• Neonatal Medicine
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• v.17 no.1
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• pp.13-20
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• 2010

Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

• Neonatal Medicine
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• v.17 no.1
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• pp.102-108
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• 2010

Purpose : The goal of this study was to measure bilirubin levels over 6 hours using a transcutaneous bilirubinometer. The change in the bilirubin levels were recorded in anomogram. The natural progress of jaundice in neonates was monitored using the nomogram and cases were identified that needed further follow-up observation and treatment. Methods : The subjects of this study were 986 healthy term or near-term infants at the age of 35 weeks or older who were born at Sung-Ae General Hospital during the period from October 1, 2007 to April 30, 2009 and whose parents were both Koreans. Transcutaneous bilirubin measurements were obtained using a transcutaneous bilirubinometer (Minolta, JM-103) from 6 hours of life to discharge at intervals of 6 hours. A nomogram was derived from the obtained data and compared to the delivery method, gestational age, and feeding method. Results : Percentile graphs were drawn according to time. Based on the graphs, phototherapy was necessary in more than 90 percent of the infants between 35 and 37.6 weeks of age and in 95 percent of the infants 38 weeks and older. The mean bilirubin level at 24, 48, 72 and 96 hours after birth were compared according to the delivery method, gestational age, and feeding method. The bilirubin level in 48 hours was significantly higher in neonates born via cesarean section delivery compared to the neonates born via vaginal delivery, however the levels were not statistically different at the other hours. Conclusion : The results of this study show the nomogram derived from hour-specific transcutaneous bilirubin levels. This information can be used to predict the risk for subsequent significant hyperbilirubinemia.

• The Journal of the Korean Society for Microbiology
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• v.3 no.1
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• pp.35-41
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• 1968

An outbreak of typhoid fever in Samchunpo city was surveyed and the results were summarized as follows: 1. 638 of clinical cases were detected in 17 Dongs(districts) of the city of Samchunpo,(54,064), during the epidemic period from 1st September to the end of November, 1967. 2. The morbidity rate was 1,189 per 100,000 population;(1,300 female, and 1,060 male). 3. The highest peak was reached in the third week of September and a second peak appeared at the end of September 1967. 4. The mode of infection was suspected strongly as a water-borne and the source of infection as an old public well called Gal-Dae-Saim, since the causative agent was found in close public latrine and the contaminated sewage ditch witch was connected with the well. 5. All patients and carriers were treated at their home under the supervision of local medical authorities. 6. The Gal-Dae-Saim was closed immediately on 7th October, 1967 by the order of the mayor. 7. At the end of November, 1967 when the outbreak in Samchunpo was almost ended, another small epidemic occurred in Koseong county which bordered the eastern outskirt of the city. 8. During the survey, a strain of Shigella flexneri was isolated from the sewage located three meters from Gal-Dae-Saim and also from one case. 9. It was reported by the local health center in May, 1968, that no carrier had been detected in the survey made among the persons who had had typhoid fever in 1967. Also thereafter no cases of typhoid fever were reported through October, 1968.

• Journal of Life Science
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• v.26 no.1
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• pp.23-33
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• 2016

Pexa-Vec (JX-594) is a specific cancer-targeted oncolytic and immunotherapeutic vaccinia virus. The purpose of this study was to develop methods to maximize the stability of Pexa-Vec. In short-term instability testing, viral activity was rapidly decreased both at 4℃ and at room temperature (RT), but it was completely restored after sonication followed by vortex. Long-term stability testing of Pexa-Vec in the following liquid formulations was performed: (A) 30 mM Tris/pH 7.6, (B) 30 mM Tris/pH 8.6, (C) 30 mM Tris/pH 7.6, 150 mM NaCl, 15% sucrose, (D) 30 mM Tris/pH 7.6, 15% sucrose, and (E) 30 mM Tris/pH 8.6, 15% sucrose. Viral activity decreased less than 2 log10 at 4℃, and RT was observed in 3 days in B, while viral activity was not decreased even after 4–8 weeks at 4℃ and at 1 week in RT in A, suggesting that neutral pH may be essential to maintain virus stability. The addition of 15% sucrose into A (D) significantly increased viral stability at −20℃, 4℃, or RT, and it was also observed at pH 8.6 (E). The addition of 150 mM NaCl into D (C) significantly increased viral stability in addition to the sucrose effect at 4℃ or RT. Accordingly, the viral activity in formulation C was maintained for 1.5 years at 4℃, and for 1-2 weeks in RT. In conclusion, we propose that formulation C can provide the most adequate condition for the proper storage of vaccinia oncolytic virus.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.846-855
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• 1999

Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.65-74
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• 1999

Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

• Clinical and Experimental Reproductive Medicine
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• v.23 no.3
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• pp.303-310
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• 1996

The objective of this study was to examine the effect of embryos development following IVF of in vitro-matured porcine oocytes treated with epidermal growth factor (EGF). When cumulus-enclosed oocytes were incubated in TCM 199 medium supplemented with (1) control group, (2) 10 ng/ml EGF, (3) 10${\mu}g$ml FSH and 10% FBS, or (4) 10 ng/ml EGF, 10 ${\mu}g$/ml FSH, and 10% FBS for 42 hr, the late developmental rates on NCSU (0.4% BSA) medium after fertilization were higher in (3) and (4) groups (13.4, 18.3%) than in (2) group (5.2%, p < 0.005), but (2) group is significantly higher than the development to blastocyst of oocytes of (1) group (1.2%). Also, when the cell number of total, ICM, and TE of those blastocysts at 6 day produced in vitro was investigated by double staining (PI and bisbenzimide), total cell number of (4) group (58.80${\pm}$ 11.90) was higher than that of (2) and (3) groups (42.17${\pm}$9.97, 49.07${\pm}$9.77, P < 0.05). ICM cell number of blastocysts of (4) group (11.69${\pm}$5.56) was higher than that of (2) and (3) groups (5.00${\pm}$4.24, 6.77${\pm}$4. 92, P < 0.05). Furthermore, the proportion of ICM in (4) group (19.0${\pm}$1.6) was higher than that in (2) and (3) groups (11.1${\pm}$3.0, 12. 7${\pm}$2.1). These results suggested that in vitromatured porcine oocytes treated with EGF alone can be developed to blastocyst, but high proportion on the development to blastocyst and number of total cell and ICM in blastocyst can be obtained when supplemented with additional FSH and FBS.

• Clinical and Experimental Reproductive Medicine
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• v.23 no.3
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• pp.319-326
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• 1996

The objective of this study was to investigate correlation between the morphology by microscopic assessments of surplus blastocysts produced in human IVF program and their cell number obtained by differential labelling method. For these experiments, 76 surplus human blastocysts were obtained from 36 patients on day 5 after IVF, the embryos were classified to early (ErB), early expanding (EEB), middle expanding (MEB), expanded blastocyst (EdB) according to their blastocoel expansion and zona thickness. When the ovum size and zona thickness of the classified blastocysts were measured using micrometer, although the embryos were produced in the same culture condition, there were significant variances in ovum size ($148.8 217.6{\mu}m$) and zona thickness ($1.2-14.4{\mu}m$). Total blastomere cell number counted after hoechst staining was increased by two to three fold during the transition period from ErB ($39.1{\pm}3.6$) to EdB ($(89.6{\pm}3.3)$) stage on day 5 after IVF. ICM ($11.9{\pm}1.8-22.2{\pm}4.3$) and TE ($24.5{\pm}3.6-70.0{\pm}7.7$) cell numbers using differential labelling were also showed the increased pattern according to the developmental level. Especially, EdB which showed poor ICM morphologically also indicated the low ICM cell number after differential labelling. This demonstrated that there is good correlation between the morphological assessment and the cell number. The count of ICM and TE nuclei using differential labelling can be used as an important criterion, if it is accompanied with morphological assessments, in selecting the better embryos for improving the pregnancy rates in human blastocyst transfer program.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.812-819
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• 2003

Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

• Journal of dental hygiene science
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• v.12 no.3
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• pp.197-207
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• 2012

The purpose of this study was to examine the impact of the oral health status and health care of elderly people on their self-rated health(SRH). The subjects on this study were 479 senior citizens who were at the age of 65 and up and resided in the city of Busan. They got a dental checkup, and a survey was conducted by having an one-on-one interview. After the collected data were analyzed, the following findings were given: The senior citizens were diagnosed with a mean of 1.43 systemic diseases, and hypertension(51.8%) was the most prevalent disease among them, followed by diabetes(25.1%), arthritis(41.8%), oral diseases(75.6%), stroke(9.0%) and heart diseases(15.9%). Their self-rated health was better when they were male, when they were aged between 65 and 69, when there was someone with whom they lived, when they were better educated and when they owned their own houses. But their self-rated health was poorer when they felt more oral symptoms, when they had more missing teeth and when they needed both of maxillary and mandibular dentures. Their self-rated health was more positively affected when they were better educated($\beta$=0.894), when they owned their own houses($\beta$=4.220), when they got a dental checkup on a regular basis($\beta$=2.997) and when the rate of their functional tooth was larger($\beta$=0.081). And that was more negatively influenced when they had a denture($\beta$=-1.110), when they had more oral symptoms($\beta$=-1.590) and when they had more systemic diseases($\beta$=3.363). There is a close relationship between the oral health and self-rated health of elderly people. Therefore how to promote their oral health should carefully be considered.