Seo, Young;Sim, Jung Yeon;Shim, Jae Won;Kim, Deok Su;Jung, Hye Lim;Park, Moon Soo
Clinical and Experimental Pediatrics
/
v.48
no.1
/
pp.48-54
/
2005
Purpose : The pathologic mechanisms of central nervous system(CNS) injuries in human meningitis are not yet completely understood. Recent studies indicate that the host inflammatory responses are as important in brain damage as the infecting organisms and toxins. There have been some reports on the relationship of nitric oxide(NO), macrophage inflammatory protein-$1{\alpha}$(MIP-$1{\alpha}$), and lactoferrin in bacterial meningitis, but few reports in aseptic meningitis. Thus, we investigated the concentrations of NO, MIP-$1{\alpha}$ and lactoferrin in cerebrospinal fluid(CSF) and serum of patients with aseptic meningitis and control subjects and evaluated their relationship with other parameters of meningitis. Methods : CSF and blood were obtained from 25 subjects with aseptic meningitis and 15 control subjects. After centrifugation, supernatants were stored at $-70^{\circ}C$ and we assayed the concentrations of NO, MIP-$1{\alpha}$ and lactoferrin with the ELISA method. There were no patients with neurologic sequelae after being recovered from aseptic meningitis. Results : Concentrations of CSF and serum NO, MIP-$1{\alpha}$ were not increased in aseptic meningitis subjects compared to control subjects. Concentration of CSF lactoferrin was significantly elevated in patients with aseptic meningitis and concentration of serum lactoferrin was significantly decreased in patients with aseptic meningitis compared with those in control subjects(P<0.05). CSF lactoferrin level was positively correlated with CSF WBC counts($r_s=0.449$, P=0.007), especially with neutrophil counts($r_s=0.574$, P<0.001) and CSF protein level($r_s=0.508$, P=0.002). Conclusion : Lactoferrin plays an important role in aseptic meningitis and may be released from neutrophils recruited from blood to the CSF through breakdown of blood-brain barrier. NO and MIP-$1{\alpha}$ may not be important factors in the pathogenesis of aseptic meningitis without neurologic sequelae.
Purpose : To identify clinical characteristics of severe respiratory syncytial virus (RSV) in neonatal period and early infancy and provide information in clinical practice. Methods : Twelve neonates and young infants (<6 months) who were infected by respiratory syncytial virus and required mechanical ventilation between March 2005 and July 2007 were enrolled. Diagnosis of RSV infection was made based on the positive results by rapid antigen immunoassay or polymerase chain reaction. Results : There were four premature infants, of whom three were near-term. Birth weight of subject patients was $2.8{\pm}0.6kg$, gestational age was $37{\pm}2weeks$ and the age at the time of admission was $35{\pm}15days$. Nine of them showed apnea and in five patients, apnea itself was an indication for mechanical ventilation. In seven of the apneic patients, apnea was the first manifestation of RSV infection. In three of these seven apneic patients, apnea preceded definite respiratory distress signs or typical stethoscopic findings by 1-3 days. Mean duration of mechanical ventilation was $3{\pm}2days$, and mean duration of stay in intensive care unit was $6{\pm}2days$. Conclusion : RSV is a major cause of severe respiratory tract infection in term or near-term infant younger than 2 months. For apnea could be the first manifestation of the RSV infection, high level of suspicion is required in practice of neonates or young infants who show any upper respiratory infection symptoms during RSV season.
Purpose: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. Methods: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. Results: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. Conclusion: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.
Kim, Hee Jin;Oh, Soo Yeon;Lee, Jin Bum;Park, Yun Sung;Lew, Woo Jin
Tuberculosis and Respiratory Diseases
/
v.65
no.4
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pp.269-276
/
2008
Background: Although the prevalence of tuberculosis infections (PTBI) is one of the basic epidemiologic indices, no survey has been carried out since 1995 because the nation-wide tuberculosis prevalence survey was changed to a surveillance system. Subjects without a BCG scar are examined in a tuberculin survey. However, it is very difficult to select these subjects under high vaccination coverage. It is important to evaluate the impact of BCG vaccinations on the tuberculin response and estimate the PTBI regardless of the BCG vaccination status. Methods: A nation-wide, school-based cross-sectional tuberculin survey was carried out among first graders in elementary school in 2006. A total of 5,148 children in 40 schools were selected by quota sampling. Tuberculin testing with 0.1 ml of two tuberculin units of PPD RT23 was carried out on 4,018 children. The maximum transverse diameter of induration was measured 48 to 72 hours later. The presence of a BCG scar was checked separately. Results: There were no BCG scars in 6.3% of the subjects. The mean induration size of tuberculin testing was $3.7{\pm}4.4mm$, which included 1,882 (46.8%) subjects with an induration size of 0 mm. The PTBI was 10.9% (439 subjects) using a cut-off point of ${\geq}10mm$ (conventional method). The annual risk of tuberculosis infections (ARTI) was 1.9% when the mean age of the subjects was assumed to be 6 years. There was no difference in the PTBI according to the presence or absence of a BCG scar [11.2% vs 7.6% (OR: 1.54, 95% CI: 0.98~2.43)]. Using a mirror image technique with 16 mm as the cut-off point, the PTBI and ARTI had decreased to 2.4% and 0.4% respectively. Conclusion: PTBI and ARTI, as estimated by conventional methods, appear to be high among BCG vaccinated children. A mirror image technique is more suitable for estimating the indices in a country with an intermediate burden of tuberculosis than the conventional method.
Eun, Baik-Lin;Moon, Jin Soo;Eun, So-Hee;Lee, Hea Kyoung;Shin, Son Moon;Seong, In Kyung;Chung, Hee Jung
Clinical and Experimental Pediatrics
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v.53
no.3
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pp.300-306
/
2010
Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.
Kim, Hee Sung;Moon, Jae Hee;Kim, Koon Joo;Seo, Jung Min;Lee, Joung Jin;Choi, Jae Hoon;Kim, Sung Ki;Jang, In-Gi
The Journal of Korean Society for Radiation Therapy
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v.30
no.1_2
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pp.177-183
/
2018
Purpose : Volumetric Modulated Arc Therapy(VMAT) has the advantage of uniformly and precisely irradiating the tumor to the shape of the tumor while reducing the risk of radiation damage to normal tissues. such as brain cancer, head and neck cancer and prostate cancer, It is being used for treatment. The purpose of this study is to evaluate the usefulness of the Jaw-Tracking technique(JTT) in VMAT for brain and head and neck cancer. Materials and Methods : We selected eight patients with brain and head and neck cancer(4 Brain, 4 head and neck) who were treated with the VMAT treatment technique. Contouring information of the patient's tumor and normal organ was fused to the Rando phantom using the deformable registration of Velocity(Varian, USA). A treatment plan was developed using the Varian Eclipse(ver 15.5, Varian, USA) with the same patient actual beam parameters except for the use of jaw-tracking. As the evaluation index, the maximum dose and mean dose of target and OAR were compared and a portal dosimetry was performed for the treatment plan verification. Results : When using JTT, the relative dose of OAR decreased by 5.24 % and the maximum dose by 7.05 %, respectively, compared with the Static-Jaw technique(SJT). In the various OARs, the mean dose and maximum dose reduction ranges ranged from 0.01 to 3.16 Gy and from 0.12 to 6.27 Gy, respectively. In the case of the target, the maximum dose of GTV, CTV, PTV decreased by 0.17 %, 0.43 %, and 0.37 % in JTT, and the mean dose decreased by 0.24 %, 0.47 % and 0.47 %, respectively. Gamma analysis The JTT and SJT passing rates were $98{\pm}1.73%$ and $97{\pm}1.83%$ on the basis of 3 % / 3 mm, respectively. Comparing the doses of all OARs applied to the experiment, it was found that the use of JTT resulted in a significant decrease in dose due to additional jaw shielding besides MLC than SJT. Conclusion : In radiation therapy using VMAT treatment plan, we can apply JTT in the case of adjacent tumor and normal organs such as brain cancer and head and neck cancer, and in radiotherapy required large field and high energy caused increase leakage dose through MLC. It is considered that the target dose of PTV can be increased by lowering the dose of normal tissue surrounding the tumor.
Traditionally, the concept of transfer is that physical records such as paper documents, videos, photos are made a delivery to Archives or Records centers on the basis of transfer guidelines. But, with the automation of records management environment and spreading new records creation and management applications, we can create records and manage them in the cyberspace. In these reasons, the existing transfer system is that we move filed records to Archives or Records centers by paper boxes, needs to be changed. Under the needing conditions of a new transfer paradigm, the fact that the revision of Records Act that include some provisions about electronic records management and transfer, is desirable and proper. Nevertheless, the electronic transfer provisions are too conceptional to apply records management practice, so we have to develop detailed methods and processes. In this context, this paper suggest that a electronic records transfer process model on the basis of international standard and foreign countries' cases. Doing transfer records is one of the records management courses to use valuable records in the future. So, both producer and archive have to transfer records itself and context information to long-term preservation repository according to the transfer guidelines. In the long run, transfer comes to be the conclusion that records are moved to archive by a formal transfer process with taking a proper records protection steps. To accomplish these purposes, I analyzed the 'OAIS Reference Model' and 'Producer-Archive Interface Methodology Abstract Standard-CCSDS Blue Book' which is made by CCSDS(Consultative committee for Space Data Systems). but from both the words of 'Reference Model' and 'Standard', we can understand that these standard are not suitable for applying business practice directly. To solve this problem, I also analyzed foreign countries' transfer cases. Through the analysis of theory and case, I suggest that an Electronic Records Transfer Process Model which is consist of five sub-process that are 'Ingest prepare ${\rightarrow}$ Ingest ${\rightarrow}$ Validation ${\rightarrow}$ Preservation ${\rightarrow}$ Archival storage' and each sub-process also have some transfer elements. Especially, to confirm the new process model's feasibility, after classifying two types - one is from Public Records center to Public Archive, the other is from Civil Records center to Public or Civil Archive - of Korean Transfer, I made the new Transfer Model applied to the two types of transfer cases.
This paper attempts to divide the narrative into three levels and review the approach methodology to understand Princess Bari as a narrative. If the stratification of the narrative, the analysis of each levels, and the integrated approach to them are made, this can contribute to suggesting new directions and ways to understand and study Princess Bari. The story level of Princess Bari, the surface structure, is shaped by the space movement and the chronological sequential structure of the life task that started from the birth of the main character. This story shows how a woman who was denied her existence by her father as soon as she was born finds an ontological transformation and identities through a process. Especially, the journey of finding identity is mainly formed through the events that occur through the relationship with family members. This structure, which can be found in the narrative level, forms a deep structure with the oppositional paradigm of family members' conflict and reconciliation, life and death. The thought structure revealed in this story is the problem of life is the problem of family composition, and the problem of death is also the same. In response to how to look at the unified world of coexistence of life and death, this tradition group of myths makes a relationship with man and God. This story is mainly communicated in the Korean shamanistic ritual(Gut) that sent the dead to the afterlife. Although the shaman is the sender and the participants in the ritual are the receivers, the story is well known a message that does not have new information repeated in certain situations. In gut, the patrons and participants do not simply accept the narrative as a message, but accept themselves as codes for reconstructing their lives and behavior through autocommunication. By accepting the characters and events of as a homeomorphism relationship with their lives, people accept the everyday life as an integrated view of life and death, disjunction and communication, conflict and reconciliation, and the present viewpoint. It can not change the real world, but it changes the attitude of 'I' about life. And it is a change and transformation that can be achieved through personal communication like the transformation of Princess Bari into god in myth. Thus, Princess Bari shows that each meaning and function in the story level, composition level, and communication level is related to each other. In addition, the structure revealed by this narrative on three levels is also effective in revealing the collective consciousness and cultural system of the transmission group.
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