• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.94-99
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• 2008

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.3
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• pp.499-506
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• 1999

The odontoma is relatively a common benign odontogenic tumor and caused by overgrowth of odontogenic tissues. The recent classification by World Health Organization divides odontoma into 2 groups such as compound odontoma and complex odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. The etiology of odontoma is unknown and almost asymptomatic. So, it usually is found in routine radiographic examination, and most common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth. It can occurs almost anywhere in jaws. It is desirable that odontoma should be removed by surgical enucleation including follicle and surrounding soft tissues. Considering the age and behavioral cooperation of patient, the development of permanent dentition, the location of odontoma in jaw, the need for the concomitant operative dentistry, operation is performed in outpatient department with/without sedation or under general anesthesia with endotracheal intubation. In this case report, 2 patients with compound odontoma were treated by surgical enucleation including follicle and surrounding soft tissues. One patient, about 5 years old, was treated under general anesthesia and concomitant operative dentistry was performed. The other patient, about 11 years old, was treated under local anesthesia in outpatient department. In 2 cases, after 4 months, surgical defects were filled with new bone and normalization of eruption path of impacted permanent teeth was observed.

• Journal of Venture Innovation
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• v.1 no.1
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• pp.129-143
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• 2018

When consulting with senior service user or his or her family members, employees of senior welfare facilities face a vertical relationship due to age rather than a horizontal relationship. Despite few cases reported, service users and the families afflict physical and mental pain on the employees through irrational demands, physical abuses, and verbal abuses. In particular, the Korean society has advocated the notion of respecting elders and thus emphasized members of society to provide unconditional support to those of old age. In reality, however, people who work at senior welfare facilities report the difficulty of providing supports to heavy demands in selfish complaints that are often impossible to fulfill. Starting from May 2018, there has been a petition to the Korean Blue House, seeking protective measures for 'Senior welfare facility professions who are exposed to violence'. The study conduct researches on the effect of job stress on the organizational commitment for senior welfare facility employees from suffering emotional labor. Furthermore, it also aims to point the difficulties that the professions face and the solutions that alleviate the conflicts between the rights of services users of senior welfare facilities and its staffs. The study surveyed 178 staffs who work in senior welfare facilities in Seoul and Gyeonggi Province as its research method. The collected data was analyzed by using IBM SPSS Statistics 24.0 to derive the general characteristics of the sample, reliability, feasibility analysis, correlation analysis, and verification of the research hypothesis. The study was able to conclude the following: First, the frequency of emotional expression of senior welfare facility staffs had negative(-) influences on job stress. Second, the incongruity of emotions of senior welfare facility staffs had negative(-) influences on job stress. Third, the incongruity of emotions of senior welfare facility staffs had negative (-) influences on job stress. Fourth, the job stress showed mediating effects between emotional labor factors and organizational commitment

• Development and Reproduction
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• v.15 no.4
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• pp.365-371
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• 2011

Water temperature governs various biological events in many aquatic animals including fish. Temperature changes the rates of gametogenesis and development, in some cases, is even capable of reversing fish sex. Treatments of fish with unusually high temperature are known to induce the expression of HSP70 gene. Development of an effective inhibitor for HSP70 gene expression is, thus, crucial to study the role of HSP70 in the temperature sensitive biological events. We have investigated the inhibitory effect of quercetin, 3,3',4',5,7-pentahydroxyflavon, a natural flavonid, on the expressions of HSP70 gene induced by high temperature ($36^{\circ}C$) in the Nile tilapia, Oreochromis niloticus, larvae and juveniles (10~13 cm in total length). The expression of HSP 70 gene was significantly decreased in tilapia larvae immersed in 50 ${\mu}M$ or 100 ${\mu}M$ quercetin solution for 6 hours before the exposure to high temperature (P<0.05). In particular, the level of HSP70 expression in fish treated with 100 ${\mu}M$ was as low as that of fish without high temperature treatment. Juveniles of tilapia were individually injected with 0.1 $m{\ell}$ of either 0.5 mM, 5 mM or 20 mM of quercetin solution before the exposure to high temperature. As the results, the expression of HSP70 gene in the gonad and brain of juvenile fish was significantly inhibited by the injection of 0.5 mM quercetin solution (P<0.05), but not by higher concentrations. We report, for the first time in the fish, that quercetin effectively inhibits the expression of HSP70 gene induced by high temperature and 100 ${\mu}M$ for the immersion of larvae and 0.5 mM for the injection to juvenile can be used for the effective concentrations for the study of temperature sensitive biological events in tilapia.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.199-205
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• 2001

Purpose : Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics Methods : We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected. Results : We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P<0.05). The cases of superinfection is higher in the ICU group than in non ICU group. Conclusion : In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.741-747
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• 2003

Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

• Journal of fish pathology
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• v.6 no.2
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• pp.111-122
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• 1993

The mechanism by which $V_H$ region gene segments is selected in B lymphocyte is not known. Moreover, evidence for both random and nonrandom expression of $V_H$ genes in matured B cells has been presented previously. In this report, the technique of in situ hybridization allowed us to analyze expressed $V_H$ gene families in normal B lymphocyte at the single cell level. The analysis of normal B cells in this study eliminated any posssible bias resulting from transformation protocols used previously and minimized limitation associated with sampling size. Therefore, an accurate measure of the functional and expressed $V_H$ gene repertoire in B lymphocyte could be made. One of the most important controls for the optimization of in situ hybridization is to establish probe concentration and washing stringency due to the degree of nucleotide sequence similarlity between different families which in some cases can be as high as 70%. When the radioactive $C{\mu}$ and $V_{H}J558$ RNA probes are tested on LPS-stimulated adult spleen cells, $2{\sim}4{\times}106cpm$/slide shows low background and reasonable frequency of specific positive cells. For the washing condition. 40~50% formamide at $54^{\circ}C$ is found to be optimum for the $C{\mu}$. $V_{H}S107$ and $V_{H}J558$ probes. The analyzed results clearly demonstrate that the level of each different $V_H$ gene family expression is dependent upon the complexity or size of that family. These findings are also extended to the level of $V_H$ gene family expression in separated bone marrow B cells depend upon the various stage of differentiation and conclude no preferential utilization of specific $V_H$ gene family. Thus, the utilization of VH gene segments in B lymphocyte of adult BALB/c mice is random and is not regulated or changed during the differentiation of B cells.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.72-78
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• 2010

Purpose: Too develop a flexible drill device that can be inserted into the shoulder joint so that arthroscopic transosseous suture repair for Bankart lesion is possible. Materials and Methods: We created a device composed of a flexible drill unit and a guide pipe unit. The flexible drill unit was made of flexible multifilament wires (1.2 mm in diameter) that was twisted into one cord so that it can flex in any direction and a drill bit (1.2 mm in diameter) that is attached onto one end of the flexible wire. The guide pipe unit was a 150 mm long metal pipe (2.0 mm in inner diameter and 3.0 mm in outer diameter), with one end bent to 30 degrees. The flexible drill set was inserted into the shoulder joint through the posterior portal of the joint. The guide pipe component was placed onto the medial wall of the glenoid so that the pipe was placed 5 mm posterior to the margin of the anterior glenoid rim. The flexible drill was driven through the glenoid by the power drill so that holes were made in the glenoid. A non- absorbable suture was passed through the hole. Tying of a sliding knot tying was accomplished over the capsule and labrum after making a stitch through the capsule and labrum with a suture hook loaded with suture passer. The same procedures were done at the 2 and 4 O'Clock positions of the glenoid. Results: Five cases with Bankart lesion received arthroscopic transosseous repair with our flexible drill device. There were no intraoperative problems. Neither redislocation nor subluxation was reported at final follow-up. Conclusion: Arthroscopic transosseous suture repair without suture anchors and easy tying of a sliding knot are possible with a flexible drill set.

• The Journal of the Korean Society for Microbiology
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• v.9 no.1
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• pp.7-11
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• 1974

The authors identified fifty-eight Shigella cultures among 1644 cultures and specimens of enteric pathogens collected from all over the country in 1973. Fifty-one out of fifty-eight cultures belonged to Shigella flexneri and the rest to Shigella sonnei. None of cultures belonging to either subgroup A or C was detected in 1973. Of fifty-one cultures of Shigella flexneri twenty-six cultures were $B_{2a}$, which were isolated in Seoul area and Kwangwon-Do. The rest were $B_{3a}$ which were isolated in Jeonla-bug-Do and Kangwon-Do. It would not be possible to understand that there might not have been the cases or carriers of Shigella in the areas where the organisms were not isolated in 1973 and that there might not have been any other serotypes existing in the country, although there was a quite disparity found in the distribution between different areas and in the detection of the serotypes as shown in Table 1. Concerning the biochemical properties there were only two cultures showing positive arginine decarboxylase test among $B_{2a}$, and there were three cultures of trehalose negative cultures, one of rhamnose positive culture and one of glycerol positive culture observed, which were considered to be unusual. All the Shigella cultures were sensitive to nitrofurantoin, cephalosporin and ampicillin, and resistant to colistin, bacitracin and neomycin. Majority of them showed sensitive results to gentamycin, and the majority of Shigella $B_{3a}$ appeared to be sensitive to chloramphenicol, tetracycline, oxytetracycline and doxycycline, but the majority of $B_{2a}$ and Shigella sonnei were observed resistant to those antibiotics by means of the In-Vitro tests.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.858-864
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• 2003

Purpose : There was a outbreak of aseptic meningitis in Busan, 2002. We report the clinical features and causative viruses. Methods : Two hundred seventy six children with aseptic meningitis who were admitted to the Department of Pediatrics, Maryknoll Hospital between January and December, 2002 were included. CSF, stool and throat swab viral cultures were done in 244 of these children. Results : The male to female ratio was 1.4 : 1. Age of patients varied from five months to fourteen years old. Average age was $5.7{\pm}6.2years$ old and mostly between one and four years.(41.3%) Monthly distribution revealed that the number of patients increased from May to July. The main symptoms were fever, headache and vomiting in this order. Respiratory tract infection symptom was associated from June to July and headache and nausea without fever were characteristically observed in children more than 10 years old from November to December. In peripheral blood examination, leukocytosis(WBC>$10,000/mm^3$) showed in 34.8%, ESR was increased in 56.1%, and CRP was positive value in 61%. Therefore differential diagnosis was difficult through peripheral blood examination. CSF findings revealed mean leukocyte count $86.5{\pm}180.2/mm^3$, protein $41.7{\pm}32.9mg/dL$, glucose $56.4{\pm}9.9mg/dL$. Median hospitalized period was $4.7{\pm}7.2days$ and compared with non-tapping group, hospitalized period was shorter and subsidance of symptoms was faster, therefore antibiotics injection period was shorter in the spinal tapping group. Virus was isolated in 31 cases of 244. The causative agents were echovirus 6, echovirus 9, echovirus 25, coxsakie virus B3, B4. Conclusion : There was an epidemics of aseptic meningitis in Busan, 2002; the causative agent was echovirus 6, 9, 25, coxsakie virus B3, B4.