• Journal of Nutrition and Health
• /
• v.43 no.3
• /
• pp.224-232
• /
• 2010

The prevalence of heart failure (HF) is increasing globally and growing evidence has shown that dietary factors play an important role in preventing and improving prognosis of HF. However, little data on nutrient intake in Korean HF patients which are available to develop dietary guidelines for HF. The aims of this study were to estimate nutrient intake in 78 HF patients and evaluate whether the estimated nutrient intake is appropriate compared to dietary reference intake for Koreans. Data are presented as the ratio of actual intake and estimated average requirement (EAR) for each nutrient. The result showed that the average nutrient intakes including total energy and protein met EAR in total patients. However, the deficiencies in mineral and vitamin intakes were found. Moreover, the proportion of subjects with lower intake than EAR was substantial. The results showed that the proportion of male HF patients with inferior intakes to EAR in calcium, potassium (compared to adequate intake: AI), folate and vitamin $B_{12}$ were 38%, 79%, 38%, and 65%, respectively. Also, the proportion of female HF patients with inferior intakes to EAR in calcium, potassium (compared to AI), folate and vitamin $B_{12}$ were 35%, 88%, 38% and 40%, respectively. In particular, the elderly with HF ($\geq$ 70 yrs, n = 28) showed more serious deficiencies in calcium, potassium (compared to AI), folate and vitamin $B_{12}$. In summary, the intakes of potassium, calcium, folate, and vitamin B12 were not sufficient to meet EAR in HF patients. Furthermore, the proportions of subjects with lower intake than EAR in these nutrients were substantial, raising the possibility that these micronutrients may be involved in the pathogenesis of HF. Practical dietary guideline for HF patients is needed to improve prognosis of HF.

• Childhood Kidney Diseases
• /
• v.11 no.2
• /
• pp.247-254
• /
• 2007

Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)

• Journal of the Korean Society of Radiology
• /
• v.11 no.1
• /
• pp.9-17
• /
• 2017

A high degree of precision and accuracy in Gamma Knife Radiosurgery(GKRS) is a fundamental requirement for therapeutical success. Elaborate radiation delivery and dose gradients with the steep fall-off of radiation are clinically applied thus necessitating a dedicated Quality Assurance(QA) program in order to guarantee dosimetric and geometric accuracy and reduce all the risk factors that can occur in GKRS. In this study, as a part of QA we verified the accuracy of single-shot dose profiles used in the algorithm of Gamma Knife Perfexion(PFX) treatment planning system employing Variable Ellipsoid Modeling Technique(VEMT). We evaluated the dose distributions of single-shots in a spherical ABC phantom with diameter 160 mm on Gamma Knife PFX. The single-shots were directed to the center of ABC phantom. Collimating configurations of 4, 8, and 16 mm sizes along x, y, and z axes were studied. Gamma Knife PFX treatment planning system being used in GKRS is called Leksell GammaPlan(LGP) ver 10.1.1. From the verification like this, the accuracy of GKRS will be doubled. Then the clinical application must be finally performed based on precision and accuracy of GKRS. Specifically the width at the 50% isodose level, that is, Full-Width-of-Half-Maximum(FWHM) was verified under such conditions that a patient's head is simulated as a sphere with diameter 160mm. All the data about dose profiles along x, y, and z axes predicted through VEMT were excellently consistent with dose profiles from LGP within specifications(${\leq}1mm$ at 50% isodose level) except for a little difference of FWHM and PENUMBRA(isodose level: 20%~80%) along z axis for 4 mm and 8mm collimating configurations. The maximum discrepancy of FWHM was less than 2.3% at all collimating configurations. The maximum discrepancy of PENUMBRA was given for the 8 mm collimator along z axis. The difference of FWHM and PENUMBRA in the dose distributions obtained with VEMT and LGP is too small to give the clinical significance in GKRS. The results of this study are considered as a reference for medical physicists involved in GKRS in the whole world. Therefore we can work to confirm the validity of dose distributions for all collimating configurations determined through the regular preventative maintenance program using the independent verification method VEMT for the results of LGP and clinically assure the perfect treatment for patients of GKRS. Thus the use of VEMT is expected that it will be a part of QA that can verify and operate the system safely.

• Journal of radiological science and technology
• /
• v.34 no.1
• /
• pp.17-25
• /
• 2011

In this study, we examined the impact caused by chronic exposure to Mn by investigating the degree of brain activation based on the data of recognition activities using fMRI (functional magnetic resonance imaging). A questionnaire survey, blood tests, and fMRI tests were carried out with respect to two groups. Group 1 was an exposure group consisting of 15 male workers who are 34 years old or older, and who worked for longer than 10 years in a shipbuilding factory as a welder. Group 2 was a control group consisting of 15 workers in manufacturing industries with the same gender and age. The results showed that blood Mn concentration of Group 1($1.3\;{\mu}g/dl$) was significantly higher than that of Group 2($0.8\;{\mu}g/dl$)(p < 0.001), and Pallidal Index (PI) of Group 1 was also significantly higher than that of Group 2 (p < 0.001). PI value of the group whose blood Mn concentration was $0.93\;{\mu}g/dl$ or higher was significantly higher than that of the group whose blood Mn concentration was less than $0.93 \;{\mu}g/dl$ (p < 0.001). As for brain activity area within the control group, the right and the left areas of occipital cortex showed significant activity and the left area of middle temporal cortex, the right area of superior inferior frontal cortex and inferior parietal cortex showed significant activity. Unlike the control group, the exposure group showed significant activity on the right area of superior inferior temporal cortex, the left of insula area. In the comparison of brain activity areas between the two groups, the exposure group showed significantly higher activation than the control group in such areas as the right inferior temporal cortex, the left area of superior parietal cortex and occipital cortex, and cerebellum including middle temporal cortex. However, in nowhere the control group showed more activated area than the exposure group. As the final outcome, chronic exposure to Mn increased brain activity during implementation of arithmetic task. In an identical task, activation increased in superior inferior temporal cortex, and insula area. And it was discovered that brain activity increase in temporal area and occipital area was more pronounced in the exposure group than in the control group. This result suggests that chronic exposure to Mn in the work environment affects brain activation neuro-network.

• Journal of Chest Surgery
• /
• v.37 no.1
• /
• pp.56-63
• /
• 2004

Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

• Journal of Embryo Transfer
• /
• v.16 no.2
• /
• pp.117-125
• /
• 2001

Vitrification of oocytes has been applied recently fur pigs, but remains elusive. The purpose of this study is to investigate the effects of vitrification in open pulled straws (OPS) on in vitro survival of porcine oocytes. When immature follicular oocytes frozen-thawed were cultured for in vitro maturation, maturation rates to metaphase-II stage were higher in oocytes with (25%) than without (15%) cumulus cells. After In vitro fertilization of oocytes frozen-thawed, the maturation rates were also significantly (P<0.05) higher in oocytes with (41%) that than without (17%) cumulus cells. However, the penetration rates were higher in oocytes without (19%) that than with (9%) cumulus. In another experiment, porcine oocytes matured in vitro were frozen and thawed for in vitro fertilization. The penetration rates were higher than in oocytes without (35%) that than with (26%) cumulus cells. However, the proportions of oocytes dead after in vitro fertilization were significantly (P<0.05) higher in oocytes with that than without cumulus cells. On the other hand, the rates of penetration and dead oocytes at 6 h after in vitro fertilization were not significant differences between oocytes with and without cumulus cells. However, the proportions of dead oocytes with (18%) and without (16%) cumulus cells were higher than in oocytes of control group (0%). These finding indicated the possible broader application for OPS, as they demonstrated that the maturation and fertilization in vitro by frozen-thawed oocytes may be accompained by cumulus cells and culture periods according to the requirements of the survival ability after freezing of mature and immature oocytes in pigs.

• Childhood Kidney Diseases
• /
• v.14 no.2
• /
• pp.203-209
• /
• 2010

Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

• Journal of Trauma and Injury
• /
• v.23 no.2
• /
• pp.68-74
• /
• 2010

Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

• Radiation Oncology Journal
• /
• v.26 no.2
• /
• pp.96-103
• /
• 2008

Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

• Science of Emotion and Sensibility
• /
• v.8 no.1
• /
• pp.17-28
• /
• 2005

With the advent of computer technology, the fundamental nature of products has shaped from physical forms towards product interactivity, The focus is now on usability of the product with ease and efficiency rather than conversing with just the looks of the product. However, most definitions of usability and contemporary usability-related researches, have focused on the performance-oriented functional aspects of usability (i.e., how well users perform tasks using a product). Today, user expectations are higher; products that bring not only functional benefits but also emotional satisfaction. So far, there have been many studies on human emotions and the emotional side of products in the field of emotional engineering. Contemporary emotion-related researches have focused mainly on the relationship between product aesthetics and the emotional responses elicited by the products, but little is known about emotions elicited from using the products. The main objective of our research is analyzing user's emotional changes while using a product, to reveal the influence of usability on human emotions. In this research, we suggested conceptual framework for the study on the relationship between usability of products, and human emotions with emphasis on mobile phones. We also extracted emotional words for measuring user's emotions expressed not from looking at the product's appearance, but from using the product. First, we assembled a set of emotions that is sufficiently extensive to represent a general overview of the full repertoire of Korean emotions from the literature study. Secondly, we found emotional words in the after note by the users on the websites. Finally, verbal protocols in which the user says out loud what he/she ks feeling while he/she ks carrying out a task were collected. And then, the appropriateness of extracted emotional words was verified by the members of the consumer panel of a company through web survey. It is expected that emotional words extracted in this research will be used to measure user's emotional changes while using a product. Based on the conceptual framework suggested in this research, basic guidelines on interface design methods that reflect user's emotions will be illustrated.