• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.92-103
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• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.36-43
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• 2007

Purpose: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children. Methods: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed. Results: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together. Conclusion: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.317-325
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• 1994

The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.552-557
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• 2007

Background: B-type natriuretic peptide (BNP) is a cardiac hormone that is primarily synthesized by the ventricular cardiac myocytes. Increased plasma BNP levels have been observed in patients suffering with congestive heart failure, ventricular hypertrophy and myocaridits and also during heart transplantation rejection. We investigated the serum BNP level as a predictive marker for rejection after heart transplantation. Material and Method: To test the usefulness of measuring the BNP level in cardiac transplant patients, consecutive blood samplings for BNP, right ventricular endomyocardial biopsies, hemodynamic measurements and transthoracic echocardiogram were all done in 10 such patients between January 2004 and August 2005 at the Department of Thoracic and Cardiovascular Surgery in Asan Medical Center. Two groups were identified with using the median value: the low BNP group (n=28, BNP: ${\le}290$ pg/mL) and the high BNP group (n=29, BNP: >290 pg/mL). We retrospectively analyzed rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy, the pulmonary capillary wedge pressure and the right atrial pressure between the 2 groups. Result: There were no differences in age, gender, rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy and the right atrial pressure between the 2 groups (p>0.05). However, a higher pulmonary capillary wedge pressure and a higher mean pulmonary atrial pressure were observed in the high BNP group (p<0.05). Further, BNP has linear correlation with the pulmonary capillary wedge pressure (r=0.590, p<0.001). Using the cut-off value of 620 pg/mL, the BNP predicted a high PCWP (>12 mmHg) with a sensitivity of 83.3% and a specificity of 91.1% (AUC: $0.900{\pm}0.045$, p<0.001). Conclusion: The BNP level after heart transplantation does not show any significant correlation with rejection, yet it might be a predictive marker of ventricular diastolic dysfunction.

• Journal of Animal Science and Technology
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• v.53 no.4
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• pp.325-332
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• 2011

This research was conducted to analyze the effects of raising farm on the heritability and breeding values of Hanwoo cows for their carcass traits, including cold carcass weight (CWT), back-fat thickness (BFT), eye-muscle area (EMA) and marbling score (MAR). The carcass data and pedigree data were collected from steers raised on Hanwoo farms in Pyeongchang-gun, Gangwon-do, South Korea. Three analytical models were applied for the estimation of heritabilities and breeding values. The first model (model 1) included slaughter house-year-month combination as fixed effects and age at slaughter was fitted as linear and quadratic covariates. The second model (model 2) was similar to model 1, but raising farm was additionally included as random effect. The third model (model 3) was similar to model 1 but farm effects were additionally included as fixed effect. The comparisons between the model 1 and the models including farm effect (model 2 and model 3) revealed that heritability estimates from model 2 or model 3 were smaller to those from model 1 for all carcass traits. Especially, obvious decrease of heritability was observed in CWT where heritability was 0.23 from model 1, 0.15 from model 2 and 0.18 from model 3. The maximum log likelihood of the model 2 and 3 were higher than those of model 1 for all traits. In model 2 that raising farm was included as a random effect, the ratio of farm variance to the total phenotypic variance were ranged from 4% (EMA) to 18% (CWT). Top 10% and bottom 10% of female cows were selected based on the breeding values from model 1, and the Spearman's rank correlation coefficients among models were estimated for each trait within selected group. The correlation coefficients were ranged from 0.57 to 0.95 in top 10% group and from 0.68 to 0.95 in bottom 10% group. These results show that the discrepancies in the rankings of breeding values can be based on the models applied. In conclusion, the results obtained in this study suggest that the herd effect or farm effect should be included in the analytical model when breeding values are estimated with the purpose of improvement of carcass traits of Hanwoo breeding cows.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.370-376
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• 2005

In children, dental anxiety of dental treatment has been recognized as a source of problems in patient man agement for many years. Dental anxiety can be causes of negative cooperation, cancel and avoid of dental treatment. Therefore, dentist and dental team should recognize of child's dental anxiety as early as possible and manage appropriately. In previous studies, it is reported that parental dental anxiety affect dental anxiety and cooperation of their child. And it is parental decision which results in a child's visit to the dentist, rather than a child's decision in most cases. Therefore, it is important to identify the relationship of dental anxiety between child and parent. We estimated child's dental anxiety before dental treatment using Venham Picture Scale that is useful even a very young child and parental dental anxiety using Corah's dental anxiety scale. Then, two values above were compared. Child's cooperation, temperament, sex, age, parental education were estimated and compared with dental anxiety, too. The results were as follows: 1. There are positive relationship of dental anxiety between child and parent with the correlation analysis(P<0.02). 2. There are negative relationship of child's dental anxiety and child's cooperation with the correlation and regression analysis(P<0.001). 3. Low anxiety group has lower mean value of four temperament item with the Student's t-test. But, there is no statistical differences(P>0.1). 4. Girl and younger group have higher mean value of dental anxiety than boy and older group with the Student's t-test(P<0.001). 5. Low educated parents have higher mean value of dental anxiety than high educated parents with the Student's t-test(P>0.1).

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.308-322
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• 2001

The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

• Journal of Veterinary Clinics
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• v.21 no.4
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• pp.329-335
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• 2004

Dog spermatozoa were recovered from the caudae epididymides of 23 domestic dogs which were 11 pure breed and 12 mix-breed dogs ranging in age from 0.6 to 3 years. The experimental designs were as follows: 1) the effect of chilling to 0. 10 or 37$^{\circ}C$. 2) the kinetics of chilling injury at 0 or 4$^{\circ}C$, and 3) the effect of sugars at $0^{\circ}C$. Viable spermatozoa were recovered by percoll gradient separation and adjusted to 5${\times}$10$^{7}$ spermatozoa/ml. In experiment 1, spermatozoa were diluted with 0.33 M glucose supplemented with 3% BSA (G-BSA) at 1:2 dilution. Spermatozoa were loaded into straws and exposed at 0, 10 or 37$^{\circ}C$ for 30 min. In experiment 2, spermatozoa were prepared as the experiment 1 and exposed for 0.5, 5, 15, or 30 min at 0 or 4$^{\circ}C$. In experiment 3, spermatozoa were diluted with different sugars (0.33 M galactose, glucose, fructose, mannitol, lactose, sucrose, raffinose) and cooled to $0^{\circ}C$ for 30 min. Sperm membrane integrity, motility and acrosome integrity were assayed after rewarming at 37$^{\circ}C$ for 5 min. Sperm motility and membrane integrity abruptly decreased with decreasing temperature but acrosome integrity gradually decreased (P<0.05). Sperm motility was more sensitive to cold shock than membrane integrity and acrosome integrity. Spermatozoa cooled to $0^{\circ}C$ were more damaged than those at 4$^{\circ}C$. Sperm motility was not different among exposed times at both. 0 and 4$^{\circ}C$. However, membrane integrity of spermatozoa exposed for 30 min at both 0 and 4$^{\circ}C$ was significantly lower (P<0.05). Spermatozoa diluted in 0.33 M fructose or galactose showed lower motility and higher morphological abnormality with coiled tail at $0^{\circ}C$. These sperm characteristics were strongly related. These results indicate that dog epididymal spermatozoa are relatively sensitive to rapid cooling and higher morphological abnormality at $0^{\circ}C$ was shown in spermatozoa diluted in fructose and galactose.

• Korean Journal of Environment and Ecology
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• v.23 no.5
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• pp.447-459
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• 2009

This study is intended to provide basic date for the efficient management of Pinus densiflora community by analyzing ecological characteristics of Pinus densiflora inhabiting Byeonsanbando National Park. According to investigations, P. densiflora community and P. densiflora-Quercus community are widely distributed, occupying 40.3% of the total area. 21 sites ($400m^2$per site) are selected for TWINSPAN analysis, and the result indicates that the whole community of P. densiflora and P. densiflora-Quercus can be classified into 8 types, and the age of P. densiflora is 40-50 years, which is similar to that of deciduous broad-leaved trees. The 8 community types are: P. densiflora community which competes with Quercus variabilis; P. densiflora community in which Fraxinus sieboldiana and Quercus serrata grow in the understory layer; P. densifloa community in which Q. serrata grow in the understory layer and Smilax china var. microphylla in the shrub layer respectively; P. densifloa community in which P. densiflora and F. sieboldiana grow in the understory layer; P. densiflora community which competes with Q. serrata and Carpinus tschonoskii; P. densiflora community which competes with Q. variabilis and Q. serrata; P. densiflora community in which Prunus sargentii grow; P. densiflora community in which Abies holophylla grow. P. densiflora community which competes with Q. variablis and C. tschonoskii seems to be in a stage of succession to deciduous broad-leaved community. The analysis indicates that Shannon diversity index is 0.2756-1.3879. It also indicates that there is a negative correlation between P. densiflora and Q. variabilis and C. tschonoskii; there is a positive correlation between P. densiflora and F. sieboldiana and Rhododendron schlippenbachii. These investigations show that the transformation of vegetation is already under way. There is a possibility that ecological succession can take place in 30.4% of the total area from P. densiflora to Quercus and deciduous broad - leaved trees. Therefore, it is recommended that the preservation and maintenance of P. densiflora be implemented by taking control of competing species which undermine the stability of P. densiflora forest community.

• Sleep Medicine and Psychophysiology
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• v.19 no.2
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• pp.77-83
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• 2012

Objectives: Recent studies have reported a correlation between obstructive sleep apnea syndrome (OSA) and depression. In attempt to verify the suggestion that eveningness is related to depression, we examined the effect of morningness-eveningness on their depressive mood in patinets with OSA. Methods: The examination was based on the medical records and polysomnography reports of 211 OSA patients. Information was gathered from the patients who filled out the H$\ddot{o}$rne and Ostberg questionnaire (HOQ), profile of mood states-Korean version (K-POMS), and Epworth sleepiness scale (ESS). We compared mean values of K-POMS total, subscales of K-POMS, ESS, and OSA severity variables among the 3 morningness-eveningness groups (morningness, eveningness, and neither groups). Partial correlation analysis was performed between variables and ANCOVA was performed among the 3 groups after adjustment with age and weight. Results: There were significant negative correlations between HOQ and the followings : K-POMS total, POMS-T (tension-anxiety), POMS-D (depression-dejection), POMS-A (anger-hostility), POMS-F (fatigue-inertia), POMS-C (confusion-bewilderment), spontaneous arousal index, average O2 saturation. There were significant positive correlations between HOQ and the followings : POMS-V (vigor-activity), apnea-hypopnea index, respiratory arousal index, snore time. There were significant negative correlations between POMS-D and the followings : HOQ, POMS-V, stage 1 sleep (%), AHI, TAI (total arousal index), oxygen desaturation index, respiratory arousal index, neck circumference, average O2 desaturation, snore time (%). There were significant positive correlations between POMS-D and K-POMS total, POMS-T, POMS-A, POMS-F, POMS-C, sleep latency, stage 2 sleep (%), heart rate, spontaneous arousal index. There were significant differences in K-POMS total, POMS-T, POMS-D, POMS-F, POMS-C, spontaneous arousal index among the three HOQ groups in ANCOVA. Conclusion: The depressive correlates of OSA patients might be affected, not by excessive daytime sleepiness or OSA severity indexes, but by eveningness circadian characteristics. It would be important to take into account the morningness-eveningness tendency when we manage the depressive mood of OSA patients.