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A Study on the Crime Prevention Design and Consumer Perception (CPTED) of Multi-Family Housing in China (중국 공동주택의 범죄 예방을 위한 디자인과 소비자의 인식에 관한 연구)

  • Kong, De Xin;Lee, Dong Hun;Park, Hae Rim
    • Journal of Service Research and Studies
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    • v.14 no.1
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    • pp.63-76
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    • 2024
  • Multi-family housing plays a crucial role as a living and experiencing space, and its environment has a direct impact on the well-being and stability of its residents. Therefore, Crime Prevention Design (CPTED) for multi-family housing is of utmost importance. However, crime-related data in China is not disclosed to the public because of its specificity, making it difficult for researchers to conduct further in-depth studies based on accurate crime data. As a result, the establishment and application of CPTED theory in terms of crime prevention is limited and delayed. This study aims to explore three aspects of CPTED in multi-family housing as perceived by home-buying consumers. It investigated consumer perception of the CPTED, the importance of each element and ways to increase awareness of CPTED in multifamily housing in order to effectively improve multifamily crime prevention design principles and further enhance public safety. This study examined the current state and future trends of CPTED in China by analyzing relevant research reports and literature, aiming to gain insights into the crime prevention awareness of Chinese homeowners. In addition, a survey was conducted on Chinese consumers to unravel the importance of CPTED and increase awareness of its various elements in multifamily-family. This study used a Likert scale and SPSS reliability analysis to determine the cognitive status of multi-family CPTED, the importance of each element, and proposed an improvement plan based on the analysis results. As this study was limited by the difficulty of implementation and the lack of validation of its practical effectiveness, it is recommended that future research needs to validate the effectiveness of crime prevention designs and produce more practical results. Furthermore, it is crucial to utilize this study to inform the implementation of security solutions that are tailored to the unique characteristics of each district. Additionally, it is important to offer guidance on how to enhance community safety by increasing residents' awareness of security through education and information dissemination. The author hopes that the representative multi-family CPTED awareness, the importance of each element, and plans for improvement shall be summarized from this study, and provide foundational data for the future development of CPTED based on the Chinese region.

Comparison of In Vitro, Ex Vivo, and In Vivo Antibacterial Activity Test Methods for Hand Hygiene Products (손 위생 제품에 대한 in vitro, ex vivo, in vivo 항균 시험법 비교)

  • Daeun Lee;Hyeonju Yeo;Haeyoon Jeong
    • Journal of Food Hygiene and Safety
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    • v.39 no.1
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    • pp.35-43
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    • 2024
  • Numerous methods have been applied to assess the antibacterial effectiveness of hand hygiene products. However, the different results obtained through various evaluation methods have complicated our understanding of the real efficacy of the products. Few studies have compared test methods for assessing the efficacy of hand hygiene products. In particular, reports on ex vivo pig skin testing are limited. This study aimed to compare and characterize the methodologies applied for evaluating hand hygiene products, involving in vitro, ex vivo, and in vivo approaches, applicable to both leave-on sanitizers and wash-off products. Our further aim was to enhance the reliability of ex vivo test protocols by identifying influential factors. We performed an in vitro method (EN1276) and an in vivo test (EN1499 and ASTM2755) with at least 20 participants, against Serratia marcescens or Escherichia coli and Staphylococcus aureus. For the ex vivo experiment, we used pig skin squares prepared in the same way as those used in the in vivo test method and determined the optimal treated sample volumes for sanitizers and the amount of water required to wash off the product. The hand sanitizers showed at least a 5-log reduction in bacterial load in the in vitro test, while they showed little antibacterial activity in the in vivo and ex vivo tests, particularly those with a low alcohol content. For the hand wash products, the in vitro test was limited because of bubble formation or the high viscosity of the products and it showed low antibacterial activity of less than a 1-log reduction against E. coli. In contrast, significantly higher log reductions were observed in ex vivo and in vivo tests, consistently demonstrating these results across the two methods. Our findings revealed that the ex vivo and in vivo tests reflect the two different antibacterial mechanisms of leave-on and wash-off products. Our proposed optimized ex vivo test was more rapid and more precise than the in vitro test to evaluate antibacterial results.

A Study on the Digital Drawing of Archaeological Relics Using Open-Source Software (오픈소스 소프트웨어를 활용한 고고 유물의 디지털 실측 연구)

  • LEE Hosun;AHN Hyoungki
    • Korean Journal of Heritage: History & Science
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    • v.57 no.1
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    • pp.82-108
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    • 2024
  • With the transition of archaeological recording method's transition from analog to digital, the 3D scanning technology has been actively adopted within the field. Research on the digital archaeological digital data gathered from 3D scanning and photogrammetry is continuously being conducted. However, due to cost and manpower issues, most buried cultural heritage organizations are hesitating to adopt such digital technology. This paper aims to present a digital recording method of relics utilizing open-source software and photogrammetry technology, which is believed to be the most efficient method among 3D scanning methods. The digital recording process of relics consists of three stages: acquiring a 3D model, creating a joining map with the edited 3D model, and creating an digital drawing. In order to enhance the accessibility, this method only utilizes open-source software throughout the entire process. The results of this study confirms that in terms of quantitative evaluation, the deviation of numerical measurement between the actual artifact and the 3D model was minimal. In addition, the results of quantitative quality analysis from the open-source software and the commercial software showed high similarity. However, the data processing time was overwhelmingly fast for commercial software, which is believed to be a result of high computational speed from the improved algorithm. In qualitative evaluation, some differences in mesh and texture quality occurred. In the 3D model generated by opensource software, following problems occurred: noise on the mesh surface, harsh surface of the mesh, and difficulty in confirming the production marks of relics and the expression of patterns. However, some of the open source software did generate the quality comparable to that of commercial software in quantitative and qualitative evaluations. Open-source software for editing 3D models was able to not only post-process, match, and merge the 3D model, but also scale adjustment, join surface production, and render image necessary for the actual measurement of relics. The final completed drawing was tracked by the CAD program, which is also an open-source software. In archaeological research, photogrammetry is very applicable to various processes, including excavation, writing reports, and research on numerical data from 3D models. With the breakthrough development of computer vision, the types of open-source software have been diversified and the performance has significantly improved. With the high accessibility to such digital technology, the acquisition of 3D model data in archaeology will be used as basic data for preservation and active research of cultural heritage.

The Effect of Seminal Plasma on Chilling and Freezing of Canine Spermatozoa (개 정액의 정장이 개정자의 냉각과 동결에 미치는 영향)

  • You, Myung-Jo;Lee, John-Hwa;Kim, In-Shik;Park, Jin-Ho;Kwon, Jung-Kee;Kim, Jong-Hoon;Kim, Bum-Seok;Yu, Il-Jeoung
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.486-492
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    • 2007
  • Seminal plasma(SP) is usually removed from semen that is to be cryopreserved. However, some reports indicate that SP has beneficial effects on spermatozoa during chilling and freezing. The purpose of this study was to determine the effect of SP on sperm survival by adding SP to the extender before cooling and freezing canine spermatozoa. In replicate experiments, ejaculates obtained from four healthy dogs(1-4 years old) of various breeds were pooled, centrifuged at $300{\times}g$ for 10 min at $25^{\circ}C$, and the supernatant of seminal plasma was decanted. Spermatozoa were suspended in egg yolk-Tris(EYT) buffer. The study comprised two experiments: [Exp 1] Sperm were suspended in EYT extender containing either 0, 20, 40, 80 or 100% SP and were slowly cooled to $4^{\circ}C$ for 2h or held at $25^{\circ}C$ as controls. Sperm concentration was adjusted to $2{\times}10^8/ml$. [Exp II] Sperm samples, each of which contained $1{\times}10^8/ml$, were assigned to nine groups to be frozen. In the first four groups, sperm in EYT containing either 20, 40, 80 or 100% SP were cooled to $4^{\circ}C$, then diluted to contain final concentrations of EYT+0.6M glycerol and then were frozen. The final concentrations of SP were 10, 20, 40 or 50%. In the other four groups, sperm in EYT alone were first cooled slowly to $4^{\circ}C$, then diluted to contain final concentrations of EYT+0.6M glycerol plus 10, 20, 40 or 50% SP and then were frozen. Spermatozoa, which chilled in EYT alone and diluted to contain final concentrations of EYT+0.6M glycerol without seminal plasma, and then frozen, was regarded as control. Spermatozoa were frozen at $25^{\circ}C/min$ of cooling rate in plastic straws that were suspended above liquid nitrogen and thawed in water at $38^{\circ}C$ for 1 min. Sperm survival was assayed by determining progressive motility and integrity of plasma and acrosome membranes. Progressive motility was determined by microscopic examination at $200{\times}$ magnification. Membrane integrity was assessed by use of a double fluorescent dye, and acrosome integrity by staining sperm with Pisum sativum agglutinin. The results of the first experiment showed that adding SP did not improve motility of spermatozoa compared to those incubated without SP regardless of temperature. The results of the second experiment showed that spermatozoa suspended in EYT+0.6M glycerol containing SP exhibited the higher progressive motility before being frozen(P<0.05). However, frozen-thawed spermatozoa that had suspended in EYT+0.6M glycerol containing SP showed the similar or lower viability(P<0.05). In summary, although seminal plasma did not affect spermatozoa that were chilled in EYT without cryoprotectant(CPA), addition of seminal plasma to EYT containing CPA did significantly improved progressive motility of canine spermatozoa that were chilled.

The Clinical Significance of ${\gamma}{\delta}$ T lymphocytes in patients with pleural tuberculosis (결핵환자에서 말초혈액과 흉막액내 ${\gamma}{\delta}$ T 림프구의 의의)

  • Song, Kwang Seon;Shin, Kye Chul;Kim, Do Hun;Hong, Ae Ra;Kim, Hee Seon;Yong, Suk Joong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.44-51
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    • 1997
  • Background : The changes of the composition in the T-lymphocyte are important as an immunological abnormality in the pathogenesis of tuberculosis. Previously, the second type of TCR dimer(${\gamma}{\delta}$ T lymphocyte) that did not express CD4 or CD8 molecules was found. In other reports the presence of this type of lymphocytes was increased in the initial stage of tuberculous infections. Method : To determine whether there are some differences in the T-lymphocyte subsets in the peripheral blood or pleural effusion between pleural tuberculosis and other pleurisy. Thirty patients with pleural effusion among the forty-nine patients were examined T-lymphocyte subset analysis(CD4+T-cell,CD8+ T-cell,${\gamma}{\delta}$ T-lymphocytes) with anti- Leu4, anti-Leu3a, anti-Lea2a, anti HLA-DR and anti-TCR-${\gamma}{\delta}$-1(Becton & Dickinson Co.). Results : The average age of the patients was 50 years old(17-81year). There were 33 males and 16 female patients. Patiensts with tuberculosis are 30cases(tuberculous pleurisy 15), lung cancer 12cases(malignant effusion 9) and pneumonia 7cases(parapneumonic effusion 6cases) In T lymphocyte subsets of pleural effusion, helper T lymphocyte(54.6 + 13.8 %) of tuberculous pleurisy was higher than that(36.2 + 25.3 %) of non-tuberculous pleurisy(p=0.04). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes in tuberculousis was insignificantly higher than non-tuberculous patients(p= 0.24). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes and pleural ${\gamma}{\delta}$ T-Iymphocytes in tuberculous pleurisy was insignificantly higher than in non-tuberculous pleurisy(p= 0.16, p= 0.12). Conclusion : The percentage of -${\gamma}{\delta}$ T lymphocytes among the total T-lymphocytes is not significantly increased in the peripheral blood or pleural effusion of the pleural tuberculosis. ${\gamma}{\delta}$ T lymphocytes is less useful as a diagnostic method of pleural tuberculosis.

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Interpreting Bounded Rationality in Business and Industrial Marketing Contexts: Executive Training Case Studies (집행관배훈안례연구(阐述工商业背景下的有限合理性):집행관배훈안례연구(执行官培训案例研究))

  • Woodside, Arch G.;Lai, Wen-Hsiang;Kim, Kyung-Hoon;Jung, Deuk-Keyo
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.49-61
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    • 2009
  • This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

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IR Study on the Adsorption of Carbon Monoxide on Silica Supported Ruthenium-Nickel Alloy (실리카 지지 루테늄-니켈 합금에 있어서 일산화탄소의 흡착에 관한 IR 연구)

  • Park, Sang-Youn;Yoon, Dong-Wook
    • Applied Chemistry for Engineering
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    • v.17 no.4
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    • pp.349-356
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    • 2006
  • We have investigated adsorption and desorption properties of CO adsorption on silica supported Ru/Ni alloys at various Ru/Ni mole content ratio as well as CO partial pressures using Fourier transform infrared spectrometer (FT-IR). For Ru-$SiO_{2}$ sample, four bands were observed at $2080.0cm^{-1}$, $2021.0{\sim}2030.7cm^{-1}$, $1778.9{\sim}1799.3cm^{-1}$, $1623.8cm^{-1}$ on adsorption and three bands were observed at $2138.7cm^{-1}$, $2069.3cm^{-1}$, $1988.3{\sim}2030.7cm^{-1}$ on vacumn desorption. For Ni-$SiO_{2}$ sample, four bands were observed at $2057.7cm^{-1}$, $2019.1{\sim}2040.3cm^{-1}$, $1862.9{\sim}1868.7cm^{-1}$, $1625.7cm^{-1}$ on adsorption and two bands were observed at $2009.5{\sim}2040.3cm^{-1}$, $1828.4{\sim}1868.7cm^{-1}$ on vacumn desorption. These absorption bands correspond with those of the previous reports approximately. For Ru/Ni(9/1, 8/2, 7/3, 6/4, 5/5; mole content ratio)-$SiO_{2}$ samples, three bands were observed at $2001.8{\sim}2057.7cm^{-1}$, $1812.8{\sim}1926.5cm^{-1}$, $1623.8{\sim}1625.7cm^{-1}$ on adsorption and three bands were observed at $2140.6cm^{-1}$, $2073.1cm^{-1}$, $1969.0{\sim}2057.7cm^{-1}$ on vacumn desorption. The spectrum pattern observed for Ru/Ni-$SiO_{2}$ sample at 9/1 Ru/Ni mole content ratio on CO adsorption and on vacumn desorption is almost like the spectrum pattern observed for Ru-$SiO_{2}$ sample. But the spectrum patterns observed for Ru/Ni-$SiO_{2}$ samples under 8/2 Ru/Ni mole content ratio on CO adsorption and vacumn desorption are almost like the pattern observed for $Ni-SiO_{2}$ sample. It may be suggested surfaces of alloy clusters on the Ru/Ni-$SiO_{2}$ samples contain more Ni components than the mole content ratio of the sample considering the above phenomena. With Ru/Ni-$SiO_{2}$ samples the absorption band shifts may be ascribed to variations of surface concentration, strain variation due to atomic size difference, variation of bonding energy and electronic densities, and changes of surface geometries according to surface concentration variation. Studies for CO adsorption on Ru/Ni alloy cluster surface by LEED and Auger spectroscopy, interation between Ru/Ni alloy cluster and $SiO_{2}$, and MO calculation for the system would be needed to look into the phenomena.

Prognosis Factors of Tricuspid Regurgitation after the Operation for Left-sided Valvular Heart Disease (좌심실 판막질환 수술 후 동반된 삼첨판패쇄부전증의 경과에 영향을 미치는 요인)

  • Jin, Ung;Kim, Hwan-Wook;Lee, Jong-Ho;Kweon, Jong-Bum;Jo, Min-Seop;Yoon, Jeong-Seob;Moon, Seok-Whan;Sim, Sung-Bo;Park, Kuhn;Kim, Chi-Kyung;Cho, Keon-Hyun;Wang, Young-Pil;Lee, Sun-He;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.150-156
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    • 2003
  • Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

The Characteristics and Fates of Pulmonary Tuberculosis Patients Seen at Medical Department of A Medium Sized General Hospital (부산에 한 중형 종합 병원 내과에서의 폐결핵 환자의 양상과 귀결)

  • Kim, Young-Hyo;Park, Ki-Chan;Bae, Seong;Lee, Sang-Hun;Chun, Myung-Ho;Lee, Sang-Ki;Jun, Kwang-Su;Lee, Chan-Se
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.417-424
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    • 1992
  • Background: There were many reports about the clinical aspect and outcomes of pulmonary tuberculosis in health center but few in a medium sized general hospital. The purposes of this study were to find any characteristic differencies in the patients and the general outcomes of the treatments and also to give some suggestive points for the insurance policy making. Methods: We made a retrograde analysis of the medical records of 1981 patients (male 992 female 1,059) who attended our clinics of the 4th internal department, Daedong general hospital during two years from January 1989 to December 1990. Result: 1) Of 1981 patients, 96 were diagnosed as pulmonary tuberculosis taking relatively large proportion in the prevalence. The ratio of prevalence between male and female was 7.81% to 2.27%. The 61.46% were the first diagnosis & initial treatment cases and the remaining 38.54% were the retreatment cases with no statistical significance between sex. 2) The most prevalent age group was between 21~40 years old and the prevalence rate was 45.45% of male and 76.76% of female. The lowest age group in male patient was above 61 showed 3.03%, and there was no female patients above age 60 years old. This phenomena could be thought as the negligence for the treatment of pulmonary tuberculosis in the old age groups rather than true tuberculosis prevalence and it could be proved by the higher rates towards old age groups in the national tuberculosis prevalence survey. 3) There were 57.07% of the minimal case, 48.96% of the moderate, 18.75% of the far advanced. The sputum examination showed 37.07% were culture positive, 46.88% were the negative, and 15.63% of the patients had no stutum examination. Moreover, uncoperatives among the far advanced cases were notable showing 22.22% of the stutum examination, where 16.13% in the minimal cases. The stutum positive rate among the initial treatment cases were 41.07% and 55.00% for the retreatment cases. The sputum no examination rates were 17.86% and 12.50% respectively. 4) The classfication of the mode of disease onset showed 68.75% with gradual onset, 9.38% hemoptic, 3.13% acute pneumonic and 18.75% was found through the radiologic examination in various occasions. 5) The percentages of patients who continued their treatment for more than 8 month were 35.71% (for initial treatment), 25.00% (for retrement), 16.13% (for the minimal), 27.78% (for the far advanced). 6) The group of patients who were treated more than 8 months showed the negative conversion rate of 80% on sputum and marked improvement on chest x-ray in 56.67%. However, in far advanced or retreatment cases, the rate of negative conversion on sputum and the rate of improvement on chest x-ray were low being 60% and 20% for the former and 60% and 10% for the latter, each respectively. Conclusion: It would be strongly emphasized that the improvement of National medical insurance system and social welfare system in Korea must be definite to improve overall treatment and control of tuberculosis diseases as well as physician's devotious National tuberculosis control policy.

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Clinical Characteristics of Arthrogryposis, Renal Tubular Dysfunction, Cholestasis(ARC) Syndrome in Korea (ARC(Arthrogryposis, Renal Tubular Dysfunction, Cholestasis) 증후군의 발병양상에 관한 연구)

  • Lee Soon Min;Kim Ji Hong;Lee Jae Seung;Han Suk Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.222-230
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    • 2005
  • Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

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