• Pediatric Infection and Vaccine
• /
• v.17 no.2
• /
• pp.169-176
• /
• 2010

Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.

• 한국지구물리탐사학회:학술대회논문집
• /
• 2004.08a
• /
• pp.104-117
• /
• 2004

Dmitri Donskoi, which went down during the Russo-Japanese War occurred 100 years ago, was found by using geophysical exploration techniques at the 400 m water depth of submarine valley off Jeodong of Ulleung Island. In the submarine area with the rugged seabed topography and volcanic seamounts, in particular, the reliable seabed images were acquired by using the mid-to-shallow Multibeam exploration technique The strength of corrosion (causticity) of the sunken Donskoi, measured by the electrochemical method, decreased to 2/5 compared with the original strength.

• Economic and Environmental Geology
• /
• v.38 no.5 s.174
• /
• pp.535-545
• /
• 2005

Environmental survey from some abandoned metal mine areas was undertaken on to assess the risk of adverse health effects on human exposure to arsenic influenced by past Au-Ag mining activities. Elevated levels of As were found in tailings from the studied mine areas. This high concentration may have a impact on soils and waters around the tailing piles. In order to perform the human risk assessment, chemical analysis data of soils, rice grains and waters fur As have been used. The HQ values fer As via the rice grain and groundwater consumption were significantly higher compared with other exposure pathways in all metal mine areas. However, there were minimal soil and water dermal contact risks. The resulting Hl values of As from the Dongil, Okdong and Hwacheon mine areas were higher than 5.0, and their toxic risk due to drinking water and rice grain was strong in these mine areas. The cancer risk of being exposed to As by the rice grain route from the Dongil, Okdong and Hwacheon mine areas was $5.2\times10^{-4},\;6.0\times10^{-4}\;and\;8.1\times10^{-4}$, respectively. The As cancer risk via the exposure pathway of drinking water from these mine areas exceeded the acceptable risk of 1 in 10,000 fer regulatory purposes. Thus, the daily intakes of groundwater and rice grain by the local residents from the Dongil, Okdong and Hwacheon mine areas can pose a potential health threat if exposed by long-term arsenic exposure.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.13 no.1
• /
• pp.93-97
• /
• 2009

Purpose: Recognize circulation work system and fixing work system's merits and demerits that is enforced in operation of PET/CT center in sudden increase recently. Wish to estimate connectivity degree of individual exposure dose and PET/CT working that is managed periodically through this and look for operation efficiency of PET/CT center. Materials and Methods: (1) Find interrelationship of length of service to be individual exposure dose and PET/CT through TLD interpretation. Specially, evaluate on the basis of data of 2.5 years until 2 quarters 2006~2008 year that show patient increase rapidly the latest. (2) Recognize what countermeasure is evaluating problems happened at circulation work system and fixing work system. Results: Patient examination's number was 14,674 items until 2 quarters 2006~2008 year, and the $^{18}F$-FDG average injection amount was 461.5 MBq. 2 people of 10 radiotechnologist did fixing work PET area and GAMMA area each, and 8 people did circulation work of 3 times for 2.5 years. Average exposure dose that PET area and Gamma area's circulation men in service receive was 1.32 mSv, and PET area men in services came out average 0.825 mSv high than Gamma area men in services. Nurse's exposure dose is 0.28 mSv, and next 2 reason is conjectured. One is contact with patient that medicate $^{18}F$-FDG injection, and another is consultation about patient's next time schedule after examination end. Although exposure dose's amount is not much, is expected to consider continuation work possibility by exposure dose in case is a nurse with pregnancy possibility. Also, $^{131}I$-isotope therapy area's radiotechnologist that use capsule appeared by 0.12 mSv and a nuclear medicine doctor appeared by exposure dose that is less of 0.11 mSv. Conclusions: In case do PET/CT center circulation work after a long time, connoted danger that most men in service is consecutiveness deficiency of business and individual exposure dose increase at early 1 month. Specially, way for individual exposure dose's decrease should be considered. Also, need to evaluate abhorrent work form for efficient work system introduction, and enforce circulation and fixing work suggestion suitable shift working. Finally, must make normalized business guide and so on to prevent circulation work people's business efficiency decline.

• Journal of Korean Society of Transportation
• /
• v.33 no.5
• /
• pp.441-448
• /
• 2015

This study aims to suggest a reasonable signal operation method for right-turn traffic management. It was found that the right-turn vehicle supplementary signal is currently operated without clear regulations or criteria. It was also analyzed that right-turn supplementary signals are used without consistency, there is a risk of traffic accidents due to the discordance between supplementary signals and traffic signals of forward vehicles, there is a lack of basis for prohibition of a right turn when right-turn vehicle's supplementary signal is red and the flashing red signal is used in a different sense from the law. In order to see the effect of the installed right-turn vehicle supplementary signals on traffic signal violation, a field investigation was conducted. As the result, there was a high proportion of signal violation on the approach lane with right-turn supplementary signals and this means that right-turn supplementary signals hardly influenced the reduction in proportion of signal violation during a right turn. Additionally, a survey was carried out to see if there were differences in driver's interpretation of traffic signals depending on the installation of right-turn supplementary signals. As the result of the survey, there were no differences in interpretation of traffic signals depending on the installation of right-turn supplementary signals or the types of right-turn supplementary signals. A right turn when the signal was red did not lead to serious traffic accidents, so it is thought that there should be a careful consideration of a total ban on a right turn when the signal is red, in order to prevent driver's confusion due to the change of the signal system. Unless there is a disturbance to cars and pedestrians after a temporary stop when the signal is red, there is a need to specify that vehicles must stop temporarily in the Road Traffic Act to facilitate a right turn. What this study finally suggested is to use tri-colored arrow signals for right-turn car supplementary signals to convey a signal to a driver clearly.

• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.674-678
• /
• 1998

The conventional surgical treatment of isolated critical stenosis of the left main coronary artery restores a less physiologic perfusion of the myocardium, leads to occlusion of the left coronary ostium, and consumes an appreciable length of bypass material. From June 1994 to February 1996, eleven patients, three male and eight female, underwent patch angioplasty and additional bypass graft to left anterior descending artery (10 internal mammary artery, 1 saphenous vein) in isolated critical left main coronary artery stenosis. Their ages ranged from 34 to 62 years, mean 44 years. All had 60% to 90% stenosis of the left main coronary artery and Class III angina. The angiogram showed nine osteal lesion and three main stem stenosis. The operation was performed with conventional cardiopulmonary bypass and cold blood cardioplegia. We approached anteriorly and used bovine pericardium as onlay patch in all patients. There were one leg wound dehiscence, but no operative deaths and infarctions. All patients are free of symptoms after a mean follow-up of 15.5 months. Angiographic restudy at an average 14.4 months was obtained in five patients and showed widely patent left main coronary artery with excellent runoff. But additional graft to left anterior descending coronary artery were stenosed in two patients and showed diminutive flow in others. Our preliminary results suggest that angioplasty of the left main coronary artery can be carried out with low operative risks. But additional bypass graft to left anterior descending coronary artery may be unnecessary. The technique appears to be a promising alternative to conventional coronary artery bypass grafting in isolated left main coronary artery stenosis.

• Journal of Chest Surgery
• /
• v.40 no.5 s.274
• /
• pp.341-350
• /
• 2007

Background: We present here the early and midterm surgical results for infective endocarditis and we especially focus on the effect of aggressive reconstruction or root implantation after wide debridement. Material and Method: Between January 1995 and Jun 2006, we enrolled 79 adult infective endocarditis patients who underwent surgical treatment. There were 63 and 16 native and prosthetic valve endocarditis cases, respectively. They included 27 cases of culture negative endocarditis. With performing valve replacement or repair, 28 of the patient underwent a more aggressive surgical option, for example, aortic root replacement or reconstruction, or heart base reconstruction etc. Result: There were statistical relationships between the in-hospital mortality and staphylococcal infection, urgent-based operation and operation during the active phase of endocarditis. Wide debridement and aggressive reconstruction were not related to either the post operative mortality or the early morbidity. Culture negative endocarditis was not related to the postoperative mortality and morbidity. Conclusion: Physicians must pay attention to patients' medical treatment during the preoperative period of the infective endocarditis. If surgery is considered for treating infective endocarditis, it should be performed before the downhill course of the disease so that the surgical outcome is improved. Wide debridement and more aggressive reconstruction are also warranted.

• Journal of Chest Surgery
• /
• v.43 no.3
• /
• pp.285-291
• /
• 2010

Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

• Journal of Arbitration Studies
• /
• v.24 no.2
• /
• pp.33-52
• /
• 2014

Although climate change is a global scale question, some concerns have been raised that principles of investment arbitration may not adequately address the domestic implementation of climate change measures. A recent ICSID investment arbitration of Vattenfall v. Germany with regard to the investor's alleged damages from the phase-out of nuclear plants is a salient climate change case. The 2005 Kyoto Protocol was made to reduce greenhouse gas emissions and it provides a number of flexible mechanisms such as Joint Implementation (JI) and Clean Development Mechanism (CDM). Implementation of the Kyoto Protocol allows dispute settlement through investor-state arbitration. Any initiation of stricter emission standards can violate the prohibition on expropriations in investment agreements, regardless of the measures created to reduce greenhouse gas emissions. The effect-based expropriation doctrine can charge changes to existing emission standards as interference with the use of property that goes against the legitimate expectation of a foreign investor. In regulatory chill, threat of investor claims against the host state may preclude the strengthening of climate change measures. Stabilization clauses also have a freezing effect on the hosting state's regulation and a new law applicable to the investment. In the fair and equitable standard, basic expectations of investors when entering into earlier carbon-intensive operations can be affected by a regulation seeking to change into a low-carbon approach. As seen in the Methanex tribunal, a non-discriminatory and public purpose of environmental protection measures should be considered as non-expropriation in the arbitral tribunal unless its decision would intentionally impede a foreign investor's investment.

• Journal of Periodontal and Implant Science
• /
• v.37 no.sup2
• /
• pp.353-369
• /
• 2007

Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflamed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflamed gingiva from patients with chronic periodontitis associated with type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantification of $IL-1{\beta}$, MMP-13 and TIMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. 1. The expressions of MMP-13 and TIMP-1 showed increasing tendency in group 2 & 3 compared to group 1. 2. The expressions of $IL-1{\beta}$ & MMP-13 were showed increasing tendency in group 3 compared to group 2. 3. As $IL-1{\beta}$ levels were increasing, MMP-13 showed increasing tendency in group 3, and although $IL-1{\beta}$ , MMP-13 levels were increasing, TIMP-1 levels were similar expressed comparing to group 2. In conclusion, this study demonstrated that the expression levels of MMP-13 and TIMP-1 had increasing tendency in inflamed tissue. It can be assumed that $IL-1{\beta}$ and MMP-13 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.