• Title/Summary/Keyword: Risk-based

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Regional Analysis on the Incidence of Preterm and Low Birth Weight Infant and the Current Situation on the Neonatal Intensive Care Units in Korea, 2009 (2009년 한국 시도별 미숙아, 저체중출생아의 빈도 및 신생아중환자실의 현황)

  • Kang, Byung-Ho;Jung, Kyung-A;Hahn, Won-Ho;Shim, Kye-Shik;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.70-75
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    • 2011
  • Purpose: Recently, the incidence of preterm and low birth weight infants (LBWI) is increasing, even though the birth rate is continuously low in Korea. Despite that change, there continues to be a deficit of beds in the neonatal intensive care unit (NICU). This study is based on the 2009 Korean Statistical Information Service that examined the development of a Korean NICU service and the survival rate of preterm infants by regionally analyzing the rate of total live births, preterm infants, LBWI, and NICU beds in Korea. Methods: Data were obtained from the Korean Health Insurance Review and Assessment Service and Korean Statistical Information Service. We confirmed the regional total live birth rate, number of LBWI, and preterm infants and NICU numbers, and all of the results were compared to the average value to determine deficient areas of NICU beds. Results: There were 25,374 (5.7%) preterm infants and 21,954 (4.9%) LBWI in the total number of live births (444,849) in 2009, and regions of high proportion compared to the mean value were Busan, Daegu, and Ulsan. Total NICU beds totaled 1,284, and regions of high rates preterm infants and LBWI per 1 NICU bed compared to the mean value were Incheon, Daegu, Ulsan, etc. The NICU holding rate was 87.5% (1,284/1,468), which was increased from 2005. However, there were still shortages of 184 NICU beds (12.5%), especially in Gyeonggi-do, which lacked 157 beds. Conclusion: High risk neonates difficult to transfer, and they need immediate and continuous treatment. As a result, a foundation of well-balanced, national NICU regionalization is necessary. This study suggested that more NICU facilities must be implemented, and clinicians should realize the continuing deficiency of NICU beds in cities and provinces.

Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey

  • Arvas, Macit;Salihoglu, Yavuz;Sal, Veysel;Gungor, Tayfun;Sozen, Hamdullah;Kahramanoglu, Ilker;Topuz, Samet;Demirkiran, Fuat;Iyibozkurt, Cem;Bese, Tugan;Ozgu, Burcin Salman;Vatansever, Dogan;Tokgozoglu, Nedim;Berkman, Sinan;Turan, Hasan;Bengisu, Ergin;Sofiyeva, Nigar;Demiral, Irem;Meydanli, Mutlu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1909-1915
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    • 2016
  • Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

A Clinical Study of the Acute Respiratory Distress Syndrome in Children (소아에서의 급성 호흡 곤란 증후군에 대한 임상적 고찰)

  • Lee, Taek Jin;Kim, Dong Soo;Shin, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.42-50
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    • 2003
  • Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

Association Between Parental Socioeconomic Level, Overweight, and Eating Habits with Diet Quality in Korean Sixth Grade School Children (부모의 사회경제적 수준 (가구 월수입, 부모 교육수준)과 초등학교 6학년 학생의 과체중 및 식습관, 식사 질과의 관계)

  • Jang, Han-Byul;Park, Ju-Yeon;Lee, Hye-Ja;Kang, Jae-Heon;Park, Kyung-Hee;Song, Ji-Hyun
    • Journal of Nutrition and Health
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    • v.44 no.5
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    • pp.416-427
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    • 2011
  • This study investigated the association among parental socioeconomic level, overweight, and eating habits with diet quality in Korean sixth grade school children. A 3-day dietary survey was conducted, and a questionnaire and anthropometric data were collected from the Korean child obesity cohort (320 boys and 345 girls). The children were classified into two groups (low or high level) based on monthly household income and paternal and maternal education status. Lower maternal education status was associated with a higher risk for overweight in girls (odd ratio, 1.91; 95% confidence interval 1.07-3.44), whereas belonging to a higher socioeconomic group in terms of parental income or parental education level resulted in the consumption of significantly more fruit. Boys did not show significant differences in the intake of most nutrients or diet quality regardless of socioeconomic status. However, girls in the lower socioeconomic group had a lower food habit score (higher frequency of breakfast skipping and ramen noodle consumption), diet quality, and intake of nutrients (carbohydrate, vitamin C, potassium, and fiber) than those in the higher socioeconomic group. Therefore future nutrition policies and interventions should support parents and children with lower socioeconomic status to develop health-related behaviors that may prevent childhood overweight.

Analysis of source localization of P300 in college students with schizotypal traits (조현형 인격 성향을 가진 대학생의 P300 국소화 분석)

  • Jang, Kyoung-Mi;Kim, Bo-Mi;Na, Eun-Chan;An, Eun-Ji;Kim, Myung-Sun
    • Korean Journal of Cognitive Science
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    • v.28 no.1
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    • pp.1-26
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    • 2017
  • This study investigated the cortical generators of P300 in college students with schizotypal traits by using an auditory oddball paradigm, event-related potentials (ERPs) and standardized low resolution brain electromagnetic tomography (sLORETA) model. We also investigated the relationship between the current density of P300 and the clinical symptoms of schizophrenia. Based on the scores of Schizotypal Personality Questionnaire(SPQ), schizotypal trait (n=37) and control (n=42) groups were selected. For the measurement of P300, an auditory oddball paradigm, in which frequent standard tones (1000Hz) and rare target tones (1500Hz) were presented randomly, was used. Participants were required to count the number of the target tones during the task and report this at the end of the experiment. The two groups did not differ significantly in the accuracy of the oddball task. The schizotypal trait group showed significantly smaller P300 amplitudes than control group. In terms of source localization, both groups showed the P300 current density over bilateral frontal, parietal, temporal and occipital lobes. However, the schizotypal trait group showed significantly reduced activations in the left superior temporal gyrus and the right middle temporal gyrus, but increased activations in both left inferior frontal gyrus and right superior frontal gyrus compared to the control group. Furthermore, a negative correlation between the current density of the right superior frontal gyrus and SPQ disorganization score was found in the schizotypal trait group. These findings indicate that the individuals with schizotypal traits have dysfunctions of frontal and temporal areas, which are known to be the source of P300, as observed in patients with schizophrenia. In addition, the present results indicate that the disorganization score, rather than total score, of the SPQ is useful in predicting the risk of future schizophrenia.

Allele Distribution and Frequency of Human Surfactant Protein-A1 in Korean Neonates (한국 신생아의 폐 표면 활성제 단백-A1 (Human Surfactant Protein-A1) 유전자 대립형질의 분포와 빈도)

  • Lee, Kyung Shin;Kim, Young Hee;Suk, Jung Su;Ko, Jung Ho;Yoo, Ook Joon;Lee, In Kyu;Oh, Myung Ho;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1497-1502
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    • 2002
  • Purpose : We evaluated allele frequencies and distribution of surfactant protein A1(SP-A1) in Korean neonates in order to estimate prevalence of RDS to find out new SP-A alleles, and to establish new steroid therapy. Methods : Genomic DNA was extracted from 100 neonates and served as a template in PCR for genotype analysis. SP-A gene-specific amplications and gene-specific allele determinations were performed using PCR-RFLP methods. Results : The distribution for the alleles of the SP-A1 gene in the study population were 6A, $6A^2$, $6A^3$, $6A^4$, $6A^8$, $6A^9$, $6A^{10}$, $6A^{11}$, $6A^{12}$, $6A^{13}$, $6A^{14}$, $6A^{15}$, $6A^{16}$, $6A^{17}$, $6A^{18}$, $6A^{20}$. The specific frequencies for the alleles of the SP-A1 gene in the study population were : $6A^2=21%$, $6A^3=45%$, $6A^4=11%$, $6A^8=9%$, $6A^{14}=8%$. Conclusion : The frequency of $6A^3$ was higher than the other SP-A1 alleles in Korean neonates. This finding suggests that the prevalence of RDS in Korea may be low compared with other countries. However, this finding also suggests that Korean neonates have a high risk of infection.

Agricultural Policies and Geographical Specialization of Farming in England (영국의 농업정책이 지리적 전문화에 미친 영향 연구)

  • Kim, Ki-Hyuk
    • Journal of the Korean association of regional geographers
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    • v.5 no.1
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    • pp.101-120
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    • 1999
  • The purpose of this study is to analyze the impact of agricultural polices on the change of regional structure based on the specialization during the productivism period. Analysis are carried on through the comparison of distribution in 1950s and 1997. Since the 1950s, governmental policy has played a leading role in shaping the pattern of farming in Great Britain. The range of British measures have also been employed in an attempt to improve the efficiency of agriculture and raise farm income. Three fairly distinct phase can be identified in the developing relationship between government policies and British agriculture in the postwar period. In the 1st phase, The Agricultural Act of 1947 laid the foundations for agricultural productivism in Great Britain until membership of the EC. This was to be achieved through the system of price support and guaranteed prices and the means of a series of grants and subsidies. Guaranteed prices encouraged farmenrs to intensify production and specialize in either cereal farming or milk-beef enterprise. The former favoured eastern areas, whereas the latter favoured western areas. Various grants and subsidies were made available to farmers during this period, again as a way of increasing efficiency and farm incomes. Many policies, such as Calf Subsidy and the Ploughing Grant, Hill cow and Hill Sheep Schemes and the Hill Farming and Livestock Rearing Grant was provided. Some of these policies favoured western uplands, whilst the others was biased towards the Lake District. Concentration of farms occured especially in near the London Metropolitan Area and south part of Scotland. In the 2nd stage after the membership of EC, very high guaranteed price created a relatively risk-free environment, so farmers intensified production and levels of self-sufficiency for most agriculture risen considerably. As farmers were being paid high prices for as much as they could produce, the policy favoured areas of larger-scale farming in eastern Britain. As a result of increasing regional disparities in agriculture, the CAP became more geographically sensitive in 1975 with the setting up of the Less Favoured Areas(LFAs). But they are biased towards the larger farms, because such farms have more crops and/or livestock, but small farms with low incomes are in most need of support. Specialization of cereals such wheat and barely was occured, but these two cereal crops have experienced rather different trend since 1950s. Under the CAP, farmers have been paid higher guaranteed prices for wheat than for barely because of the relative shortage of wheat in the EC. And more barely were cultivated as feedstuffs for livestock by home-grown cereals. In the 1950s dairying was already declining in what was to become the arable areas of southern and eastern England. By the mid-1980s, the pastral core had maintained its dominance, but the pastoral periphery had easily surpassed arable England as the second most important dairying district. Pig farming had become increasingly concentrated in intensive units in the main cereal areas of eastern England. These results show that the measure of agricultural policy induced the concentration and specialization implicitly. Measures for increasing demand, reducing supply or raising farm incomes are favoured by large scale farming. And price support induced specialization of farming. And technology for specialization are diffused and induced geographical specialization. This is the process of change of regional structure through the specialization.

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Preservation Conditions of Aqueous Samples Containing silver Nanomaterials (은나노물질을 포함한 수질시료의 보관조건)

  • Kang, Mun Hee;Park, Sol;Lee, Sang-Woo;Kim, Hyun-A;Lee, Byung-Tae;Eom, Ig-Chun;Kim, Soon-Oh
    • Journal of Korean Society of Environmental Engineers
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    • v.37 no.4
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    • pp.218-227
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    • 2015
  • A prerequisite for precise quantification of nanomaterials contained in environmental samples is to prepare suitable preservation conditions of samples. This study was initiated to suggest preservation conditions of aqueous samples for analyses of metal nanomaterials. Variation in the size of silver nanomaterial (cit-AgNP) was observed according to change in various conditions, such as pH, electrolyte concentration, temperature, nanomaterial concentration, and time. Aggregation of AgNP was characterized for each environmental condition, and finally proper preservation conditions of samples were proposed based on experimental results on AgNP aggregation. In addition, the preservation period of sample was computed by the doublet time of AgNP. The results indicate that the aggregation rate of cit-AgNP was close to 0 at the conditions of pH of ${\geq}7$, electrolyte ($Ca(NO_3)_2$) concentration of ${\leq}3mM$, temperature of $4^{\circ}C$, and cit-AgNP concentration of ${\leq}2mg/L$. Furthermore, the experimental results on doublet time of cit-AgNP suggest that maximum preservation period was evaluated to be 15.79~17.53 days when the concentration of 100 nm cit-AgNP is assumed to be $1{\mu}g/L$ which is considered as an environmentally-relevant concentration of engineered nanomaterials. Our results suggest that samples should be preserved at $4^{\circ}C$ and analyzed within 2 weeks.

Nuclear Terrorism and Global Initiative to Combat Nuclear Terrorism(GICNT): Threats, Responses and Implications for Korea (핵테러리즘과 세계핵테러방지구상(GICNT): 위협, 대응 및 한국에 대한 함의)

  • Yoon, Tae-Young
    • Korean Security Journal
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    • no.26
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    • pp.29-58
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    • 2011
  • Since 11 September 2001, warnings of risk in the nexus of terrorism and nuclear weapons and materials which poses one of the gravest threats to the international community have continued. The purpose of this study is to analyze the aim, principles, characteristics, activities, impediments to progress and developmental recommendation of the Global Initiative to Combat Nuclear Terrorism(GICNT). In addition, it suggests implications of the GICNT for the ROK policy. International community will need a comprehensive strategy with four key elements to accomplish the GICNT: (1) securing and reducing nuclear stockpiles around the world, (2) countering terrorist nuclear plots, (3) preventing and deterring state transfers of nuclear weapons or materials to terrorists, (4) interdicting nuclear smuggling. Moreover, other steps should be taken to build the needed sense of urgency, including: (1) analysis and assessment through joint threat briefing for real nuclear threat possibility, (2) nuclear terrorism exercises, (3) fast-paced nuclear security reviews, (4) realistic testing of nuclear security performance to defeat insider or outsider threats, (5) preparing shared database of threats and incidents. As for the ROK, main concerns are transfer of North Korea's nuclear weapons, materials and technology to international terror groups and attacks on nuclear facilities and uses of nuclear devices. As the 5th nuclear country, the ROK has strengthened systems of physical protection and nuclear counterterrorism based on the international conventions. In order to comprehensive and effective prevention of nuclear terrorism, the ROK has to strengthen nuclear detection instruments and mobile radiation monitoring system in airports, ports, road networks, and national critical infrastructures. Furthermore, it has to draw up effective crisis management manual and prepare nuclear counterterrorism exercises and operational postures. The fundamental key to the prevention, detection and response to nuclear terrorism which leads to catastrophic impacts is to establish not only domestic law, institution and systems, but also strengthen international cooperation.

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토양 및 지하수 Investigation 과 Remediation에 대한 현장적용

  • Wallner, Heinz
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2000.11a
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    • pp.44-63
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    • 2000
  • Situated close to Heathrow Airport, and adjacent to the M4 and M25 Motorways, the site at Axis Park is considered a prime location for business in the UK. In consequnce two of the UK's major property development companies, MEPC and Redrew Homes sought the expertise of Intergeo to remediate the contaminated former industrial site prior to its development. Industrial use of the twenty-six hectare site, started in 1936, when Hawker Aircraft commence aircraft manufacture. In 1963 the Firestone Tyre and Rubber Company purchased part of the site. Ford commenced vehicle production at the site in the mid-1970's and production was continued by Iveco Ford from 1986 to the plant's decommissioning in 1997. Geologically the site is underlain by sand and gravel, deposited in prehistory by the River Thames, with London Clay at around 6m depth. The level of groundwater fluctuates seasonally at around 2.5m depth, moving slowly southwest towards local streams and watercourses. A phased investigation of the site was undertaken, which culminated in the extensive site investigation undertaken by Intergeo in 1998. In total 50 boreholes, 90 probeholes and 60 trial pits were used to investigate the site and around 4000 solid and 1300 liquid samples were tested in the laboratory for chemical substances. The investigations identified total petroleum hydrocarbons in the soil up to 25, 000mg/kg. Diesel oil, with some lubricating oil were the main components. Volatile organic compounds were identified in the groundwater in excess of 10mg/l. Specific substances included trichloromethane, trichloromethane and tetrachloroethene. Both the oil and volatile compounds were widely spread across the site, The specific substances identified could be traced back to industrial processes used at one or other dates in the sites history Slightly elevated levels of toxic metals and polycyclic aromatic hydrocarbons were also identified locally. Prior to remediation of the site and throughout its progress, extensive liaison with the regulatory authorities and the client's professional representatives was required. In addition to meetings, numerous technical documents detailing methods and health and safety issues were required in order to comply with UK environmental and safety legislation. After initially considering a range of options to undertake remediation, the following three main techniques were selected: ex-situ bioremediation of hydrocarbon contaminated soils, skimming of free floating hydrocarbon product from the water surface at wells and excavations and air stripping of volatile organic compounds from groundwater recovered from wells. The achievements were as follows: 1) 350, 000m3 of soil was excavated and 112, 000m3 of sand and gravel was processed to remove gravel and cobble sized particles; 2) 53, 000m3 of hydrocarbon contaminated soil was bioremediated in windrows ; 3) 7000m3 of groundwater was processed by skimming to remove free floating Product; 4) 196, 000m3 of groundwater was Processed by air stripping to remove volatile organic compounds. Only 1000m3 of soil left the site for disposal in licensed waste facilities Given the costs of disposal in the UK, the selected methods represented a considerable cost saving to the Clients. All other soil was engineered back into the ground to a precise geotechnical specification. The following objective levels were achieved across the site 1) By a Risk Based Corrective Action (RBCA) methodology it was demonstrated that soil with less that 1000mg/kg total petroleum hydrocarbons did not pose a hazard to health or water resources and therefore, could remain insitu; 2) Soils destined for the residential areas of the site were remediated to 250mg/kg total petroleum hydrocarbons; in the industrial areas 500mg/kg was proven acceptable. 3) Hydrocarbons in groundwater were remediated to below the Dutch Intervegtion Level of 0.6mg/1; 4) Volatile organic compounds/BTEX group substances were reduced to below the Dutch Intervention Levels; 5) Polycyclic aromatic hydrocarbons and metals were below Inter-departmental Committee for the Redevelopment of Contaminated Land guideline levels for intended enduse. In order to verify the qualify of the work 1500 chemical test results were submitted for the purpose of validation. Quality assurance checks were undertaken by independent consultants and at an independent laboratory selected by Intergeo. Long term monitoring of water quality was undertaken for a period of one year after remediation work had been completed. Both the regulatory authorities and Clients representatives endorsed the quality of remediation now completed at the site. Subsequent to completion of the remediation work Redrew Homes constructed a prestige housing development. The properties at "Belvedere Place" retailed at premium prices. On the MEPC site the Post Office, amongst others, has located a major sorting office for the London area. Exceptionally high standards of remediation, control and documentation were a requirement for the work undertaken here.aken here.

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