• Title/Summary/Keyword: 배출율

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The Study on the Relationship Between the Duration of Chest Vibration prior to Endotracheal Suctioning and the Changes in Oxygen Saturation in Low-Birth-Weight Infants (저체중아에 있어 기관내 흡인전 흉부진동법의 기관과 산소포화 변화간의 관계 연구)

  • Ahn, Young-Mee
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.597-607
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    • 1995
  • 1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.

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Colon Interposition as a Gastric Substitute after Performing Gastrectomy in Patients with Gastric Cancer (위암 환자에서 위 절제술 후 결장 간치술)

  • Lee, Jun-Hyun;Hur, Hoon;Jeon, Hae-Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.217-224
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    • 2008
  • Purpose: For most surgeons, colon interposition after gastrectomy remains an infrequently performed procedure because of its complexity. The aim of this study was to assess its technical feasibility and safety as a post-gastrectomy reconstruction method by reviewing our experience with colon interposition. Materials and Methods: From March 2001 to February 2002, 30 colon interpositions after-gastrectomy were done with using the ileo-ascending or transverse colon. We analyzed the clinicopathologic features and the surgical outcomes. Results: There were 16 males and 14 females in this study with a mean age of 67.5 years (range: 31 to 76 years). Twenty-five ascending colons and 5 transverse colons were used for the interposition, respectively. The mean operation time was 373 minutes (range: 204 to 600 minutes). There were 9 operative morbidities (30%) and 1 operative mortality. The restoration of bowel motility was noted at 3.8 postoperative days; a soft diet was started at 4.9 postoperative days and the duration of the hospital stay was 18.2 days. The percentage of weight loss in the patients with total, proximal and distal gastrectomy was 16.3%, 14.0% and 8.8%, respectively, at 6 months, and thereafter the weight loss gradually recovered as 8.1%, 7.5% and 5.6%, respectively, at 5 years postoperatively. Gastric stasis was the one of the most meaningful long-term complications, and especially in the patients who underwent distal gastrectomy with colon interposition. Conclusion: Colon interposition after gastrectomy was a very complex procedure with a long operating time and many anastomosis sites. The postoperative outcomes failed to achieve satisfactory weight gain and the patients displayed postprandial symptoms. This suggested that this procedure was not an appropriate procedure for conventional reconstruction after gastrectomy.

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A Study on Management of Seafood Wastewater Treatment Facility using Submerged MBR (침지식 MBR을 이용한 수산물 폐수처리장 운영에 관한 연구)

  • Choi, Yong-Bum;Lee, Hae-Seung;Han, Dong-Joon;Kwon, Jae-Hyouk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7227-7236
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    • 2015
  • The survey revealed that, due to the discharge characteristics of seafood wastewater, irregular inflow loads were caused, making it difficult to treat the wastewater safely. It is crucial for the operation of pressure and floating tanks for the treatment of high-concentration organic wastewater such as seafood wastewater. The survey of operation factors for the pressure and floating tanks revealed this: A/S ratio 0.05 (design criteria 0.01), the pressurized air pressure 8bar(design criteria 6bar), the pressure tank pressure 6bar (design criteria 4.5bar), and HRT 60sec(design criteria: 10sec). Also, the recirculation rate was changed to over 40%(design criteria: 30%), and the surface load rate was changed to under $13.7m^3/m^2{\cdot}hr$(design criteria: under $17.7m^3/m^2{\cdot}hr$); thus, compared to the initial design criteria, the operation factors were changed according to inflow characteristics, thus enhancing the pressure and floating tank performance. The survey of inflow load revealed BOD 140.7%, $COD_{Mn}$ 120.32%, and SS 106.3%, compared to the inflow design criteria, as well as T-N 135.5% and T-P173.3%, higher than the design criteria. The survey of the treatment facility annual operation cost revealed high portions in sludge treatment cost(27.7%) and chemicals costs(26.0%), and the sludge treatment cost will likely further increase due to the ban on ocean dumping. The unit cost for the treatment of seafood wastewater was found to be KRW 3,858 per ton, more than 27 times higher than the sewage treatment cost(KRW 142.6/ton), presumably because the seafood wastewater contains high-concentration organic substances and nutritive salts.

The Origin and Geochemical Behavior of Fluoride in Bedrock Groundwater: A Case Study in Samseung Area (Boeun, Chungbuk) (화강암 지역 암반 지하수 내 불소 이온의 기원 및 거동: 충북 보은 삼승면 일대의 현장 조사와 실내 실험 연구)

  • Chae, Gi-Tak;Koh, Dong-Chan;Choi, Byoung-Young
    • The Journal of Engineering Geology
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    • v.18 no.4
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    • pp.555-566
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    • 2008
  • Hydrogeochemical study in Samseung area (Boeun, Chungbuk) and waterrock interaction experiment using rock samples from the area were performed to elucidate the fluoride source in groundwater and explaining geochemical behavior of fluoride ion. Fluoride concentration of public water supply mostly using groundwater in Boeun area was significantly higher in South Korea. The maximum fluoride concentration of the study area was 3.9 mg/L, and 23% of samples exceeded the Korean Drinking Water Standard of fluoride (1.5 mg/L). The average concentration of fluoride was 1.0 mg/L and median was 0.5 mg/L. Because of high skewness (1.3), median value is more appropriate to represent fluoride level of this area. The relationships between fluoride ion and geochemical parameters ($Na^+$, $HCO_3$, pH, etc.) indicated that the degree of waterrock interaction was not significant. However, high fluoride samples were observed in $NaHCO_3$ type on Piper's diagram. The negative relationship between fluoride and $NO_3$ ion which might originate from surface contaminants was obvious. These results indicate that fluoride ion in groundwater is geogenic origin. The source of fluoride was proved by waterrock interaction batch test. Fluoride concentration increased up to 1.2 mg/L after 96 hours of reaction between water and biotite granite. However, the relationship between well depth and fluoride ion, and groundwater age and fluoride ion was not clear. This indicates that fluoride ion is not correlated with degree of waterrock interaction in this area but local heterogeneity of fluoriderich minerals in granite terrain. High fluoride concentration in Boeun area seems to be correlated with distribution of permeable structures in hard rocks such as lineaments and faults of this area. This entails that the deep bedrock groundwater discharges through the permeable structures and mixed with shallow groundwater.

Separation and Recovery of $SF_6$ Gas from $N_2/SF_6$ Gas Mixtures by using a Polymer Hollow Fiber Membranes (고분자 중공사 분리막을 이용한 $N_2/SF_6$ 혼합가스로부터 $SF_6$의 분리 및 회수)

  • Lee, Hyun-Jung;Lee, Min-Woo;Lee, Hyun-Kyung;Lee, Sang-Hyup
    • Journal of Korean Society of Environmental Engineers
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    • v.33 no.1
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    • pp.47-53
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    • 2011
  • $SF_6$ (Sulfur hexafluoride) possesses high GWP (Global Warming Potential) as sepcified by the IPCC (Intergonvernmental Panel of Climate Change). Recently, the recovery-separtion of $SF_6$ research area, including permeation properties studies using various membrane's materials and the practical operation of recovery-separtion using membrane of waste $SF_6$ gas is in the initial state. The separation efficiency of a single $SF_6$ and waste $SF_6$ mixture was evaluated using a PSF (polysulfone), PC (tetra-bromo polycarbonate) and PI (polyimide) hollow fiber membranes. According to the results of single gases permeation properties, PI membrane has the highest permselectivity of $N_2$ gas in $N_2/SF_6$ gas. Under the condition of P=0.5 MPa, the highest concentration of recovered $SF_6$ is 95.6 vol % in the separation experiment of $SF_6/N_2$ mixture gas by PC membrane. Under the operation pressure of P=0.3 MPa at a fixed retentate flow rate fixed of 150 cc/min, the maximum recovery efficiency of $SF_6$ is up to 97.8% by PSF membrane. From the results above, it is thought that the separation and recovery technique of $SF_6$ gas using membrane will be used as the representative eco-technology in the $SF_6$ gas treatment in the future.

Patient's Selection for Extracorporeal Shock Wave Lithotripsy for Treatment of Common Bile Duct Stones Resistant to Endoscopic Extraction (체외충격파쇄석술 적용을 위한 총담관결석의 선택)

  • Lee, Won-Hong;Son, Soon-Yong;Kim, Chang-Bok;Park, Cheon-Kyoo;Kang, Seong-Ho;Ryu, Meung-Sun;Lee, Yong-Moon
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.105-110
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    • 2005
  • Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

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Electricity Demand in the Korean Households-A Technology/Sustainable Option- (우리 나라 가정부문 전력수요에 관한 연구-기술개발/지속적 개발 시나리오)

  • 박희천
    • Journal of Technology Innovation
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    • v.2 no.1
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    • pp.1-57
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    • 1994
  • 본 고는 지속적 개발 론에 입각한 적극적인 에너지수요 관리정책을 추진한다는 전제하에 2001년과 2006년의 우리 나라 가정부문 전력수요를 전망하고자 한다. 본 고는 지속적 개발 시나리오를 추정함에 있어서 기존의 계량모형보다 일종의 공학적 모형인 공정분석(process analysis)을 선호한다. 계량모형이 주로 과거 수요의 소득 및 가격 탄성 치를 바탕으로 미래의 수요를 예측하는데 비하여 공정분석모형은 기술발전에 따른 미래의 효율변화(향상)를 비교적 잘 반영할 수 있기 때문이다. 본 고는 덴마크공과대학교 Norgard 교수팀이 개발한 모형을 도입하여 분석모형(수식 (6))을 전력수요 = 기기 수 $\times$ 전력서비스$\times$ 전력집약도와 같이 설정하고 이를 사용하여 냉장고, 텔레비전, 조명 기기, 난방기기 등과 같은 전력사용 기기 별로 2001년과 2006년이 전력수요를 전망하였다. 본 고는 전력수요를 전력사용 기기의 사용용량(300리터 용량의 냉장고 등)과 사용시간을 나타내는 전력서비스와 전력 서비스당 필요 전력사용량을 나타내는 전력집약도로 나누어 구분하고 있는 모형을 이용함으로써 소득향상효과와 함께 기술발전에 따른 효율개선효과를 분석할 수 있다. 1) 생활수준 향상에 따라 전력서비스는 지금과 같이 증가한다, 2) 현실적으로 가능한 범위 내에서 전력사용 기기에 대한 최저 에너지 효율 제를 실시한다, 3) 현재 사용중인 기기 들은 원칙적으로 수명이 다한 후 고효율 기기 들로 자연 교체한다, 4) 최저 에너지 효율 제를 제외한 다른 제도 및 정책개선, 사용자의 에너지소비형태 개선에 따른 절전 잠재 량을 고려하지 않는다 등의 가정 하에 전력수요를 추정한 결과 1992년에 796 GWh(100)이었던 우리 나라 가정부문 전력수요는 2001년과 2006년에 29,237 GWh(134)와 33,118 GWh(152)로 각각 34%와 52%증가할 것으로 나타났다. 이 경우 1992년부터 2006년까지 가정용 전력수요 증가율은 연평균 3%로 추정된다. 기기의 서비스(가구수$\times$기기의 보급 율$\times$기기의 전력서비스)가 소득향상에 따라 증가하는데도 불구하고 전력수요의 증가율이 GDP(같은 기간 동안 연평균 증가율 5.7%)보다 매우 낮은 것은 기기의 대형화와 기기의 보급을 증가에 따른 전력의 추가수요가 기기의 에너지효율 개선으로 대부분 상쇄될 것이기 때문이다. 향후 10년 내에 기기에 따라 전력사용량을 25%~50%정도까지 줄일 수 있을 것으로 분석된다. 기술발전에 따른 기기의 에너지효율 개선효과는 본 고의 2006년도 가정용 전력수요의 전망치 33,118 GWh가 기존방식에 의한 한전의 전망치 61,155 GWh의 54%수준밖에 되지 않는데 서도 잘 나타나고 있다. 한편 본 고는 경제성장과 환경보존을 동시에 달성할 수 있는 지속적 개발의 실천방안으로서 에너지 수요관리를 논하고자 한다. 고효율 기기의 개발과 조기도입을 촉진시키는 에너지 수요관리 통하여 우리는 에너지효율을 대폭 개선시키며 대기오염 배출량도 대폭 줄일 수 있다. 본 고는 에너지 공급관리(공급확충)위주에서 에너지 수요관리위주로서의 에너지정책 전환은 불가피하다고 판단한다. 에너지 공급시스템보다 에너지 수요시스템위주로 전체 에너지시스템을 획기적으로 개선시키기 위해서는 최저 에너지효율제의 광범위한 실시와 함께 고효율 기기의 개발과 보급에 필요한 유인책의 도입, 고효율 기기와 에너지의 효율적 이용에 대한 정보 등이 필요시 되고 있다. 우리 나라의 경우 현재의 산업구조와 기술수준을 고려하여 에너지 효율의 기준을 미국보다 다소 낮게 설정한다면 최저 에너지효율제의 도입이 문제가 되지 않을 것으로 판단된다. 본 고는 고효율 기기의 개발과 조기도입을 지원하기 위한 가칭 대기환경보존 및 에너지 수요관리기금의 창설을 제안한다. 전력부문의 경우 기금은 1. 탄소세, 2. 전력소비에 대한 수요 관리 세의 도입 혹은 3. 한국전력공사 전력판매수입의 일정 분으로 조성될 수 있을 것으로 본다. 예를 들어 선진국들이 탄소세를 예정대로 도입한다는 전제하에 우리 나라가 2000년을 기준으로 탄소 톤당 8달러(석유 배럴 당 85센트)의 탄소세를 도입한다면 연간 7억 2,000만 달러(약5,760억 원)규모의 기금을 조성할 수 있다. 이 중 연간 2,000억 원 정도를 고효율 기기의 개발과 조기도입에 지원한다면 우리 나라 에너지 시스템 효율은 대폭 개선될 수 있을 것으로 예상된다.

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Determination of the Optimum Application Rate of Pig Slurry for Red Pepper Cultivation (고추에 대한 돈분액비 시용기준 설정)

  • Kang, Bo-Goo;Kim, Hyun-Ju;Lee, Gyeong-Ja;Park, Seong-Gyu
    • Korean Journal of Soil Science and Fertilizer
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    • v.37 no.6
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    • pp.388-395
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    • 2004
  • This study was carried out to determine the application rate of pig slurry for red pepper. Field experiment was designed with non-fertilizer, chemical fertilizer recommended by soil testing (CFRST) and pig slurry treatments. In pig slurry (PS) plots, pig slurry was applied as basal fertilizer with different equivalents to nitrogen of chemical fertilizer plot (60%: PS60, 80%: PS80, 100%: PS100, 120%: PS120) and chemical fertilizer was top-dressed additionally. Soil organic matter contents after 50 day of planting and after experiment in the plots treated with PS were higher than that of CFRST plot, whereas content of $NO_3-N$ of CFRST plot was higher than that of PS plot. Growth of red pepper were lowest in the non-fertilizer plot. Plant lengths of red pepper at 50 day after planting were similar among the different treatments, plant lengths of red pepper of PS100, PS120 and CFRST at 100 day after planting were higher than those of the PS60 and PS80 plots. But Main stem and stem diameter of red pepper were not different among the treatments. Uptake rate of N, P and K by red pepper plant were 27-44, 9-16 and 41-68% for total N, $P_2O_5$ and $K_2O$, respectively. Utilization of applied fertilizer ingredient by red pepper plant were in the order of PS80> PS60> FRST> PS100> PS120. Yield of red pepper tends to increase by 3% in the PS100 compared with the CFRST, but there was not significant difference between PS120 and CFRST. Chemical component of run-off collected from the furrow of the red pepper field was not different among the treatments. Greenhouse gases ($CH_4$ and $N_2O$) emission of non-fertilizer, PS100 and CFRST during the whole red pepper growth period were 4.0, 4.8 and $5.9kg\;CH_4\;ha^{-1}$, and 0.74, 6.68 and $8.38kg\;N_2O\;ha^{-1}$. Emission of $CH_4$ and $N_2O$ in PS100 was higher than those of CFRST by 23% and 26%, respectively. In this connection, to be used the pig slurry for red pepper, it is required that pig slurry must be decomposed for six months or more. Consequently, pig slurry equivalent to nitrogen of basal fertilizer of CFRST with additional top dressing of chemical fertilizer is recommend as an optimum application rate of pig slurry for red pepper.

Pediatric Urolithiasis: Our 22-year Experience at a Single Center (소아에서의 요로결석: 단일기관에서 22년간의 경험)

  • Kim, Su-Yon;Kim, Min-Jee;Lee, Joo Hoon;Kim, Kun Suk;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.

A study to evaluate the safety of iodine intake levels in women of childbearing age: 2013-2015 Korea National Health and Nutrition Examination Survey (가임기 여성의 요오드 섭취 수준의 안전성 평가 연구: 2013-2015 국민건강영양조사 자료 활용)

  • Lee, Jung-Sug
    • Journal of Nutrition and Health
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    • v.54 no.6
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    • pp.644-663
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    • 2021
  • Purpose: This study was conducted to evaluate the safety of iodine intake based on ingestion levels and urinary iodine excretion of women of childbearing age (15-45 years old) using data from the 2013-2015 Korea National Health and Nutrition Examination Survey. Methods: Iodine intake was calculated using the 24 hours dietary recall method and urinary iodine excretion. The iodine nutrition database for the analysis of dietary iodine intake was constructed using the food composition database of the Rural Development Administration (RDA), the Korean Nutrition Society (KNS), the Ministries of Food and Drug Safety, China and, Japan. The World Health Organization (WHO) evaluation criteria and hazard quotient (HQ) calculated using biomonitoring equivalents (BE) were applied to evaluate the safety of the iodine intake. Results: Of the study subjects, 15.22% had a urinary iodine concentration level of less than 100 ㎍/L, which was diagnosed as deficient, and 48.16% had an excessive iodine concentration of over 300 ㎍/L. Urinary iodine concentration was 878.71 ㎍/L, iodine/creatinine was 589.00 ㎍/g, and iodine/creatinine was significantly higher at the age of 30-45 years. The dietary iodine intake was 273.47 ㎍/day, and the iodine intake calculated from the urinary iodine excretion was 1,198.10 ㎍/day. Foods with a high contribution to iodine intake were vegetables, seafood, seaweed and processed foods. The HQ was 1.665 when the urinary iodine content was > 1,000 ㎍/L. Conclusion: The results of this study implicate that the urinary iodine concentration, rather than the dietary iodine intake, is more appropriate to evaluate the iodine status under the current situation that a comprehensive iodine database for Koreans has not been established.