• Title/Summary/Keyword: 위험도 지수

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A Case of Child with Obstructive Sleep Apnea Syndrome Recurred after Adenotonsillectomy (편도 및 아데노이드 절제술 후 재발한 폐쇄성 수면 무호흡 증후군 소아 1례)

  • Kim, Cu-Rie;Kim, Dong-Soon;Seo, Hyun-Joo;Shin, Hong-Beom;Kim, Eui-Joong;Shim, Hyun-Joon;Ahn, Young-Min
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.94-99
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    • 2008
  • The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

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Effects of Ethylacetate Fraction of Plantago asiatica L. on Hypercholesterolemia Induced by High Cholesterol Diet in Rats (질경이(Plantago asiatica L.) 에틸아세테이트분획이 흰쥐의 고콜레스테롤혈증에 미치는 효과)

  • Lee Jae-Joon;Lee Jeong-Hwa;Jeong Chang-Ju;Choi Hyun-Sook;Lee Myung-Yul
    • Food Science and Preservation
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    • v.12 no.6
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    • pp.624-630
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    • 2005
  • Plantain was extracted with ethanol and fractionated systemically with n-hexane, chloroform, ethylacetate, n-butanol and water to study inhibitory effect on cholesterol synthesis in vitro. To screen the effect, inhibitory activities on 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase obtained from Saccharomyces cerevisiae were examined using the five fractions of Plantain. The HMG-CoA reductase activity was inhibited most by ehylacetate fraction among the fractions, although the all five fractions had the effect To see the hypocholesterolemic effect of the ethylacetate fraction of Plantanin (PAE) in vivo, male Sprague-Dawley rats were received 5 types of diets for 6 weeks: normal diet group (NOR), high cholesterol diet group($1\%$ cholesterol and $0.25\%$ sodium cholate, CON), normal diet and PAE 70 mg/kg administered group(S1), high cholesterol diet and PAE 140 mg/kg administrated group(S2), and high cholesterol diet and PAE 140 mg/kg administered group(S3). Body weight gains of the CON were significantly increased compared to those of S1, S2 and S3. Activities of serum AST and ALT were tended to be increased in CON compared with NOR and reduced by the PAE administration. Concentrations of serum total cholesterol, free cholesterol, LDL-cholesterol, triglyceride and the atherogenic index were tended to be decreased in the PAE administered groups compared with the CON. HDL-cholesterol and phospholipid concentrations were significantly decreased in the CON and markedly increased by the PAE administered groups. Taten together, it is suggested that the ethylacetate fraction of Plantanin exerts antiatherosclerotic effect by reducing serum cholesterol concentrations in rats fed high cholesterol diets.

Results of Postoperative Irradiation in Patients with Carcinoma of Uterine Cervix Stage IB and IIA (자궁경부암 IB와 IIA 환자의 수술후 방사선치료 결과)

  • Ahn Sung Ja;Nam Taek Keun;Chung Woong Ki;Nah Byung Sik;Choi Ho Sun;Byun Ji Soo
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.41-48
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    • 1995
  • Purpose : The adjuvant postoperative radiotherapy has been usually applied to the patients with unfavorable prognostic factors after radical operation in early cervical cancer. We focused on the evaluation of the survival status and failure patterns of the patients with postoperative radiotherapy. Materials and Methods : We retrospectively analyzed ninety patients with FIGO stage IB and IIA cervix cancer who received postoperative pelvic irradiation at Chonnam University Hospital between August 1985 and December 1988, Seventy-eight patients had adequate follow-up information for survival analysis. Median follow-up time of these patients was 64 months. Results : The 5 year overall and disease free survival rate of ninety patients was $80.0\%$ and $80.2\%$, respectively. The prognostic significance to the survival was determined by multivariate analysis. Adequacy of resection margin(p=0.005) and lymph node status(p=0.005) appeared to be independent prognostic factors. Recurrence occurred in 13 patients, 5 in the pelvis and 8 at distant sites. The median time to recurrence was 19 months(range:3-39 months). The pelvic recurrence was more prevalent in the group of patients with adenocarcinoma, depth of stromal invasion more than 10mm and use of chemotherapy. The distant failure was more prevalent in the group of positive resection margin or positive lymph node with statistical significance. Conclusion : Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group in this analysis and should be considered as candidates for some form of adjuvant therapy.

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A Study of Serum Lipid Levels, Blood Sugar, Blood Pressure of Vegetarian Buddhist Nuns and Non-Vegetarian Female Adults (II) - Based on Favored Salty Taste - (채식을 하는 여승과 비채식 성인여성의 혈중 지질수준, 혈당, 혈압에 관한 연구(II) -짠맛에 대한 기호를 중심으로-)

  • 차복경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.871-876
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    • 2002
  • This study was conducted to verify the relation between relation between vegetarian diet and the serum lipid levels, blood sugar and blood pressure from October 1996 to February 1997. The vegetarians subjects were 245 Buddhist nuns (age:23~79 yrs) and control subjects consisted of 235 healthy female adults (age: 23~70 yrs) selected from the teachers, the nurses and the housekeepers living in Chinju Gyeongsang Nam-do. The contents included anthropometric measurement, questionnaires about eating behavior score and preference for taste and biochemical characteristics of the blood. The results were summarized as follows. The average duration of vegetarian diet of the vegetarians was 13.1 years. Vegetarians prefer to a pepper, a sweet and a acidic in the right order but that non-vegetarians prefer to a sweet, a acidic and pepper in the right order. Both groups of less than a decade and more than two decade of vegetarian diet prefer to a pepper, sweet, a acidic, a bitter, a salty and a lily, and a 10~20 yr group with vegetarian diet was fond of a pepper, a bitter, a acidic, a sweet, and a oily, in the right order. This seems to be ascribable to a difference in the health knowledge and interest. Vegetarians and non-vegetarians who said that they were fond of salty were 38.8% and 52.8%, medium was 33.9% and 33.6%, and not salty was 27.3% and 13.6%. Eating behavior score of vegetarians and non-vegetarians were 25.1 and 23.1 respectively. Eating behavior scores of vegetarians were significantly higher than those of non-vegetarians (p<0.05). Eating behavior scores of the group with more than a decade of vegetarian diet were significantly higher than those of the group with less than a decade of vegetarian diet. Levels of serum total-cholesterol, LDL-cholesterol, and AI of the salty group were significantly higher (p<0.05) than those of not salty group. Levels of serum triglyceride, HDL-cholesterol, blood sugar had no significant relation with preference of salty. Blood pressure was not related with preference of salty, but that of those who prefer a salty tended to be high. This study also reveals that the preference of a salty was significant influence on serum total-cholesterol, LDL-cholesterol, and AI, but the vegetarians did not prefer salty and have a good eating behavior. Consequently, vegetarian diet can be considerably effective in reducing the level of the risk factors of cardiovascular disease.

Status of Health and Safety Management in Occupational Hygiene Laboratories in Korea

  • Yang, Hyukseung;Choi, Jaewook;Yoon, Seokjoon;FARR, Terry
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.17 no.1
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    • pp.53-62
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    • 2007
  • 목적: 1990년대 초반부터 시작된 우리나라의 산업 보건에 대한 사회적 관심의 증대와 시장의 요구에 따라 산업위생기관의 양적인 팽창이 이루어지긴 하였으나 실험실 관련 안전보건규정이 미비한 상태에서 추진되어 산업위생 실험실에서 다양한 유해 위험성 인자를 취급함에도 불구하고 사용되는 량이 소규모로 인해 안전보건과 관련된 사항은 대부분 간과하고 있으며, 산업위생 실험실의 안전보건관리 실태는 선진외국에 비해 상당히 낙후되어 있는 실정이다. 따라서 본 연구는 우리나라 산업위생 실험실과 관련한 안전보건관리 실태를 평가함으로써 향후 실험실의 안전보건관리 수준을 향상 시키는데 효과적인 자료로 활용하는데 기여하고자 한다. 방법: 산업위생실험실의 안전보건 실태를 파악하기 위해 설문조사를 수행하였으며, 설문은 실험실의 전반적인 안전보건, 화학물질 저장 및 용기, 가연성 및 인화성 화학물질, 가스 실린더, 의사전달, 응급처치 및 비상사태 장비, 정리정돈, 소방안전, 전기안전, 개인보호구, 흄후드 및 환기, 및 이황화탄소 취급 사례로서 12개 영역으로 구성되었다. 연구대상은 2001년 한국산업안전공단 정도관리프로그램에 참여한 기관으로서 총 대상은 119개 기관이었다. 연구기간은 2002년 7월 01일부터 8월 30일까지 약 60일 이었다. 설문은 반송봉투에 넣어 설문완성 후 연구자에게 보낼 수 있도록 배려하였으며, 1차 설문을 보낸 후 2주 후에 설문 참여를 독려하기 위해 엽서를 발송하였고, 다시 2주 후에 각 산업위생기관에 개별 전화 연락을 취하였다. 그 결과 63% (75개 기관)의 완성된 설문을 얻을 수 있었다. 설문의 총 조사항목은 79문항으로 구성되어 있으며, 산업위생실험실의 안전보건 수준을 정량적으로 평가하기 위해 안전보건 매뉴얼, 교육훈련프로그램 및 한국산업안전공단 실험실 지침서를 보유한 기관과 그렇지 않은 기관간의 차이는 선별된 67문항에 대해 각 문항에 합당하거나 적절할 경우 1점을 부여하는 방식으로 점수화하였다. 이들의 관련성을 파악하기 위하여 Microsoft-Excel 2000 프로그램을 이용하여 two-tailed t-test 분석을 실시하였다. 결과 1. 산업위생실험실 운영과 관련한 67개 항목(항목별로 각 1점 부여)에 대한 안전보건 성과지수화 (100점으로 점수 환산) 결과 안전보건 매뉴얼을 보유한 기관은 $42.98{\pm}13.36$(p<0.001)점, 교육훈련프로그램을 보유한 기관은 $50.75{\pm}14.12$(p<0.01)점, 한국산업안전공단 실험실 지침서를 보유한 기관은 $43.58{\pm}11.92$(p<0.01)점으로 그렇지 않은 기관에 비해 통계적으로 유의하게 높은 점수분포를 보였다. 2. 화학물질 보관 캐비닛이 있는 기관 중 64.8%의 기관은 화학물질을 알파벳 순으로, 27.8%는 분류 기준에 따라, 그리고 7.4%는 무작위로 보관하고 있었다. 3. 단지 8.0% (6개)의 기관만이 실험실내에 눈세정 분수(2 개), 샤워기(3개) 및 눈세정물병(3개, 2개 중복 응답 기관)과 같은 응급처치 장치 및 물품을 갖추고 있었다. 4. 89.0%의 기관이 흄후드내에 화학물질을 보관하고 있었다. 5. 물질안전보건자료, 흄후드 기록지, 비상사태 절차서 및 한국산업안전공단 실험실 지침서와 같은 문서관리는 부적절하게 관리 및 기록되고 있었다. 6. 대부분의 산업위생 실험실은 응급처치 장비, 화학물질 또는 가스용기 보관실과 같은 실험실 안전설비가 부족할 뿐만 아니라 정리정돈, 화학물질 저장 캐비닛, 안전보호구 및 흄후드와 같은 관리가 미비하였다. 결론: 이상의 결과에 근거하여 기관장은 실험실의 안전보건관리를 위하여 문서관리체계를 제공하고, 모든 실험실 종사자가 적절한 개인보호구를 착용할 수 있도록 하며, 비상 장비를 설치하고, 실험실과 관련한 적절한 규정을 제정하며, 교육훈련 프로그램을 제공하여야 한다. 또한 실험실 종사자는 실험 중 적절한 개인보호구의 착용하고, 비상장비 이용에 대한 교육훈련에 참여하며, 적절한 실험실 운영관리에 대한 책임감을 가져야 한다. 위의 권고사항 이행을 위해서 KOSHA는 KQCP 프로그램에 실험실 안전보건관리 항목을 삽입하여 주기적인 평가를 수행할 필요가 있다. 우리나라 실험실의 특성을 고려할 때 본 연구결과는 일반 실험실에도 적용될 수 있을 것으로 생각된다.

Simple and Effective Surgical Repair with Vascular Graft Strip for Ischemic MR (인조혈관대를 이용한 허혈성 승모판막 폐쇄부전의 수술적 치료)

  • 민호기;이승훈;이주현;성기익;박계현;전태국;박표원;이영탁
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.646-650
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    • 2003
  • Many surgical techniques for ischemic mitral regurgitation (IMR) have been used with their excellent results and advantages. Here, we report our simple posterior annuloplasty techniques using vascular graft strip with their early results. Material and Method: Twenty two patients (13 male) underwent the operations for IMR (excluding the papillary muscle rupture) from December 2001 to January 2003. Preoperative risk factors were low ejection fraction (<35%, n=9), hypertension (n=13), diabetes (n=9), and renal failure (Cr>2.5, n=4). The wide dissection beneath the both vena cavae and interatrial groove after bicaval cannulation enabled the easy exposure of mitral valve even in the small left atrium. After eight or nine interrupted sutures in posterior annulus for anchoring the 6 mm width vascular graft strip, symmetric (n=8) or asymmetric (n=14) annuloplasty were done. Combined surgeries were CABG (n=21), Dor procedures (n=3), tricuspid valve annuloplasty (n=1), Maze operation (n=1), and aorto-right subclavian artery bypass (n=1). Result: Except for one surgical mortality, all the patients were doing well and the mean grade of regurgitation was decreased from 2.95 to 0.88, however the ejection fraction had not changed significantly just before discharge. Post-operative valve function evaluated before discharge revealed no residual regurgitation in 8 (including 1 patient with mild stenosis due to over reduction), minimal in 11, mild in 2, and mild to moderate regurgitation in 1. One patient who had ischemic cardiomyopathy and renal failure died of the arrhythmia during the hemodialysis. Conclusion: These observations suggest that the annuloplasty with vascular graft strip could be a safe and cost effective techniques for ischemic mitral regurgitation. However, the long term evaluation for the mitral valve function should be defined for the final conclusion.

Brain F-18 FDG PET for localization of epileptogenic zones in frontal lobe epilepsy: visual assessment and statistical parametric mapping analysis (전두엽 간질에서 F-18-FDG PET의 간질병소 국소화 성능: 육안 판독과 SPM에 의한 분석)

  • Kim, Yu-Kyeong;Lee, Dong-Soo;Lee, Sang-Kun;Chung, Chun-Kee;Yeo, Jeong-Seok;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.131-141
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    • 2001
  • Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

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Cumulative Risk Assessment of Organophosphorus Pesticides in the Diet (식품을 통한 유기인계농약류의 동시노출위해성평가)

  • 이효민;한지연;윤은경;김효미;황인균;최동미;이강봉;원경풍;송인상
    • Journal of Food Hygiene and Safety
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    • v.16 no.1
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    • pp.21-26
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    • 2001
  • Risk assessment traditionally are conducted on individual chemicals; however, humans are exposed to multiple chemicals in daily life. The organophosphorus (OP) pesticides are considered in a single risk assessment because they act by a common mechanism of toxicity, and there is likely to be expose to multiple OP pesticides simultaneously or sequentially. The OP pesticides act by inhibiting the enzyme acetylcholinesterasc (AChE) and have available extensive database. AChE is widely distributed throughout the body, most importantly in the nervous system. Inhibition of AChE results in accumulation of acetylcholine in the nervous system that results in clinical signs of cholinergic toxicity, including increased salivation and lacrimation, nausea and vomiting, muscle fasciculation, lethargy and fatigue, among others. To conduct an exposure assessment for pesticides in the diet, we need to know the food consumption patterns of the populations, and the pesticide residue levels in the foods that are consumed. This study was conducted to identify cumulative dietary risk due to multiple OP pesticides that can be exposed through various foods. Total 22 food samples including cereals, vegetables and fruits were collected randomly two times from food markets in several sites (4 cities). The subjected foods were selected by regarding of highly consumed foods to general Korean people. The 12 OP pesticides including Acephate, Azinphos-methyl, Chlorpyrifos, and Diazinon were monitored. For the exposure assessment, general adult group of 60 kg body weight was regarded as target population and food consumption data suggested by Lee et al. (2000) were used as consumed value of individual food. Analyses of samples for OP pesticides have been carried out according to the multiclass multiresidue analysis method and acephate and methamidophos analysis method of Korea Food Code. In general the levels of OP pesticides found in the food samples were very low or not detected.

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Serum Adiponectin Levels and Insulin Resistance in Obese Children (비만 소아의 혈중 아디포넥틴과 인슐린저항성에 관한 연구)

  • Lee, Hee-Sun;Lee, Jin;Kang, Min-Joo;Choi, Byung-Min;Lee, Kee-Hyoung
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.481-487
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    • 2005
  • Purpose : Adiponectin, adipose tissue-specific protein, has anti-inflammatory and anti-atherogenic properties. It has been found to have a negative correlation with obesity and to play a role in modulating glucose tolerance and insulin sensitivity. Serum adiponectin concentrations are decreased in adults with obesity and type 2 diabetes. We investigated the difference in adiponectin levels between obese and non-obese children, and evaluated the relationship of serum adiponectin with body mass index(BMI), serum fasting insulin, lipid profiles and homeostasis model assessment(HOMA) in children. Methods : We measured serum adiponectin levels by radioimmunoassay in 113 children(82 obese children and 31 non-obese controls) from 8 to 15 years of age, and also checked BMI, fasting serum glucose, insulin and lipid profiles. Fasting and postprandial serum adiponectin concentrations were compared by oral glucose tolerance tests in 27 obese children. The correlations of adiponectin with BMI, insulin, low density lipoprotein(LDL)-cholesterol and HOMA were analyzed by Pearson's correlation. Results : The serum adiponectin levels were significantly lower in the obese group(19.7 mg/mL) than in the non-obese group(27.5 mg/mL)(P<0.01). Serum adiponectin concentrations were negatively correlated with BMI(r=-0.39, P<0.01), serum insulin(r=-0.28, P<0.01), LDL-C(r=-0.20, P<0.01) and HOMA(r=-0.22, P<0.01). At oral glucose tolerance tests in obese children, postprandial 2 hours adiponectin level(19.8 mg/mL) was decreased compared to fasting level(25.8 mg/mL)(P<0.01). Conclusion : Serum adiponectin concentrations were inversely related to adiposity and insulin resistance in children. We suggest the serum adiponectin level could be used as an early marker of insulin resistance in obese children.

Risk Factors of Childhood Obesity II (소아 비만의 위험요소에 관한 연구 II)

  • Lim, Weon-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.213-225
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    • 1999
  • Objectives : The purpose of this study was to investigate how the play habits, temperament, and environmental factors might affect childhood obesity. Methods : Two hundred sixty children, aged 4 through 6 years living in Seoul & Cheonan were surveyed by a questionnaire about the children's play habit and the parent's related factors such as weight, height, education, income. In addition the Korean version of the Parent Temperament Questionnaire for Children and the Korean version of the Family Environment Scale were also administered to parents of those children. The height and weight of those children were measured and the percentage of body fat was measured by Bioelectrical Impedance Fatness Analyzer. Result : 1) Among 260 children, 25 children were considered to be obese on the basis of both obesity index and percentage of body fat. 2) Parents of obese children showed a significantly higher educational level(p<0.05) and mothers of obese children had significantly more jobs(p<0.05) and showed higher body mass index(p<0.05) than those of nonobese children. 3) By observing play habits of children, obese children spent significantly longer time in watching TV and video(p<0.05), while nonobese children showed a trend to play outside(p<0.1). 4) On the Korean version of the Parent Temperament Questionnaire for Children, obese children showed significantly less activity than nonobese ones(p <0.05). 5) Family of obese children had significantly higher point on subscale of Achievement orientation, Intellectual-cultural orientation and Moral-religious emphasis of the Korean version of the Family Environment Scale(p<0.05). 6) Percentage of body fat of obese children was correlated with children's watching TV time, activity level, scores of Achievement orientation, Intellectual-cultural orientation of the Korean version of the Family Environment Scale and the both parent's education levels(p<0.05). Conclusion : Obese children showed hypoactivity and more watching TV time. And obese children's both parent had higher educational level and their mother had higher Body Mass Index and more jobs. Family of obese children had higher point on items of Achievement orientation, Intellectual-cultural orientation and Moral-religious emphasis. Family environmental factors influence on children's obesity through interaction of genetic and behavioral-psychological factors concomittently.

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