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The Narrative Inquiry on the Identity and Role of Local Cultural Art Director as a Local Resident: Focus on C Region Crafts Biennale (지역민인 지역문화예술 감독의 정체성과 역할에 관한 내러티브 탐구 - C지역 공예비엔날레를 중심으로 -)

  • Sa, Yuntaek
    • Korean Association of Arts Management
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    • no.50
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    • pp.101-146
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    • 2019
  • After the enactment of the Local Culture Promotion Act in 2014, the government has been continuously trying to find the direction of the local culture that reflects the local life and conforms to the local people's emotions. In response to these efforts, the Organizing Committee for the C Region Biennale has uniquely formed the Biennale Artistic Director as a local artist who includes the historical, ecological and emotional characteristics of the C region. Therefore, I sought to explore the perception of the identity and role of the local cultural arts director through the narratives of the research participants who were appointed as the local residents of the C region and the director of the Craft Biennale. For the study, six local cultural arts directors were selected as research participants, and their identity as a local cultural arts director and its role were explored, focusing on their narratives. In this process, various types of data such as photographs, documents, in - depth interviews, and conference materials were collected and narrative was analyzed based on deterministic events. The results of the investigation are as follows. The idea of the identity of the local cultural arts directors was found to be in three directions. First, it is the view that the symbolic role of the artistic supervisory system of the 10 persons guarantees the identity. Second, the identity of local cultural arts directors was recognized as a role to find ways to be localized by developing and debating cultural and artistic discourses in various regions. Third, the participants had a concern and affection for local cultural arts, not one-time but continuous, and recognized it as their identity. The directors who participated in the interviews showed that the discourse of cultural arts in various regions were developed and discussed, and they wanted to find ways to be localized. The roles of local cultural arts directors recognized by research participants in connection with their identity are as follows. First, it should be the subject of systematic and long-term planning that can close the year and connect with the art events of the following year. Second, it should play a role of academic / research that can derive the identity of social and cultural ecological analysis connected with the area. Third, local arts professionals are required to act as cultural brokers, ie local culture professionals, who can create a venue for international cultural exchanges. Research on the form of local government supervision as a mediator of local cultural arts is to find out the origin of the identity of local artists and to establish a methodology for the direction of culture and art as a subject of local people. In addition, there is a need for continued interest and research in providing a reflection on the communication and meaning of the desirable local culture, and suggesting the system for cultivating local cultural arts intermediaries.

Use of Parasites for Stock Analysis of Salmonid Fishes (연어과 어류의 계군분석을 위한 기생충의 활용)

  • Kim, Jeong-Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.2
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    • pp.112-120
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    • 2007
  • This paper reviews the use of parasites as 'biological tags' for studying stock analysis of salmonid fishes. Numerous definitions of stock concepts exist, but most of them essentially define a group of fish as having similar biological characteristics and being self-reproducing as stocks. It is important to manage fish stocks for human consumption and sustainable production and especially for salmonid fishes. Because these fry are considered as each country's property, it is necessary to identify and discriminate each fish stock in the open sea. Methods of separating fish stocks are very diverse. Artificial tags, parasites, otoliths scales and genetic characters have been used for stock analysis and each method has advantages and disadvantages. Of these parasites can be good biological tags because they are applied by nature at no cost. Parasites can be infected with susceptible host fishes when they enter into certain areas. Then if they move to the outside and are caught researchers can infer that the fish had been in the endemic area for a period of time during their life. Hence the host fish can be considered as naturally 'tagged' by parasites. However, if they do not pass the parasites-endemic. area, they will harbour no parasites. Therefore, researchers can discriminate each fish stocks and trace their migration routes with these biological tags. In this paper, several examples on the use of parasites as biological tags for studying salmonids, as well as other species, are listed. The advantages and limitations of parasites as biological tags are also discussed. Chum salmon (Oncorhynchus keta), the main salmonid species migrating to Korea, is distributed all around the North Pacific. Korean chum salmon are generally thought to move to the Sea of Okhotsk, the western North Pacific and the Bering Sea. However, there is no clear information on the distribution and migration pathways of Korean chum salmon, and no markers exist for separating them from others yet. Recent Korean chum salmon stock analysis including parasites information are mentioned.

A Study on the Medical Application and Personal Information Protection of Generative AI (생성형 AI의 의료적 활용과 개인정보보호)

  • Lee, Sookyoung
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.67-101
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    • 2023
  • The utilization of generative AI in the medical field is also being rapidly researched. Access to vast data sets reduces the time and energy spent in selecting information. However, as the effort put into content creation decreases, there is a greater likelihood of associated issues arising. For example, with generative AI, users must discern the accuracy of results themselves, as these AIs learn from data within a set period and generate outcomes. While the answers may appear plausible, their sources are often unclear, making it challenging to determine their veracity. Additionally, the possibility of presenting results from a biased or distorted perspective cannot be discounted at present on ethical grounds. Despite these concerns, the field of generative AI is continually advancing, with an increasing number of users leveraging it in various sectors, including biomedical and life sciences. This raises important legal considerations regarding who bears responsibility and to what extent for any damages caused by these high-performance AI algorithms. A general overview of issues with generative AI includes those discussed above, but another perspective arises from its fundamental nature as a large-scale language model ('LLM') AI. There is a civil law concern regarding "the memorization of training data within artificial neural networks and its subsequent reproduction". Medical data, by nature, often reflects personal characteristics of patients, potentially leading to issues such as the regeneration of personal information. The extensive application of generative AI in scenarios beyond traditional AI brings forth the possibility of legal challenges that cannot be ignored. Upon examining the technical characteristics of generative AI and focusing on legal issues, especially concerning the protection of personal information, it's evident that current laws regarding personal information protection, particularly in the context of health and medical data utilization, are inadequate. These laws provide processes for anonymizing and de-identification, specific personal information but fall short when generative AI is applied as software in medical devices. To address the functionalities of generative AI in clinical software, a reevaluation and adjustment of existing laws for the protection of personal information are imperative.

Development of Eggs, Larvae and Juveniles of the Hypomesus nipponensis (Pisces:Osmeridae) from Western Coastal, Daeho-man (서해안 대호만에 서식하는 빙어 Hypomesus nipponensis의 난발생 및 자치어 형태발달)

  • Jae-Min Park;Dong-Jae Yoo;Jeong-Nam Yu;Seong-Ryul Lim;Dal-Young Kim;Kyeong-Ho Han
    • Korean Journal of Ichthyology
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    • v.36 no.2
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    • pp.120-128
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    • 2024
  • In this study, the characteristics of the early life history were investigated for the Hypomesus nipponensis in the west coast Daeho Bay. Egg's were adhesive eggs that had the property of sinking in water in a circular shape. The size of mature eggs was 0.52~0.66 (average of 0.59±0.03, n=30) mm. The hatching time took 140 hours at a water temperature of 22~23℃. Immediately after hatching, the yolk sac larvae was 4.78~5.60 (average of 5.25±0.26, n=30) mm in total length, and the mouth and anus were not completely opened. On the 7 days after hatching, the preflexion larvae was 5.91~6.64 (6.32±0.21) mm in total length, and the mouth and anus were opened, and feeding activities were started. On the 25 days after hatching, the flexion larvae was 9.70~12.3 (10.2±0.63) mm in total length, and the end of the spine at the tail end began to bend upward. On the 42 days after hatching, the postflexion larvae was 14.1~18.8 (16.9±1.44) mm in total length, and the end of the spine at the tail was completely bent at 45°. On the 56 days after hatching, it reached the integer with 10 dorsal fins, 16 anal fins, 7 ventral fins, and 19 caudal fins. According to the study, there were spot-shaped melanophore vesicles under the pectoral fins during the incubation period, the different positions of the egg yolk compared to the battlefield, the deposition of melanophore vesicles on the back and under the body of the caudal part during the postflexion larvae period, and the absence of melanophore vesicles on the torso between the head and the starting point of the dorsal fin. It was distinguished from related species in that melanophore vesicles were deposited in one row from the back of the body to the caudal part during the juvenile period.

Development of Eggs, Larvae and Juveniles of the Ladislavia taczanowskii from Hongcheongang-River (홍천강에 서식하는 멸종위기종 새미 Ladislavia taczanowskii의 난발생 및 자치어 형태발달)

  • Jae-Min Park;Seong-Jang Cho;Kyeong-Ho Han
    • Korean Journal of Ichthyology
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    • v.36 no.2
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    • pp.109-119
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    • 2024
  • This study was conducted to investigate the early life history by observing the egg development of Ladislavia taczanowskii in endangered fish and to use it as basic data for species conservation research. The broodstork used in the study was secured from the area of the Hongcheon River in Hongcheon-gun, Gangwon State. The broodstork, who was being raised in the laboratory, selected mature individuals in May 2021 and induced them to spawn by hormone injection. The size of the maturation egg was 1.50~1.79 (average 1.59±0.08, n=30) mm due to the circular invasive egg. The incubation time took 168 hours at 16.5℃ and 109 hours and 30 minutes at 25.5℃. Newly hatched larvae, the consonants had a total length of 5.55~6.31 mm (6.30±6.93, n=30) mm, and the mouth and anus did not open and had egg yolk. 5 days after hatching, the preflexion larvae had a total length of 9.91~10.8 (10.1±0.27, n=30) mm, and the mouth and anus opened, and feeding activities began. 8 days after hatching, the flexion larvae had a total length of 10.3~11.4 (10.8±0.38, n=30) mm, and the end of the vertebrae at the tail fin tip began to bend upward. 10 day after hatching, the postflexion larvae had a total length of 11.8~13.1 (12.3±0.43, n=30) mm, and the end of the vertebrae at the tail tip was completely bent at 45°. 18 days after hatching, the total length of the juveniles was 18.9~23.4 (20.4±1.69, n=30) mm, and the number of fins in each part was fin rays with 10 dorsal fins, 9 anal fins, 22 caudal fins, and 7 ventral fins. As a result of the study, the postflexion larvae showed differences in morphology from other Gobioninae fishes in the upper part of the tail's hypural, the shape of spots on the dorsal vertebrae, the vertical stripes developed on the head, and the irregularly deposited melanophore throughout the body.

Spatial Distribution of Aging District in Taejeon Metropolitan City (대전광역시 노령화 지구의 공간적 분포 패턴)

  • Jeong, Hwan-Yeong;Ko, Sang-Im
    • Journal of the Korean association of regional geographers
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    • v.6 no.2
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    • pp.1-19
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    • 2000
  • This study is to investigate and analyze regional patterns of aging in Taejeon Metropolitan city-the overpopulated area of Choong-Cheong Province-by cohort analysis method. According to the population structure transition caused by rapid social and economic changes, Korea has made a rapid progress in population aging since 1970. This trend is so rapid that we should prepare for and cope with aging society. It is not only slow to cope with it in our society, but also there are few studies on population aging of the geographical field in Korea. The data of this study are the reports of Population and Housing Censuses in 1975 and 1985 and General Population and Housing Censuses with 10% sample survey in 1995 taken by National Statistical Office. The research method is to sample as the aging district the area with high aged population rate where the populations over 60 reside among total population during the years of 1975, 1985, 1995 and to sample the special districts of decreasing population where the population decreases very much and the special districts of increasing population in which the population increases greatly, presuming that the reason why aged population rate increases is that non-elderly population high in mobility moves out. It is then verified and ascertained whether it is true or not with cohort analysis method by age. Finally regional patterns in the city are found through the classification and modeling by type based on the aging district, the special districts of decreasing population, and the special districts of increasing population. The characteristics of the regional patterns show that there is social population transition and that non-elderly population moves out. The aging district with the high aged population rate is divided into high-level keeping-up type, relative falling type below the average of Taejeon city in aging progress, and relative rising type above the average of the city. This district can be found at both the central area of the city and the suburbs because Taejeon city has the characteristic of over-bounded city. But it cannot be found at the new built-up area with the in-migration of large population. The special districts of decreasing population where the population continues to decrease can be said to be the population doughnuts found at the CBD and its neighboring inner area. On the other hand, the special districts of increasing population where the population continues to increase are located at the new built-up area of the northern part in Taejeon city. The special districts of decreasing population are overlapping with the aging district and higher in aged population rate by the out-migration of non-elderly population. The special districts of increasing population are not overlapping with the aging district and lower in aged population rate by the in-migration of non-elderly population. To clarify the distribution map of the aging district, the special districts of decreasing and increasing population and the aging district are divided into four groups such as the special districts of decreasing population group-the same one as the aging district, the special districts of decreasing population group, the special districts of increasing population group, and the other district. With the cohort analysis method by age used to investigate the definite increase and decrease of aging population through population transition of each group, it is found that the progress of population aging is closely related to the social population fluctuation, especially that aged population rate is higher with the out-migration of non-elderly population. This is to explain each model of CBD, inner area, and the suburbs after modeling the aging district, the special districts of decreasing population, and the special districts of increasing population in Taejeon city. On the assumption that the city area is a concentric circle, it is possible to divide it into three areas such as CBD(A), the inner area(B), and the suburbs(C). The special districts of increasing and decreasing population in the city are divided into three districts-the special districts of decreasing population(a), the special districts of increasing population(b), and the others(c). The aging district of this city is divided into the aging district($\alpha$) and the others($\beta$). And then modeling these districts, it is probable to find regional patterns in the city. $Aa{\alpha}$ and $Ac{\beta}$ patterns are found in the CBD, in which $Aa{\alpha}$ is the special district of decreasing population and is higher in aged population rate because of aged population low in mobility staying behind and out-migration of non-elderly population. $Ba{\alpha}$, $Ba{\beta}$, $Bb{\beta}$, and $Bc{\beta}$ patterns are found in the inner area, in which neighboring area $Ba{\alpha}$ pattern is located. $Bb{\beta}$ pattern is located at the new developing area of newly built apartment complex. $Cb{\beta}$, $Cc{\alpha}$, and $Cc{\beta}$ patterns are found in the suburbs, among which $Cc{\alpha}$ pattern is highest in population aging. It is likely that the $Cc{\beta}$ under housing land readjustment on a large scale will be the $Cb{\beta}$ pattern. As analyzed above, marriage and out-migration of new family, non-elderly population, with house purchase are main factors in accelerating population aging in the central area of the city. Population aging is responsible for the great increase of aged population with longer life expectancy by the low death rate, the out-migration of non-elderly population, and the age group of new aged population in the suburbs. It is necessary to investigate and analyze the regional patterns of population aging at the time when population problems caused by aging as well as longer life expectancy are now on the increase. I hope that this will help the future study on population aging of the geographical field in Korea. As in the future population aging will be a major problem in our society, local autonomy should make a plan for the problem to the extent that population aging progresses by regional groups and inevitably prepare for it.

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The Aspects of Change of Sijo (시조의 변이 양상)

  • Kang Myeoung-Hye
    • Sijohaknonchong
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    • v.24
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    • pp.5-46
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    • 2006
  • Korean verse has flexibly changed its form and contents according to the historical background of the times. This fact arouses reader sympathy because it has reflected ideas, historical aspects and realities of the times. However, korean verse has kept its own characteristics in some ways, allowing it to exist today. It holds its form as 3 verses of three by three or four meter and three letters of the last of three verses. It makes every different version which has specific aspects of each times in the same 'sijo' area. 'Sijo' in Korean poems, is the first form that has been changed from formal to private functionally. As a result of that common verses in the Goryeo to Joseon eras were going with the stream of the times. Verse was the plate for justice so that there was no double meaning, symbols, or technical sentences. It had to show the idea of Myungchundo Jwonginryun. The theme was commonly fitted within certain areas. such as blessings, fidelity, devotion, etc. Around the end of the Joseon era, there was activation of private verses - a form of sijo with no restrictions on the length of the first two verses. Some ideas had been changed because Sarimpa gained power, domestic conflict, and the introduction of practical science. These things had an effect on the form of Sijo. After all, it shows the ideas of collapsing feudalism, resistance of confucian ideas, equality of the sexes, and opposition to the group who rule the government. Thus Sasul Sijo seems to have the tendency of resistance to reality. It was a specialty of realism poetry It explained our life in detail and reflected real life by being an intermediary of realism. This met and represented the demand of a reader's expectations. After 1905, there was new form of sijo that is very different, in form and content, from the previous versions. It was even different in areas of what people accepted. They started to think sijo was not the form of lyrical verse that is once was. It became a 'record of reading'. The form changed to 'hung or huhung' that satirized the times and the ending of a word in the last verse. Although this form could deliver the tension in statement, it was too iu from the original form. Therefore, it didn't last long, and its position got smaller because of the free verse that had western influence and was emerging in the times. In the middle of 1920, there was a movement of Sijo revival. It was lead by Choinamsun. He wrote poems and Sijo which were effected by western ideas in his early works. Although he worked with that, he took the lead in the movement of Sijo revival. He published the collection of Sijo $\ulcorner$Baekpalbunnwoi$\lrcorner$ that has one major theme-patriotic sentiment. He thought an ancient poem was a part of racial characteristics so that he expressed the main theme which represented the times and situations of his era. Modern Sijo is difficult. Sijo has to have modern and Korean verse characteristics at the same time. If it considers a modern aspect too much, it could not be distinguished from sijo and free verse. If it overly leans toward Sijo. it would seem to be too conservative which it then could be said to have no real charm of a poem. In spite of these problems, it is written constantly, because it has its own specialty. It has been focused on some works because they reflect awareness of modern times, the democratic idea, and realism. Overall, the authors of Modern Sijo express various themes by using different forms. The more what we can guess in this work, Sijo will exist permanently because of its flexibility. Furthermore, one special characteristic-flexibility of the korean verse will make it last forever and it will be a genre in Korean poetry.

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Studies on Press Drying of Fire-Retardant Treated Plywood (내화처리합판(耐火處理合板)의 열판건조(熱板乾燥)에 관(關)한 연구(硏究))

  • Kim, Jong Man
    • Journal of Korean Society of Forest Science
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    • v.56 no.1
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    • pp.1-25
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    • 1982
  • Plywood used for construction as a decorative inner material is inflammable and can cause fire accidents. causing destruction of human life and property. To diminish the fire disaster, fire retardant plywood is indeed required. In the methods of manufacturing the fire retardant plywood, a soaking method is occasionally used. However after soaking plywood into fire retardant chemical solutions redrying of soaked plywood is of the utmost importance. In this study 3.5mm and 5.0mm thickness plywoods were selected for fire retardant treatment. Treating solutions were prepared for 20% dilute solutions of ammonium sulfate, monoammonium phosphate, diammonium phosphate, borax-boric acid minalith, and water solution, 1-, 3-, 6-, and 9 hour-soaking treatments in borax-boric acid and minalith, and 6- and 9 hours in the other chemicals were applied and after the treatment hot drying was applied to treated plywoods at $90^{\circ}C$, $120^{\circ}C$ and $150^{\circ}C$ of press temperature. Drying rates, drying curves, water absorption rates of fire retardant chemicals, weight per volume and fire retardant degree of plywood were investigated. The results may be summarized as follows: 1) In the 9 hours-soaking treatment of fire retardants by hot and cold bath method, the chemical retentions of 3.5mm thickness plywood could be attained within the range ($1.125-2.25kg/(30cm)^3$) of minimum retention specification as follows: $1.353kg/(30cm)^3$ in monoammonium phosphate, $1.331kg/(30cm)^3$ in diammonium phosphate, $1.263kg/(30cm)^3$ in ammonium sulfate, $1.226kg/(30cm)^3$ in borax-boric acid. But the chemical retention, $0.906kg/(30cm)^3$, in minalith could not be attained within the range of minimum retention specification. And also in case of 5.0mm thickness plywood, chemical retentions, as $1.356kg/(30cm)^3$ and $1.166kg/(30cm)^3$ respectively, of ammonium sulfate and diammonium phosphate could be attained within the range minimum retention specification, but the other fire retardant chemicals could not. 2) In the 6- and - hours-soaking treatments of 3.5mm and 5.0mm thickness plywood, the drying curve sloped of chemical treated plywood was smaller than that of water treated. The drying rate related to thickness of treated plywood, was about three times as fast in 3.5mm thickness plywood compared with 5.0mm thickness plywood. 3) In the treatment at $120^{\circ}C$ of hot platen temperature, the drying rates of chemical-treated plywood showed the highest quantity in diammonium phosphate of 3.5mm and 5.0mm thickness plywood. But the drying rate of water treated plywood was highest during the 6- and 9 hours-soaking treatments. 4) The drying rate remarkably increased with proportion to increase of the platen temperature, and the values were respectively 1.23%/min., 6.54%/min., 25.75%/min. in hot platen temperature of $90^{\circ}C$, $120^{\circ}C$, $150^{\circ}C$ in 3.5mm thickness plywood and 0.55%.min., 2.49%/min., 8.19%/min. in hot platen temperature of $90^{\circ}C$, $120^{\circ}C$, $150^{\circ}C$ in 5.0mm thickness plywood. 5) In the fire retardant degree of chemical treated plywood, the loss in weight was the smallest in diammonium phosphate, next was in monoammonium phosphate and ammonium sulfate, and the greatest was in borax-boric acid and minalith. And the fire-retardant effect in burning time, flame-exhausted time and carbonized area were greatest in diammouniun phosphate, next were in monoammonium phosphate and ammonium sulfate, and the weakest were in borax-boric acid and minalith.

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An Analysis of the Research Trends in Safety Education for Home Economics Education (가정과 안전교육의 연구 동향 분석)

  • Kim, Nam Eun
    • Journal of Korean Home Economics Education Association
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    • v.28 no.3
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    • pp.47-63
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    • 2016
  • The purpose of this study is to suggest the basic information for diverse and balanced research and development in this field with understanding research trends related to safety education in home economics. In order to so, this study makes population and sampling by targeting cases which refer to 'safety' on 15 papers of academic journals related to home economics registered in the National Research Foundation from 2001 to 2015, 244 papers related to safety education area and 179 master doctorate thesis by searching keyword as 'safety'. Analysis contents are research trends of papers related to safety education by year and by subject and research trends of safety education by area and by research method. As a result of the study, first, the number of research papers related to safety education by year on home economics curriculum repeated increase and decrease and there have been consistent studies conducted on safety education with 14-52 papers per every year and yearly average 28.2 papers. On the other hand, the most number of studies conducted in 2015 with 52 papers which are twice as much of 26 papers in 2014. This seems to be affected by the announcement of safety comprehensive countermeasures from government and the emphasis of safety subject on 2015 curriculum revision of the Ministry of Education. Second, with regards to research trends by topic, 137 papers are related to safety education (29%), 336 papers are related to safety actual condition (71%). Accidents and recognition had a greater percentage in a paper before 2009 (74.4%) and studies are increased after 2009 (from 21 papers to 53 papers) in terms of development or evaluation of safety education program, development of education materials, development of education method etc. Subject area dealt with the most on the research of safety actual condition is regarding safety accidents or effective variables (23.2%). Subject regarding the variables are researches related to factors influencing family violence, internet addiction, spouse violence, willingness to purchase unsafe food, age harassment, or suicidal attempt etc. Next, researches related to safety recognition (13.9%), safety knowledge and attitude (7.4%), safety behaviors (6.3%), safety consciousness (2.3%) show in sequence. Subject area dealt with the most on the researches regarding safety education is development and evaluation of safety education program (11%) and this appears the most in 2015 by year (21.5%). Third, with regards to eight areas of safety education, there are 143 papers regarding public safety (33.8%), 106 papers regarding violence and personal safety (25.1%), 93 papers regarding general subject on safety or whole safety area (22%) and 58 papers regarding drug and internet addiction (13.7%) in sequence. And there is no paper related to first aid and 1 paper is related to occupational safety (0.2%). Occupational safety area is less researched nevertheless its included in home economic curriculum as relative chapter. First aid does not directly correlate with home economics curriculum but should be studied in preparation for accident which could happen in practical class. Forth, with regards to research trends by research method, quantitative research (89.1%) is mostly used and both research study (70.4%) and experimental research (18.7%) are used the most frequently. In particular, researches on the actual condition of safety education and experimental studies for effectiveness verification take most of research method. As qualitative studies, there are phenomenological study (3.1%) and case study (3.1%) related to actual conditions of safety accidents. 10 papers (2.4%) are mixture of quantitative and qualitative research and some research conducted research study and experimental research at the same time (0.9%). With regards to subject of study, human environments (87.5%) are more than physical environments (12.5) and students (48.4%) are more than teachers and school parents (20.6%). As the subject of physical environments, school (6.5%) is the most but home environment is none. As a result of the study, research for the development of evaluation tool for evaluating safety education, occupational safety and lifelong education should be conducted from this time forward. In addition, the object of study shall be expanded to both human environments in terms of entire life and physical environments for home. An in-depth qualitative research should be needed by observing and meeting with each student.

The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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