% of constant proteinuria, 12% of proteinuria with hematuria, and 2% of transient proteinuria with isolated hematuria. Pathologic proteinuria were totaled as 20%. The prevalence of renal diseases among the age group of 7-18 years old was estimated to be 1.4 per 10,000. 4) Renal biopsy performed on 38 children with proteinuria at the third test revealed IgA nephropathy in 17(44%), focal segmental glomerusclerosis in 5(13%), minimal change disease in 4(11%), membranoproliferative glomeronephritis in 3(8%), $Henoch-Sch\"{o}nlein$ purpura nephritis in 3(8%), and others in 6(16%). Therefore, the prevalence of IgA nephropathy among the age group of 7-18 years old was estimated to be 0.64 per 10,000. 5) The prevalence of chronic renal failure was estimated to be 5.7 per 1 million of 7 to 18 years age group. Conclusions : 1) The prevalence of proteinuria in the first screening test was 0.28% and finally only 5% of them showed the pathologic proteinuria at the third test. 2) The prevalence of IgA nephropathy and chronic renal failure were 0.63 per 10,000 and 5.7 per 1 million, respectively among school-aged children in Seoul.

  • PDF

Operative Treatment of Congenitally Corrected Transposition of the Great Arteries(CCTGA) (교정형 대혈관 전위증의 수술적 치료)

  • 이정렬;조광리;김용진;노준량;서결필
    • Journal of Chest Surgery
    • /
    • v.32 no.7
    • /
    • pp.621-627
    • /
    • 1999
  • Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

  • PDF