• Title/Summary/Keyword: Cause classification

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A Clinicopathological Study of Rapidly Progressive Glomerulonephritis in Children (소아 급속 진행성 사구체 신염의 임상-병리학적 고찰)

  • Cho Hee-Yeon;Chung Dae-Lim;Kang Ju-Hyung;Ha Il-Soo;Choi Yong;Cheong Hae-Il
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.176-185
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    • 2004
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

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A Study on the Real Condition and the Improvement Directions for the Protection of Industrial Technology (산업기술 보호 관리실태 및 발전방안에 관한 연구)

  • Chung, Tae-Hwang;Chang, Hang-Bae
    • Korean Security Journal
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    • no.24
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    • pp.147-170
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    • 2010
  • This study is to present a improvement directions for the protection of industrial key technology. For the purpose of the study, the survey was carried out on the administrative security activity of 68 enterprises including Large companies, small-midium companies and public corporations. survey result on the 10 items of security policy, 10 items of personal management and 7 items of the assets management are as follows; First, stable foundation for the efficient implement of security policy is needed. Carrying a security policy into practice and continuous upgrade should be fulfilled with drawing-up of the policy. Also for the vitalization of security activity, arrangement of security organization and security manager are needed with mutual assistance in the company. Periodic security inspection should be practiced for the improvement of security level and security understanding. Second, the increase of investment for security job is needed for security invigoration. Securing cooperation channel with professional security facility such as National Intelligence Service, Korea internet & security agency, Information security consulting company, security research institute is needed, also security outsourcing could be considered as the method of above investment. Especially small-midium company is very vulnerable compared with Large company and public corporation in security management, so increase of government's budget for security support system is necessary. Third, human resource management is important, because the main cause of leak of confidential information is person. Regular education rate for new employee and staff members is relatively high, but the vitalization of security oath for staff members and the third party who access to key technology is necessary. Also access right to key information should be changed whenever access right changes. Reinforcement of management of resigned person such as security oath, the elimination of access right to key information and the deletion of account. is needed. Forth, the control and management of important asset including patent and design should be tightened. Classification of importance of asset and periodic inspection are necessary with the effects evaluation of leak of asset.

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Analysis of Isolated Proteinuria on School Urinary Mass Screening (학교 신체 검사에서 발견된 단독 단백뇨에 대한 연구)

  • Kim Cheol- Min;Hahn HyeWon;Lee Byung-Sun;Park Young Seo
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.61-67
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    • 2002
  • Purpose: The urinary mass screening program in school aged population has been performed since 1981, but the consensus on the follow-up schedule and the management of isolated proteinuria has not been reached yet. The aim of this study was to investigate the cause of isolated proteinuria and to propose a guideline for the treatment and follow-up afterwards Methods: The medical records of 114 cases of isolated proteinuria detected through the analysis of urinary mass screening and evaluated at the pediatric outpatient clinic of Asan Medical Center from January 1990 to July 2001 have been reviewed. Results: The classification of isolated proteinuria was as follows. Transient proteinuria $32\%$, orthostatic proteinuria $65\%$, persistent proteinuria $3\%$, In orthostatic proteinuria group, daytime and nighttime proteinuria were $319.2{\pm}189.1\;mg/dL$ and $56.5{\pm}56.1\;mg/dL$. In persistent proteinuria group, daytime and nighttime proteinuria were $1140{\pm}540.5\;mg/dL$ and $289{\pm}58\;mg/dL$. After 30 month follow-up, 2 cases of persistent proteinuria were needed renal biopsy and 1 case revealed focal segmental glomerular sclerosis. In all cases, serum creatinine, albumin and complements levels were normal. In the orthostatic proteinuria group, no significant renal diseases were detected. Conclusion: Since most of the isolated proteinuria detected through the school urinary mass screening were orthostatic proteinuria or transient proteinuria, initially aggressive diagnostic method such as renal biopsy is not needed and regular follow- up with quantitation of proteinuria is warranted.(J Korean Soc Pediatr Nephrol 2002 ; 6 61-7)

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Congenital Cystic Adenomatoid Malformation of Lung in Adults: Clinical, Pathologic and Radiologic Evaluation of Six Patients (성인에서 진단된 선천성 낭포성 유선종 폐기형 6예)

  • Park, Young Jin;Jung, Hoon;Park, I-Nae;Choi, Sang Bong;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Koo, Ho-Seok;Lee, Yang-Haeng;Choi, Suk-Jin;Jung, Soo-Jin;Lee, Hyun-Kyung;Kim, Ae Ran
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.110-115
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    • 2008
  • Background: Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare congenital developmental anomaly of the lower respiratory tract. Most cases are diagnosed within the first 2 years of life, so adult presentation of CCAM is rare. We describe here six adult cases of CCAM and the patients underwent surgical resection, and all these patients were seen during a five and a half year period. The purpose of this study was to analyze the clinical, radiological and histological characteristics of adult patients with CCAM. Methods: Through medical records analysis, we retrospectively reviewed the clinical characteristics, the chest pictures (X-ray and CT) and the histological characteristics. Results: Four patients were women and the mean age at diagnosis was 23.5 years (range: 18~39 years). The major clinical presentations were lower respiratory tract infection, hemoptysis and pneumothorax. According to the chest CT scan, 5 patients had multiseptated cystic lesions with air fluid levels and one patient had multiple cavitary lesions with air fluid levels, and these lesions were surrounded by poorly defined opacities at the right upper lobe. All the patients were treated with surgical resection. 5 patients underwent open lobectomy and one patient underwent VATS lobectomy. On the pathological examination, 3 were found to be CCAM type I and 3 patients were CCAM type II, according to Stocker's classification. There was no associated malignancy on the histological studies of the surgical specimens. Conclusion: As CCAM can cause various respiratory complications and malignant changes, and the risks associated with surgery are extremely low, those patients who are suspected of having or who are diagnosed with CCAM should go through surgical treatment for making the correct diagnosis and administering appropriate treatment.

A Study on the Estimation Method of the Repair Rates in Finishing Materials of Domestic Office Buildings (국내 업무시설 건축 마감재의 수선율 산정 방안에 관한 연구)

  • Kim, Sun-Nam;Yoo, Hyun-Seok;Kim, Young-Suk
    • Korean Journal of Construction Engineering and Management
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    • v.16 no.1
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    • pp.52-63
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    • 2015
  • Business facilities among domestic architectures have rapidly been constructed along with domestic economic development. It is an important facility taking the second largest proportion next to apartment buildings among current 31 building types of fire department classification of 2012 year for urban architectures. The expected service life of business facilities is 15 years, but 70% of those in urban areas have surpassed the 15 year service life as of the present 2014. Thus, the demand for urgent rehabilitation of such facilities is constantly increasing due to the aging and performance deterioration of the facilities'main finishing materials. Especially, the business facilities are being used for the lease of company office or private office, and such problems as aging and performance deterioration of the facilities could cause less competitive edge for leasing and real estate value depreciation for the O&M (Operation & Management) agent and the owner, respectively. Therefore, an effective planned rehabilitation as a preventive measure according to the standardized repair rate by the number of years after the construction is in need in order to prevent the aging and performance deterioration of the facilities(La et al. 2001). Nonetheless, domestic repair/rehabilitation standards based on the repair rate are mainly limited to apartment buildings and pubic institutions, resulting in impractical application of such standards to business facilities. It has been investigated and analyzed that annual repair rate data for each finishing material are required for examination of the applicability of the repair rate standard for the purpose of establishment of a repair plan. Hence, this study aimed at developing a repair rate computation model for finishing materials of the facilities and verifying the appropriateness of the annual repair rate for each finishing material through a case study after collecting and analyzing the repair history data of six business facilities. The results of this study are expected to contribute to the planning and implementation of more efficient repair/rehabilitation budget by preventing the waste of unpredicted repair cost and opportunity cost for the sake of the business facilities' owners and O&M agents.

The First Report on the Acanthocephalan Infection of the Dybowskii's Brown Frogs (Rana dybowskii) Collected Inside and Outside the Commercial Frog Farms in Korea (국내 개구리 양식장 내·외에서 채집된 북방산개구리(Rana dybowskii)의 구두충 감염 최초보고)

  • Kim, Jong-Sun;Koo, Kyo-Soung;Park, Jae-Jin;Kwon, Sera;Choia, Woo-Jin;Cho, Han-Na;Park, Daesik
    • Korean Journal of Environment and Ecology
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    • v.30 no.4
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    • pp.694-704
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    • 2016
  • Various infectious and parasitic diseases are known to be the main factors that cause decline in the global amphibian population. In Korea, commercial frog farms have been running since 2005. However, until now, studies on diseases including studies on parasitic diseases that occur in farm frogs have not been conducted. In this study, we studied and compared the acanthocephalan infection rates and the number of parasites in the body cavity, stomach, and small and large intestines of the Dybowskii's brown frogs collected from inside and outside the frog farms in Inje, Goesan, Gongju and Boryeong. In addition, we classified the acanthocephalan parasites into genera by analyzing their nuclear 18S rRNA genes. On an average, 51.7% of the investigated frogs were infected by acanthocephalans, which belong to the Centrorhynchus genus. The infection rate of the frogs collected in the Inje farm was 15%, significantly lower than those from the Goesan, Gongju and Boryeong farms. The rate in Goesan was 55%, which is lower than Gongju (80%) and Boryeong (90%) although it is not statistically significant. No difference was found in the infection rate and in the number of parasites in male and female frogs and between the groups collected from inside and outside of the farms. The number of infected parasites negatively correlated with the body condition of the frogs. The most parasites were found in the stomach followed by the small and large intestines and the body cavity. This study is the first report on the Centrorhynchus acanthocephalan infection of amphibians in Korea and it suggests the necessity for acanthocephalan parasite management and for conducting further disease-related studies in commercial frog farms.

Development and Research on a Functional Hydrolyzed Whey Protein Powder Product with Sialic Acid as a Marker Compound - II. Repeated 90-day Oral Administration Toxicity Test using Rats Administered Whey Protein Powder containing Highly Concentrated Sialic Acid (23%) produced by Enzyme Separation and Solvent Enrichment Method - (Sialic Acid를 지표성분으로 하는 유청가수분해단백분말의 기능성식품 개발연구 - II. 효소분리 용매정제로 고농도 Sialic Acid가 함유된 유청가수분해단백분말(23%)의 랫드를 이용한 90일 반복경구투여 독성시험 평가 연구 -)

  • Noh, Hye-Ji;Cho, Hyang-Hyun;Kim, Hee-Kyong;Koh, Hong-Bum
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.2
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    • pp.117-135
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    • 2016
  • The present study was performed to develop a functional raw food material from hydrolyzed whey protein powder (23%-GNANA) medication containing sialic acid as a marker compound that is naturally occurring at 7% concentration in GMP (glycomacropeptide). GMP is used worldwide in foodstuffs for babies and infants and is obtained from the milk protein as safe food. While the purpose of our detailed evaluation was aimed to assess preliminary NOAEL values for and above 2,000 mg/kg/day, a clinical dose allowance for 23%-GNANA (as per characteristic of a functional health product, a highly refined test substance of 23% (v/v) sialic acid combined in GMP), at the same time we also wanted to assess the safety of GMP hydrolyzate lacking sialic acid but with identical properties as GMP. Animal safety evaluation was conducted using 23%-GNANA as the test substance, produced from hydrolyzed whey protein powder (product name: HELICOBACTROL-23; provided by Medinutrol Inc. [Korea]; composed of 23% sialic acid and GMP protein) after isolating the sialic acid using enzymes approved as food additives, with GMP as a raw material, and subsequently increasing the content of xx up to 23% through 80% (v/v) ethanol soaking and concentrating, in accordance with GLP Guideline. The animal safety evaluation mentioned above was made on the basis of toxicity in SPF Sprague-Dawley female and male rats dosed with 10 mL of the test substance diluted to 0, 1,250, 2,500, and 5,000 mg/kg directly into their stomachs for 90 d. This was determined in terms of the general symptoms and animal viability, weight and amount of feed intake, eye examination, uracrasia tests, hematological and blood biochemical disorder tests, blood coagulation test, abnormal intestine weight, abnormalities during postmortem and histopathological examinations. Statistical significance was set at P<0.05. Based on the toxicity determination, a certain minor effect associated with the test substance was observed in male rats with no major effects of the tested substance, in comparison with the control group dosed with sterilized water. Nevertheless, the NOAEL value, evaluated as per toxicity criteria, was verified as 5,000 mg/kg/day (P<0.05). Similarly, for female rats, a certain minor effect associated with the test substance was observed in 5,000 mg/kg/day dosed group, with no major effect, yet the NOAEL value (as assessed as per toxicity criteria) was determined to be 5,000 mg/kg/day (P<0.05), which was the same as for male rats. Accordingly, the NOAEL values of the test substances for all female and male rats were finally verified as 5,000 mg/kg/day (P<0.05). In conclusion, it was determined that the 23%-GNANA test substance exceeds 2,000 mg/kg/day, the clinical allowance characteristic for functional health food, and was finally evaluated to cause no safety concerns when used as a raw material in functional health food production, which was the ultimate goal of the present study.

Clinical Manifestation and Treatment Outcome of Lupus Nephritis in Children (소아 루프스 신염의 임상양상 및 치료결과)

  • Park Jee-Min;Shin Jae-Il;Kim Pyung-Kil;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.155-168
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    • 2002
  • Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

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A Study on the Service Quality Improvement by Kano Model & Weighted Potential Customer Satisfaction Index (Kano 모델 및 가중 PCSI를 통한 서비스품질 개선에 관한 연구)

  • Kim, Sang-Cheol
    • Journal of Distribution Science
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    • v.8 no.4
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    • pp.17-23
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    • 2010
  • The Banking industry is expanding rapidly. To keep the competitive advantages, participating companies concentrate their resource to provide the distinguishable services by increasing the service quality. This study is to find that how three kinds of service quality(process, output, and service environment) affect on the customer satisfaction. In this paper, WPCSI (Weighted Potential Customer Satisfaction Index) was developed using Kano model and PCSI. Kano's model of service quality classification was used to improve customer satisfaction, customer satisfaction index was calculated. Customer satisfaction index was calculated using the existing potential for improving customer satisfaction index (PCSI Index) to complement the limitations of the weighted potential improve customer satisfaction index (WPCSI) were used. Analysis using PCSI improve the quality of service levels may be useful in assessing. However, this figure is a marginal degree of importance on customers and quality characteristics have been overlooked but has its problems. A service provided to customers with some important differences depending on the interpretation of the scope for improvement is to be classified. In other words, the level of customer satisfaction and the satisfaction of the current difference between the comparison factor for the company to provide information about the priority of the improvement was not significant. Companies are also considered important that the customer does not consider the uniform quality of service provided can be fallible. In this study, the weighted potential to improve it improve customer satisfaction index (WPCSI) proposed a new customer satisfaction index. This is for customers to recognize the importance of quality characteristics by weighting factors, to identify practical and improved priority to provide more useful information than has been. Weighted potentially improve customer satisfaction index (WPCSI) presented in this study by the customers aware of the importance of considering the quality factor is an exponent. The results, 'Employees' working ability', 'provided the desired service level', 'staff to handle this task quickly enough' to the customer of the factors had significant effects on satisfaction are met. On the other hand 'aggressiveness on the product description of employees', 'service environment as a whole, beautiful enough to' meet and shows no significant difference between satisfaction. But 'aggressiveness on the product description of employees' and reverse (逆) were attributable to the quality. Small dogs and overly aggressive products that encourage the customer dissatisfaction that can result in widening should be careful because the quality factor can be said. As a result, WPCSI is more effect to find critical factors which can affect customer satisfaction than PCSI. After that, we discuss effects and advantages of customer satisfaction using WPCSI. This study, along with these positive aspects, the limitations are implied. First, this study directly to the bank so that I could visit any other way for customers, utilizing the Internet or mobile to take advantage of the respondents were excluded from the analysis. Second, in survey questionnaires can help improve understanding of the measures will be taken. In addition to the survey targeted mainly focused on Seoul, according to a sample, so sampling can cause problems is the viscosity revealed intends.

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Treatment and Prognosis for an Esthesioneuroblastoma over a 20-Year Period: Impact of Treatment Era (감각신경모세포종의 20년에 걸친 치료와 예후 분석: 치료 시기에 따른 차이)

  • Song, Chang-Hoon;Kim, Il-Han;Wu, Hong-Gyun;Kim, Dong-Wan;Rhee, Chae-Seo
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.189-193
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    • 2009
  • Purpose: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. Materials and Methods: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). Results: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. Conclusion: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.