Cardiopulmonary bypass(CPB) in children is associated with the accumulation of body water after cardiac operation, as a consequence of an inflammatory capillary leak. Following work by Elliott in 1991, modified ultrafiltration(MUF) was introduced after bypass as a means of hemoconcentrating patients and a potential way of removing water from the tissues. We have carried out a prospective randomized study of 20 children undergoing open heart surgery, comparing MUF with nonfiltered controls. MUF was carried out for a mean of 18.9 minutes after completion of CPB to a hematocrit of 37.1%(mean). The mean water volulme removed by the ultrafiltration was 38.4 ml/kg and the mean blood volume retransfused from the oxygenator during the ultrafiltration was 32.1 ml/kg. Fluid balance, hemodynamics, hematocrit, osmolarity and dosage of drug treatment were recorded for 4∼12 hours postoperatively. The results were analyzed using Student t-test and ANOVA, comparing controls(n=10) to MUF(n=10). Blood loss(ml/kg/24hr) was 14.5(mean) in MUF versus 13.7 in controls; blood transfused(ml/kg/24hr) 6.6 in MUF versus 15.2 in controls; plasma transfused(ml/kg/24hr) 65.7 in MUF versus 59.6 in controls. There was rise in arterial blood pressure and hematocrit during MUF. Percent rise of systolic blood pressure was 28.8% in MUF versus 18.7% in controls(p=0.366); percent rise of diastolic blood pressure was 28.8% in MUF versus 8.5% in controls(p=0.135); and percent rise of mean blood pressure was 36.2% in MUF versus 8.2% in controls (p=0.086). Percent rise of hematocrit was 40.0% in MUF versus 23.5% in controls(p=0.002). There was no significant difference in the inotropic requirement and the postoperative serum osmolarity between two groups. The number of days on the ventilator, the duration of stay in the intensive care unit, and the postoperative hospital stay were not significantly different between the two groups.
The effects of growth regulators, sucrose and gelling agents were investigated to increase the efficiency of the callus growth and plant regenerarion in tissue culture of Angelica koreana Max. The fresh weight and dry weight of subcultured callus was highest in MS medium supplemented with 1 mg/l 2,4-D. Callus growth was excellent in 2% sucrose, but it was inhibited in propotion to sucrose content. Effect of gelling agents on callus growth was highest on 1.2% agar and 0.4% Gelrite medium, respectively. The browning of callus was protected on the media supplemented with 10 mg/l ABA and 5 or 10 mg/l $AgNO_3$. In the callus induction and growth from the peduncle of immature inflorescence, 2,4-D was more effective than NAA, and the frequency of callus induction was highest as 81.7% in 2 mg/l 2,4-D. Plant was not regenerated from the callus derived from young leaf. Somatic embryos were developed from the surface of callus drived from the peduncle of immature inflorescence in the medium containing 0.5 mg/l 2,4-D, 1 mg/l kinetin, 5 mg/l ABA and 5 mg/l $AgNO_3$. Plants were developed from the matured somatic embryos in the medium supplemented with 0.2 mg/l 2,4-D and 1 mg/l kinetin.
Purpose : Although many studies have investigated the dosimetric aspects of stereotactic radiosurgery in terms of target volume, the absorbed doses at extracranial sites: especially the lens or thyroid - which are sensitive to radiation for deterministic or stochastic effect -have infrequently been reported. The aim of this study is to evaluate what effects the parameters of radiosurgery have on the absorbed doses of the lens and thyroid in patients treated by stereotactic radiosurgery, using a systematic plan in a humanoid phantom. Materials and Methods : Six isocenters were selected and radiosurgery was planned using the stereotactic radiosurgery system which the Department of Therapeutic Radiology at Seoul National University College of Medicine developed. The experimental radiosurgery plan consisted of 6 arc planes per one isocenter, 100 degrees for each arc range and an accessory collimator diameter size of 2 cm. After 250 cGy of irradiation from each arc, the doses absorbed at the lens and thyroid were measured by thermoluminescence dosimetry. Results : The lens dose was 0.23$\pm$0.08$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the lens and was 0.76$\pm$0.12$\%$ of the maximum dose for each isocenter when the exit beam passed through the lens. The thyroid dose was 0.18$\pm$0.05$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the thyroid and was 0.41$\pm$0.04$\%$ of the maximum dose for each isocenter when the exit beam Passed through the thyroid. The passing of the exit beam is the most significant factor of organ dose and the absorbed dose by an arc crossing organ decides 80$\%$ of the total dose. The absorbed doses of the lens and thyroid were larger as the isocenter sites and arc planes were closer to each organ. There were no differences in the doses at the surface and 5 mm depth from the surface in the eyelid and thyroid areas. Conclusion : As the isocenter and arc plane were placed closer to the lens and thyroid, the doses increased. Whether the exit beams passed through the lens or thyroid greatly influenced the lens and thyroid dose. The surface dose of the lens and thyroid consistently represent the tissue dose. Even when the exit beam passes through the lens and thyroid, the doses are less than 1$\%$ of the maximum dose and therefore, are too low to evoke late complications, but nevertheless, we should try to minimize the thyroid dose in children, whenever possible.
Paik, Ji Yeun;Choi, Jae Hong;Cho, Eun Young;Oh, Chi Eun;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
Pediatric Infection and Vaccine
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v.18
no.2
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pp.109-116
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2011
Purpose : Pneumococcus is one of the most important causes of invasive infection through the childhood period. In January 2008, the Clinical and Laboratory Standards Institute (CLSI) published revised penicillin breakpoints for Streptococcus pneumoniae and penicillin susceptibility rates of S. pneumoniae increased in Korea. This study was performed to determine the probability of oral amoxicillin for the empirical treatment achieving bactericidal exposure against pneumococcus using pharmacodynamics model. Methods : Twenty-three isolates of pneumococci were subjected to determine minimum inhibitory concentration (MIC) for ${\beta}$-lactams and macrolide. For the ${\beta}$-lactams, exposure of fT >MIC (time that free drug concentrations remain above the MIC) for 50% of the administration interval have determined the probability of target attainment (PTA), and regimens that had a PTA >90% were considered optimal. An analysis was performed by applying MIC of 23 isolates to a 5000-patient Monte Carlo simulation model. Results : Among 23 isolates from healthy children, 7 (30.4%) isolates were MIC ${\leq}$1.0 ${\mu}g$/mL and 19 (82.6%) were MIC ${\leq}$2 ${\mu}g$/mL for amoxicillin. Amoxicillin 40 mg/kg/day achieved PTA >90% at MIC ${\leq}$1.0 ${\mu}g$/mL but PTA decreased to 52% at MIC 2 ${\mu}g$/mL, whereas amoxicillin 90 mg/kg/day can predict 97% of PTA at MIC 2 ${\mu}g$/mL. Overall, oral amoxicillin 90 mg/ kg/day for the empirical treatment against pneumococcus can expect more successful response in Korean children. Conclusion : Considering the resistantce pattern of pneumococci in Korean children, we estimate that oral amoxicillin 90 mg/kg/day will provide a pharmacodynamic advantage for the empirical treatment against pneumococcus. And low dose amoxicillin or macrolide are expected to have higher chance of treatment failure than high dose oral amoxicillin.
This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.
Kim, Hyo-Young;Yoo, Eun-Sil;Kim, Yeol;Kong, Kyoung-Ae;Song, Hye-Young;Choi, Jin-Young
Journal of Hospice and Palliative Care
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v.14
no.4
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pp.212-217
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2011
Purpose: Since 2005, the Ministry of Health & Welfare has provided financial support to promote palliative care for terminal cancer patients. We analyzed how palliative care facilities used the funding between 2006 and 2010. Methods: Frequency analysis was conducted by the item of expenditure based on fiscal reports of the palliative care facilities. Linear regression analysis was performed to examine a trend over time. Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare expenditure items, the number of provision of financial support and type of palliative care units. Results: About a half of the fund was spent to pay care givers salary, improve facilities and purchase equipment regardless of the year, the number of financial support provided or facility type. By year, the operation cost for palliative care program and the education cost for health care workers have significantly increased in linear regression analysis (P<0.01). However, the amount of financial support for the low income group has decreased over years (P=0.024). This trend was affected by evaluation criteria and weight. Conclusion: The government aid for palliative care units has been used to improve facilities and equipment. Moreover, desirable changes were noted such as a higher portion of expenses for program operation and care giver training to enhance the quality of care. However, the evaluation criteria need to be adjusted to prevent any further decrease in the support provided to the low income group.
The purpose of this study is to acquire the information on the current situation of students' selection process in order to renovate the system of picking up the students. As a first step of the study, we examined the validity of the factors of the single-out system such as qualification and the process for the application and the standards and proceeding of the selection. Then we analysed the result of the entrance examination of Hansung Science Highschool in 2002. The analysis was on the correlation between the result of entrance examination and the achievement in the school and the decision of the course after graduation. To know on the achievement of the students, we investigated the records of regular tests and asked the teachers' opinion in math and science classes. As a result, we gained the following points: First, the present single-out system has a danger of excluding students who are much talented in science and math field because it is based on students' achievements in middle schools; Second, the new selection system should consider the character and attitude of the applicants in addition to their knowledge; Third, the continuous observation of the teacher in middle school should be an important factor of the picking up system; Fourth, more questions requiring divergent thinking ability and inquiry skill should be developed as selective examination question. Also examination questions should cover the various contents from mathematics to science, and do not affect pre-learning; Finally, the system of present letting all students stand in one line should be changed into that of letting students in various lines. We can consider using multi-step selection system.
The consumer perception on health and food habit, the experience of health food use and the discrimination between health food and drug of Korean consumer were surveyed by using a questionnaire containing 20 items in order to obtain the basic data for the assessment of the benefit and risk of health foods in Korea. A total of 1,000 people over 20 years of age living in Seoul and the vicinities were interviewed and asked to fill out the questionnaire during the period from the October 1995 to the February 1996. Among the 882 answers collected 23 was incomplete data, and 859 answers were used for the statistical analysis by using SAS program. The survey revealed a strong interest of the consumer on health food by showing that more than a half of the subjects (58.8%) had the experience of actual use of health food, and 68.2% believed the effectiveness. What the consumer expect most from health food was to have beneficial effect to maintain overall health condition (59.8%), and the most negative aspect of health food was the overstatement on the effectiveness by the producers (52.1%). The most important source of information for the purchase of health food was the suggestion of friends and relatives (30.6%). Among the health foods registered and regulated by the food law, royal jelly (22.7%), squalene (16.0%), refined fish oil (15.1%), lactic acid bacteria (10.6%) and aloe (8.8%) were relatively well aware. Although 84% of the subjects perceived that health food is different from drug or traditional medicine, the largest percentage of the subject selected ginseng as the most well known type of health food (22.7%) as well as the most well known drug (or traditional medicine) (41.7%). Ginseng was also chosen as the most frequently used health food (17.0%), and vitamin tablets the third (13.0%). The vague definition of health food and unambiguous discrimination of it from medicine by the consumers were problematic for the correct use and reasonable purchasing behavior. The clear definition and proper regulation on the manufacture and distribution of health food, more strict control of labelling and advertisement, and a wide consumer education on health food were recommended.
Journal of the Korean Institute of Traditional Landscape Architecture
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v.28
no.2
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pp.23-36
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2010
The purpose of this study is to infer the aspects and significance of Musa basjoo of latter part of Chosun Dynasty by analyzing the planting tendency and planting location of Musa basjoos drawn in total 77 old paintings and the characteristics of the paintings where Musa basjoos appeared, while trying to understand symbolic meanings of floral languages as well as the images and significance of Musa basjoos which appeared in the prose and poetry of Chosun Dynasty, and the results are as follows; With its floral languages of 'waiting', 'parting' and 'beauty', Musa basjoo represented the wealth and resuscitation and it aroused the elegance of hermits in its Taoistic sense. And it also represented 'the unworldliness to get out of transient human affairs' in its Buddhistic sense. Musa basjoos which appeared in 'Garden Custom Painting(庭園雅集圖)', 'Gosa Figure Painting(故事人物圖)' and 'Gyehoe Painting(契會圖)' is considered a device to increase the unworldly atmosphere of gardens and to dignify the elegant meetings of scholars, reflected by the high appearance frequencies of cranes and deer. And it seems that the meaning of Musa basjoo in certain paintings like 'Life-time Paintings(平生圖)', 'Castle City Painting(盛市圖), and 'Cultivating and Weaving Painting(耕織圖)' is an aspiration for wealth and prosperity, and the Musa basjoos planted in temples are considered to have symbolic meanings of aspiration for 'Salvation through Belief' as well as a unworldly meaning which reminds the transiency of human affairs. In addition, the expected effect of experiencing 'the sound of rain falling on the leaves of Musa basjoo' has been pursued, which can be confirmed by the fact that Firmiana simlex with wide leaves similar to Musa basjoo can be frequently spotted near the houses. Meanwhile, Musa basjoos seem to have been planted mainly in front garden or side garden around detached house and Musa basjoos inside the houses seem to have been planted mainly in right side when viewed from the entrance, in relation with the location of bedrooms where it is easier to hear the sounds from the right side of the environment. And the paintings where Musa basjoos appear with strange rocks and bizarre stones among other things have greater part of all the paintings, which is considered a kind of intentional landscaping and a product of mixed materials for elegant appreciation. And the major characters of the painting were involved in the activities of scholars such as arts, and the activities of minor characters were greatly related to their everyday lives. Musa basjoo of Chosun Dynasty in $17^{th}$ and $18^{th}$ century was one of the symbols necessary for description of gardens. And it provided the images of rainy scenes together with scholar culture which had a meaning of self-discipline, and it is assumed that the planting of Musa basjoo with the spirit of cease lessen deavor of a new leaf pushing up the tree and the spirit of resuscitation had the same trace of wheels in the city space of our country as the decline of scholar culture of Chosun Dynasty.
Journal of the Korean Society of Food Science and Nutrition
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v.30
no.5
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pp.796-801
/
2001
A total of 277 mineral spring water samples in Kangwon province from 1999 to 2000 were analyzed for the presence of Yersinia spp. by the conventional Food and Drug Administration protocol, and presumptive strains were identified by morphological, cultural and biochemical tests according to Bergey’s manual. Also, the biotypes, serotypes, and susceptibility to 12 antibiotics were tested. Among the total 277 mineral spring water samples, 40 samples (14.4%) were found to be contaminated with Yersinia species. Among the 40 strains of Yersinia spp. isolates, 33 strains (82.5%) for Yersinia enterocolitica, 4 strains (10%) for Yersinia frederiksenii, 2 strains (5%) for Yersinia intermedia, and 1 strain (2.5%) for Yersinia sakazaki were identified, respectively. Of 40 Yersinia spp. isolates, Yersinia enterocolitica (82.5%) was the most predominant species in the mineral spring water samples compared to other Yersinia species. Compared to direct culture method after KOH treatment and KOH treatment method after cold enrichment for better isolation ratio of according to comparision of Yersinia species, the detection ration (18.5%) of KOH treatment method after cold enrichment was about 3 times better than that (6.1%) of direct culture method after KOH treatment. According to serotypes of Y. enterocolitica isolates, O : 5 (12.9%) was the most predominant and followed by O : 3 (9.7%), O : 8 (6.5%), and O : 9 (3.2%), and others. For biotypes of Y. enterocolitica isolates, 1A (71.0%) was the most predominantly abundant and followed by 3A (12.9%), 3B (9.7%), 1B (3.2%) and 5 (3.2%). Also, an antibiotic susceptibility test showed that Yersinia spp. isolates were very susceptible to the antibiotics tested, but they were very strongly resistant to ampicillin, cephalothin and carbenicillin.
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