• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.25-43
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• 1997

Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (${\pm}17.2$ years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (${\pm}13.1$ days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, $Pa0_2$, $PaCO_2$, $Sa0_2$, alveolar-arterial oxygen differences, $PaO_2/FIO_2$, and PEEP/$FI0_2$ between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

• Korean Journal of Environment and Ecology
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• v.28 no.5
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• pp.542-549
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• 2014

This study was conducted to investigate the body size, sexual size dimorphism (SSD), and related environmental factors between Red-tongued viper snakes (Gloydius ussuriensis) inhabiting two different places, i.e., Jeju Island and its islet Gapado, and to provide data required to maintain species diversity from May, 2006 until June, 2009. The snout-vent length of the Red-tongued viper snake population inhabiting Jeju Island was found to be 242-532 mm ($422.0{\pm}46.7mm$, n = 100) in females and 296-580 mm ($434.5{\pm}51.7mm$, n = 63) in males. In contrast, the snout-vent length was observed to be 205-395 mm ($335{\pm}43.6mm$, n = 55) in female and 215-430 mm ($328{\pm}39.4mm$, n = 73) in male Red-tongued viper snakes inhabiting Gapado. These data demonstrated the snout-vent length of both female and male Red-tongued viper snakes on Jeju Island to be larger than those on Gapado (Female t = 17.343, df = 115, P<0.001; Male = 19.128, df = 101, P<0.001). SSD was measured to be -0.03 in the Red-tongued viper snake population on Jeju Island, with more or less larger sizes in the males, while it was 0.02 in the Red-tongued viper snake population in the Gapado, with a little larger sizes in the females. The reason for this difference in the snake populations between Jeju Island and Gapado may be due to adaption to the different ecological environments. In addition, as SSD, the snout-vent length of the Red-tongued viper snake populations and in young vipers was somewhat higher in the males than in the females on Jeju Island (t = -2.011, df = 117, P<0.05). However, no significant differences were observed in the snout-vent length of the young and the general Red-tongued viper snake populations on Gapa Island. For the population on Jeju island, the head length (F = 6.318, $df_{1,2}$=1,117, P<0.05), head width (F=8.090, $df_{1,2}$=1,117, P<0.01), inter eye length (F=15.898, $df_{1,2}$=1,117, P<0.001), and tail length (F=238.488, $df_{1,2}$=1,111, P<0.001) were all larger in the males, while females showed higher body mass (F=64.111, $df_{1,2}$=1,114, P<0.001). In the case of the Gapa Island population, no significant differences in the head length, head width, and inter eye length between females and males were observed, while the males had a longer tail length (F=168.555, $df_{1,2}$=1,74, P<0.001) and the females were heavier (F=17.812, $df_{1,2}$=1,76, P<0.001). Though no significant differences were found in the head length, head width, and inter eye length, the tail length (F=67.793, $df_{1,2}$=1,72, P<0.001) and body mass (F=4.558, $df_{1,2}$=1,72, P<0.05) were higher in the young male Red-tongued viper snakes than in the females. The snout-vent length, head length, head width, and inter eye length, which did not display SSD in the young Red-tongued viper snake populations, were higher in the male Red-tongued viper snake populations than in the female population from Jeju Island, implying that SSD in the Red-tongued viper snake population on Jeju Island is expressed due to environmental effects during their growth.

• Korean Security Journal
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• no.9
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• pp.69-98
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• 2005

The security industry for civilians (Private Security), was first introduced to Korea via the US army's security system in the early 1960's. Shortly after then, official police laws were enforced in 1973, and private security finally started to develop with the passing of the 'service security industry' law in 1976. Korea's Private Security industry grew rapidly in the 1980's with the support of foreign funds and products, and now there are thought to be approximately 2000 private security enterprises currently running in Korea. However, nowadays the majority of these enterprises are experiencing difficulties such as lack of funds, insufficient management, and lack of control over employees, as a result, it seems difficult for some enterprises to avoid the low production output and bankruptcy. As a result of this these enterprises often settle these matters illegally, such as excessive dumping or avoiding problems by hiring inappropriate employees who don't have the right skills or qualifications for the jobs. The main problem with the establishment of this kind of security service is that it is so easy to make inroads into this private service market. All these hindering factors inhibit the market growth and impede qualitative development. Based on these main reasons, I researched this area, and will analyze and criticize the present condition of Korea's private security. I will present a possible development plan for the private security of Korea by referring to cases from the US and Japan. My method of researching was to investigate any related documentary records and articles and to interview people for necessary evidence. The theoretical study, involves investigation books and dissertations which are published from inside and outside of the country, and studying the complete collection of laws and regulations, internet data, various study reports, and the documentary records and the statistical data of many institutions such as the National Police Office, judicial training institute, and the enterprises of private security. Also, in addition, the contents of professionals who are in charge of practical affairs on the spot in order to overcomes the critical points of documentary records when investigating dissertation. I tried to get a firm grasp of the problems and difficulties which people in these work enterprises experience, this I thought would be most effective by interviewing the workers, for example: how they feel in the work places and what are the elements which inpede development? And I also interviewed policemen who are in charge of supervising the private escort enterprises, in an effort to figure out the problems and differences in opinion between domestic private security service and the police. From this investigation and research I will try to pin point the major problems of the private security and present a developmental plan. Firstly-Companies should unify the private police law and private security service law. Secondly-It is essential to introduce the 'specialty certificate' system for the quality improvement of private security service. Thirdly-must open up a new private security market by improving old system. Fourth-must build up the competitive power of the security service enterprises which is based on an efficient management. Fifth-needs special marketing strategy to hold customers Sixth-needs positive research based on theoretical studies. Seventh-needs the consistent and even training according to effective market demand. Eighth-Must maintain interrelationship with the police department. Ninth-must reinforce the system of Korean private security service association. Tenth-must establish private security laboratory. Based on these suggestions there should be improvement of private security service.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.140-151
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• 2003

Purpose: We tried to evaluate the long term efficacy and positive predictive factors of interferon-alpha treatment in children with chronic hepatitis B. Methods: The study population included 113 children who received interferon therapy between May 1982 and July 2002 (20 years) for chronic hepatitis B in Department of Pediatrics, Yonsei University College of Medicine. Male to female ratio was 2.3 : 1 and the mean age at diagnosis was $11.1{\pm}4.1$ years old. Response to treatment was defined as normalization of alanine aminotransferase (ALT), disappearance of HBeAg and HBV-DNA Eighty two children responded while 32 did not. Interferon-alpha was given intramuscularly for 6 months at a dosage of $3{\times}10^6$ unit, 3 times weekly. In relapsed cases, lamivudine or interferon retreatment was done. Results: Seroconversion rate was 77.0% in terms of HBeAg, 74.3% in terms of HBV-DNA, and 80.5% in terms of ALT normalization after treatment. Seroconversion rate of both HBeAg and HBV-DNA was 72.6%. Analyzed by life table method, the effect of the treatment had been maintained over 10 years after cessation of therapy. Pre-treatment ALT level was the only significant positive predictive factor of response. Eleven cases (13.4%) relapsed, and 2 out of 3 showed response when treated with lamivudine and 1 out of 3 with interferon retreatment. Conclusion: Interferon-alpha showed significant efficacy in the treatment of chronic hepatitis B in our study. Further studies about the effect of interferon therapy on complications of hepatitis such as hepatocarcinoma, cirrhosis are warranted.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.1-11
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• 2008

Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.49-56
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• 2010

Objective: To investigate assisted reproductive technology (ART) outcomes in women with WHO class I anovulation compared with control group. Design: Retrospective case-control study. Methods: Twenty-three infertile women with hypogonadotropic hypogonadism (H-H) who undertook ART procedure from August 2003 to January 2009 were enrolled in this study. A total of 59 cycles (H-H group) were included; Intra-uterine insemination with super-ovulation (SO-IUI, 32 cycles), in vitro fertilization with fresh embryo transfer (IVF-ET, 18 cycles) and subsequent frozenthawed embryo transfer (FET, 9 cycles). Age and BMI matched 146 cycles of infertile women were collected as control group; 64 cycles of unexplained infertile women for SO-IUI and 54 cycles of IVF-ET and 28 cycles of FET with tubal factor. We compared ART and pregnancy outcomes such as clinical pregnancy rate (CPR), clinical abortion rate (CAR), and live birth rate (LBR) between the two groups. Results: There was no difference in the mean age ($32.7{\pm}3.3$ vs. $32.6{\pm}2.7$ yrs) and BMI ($21.0{\pm}3.1$ vs. $20.8{\pm}3.1kg/m^2$) between two groups. Mean levels of basal LH, FSH, and $E_2$ in H-H group were $0.62{\pm}0.35$ mIU/ml, $2.60{\pm}2.30$ mIU/ml and $10.1{\pm}8.2$ pg/ml, respectively. For ovarian stimulation, H-H group needed higher total amount of gonadotropin injected and longer duration for ovarian stimulation (p<0.001). In SO-IUI cycles, there was no significant difference of CPR, CAR, and LBR between the two groups. In IVF-ET treatment, H-H group presented higher mean $E_2$ level on hCG day ($3104.8{\pm}1020.2$ pg/ml vs. $1878.3{\pm}1197.7$ pg/ml, p<0.001) with lower CPR (16.7 vs. 37.0%, p=0.11) and LBR (5.6 vs. 33.3%, p=0.02) and higher CAR (66.7 vs. 10.0%, p=0.02) compared with the control group. However, subsequent FET cycles showed no significant difference of CPR, CAR, and LBR between the two groups. Conclusion: H-H patients need higher dosage of gonadotropin and longer duration for ovarian stimulation compared with the control groups. Significantly poor pregnancy outcomes in IVF-ET cycles of H-H group may be due to detrimental endometrial factors caused by higher $E_2$ level and the absence of previous hormonal exposure on endometrium.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.184-193
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• 2006

Background: Off-pump coronary artery bypass grafting (OPCAB) has been proven to result in less morbidity. The patients who have left ventricular dysfunction may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The present study compared early and midterm outcomes of off-pump versus on-pump coronary artery bypass grafting (On pump CABG) in patients with severe left ventricular dysfunction. Material and Method: Ninety hundred forth six patients underwent isolated coronary artery bypass grafting by one surgeon between January 2001 and Febrary 2005.. Data were collected in 100 patients who had left ventricular ejection fraction (L VEF) less than $35\%$ (68 OPCAB; 32 On pump CABG). Mean age of patients were 62.9$\pm$9.0 years in OPCAS group and 63.8$\pm$8.0 years in On pump CABG group. We compared the preoperative risk factors and evaluated early and midterm outcomes. Result: In OPCAB and On pump CABG group, mean number of used grafts per patient were 2.75$\pm$0.72, 2.78$\pm$0.55 and mean number of distal anastomoses were 3.00$\pm$0.79, 3.16$\pm$0.72 respectively. There was one perioperative death in OPCAB group ($1.5\%$). The operation time, ventilation time, ICU stay time, CK-MB on the first postoperative day, and occurrence rate of complications were significantly low in OPCAB group. Mean follow-up time was 26.6$\pm$12.8 months (4${\~}$54 months). Mean LVEF of OPCAB and On pump CABG group improved significantly from $27.1\pm4.5\%$ to $40.7\pm13.0\%$ and $26.9\pm5.4\%$ to $33.3\pm13.7\%$. The 4-year actuarial survival rate of OPCAB and On pump CABG group were $92.2\%,\;88.3\%$ and the 4-year freedom rates from cardiac death were $97.7\%,\;96.4\%$ respectively. There were no significant differences between two groups in 4 year freedom rate from cardiac event and angina. Conclusion: OPCAS improves myocardial function and favors early and mid-term outcomes in patients with severe left ventricular dysfunction compared to On pump CABG group. Therefore, OPCAB is a preferable operative strategy even in patients with severe left ventricular dysfunction.