• Sleep Medicine and Psychophysiology
• /
• v.3 no.1
• /
• pp.85-95
• /
• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.3
• /
• pp.275-284
• /
• 2002

Background : Gemcitabine is a new anti-cancer agent for treating non-small cell lung cancer. Functioning as an antimetabolite, it induces anti-cancer effects by suppressing DNA synthesis after being incorporated into the DNA as a cytosine arabinoside analogue. When Gemcitabine is incorporated into the DNA, the p53 gene may be activated by induction of the DNA defect. However, there are a few studies on the molecular mechanisms of Gemcitabine-induced cell death. This study examined the role of p53 in Gemcitabine-induced cell death. Methods : A549 and NCl-H358 lung cancer cells were used in this study. The cell viability test was done using a MTT assay at Gemcitabine concentrations of 10nM, 100nM, 1uM, 10uM and 100uM. A FACScan analysis with propium iodide staining was used for the cell cycle analysis. Western blot analysis was done to investigate the extent of p53 activation. For the functional knock-out of p53, stable A549-E6 cells and H358-E6 cells were transfected pLXSN-16E6SD which is over expresses the human papilloma virus E6 protein that constantly degrades p53 protein. The functional knock out of p53 was confirmed by Western blot analysis after treatment with a DNA damaging agent, doxorubicine. Results : Gemcitabine exhibited cell toxicity in dose-dependent fashion. The cell cycle analysis resulted in an S phase arrest. Western blot analysis significant p53 activation in time-dependent manner. Gemcitabine-induced cytotoxicity was reduced by 20-30% in the A549-E6 cells and the 30-40% in H358-E6 cells when compared with the A549-neo and H358-neo control cells. Conclusion : Gemcitabine induces an S phase arrest, as expected for the anti-metabolite, and activates the p53 gene, Furthermore, p53 might play an important role in Gemcitabine-induced cell death. Further investigation into the molecular mechanisms on how Gemcitabine activates the p53 gene and its signaling pathway are recommended.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.2
• /
• pp.236-244
• /
• 2001

Background : Most current research using prognostic scoring systems in critically ill patients have focused on prediction using the first intensive care unit (ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. Methods : 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the $1^{st}$ and $7^{th}$ APACHE III scores and the mortality risk. Results : 1 )The mean length of stay in the ICU was $10.3{\pm}13.8$ days. 2)The mean $1^{st}$ and $7^{th}$ day APACHE III scores were $59.7{\pm}30.9$ and $37.9{\pm}27.7$. 3) The mean $1^{st}$ day APACHE III score was significantly lower in survivors than in non- survivors($49.9{\pm}23.8$ vs $86.3{\pm}32.3$, P<0.0001). 4)The mean $7^{th}$ day APACHE III score was significantly lower in survivors than in non- survivors($30.1{\pm}18.5$ vs $80.1{\pm}30.4$, P<0.0001). 5)The odds ratios among the $1^{st}$ and $7^{th}$ day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. Conclusion : These results suggest that the seventh day APACHE III score is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the $1^{st}$ and $7^{th}$ day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the $7^{th}$ day APACHE III score is useful for predicting the clinical outcome.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.1
• /
• pp.80-90
• /
• 2003

Background : Goblet cell hyperplasia is a critical pathological feature in hypersecretory diseases of the airways. A bacterial infection of the lung is also known to induce inflammatory responses, which can lead to the overproduction of mucus. Recently, mucin synthesis in the airways has been reported to be regulated by neutrophilic inflammation-induced epidermal growth factor receptor (EGFR) expression and activation. In addition, it was reported that migration of the activated neutrophils is dependent on the matrix metalloproteinases (MMPs), especially MMP-9. In this study, bacterial lipopolysaccharide (LPS)-induced goblet cell hyperplasia and mucus hypersecretion by EGFR cascade, resulting from the MMPs-dependent neutrophilic inflammation were investigated in the rat airways. Methods : Pathogen-free Sprague-Dawley rats were studied in vivo. Various concentrations of LPS were instilled into the trachea in $300{\mu}{\ell}$ PBS (LPS group). Sterile PBS ($300{\mu}{\ell}$) was instilled into the trachea of the control animals (control group). The airways were examined on different days after instilling LPS. For an examination of the relationship between the LPS-induced goblet cell hyperplasia and MMPs, the animals were pretreated 3 days prior to the LPS instillation and daily thereafter with the matrix metalloproteinase inhibitor (MMPI; 20 mg/Kg/day of CMT-3; Collagenex Pharmaceuticals, USA). The neutrophilic infiltration was quantified as a number in five high power fields (HPF). The alcian blue/periodic acid-Schiff (AB/PAS) stain were performed for the mucus glycoconjugates and the immunohistochemical stains were performed for MUC5AC, EGFR and MMP-9. Their expressions were quantified by an image analysis program and were expressed by the percentage of the total bronchial epithelial area. Results : The instillation of LPS induced AB/PAS and MUC5AC staining in the airway epithelium in a time- and dose-dependent manner. Treatment with the MMPI prevented the LPS-induced goblet cell hyperplasia significantly. The instillation of LPS into the trachea induced also EGFR expression in the airway epithelium. The control airway epithelium contained few leukocytes, but the intratracheal instillation of LPS resulted in a neutrophilic recruitment. A pretreatment with MMPI prevented neutrophilic recruitment, EGFR expression, and goblet cell hyperplasia in the LPS-instilled airway epithelium. Conclusion : Matrix metalloproteinase is involved in LPS-induced mucus hypersecretion, resulting from a neutrophilic inflammation and EGFR cascade. These results suggest a potential therapeutic role of MMPI in the treatment of mucus hypersecretion that were associated with a bacterial infection of the airways.

• KDI Journal of Economic Policy
• /
• v.32 no.2
• /
• pp.144-170
• /
• 2010

This paper considers the effect of various types of procurement auction system on competition focusing on the rate of successful bidding. We analyze the number of bidders and the rate of successful bids using online procurement data of the Public Procurement Service. The average number of bidders is 301 and the average rate of successful bids is 87.42% while the weighted average rate is 75.13%. These numbers show that there is quite strong competition among bidders and the rate is lower as the expected price is higher. When we analyze the data of price procurement auction, the rate is also shown to be lower as the expected price is higher. Furthermore, the rate decreases as the number of bidders increases which naturally makes the competition stronger. Meanwhile, the analysis finds that the inclusion of the onsite bidding, the PQ(Pre-Qualification) result, or major-10 winning companies cannot explain the rate much in our data. In case of turnkey-alternative, the average rate of successful bidding for 484 cases record 90.20%. The average is 84.89% with 120 alternatives and 91.97% with 364 cases of turnkey. The reason why the rate of turnkey-alternative is lower than that of price procurement auction is the lack of competition as well as the systematic difference. By setting up a model, we are able to explain the difference in rate caused by the respective reason. When we suppose there are 3 bidders in case of price procurement auction for a project that exceeds 100 billion won, the rate is expected to be around 64%. This implies that difference of 26% is caused by the systemic difference and 3% by the lack of competition. Therefore, we conclude that the difference in rate between turnkey-alternative and price procurement auction is caused mainly by the systemic difference. In case of PPP(Public Private Partnership) projects, among 154 projects in total, only 40% has more than 2 bidders that compete. The average number of bidders is 1.88 which is less than 2, and the average rate of successful bids is 90%. In sum, under the price procurement auction, there is strong competition which is reflected by the rate of successful bids. However, there is room to decrease the rate by strengthening the competition under the turnkey-alternative. Also with PPP projects, we expect the rate can be steadily reduced with revived competition among bidders.

• Clinical and Experimental Reproductive Medicine
• /
• v.37 no.4
• /
• pp.329-338
• /
• 2010

Objective: This study was carried out to know whether cryopreservation of sibling 2PN zygotes could increase the cumulative delivery rates in the patients who had less than 10 fertilized zygotes. Methods: A retrospective analysis was performed in 138 in vitro fertilization-embryo transfer (IVF-ET) cycles with less than 10 fertilized zygotes during January 2003 to December 2007 in Cheil General Hospital. These cycles were divided into two groups. In Group I (n=86), all fertilized embryos were cultured to transfer on day 3 without cryopreserved embryos at the 2PN stage. In Group II (n=52), among fertilized zygotes, some sibling zygotes were frozen at the 2PN stage, the remainder were cultured to transfer. Clinical outcomes in fresh ET cycles and cumulative ongoing pregnancy rates after subsequent frozen-thawed (FT)-ET cycles were compared. Results: There were no significant differences in female mean age, number of retrieved oocytes and total fertilized embryos between two groups, Number of cultured embryos was significantly lower in Group II ($5.2{\pm}0.5$) than in Group I ($8.4{\pm}0.7$) (p<0.01). Also, number of transferred embryos was significantly lower in Group II ($3.3{\pm}0.6$) compared with Group I ($3.6{\pm}0.6$) (p<0.01). ${\beta}$-hCG positive rates and delivery rates (51.2 vs. 46.2 % and 41.9 vs. 34.6 %, respectively) after fresh ET were slightly higher in Group I than in Group II. However, the differences were not statistically significant. Also, the cumulative delivery rates after subsequent FT-ET cycles were not significantly different between Group I (48.8%) and Group II (50.0%). Conclusion: This study showed that cryopreservation of sibling 2PN zygotes from patients who had less than 10 zygotes in the fresh ET cycles did not increase cumulative delivery outcomes. But, it could provide an alternative choice for patients due to offering more chance for embryo transfers if pregnancy was failed in fresh IVF-ET cycles.

• Journal of dental hygiene science
• /
• v.13 no.4
• /
• pp.386-392
• /
• 2013

The purpose of this study was to evaluate the factors related to xerostomia in patients with systemic diseases, and the results were analyzed through t-test, ANOVA, and multiple linear regression analysis. There were 62 respondents (56.9%) who reported dry mouth and the season of the most severe dry mouth was reported to be the highest during winter. According to the analysis made in the relationship of xerostomia with the awareness of general health and health behavior, the group that understood their own health poorly, had more than two kinds of diseases, and had been administered more than two kinds of daily medication showed higher xerostomia. Also, those who experienced desperation, had high dryness in other parts of the body, and heavy snoring were more aware of xerostomia (p<0.05). According to the analysis made in the relationship between xerostomia and awareness of oral health state, the group that understood their oral health poorly and had pain in the oral mucous membrane and halitosis was more aware of xerostomia (p<0.05). According to the analysis made in the relationship between quality of life and xerostomia, the group that showed high level of problem in daily living and stress and were self-conscious and felt tense due to halitosis reported more xerostomia (p<0.05). Finally, xerostomia was most correlated with consciousness of the eyes of others due to halitosis followed by the number of transferred systemic diseases and stress level. Based on such results, xerostomia was understood to be an obstacle in maintaining favorable social life and health. Since xerostomia was shown to be related to the number of transferred systemic diseases, the dental professions are asked to further improve their understanding not only on oral health but also systemic diseases. Therefore, these efforts are expected to prevent xerostomia and reduce various complications caused by xerostomia.

• Journal of dental hygiene science
• /
• v.18 no.2
• /
• pp.97-104
• /
• 2018

The purpose of this study was to classify risk groups according to Caries Risk Assessment (CRA) and to investigate the effect of caries prevention program after 1 year of caries prevention intervention program in 6-year-old infants with high caries risk. The subjects were selected based on responses to CRA questionnaires. At the first visit, oral examination, Cariview, bacteria and saliva flow test were performed. The caries risk group was classified accordingly. The subjects were given fluoride application and oral health education every four months and evaluated the same as the first visit after 1 year. As a result of classifying the risk level according to CRA, more than 80% of the subjects were in the high or extreme high risk. The dft index was increased in all risk groups after the intervention. There was a significant difference between the before and after intervention (p<0.05). The Cariview score showed a slight decrease after the intervention in the moderate and high risk groups. As a result of the evaluation of bacteria test, Streptococcus mutans were decreased to ${\geq}10^5CFU/ml$ saliva after intervention in all groups. Lactobacilli were decreased after intervention in high risk and extreme high risk groups. As a result of saliva flow, there was significant difference between caries risk groups before and after intervention (p<0.05). In conclusion, regular caries management has been shown to influence caries risk factors in high-caries risk children. Also, it is necessary to find out periodical dental risk management system which is suitable for domestic situation through the related studies.

• Journal of dental hygiene science
• /
• v.1 no.1
• /
• pp.28-38
• /
• 2001

The aim of this study was to analyze the dental caries of chilren's deciduous teeth in relation to their mothers' socioeconomic factors and their oral health beliefs to increase the effect on children's oral health. One hundred seventy four children and their mothers were selected for the study. The children were 5 and 6 years old in children house in Kun-san, Korea. Research was conducted by oral examination, their mothers' socioeconomic factors and dental health belief model. The finding of analysis can be summaried as follows; In regard to the caries in deciduous teeth status, the five-year-old boy children's dft index was 3.39 and that of the girls of the same age was 2.76. The dft index of the boys of six was 3.86 and that of the girls of the same age was 3.27. The five-year-old boy children had the highest df rate(81.8%), and their dt rate was more than their ft rate. But for the six-year-old girl children, ft rate was higher than dt rate. For the five years old, the boy children's ft rate was significantly higher than that of the girls(p<0.05). Concerning the caries in deciduous teeth states by socioeconomic factors, their oral health status was significantly different according to mother employment and householder age. The df rate of the preschoolers with working mothers(84.7%) was significantly higher than that of those with nonworking mothers(66.7%)(p<0.05). The dft index of the group whose households were over forty was highest with 4.07, followed by the children of the households aged 35 to 39 with 3.83, those of the households aged 25 to 29 with 3.33, and those of the households aged 30 to 34 with 2.15. The difference between the groups was significant(p<0.05). As to the difference of maternal dental health beliefs by maternal socioeconomic factors, households educational background and whether to live with parents or parents-in-law under the same roof made a significant difference to maternal oral health beliefs. The mothers whose households were college graduates or better-educated were stronger in oral health susceptibility and seriousness(p<0.01, p<0.05). The salience was recognized more by those who lived with parents or parents-in-law than by the others who didn't(p<0.05). The dft index of the preschoolers was related to maternal dental health beliefs. That was lower when their mothers perceived dental health benefit better.

• Korean Journal of Poultry Science
• /
• v.43 no.4
• /
• pp.253-261
• /
• 2016

Egg quality is a very important factor for both consumers and producers. Factors affecting egg quality include strain and age of hens; egg storage temperature, time, and humidity; laying season; and feeding. This study aimed to determine the effect of hen age and egg storage time on egg quality. A total of 700 eggs obtained from Hyline Brown commercial layers were used for this experiment, and they were separated into two hen age groups (30 vs. 60 weeks) with eight treatments and four storage times (day 0, 10, 20, and 30). The egg weight; shell color, thickness, and density; albumen height; Haugh unit (HU); yolk color; and the yolk and albumen pH and viscosity were measured for the egg quality assessment. The results showed that the age of the hen and egg storage time significantly affected almost all parameters of the internal and external egg quality. The shell thickness, albumen height, HU, yolk color, pH of yolk and albumen, and yolk viscosity significantly decreased with increasing hen age. The egg shell color was significantly lighter in eggs from 60-week-old hens than in those from 30 weeks-old hens. The egg weight; shell weight, thickness, and density; albumen height, HU; and albumen viscosity significantly decreased, but the yolk color and pH of the yolk and albumen increased with increasing egg storage time. The interaction effects between the storage time and hen age were significant in shell thickness, albumen height, yolk color, and yolk and albumen pH and viscosity. The eggs obtained from 60-week-old hens showed significantly lower shell thickness, albumen height, and HU values, which are considered typical egg quality measurements, than values of eggs from 30-week-old hens. Therefore, increasing hen age and egg storage time caused the deterioration of egg quality. In conclusion, this study demonstrated that hen age is the major factor affecting the quality of fresh eggs, whereas the storage time is the determinant factor affecting the quality of stored eggs.