• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.191-196
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• 2005

Purpose : Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. Methods : The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. Results : Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was $0.8{\pm}0.2IU/kg/wk$ in GH treated group. Mean growth velocity was $5.6{\pm}2.0cm/yr$, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were $12.2{\pm}2.7yr$ $10.3{\pm}2.5yr$ $127.5{\pm}10.1cm$ and $-3.1{\pm}1.1$, respectively. In the GH treated group, the mean FAH and SD score of FAH were $146.9{\pm}5.8cm$ and $-2.7{\pm}1.2$, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. Conclusion : GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.75-85
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• 2005

Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.

• Progress in Medical Physics
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• v.14 no.2
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• pp.90-98
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• 2003

Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

• Journal of Veterinary Clinics
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• v.14 no.2
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• pp.319-337
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• 1997

The electrocardiographic (ECG) parameters in the normal Korean black goat have been measured with a 3-channel Electrocardiograph and computed, analyzed. ECG in 243 black goats were made with the limb leads (I, II, III, aVR, aVL, aVF), that were recorded conduction parameters of wave and interval, and were analyzed as to shape and amplitude of the P and T waves and the components of the QRS complex. Heart rate were recorded by the ECG which were a mean of 106.1$\pm $21.8 beats/min. Average conduction times in the PR, the QRS complex and the QTc interval were recorded 103.9$\pm $34.9 msec., 58.3$\pm $23.2 msec. and 302.6$\pm $67.8 msec., in the P and T wave duration recorded 24.8$\pm $6.4 msec. and 51.7$\pm $10.8 msec. respectively. The shape of wave in each leads were observed various types, and any spacial wave type appeared the highest frequency in each lead that ware shown less than 60%, and these frequent rate and average amplitudes as fallow: 1. In P waver the frequent rate and average amplitudes of the positive type showed in leads I, II and aVL that were 54.8% (93.0$\pm $ 33.2 $\mu $V), 50.5% (90.1$\pm $30.5 $\mu $V) and 41.7% (58.5$\pm $ 31.1 $\mu $V). Average amplitude of the negative type showed the frequent rate of 49.8% in lead aVE which was -77.6$\pm$ 25.2 $\mu $V. Biphasic type in leads III and aVF were 46.1% (108.4 $\mu $V, -90.2 $\mu $V.) and 45.7% (137.4 $\mu $V, -105.4 $\mu $V.), and amplitudes between positive and negative of it were significant difference. 2. The highest amplitudes of the QRS complex in all leads were 534.8$\pm $ 232.3 $\mu $V of lead II. The frequent rate and amplitudes of the R wave type in the I, II, III and aVF were 30.2% (277.8 $\pm $131.3 $\mu $V), 45.1% (393.1$\pm $114.2 $\mu $V), 48.5% (349.3$\pm $178.3 $\mu $V) and 54.9% (334.4$\pm $129.7 $\mu $V), and QS ways type in the lead aVL was 49.5% (359.2$\pm $195.5$\mu $V), and RS and QS wave types in the lead a VR were 43.3% (312.4 $\mu $V, -212.7 $\mu $V.) and 41.1% (399.2$\pm $92.2 $\mu $V), respectively. 3. In T wave, the frequent rata and amplitudes of the positive type in the leads I, II, III and aVF were 44.6% (207.9$\pm $ 97.1 $\mu $V), 41.6% (245.1$\pm $92.1 $\mu $V), 46.9% (189.8$\pm $ 82.7 $\mu $V) and 53.0% (195.4197.8 $\mu $V), and the negative in the lead aVR was 41.2% (-230.7$\pm$ 103.1 $\mu $V), respectively. The positive and negative types in the lead aVe appeared with same frequent rate of 43.2%.4. Frontal plane vectors for P, QRS, and T were found to lie at 38.1$\pm $ 21.5, 142.0$\pm $ 57.2, and 117.2$\pm $ 63.9 degrees, respectively. These results in ECG of goats may be served to the limited purposes as to conduction parameters, arrhythmias except abnormal ECG because of waveforms, amplitudes and electrical axis of it were variability.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.299-316
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• 1996

This study is the descriptive survey to provide basic data for nursing intervention to pain management of cancer patients by finding more effective way to manage pain with recognize pain level and pain characteristics. To achieve the purpose of this study, the subjects of this study are 110 male or female gastro intestinal tract patients who are older than twenty, are hospitalized in Pusan University Hospital from 1995. 5. 28 to 1995. 9. 25 and have had medical treatment. The modified pain assessment of cancer patients of Cornne, H. Rosermary, M. was used as the tool of study with 16 questionaries. The pain score consists of sensory intensity score and distress score. The data was analyzed by the SPSS statistical program number, percentage, mean, standard deviation, t-test, One Way Anova and Duncan's Multiple Range Test were utilized for analysis. The results were summarized as follows : 1. In population-sociological characteristics : in the age-range of subject, the sixties are most as 32.7% and the subjects after the forties are 89.5%, in sex of subjects, male patients are 66.4% and female 33.6%, in the number of family, the subjects who has 4 or above families are 70% and the subjects who live with their spouse, sons and daughters are 54.5% 2. In the disease characteristics : stomach cancer patients were most as 39.1%. And the most of patient who had never been operated before. In time of pain, the most of subjects were intermittent. In the type of pain, the most of subjects were 'dully pain' as 31.8%. Metastatic subjects were 30.0%. In the origin of pain, nervous pressure was 50.8%. The number of complication was 46 and most of complication are obstruction as 6%. 3. In the pain level, 91subjects complained pain. And mean pain score was $287.1{\pm}116.1$ The mean pain score of female subjects was higher than that of male subjects. 4. In the pain characteristics, the pain began usually at meal time as 40.7%. The duration of pain was mostly from 1 month to 3 months as 57.1%. The appetite was mainly concerned with the pain as 31.8%. The etiology of pain was usually tumor as 69.3%. The meaning of pain was incurable disease as 14.5%, anxiety, death and suffering. 5. The 56(61%) of 91subjects were treated with Analgesic pain management. The kinds of Analgesic is usually valentac as 46.4%. The medication was usually intramuscle as 66.1% at whenever necessary, Response of Analgesic after Medication was usually 'moderate release'. The side effects of medication were nausea as 26.8%. The average amount of morphine dosage hospitalized to cancer patients with pain was 80mg in a day and metastatic cancer patients with pain was 101.9mg in a day. 6. In the relation between the disease characteristics and pain level, there is a significant statistical difference : whether subjects had been operated or not : (t=2.88, p=0.005), time of pain is(t=3.34, p=0.005), stage of metastatic(F=9.323, P=0.0002), and type of pain(F=4.013, p=0.0008). In the pain level of diagnosis, Colon cancer was $353.3{\pm}81.7$(F=2.34, p=0.049), the origin of pain, nerve pressure $316.3{\pm}98.5$(F=2.44, P=0.045), In the complication, ascites and obstruction $324.9{\pm}96.8$(T=2.60, P=0.04).

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.440-446
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• 2006

Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.248-260
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• 2004

Background : As an effective regimen for isoniazid (INH)-resistant pulmonary tuberculosis, several treatment regimens have been recommended by many experts. In Korea, a standard regimen has not been established for INH-resistant tuberculosis, and the treatment by individual physicians has been performed on an empirical bases. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the treatment outcomes of patients with INH-resistant tuberculosis. Materials and Methods : Sixty of 69 patients reported to have INH-resistant tuberculosis from 1994 to 2001 were retrospectively analyzed. Exclusion criteria included: death from other causes, with the exceptions of tuberculosis and incomplete treatment, including a patient's transfer-out. Results : A previous tuberculosis history was found in 28 (46.7%) patients. The sputum smear for acid-fast bacilli was positive in 44 (73.3%) patients, and 30 (50.0%) had cavitary disease. Streptomycin resistance coexisted in 25.0% of isolates. INH was to be prescribed continuously, even after INH resistance was reported, in 86.0% of patients. The treatment regimens were diverse between the patients according to drug regimen composition and treatment duration. The most frequent prescribed regimen included rifampin, ethambutol and pyrazinamide, with and without INH, for the full 12-month term of treatment. Treatment failure occurred in 13 (21.7%) patients. Cavitary disease (p=0.005) and a treatment regimen with second-line drugs, excluding rifampin (p=0.015), were associated with treatment failure. One patient experienced a relapse. Conclusions : Standardized treatment guidelines will be needed in Korea to improve the treatment efficacy for INH-resistant tuberculosis.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.41-72
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• 2018

In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.

• Korean Journal of Breeding Science
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• v.40 no.3
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• pp.328-331
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• 2008

Hwangeumnodeul is a new japonica rice cultivar developed from a cross between Milyang165 and HR15151-B-21-3 at Honam Agricultural Research Institute (HARI), NICS, RDA, in 2007. This cultivar has short grains and about 139 days of growth duration from direct seeding to harvesting in the southern plain areas. Culm length of this cultivar is 78 cm and the number of spikelet per panicle is similar to that of the check cultivar, Nampyeongbyeo, while filled grain rate is lower than the check variety. This cultivar is moderately resistant to leaf blast, bacterial blight pathogens of $K_1$, $K_2$ and $K_3$ and stripe virus but susceptible to major virus diseases and insect pests. Milled kernel of Hwanggeumnodeul is translucent with non-glutinous endosperm. This cultivar has about 5.7% and 18.6% of protein and amylose contents, respectively. Palatability of cooked rice of Hwanggeumnodeul is similar to Nampyeongbyeo. Its milling recovery and head rice were 75.6% and 90.0%, respectively. Hwanggeumnodeul yielded 5.69 and 5.61 MT/ha in milled rice at the under wet-direct and dry-direct seeding conditions, respectively which are 17% and 12% higher than the check variety, Juanbyeo. It yielded 5.86 MT/ha, 8% higher than Nampyeongbyeo at the standard fertilizer level of the ordinary transplanting cultivation. "Hwanggeumnodeul" would be adaptable for ordinary transplanting as well as direct seeding in the southern plain including Chungcheong province.

• Korean Journal of Breeding Science
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• v.40 no.3
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• pp.324-327
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• 2008

'Onnuri' is a japonica rice cultivar developed from the cross between 'Milyang 165' and HR14732-B-67-2-3 at Honam Agricultural Research Institute (HARI), NICS, RDA, in 2005. This cultivar has a short grain shape and about 121 days growth duration from transplanting to harvesting in Korean climate condition. In reaction to biotic and abiotic stresses, it shows resistance to blast, bacterial blight pathogen from $K_1$ to $K_3$ and stripe virus, but susceptible to other major diseases and insect pests. The milled kernel of 'Onnuri' is translucent with non-glutinous endosperm. It has about 18.6% of amylose content and better palatability of cooked rice compared with 'Chucheongbyeo' cultivated in Kyunggi province. The milled rice yield of 'Onnuri' is about 5.94 MT/ha under the standard fertilizer level of the ordinary transplanting cultivation. 'Onnuri' would be adaptable to southern plain of Cheonan, middle-northern plain, and southern mid-mountainous of Korea.