• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.538-543
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• 2009

Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response. Results : For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period. Conclusion : Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.213-220
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• 2008

Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.

• Economic and Environmental Geology
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• v.30 no.3
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• pp.249-262
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• 1997

The Sr and Nd isotopic compositions of two foliated granitic plutons located in the Chonju and Sunchang area were determined in order to reconfirm the intrusion ages of granitoids and to study the sources of granitic magmas. The best defined Rb-Sr isochron for the whole rock samples of the Chonju foliated granite (CFGR) give an age of $284{\pm}12Ma$, suggesting early Permian intrusion age. In contrast, the whole rock Rb-Sr data of the Sunchang foliated granite (SFGR) scatter widely on the isochron diagram with very little variation in the $^{87}Rb/^{86}Sr$ ratios and, therefore, yield no reliable age information. Futhermore they show the concordance of mineral and whole rock Rb-Sr isochron and divide into two linear groups with roughly the same slopes and significantly different $^{87}Sr/^{86}Sr$ ratios, indicating some kind of Rb-Sr distortion in whole rock scale and a difference in source material and/or magmatic evolution between two subsets. The reconstructed isochrons of 243 Ma, which was defined from the proposed data by the omission of one sample point with significantly higher $^{87}Rb/^{86}Sr$ ratio than the others, and 252 Ma, from the combined data of it and some of this study, strongly suggest the possibility that the SFGR was intruded appreciably earlier than had previously been proposed, although the reliability of these ages still questionable owing to high scatter of data points and, therefore, further study is necessary. All mineral isochrons for the investigated granites show the Jurassic to early Cretaceous thermal episode ranging from 160 Ma to 120 Ma Their corresponding initial $^{87}Sr/^{86}Sr$ ratios correlate well with their whole rock data, indicating that the mineral Rb-Sr system of the investigated granites was redistributed by the postmagmatic thermal event during Jurassic to early Cretaceous. The initial ${\varepsilon}Sr$ values for the CFGR (64.27 to 94.81) tend to be significantly lower than those for the SFGR (125.43 to 167.09). Thus it is likely that there is a marked difference in the magma source characteristics between the CFGR and the SFGR, although the possibility of an isotopic resetting event giving rise to a high apparent initial ${\varepsilon}Sr$ in the SFGR can not be ruled out. In contrast to ${\varepsilon}Sr$, both batholiths show a highly resticted and negative values of initial ${\varepsilon}Nd$, which is -14.73 to -19.53 with an average $-16.13{\pm}1.47$ in the CFGR and -14.78 to -18.59 with an average $-17.17{\pm}1.01$ in the SFGR. The highly negative initial ${\varepsilon}Nd$ values in the investigated granitoids strongly suggest that large amounts of recycled old continental components have taken part in their evolution. Furthermore, this highly resticted variation in ${\varepsilon}Nd$ is significant because it requires that the old crustal source material, from which the granitoid-producing melts were generated, should have a reasonably uniform Nd isotopic composition and also quit similar age. Calculated T2DM model ages give an average of $1.83{\pm}0.25Ga$ for CFGR and $1.96{\pm}0.19Ga$ for SFGR, suggesting the importance of a mid-Proterozoic episode for the genesis of two foliated granites. Although it is not possible to determine precisely the source rock compositions for the investigated foliatic granites, the Sr-Nd isotopic evidences indicate that midcrustal or less probably, a lower crustal granulitic source could be the most likely candidate.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.94-99
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• 2005

This prospective study aimed to assess the efficacy of dexamethasone to prevent xylazine induced emesis in dogs. The antiemetic effect of graded, single high-dose intravenous dexamethasone against xylazine hydrochloride was studied. Clinically healthy mixed breed dogs that weighed $ 4.64\pm1.25kg$ were used in this study. Food and water were given 3 hours before the experiment. Venous blood specimens were collected from all experimental animals for hema-tological and blood chemical test pre- and post-experiment. Twenty-eight experimental animals were randomly divided into 4 groups; the group treated with 0.2ml/kg of normal saline (Control group), the groups treated with 1mg/kg (D1 group), 2mg/kg (D2 group) and 4 mg/kg of dexamethasone (D4 group). Three doses of the dexamethasone or normal saline was administered intravenousely to each group and after 5 minutes, xylazine (2.2 mg/kg) was administered intramuscularly. The time until onset of the first emetic episode and rate of emesis were investigated. At the same time, the extent of sedation was scored subjectively 5, 15, 30 and 60 minutes after injection of xylazine hydrochloride using Visual Sedation Score. The time until onset of the first emetic episode was $203.25\pm11.35$ sec in Control group, $187.33\pm48.0l$ sec in D1 group and 218.33± 13.58 sec in D2 group. The rate of xylazine induced emesis were $57\%$ in Control group and $43\%$ in D1 and D2 group respectively. On the other hand, any emetic episodes were not observed in 04 group. At extent of sedation score, all experimental animals especially including the animals in D1 group were highly sedated at 15 minutes after administration of xylazine hydrochloride. Hematological and blood chemical values showed normal ranges pre- and post-experiment. We concluded that prior treatment with 4 mg/kg of dexamethasone hardly caused xylazine-induced emesis without disturbing the sedative effect of xylazine in dogs.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.23 no.8
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• pp.2052-2063
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• 1998

Various full-scale radio location systems have been developed since ground-based radio navigation systems appeared during World War II, and more recently global positioning systems (GPS) have been widely used as a representative location system. In addition, radio location systems based on cellular systems are intensively being studied as cellular services become more and more popular. However, these studies have been focused mainly on macrocellular systems of which based stations are mutually synchronized. There has been no study about systems of which based stations are asynchronous. In this paper, we proposed two radio location algorithms in microcellular CDMA systems of which base stations are asychronous. The one is to estimate the position of a personal station at the center of rectangular shaped area which approximates the realistic common area. The other, as a method based on road map, is to first find candidate positions, the centers of roads pseudo-range-distant from the base station which the personal station belongs to and then is to estimate the position by monitoring the pilot signal strengths of neighboring base stations. We compare these two algorithms with three wide-spread algorithms through computer simulations and investigate interference effect on measuring pseudo ranges. The proposed algorithms require no recursive calculations and yield smaller position error than the existing algorithms because of less affection of non-line-of-signt propagation in microcellular environments.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.773-780
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• 1999

Background: It has been demonstrated that brief periods of calcium depletion and repletion (calcium-free preconditioning, CP) have cardioprotective effects as seen in ischemic preconditioning(IP) which enhances the recovery of post-ischemic contractile dysfunction and reduces the incidence of reperfusion-induced arrhythmia or infarct size after a prolonged ischemia. In the present study, we tested this paradoxical phenomenon in isolated rabbit hearts. Material and Method: Hearts isolated from New Zealand white rabbits(1.5∼2.0 Kg body weight) were perfused with Tyrode solution using the Langendorff technique. After stabilizing the baseline hemodynamics, the hearts were subjected to 45 minutes of global ischemia followed by 120 minutes of reperfusion with IP(IP group, n=7) or without IP (ischemic control group, n=7). IP was induced by a single episode of 5 minutes global ischemia and 10 minutes reperfusion. In the CP group(n=7), the hearts were subjected to perfusion with Tyrode solution with calcium depletion for 5 minutes and repletion for 10 minutes, and 45 minutes of ischemia and 120 minutes of reperfusion. Left ventricular function including developed pressure, dP/dt, heart rate, left ventricular end-diastolic pressure and coronary flow was measured. Infarct size was determined by staining with 1% triphenyltetrazolium chloride and planimetry. Data were analyzed by a one-way analysis of variance and Tukey's post-hoc test. Result: In comparison with the ischemic control group, IP significantly enhanced the recovery of the left ventricular function including the left ventricular developed pressure, contractility, and coronary flow; in contrast, these functional parameters of the CP group tended to be lower than those of the ischemic control group. However, the infarct size was significantly reduced by IP or CP(p<0.05). Conclusion: These results suggest that in isolated Langendorff-perfused rabbit heart model, CP(induced by single episode of 5 minutes calcium depletion and 10 minutes repletion) could not improve the post-ischemic contractile dysfunction(after a 45-minute global ischemia) but it has an infarct size-limiting effect.

• Microbiology and Biotechnology Letters
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• v.50 no.4
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• pp.548-556
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• 2022

Acylases can have a significant effect on biofilm formation owing to their quorum quenching activity. In this study, we investigated the effects of acylase treatment episodes on multispecies biofilm development. A consortium composed of 9 species belonging to different genera was allowed to form biofilms for 5 days under various treatment episodes (different treatment periods, 1, 2, 3, or 4 days; and two application timings, beginning or later) at 1, 5, 10, 20 and 50 mg·l^-1 acylase concentrations. The acylase treatment for 5 days showed that acylase concentration was negative with biofilm development (linear regression, Y = -0.05·x + 2.37, p < 0.05, R² = 0.88). Acylase was more effective in reducing biofilm formation when it was applied in the beginning (vs. in later development stage) at all acylase concentrations (p < 0.05). ANOVA indicated that treatment period was significant on biofilm formation in both application timings at ≥ 10 mg·l^-1 (p < 0.05). Linearity test results showed that all slope values between period and biofilm were negative in both timings at ≥ 10 mg·l^-1 (p < 0.05, except for the later application at 20 mg·l^-1). When temporal biofilm dynamics were monitored at 20 mg·l^-1, biofilms gradually increased with time at all treatment episodes (p < 0.05), and slope values in linear regression between biofilm and time were lower when acylase was applied in the beginning (p < 0.05). Our findings suggest the importance of the acylase treatment period and application timing on biofilm control.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.448-455
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• 1999

Background: Recent developments in techniques of video-assisted thoracic surgery(VATS) and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery. Especially, it will probably become the treatment of choice of spontaneous pneumothorax(SP). There is, however, a high recurrence rate, high cost, and paucity of long-term results. We report the results of postoperative follow-up and analyze perioperative parameters affected to recurrence, retrospectively. Material and Method: From march 1992 to march 1997, 276 patients with spontaneous pneumothorax underwent 292 VATS procedures. Conversion to open thoracotomy was necessitated in eight patients, and this patients excluded from the study. Result: The sex distribution was 249 males and 31 females. The mean age was 28.1 12.2 years(range, 15 to 69 years). Primary SP was 237cases(83.5%) and secondary SP was 47cases(16.5%). The major underlying lung diseases associated with secondary SP were tuberculosis 27cases(57.4%) and emphysema 8cases (38.3%). Operative indications included Ipsilateral recurrence 123(43.9%), persistent air-leak 53(18.9%), x-ray visible bleb 40(14.3%), tension 30(10.7%), contralateral recurrence 21(7.5%), uncomplicated first episode 8(2.9%), bilateral 3(1.1%), complicated episode 2(0.7%). Blebs were visualized in 247cases(87%) and 244cases(85.9%) performed stapled blebectomy. Early postoperative complications occurred in 33 cases(11.6%): 16 prolonged air-leak more than 5 days(four of them were required a second operation and found missed blebs); 5 bleeding; 5 empyema; 2 atelectasis; 1 wound infection. No deaths occured. The mean operative time was 52.8 23.1 minutes(range, 20 to 165 minutes). The mean d ration of chest tube drainage was 5.0 4.5 days(range, 2 to 37 days). The mean duration ofhospital stay was 8.2 5.5 days (range, 3 to 43days). At a mean follow-up 22.3 18.4 months(range, 1 to 65 months), 12 patients(4.2%) were lost to follow-up. There were 24 recurrences and seven patients underwent second operation and 6 patients(85.7%) were found the missed blebs. 12 perioperative parameters(age, sex, site, underlying disease, extent of collapse, operative indication, size of bleb, number of bleb, location of bleb, bleb management, pleural procedure, prolonged postoperative air-leak) were analyzed statistically to identify significant predictors of recurrence. The significant predictors of recurrence was the underlying disease[17.0%(8/47): 6.8%(16/237), p=0.038], prolonged postoperative air-leakage[37.5%(6/16): 6.7%(18/268), p=0.001], and pleural procedure [11.4%(19/167): 4.3%(5/117), p=0.034]. Blebectomy has less recurrence rate then non-blebectomy [8.2%(20/244) : 10.0%(4/40), p>0. 5]. However, this difference was not statistically significant(p=0.758). Conclusion: We conclude that it is important that we shoud careful finding of bleb during VATS due to reducing of recurrnece, and cases of no bleb identified and secondary spontaneous pneumothorax were indicated of pleurodectomy. VATS is a valid alternative to open procedure for the treatment of spontaneous pneumothorax with less pain, shorter hospital stay, more rapid return to work, high patient acceptance, less scar and exellent cosmetics. But, there is high recurrence rate and high cost, and than it is necessary to evaluate of long-term results for recurrence and to observate carefully during VATS.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.531-540
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• 2000

Baclgrpimd; Recent studies have suggested that the cardioprotective effect of ischemic preconditioning(IP) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G)-free perfusate. Material and Method; Hearts isolated from New Zealand white rabbits(1.5~2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45 min global ischemia followed by 120 min reperfusion with IP(IP group, n=13) or without IP(ischemic control group, n=10). IP was induced by single episode of 5 min global ischemia and 10 min reperfusion. In the G-free preconditioned group(n=12), G depletion was induced by perfusionwith G-free Tyrode solution for 5 min and then perfused with G-containing Tyrode solution for 10 min; and 45 min ischemia and 120 min reperfusion. Left ventricular functionincluding developed pressure(LVDP), dP/dt, heart rate, left ventricular end-distolic pressure(LVEDP) and coronary flow (CF) were measured. Myocardial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific peptide and PKC isozymes were analyzed by Western blot with monoclonal antibodies. Infarct size was determined by staining with TTC(tetrazolium salt) and planimetry. Data were analyzed by one-way analysis of variance (ANOVA) and Turkey's post-hoc test. Result ; In comparison with the ischemic control group, IP significantly enhanced functional recovery of the left ventricle; in contrast, functional significantly enhanced functional recovery of the left ventricle; in contrast, functional recovery were not significantly different between the G-free preconditioned and the ischemic control groups. However, the infarct size was significantly reduced by IP or G-free preconditioning(39$\pm$2.7% in the ischemic control, 19$\pm$1.2% in the IP, and 15$\pm$3.9% in the G-free preconditioned, p<0.05). Membrane PKC activities were increased significantly after IP (119%), IP and 45 min ischemia(145%), G-free [recpmdotopmomg (150%), and G-free preconditioning and 45 min ischemia(127%); expression of membrane PKC isozymes, $\alpha$ and $\varepsilon$, tended to be increased after IP or G-free preconditioning. Conclusion; These results suggest that in isolated Langendorff-perfused rabbit heart model, G-free preconditioning (induced by single episode of 5 min G depletion and 10 min repletion) colud not improve post-ischemic contractile dysfunction(after 45-minute global ischemia); however, it has an infarct size-limiting effect.