• Title/Summary/Keyword: 성장과 발달

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Clinacal investigation of child sexual abuse (소아 성폭력에 관한 임상적 고찰)

  • Lee, Hyun Joo;Han, Hye Jung;Kim, Ji Hee;Lee, Hye Sun;Lee, In Sil
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.20-27
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    • 2007
  • Purpose : Child sexual abuse is a significant and serious problem that affects public health and society. Pediatricians are responsible for preventing and detecting sexual abuse of children. The aim of this study was to examine clinical findings of child sexual abuse. Methods : The authors retrospectively studied 292 patients between the ages of 0 and 18 who were referred for evaluation of sexual abuse to the Emergency Department of the National Police Hospital from Oct 1, 2001 to May 5, 2005. Results : Sixty three (21.6 percent) of sexual abuse victims were younger than 6 years of age; 89 (30.5 percent) were 6-12 years of age; and 104 (47.9 percent) were 12-18 years of age. Attack time was the most common between noon and 6 pm. Victims were attacked in their home or nearby (51.4 percent). One hundred fifty six (53.6 percent) offenders were accquaitances, thirty nine (13.4 percent) of whom were family members. The disclosure of attack by parents with abnormal physical symptoms was more common in younger children than in adolescence. Eighty nine (30.5 percent) victims had no specific physical findings, 51 percent had injury to the hymen, 37.3% had injury to external genitalia, and 4 percent had anal injury. One case of gonorrhea and thirteen cases of chlamydia were found. Sperm was found in 19 cases and acid phosphatase was positive in 28 cases. The absence of physical findings and laboratory findings was more common in younger children than in those in adolescence. The time interval from attacks to hospital visits had a significant negative correlation with age. Conclusion : For younger victims, the time interval from attack to hospital visitis was more prolonged. Victims may have no physical evidence of sexual abuse. Therefore, a careful history should be obtained and a through physical examination should be performed. Pediatricians must play a leading role in evaluation and treatment of sexually abused children, considering children,s growth and development. Coordination with other professionals is necessary to provide consultation, medical treatment, and legal assistance for the sexually abused children and families.

A study on the school health education curriculum development focused on the health education course in primary school (국민학교 보건교육 교과과정의 개선방안에 대한 연구)

  • Kim, Hwa-Joong;Lee, In-Sook
    • Journal of the Korean Society of School Health
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    • v.5 no.1
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    • pp.36-63
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    • 1992
  • The purpose of this study was development of school health education curriculum in primary school based on analysis of the textbooks published in 1991. 1) The health education curriculum in primary school consisted of four major components such as health education aspects of the healthful school environments, health education aspects of school health services, health education course, and health instruction in related subjects. However, health instruction taught by physical education, biology, and other health related subjects was not systematic organization for health care. 2) A considerable amount of health knowledge and attitude, and some health practices was learned as the result of experiences in other courses, where there was little or no reference to health. It must be developed health edcation course separated from health related subjects. 3) Direct health insruction was represented by the health education course. The health education courses must be considered to be heart of the school health education curriculum. 4) The health education course developed by this study was consisted of eight health units and problems in the early elementary grade or health classes in the higher years. 5) The health education course developed by this study provided the opportunity for acquring new knowledge, attitude, and practice, for discarding the unhealtful attitude and strengthening the healthful attitude and practices of primary school students.

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A Case of Carbamoyl Phosphate Synthetase 1 Deficiency with Novel Mutations in CPS1 Treated by Liver Cell Transplantation (신생아기에 새로운 CPS1 유전자 돌연변이가 확인되고, 간세포이식 시행 받은 Carbamoyl phosphatase synthetase 1 deficiency 1례)

  • Lee, Jisun;Yang, Aram;Kim, Jinsup;Park, Hyung-Doo;Lee, Sanghoon;Lee, Suk-Koo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.1
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    • pp.31-37
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    • 2017
  • Carbamoyl phosphate synthetase 1 deficiency (CPS1D) is an autosomal recessive disorder of the urea cycle that causes hyperammonemia. Two forms of CPS1D are recognized: a lethal neonatal type and a less severe, delayed-onset type. Neonatal CPS1D cases often present their symptoms within the first days of life. Delayed-onset cases are predominantly adolescents or adults, and infantile delayed-onset cases are rare. Severe hyperammonemia in the neonatal period leads to serious brain damage, coma, and death if not treated promptly. Therefore, early diagnosis and acute treatment are crucial. Despite the improvement of treatments, including continuous hemodialysis, ammonia-lowering agents, and a low-protein diet, the overall outcome of severe forms of hyperammonemia often remains disappointing. As the liver is the only organ in which ammonia is converted into urea, liver transplantation has been considered as an elegant and radical alternative therapy to classical dietary and medical therapies. However, liver transplantation has many disadvantages, such as a considerable risk for technical complications and perioperative metabolic derangement, especially in neonates. Additionally, there is a lack of suitable donor organs in most countries. According to recent studies, liver cell transplantation is a therapeutic option and serves as a bridge to liver transplantation. Here, we report a Korean CPS1D patient with novel mutations in CPS1 who was treated by liver cell transplantation after being diagnosed in the neonatal period and showed a good neurodevelopmental outcome at the last follow-up at six months of age.

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A Study on a Quantitative Method in Estimating Forest Effects for Streamflow Regulation (II) - Mainly Dealing with Application of Coefficient for Slope Roughness - (삼림이수기능(森林理水機能)의 정량적(定量的) 평가방법(平價方法)에 관한 연구(硏究)(II) - 조도계수(粗度係數)의 응용(應用)을 중심(中心)으로 -)

  • Lee, Heon Ho
    • Journal of Korean Society of Forest Science
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    • v.81 no.4
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    • pp.337-345
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    • 1992
  • In this research, a kinematic wave model was applied for the runoff analysis, Regulation of streamflow was estimated by the calibration of roughness coefficient as a parameter. The data analyzed were obtained from Ananomiya and Shirasaka experimental basins at Tokyo University Forest in Aichi. Estimation methods and characteristics of roughness coefficient as a evaluation method of hydrological function of forest are summarized as follows ; 1. Roughness coefficient($N_s$) indicates the resistance of hillslope to the flowing water of surface runoff. There exists an hypothesis that resistance of hillslope to flowing water increase with the growth forest and development of the $A_o$ layer. 2. Roughness coefficient($N_s$) was estimated by the parameter when the stream direct runoff was calculated by using the kinematic wave. 3. Secular change of '$N_s$' in ananomiya has a curve which has an upper limit and increases exponentially near the limit. The curve quickly increased from 1935 to 1945 when results of afforestation for erosion control were thought to be effective. On the other hand, slight increase of '$N_s$' in Shirasaka indicates that there was not such a big change in the surface of soil layer. 4. The increase of '$N_s$' was related with decrease of direct runoff and increase of base flow. It was recognized that the rate of direct runoff decreased with the improvement of forest physiognomy and the rate of base flow was increased. But absolute value of water runoff per one storm decreased in chronological order.

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A Study on the Efficacy of Dietary Supplementation of Organic Acid Mixture in Broiler Chicks (육계에 대한 복합 유기산제의 첨가급여 효과에 관한 연구)

  • Kim, Dong-Wook;Kim, Ji-Hyuk;Kim, Sung-Kwon;Kang, Geun-Ho;Kang, Hwan-Ku;Lee, Sang-Jin;Kim, Sang-Ho
    • Journal of Animal Science and Technology
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    • v.51 no.3
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    • pp.207-216
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    • 2009
  • This experiment was conducted to investigate the effects of dietary supplementation of organic acid mixture on growth performance, cecal microflora, blood characteristics and immune response in broiler chicks and to prove the possibility of organic acid mixture as an alternative to antibiotics growth promotor. A total of four hundred eighty, 1-day-old male broiler chicks (Ross$\times$Ross 308) were randomly divided into 4 groups with 4 replicates of 30 birds each. The treatments were NC (free antibiotics), PC (basal diet with virginiamycin 10 ppm and salinomycin 60 ppm), 0.3% organic acid, and 0.5% organic acid. The final body weight and body weight gain were significantly higher in organic acid 0.5% than NC (P<0.05). The feed conversion ratio in all treated groups were significantly improved as compared to that of NC (P<0.05). The carcass rate and relative organs weight were not significantly difference among the groups. The relative weight and length of small intestine in PC were significantly decreased than the other groups. The numbers of cecal coliform bacteria and Salmonella in all treated groups were significantly lower than NC (P<0.05). The number of cecal lactic acid bacteria was not different among the groups. No significant differences among the groups were observed in the contents of total cholesterol, triglyceride, blood urea nitrogen (BUN), albumin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in blood serum. The contents of total protein and globulin in blood serum of PC and organic acid treated groups were significantly increased as compared to those of NC (P<0.05). Therefore, albumin:globulin ratio of PC and organic acid treated groups was significantly lower than NC (P<0.05). The total white blood cell (WBC), heterophil, lymphocyte, and stress indicator (heterophil:lymphocyte ratio) were not significantly different among the groups. No significant difference was observed on the expression rate of splenic cytokines mRNA in organic acid treated groups compared to the control. Consequently, supplemental organic acid mixture improved the growth performance, and influenced positive effects on the intestinal microflora by inhibiting the growth of harmful bacteria without any adverse effects on relative weights of organs and blood biochemical parameters in broiler chicks.

가금에서 분리된 유산균의 생리적 특성 및 급여효과

  • 김상호
    • Proceedings of the Korea Society of Poultry Science Conference
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    • 2002.11a
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    • pp.64-84
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    • 2002
  • These studies were conducted to evaluate the Properties of lactic acid Producing bacteria(LAB), isolated from broiler and laying hens cecum and select the optimum strains to improve the performance, environment of poultry house, immunity, and intestinal microflora of broiler and laying hens. In experiment I , 23 LAB strains were isolated from broiler and laying hens cecum as a colony form. Six strains were selected by acid tolerance, bile salt tolerance, viability, enzyme release, antagonism, and antibiotics susceptibility. In Experiment II, selected LABs from Ex. 1 were conducted to investigate the effects of feeding various Lactobacillus on performance, nutrients digestibility, intestinal microflora, villi development and observation of epithelium surface, blood chemicals and fecal noxious gas of broiler chicks. One thousand eighty one day old broiler chicks were fed into Lactobacillus crispatus avibrol(LCB), Lactobacillus reuteri avibro2(LRB), Lactobacillus crispatus avihen1(LCH), and Lactobacillus vaginalis avihen2(LVH) at the level of 10$^4$ and 10$\^$7/cfu/g diet. Weight gam of chicks fed Lactobacillus tended to increase from the first week and was higher from 50 to 100g in Lactobacillus treatments than control. Feed intake and feed conversion were not statistically different of all treatments. Dry Matter digestibility of Lactobacillus treatments was prone to improve compared to that of control, but was not significantly different. Protein and Ca digestibility were also tended to improve in Lactobacillus treatments relative that of control. Lactobacillus treatments showed improved tendency in crude ash and fat compared to those of control, whereas phosphorus digestibility was not consistency. Nutrients digestibilities of bird fed LCH were superior to those of other treatments, It showed significantly higher in Ca and P digestibility than control(P〈0.05). Total Lactobacillus spp. of birds fed various Lactobacillus was significantly higher in illeum for five weeks(P〈0.05), but was not different at cecum. Yeast was thought to be not completely attached to intestinal lumen for one week. However, total number of yeast was significantly increased in cecum and illeum of three weeks old chicks (P〈0.05). The number of anaerobes exhibited to tendency the increase in Lactobacillus treatments from one week old of age at both ileum and cecum.

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병원정보시스템 품질 항목에 대한 제안

  • Park, Chan-Seok;Go, Seok-Ha
    • Proceedings of the Korea Society of Information Technology Applications Conference
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    • 2007.05a
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    • pp.300-320
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    • 2007
  • 정보기술의 발달과 함께 소프트웨어 제품은 모든 산업에 필수요소가 되었고, 품질과 평가에 대한 관심도 점차 증가되고 있다. 하지만 일부 산업에서는 소프트웨어 품질 평가에 대한 사용자들의 만병 통치적 기대, 품질 표준의 부족, 측정을 위한 양질의 데이터 부족, 소프트웨어 분석과 디자인에 대한 공학적 한계로 소프트웨어 품질 평가에 대해 많은 문제점이 지적되고 있다. 국내에서도 의료산업 관련 정보시스템의 오류 및 사용자들의 운영 미숙은 매년 많은 금액의 사회적 비용을 증가시켰고, 병원정보시스템의 품질에 대한 관심을 초래하였다. 특히, 산업적 특성이 강한 병원정보시스템은 성공적 구축을 위해 사용자 중심의 소프트웨어 디자인과 다양한 전문가들의 지식 통합이 필요하며, 정보시스템 품질 측정으로 연구자들과 개발자들의 시스템 설계 혼란을 감소시키는 방법론이 필요하다는 연구들이 등장하고 있다. 대부분의 병원정보시스템이 단편적인 업무처리 위주로 개발 운영되고 있고, 장기적 경영전략이나 임상연구를 위한 분석적 정보처리 기능들은 결여되어 있다. 또한 소프트웨어 재설계나 추가적 개발 에 활용될 수 있는 객관적 품질 기준이 부족하고, 사용자들의 요구사항에 대해 소프트웨어 설계에 있어서 효율적으로 반영되지 못하고 있다. 이에 본 연구는 최근 발표된 병원정보시스템 품질 평가에 대한 연구 경향을 종합하고, 품질 평가에 대 해 효율적으로 활용되고 있는 사용성(Usability)을 기준으로 병원산업의 특수성을 포함한 품질 평가 방법과 품질척도를 제안하고자 한다. 국제표준기구(ISO:International Standards Organization)에서는 품질 특성을 기능성, 신뢰성, 사용성, 효율성, 유지 보수성과 이식성의 특성을 제시하고 있다. 특히 Folmer & Bosch(2004)가 정리한 ISO9126에서는 품질의 특성을 배움의 용이성, 운영의 용이성, 이해성과 매력성으로 분류하였고, ISO9241-11는 효과성, 효율성과 만족성으로 분류하였다. 또한 Shackel(1991)은 배움의 용이성(배움과 시간, 기억력), 효과성(오류, 직무시간), 유연성과 마음가짐으로 분류하고 있다(Shackel, 1991). Nielsen(1997)은 배움의 용이성, 기억의 용이성, 오류, 효율성, 만족성으로 분류하고 있고(Nielsen, 1997), Shneiderman(1998)는 효과성(직무시간, 배움의 시간), 효율성(기억의 지속시간, 오류), 만족도를 품질의 특성으로 분류하였다. 이와 같은 소프트웨어의 품질은 소프트웨어 계획, 개발, 성장과 쇠퇴의 모든 과정에 적용되며, 환경적 변화에 따라 사용자들의 정보욕구를 적절하게 반영하여 만족도를 높이 는 것이라고 요약할 수 있다. 그러나 현재까지 소프트웨어 품질 평가에 대한 연구들 은 보편적인 평가 항목들을 대상으로 측정하여 일반적인 품질기준을 제시하고 있고, 유사한 측정 내용들이 중복되어 있다. 이러한 경향은 산업별 특수성이 강한 소프트웨어에 대해서는 정확한 품질측정이 어려웠고, 품질측정에 대한 신뢰성을 떨어뜨리는 계기가 되었다. 이러한 한계를 극복하고자 나타난 방법론이 최종사용자들의 요구사항을 얼마나 적절하게 시스템에 반영했는지에 대한 사용성(Usability) 측정이다. 사용성에 대한 정의는 사용자들이 실질적으로 일하는 장소에서 직접 사용자들의 시스템 운용실태를 파악하여 문제점을 개선하는 것으로 요약할 수 있다. ISO9124-11에서는 사용성을 "어떤 제품이 구체적인 사용자들에 의해 구체적인 목적을 달성하기 위한 구체적인 사용의 맥락에서 효율성, 효과성을 만족함으로 사용될 수 있는 정도"로 정의하고 있다. 지난 10년간 병원정보시스템 평가에 대한 문헌들을 고찰한 결과 품질 측정의 효과는 정보화에 대한 동기유발과 의료품질을 높이는 게기가 되었으며, 질병에 대한 예방효과도 높은 것으로 조사되었다. 그러나 평가에 대한 인식의 문제, 평가 방법의 신뢰성 부족, 평가 지침과 부분적 평가에 따른 인증의 어려움 평가 결과에 대한 확산과 단편적 연구의 한계 등으로 연구결과에 대한 신뢰도와 활용도는 낮은 것으로 조사되었고, HIS에 대한 연구 빈도와 범위 가 매우 미약하였다. 특히, 품질속성은 같은 용어이지만 연구자에 따라 전혀 다른 측정 내용을 제시하고 있어 효율적인 품질 지표를 제시하는데 많은 혼란을 초래하고 있다. 이러한 품질 평가의 경향은 시스템 설계 및 개발자들에게 필요한 사용자들의 구체적이고 독특한 욕구나 병원정보시스템 환경의 특수성 파악에 한계를 보였으며, 평가 범위도 부분적으로 이루어져 전사적 시스템 설계 및 개발에 중요한 자료를 제공하지 못하고 있다. 이러한 문제점과 한계를 극복하고자 ISO와 같은 품질 표준 속성과 컨텍스트(Context)를 중심으로 사용자에 의한 평가 척도의 설정은 구체적이고 실용적이며 신뢰성 있는 평가 방법이 될 것이다.

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Surgical Closure of the Patent Ductus Arteriosus in Premature Infants by Axillary Minithoracotomy (액와 소개흉술에 의한 미숙아 동맥관 개존증의 외과적 치료)

  • Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Kim, Kwang-Ho;Hong, Yung-Jin;Jun, Yong-Hoon;Shinn, Helen Ki;Baek, Wan-Ki
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.837-842
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    • 2007
  • Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

Future Development of Genetics and the Broiler (BROILER 육종기술의 전망)

  • 오봉국
    • Korean Journal of Poultry Science
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    • v.8 no.1
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    • pp.1-5
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    • 1981
  • In trying to predict the effect of genetics on the broiler in the year 2000, this is a relatively short period of time as far as broiler genetics in concerned. Modern broiler genetics started around 1945 and tremendous gains when made in past 35 years. Futher improvements on broiler will depend on the evolution and revolution: 1. Evolution: (1) Growth rate has been made 4-5% per year. (2) Feed conversion has improved approximately 1% per year. (3) Abdominal fat is becoming a major complaint in broiler. (4) Because of the changing life-style, broiler meat sales in the future will be more and more in cut-up form. (5) Breeding for stress resistance and selection for docile temperament can be important in order to funker improve fled efficiency. (6) In female parent stock, reproduction characteristics are in many can negatively correlated with the desired broiler traits. (7) Egg production and hatchability in moot commercial parent nod m at a fairly high level. (8) In male parent stock, the heavier and mon super-meat-type male lines are desired to Product better broilers. 2. Revolution: Trying to forecast revolutionary change in broiler genetics is highly speculative, as sudden change are aften unpredictable. (1) Species hybridization, such as a turkey-chicken cross (2) Biochemical tools, such as blood typing. (3) Mutation breeding by radiation or chemical mutagentia. (4) Broiler breeding would be to change the phenotypic appearance by single gene, such as naked, wingless. (5) Changes in production techniques. such as growing in cage or growing in filtered air positive pressure houses.

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Relative Growth of the Melanin Snail, Semisulcospira libertina libertina and Monthly Composition of Larval Stages in its Brood Pouch (다슬기 (Semisulcospira libertina libertina)의 상대성장과 보육낭 유생단계의 월별 조성)

  • CHANG Young Jin;CHANG Hae Jin;KIM Jae Jun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.2
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    • pp.131-136
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    • 2001
  • Relative growth and composition of larval development stages in brood pouch of the melania snail, Semisulcospira libertina libertina were investigated based on monthly field samples for a year. Total number of specimens examined was 1,200. Size values (mean$\pm$S. D.) of shell height (SH), shell diameter (SD), total weight (TW), meat weight (MW) and shell weight (SW) were $15.96\pm3.41\;mm$, $7.82\pm1.38\;mm$, $0.55\pm0.31\;g$, $0.24\pm0.15\;g$ and $0.39\pm0.23\;g$, respectively, Water temperature (WT) of the sampling site varied from $1.3^{\circ}C\;to\;22.5^{\circ}C$. Relative growth equations among SH, SD, TW, MW and SW of S. libertina libertina specimens pooled were as follows: SD=0,3583SH+2.1648 $(R^2=0.8391)$, $TW=0.0005SH^{2.4853}\;(R^2=0.8391)$,$MW:\;0.0005SH^{2.849}\;(R^2= 0.8391)$ and $SW=0.0004SH^{2.3798}\;(R^2=0.7057)$. Female S. libertina libertina had larvae in its brood pouch throughout the year, Average number of larvae in the brood pouch varied from $91\pm33(July)$ to $396\pm174\;(November)$, decreasing in spring and increasing in autumn. In the monthly composition of larval stage in the brood pouch, trochophore, pre-veliger, veliger and juvenile showed maximum as $66.7\%$ in May, $70.7\%$ in November, $60.9\%$ in February and $13.9\%$ in January, respectively. Percent composition of the juveniles decreased in spring and autumn. In conclusion, S. libertina libertina is likely to have two main parturition periods, March to May and September and October.

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