• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.443-448
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• 2007

Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.319-336
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• 2020

The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.49-62
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• 2020

Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.

• Geophysics and Geophysical Exploration
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• v.19 no.1
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• pp.1-10
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• 2016

The hypocenter distribution of microseismic events generated by hydraulic fracturing for shale gas development provides essential information for understanding characteristics of fracture network. In this study, we evaluate how inaccurate velocity models influence the inversion results of two widely used location programs, hypoellipse and hypoDD, which are developed based on an iterative linear inversion. We assume that 98 stations are densely located inside the circle with a radius of 4 km and 5 artificial hypocenter sets (S0 ~ S4) are located from the center of the network to the south with 1 km interval. Each hypocenter set contains 25 events placed on the plane. To quantify accuracies of the inversion results, we defined 6 parameters: difference between average hypocenters of assumed and inverted locations, $d_1$; ratio of assumed and inverted areas estimated by hypocenters, r; difference between dip of the reference plane and the best fitting plane for determined hypocenters, ${\theta}$; difference between strike of the reference plane and the best fitting plane for determined hypocenters, ${\phi}$; root-mean-square distance between hypocenters and the best fitting plane, $d_2$; root-mean-square error in horizontal direction on the best fitting plane, $d_3$. Synthetic travel times are calculated for the reference model having 1D layered structure and the inaccurate velocity model for the inversion is constructed by using normal distribution with standard deviations of 0.1, 0.2, and 0.3 km/s, respectively, with respect to the reference model. The parameters $d_1$, r, ${\theta}$, and $d_2$ show positive correlation with the level of velocity perturbations, but the others are not sensitive to the perturbations except S4, which is located at the outer boundary of the network. In cases of S0, S1, S2, and S3, hypoellipse and hypoDD provide similar results for $d_1$. However, for other parameters, hypoDD shows much better results and errors of locations can be reduced by about several meters regardless of the level of perturbations. In light of the purpose to understand the characteristics of hydraulic fracturing, $1{\sigma}$ error of velocity structure should be under 0.2 km/s in hypoellipse and 0.3 km/s in hypoDD.

• Korean Journal of Veterinary Research
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• v.35 no.2
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• pp.271-278
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• 1995

The objective of the present study was to investigate the inhibitory effect of physiologically pulsatile pattern of testosterone(T) on luteinizing hormone(LH) in wethers. To do this, 3 separate experiments were conducted. Infusion rates and patterns needed to produce normal T secretory profiles found in intact rams were established in Experiment 1, the time-course of the suppressive effect of T on circulating LH concentrations was determined in Experiment 2, and the effectiveness of a pulsatile versus a constant pattern of T to suppress LH secretion in wethers was compared in Experiment 3. In Experiment 1, three different doses(25, 50 or $100{\mu}g$) of T were injected intravenously to animals to do pharmacokinetic analysis of T. Elimination rate constant, volume of distribution, and total body clearance of T averaged $0.18min^{-1}$, 0.531/kg BW, and 0.091/min/ kg BW, respectively. In Experiment 2, three different doses(192,384, or $768{\mu}g/kg/24h$) of T were infused at 4h intervals for 3 days into animals to evaluate the time course of the inhibitory effect of T on mean LH concentration. As duration of T infusion increased, mean LH concentrations gradually reduced. Mean LH concentrations were significantly lower at day 2 or day 3 than at day 0. However, mean LH concentrations did not differ between day 0 and day 1 or between day 2 and day 3. In Experiment 3, animals were subjected to two different intravenous infusion regimens for 3 days: constant T($768{\mu}g/kg/24h$) and pulsatile(one pulse every 4h) T($768{\mu}g/kg24h$). Blood samples were collected at 10-min intervals for 4h both prior to infusion and during the last 4h of the infusion. Mean LH was more suppressed(p=0.045) by constant T than by pulsatile T. LH pulse amplitude was not affected by constant T or pulsatile T. LH interpulse interval was increased more(p=0.034) by constant T than pulsatile T.

• Korean Journal of Soil Science and Fertilizer
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• v.4 no.2
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• pp.167-175
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• 1971

A pot experiment with an acid sulfate soil from Kimhae was carried out to find out the cause of toxicity in rice plant. The effect of liming on changes in pH, Eh, Al, and $Fe^{2+}$ in soil and leachate was examined at two-week interval during the growth of rice. Also, total $P_2O_5$, $SiO_2$, Fe and Al contents in plants at harvesting stage were determined. In the early stage, the rice plant in the check soil showed the same healthy growth as did in limed soil even at high Al in soil and leachate. Around panicle forming stage, reddish brown mottlings suddenly infested all over the plants when accompanied with strong reduction, and afterward growth was severely retarded, and finally caused the significant difference in yield. During the strong reduction, significant amount of sulfide was formed only in check soils, but no free $H_2S$ was detected. Appreciable Al was still present in soil and leachate, and $Fe^{2+}$ in check soil was lower than that in limed soil, but $Fe^{2+}$ in leachate was slightly higher. Limed soils were more reduced and produced more $Fe^{2+}$ due to increased microorganism activity in the neutral pH. In the leachate, the check showed slightly higher $Fe^{2+}$ concentration but considerably higher than limed one at later stage. Appreciable amount of Al was detected only in check soil and leachate from transplanting to panicle formation stage. Plant tissues at harvesting stage contained very low P regardless of liming. Uptake of Si was markedly increased by liming. Contents of Fe an Al was markedly higher in check than limed one, but difference in Fe content was more drastic possibly due to more Fe uptake in presence of markedly higher $Fe^{2+}$ in soil and leachate at later growing stage. In conclusion toxic symptom in this acid sulfate soil seems to be primarily due to Al when accompanied with low pH and strong reduction. But association with $Fe^{2+}$ toxicity is not completely excluded. In order to differentiate the effect of $Fe^{2+}$ from that of Al more detailed plant analysis at different stage is required.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.280-287
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• 2009

Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

• Journal of Korean Biological Nursing Science
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• v.1 no.1
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• pp.100-114
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• 1999

This study was done to investigate the effects of rapidly-rotating shift work of two-day interval on fatigue level and the concentration of urinary 17-KS, $Na^+,\;Cl^-$. The subjects were 20 nursing college students(control group) and 15 nurses in a university hospital and the study was done from Apr. 21 to May 4th, 1999. In the test group, each 5 nurses were allocated to day shift(8 AM-4 PM), evening shift(4 PM-12 MN) and night shift(12 MN-8 AM) respectively. The fatigue level were measured 30 minutes after work start on the 2nd day of work shift. Urine specimens were collected at 8 AM, 4 PM and 12 MN on the 2nd day of work shift in the control group and 30 minutes before and after work on the 2nd day of work shift in the test group. The data were analyzed with SPSS(for Window, ver 7.5). Statistical analysis was performed by using t-test, paired t-test and ANOVA. The results were as follows. 1. The perceived fatigue level in shift work 1) The physical and mental fatigue level were significantly higher in night shift than that in day or evening shift(p<0.05). In the neuro-sensory fatigue level, night shift showed higher tendency than that in day or evening shift, but there were no significant differences between each shifts. 2) Comparison between the control group and the test group: Physical fatigue level was significantly higher in night shift than that in day or evening shift of the control group(P<.001). Mental fatigue level was significantly higher in day or night shift than that in evening shift of the control group(P<.05). In the neuro-sensory fatigue level, test group showed higher tendency than that in the control group, but there were no significant differences between two groups. 3) The total fatigue level was higher in night shift than that in day shift or evening shift(P<.05). In comparing with the control group, night shift and day shift showed higher total fatigue level than that in the control group(p<0.05). 2. The concentration of urinary 17-KS, $Na^+$ and $Cl^-$ In the control group, urinary 17-KS, $Na^+$ and $Cl^-$ showed higher level in afternoon that in morning and night. In the test group, cr in day and evening shift and $Na^+$ in evening shift showed higher level at the end of work. The 17-KS concentration at the begining and the end of work in three shift groups were lower than those in control group(p<0.05), however, $Cl^-$ concentration at the begining of work in day shift, and the end of work in day and evening shift were higher than those in control group(p<0.05). $Cl^-$ concentration at the begining and end of work in night shift were considerably higher than those in control group repectively(p<0.1, p<001). $Na^+$ concentration showed a higher tendency in three shift groups except at the begining of work in night shift, but there were no statistical difference. In comparing concentration of the 17-KS, $Na^+$ and $Cl^-$ among the shift groups, 17-KS concentration showed a lower tendency and $Na^+,\;Cl^-$ showed a higher tendency in night shift: The result of this study showes that biorhythm of shift work nurse was irregular. Fatigue level as the subjective index for evaluating the health problem concerning shift work was higher in night shift and proved to be in accordance with the concentration of urinary 17-KS, $Na^+$ and $Cl^-$ used as objective indices. Disturbation of biorhythm and work stress due to night shift seems to cause the health problem of nurses and decrease of work efficiency. It is considered that work regualtion is necessary for the rational management of the nursing administration.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• Journal of Bio-Environment Control
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• v.22 no.2
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• pp.138-145
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• 2013

In order to develop the efficient control algorithm of the two-fluid fogging system, cooling experiments for the many different types of fogging cycles were conducted in tomato greenhouses. It showed that the cooling effect was 1.2 to $4.0^{\circ}C$ and the cooling efficiency was 8.2 to 32.9% on average. The cooling efficiency with fogging interval was highest in the case of the fogging cycle of 90 seconds. The cooling efficiency showed a tendency to increase as the fogging time increased and the stopping time decreased. As the spray rate of fog in the two-fluid fogging system increased, there was a tendency for the cooling efficiency to improve. However, as the inside air approaches its saturation level, even though the spray rate of fog increases, it does not lead to further evaporation. Thus, it can be inferred that increasing the spray rate of fog before the inside air reaches the saturation level could make higher the cooling efficiency. As cooling efficiency increases, the saturation deficit of inside air decreased and the difference between absolute humidity of inside and outside air increased. The more fog evaporated, the difference between absolute humidity of inside and outside air tended to increase and as the result, the discharge of vapor due to ventilation occurs more easily, which again lead to an increase in the evaporation rate and ultimately increase in the cooling efficiency. Regression analysis result on the saturation deficit of inside air showed that the fogging time needed to change of saturation deficit of $10g{\cdot}kg^{-1}$ was 120 seconds and stopping time was 60 seconds. But in order to decrease the amplitude of temperature and to increase the cooling efficiency, the fluctuation range of saturation deficit was set to $5g{\cdot}kg^{-1}$ and we decided that the fogging-stopping time of 60-30 seconds was more appropriate. Control types of two-fluid fogging systems were classified as computer control or simple control, and their control algorithms were derived. We recommend that if the two-fluid fogging system is controlled by manipulating only the set point of temperature, humidity, and on-off time, it would be best to set up the on-off time at 60-30 seconds in time control, the lower limit of air temperature at 30 to $32^{\circ}C$ and the upper limit of relative humidity at 85 to 90%.