• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.153-166
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• 2022

During the coronavirus disease 2019 (COVID-19) pandemic, a novel multisystem inflammatory syndrome in children (MIS-C) has been reported worldwide since the first cases were reported in Europe in April 2020. MIS-C is temporally associated with severe acute respiratory syndrome coronavirus 2 infection and shows Kawasaki disease (KD)-like features. The epidemiological and clinical characteristics in COVID-19, KD, and MIS-C differ, but severe cases of each disease share similar clinical and laboratory findings such as a protracted clinical course, multiorgan involvement, and similar activated biomarkers. These findings suggest that a common control system of the host may act against severe disease insult. To solve the enigmas, we proposed the protein-homeostasis-system hypothesis in that every disease involves etiological substances and the host's immune system controls them by their size and biochemical properties. Also, it is proposed that the etiological agents of KD and MIS-C might be certain strains in the microbiota of human species and etiological substances in severe COVID-19, KD, and MIS-C originate from pathogen-infected cells. Since disease severity depends on the amounts of inflammation-inducing substances and corresponding immune activation in the early stage of the disease, an early proper dose of corticosteroids and/or intravenous immunoglobulin (IVIG) may help reduce morbidity and possibly mortality among patients with these diseases. Corticosteroids are low cost and an analogue of host-origin cortisol among immune modulators. This study's findings will help clinicians treating severe COVID-19, KD, and MIS-C, especially in developing countries, where IVIG and biologics supplies are insufficient.

• Pediatric Infection and Vaccine
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• v.29 no.3
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• pp.155-160
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• 2022

Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.283-288
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• 2023

Severe chronic neutropenia is classified as severe congenital, cyclic, autoimmune, or idiopathic. However, there is a lot of uncertainty regarding the diagnosis of severe congenital neutropenia (SCN) and chronic idiopathic neutropenia, and this uncertainty affects further evaluations and treatments. A 20-year-old man presented with fever and knee abrasions after a bicycle accident. On admission, his initial absolute neutrophil count (ANC) was 30/µL. He had no medical history of persistent severe neutropenia with periodic oscillation of ANC. Although his fever resolved after appropriate antibiotic therapy, ANC remained at 80/µL. Bone marrow (BM) aspiration and biopsy were performed, and a BM smear showed myeloid maturation arrest. Moreover, genetic mutation test results showed a heterozygous missense variant in exon 4 of the neutrophil elastase ELANE: c597+1G>C (pV190-F199del). The patient was diagnosed with SCN. After discharge, we routinely checked his ANC level and monitored any signs of infection with minimum use of granulocyte colony-stimulating factor (G-CSF), considering its potential risk of leukemic transformation. Considering that SCN can be fatal, timely diagnosis and appropriate management with G-CSF are essential. We report the case of a patient with SCN caused by ELANE mutation who had atypical clinical manifestations. For a more accurate diagnosis and treatment of severe chronic neutropenia, further studies are needed to elucidate the various clinical features of ELANE.

• Journal of the Society of Disaster Information
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• v.19 no.2
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• pp.372-382
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• 2023

Purpose: Suggests measures to improve the construction company's safety management system according to the enforcement of the Severe Accident Punishment Act. Method: The effectiveness of practice-oriented disaster prevention activities was analyzed through safety and health diagnosis of the level of safety and health management system for the countermeasures against the Severe Accident Punishment Act implemented at the construction site and headquarters. Result: The effect of reducing the accident rate and the advancement of the safety and health management system were analyzed by linking the Severe Accident Punishment Act with the safety and health management system, and a plan to improve the safety and health management system was presented through the analysis of the comprehensive results of safety activities before and after the implementation of the Severe Accident Punishment Act. Conclusion: The effect of practical performance measurement was manifested through the improvement of business owners' awareness, the expansion of investment for disaster prevention, and the quantification of disaster prevention activities according to the enforcement of the Severe Accident Punishment Act.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.5
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• pp.472-483
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• 2020

Purpose: Sodium is an essential nutritional electrolyte that affects growth. A low serum sodium concentration in healthy premature infants beyond 2 weeks of life is called late-onset hyponatremia (LOH). Here, we investigated the association between LOH severity and growth outcomes in premature infants. Methods: Medical records of premature infants born at ≤32 weeks of gestation were reviewed. LOH was defined as a serum sodium level <135 mEq/L regardless of sodium replacement after 14 days of life. Cases were divided into two groups, <130 mEq/L (severe) and ≥130 mEq/L (mild). Characteristics and growth parameters were compared between the two groups. Results: A total of 102 premature infants with LOH were included. Gestational age ([GA] 27.7 vs. 29.5 weeks, p<0.001) and birth weight (1.04 vs. 1.34 kg, p<0.001) were significantly lower in the severe group. GA was a risk factor of severe LOH (odds ratio [OR], 1.328, p=0.022), and severe LOH affected the development of bronchopulmonary dysplasia (OR, 2.950, p=0.039) and led to a poor developmental outcome (OR, 9.339, p=0.049). Growth parameters at birth were lower in the severe group, and a lower GA and sepsis negatively affected changes in growth for 3 years after adjustment for time. However, severe LOH was not related to growth changes in premature infants. Conclusion: Severe LOH influenced the development of bronchopulmonary dysplasia and developmental outcomes. However, LOH severity did not affect the growth of premature infants beyond the neonatal period.

• Korean Journal of Soil Science and Fertilizer
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• v.39 no.3
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• pp.173-183
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• 2006

Purpose of this study was to estimate of soil erosion, which is related with crop productivity and water quality in watershed, in Seonakdong river watershed using USLE. The data set for USLE estimation were derived from detailed digital map(K factor), satellite imagery(C and P factors) and DEM(LS factor). The R factor was calculated by AWS data from Kimhae agricultural technology center. The soil loss from arable land was equivalent of 31.5% of total soil loss in Seonakdong river watershed. The soil loss amount of paddy field and upland were 2.8% and 97.2% of arable land, respectively, even in the area where paddy field was occupied much largely as 76.3%. The reason of large amount of soil loss from upland was that 30.4% of upland was distributed at "severe" and "very severe" soil erosion grade in watershed. The distribution of soil erosion grade during cropping season(May-Sept.) was similar to the annual soil loss. Soil erosion of non-cropping season(Oct.-Apr.) was small due to a low R factor. But, soil erosion grade of near mountain footslope areas showed severe and very severe even in non-cropping season.

• The Journal of Korean Physical Therapy
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• v.11 no.1
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• pp.23-43
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• 1999

A study on severity of cerebro-vascular accident patients in Korea was conduced in order to determine the risk factors affecting the severity of stroke patients. This study was performed by interviewing a total of 477 hospitalized and ambulatory patient of CVA in Seoul, Taejon, and Taegu and Pusan areas from April 1, 1998 through June 30, 1998. The results are as follows; 1. Two hundred and sixty seven $(56\%)$ at Four hundred and seventy seven subjects were manes, md two hundred and ten $(44\%)$ were females. $28.3\%$ of the subjects' ages were 50's and $27.3\%$ were 60's and $18.5\%$ were 70's. $22.6\%$ of the subjects' occupations were home makers, $17.8\%$ were farming. $66.4\%$ of the subjects spent their childhood in urban areas and $33.1\%$in rural areas. $41.7\%$ of the subjects became violin of CVA in Spring, $35.0\%$ in Winter. 2. On physical and mental conditions of the subjects at the occurrence of CVA, $28.7\%$ of the subjects were engaged in physical activities. $22.6\%$ were in a rest stale $19.5\%$ were in sleeping and $18.9\%$ were mentally shocked. $79.4\%$ of the male subjects and $14.8\%$ of female subjects smoked cigarettes. $82\%$ of male subjects drank coffee. $81.1\%$ of the subjects did not exercise regularly. $45.9\%$ of the subjects had the systolic blood pressures in the range of 160 to 199 mmHg and $5.6\%$ of the subjects had hypertension before the occurrence of stroke and $11.7\%$ had diabetes. 3. Of the types of strokes, cerebral hemorrhage was the highest $(49.1\%)$. cerebral infarction was the second $(41.1\%)$. Severe strokes were found in cerebral hemorrhage cases $(52.0\%)$ and cerebral infarction cases $(40.1\%).\;50.9\%$. of the male subjects were moderate cases, $50.9\%$ were severe cases. In females, moderate cases were $72.4\%$, severe cases $15.2\%$. $37.5\%$ of the subjects who had preceding diseases were severe cases, and $15.6\%$ of the subjects without preceding diseases were severe cases. $50.7\%$ of the subjects whose family members had strokes had severe strokes. $34\%$ of the subjects sleeping less than 6 hours a day, $42.4\%$ of the subjects with irregular eating habits, $33.3\%$ of the subjects who liked meat, and $42.3\%$ of the subjects who liked salty foods had severe strokes. $35.9\%$ of the subjects with hot temper, $27.6\%$ of the subjects with moderate temper and $14.5\%$ of subjects with mild temper were severe cases. 4. The correlation coefficient between obesity and blood pressure was 0.094.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.172-178
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• 2009

Purpose: We performed this study to determine how the emergency trauma team affects the treatment of patients with multiple severe trauma and to discuss the effect and the direction of the emergency trauma team's management. Methods: We performed a retrospective analysis of 518 patients who visited our emergency department with severe trauma from August 2006 to July 2008. We divided the severe trauma patients into 2 groups : patients before and after trauma team management (Group 1 and Group 2). Then, we compared demographic characteristics, mechanisms of injury, and treatment outcomes (lengths of stay in the ED, admission ratio, and in-hospital mortality) between the 2 groups. In the same way, patients with multiple severe trauma were divided into 2 groups, that are patients before and after trauma team management (Group 3 and Group 4) and analyzed. Results: There was no significant difference, except mean age, between groups 1 and 2. In group 4 patients, compared to group 3 patients, the lengths of stay in the ED were lower (p value < 0.001), and the admission ratio were higher (p value = 0.017), but there was no significant difference in the in-hospital mortality between the groups 3 and 4. Conclusion: When patients with multiple severe trauma visit the ED, the emergency trauma team' management can decrease the lengths of stay in the ED and increase the admission ratio, but does not produce a decrease in the in-hospital mortality rate. Further investigations of emergency trauma team management are needed to improve treatment outcomes for patients with multiple severe trauma.

• Journal of Radiation Protection and Research
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• v.42 no.2
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• pp.114-129
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• 2017

Background: The purpose of this paper is to confirm the event timings and the magnitude of fission product aerosol release from the Fukushima accident. Over a few hundreds of technical papers have been published on the environmental impact of Fukushima Daiichi accident since the accident occurred on March 11, 2011. However, most of the research used reverse or inverse method based on the monitoring of activities in the remote places and only few papers attempted to estimate the release of fission products from individual reactor core or from individual spent fuel pool. Severe accident analysis code can be used to estimate the radioactive release from which reactor core and from which radionuclide the peaks in monitoring points can be generated. Materials and Methods: The basic material used for this study are the initial core inventory obtained from the report JAEA-Data/Code 2012-018 and the given accident scenarios provided by Japanese Government or Tokyo Electric Power Company (TEPCO) in official reports. In this research a forward method using severe accident progression code is used as it might be useful for justifying the results of reverse or inverse method or vice versa. Results and Discussion: The release timing and amounts to the environment are estimated for volatile radioactive fission products such as noble gases, cesium, iodine, and tellurium up to 184 hours (about 7.7 days) after earthquake occurs. The in-plant fission product behaviors and release characteristics to environment are estimated using the severe accident progression analysis code, MELCOR, for Fukushima Daiichi accident. These results are compared with other research results which are summarized in UNSCEAR 2013 Report and other technical papers. Also it may provide the physically based arguments for justifying or suspecting the rationale for the scenarios provided in open literature. Conclusion: The estimated results by MELCOR code simulation of this study indicate that the release amount of volatile fission products to environment from Units 1, 2, and 3 cores is well within the range estimated by the reverse or inverse method, which are summarized in UNSCEAR 2013 report. But this does not necessarily mean that these two approaches are consistent.

• Journal of Ginseng Research
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• v.47 no.4
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• pp.534-542
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• 2023

Background: Ginsenoside Rg1, a bioactive component of Ginseng, has demonstrated anti-inflammatory, anti-cancer, and hepatoprotective effects. It is known that the epithelial-mesenchymal transition (EMT) plays a key role in the activation of hepatic stellate cells (HSCs). Recently, Rg1 has been shown to reverse liver fibrosis by suppressing EMT, although the mechanism of Rg1-mediated anti-fibrosis effects is still largely unclear. Interestingly, Smad7, a negative regulator of the transforming growth factor β (TGF-β) pathway, is often methylated during liver fibrosis. Whether Smad7 methylation plays a vital role in the effects of Rg1 on liver fibrosis remains unclear. Methods: Anti-fibrosis effects were examined after Rg1 processing in vivo and in vitro. Smad7 expression, Smad7 methylation, and microRNA-152 (miR-152) levels were also analyzed. Results: Rg1 significantly reduced the liver fibrosis caused by carbon tetrachloride, and reduced collagen deposition was also observed. Rg1 also contributed to the suppression of collagenation and HSC reproduction in vitro. Rg1 caused EMT inactivation, reducing Desmin and increasing E-cadherin levels. Notably, the effect of Rg1 on HSC activation was mediated by the TGF-β pathway. Rg1 induced Smad7 expression and demethylation. The over-expression of DNA methyltransferase 1 (DNMT1) blocked the Rg1-mediated inhibition of Smad7 methylation, and miR-152 targeted DNMT1. Further experiments suggested that Rg1 repressed Smad7 methylation via miR-152-mediated DNMT1 inhibition. MiR-152 inhibition reversed the Rg1-induced promotion of Smad7 expression and demethylation. In addition, miR-152 silencing led to the inhibition of the Rg1-induced EMT inactivation. Conclusion: Rg1 inhibits HSC activation by epigenetically modulating Smad7 expression and at least by partly inhibiting EMT.