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Establishment of Reference Range of Proinsulin (Proinsulin 참고치 설정에 관한 연구)

  • Nam, Yee Moon;Shin, Yong Hwan;Kim, Ji Young;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.76-79
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    • 2013
  • Purpose: It is very important to establish the appropriate reference range in the laboratory for preventing mistakes like false positive or false negative. Because the reference range in the laboratory is standard of patient test results interpretation. Proinsulin is precursor hormone of insulin, and the importance is increasing for diagnosing diabetes or insulinoma. Proinsulin reagent used in our laboratory is produced in the USA, and the reference range provided by manufacturer was adapted to our reference range after the validation test. But, it is generally recommend for the every laboratory to establish the their own reference range. So, we decided to re-evaluate the reference range with our patients' test results. Materials and Methods: Among 737 patients who had been to health promotion center in our hospital between Dec. $8^{th}$ 2011 and Dec. $21^{st}$ 2011, 563 patients are chosen with exception of diabetics patients and patients showing abnormal test results in Fasting Glucose, HbA1c, Insulin, and C-peptide. The 563 test results (275 males and 288 females) were classified with three groups(entire, male, female), and analysis of normal distribution was performed with aid of SPSS(version 19.0). Because Each group didn't show normal distribution, the reference range was set from the lowest limit of 2.5% to the highest limit of 97.5% with Percentile method used in non-normal distribution. Results: When evaluation values are sorted in ascending order, the entire range is 4.5~52.0 pM and 5.3~51.9 pM for male and 4.5~52.0 pM for female. The calculated reference range with percentile method shows 6.7~26.5 pM for entire group, 6.8~26.5 pM for male and 6.7~26.5 pM for female, respectively. Conclusion: The reference range provided by reagent manufacturer is 6.4~9.4 pM and the one established in this study is 6.7~26.5 pM. This difference might be caused by racial characteristics between Western people and Koreans. So an ideal reference range can be gotten with normal population visiting to every hospital. Our hospital has been using the newly re-establishing reference range under consultation with the department of endocrinology since Aug. $1^{st}$ 2012.

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Predictability of Impending Events for Death within 48 Hours in Terminal Cancer Patients (말기암환자에서 임박사건 간 48시간 임종예측도 비교)

  • Hwang, In-Cheol;Choi, Chung-Hyun;Kim, Kyoung-Kon;Lee, Kyoung-Shik;Suh, Heuy-Sun;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.28-33
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    • 2011
  • Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

EVALUATION OF RADIOPACITY AND DISCRIMINABILITY OF VARIOUS FIBER REINFORCED COMPOSITE POSTS (수종의 섬유 강화 레진 포스트의 방사선 불투과도와 식별도 평가)

  • Lee, Eun-Hye;Choi, Hang-Moon;Park, Se-Hee;Kim, Jin-Woo;Cho, Kyung-Mo
    • Restorative Dentistry and Endodontics
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    • v.35 no.3
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    • pp.188-197
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    • 2010
  • The purpose of this study was to compare radiopacity and radiographic discriminability of various FRC-Posts. Six FRC-Posts were investigated ; 1) FRC Postec Plus (Ivoclar Vivadent AG, Schaan, Liechtenstein), 2) Snowlight (Carbotech, Lewis center, OH, USA), 3) Dentin Post (Komet Brasseler, Lamgo, Germany), 4) Rely-X Fiber Post (3M ESPE, St.paul, MN, USA), 5) D.T.-Light Post (BISCO, Schaumburg, IL,USA), 6) Luxapost (DMG, Hamburg, Germany) The radiographs of each post with a reference 1 mm / 2 mm aluminum step-wedge was taken using digital sensor. The optical density were calculated by gray value of $10{\times}10$ pixel and compared in mm Al equivalent at five points. Six maxillary incisors of similar radiopacity were used. Radiographs of posts in Mx. incisors of lingual side of dry mandible were taken. We showed radiographs and asked the questionnaire to 3 radiologists, 3 endodontists, 3 general practitioners. The questionnaire was comprised of choices of the highest, lowest radiopaque individual post and the choices of best discriminable post at apical, coronal area. The following results were obtained. 1. Each post system showed various radiopacity. 2. There was change of discriminability between each post and simulated specimens regardless of examiner. Although each post showed various radiopacity, the difference of radiopacity did not affect on discriminability.

Review of 2019 Major Medical Decisions (2019년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Park, Noh Min;Jeong, Hye Seung;Lee, Dong Pil;Lee, Jung Sun;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.107-152
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    • 2020
  • During the main ruling in 2019, a number of rulings that were of interest or meaningful were handed down, such as just because the complication of medical practice has occurred, there is no presumption of negligence, a case involving a fall accident in which a lot of culpability has recently been made. the death of a well-known singer that caused a sensation, a case about damages caused by MERS in 2015, which is more meaningful in connection with damages caused by COVID-19, an infectious disease that has recently hit the world, including Korea. In preaching the principles of the law, just because there has been a complication caused by medical practice, there is no presumption of negligence, 'The scope of the complication without presumption of negligence' was determined differently by the court, the court was not able to specify the criteria. Specific circumstances were presented to limit the responsibility of the medical institution while acknowledging the malpractice of the medical institution in relation to the fall accident. In relation to the scope of damages, judgment was made on issues related to the calculation of lost profits of medical malpractice; criteria for determining celebrities' daily income, criteria for determining daily income in case of receiving survivor's pension due to medical accident, an incident in which the daily income is denied if the labor capacity is already lost at the time of a medical accident. But, it seems that judgments should be made based on clearer and more reasonable standards. Related to Medical Advertise, specific logic of judgment was presented as to whether it was interpreted as being in accordance with the specific prohibition listed in Article 27 paragraph 3 of the Medical Law, which is the criterion for violation of the Medical Law, or if it constitutes a significant harm to the order of the medical market. In response to the prohibition of operating the multiple medical institutions, the Constitutional Court decided that it was constitutional because it did not violate the regulations on excessive funding, and rationally limited the scope of the prohibited 'redundant operation'. The Supreme Court ruled for the first time that even a medical institution established and operated in violation of the Medical Service Act did not make it impossible to receive all medical care benefits implemented by a medical institution under the National Health Insurance Act. Significant rulings were finalized that recognized the existence of specific protection obligations for the people of the country in the management of infectious diseases.

Analysis of Potential Toxigenicity and Phylogeny using Target Genes in Aphanizomenon flos-aquae (Cyanophyceae) strains isolated from the Nakdong River (낙동강에서 분리된 Aphanizomenon flos-aquae (Cyanophyceae) 균주의 목표 유전자를 이용한 잠재적 독소 생성능 및 계통학적 분석)

  • Ryu, Hui-Seong;An, Sung-Min;Lim, Chang-Kun;Shin, Ra-Young;Park, Jong-Guen;Lee, Jung-Ho
    • Korean Journal of Ecology and Environment
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    • v.50 no.1
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    • pp.137-147
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    • 2017
  • The identity of toxin producers remains only hypothesis unless there were identified by strain isolation and analytical confirmation of both the cyanotoxin production and the genetic identity of the monoculture. The purposes of this study were to identify a morphologic and phylogenetic classification in Aphanizomenon flos-aquae strains isolated from the Nakdong River and to investigate the potential ability of the strains to produce toxins such as saxitoxin and cylindrospermopsin using target genes. The 16S rRNA and sxtA, sxtI, cyrA, cyrJ genes were analyzed on two strains (DGUC001, DGUC003) isolated from the Nakdong River. Morphological features of the strains were observed a shape of aggregated trichomes in parallel fascicles which can reach up to macroscopic size and a hyaline terminal cell without aerotope. In addition, the 16S rRNA phylogenetic analyses showed that the strains were identified as the same species with high genetic similarity of 98.4% and grouped within a monospecific andsupported cluster I of Aphanizomenon flos-aquae selected from GenBank of the NCBI. The cyrA and cyrJ genes encoding for the cylindrospermopsin-biosynthesis were not detected in the present study. The sxtA gene was in detected both the two strains, whereas the sxtI gene which had been suggested as a suitable molecular marker to detect saxitoxin-producing cyanobacteria was not found both the strains. Thus, the two strains isolated from Nakdong River were identified as the same species of Aphanizomenon flos-aquae Ralfs ex Bornet et Flahault 1888, the two strains were confirmed as potential non-producing strains of the saxitoxin and cylindrospermopsin.

A Study on Effective Adjustment of the Curriculum in Film and Film Related Major in Korean Colleges (국내 대학의 영화 및 영화 관련학과 교과과정 효율화를 위한 연구)

  • Lee, Chan-Bok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3514-3523
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    • 2009
  • Before 1990's, Korea had only few colleges that had film and film related majors. As Korean film industry started its marvelous improvement in both commercial and artistic phase, many colleges were interested in this new academic field. They hurried up to launch this new and profitable major; as a result, Korea now has more than hundred colleges and universities that has film related majors. Each college enumerates numbers of academic courses that may look reasonable; they have almost every course a fine film school should provide such as film theory, production, and performance in film. Lots of film schools offer lots of film courses; and they look alike. One unique thing in film major is its vast sub fields and categories. After you decide to study film, you have to select what specific field in film you want to study. Studying film theory and film production can be as different as majoring physics and physical education. The problem Korean colleges are dealing with is that there are too much film schools, and moreover those colleges have similar curriculums that just look like a department store that sells everything. One suggestion is specializing its curriculum in which the school can take advantages using their special conditions. San Francisco Art Institute is one of United States well known private film schools, but many people remember this school as a specialized film school in experimental film. San Francisco where this school is located has had many liberal and experimental artists as the city has been supporting and offering them an environment they can concentrate their work. Naturally, the school has world famous faculty members in experimental film, and students who want to study and make experimental film come to this school from all over the world because they know this school would be the best to study experimental film. There are many film schools in metro Los Angeles area; since its location near Hollywood, no wonder these schools concentrate on film producing and film production. They take advantage of their geographical location to hire film industry professional and to focus on commercial feature film productions. What we can do now to adjust the curriculum in film and film related major in Korean colleges is to adapt new standards in this changed film industry. One school can emphasize digital production while another school focuses on digital intermediate process. But if one school tries to both fields or all fields of film major just like we have done so far, the school could not take care of all the equipment and the faculty that the fields would need. Korean film schools should devide the field in film major and concentrate what they selected. Selection and concentration can be and should be applied in Korean film schools.

Half a cenury of the rural geography in Korea(1945-1995):review and prospect (촌락지리학 50년(1945-1995)의 회고와 전망)

  • ;Lee, Moon-Jong
    • Journal of the Korean Geographical Society
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    • v.31 no.2
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    • pp.213-254
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    • 1996
  • The Korean Geographical Society was founded in 1945, when Korea was liberated from the Japanese rule. And The Journal of the Korean Geography activated academic studies of geography by publishing research papers in it. Professor Kang, Dae-Hyun wrote the first two specialized papers of rural geography in 1966: " Flood Plain Settlements on the Han River" and "The Location and Form of the Dispersed Villages around Dae-Cwan-Ryung". The early studies of rural geography were not based on serious academic foundations, such as the adjustment of theoretical notions and a good grasp of subjects. After choosing subjects that came to hand without academic consideration. they simply enumerated generalized items of the results of the field work investigation such as the location the landscape and the process of formation of the settlements. In the 1970s and 1980s, however, rural settlement studies progressed remarkably in Korea. More than 80% of 318 dissertations, theses, or papers collected for this review were written in the late 1980s, and the subjects and methodology became diversified. As may be expected, recent studies are found very systematic and problem-solving in the various fields - contexual understanding spatial structure, the development of clan villages according to the socialization process, the effects of rural-out migration on the change of villages etc. Such a trend can be understood as a reaction to the circumstances under which, as the Western society already experienced, rural villages become washed out by the waves of industralization and urbanization and hardly continue to exist. In this paper, geographical studies of rural settlement which have been carried out in Korea last fifty years will be reviewed under the four headings on the studies related to a) farming villages; b) fishing villages; c) mountain villages: and d) special function villages. Studies of farming villages and related ones are very diverse. The results of the studies carried out last fifty years can be classified into sixteen subjects. Just as, in the West, studies of rural settlement have been mainly concerned with farming villages since rural geography came into being, so, in Korea, they have been centred on farming villages. It is a natural result considering the history of human life. Even in Korea, however the rural settlement is no more an isolated life space which keeps unique traditions of old life style, but it begins to form a dynamic life space connected to big cities by heavy traffic. Because the modern farming villages of Korea have an undetachable connection with the cities, special methodology to solve new problems has been posed in the studies of rural settlement. Many scholars have produced a lot of studies of farming villages, and three of them are prominent: Oh. Hong-Seok, Choi, Ki-Yeop, and Lee, Moon-Jong. Oh, Hong-Seok is a versatile and hard-working scholar who has published more papers than anyone else in the various fields of rural geography such as farming villages, fishing villages, mountain villages, and reclamation villages. And he has expanded his concerns to environment issues in recent years. Choi, Ki-Yeop has maintained that the prototype of Korean rural villages is clan villages continuing to write a series of good papers in which he pursues their regionalizion in the process of socialization. Lee, Moon-Jong divides the spatial organization of side settlement, sahachon (settlement near the temple), religion settlement, orchard settlement, settlement near the foreign military camp, displaced people's settlement. Chung Gam Lok settlement, etc. Though The Korean Geographical Society has half a century's history, academic activties in the field of rural settlement have been performed no more than thirty years. We cannot help saying that it is admirable that in such a rather short time we have five academical schools of the rural geography in Korea. geography in Korea.

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Exploring Small Group Features of the Social-Construction Process of Scientific Model in a Combustion Class (연소 모델의 사회적 구성과정에서 나타나는 소집단 활동 특징 탐색)

  • Shim, Youngsook;Kim, Chan-Jong;Choe, Seung-Urn;Kim, Heui-Baik;Yoo, Junehee;Park, HyunJu;Kim, HyeYeong;Park, Kyung-Mee;Jang, Shinho
    • Journal of The Korean Association For Science Education
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    • v.35 no.2
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    • pp.217-229
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    • 2015
  • In this study, we explored the development of scientific model through the social-construction process on "combustion." Students were 8th graders from one middle school class. Each student engaged in small group discussions three times and made a group model on combustion. Discourses between peers and teacher were videotaped, audiotaped, and transcribed. The results show that the small groups constructed an initial concept: 'Conditions of combustion', which they then evaluated and revised the initial concept through combustion experiment. Following the discussions, some small groups evaluated their model and made a revised model. Then, the small groups compared various models and constructed a scientific model through consensus within the small group and as a whole class. Finally, students kept revising their model to 'Burning needs oxygen.' This tells us that the social construction process of scientific model made a meaningful role to build scientific model through diverse discussion between the students and their teacher, although they have had some difficult process to reach the final consensus. The data also showed some group features: the members were open to other's ideas. They analyzed the differences between their own ideas from others and revised their model after the whole class discussion. Lastly, they showed the tendency to make a good use of teacher's guidance. This study implies the importance of having social interaction process for students to understand the scientific model and learn the nature of scientific inquiry in class.

Proposal for Amendment of the Basic Environmental Policy Act ('BEPA') Article 31 (환경정책기본법 제31조 무과실책임규정의 개정방안)

  • Koh, Moon-Hyun
    • Journal of Environmental Policy
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    • v.8 no.4
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    • pp.125-147
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    • 2009
  • The Basic Environmental Policy Act (BEPA) (Law No. 4257 effective 1. August 1990) sets forth the basic policies and administrative framework for environmental preservation, leaving more detailed regulations, and emission controls to separate laws targeting air, water, and solid waste, etc. The BEPA Article 31 adopts an unprecedented strict liability standard for damages as an absolute liability. The BEPA Article 31 provides for liability as follows. If a company is alleged to have caused damage through pollution of the environment, it will be liable for damages unless it can show that the pollution did not cause damages, or that it did not actually cause pollution. If the company did cause pollution, and if the pollution is the cause for the damages in question, the company will be liable irrespective of whether it was negligent or otherwise at fault. If there are two or more companies involved in the pollution, but it is unclear which company caused the damages, all of the companies will be jointly and severally liable for the damages. In this paper, the author attempts to uncover the problems of BEPA Article 31 and then seeks desirable amendments by comparing it to the German Environmental Liability Act. First, it will be necessary to provide definitions of 'companies etc.'. Second, it will be necessary to enumerate the kinds of company facilities. Third, it will be necessary to provide exclusionary clauses on material damages. Fourth, it will be necessary to show 'presumption of cause and effect'. Fifth, it will be necessary to provide a clause on 'right to information'. Sixth, it will be necessary to provide a clause for force majeure. Seventh, it will be necessary to take measures to secure abundant liability for damages which can be caused by the owner of the facility, the potential polluter. Finally, it is appropriate that Korea now legislate an Environmental Liability Act akin to the German Environmental Liability Act.

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Drugs Most Frequently Used in OPD of Yeungnam University Hospital: March to August, 1985 (영남대학교 의과대학 부속병원 외래환자에 대한 약물처방 동향의 분석)

  • Lee, Kwang-Youn;Kim, Won-Joon;Kim, Sung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.95-102
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    • 1985
  • This report offers descriptive data about the drugs utilized in out patient department (OPD) of Yeungnam University Hospital (YUH) in the period of march to august in 1985. The data in this report were produced by the computerized totalization of the number of mentions of individual drugs included in the prescriptions. The 100 drug entries that were most frequently recorded are listed in rank order. The listing is arbiturarily restricted to the drugs that were prescribed as single preparations, the drugs of basis of compound preparations and the drugs of adjuvent or corrective of compound preparations that have significant therapeutic effects either by generic names. And in addition, the listing also involves the compound preparations used in relatively large frequency, and the individual components of which have the unique pharmacological actions each other by proprietary names. And all routes of administrations were allowed. The 10 drugs most frequently named are diazepam, aluminum compounds, acetaminophen, isoniazid, metoclopramide, $polaramine^{(R)}$, carboxymethylcystem, ephedrine, codeine and caroverine in order. The 521,855 drug mentions listed as above are described by the chief therapeutic usage that each is intended to apply generally. The drugs which account the largest proportion of total mentions were those acting on the central nervous system (20.57%), including tranquilhzers and sedative hypnotics (11.71%), analgesic antipyretics (5.55%), antidepressants (2.15%) etc. Gastrointestinal drugs and smooth muscle preparations (18.64%) included antacids and anti-ulcer drugs (9.24%), antiemetics (3.57%), spasmolytics (3.14%) and others. Respiratory drugs (16.11%) included expectorants and cough preparations (10.99%) and bronchodilators (5.12%). Chemotherapeutic agents (15.12%) included the antiTbc drugs (7.09%) most frequently, and the penicillins (3.33%) accounted the largest proportion among the antibiotics. Cardiovascular drugs (5.64%) included cardiac drugs and coronary vasodilator (4.12%) and antihypertensives and vasodilators (1.06%). And anti-inflammatory drugs (4.33%), vitamins of single preparations (3.76%), hormones and their antagonists (3.29%), common cold preparations (3.12%), diuretics (2.81%), drugs supporting liver function (2.02%), drugs affecting autonomic nervous system(1.89%) including anti-glaucomas, atropine and cerebral vasodilators, antihistamine drugs (1.02%) and disinfectants (0.74%) were following in order. The data in this report were compared to those reported by H. Koch, et al. in United States (US), 1981 as "Drugs Most Frequently Used in Office Practice:National Ambulatory Medical Case Survey, 1981." Cardiovascular drugs prescribed in YUH were much less in proportion than in US (10.56%), but gastrointestinal drugs accounted the larger proportion than in US (3.72%). Expectorants and cough preparations in YUH also accounted the larger proportion than in US (2.74%). In conclusion, in the period of march to august, 1985, OPD of YUH prescribed the CNS drugs including diazepam most frequently, and gastrointestinal, repiratory and chemotherapeutic drugs in next orders. It is supposed that the eating habits of Koreans and a unique atmospheric condition in Taegu as a basin were some important factors that affected the proportions of drugs acting on gastrointestinal and respiratory tracts.

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