• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.732-739
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• 2007

Purpose : A universal standard of the birth weight for gestational age cannot be made since birth weight distribution varies with races, nations and eras. This report aims to establish the birth weight for gestational age patterns by sex, plurality, and parity, specific for Korean live births. Methods : The national birth certificate data of all live births in Korea from January 2000 to December 2004 were used: for live births with gestational age 24 weeks to 42 weeks (n=2,585,5160), mean birth weight, standard deviation and 10th, 25th, 75th and 90th percentile values were obtained for each gestational age group by one week increment. To establish final standard values of Korean birth weight distribution by gestational age, the finite mixture model to eliminated erroneous birth weights was used for respective gestational age. Same as above method the birth weight for gestational age standard by sex, plurality, and parity were completed. Results : The male newborns are more heavier than female during the entire gestational age. The singletons are more heavier than twin during the entire gestational age. The para 2 are more heavier than the para 1 during the entire gestational age. Korean standard was more heavier in 10th and 50th percentile than Lubchenco's standard. Alexander's standard was more heavier in 50th and 90th percentile than Korean standard. Conclusion : These birth weight for gestational age patterns by sex, plurality, and parity are similar to the other standards. I hope that for Korean infants, this curve will help clinicians in defining and managing the large for gestational age infants and also for infants with intrauterine growth retardation.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.494-503
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• 1994

Background: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic stent, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. Method: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-Y AG) laser through a flexible bronchoscopy. Results: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. Conclusion: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.164-171
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• 1997

Heart transplantation is now accepted as a definitive therapeutic modality in patients with terminal hear failure. The first successful heart transplantation in humans was done in 1967 and the first case in Korea was performed in november, 1992. Since the first case in 1992, more than 50 cases have been performed in Korea. A total of 20 patients underwent orthotopic heart transplantation since November, 1992 in Asan Medicla Center. The purpose of this study is to evaluate the early results and the follow-up course of 20 cases of heart transplantation done in Asan Medical Center. The average age of 20 patients was 39.9$\pm$11.8 years old(20~58). The mean follow-up duration was 14.4$\pm$11.2 months(1~41). All patients are alive till now. The blood type was identical in 14 and compatible in 6 patients. ihe original heart disease was dilated cardiomyopathy in 16, valvular heart disease in 2, ischemic cardiomyopathy in 1, and giant cell myocarditis in 1 patient. HLA cross matching for recipient and donor was done in 18 cases and the results were negative for T-cell and B-cell in 16 patients, pos tive for warm B-cell in 2 patients. Among 6 loci of A, B, and DR, one locus was matched in 8 cases, 2 loci in 5 cases, and 3 loci matched in 1 case. The number of acute allograft rejection averaged 2.8$\pm$0.5 (0~6) per case and the number of acute allograft rejection requiring treatment averaged 1.0$\pm$0.9 (1~3) per case. The time interval from operation to the first acute rejection requiring treatment was 35.5$\pm$20.4 days (5~60). Acute humoral rejection was suspected strongly in 1 case and was successfully treated. The left ventricular ejection fraction measured by echocardiography and/or MUGA scan was dramatically increased from 17.5$\pm$6.8 (9~32)% to 58.9$\pm$2.0 (55~62)% after heart transplantation. Temporary pacing was needed in 5 patients over 24 hours but normal sinus rhythm appeared within 7 days in all cases. One patient has been taken permanent pacemaker implantation due to complete AV block appearing 140 days after heart transplantaion. One patient had cyclosporine-associated n urotoxicity during the immediate postoperative period and was recovered after 27 hours. The heart transplantation of Asan Medical Center is on a developing stage but the early result is comparable to that of well established centers in other countries, even though the long-term follow-up result must be reevaluated. We can conclude that the heart transplantion is a promising therapeutic option in patients with terminal heart failure.

• Journal of dental hygiene science
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• v.15 no.6
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• pp.768-774
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• 2015

The purpose of this study was to grasp the benefits from pit and fissure sealants and to analyze the factors of influencing the benefit amount by using the raw data of the Korea National Health and Nutrition Examination Survey for 2007~2013 targeting the subjects aged from 6 years in full to 18 years. The analysis was used STATA 11.0. As a result of the analysis, the following conclusions were obtained. It rose up to 1.24 pieces after carrying out the national health insurance coverage from averagely 0.93 piece until the year in 2007~2009 (up to November) when is before enforcing the national health insurance coverage in the pit and fissure sealants. The benefits from pit and fissure sealants depending on general characteristics were surveyed to be higher in the higher income level, in the more subscription to health insurance and private insurance, and in the more toothbrushing frequency per day. The factors that have influence upon the benefits from pit and fissure sealants were shown to include whether or not to have the national health insurance coverage in the pit and fissure sealants, income level, health insurance type and private insurance subscription appearance, and one-day toothbrushing frequency. Synthesizing the results, a rise in the benefits from pit and fissure sealants is shown in 2010 based on December 2009 when the national health insurance coverage in the pit and fissure sealants was implemented, but is showing the tendency of declining again from 2011. To increase the benefits from pit and fissure sealants, it is thought that the schemes will need to be discussed such as reinforcing publicity on the national health insurance coverage in the pit and fissure sealants, expanding a support for low-income bracket, and differentiating the outpatient cost sharing according to socio-economic level.

• Journal of Korean Ophthalmic Optics Society
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• v.15 no.3
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• pp.263-268
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• 2010

Purpose: Eye movements and fixation ability are an important procedure to obtain external information and essential means of clear vision. The purpose of this study was to determine the reading performance such as reading time and number of fixations when random text was viewed at varying distances. Methods: Twenty two presbyopes were participated. All subjects were screened for their suitability to participate in the study by clinical examination, and none of the participants had previously worn contact lenses and no previous experience of wearing any types of presbyopic vision correction except single vision. The reading time and number of fixations were recorded using eye tracker while each subjects was waring four vision corrections which included single vision for distance (SV), bifocal spectacle lenses (BIF), progressive addition lenses (PAL), and monovision (MV). The reading material was presented at distance and near distance. Results: Reading time and number of fixations for near stimulus were significantly different among vision correction used in this study (p<0.001). In particular, wearing SV required longer reading time and produced longer fixation duration for near text. However, reading distance text was similarity performed across vision corrections tested and there was no statistical difference found for either reading time and number of fixations. Conclusions: Wearing presbyopic vision correction is advantageous for reading task of near stimuli, but not having near correction such as wearing SV could result in longer reading time and higher number of fixation due to lacks of accommodative ability for near task. For the future studies, it would be interesting to examine the performance of reading both at adapted and unadapted stages as examining only unadapted wearers was limitation of this study.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.542-547
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• 1996

All patients who underwent video-assisted thoracic surgery (VATS) for diagnostic purposes from Jan. 1992 to Aug. 1995 were reviewed. The total number of patients were 111 with 57 male and 54 female, and the mean age was 49 years (range 1 to 74). Multiple biopsies from more than one location were performed in 17 patients , pleural biopsies were performed In 49 patients, lung biopsies in 43 patients, mediastinal mass or Iymph node biopsies in 33 patients, and two pericardium biopsies and one dia- phragm biopsy, for a total of 128 biopsies. Seventeen pleural biopsy cases and one lung biopsy case underwent operation under local anesthesia , the rest were performed under general anesthesia. In patients who underwent lung biopsy, the mean age was 49.1 ye rs (range 22~ 73). The operating time was 40 to 170 minutes (mean 97), intravenous or intramuscular injection for pain control was required 0 to 22 times(mean 4.7), and chest tube was inserted from 1 to 26 days(mean 7). In all patients except two, a diagnosis was obtained from the biopsy and complication was encountered in one patient in whom intraoperative paroxysmal atrial tachycardia was detected. In 7 patients, a thorn- cotomy had to be done due to pleural adhesion or intraoperative bleeding, and 7 patients had postoperative complications associated with the chest tube. In the pleural biopsy group, the mean age was 49 years (range 17~ 74). The operating time was 25 to 80 minutes (mean 49), intravenous or intramuscular injection for pain control was needed 0 to 20 times (mean 3.6), and the chest tube was i.nserted for 0 to 67 days(mean 9.8). In all the patients, a diagnosis was possible. The chest tube was inserted for longer than 7 days in 11 patients. In the Iymph node biopsy roup, the mean age was 44.2 years (range 1 ~ 68). The operating time was )0 to 3)5 minutes(mean 105), pain control was required 0 to 15 times(mean 3.2), and a chest tube was kept in place for 1 to 36 days(mean 6.1). In one patient, a diagnosis was not possible and a chest tube was kept in place for longer than 7 days in 7 patients. In the multiple biopsy group, the mean age was 53.1 years(range 20~ 71). The operating time was 15 to 165 minutes(mean 85), and pain control was done from 0 to 17 times(mean 3.1). The chest tube was kept in place for 1 to 16 days (mean 7.9).

• Proceedings of the Korea Water Resources Association Conference
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• 2019.05a
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• pp.9-9
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• 2019

기후변화로 인한 다년 가뭄은 매년 증가하여, 충청남도에 위치한 보령댐과 보령댐으로부터 용수를 공급받는 지자체의 시민들 또한 2015년부터 2017년까지 지속된 가뭄으로 인해 총 127일 동안의 생 공용수 급수조정으로 인한 불편함을 경험하였다. 지금까지 시행된 국내의 다양한 가뭄 피해 저감 정책 설립 과정은 대부분 일방적인 하향식(top-down) 의사결정 과정을 바탕으로 진행되었고, 이는 이해당사자와 정책결정자간의 갈등을 유발했다. 이로 인한 피해를 방지하기 위해 본 연구에서는 참여형(bottom-up) 의사결정 과정 중 하나인 비전공유계획을 충청남도 기후변화 적응 물관리정책 협의회를 통해 적용하였다. 또한, 비전공유계획의 핵심 요소인 비전공유모형을 시스템 다이내믹스 모형의 특성을 포함하여 개발하고자 STELLA Architect 소프트웨어로 보령댐 및 8개 지자체를 포함한 저수지 운영모형을 구축하였고, 총 3차례의 소위원회를 거쳐 수렴한 이해당사자의 요구사항에 따라 개발한 모형을 보완하였다. 구축한 모형으로는 미래에 발생 가능한 가뭄의 위험을 포함하고 있는 기후변화 시나리오에 대한 모의를 진행하였고, 보령댐과 보령댐으로부터 용수를 공급받는 충청남도 서해수역 지자체의 가뭄으로 인한 취약성을 평균부족횟수, 평균부족기간, 평균부족량으로 표현하였다. 모의 결과, 보령댐은 8개 지자체보다 가뭄에 상대적으로 더 취약하며, 8개 지자체에서는 가뭄 대응 대책이 주로 계획되어 있는 지역과 모의에서 가뭄이 발생하는 지역의 불일치로 인한 피해가 발생할 수 있음을 확인하였다. 또한, 다른 평가지표에 비해 예측하기 어려운 평균회복기간에 대해서는 댐과 지자체에서 이를 고려하는 것이 필요하다. 비전공유모형을 통한 가뭄 취약성 분석 결과를 미래 회의에서 이해당사자와 공유하고, 용수 공급처과 수요처의 입장에서 용수 부족을 해소할 방안을 모형에 적용함으로써 미래 가뭄 대응 정책 수립 과정에는 참여형으로 의사결정을 할 수 있음을 제안하였다.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1090-1095
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• 2008

Purpose : To assess the height growth of children with epilepsy receiving antiepileptic drugs (AEDs) and the related factors. Methods : The subjects were 148 children diagnosed with epilepsy at Pusan National University Hospital between January 1996 and December 2003, who received AEDs for more than 3 y. We measured height at the initiation of AED medication and at the last visit during AED medication. We analyzed the mean height standard deviation score (SDS) according to several factors, including sex, age at initial medication, seizure type, underlying causes of epilepsy, seizure frequency before AED medication, seizure control, number of AEDs, height SDS before medication, and duration of medication. Results : In the total population, height SDS at initial therapy and last follow-up were $-0.06{\pm}1.39$ versus $0.10{\pm}1.12$ (P=0.09). Children with controlled seizures showed a significant increase in height SDS, from $-0.12{\pm}1.39$ to $0.10{\pm}1.09$ (P=0.04), and children on medication for less than 6 y showed a significant increase in height SDS, from $-0.09{\pm}1.54$ to $0.21{\pm}1.07$ (P=0.03). Also, children with negative initial height SDS showed a significant increase in height SDS (P<0.05). No height SDS changes were observed in any of the other groups, regardless of sex, seizure type, underlying causes of epilepsy, or age at initial medication. Conclusion : Neither epilepsy nor AED medication affects long-term height growth. Controlled seizure and short duration of AED medication are positive factors for height growth in children with epilepsy.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.72-75
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• 2006

Background : This report reviews our experience with persistent air leaks in the peumothorax that were not considered candidates for surgical treatment in order to evaluate the efficacy and risks of the OK-432 plus autoblood or OK-432 pleurodesis. Material & Methods : From March 2004 to July 2005, 8 consecutive patients who had an air leak in the pneumothorax over 5 days and had been treated with OK-432 plus autoblood or OK-432 pleurodesis. The patients were not considered candidates for surgical treatments because the chest CT findings revealed severe chronic lung disease with multiple bullae and/or bullous changes. A prolonged air leak with/without dead space was treated with either OK-432 plus autoblood or OK-432 pleurodesis. The efficacy and side effects of OK-432 pleurodesis were assessed by determining the duration of the air leak, the number of pleurodesis, the patients' symptoms, measurements of the white blood cell count and the c-reactive protein level. Results : All of eight patients were male and the mean age was $72.4{\pm}8.5$. The mean number of pleurodesis was $1.9{\pm}1.1$ and the mean duration of the air leak was $4.6{\pm}4.6days$ after pleurodesis. Side effects after pleurodesis were encountered in 7 patients, which included a chilling sensation in 7 cases, chest pain in 5 cases, headache in 3 cases, local heat sensation in 2 cases, and fever in 1 case. Leukocytosis was observed in 6 patients, and the mean of WBC count and CRP were $14500{\pm}2100$ and $21.9{\pm}11.4mg/dL$, respectively. Conclusion : Either OK-432 plus autoblood or OK-432 pleurodesis has acceptable side effects, and can be considered a treatment option for persistent air leaks in the pneumothorax that are not candidates for surgical treatment.

• Korean journal of food and cookery science
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• v.21 no.6 s.90
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• pp.829-837
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• 2005

본 연구는 중학교 급식의 품질 개선을 위한 기초 자료를 제공하고자 학교급식을 시행하고 있는 부산지역 중학교 중에서 8개 학교를 대상으로 학교급식 서비스 품질의 급식 성과와 잔식에 대해 조사하였으며 이에 대한 결과는 다음과 같다. 1. 중학교 급식서비스의 품질 특성의 급식성과에 대한 결과, 전체 평균은 2.93점이고 공지된 식단의 정확한 배식>음식의 영양>음식의 맛>식단의 다양한 순으로 급식성과가 높은 것으로 나타났으나, 건의사항의 반영, 불만처리의 신속함, 반납장소의 청결 항목은 급식성과가 2.50점 이하로 전체 평균에 훨씬 못 미치는 것으로 나타났다. 여학생들이 남학생들에 비해, 급식경험 기간이 낮은 학생들이 급식경험 기간이 높은 학생들에 비해 급식서비스 품질특성 다섯 영역 모두에서 유의적으로(< 0.01) 높은 점수를 나타냈다. 그리고 매일 아침식사를 하는 학생들이 결식을 하는 학생들에 비해 식단의 다양함, 배식시간의 정확성, 공지된 식단의 정확한 배식에서 유의적(p <0.01)으로 높은 점수가 나타났다. 2. 학생들의 급식되는 음식에 대한 섭취정도에 대한결과에서, 여학생들이 남학생들에 비해 김치(>0.01)와 국 및 찌개(<0.05)에서 유의적으로 낮은 섭취율을 보였다. 또한 매일 아침식사를 하는 학생들이 아침식사횟수가 적은 학생들 보다 모든 식단에서 유의적으로 섭취율이 높게 나타났다. 3. 급식된 음식을 남기는 이유에 대한 결과에서, 밥의 경우에는 양이 너무 많아서, 국 및 찌개와 반찬의 경우에는 음식 맛이 없어서, 김치의 경우에는 자주 배식되어서가 주된 이유로 나타났다. 4. 학생들이 개선되기를 바라는 항목은 위생적인 음식> 식기류의 청결> 반찬 맛 순으로 높은 개선 요구도를 나타내었다 아침식사 횟수가 주 2회 이하인 학생들이 다른 학생들에 비해 #반찬수의 증가(<0.01)#,#음식양의 증가(<0.05)#,#급식종사자의 친절함(<0.05)#과 #공지된 식단의 정확한 배식(<0.05)#에 대해 유의적으로 높은 급식개선 요구도를 나타냈다. 5. 급식경험 기간과 급식성과 점수간의 상관관계에서, 급식성과는 급식경험 기간과 음(-)의 상관관계를, 아침식사횟수와는 양(+)의 상관관계를 보였으며, 서비스 품질의 특성 영역은 각 영역들에 대한 급식성과 점수가 높을수록 다른 영역의 급식성과 점수가 높은 유의적인(p <0.01) 양(+)의 상관관계를 보였다. 이상의 결과를 살펴볼 때, 균형된 영양공급이 다른 어느 시기보다 더 중요한 우리의 청소년들의 학교급식에 대한 만족도를 높이기 위해서 다음과 같은 제언을 하고자 한다. 먼저, 학교급식에 대한 식단 작성 시 학생들이 학교에서 제공되기 원하는 식단에 대한 의견을 받고 그 의견에 대한 결과를 게시하여 학생들이 제공되기 원하는 식단을 급식 시 제공하여 학생들이 식단선택에 동참할 수 있는 기회를 주는 것이 바람직하겠다. 또한 영양사는 학급의 반대표와의 정기적인 모임을 가짐으로서 학생들의 불만사항 및 개선 요구사항에대해 서로 의견을 교환하여 설문지조사가 아닌 직접적인 대화를 하여 문제점을 파악하고자 하는 적극적인 자세가 필요하겠다. 특히 아침식사의 결식 빈도가 높았고 이는 급식성과에 부정적인 영향을 줄 뿐 아니라 학교에서 제공하는 음식의 섭취정도에도 영향을 주고 있으므로 학생들에게 학부모와 전담교사 및 학교영양사는 학생들에게 이상적인 아침식사에 대한 교육은 물론이고 아침식사를 실천할 수 있도록 다양한 방안에 대해 함께 연구해야 하겠다. 정부차원에서 학교급식에 아침식사 프로그램을 도입할 수 있는 방안을 연구하고, 아침을 결식하는 학생이 학교에서 수업시작 하기 전에 간단한 식사를 할 수 있는 정책 도입이 필요하다