• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.98-104
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• 1998

A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.7 no.2
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• pp.161-170
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• 1997

This is an effort to confirm changes biological monitoring according to changes in levels of exposure to styrene for industrial workers. This study was conducted on 108 workers, including male of 64 and female 44 who were working at factories of FRP, dipping, and coating. An improved passive monitor method(organic vapor monitor; OVM) was employed to determine levels of exposure. The biological monitoring include blood styrene concentration, urinary mandelic acid(MA), and urinary phenylglyoxylic acid(PGA). Biological monitoring were made through the Collection of blood and urine. The mean value of exposure to styrene was 21.0ppm, which is measured by organic vapor monitor, one of improved passive monitors. The highest exposure level was observed among workers in boat factories, laminating procedure workers, processing workers, respectively(p<0.01). For exposure level, 11% of subjects under study showed over 50ppm which is time weighted average(TWA). The correlation coefficient between biological specimens and the exposure level was 0.62 for blood styrene concentration, 0.58 for MA corrected by creatinine, and 0.70 for PGA corrected by creatinine, respectively(p<0.01). The regression analyses found exposure level relative importance in explaining variance in biological monitoring. In additional to that, gender was a significant factor in explaining variance of MA and MA+PGA. Almost half of variance(49%) in blood styrene concentration was explained by predictors, including exposure level, age, gender, duration, and drinking volume during the last week(p<0.01). The very high correlation(higher than 0.95 was found when a comparison was made among three types of corrected methods, including uncorrected specific gravity and creatinine. In conclusion, these findings suggest OVM to represent levels of exposure to styrene for industrial workers. A discussion was made on possible use of specific gravity sample for biological monitoring. Exposure level may be predicted on MA, PGA in urine, which could be applied to represent biological monitoring.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.283-291
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• 1993

Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.345-359
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• 1993

This study was conducted to identify the factors related to the blood pressure in school children. The study subjects were 144 boys and 140 girls aged 10 years old, 4th grade student of one elementary school in Taegu City. Blood pressure and 18 variables for 284 school children were measured in May 1992. A weight-for-height index, R$\ddot{o}$hrer index(weight/$height^3$) was calculated for each individual as a measure of obesity. Body fat percent, fat weight, and lean body mass were measured by impedance fat meter(Model SIF-891). Serum total cholesterol, high-density lipoprotein, triglyceride, uric acid, total protein, and electrolyte were measured by automated clinical chemistry analyzer(Hitachi 4020). Low-density lipoprotein and atherogenic index were calculated by the equation. The variables assessed were sex, systolic blood pressure, diastolic blood pressure. R$\ddot{o}$hrer index, body fat percent, body fat weight, lean body mass, total cholesterol, high-density lipoprotein, low-density lipoprotein, uric acid, total protein, serum electrolyte and blood glucose. The mean systolic and diastolic blood pressures for boys were 104.1mmHg and 66.6mmHg and those for girls were 102.9mmHg and 67.5mmHg. Systolic blood pressure of boys was positively correlated with height, weight, R$\ddot{o}$hrer index, fat weight, lean body mass, and triglyceride. Systolic blood pressure of girls was positively correlated with height, weight, lean body mass, and uric acid. Diastolic blood pressure of boys was positively correlated with weight. R$\ddot{o}$hrer index, and lean body mass. Diastolic blood pressure of girls was positively correlated with height, weight, fat weight, and lean body mass and negatively with total serum protein. In multiple regression analysis for the systolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index and serum sodium in boys, and serum uric acid, fat percent, and R$\ddot{o}$hrer index in girls. In multiple regression analysis of the diastolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index in boys and total serum protein in girls. This study indicated that important factors influencing blood pressure in school children were R$\ddot{o}$hrer index, fat percent, serum sodium, uric acid, and total protein. R$\ddot{o}$hrer index was most important among these. It is recommended to enforce the nutritional education for diet control of obesity to prevent hypertention in children and to adopt healthy life-styles that promote good health and prevent development of cardiovascular risk factors.

• The Journal of the Petrological Society of Korea
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• v.2 no.2
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• pp.74-94
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• 1993

Metabasites and metapelites in the Mungyong area were intruded by Cretaceous granites with radius of 4-8 km. As the distance from granite body increases, the mineral assemblage of metabasite changes from amphibole + plagioclase through amphibole + plagioclase + epidote to amphibole + plagioclase + epidote + chlorite. The compositional variations of amphibole and plagioclase according to the change of metamorphic grade and bulk rock compositions are very complex. Towards the Mungyong Cretaceous granite body, the mineral assemblage of metapelite changes from chlorite+ muscovite(ch1orite zone) through biotite + chlorite + muscovite(biotite zone) to andalusite+biotite + muscovite${\pm}$chlorite or cordierite+ biotite+ muscovite${\pm}$chlorite(cordierite zone). The estimated metamorphic conditions of cordierite zone are 480~$580^{\circ}C$ 1.5-3.3 kb. The theoretical study on the thermal metamorphism caused by the Cretaceous granite with radius longer than 4 km in the Mungyong area suggests the followings: The degree of metamorphism is mainly determined not by the size of granite body but by the temperature of granite intrusion; The country rocks within 2 km from Cretaceous granite have undergone metamorphism with temperature higher than $500^{\circ}C$, which is consistent with the petrological study in the Mungyong area. Mungyong Cretaceous granite caused a low P/T thermal metamorphism to the country rocks; the amphibolite facies metamorphism to the country rocks within 1-2 km from the granite body and the epidote-amphibolite and greenschist facies metamorphism to the country rocks within 2-5 km.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.152-155
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• 2005

Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.167-172
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• 2010

Purpose : With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. Methods : We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. Results : Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P =0.022) and fraction of inspired oxygen (P <0.001) were significantly higher in the dead group and values of base excess (P =0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, $CO_2$, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P =0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P =0.022). Conclusion : Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.12 no.1
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• pp.42-62
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• 2008

Objectives: It is well known that some parameters of the photoplethysmogram (PPG) acquired by time domain contour analysis can be used as markers of vascular aging. But the previous studies that have been performed for frequency domain analysis of the PPG to date have provided only restrictive and fragmentary information. The aim of the present investigation was to determine whether the harmonics extracted from the PPG using a fast Fourier transformation could be used as an index of vascular aging. Methods: The PPG was measured in 600 recruited subjects for 30 second durations, To grasp the gross age-related change of the PPG waveform, we grouped subjects according to gender and age and averaged the PPG signal of one pulse cycle. To calculate the conventional indices of vascular aging, we selected the 5-6 cycles of pulse that the baseline was relatively stable and then acquired the coordinates of the inflection points. For the frequency domain analysis we performed a power spectral analysis on the PPG signals for 30 seconds using a fast Fourier transformation and dissociated the harmonic components from the PPG signals. Results: A final number of 390 subjects (174 males and 216 females) were included in the statistical analysis. The normalized power of the harmonics decreased with age and on a logarithmic scale reduction of the normalized power in the third (r=-0.492, P<0.0001), fourth (r=-0.621, P<0.0001) and fifth harmonic (r=-0.487, P<0.0001) was prominent. From a multiple linear regression analysis, Stiffness index, reflection index and corrected up-stroke time influenced the normalized power of the harmonics on a logarithmic scale. Conclusions: The normalized harmonic power decreased with age in healthy subjects and may be less error prone due to the essential attributes of frequency domain analysis. Therefore, we expect that the normalized harmonic power density can be useful as a vascular aging marker.

• Journal of Korean Society of Environmental Engineers
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• v.27 no.8
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• pp.870-876
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• 2005

The multiple regression models which have two factors(population and commercial area) have been used to forecast the water demand in the future. But, the coefficient of population had a negative value because proper regional classification wasn't performed, and it is not reasonable because the population must be a positive factor. So, the regional classification was performed by principal component and cluster analysis to solve the problem. 6 regional characters were transformed into 4 principal components, and the areas were divided into two groups according to cluster analysis which had 4 principal components. The new regression models were made by each group, and the problem was solved. And, the future water demands were estimated by three scenarios(Active, moderate, and passive one). The increase of water demand ore $89.034\;m^3/day$ in active plat $49,077\;m^3/day$ in moderate plan, and $19,996\;m^3/day$ in passive plan. The water supply ability as scenarios is enough in water treatment plant, however, 2 reservoirs among 4 reservoirs don't have enough retention time in all scenarios.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.75-85
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• 2005

Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.