• Title/Summary/Keyword: 방지방도

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A Study on Significance Testing of Driver's Visual Behavior due to the VMS Message Display Forms on the Road (도로상 VMS 표출방식별 운전자 유의성 검증에 관한 연구)

  • Kum, Ki-Jung;Son, Young-Tae;Bae, Deok-Mo;Son, Seung-Neo
    • International Journal of Highway Engineering
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    • v.7 no.4 s.26
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    • pp.151-162
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    • 2005
  • Variable Message Sign (VMS), which provides drivers with direct information about state of traffic congestion and for prevent an accident, is the most effective method among the methods of providing information in Advanced Transportation Management System. Currently establishment and the VMS which is operated foundation lets in Guidelines on the use of Variable message sign (a book of the VMS) of 1999 November the Ministry Construction & Transportation, these contents mean main viewpoint on physical part such as message special quality variable (font, character size and line space, word interval) and position mainly among standard about establishment in general. But, it is true that using without effect verification on the character of VMS display and that using mode of stationary-centered. In this paper, it executed significance test to effort verification on the character of VMS display for more practical and effective information transmission based on the driver viewpoint For the researches; develop 3D-Simulation, select characteristics of driver's visual cognition behavior (the conspicuity, the legibility and the comprehensibility), evaluation each issue (day or night, 80km/h or 100km/h). Especially, that used the Eye Marker Recorder to measure of reading-time (legibility) thus, confirmed objectivity and reduce an observational error. The results showed that the conspicuity is Flashing> Stationary>Scroll. The legibility is not deference that Flashing between stationary form. Also the comprehensibility result showed that Flashing> Stationary>Stroll form.

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A Clinical Study of Child Abuse (아동학대로 진단된 환아의 임상적 고찰)

  • Choi, Yoon Jin;Kim, Shin Mi;Sim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.436-442
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    • 2007
  • Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

A pilot study of neuroprotection with umbilical cord blood cell transplantation for preterm very low birth weight infants (극소 저 출생체중 미숙아에서 자가 제대혈 줄기세포 이식을 통한 신경 손상 방지 연구)

  • Chae, Kyu Young;Lee, Kyu Hyung;Eun, So Hee;Choi, Byung Min;Eun, Baik-Lin;Kang, Hoon-Chul;Chey, Myung Jae;Kim, Nam Keun;Oh, Doyeun
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.882-890
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    • 2007
  • Purpose : Preterm very low birth weight infant have high rate of adverse neurodevelopmental sequale. Recently, there have been lots of reports that human umbilical cord blood transplantation ameliorates functional deficits in animal models as hypoxic ischemic injury. This pilot study was undertaken to determine the clinical efficacy and safety of autologous umbilical cord blood cell transplantation for preventing neurodevelopmental sequale in perterm VLBW. Methods : Subjects were 26 preterm infants whose birth weight are less than 1,500 g and delivered under the intrauterine period 34 weeks. Autologous umbilical mononuclear cells (about $5.87{\times}10^7/kg$) were injected to neonate via the umbilical vein on the postnatal 24-48 hour. The therapeutic efficacy was assessed by numbers of nucleated RBC, urinary uric acid/creatinine ratio, concentration of neuron specific enolase (NSE), interleukin 6 (IL6), interleukin-$1{\beta}$ ($IL-1{\beta}$), and glial cell derived neurotrophic factor (GDNF) in serum and cerebrospinal fluid on day 1 and 7. Results : There were no significant differences in the numbers of the nucleated RBC, urinary uric acid/creatinine ratio, concentration of creatine kinase between the transplanted infants and controls. But the nucleated RBC is more likely to be rapidly discharged in the transplanted group. In the transplanted group, the concentrations of IL6, $IL-1{\beta}$, and GDNF were no significant difference between day 1 and 7, although GDNF seemed to be elevated. Serum NSE concentration was significantly elevated after transplantation, but not in CSF. Conclusion : It is suggested that autologous umbilical cord blood transplantation in preterm very low birth weight infant is safe to apply clinical practice. Long term follow up study should be needed to evaluate the potential therapeutic effect of umbilical cord blood transplantation for neuroprotection.

Breakthrough Urinary Tract Infection: A Clinical Study of Experience of a Single Center (예방적 항생제 사용중에 발생한 요로감염: 단일 병원에서 경험한 임상연구)

  • Bae, Sang-In;Cheon, Chong-Kun;Kim, Su-Young
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.203-209
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    • 2010
  • Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

A clinical analysis of juvenile dermatomyositis; focus on clinical manifestations at diagnosis (소아기 피부근염의 임상적 고찰; 진단시 임상증상을 중심으로 한 고찰)

  • Lee, So Young;Bang, Ji Seok;Kim, Hee Seok;Kim, Joong Gon
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1116-1124
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    • 2007
  • Purpose : Juvenile dermatomyositis (JDM) is the most common of the idiopathic inflammatory myopathies in children. The purpose of this study is to observe demographic, initial presentations, duration of time between disease onset and diagnosis, clinical manifestations and laboratory findings at diagnosis of patients with JDM. Methods : Forty seven patients identified at Seoul National University Children's Hospital from January 1986 to May 2007. Medical records were reviewed retrospectively focusing on initial presentations, clinical manifestations and laboratory findings at the time of diagnosis of patients with JDM. Results : Male and female patients were 25 and 22, respectively and sex ratio was 1.14:1. The average age at the time of diagnosis was 6.51 years. Skin rash (94%) was the most common symptom, followed by the proximal muscle weakness (89%). The disease activity score was 10.8. The duration between the onset of the skin rash and the muscle weakness and diagnosis was 7.18 and 4.70 months, respectively. The serum muscle enzymes, LDH, AST, CK and aldolase, were elevated in the patient with JDM. Autoimmune antibodies, antinuclear antibody, anti SSA antibody and anti SSB antibody, were negative findings. Electromyography findings were consistent with JDM in 88% of the patients, the muscle biopsy was in 91% and all MRI findings were compatible with those of patients with JDM. The most common symptom besides musculocutaneous lesions was the calcinosis (62.5%). The most common site of calcinosis was the pelvic area and buttocks. Conclusion : This study shows that the major symptoms are proximal muscle weakness and cutaneous lesion, and they are important to diagnose JDM.

Evaluation of Steroid Therapy in Tuberculous Pleurisy - A prospective, randomized study - (결핵성 흉막염에서 스테로이드의 치료 효과 - 전향적, 임의추출법에 의한 비교 -)

  • Bang, Jei So;Kim, Myong Sik;Kwak, Seung Min;Cho, Chul Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.52-58
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    • 1997
  • Background : Tuberculous pleurisy has been treated With a combined regimen of corticosteroids- antimicrobial therapy. But whether such combination therapy add to benefits is unknown. We evaluate the effects of corticosteroid and its routine application in relief of clinical symptoms, absorption of pleural effusion, and pleural adhesions. Methods : A prospective, randomized study of the role of corticosteroid in the treatment of tuberculous pleurisy was performed in 83 patients(nonsteroid group: 50 patients, steroid group: 33 patients) from June, 1991 to September, 1994. Results : 1) The mean duration from symptoms(fever, chest pain, dyspnea) to relief was 3.8 days in the steroid group, and 7.4 days in the nonsteroid group(P<0.05). Clinical symptoms including fever, chest pain, sputum and weight loss were relieved more rapidly in the steroid group than other symptoms(weakness, night sweating and dyspnea). 2) Pleural effusion was taken an averge of 88 days in the steroid group and 101 days in the nonsteroid group 10 be absorbed completely(p>0.05) 3) The incidence of pleural adhesions was 17/33(5l.5%) in the steroid group and 32/50(64%) in the nonsteroid group(p>0.05) 4) Side effects of corticosteroids were observed in only one patient causing epigastric pain and discontinuation of drug. Conclusion : Corticosteroid exert benefitial role in the more rapid relief of clinical symptoms to patients with tuberculous pleurisy, but absortion of pleural effusion and occurrence of pleural adhesions was not influenced significantly Therefore, its routine application should be reevaluated.

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Effect of CpG Oligodeoxynucleotides on Airways of Mice with Established Airways Inflammation (기도 염증이 유발된 생쥐에서 CpG Oligodeoxynucleotides가 미치는 효과)

  • Hwang, Hei-Won;Kim, Su-Jin;Kim, Won-Duk;Cho, Sung-Min;Lee, Dong-Suk;Choi, Sung-Min
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.875-883
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    • 2002
  • Purpose : Airways eosinophilia and increased IgE, characteristic features of asthma, result from a predominant Th2 response. In this study, we investigated the effect of CpG oligodeoxynucleotides (ODNs) on the inhibition of airways eosinophilia in mice with established airway inflammation. We also investigated the immunological mechanisms involved. Methods : Groups of BALB/c mice were sensitized intradermally with ovalbumin(OVA). At week 10, airway inflammation was induced by intranasal challenge of the mice with OVA. At week 14, the mice were challenged intranasally again with OVA in the presence and without the presence of CpG ODNs. Mice with saline administration served as negative controls. Bronchoalveolar lavage fluids(BALF) were obtained and eosinophils were counted. Th1 and Th2 cytokines in the spleen cell cultures were measured by ELISA. Serum OVA-specific IgE and IgG2a antibodies were also measured by ELISA. Results : BALF eosinophils were significantly inhibited in the CpG ODNs-treated mice(P<0.01). IgE and IgG2a levels increased significantly in both CpG ODNs-treated and untreated groups as compared to the negative control group; there was, however, no significant difference between the two groups four days after intranasal administration of CpG ODNs. Cytokine analysis revealed decreased production of IL-4, IL-5, and IL-13 and increased production of IL-12 in the CpG ODNs-treated group as compared to the untreated group. Interestingly, $IFN-{\gamma}$ levels were not upregulated in the CpG ODNs-treated group. Conclusion : CpG ODNs vaccination is a potentially useful approach for reversing airways eosinophilia in mice with established airways inflammation.

Clinical implications on vancomycin-resistant enterococci isolated from the specimen of pediatric patients in a university hospital (단일 기관에서 소아 환자들의 임상검체로부터 분리된 Vancomycin 내성 장구균에 대한 임상적 고찰)

  • Park, Yeo Hoon;Kim, Khi Joo;Kim, Ki Hwan;Chun, Jin-Kyong;Lee, Taek Jin;Kim, Dong Soo;Park, Eun Suk
    • Pediatric Infection and Vaccine
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    • v.14 no.2
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    • pp.162-170
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    • 2007
  • Purpose : While cases of vancomycin-resistant enterococci (VRE) have increasingly been reported worldwide since it was first reported in the late 1980s, there have been few systemic studies on the pediatric population. The purpose of this study is to contribute to the planning of VRE prevention by investigating the prevalence, risk factors and transmission of VRE infection. Methods : We studied 230 patients under age 15 years who were isolated VRE between January 2001 and December 2006 retrospectively. The patients were classified into the intensive care unit (ICU) and the non-ICU groups. We reviewed the procedures before VRE detection as well as antibiotic sensitivity of detected organisms. Results : The number of VRE-isolation cases was higher in the ICU group than the non-ICU group. Instances of VRE-isolation were also more prevalent in patients who underwent operations or active procedures while taking 3rd-generation cephalosporins or glycopeptides. Almost all antibiotics except tetracycline were resistant to VRE. The proportion of 3rd-generation cephalosporin use was higher than those of any other antibiotics before VRE detection. Additionally, the use of 3rd-generation cephalosporins has increased annually, but that of glycopeptides had decreased in 2006. Also, the rates of VRE isolation have been increasing since 1998. Conclusion : VRE infection is increasing in pediatric population. Strict adherence to appropriate infection control guidelines for the prevention of VRE transmission in hospitals, and tracking of VRE colonization through active surveillance in high risk units are recommended.

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Photoelastic evaluation of Maxillary Posterior Crossbite Appliance (Maxillary Posterior Crossbite Appliance의 적용시 응력 분포에 관한 광탄성법적 연구)

  • Jang, Sung-Ho;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.549-558
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    • 2001
  • This study was undertaken to demonstrate the forces in the maxillary alveolar bone generated by the activation of the maxillary posterior crossbite appliance In the treatment of posterior buccal crossbite caused by buccal ectopic eruption of the maxillary second molar. A photoelastic model was fabricated using a Photoelastic material (PL-3) to simulate alveolar bone and ivory-colored resin teeth. The model was observed throughout the anterior and posterior view in a circular polariscope and recorded photographically before and after activation of the maxillary posterior crossbite appliance. The following conclusions were reached from this investigation : 1. When the traction force was applied on the palatal surface of the second molar, stresses were concentrated at the buccal and palatal root apices and alveolar crest area. The axis of rotation of palatal root was at the root apex and that of the buccal root was at the root li4 area. In this result, palatal tipping and rotating force were generated. 2. When the traction force was applied on the buccal surface of the second molar, more stresses than loading on the palatal surface were observed in the palatal and buccal root apices. Furthermore, the heavier stresses creating an intrusive force and controlled tipping force were recorded below the buccal and palatal root apices below the palatal root surface. In addition, the axis of rotation of palatal root disappeared whereas the rotation axis of the buccal root moved to the root apex from the apical 1/4 area. 3. When the traction force was simultaneously applied on the maxillary right and left second molars, the stress intensity around the maxillary first molar root area was greater than the stress generated by the only buccal traction of the maxillary right or left second molar. As in above mentioned results, we should realize that force application on the palatal surface of second molars with the maxillary posterior crossbite appliance Produced rotation of the second molar and palatal traction, which nay cause occlusal Interference. That is to say, we have to escape the rotation and uncontrolled tipping creating occlusal interference when correcting buccal posterior crossbite. For this purpose, we recommend buccal traction rather than palatal traction force on the second molar.

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The Eradication of Helicobacter pylori in the Duodenal Ulcer in Children and the Duodenal Recurrence (소아 십이지장궤양에서의 H. pylori 박멸과 궤양재발에 대한 연구)

  • Choe, Yon-Ho;Ko, Jae-Sung;Kim, Soon-Yeong;Yoo, Young-Mee;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.30-36
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    • 1998
  • Purpose: It is well known that duodenal ulcer disease does not relapse if H. pylori is cleared from the gastric mucosa. Little is known about the recurrence of duodenal ulcer in children. The purpose of this study was to evaluate the effect of the eradication of H. pylori in duodenal ulcer in children upon the duodenal ulcer recurrence. Methods: 105 patients (M:F=78:27) diagnosed as duodenal ulcer by endoscopy in 1987~1995 were reviewed clinically, and were parted into two groups. The two treatment groups were ranitidine/antacid (RAN/ANT) and ranitidine/amoxicillin/denol (RAN/AMX/D). The latter was for H. pylori-positive children with duodenal ulcer who were diagnosed by serology and/or antral biopsies for histology, culture, and urease testing. The recurrence rates were compared between the two groups. Results: 1) 30 patients with primary duodenal ulcer underwent endoscopy for H. pylori and 27 (90.0%) of them were positive for H. pylori. 2) 27 of H. pylori-positive children received RAN/AMX/D. 23(85.2%) of them showed cure of duodenal ulcer and eradication of H. pylori. 3) The duodenal ulcer recurrence rate in RAN/ANT group was 65.3% and the rate in RAN/AMX/D was 4.3% by a year. Conclusions: There is a strong correlation between the duodenal ulceration and H. pylori infection in children, and the eradication of H. pylori in duodenal ulcer patients reduces the recurrence of the ulcer. Because of the low incidence of duodenal ulcers in children, a multicenter prospective study is required to determine the effect of treating H. pylori infetion on the long term natural history of duodenal ulcer disease.

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