• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.8-16
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• 2021

Purpose: This study was conducted to analyze the social factors influencing the 'authenticity of suicidal ideation' based post-suicidal care programs in emergency departments (EDs). Methods: This retrospective study was an analysis using the data of patients who had attempted suicide and visited the ED in tertiary urban hospitals from January 1, 2016, to December 31, 2018. The variables examined included gender, age, history of previous psychiatric disease, suicide method, and the number of previous attempts. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the registration rate for the community-based post-suicide care program. Results: Overall,1,460 suicides were analyzed, 177 (1.16%) showed a high authenticity of suicide. The social factors influencing the authenticity of suicide intent were the unmarried status of men and women, joblessness, history of mental illnesses, more than two previous suicide attempts, the influence of alcohol, and an attempt to commit suicide after midnight more specifically between 24:00 to 6:00 hours in the morning (p<.05). The factors influencing the severity of the condition of high authenticity suicide patients were low Glasgow coma scores (12 points or less), lactate levels, and oxygen saturation observed in the patients who were admitted to the intensive care unit for treatment and died (p<.05). Conclusion: The need for evidence-based preventive measures and early assessment tools at the emergency medicine level is emphasized to reduce the rate of suicide attempts. If the results of this study are used in the management of suicide prevention, the evaluation of the authenticity of suicide intent will be more likely to be made at the emergency medicine level, allowing the severity to be assessed earlier.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1811-1815
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• 2014

Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4517-4525
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• 2016

Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

• Economic and Environmental Geology
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• v.40 no.5
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• pp.651-660
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• 2007

Acid drainage has been recognized as an environmental concern in abandoned mine sites for long time. Recently, the environmental and structural damage by acid drainage is a current issue in construction sites in Korea. Here, the author introduces the type of damages by acid drainage in construction sites and emphasizes the importance of geoscience discipline in solving the problem. Metasedimentary rock of Okcheon group, coal bed of Pyeongan group, Mesozoic volcanic rock. and Tertiary sedimentary and volcanic rocks are the major rock types with a high potential for acid drainage upon excavation in Korea. The acid drainage causes the acidification and heavy metal contamination of soil, surface water and groundwater, the reduction of slope stability, the corrosion of slope structure, the damage on plant growth, the damage on landscape and the deterioration of concrete and asphalt pavement. The countermeasure for acid drainage is the treatment of acid drainage and the prevention of acid drainage. The treatment of acid drainage can be classified into active and passive treatments depending on the degree of natural process in the treatment. Removal of oxidants, reduction of oxidant generation and encapsulation of sulfide are employed for the prevention of acid drainage generation.

• Journal of the Korean Wood Science and Technology
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• v.2 no.4
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• pp.4-14
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• 1974

The total forest land area in Korea accounts for some 67 percent of the nation's land total. Its productivity, however, is very low. Consequently, forest production accounts for only about 2 percent of the gross national product and a minor proportion of no more than about 5 percent versus primary industry. In this case, however, only the direct income from forestry is taken into account, making no reference to the forestry output induced by other industrial sectors. The value added Or the induced forestry output in manufacturing the primary wood products into higher quality products, makes a larger contribution to the economy than direct contribution. So, this author has tried to analyze the structure of forestry and compute the repercussion effect and the induced output of primary forest products when utilized by other industries for their raw materials, Hsing the input-output table and attached tables for 1963 and 1966 issued by the Bank of Korea. 1. Analysis of forestry structure A. Changes in total output Durng the nine-year period, 1961-1969, the real gross national product in Korea increased 2.1 times, while that of primary industries went up about 1. 4 times. Forestry which was valued at 9,380 million won in 1961, was picked up about 2. 1 times to 20, 120 million won in 1969. The rate of the forestry income in the GNP, accordingly, was no more than 1.5 percent both in 1961 and 1962, whereas its rate in primary industries increased 3.5 to 5.4 percent. Such increase in forestry income is attributable to increased forest production and rise in timber prices. The rate of forestry income, nonetheless, was on the decrease on a gradual basis. B. Changes in input coefficient The input coefficient which indicates the inputs of the forest products into other sectors were up in general in 1966 over 1963. It is noted that the input coefficient indicating the amount of forest products supplied to such industries closely related with forestry as lumber and plywood, and wood products and furniture, showed a downward trend for the period 1963-1966. On the other hand, the forest input into other sectors was generally on the increase. Meanwhile, the input coefficient representing the yolume of the forest products supplied to the forestry sector itself showed an upward tendency, which meant more and more decrease in input from other sectors. Generally speaking, in direct proportion to the higher input coefficient in any industrial sector, the reinput coefficient which denotes the use of its products by the same sector becomes higher and higher. C. Changes in ratio of intermediate input The intermediate input ratio showing the dependency on raw materials went up to 15.43 percent m 1966 from 11. 37 percent in 1963. The dependency of forestry on raw materials was no more than 15.43 percent, accounting for a high 83.57 percent of value added. If the intermediate input ratio increases in any given sector, the input coefficient which represents the fe-use of its products by the same sector becomes large. D. Changes in the ratio of intermediate demand The ratio of the intermediate demand represents the characteristics of the intermediary production in each industry, the intermediate demand ratio in forestry which accunted for 69.7 percent in 1963 went up to 75.2 percent in 1966. In other words, forestry is a remarkable industry in that there is characteristics of the intermediary production. E. Changes in import coefficient The import coefficient which denotes the relation between the production activities and imports, recorded at 4.4 percent in 1963, decreased to 2.4 percent in 1966. The ratio of import to total output is not so high. F. Changes in market composition of imported goods One of the major imported goods in the forestry sector is lumber. The import value increased by 60 percent to 667 million won in 1966 from 407 million won in 1963. The sales of imported forest products to two major outlets-lumber and plywood, and wood products and furniture-increased to 343 million won and 31 million won in 1966 from 240million won and 30 million won in 1963 respectively. On the other hand, imported goods valued at 66 million won were sold to the paper products sector in 1963; however, no supply to this sector was recorded in 1963. Besides these major markets, primary industries such as the fishery, coal and agriculture sectors purchase materials from forestry. 2. Analysis of repercussion effect on production The repercussion effect of final demand in any given sector upon the expansion of the production of other sectors was analyzed, using the inverse matrix coefficient tables attached to the the I.O. Table. A. Changes in intra-sector transaction value of inverse matrix coefficient. The intra-sector transaction value of an inverse matrix coefficient represents the extent of an induced increase in the production of self-support products of the same sector, when it is generated directly and indirectly by one unit of final demand in any given sector. The intra-sector transaction value of the forestry sector rose from 1.04 in 1963 to 1, 11 in 1966. It may well be said, therefore, that forestry induces much more self-supporting products in the production of one unit of final demand for forest products. B. Changes in column total of inverse matrix coefficient It should be noted that the column total indicates the degree of effect of the output of the corresponding and related sectors generated by one unit of final demand in each sector. No changes in the column total of the forestry sector were recorded between the 1963 and 1966 figures, both being the same 1. 19. C. Changes in difference between column total and intra-sector transaction amount. The difference between the column total and intra-sector transaction amount by sector reveals the extent of effect of output of related industrial sector induced indirectly by one unit of final demand in corresponding sector. This change in forestry dropped remarkable to 0.08 in 1966 from 0.15 in 1963. Accordingly, the effect of inducement of indirect output of other forestry-related sectors has decreased; this is a really natural phenomenon, as compared with an increasing input coefficient generated by the re-use of forest products by the forestry sector. 3. Induced output of forestry A. Forest products, wood in particular, are supplied to other industries as their raw materials, increasng their value added. In this connection the primary dependency rate on forestry for 1963 and 1966 was compared, i. e., an increase or decrease in each sector, from 7.71 percent in 1963 to 11.91 percent in 1966 in agriculture, 10.32 to 6.11 in fishery, 16.24 to 19.90 in mining, 0.76 to 0.70 in the manufacturing sector and 2.79 to 4.77 percent in the construction sector. Generally speaking, on the average the dependency on forestry during the period 1963-1966 increased from 5.92 percent to 8.03 percent. Accordingly, it may easily be known that the primary forestry output induced by primary and secondary industries increased from 16, 109 million won in 1963 to 48, 842 million won in 1966. B. The forest products are supplied to other industries as their raw materials. The products are processed further into higher quality products. thus indirectly increasing the value of the forest products. The ratio of the increased value added or the secondary dependency on forestry for 1963 and 1966 showed an increase or decrease, from 5.98 percent to 7.87 percent in agriculture, 9.06 to 5.74 in fishery, 13.56 to 15.81 in mining, 0.68 to 0.61 in the manufacturing sector and 2.71 to 4.54 in the construction sector. The average ratio in this connection increased from 4.69 percent to 5.60 percent. In the meantime, the secondary forestry output induced by primary and secondary industries rose from 12,779 million Wall in 1963 to 34,084 million won in 1966. C. The dependency of tertiary industries on forestry showed very minor ratios of 0.46 percent and 0.04 percent in 1963 and 1966 respectively. The forestry output induced by tertiary industry also decreased from 685 million won to 123 million won during the same period. D. Generally speaking, the ratio of dependency on forestry increased from 17.68 percent in 1963 to 24.28 percent in 1966 in primary industries, from 4.69 percent to 5.70 percent in secondary industries, while, as mentioned above, the ratio in the case of tertiary industry decreased from 0.46 to 0.04 percent during the period 1963-66. The mining industry reveals the heaviest rate of dependency on forestry with 29.80 percent in 1963 and 35.71 percent in 1966. As it result, the direct forestry income, valued at 8,172 million won in 1963, shot up to 22,724 million won in 1966. Its composition ratio lo the national income rose from 1.9 percent in 1963 to 2.3 per cent in 1966. If the induced outcome is taken into account, the total forestry production which was estimated at 37,744 million won in 1963 picked up to 105,773 million won in 1966, about 4.5 times its direct income. It is further noted that the ratio of the gross forestry product to the gross national product. rose significantly from 8.8 percent in 1963 to 10.7 percent in 1966. E. In computing the above mentioned ratio not taken into consideration were such intangible, indirect effects as the drought and flood prevention, check of soil run-off, watershed and land conservation, improvement of the people's recreational and emotional living, and maintenance and increase in the national health and sanitation. F. In conclusion, I would like to emphasize that the forestry sector exercices an important effect upon the national economy and that the effect of induced forestry output is greater than its direct income.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.757-762
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• 2006

Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.1-10
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• 2019

Purpose: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. Methods: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for ${\beta}-lactams$ and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. Results: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. Conclusions: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.