• Title/Summary/Keyword: 단계적 시행군

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OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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One-stage Repair of Aortic Arch Anomalies and Intracardiac Defects through Median Sternotomy (정중 흉골절개를 통한 대동맥궁 기형과 심기형의 일차교정술)

  • Chang Yun Hee;Lee Sang Kwon;Lee Hyung Doo;Kim Siho;Yie Kilsoo;Woo Jong Soo;Lee Young Seok;Sung Si Chan
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.291-300
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    • 2005
  • One-stage repair of aortic arch anomalies and intracardiac defects through median sternotomy has been recently adopted by many institutions since it is known to be safer than the staged repair. The early and midterm results of the one-stage repair of aortic arch anomalies and intracardiac defects were retrospectively evaluated. Material and Method: 45 patients who underwent one-stage repair of aortic arch anomalies and intracardiac defects performed by one surgeon from January 1996 to July 2003 were included in this retrospective study. The median age of repair was 16 days (range, 3 days$\~$23.7 months) and the mean weight was $3.62\;\pm\;1.30 kg$. Thirty one $(68.9\%)$ had coarctation and 14 $(31.1\%)$ had interrupted aortic arch. Associated intracardiac anomalies were VSD in 31 patients (VSD group), TGA or Taussig-Bing anomaly in 10 (TGA group), and others in 4 (ASD in 1, aortopulmonary window 1, truncus arteriosus 1, aortic and mitral stenoses 1, miscellaneous group). The arch obstruction was repaired with end-to-side anastomosis in 23 patients and end-to-end anastomosis in 22. Result: Overall postoperative hospital mortality was $22.2\%\;(10/45);\;16.1\%$ (5/31) in VSD group, $40\%$ (4/10) in TGA group, and$25\%$ (1/4) in miscellaneous group. There was no mortality in VSD group since 1998, and the mortality in TGA group has remarkably reduced since technical modification for coronary transfer was adopted $(75\%\;vs\;16.7\%)$. There was no postoperative seizure or other neurological complications. Postoperative aortic restenosis occurred in 5 patients $(5/35,\;14.3\%)$. Two patients underwent balloon aortoplasty with successful results. There was no reoperation. There was one late death caused by pneumonia 5 months after the operation. Two-year actuarial survival rate including operative death was $72.9\%$. Conclusion: The operative mortality of one-stage repair has been reduced with time and aortic restenosis rate was also acceptable. We concluded that this procedure is a reproducible procedure for aortic arch anomalies associated with intracardiac defects.

Utility of the Dispatch Protocol to Triage the Emergency Patients who presented with Symptoms of Stroke or Chest Pain (흉통 및 뇌졸중 증상 환자에 대한 전화 중증도분류 지침의 유용성)

  • Cho, Suck-Ju;An, Byeung-Ki;Park, Jae-Yong
    • The Journal of the Korea Contents Association
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    • v.12 no.12
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    • pp.345-355
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    • 2012
  • Delayed treatment of acute cardiovascular and cereb-directrovascular diseases is related to poor prognosis and sequelae. For rapid and adequate treatment, role of prehospital emergency dispatchers for adequate triage and selection of hospital is important. In several advanced countries, emergency dispatchers use standardized protocols for decision of rescuer resources or distribution of patients at each hospital. ut, there has not been developed standardized protocol for emergency dispatchers in Korea. We developed standardized protocol based on NHS-direct and CTAS system for triage of symptoms of chest pain and Stroke. Groups with standardized protocol and without protocol was compared to triage result at emergency department which patient visited. The accuracy of triage on chest pain was 70.0% in group A, 94.0% in group B(p<0.01). The accuracy of triage in stroke symptoms was 64.2% in group A, 84.6% in group B(p<0.01). Conclusion: In this study, the accuracy of telephone triage with the protocol was more accurate than without the protocol. But, more studies are needed to generalize the protocol in South korea.

Optimal Cutoff Points of Rate Pressure Product in Each Stage of Treadmill Exercise Test According to the Degree of Metabolic Syndrome in Korean Adults (한국성인의 대사증후군 예방을 위한 운동부하 검사시 각 단계별 심근부담률의 적정 임계점)

  • Shin, Kyung-A
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.2
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    • pp.136-143
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    • 2018
  • The rate pressure product (RPP) is expressed as a product of the heart rate and systolic blood pressure as an index indirectly measuring the myocardial oxygen consumption, and it indicates the burden on the myocardium. The aim of this study was to determine the optimal level of RPP for preventing metabolic syndrome in a treadmill exercise test in Korean adults. Metabolic syndrome was the diagnosis of the third executive summary report on the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. According to the criteria, the metabolic syndrome diagnosis group (MetS, N=25), pre-metabolic syndrome group (Pre-MetS, N=106), and non-risk factor group (Non-MetS, N=65) were classified. The exercise stress test was performed based on the Bruce protocol. The RPP was calculated as (heart rate${\times}$systolic blood pressure)${\div}1,000$. The results showed that the maximum systolic blood pressure was high despite the low daily dose reached in the diagnostic group of metabolic syndrome. The optimal threshold of the RPP at the time of the exercise treadmill test for a metabolic syndrome prediction was $12.56mmHg{\times}beats/min{\times}10^{-3}$ in the first stage of the exercise stress test. The second stage of the exercise test was $16.94mmHg{\times}beats/min{\times}10^{-3}$, and at the third stage of the exercise test was $21.11mmHg{\times}beats/min{\times}10^{-3}$.

Interval-Based Singing Program for Improving the Accuracy of Pitch Production in Children With Cochlear Implants: A Case Study (음정 모방 중심 노래부르기를 통한 인공와우이식아동의 음고 산출 정확도 향상 사례)

  • Kim, Hyo Jin;Chong, Hyun Ju
    • Journal of Music and Human Behavior
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    • v.14 no.1
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    • pp.1-16
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    • 2017
  • The purpose of this study was to examine changes in the accuracy and range of produced pitch in children with cochlear implants (CI) after an interval-based singing program. A total of three children with CIs aged 5 received twelve 35-minute individual sessions two to three times per week. The interval-based singing program was composed with third, fifth, and eighth intervals and implemented pitch discrimination, pitch imitation, and singing songs with target intervals in a sequence. At pretest and posttest, the changes in accuracy of pitch production during pitch imitation and singing were measured. The results demonstrated that all participants showed improvement in pitch accuracy and produced the target notes with great similarity to the expected pitches in the original song. The range of produced pitch also increased after the program. The results indicate that sequential trials to imitate pitches in a multisensory environment to facilitate the processing of pitch information may reflect how this population perceives pitch information and assist children with CIs to improve their pitch accuracy.

Population Characteristics of Ichthyofauna and Bluegill, Lepomis macrochirus in 4 Water Dams(Daegok Dam, Sayeon Dam, Daeam Dam, Seonam Dam) in Ulsan Area (울산권 4개 용수댐(대곡댐, 사연댐, 대암댐, 선암댐)의 어류상과 블루길(Lepomis macrochirus)의 개체군 특성)

  • Jang, Chang-Ryeol;Kim, Jin-Hong;Shin, Young-Seob;Lee, Hak-Joon;Kim, Bong-Seok;Kim, Jung-Hwa;Bae, Yang-Seop
    • Korean Journal of Environment and Ecology
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    • v.34 no.5
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    • pp.402-412
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    • 2020
  • This study aims to examine the population characteristics of the fish and the bluegill (Lepomis macrochirus), designated as ecologically disturbing fish, living in four water dams in the Ulsan area and to provide basic data. The survey of fish living in 4 water dams and surrounding tributaries in the Ulsan area from 2016 to 2017 found a total of 1,987 individuals of 28 species of 9 families and identified 6 Korea's endemic species is (21.4% indigenous rate), 4 exotic species, and 2 ecosystem disturbing species. Based on the number of fishes identified, the dominant species was Lepomis macrochirus, and the subdominant species was Hemiculter eigenmanni. The investigation of the age structure of the L. macrochirus found in the 4 water dams in the Ulsan area showed a large population of 1 to 2 old, and the population was growing fast. Moreover, the analysis of the total length-weight relationship and obesity of the L. macrochirus population showed that the regression coefficient b of the total length-weight relationship was greater than 3.0, and the habitat of the L. macrochirus population was in good condition. Obesity had a positive slope, and the growth state was relatively good. The result of this study can be used as useful data to predict the trend of the L. macrochirus fauna inhabiting in 4 water dams in the Ulsan area.

The effects of early surfactant treatment and minimal ventilation on prevention of bronchopulmonary dysplasia in respiratory distress syndrome (미숙아 호흡곤란증후군에서 폐표면활성제의 조기 투여와 연성 환기요법이 만성폐질환의 예방에 미치는 영향에 관하여)

  • Park, Jong Jin;Lee, Pil Sang;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.44-49
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    • 2009
  • Purpose : Early surfactant treatment and minimal ventilation, bronchopulmonary dysplasia needed prolonged oxygen supplement is a problem. This study aimed to report the effects of early surfactant treatment and minimal ventilation on the prevention of bronchopulmonary dysplasia in respiratory distress syndrome. Methods : We retrospectively studied 139 premature newborn infants (gestational age, 36 weeks; birth weight, 1,500 gm) admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2001 and December 2006. We analyzed the occurrence of bronchopulmonary dysplasia with respect to ventilator care and surfactant treatment. Results : The incidence of bronchopulmonary dysplasia was significantly higher with prolonged ventilator care, moderate to severe respiratory distress syndrome, and low Apgar score (P<0.001). Despite early surfactant treatment and minimal ventilation, mild bronchopulmonary dysplasia occurs in a considerable number of patients with mild respiratory distress syndrome. The patient group with low Apgar scores required ventilator care for a prolonged period (P=0.020). Conclusion : Early surfactant treatment and minimal ventilation shortens the duration of ventilator care; however, the preventive effects on bronchopulmonary dysplasia are limited. Therefore, not only early surfactant treatment and minimal ventilation but also appropriate management in the delivery room is essential.

Effects of Herbs and Green Tea on the Sensory and the Antioxidative Qualities of Beef-Yukwonjeon (서양 향신료 및 녹차를 첨가한 쇠고기 육원전의 관능적 특성과 항산화 효과)

  • Lee, Joo-Hee;An, Lee-Hwa
    • Journal of the East Asian Society of Dietary Life
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    • v.17 no.6
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    • pp.808-815
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    • 2007
  • Four different herbs, including rosemary, oregano, basil and sage, along with green tea were individually added to ground beef at different percentages: 0.5, 1.0, and 1.5, respectively. The sensory qualities of the five natural herbs and their antioxidant effects were evaluated using Beef-Yukwonjeon. For the sensory evaluation results, the 0.5% herb addition and the control group generally showed higher acceptability scores than the 1.0% or 1.5% herb addition groups. In particular, the Yukwonjeon made with 0.5% green tea showed higher preferences in the acceptance tests and ranking tests. However, the sensory differences among samples were reduced after 3 days of storage at $6^{\circ}C$. For the results of lipid oxidation without storage, the TBARS values of the herb addition groups were slightly lower than the value of the control group, but not significantly(p>0.05). However, the antioxidant effects of each herb showed higher values over a longer storage period as well as at the higher herb concentrations. The antioxidant effects of the herbs during 7 days' of storage at $6^{\circ}C$ were evaluated as $10.0{\sim}38.5%$ reductions in TBARS values as compared to the group without herbs. Furthermore, the antioxidant effects of the herbs during 30 days' of storage at $-20^{\circ}C$ were shown as $16.8{\sim}27.8%$ reductions in the TBARS value. The green tea showed the highest antioxidant activity against lipid oxidation, because it was acceptable at higher concentrations in the sensory evaluation. These results indicate the potential to produce better quality beef-Yukwonjeon, with herbs, especially green tea.

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Deterioration Assessment for Conservation Sciences of the Five Storied Stone Pagoda in the Jeongrimsaji Temple Site, Buyeo, Korea (부여 정림사지 오층석탑의 보존과학적 풍화훼손도 평가)

  • Kim, Yeong-Taek;Lee, Chan-Hee;Lee, Myeong-Seong
    • Economic and Environmental Geology
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    • v.38 no.6 s.175
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    • pp.675-687
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    • 2005
  • The rocks of the five storied stone pagoda in the Jeongrimsaji temple site are 149 materials in total with porphyritic biotite granodiorite. They include pegmatite veinlet, basic xenolith and evenly developed plagioclase porphyry. This stone pagoda has comparably small fracture and cracks which are farmed in the times of rock properties, but surface exfoliation and granular decomposition are in process actively since the rocks are generally weakened from the influence of air contaminants and acid rain. Structural instability of constituting rocks in the 4th roof materials are observed to occur from distortion and tilt. Such instability is judged to threat stability of the upper part of the stone pagoda. Also, chemical weathering is operating even more as the contaminants, ferro-manganese hydroxides eluted from water-rock interaction on the rock surface. Most of the rock surface is covered with yellowish brown, dark black and light gray contaminants, and especially occur in the lower part of the roof rocks on each floor. The roof underpinning rocks are severe in surface pigmentation from manganese hydroxides and light gray contaminants. The surface of rocks lives bacteria. algae, lichen, or moss and diverse productions in colors of light gray, dark Bray and dark green. Grayish white crustose lichen grows thick on the surface with darkly discolored by fungi and algae in the first stage on basement rocks, and weeds grows wild on the upper part of each roof rocks. This stone pagoda must closely observe the movements of the upper part rock materials through minute safety diagnosis and long term monitoring for structural stability. Especially since the surface discoloration of rocks and pigmentation of secondary contaminants are severe, establishment of general restoration and scientific conservation treatment are necessary through more detailed study for this stone pagoda.

Proposal for Social Casino Game Policy based on Responsible Game System (책임게임시스템 기반 소셜 카지노 게임 정책 제언)

  • Song, Seung-keun
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.11
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    • pp.2039-2044
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    • 2016
  • This study aims to investigate the safety instrument to prepare the policy alternative for social web-board game which will be developed to base on social network in the future although social casino game is not available in Korea now. We reviewed several literature about responsible game system applied to especially U.S. New Jersey, responsible gambling system acted in the being advanced all countries. Game experts built up user protection model as previous work to prepare the law and policy which such a responsible game system will apply for current web-board gaem and future social casino game. As a result, this research revealed that standard of judgement which can identify four kind of addiction danger user group are raised. We expect to help this user protection alternative to provide the law and policy instrument for future social casino game and complement the problem of current web-board enforcement.