• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.30-38
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• 2009

Purpose: To investigate the physical and biochemical parameters related with elevated serum alanine aminotransferase (ALT) levels in obese children. Methods: One hundred forty-two obese or overweight children who visited the out-patient clinics of Chungnam National University Hospital between January 2006 and August 2008 were enrolled. Physical measures and biochemical tests were performed in all patients. Liver sonography was performed in 43 patients. They were divided into the following 2 groups based on ALT levels: group I, normal ALT levels (n=65); and group II, elevated ALT levels (n=77). We compared the physical measures, biochemical results, and ultrasonographic findings of the livers in both groups. Other causes of elevated serum ALT levels were ruled out. Results: The male-to-female ratios were 1.6:1 in group I and 7.6:1 in group II. Among physical parameters, the waist circumference-to-height ratio and hip circumference-to-height ratio were significantly higher in group II (p=0.001 and 0.046, respectively). Among biochemical parameters, aspartate aminotransferase (AST), ${\gamma}$-glutamyltransferase (${\gamma}$-GT), and total cholesterol levels were significantly higher in group II (p<0.001, 0.001, and 0.001, respectively). The AST/ALT ratio was <1 (mean, 0.55) and statistically lower in group II. There was a positive correlation between the serum ALT level and ${\gamma}$-GT (p<0.001, r=0.750), and a positive correlation between the serum ALT level and the waist circumference-to-height ratio in group II (p<0.001, r=0.401). Conclusion: The results suggest that the waist circumference-to-height ratio and ${\gamma}$-GT may be associated with elevated alanine aminotransferase activity in obese children.

• Journal of Home Health Care Nursing
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• v.9 no.2
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• pp.114-128
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• 2002

In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.

• Research in Community and Public Health Nursing
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• v.14 no.4
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• pp.568-578
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• 2003

This study was conducted to estimate the effects of self-care program on knowledge and symptoms related hypertension self-care and physiological index in essential hypertensive patients aged between 35-74 year. The subjects for the experiment group and the control group of this study were 70 men and women selected through random sampling from adults at Sangju Red Cross Hospital in Gyeongsanbuk-do, and the experiment was carried out during the period from the 15th of September to the 30th of April in 2002. This study measured systolic and diastolic blood pressure (SBP, DBP, the mean value of the two measures) and total cholesterol (TC) and surveyed the subjects' diet and life style in relation to hypertension using a self-report questionnaire. In order to study the significance of the effects of self-care program, the author carried out t-test, paired t-test, ANCOVA, chi-square analysis and effectiveness index (EI) analysis. Results of the study are as follows: The experiment group got higher mean scores than the control group in the degree of low sodium intake and the degree of high calcium and high potassium intake, and the difference was statistically significant(P<0.05). The effectiveness index of the self-care program in smoking was 0.797 at the 1st posttest and 0.601 at the 2nd posttest, and in physical activities 0.600 at the 1st posttest and 0.849 at the 2nd posttest. The rate of regular antihypertensive drugs intake of the experimental group was higher than that of the control group. and the effectiveness index of the self-care program was 0.715. The mean score of the systolic blood pressure of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). In conclusion, these findings support usefulness of self-care programs in reducing systolic blood pressure and in promoting self-care related to diet and life style for treating and preventing hypertension.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.440-446
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• 2003

Purpose : The genetic disturbance of galactosemia is expressed as a cellular deficiency of either galactose-1-phosphate uridyltransferase(GALT) or galactokinase(GALK) or UDP galactose 4-epimerase(GALE). To find-out the pattern of galactosemia in Korea, we retrospectively analyzed cases of galactosemia detected by neonatal screening program. Methods : We analyzed medical records of patients who visited Soonchunhyang University Hospital at age of 1 month after showing abnormalities in neonatal screening of galactosemia. For accurate diagnosis, galactose was measured by enzyme immunoassay(EIA) and fluorophotometer, also galactose-1-phosphate by fluorophotometer. Enzyme activities of GALK, GALT and GALE in RBC and galactose-1-phosphate were measured by radioisotope assay(RIA). Beutler test were done. Patients went on a lactose-free diet and follow-up tests for galactose, galactose-1-phosphate level and enzyme activity were performed. Results : 10 patients(male : 6, female : 4) were diagnosed as galactosemia. Two patients had GALK deficiency and two had GALT deficiency. Six were GALE deficient showing the largest number. In two patients with GALK deficiency, GALT and GALE activities were normal but GALK activities showed respectively reduced activity. For GALT deficiency, two patients had low GALT activity in RBC and showed genotype of Duarte 2/G(galactosemia) in DNA analysis. In one patient, GALT activity was normal. Three patients seemed to be heterozygote state of GALE deficiency according to GALE activity levels. Four patients showed GALK hyperactivity. Conclusion : GALE deficiency provided the highest number. After lactose-free diet, galactose and galactose-1-phosphate were normaly maintained. Neonatal screening on galactosemia is essential for preventing life-threatening symptoms and an accurate diagnosis is needed for finding out the type of galactosemia which is important for prognosis.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.13-23
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• 1979

A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

• Journal of Korean Ophthalmic Optics Society
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• v.12 no.2
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• pp.1-12
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• 2007

Object of this research is to estimate the effect of myopia correction and safety on reverse geometry contact lens fitting in school children. This research include 53(106eyes) schoolchildren among 7 to 18 years who has low to moderate myopia(-1.00D~-5.00D) and prescribed reverse geometry contact lens for purpose on orthokeratology between January to July 2004 and had 3months full follow up examination. They were tested for slit lamp examinations, BUT(Break up time), direct ophthalmoscopy, retinoscopy, uncorrected visual acuity, best corrected visual acuity, autorefraction, autokeratometry and corneal topography in each examination(1day, 1week, 2weeks, 1, 2, and 3months) of before-and-after lens wearing to find out the effect of myopic correction and side effect. The results came out as follow. The average of uncorrected visual acuity was $0.0938{\pm}0.378$ before lens wear and $0.3136{\pm}0.283$ after 1day lens wear, and there was fast improvement after 1week($0.7925{\pm}0.301$) and little improvement after 2weeks period but still they shows better uncorrected visual acuity(p<0.01). The result of this study, the reverse geometry lens is very useful to correct refractive error and control the progression of myopia temporally among low to moderate myopic patient. The side effects were relatively rare but further study should be necessary with long term lens wear effect on eye health. For the lens prescription, the clinical fitting process had higher rate of success with consideration of eccentricity and corneal topography.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.214-222
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• 2002

Purpose : The aim of this study was to evaluate myocardial injury in children treated with adriamycin by echocardiography, which is non-invasive and safe measurement for children. Methods : Left ventricular dimensions, wall stress, and contractile function were determined by echocardiographic methods in 17 patient recepients with adriamycin chemotherapy at rest(group 1) and during stress(group 2). Twenty age-matched normal subjects were established as control group. Results : End-diastolic dimension was decreased in both groups(group 1; $92{\pm}7%$ of normal, group 2; $87{\pm}8%$ of normal, P<0.05). Left ventricular end diastolic volume and wall mass were also decreased in both groups(group 1; $96{\pm}12mL/m^2$ and $145{\pm}18g/m^2$, group 2; $87{\pm}8mL/m^2$ and $137{\pm}16g/m^2$, respectively, P<0.05 and P<0.05) and group 2 showed lower values than group 1. Meridional end systolic stress(ESSm) was increased in both groups but there was no significant difference between the two groups(group 1; $52.6{\pm}6.2g/cm^2$, group 2; $63.5{\pm}8.5g/cm^2$, P<0.05, normal value $45.7{\pm}3.5g/cm^2$). The load-independent relation of rate-corrected circumferential fiber shortening velocity(Vcfc) to ESSm has a significant abnormal change in 7 out of 17(41%) in group 1 and 12 out of 17(71%) in group 2. Conclusion : The load-dependent systolic index, such as fractional shortening, may fail to show abnormality because of the compensatory changes in preload and afterload which can mask the impaired contractility. Therefore, systolic performance also should be monitored by a load-indepedent contractility index such as slope value of the end-systolic pressure-dimension relation and the position of the left ventricular stress-fiber shortening velocity after exercise.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.84-88
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• 1999

Purpose :To develop a method for verifying a treatment setup in stereotactic radiotherapy by ma- tching portal images to DRRs. Materials and Methods : Four pairs of orthogonal portal images of one patient immobilized by a thermoplastic mask frame for fractionated stereotactic radiotherapy were compared with DRRs. Portal images are obtained in AP (anteriorfposterior) and lateral directions with a target localizer box containing fiducial markers attached to a stereotactic frame. DRRs superimposed over a planned iso-center and fiducial markers are printed out on transparent films. And then, they were overlaid over onhogonal penal images by matching anatomical structures. From three different kind of objects (isgcenter, fiducial markers, anatomical structure) on DRRs and portal images, the displacement error between anatomical structure and isocenters (overall setup error), the displacement error between anatomical structure and fiducial markers (irnrnobiliBation error), and the displacement error between fiducial markers and isocenters (localization error) were measured. Results : Localization error were 1.5$\pm$0.3 mm (AP), 0.9$\pm$0.3 mm (lateral), and immobilization errors were 1.9$\pm$0.5 mm (AP), 1.9$\pm$0.4 mm (lateral). In addition, overall setup errors were 1.0$\pm$0.9 mm (AP), 1.3$\pm$0.4 mm (lateral). From these orthogonal displacement errors, maximum 3D displacement errors($\sqrt{(\DeltaAP)^{2}+(\DeltaLat)^{2}$)) were found to be 1.7$\pm$0.4 mm for localization, 2.0$\pm$0.6 mm for immobilization, and 2.3$\pm$0.7 mm for overall treatment setup. Conclusion : By comparing orthogonal portal images with DRRs, we find out that it is possible to verify treatment setup directly in stereotactic radiotherapy.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.24-33
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• 2009

Objectives: In September 2008, an outbreak of diarrhea occurred among students attending Y school in Yeongcheon-si. Shigella sonnei was cultured from some of the rectal swabs. An epidemiological investigation was carried out to determine the source of the infection and the mode of transmission of the shigellosis outbreak. Methods: The index case lived in the D rehabilitation facility in Gyeongsan-si and an additional epidemiological investigation was carried out there. The cases could not be questioned due to their mental handicaps. The teachers were interviewed instead. A patient case was defined as a resident with diarrhea more than one time a day from September 18 to September 26, 2008 or a resident with confirmed Shigella sonnei at the Y school or the D rehabilitation facility. Results: The attack rate was 1.2% (8 persons) among 659 persons in the Y school and D rehabilitation facility. Five persons were microbiologically confirmed to have the infection and three persons were diagnosed on the basis of symptoms. Shigella sonnei was cultured from five of the 659 rectal swabs. However, 80 environmental specimens including drinking water, preserved foods, and cooking utensils were negative. All eight patients were Y school students and had been living in group boarding and lodging. Six of them lived in the D rehabilitation facility and two lived in the dormitory at the Y school. Five cases showed pulsed-field gel electrophoresis patterns that were identical for Shigella sonnei. Conclusions: The results of this study showed that the infection source of the shigellosis outbreak, in the two places, were identical. It is likely that the infections initially spread from a teacher or volunteer and then among the students.

• Tuberculosis and Respiratory Diseases
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• v.51 no.1
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• pp.25-34
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• 2001

Background : Inhaled glucocorticoids are the medical treatment of choice in asthma patients. Fluticasone propionate is one of the most effective inhaled corticosteroids and has been reported to have minimal effect on the hypothalamic-pituitary-adrenal axis at the recommended dose. However, reports of long-term trials characterizing their systemic safety with chronic use are rare. This study was designed to evaluate the long-term safety of inhaled fluticasone propionate to the hypothalamic-pituitary-adrenal axis. Method : This study was conducted on 21 patients to evaluate the adrenal response to rapid ACTH stimulation test after 6 months of treatment with fluticasone propionate from $200\;{\mu}g$ to $750\;{\mu}g$ daily. The serum cortisol levels was measured to assess its effect on the hypothalamic-pituitary-adrenal axis just prior to the injection, at 30 minutes and 60 minutes after an intramuscular injection of synthetic ACTH. Result : The mean dose of inhaled fluticasone propionate was $355\;{\mu}g$ per day(SD=$174\;{\mu}g$, range=$200\;{\mu}g$ to $750\;{\mu}g$). The mean serum cortisol levels of the patients was $11.0\;{\mu}g/d{\ell}$(SD=$6.4\;{\mu}g/d{\ell}$) prior to the injection, $20.0\;{\mu}g/d{\ell}$ (SD=$7.7\;{\mu}g/d{\ell}$) after 30 minutes, and $23.0\;{\mu}g/d{\ell}$(SD=$6.3\;{\mu}g/d{\ell}$) after 60 minutes. Sixteen patients of the 21 patients had a normal response(> $18\;{\mu}g/d{\ell}$), and 5 out of the 21 patients had serum cortisol levels below the normal range after the rapid ACTH stimulation test. Conclusion: Adrenal suppression occurred in 5 out of 21 patients with 6 months treatment with inhaled fluticasone propionate.