• Title/Summary/Keyword: Assessment model

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Clinical significance of acanthosis nigricans in children and adolescents with obesity induced metabolic complications (비만으로 인한 대사적 합병증을 가진 소아 및 청소년에서 흑색가시세포증의 임상적 의의)

  • Chueh, Hee Won;Cho, Gyu Rang;Yoo, Jaeho
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.987-994
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    • 2007
  • Purpose : This study investigated the clinical significance of AN in children and adolescents with obesity induced metabolic complications. Methods : Forty-nine patients who had obesity induced metabolic complications were participated in this cross-sectional study. Obesity induced metabolic complications are as follows: hypertension, dyslipidemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), nonalcoholic steatohepatitis (NASH), homeostasis model assessment of insulin resistance (HOMA-IR)>3.16. Clinical characteristics, such as, age, percentage-weight-for-height (PWH), pubertal status, blood pressure (BP), fasting plasma insulin level, fasting and post-oral glucose tolerance test 2-hour glucose levels, liver function test, lipid profile, HOMA-IR were compared according to the presence of AN. Results : Sixty-five percent of patients had AN, 57.1% NASH, 57.1% dyslipidemia, 55.1% hypertension, 46.9% IFG, 24.5% HOMA-IR>3.16 and 16.2% IGT. The patients who were moderately to severely obese with AN had higher incidence of IGT and HOMA-IR>3.16. The patients with AN had significantly higher diastolic BP ($79.4{\pm}6.9$ vs $75.4{\pm}5.6mmHg$), fasting levels of plasma insulin ($10.6{\pm}6.0$ vs $6.2{\pm}5.4{\mu}IU/mL$), HOMA-IR index ($2.6{\pm}1.4$ vs $1.4{\pm}1.3$) and PWH ($42.4{\pm}13.0$ vs $34.3{\pm}1.8%$). The increasing tendency for the presence of AN was significantly related to the cumulative number of obesity induced metabolic complications. Binary logistic regression analysis revealed that the presence of AN was significantly associated with fasting plasma insulin level, PWH and IFG. Conclusion : AN could be useful as a clinical surrogate of obesity induced metabolic complications.

Assessment of Natural Environment - II. Based on the Plant Taxa of the Natural Parks and Ulleung island- (자연환경 평가 -II. 국내 자연공원과 울릉도의 식물군을 이용하여-)

  • 김철환;이희천
    • Korean Journal of Environmental Biology
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    • v.19 no.1
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    • pp.49-58
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    • 2001
  • This study aims to compare and analyze the environment of natural parks and Ulleung island using the plant taxa classified by five degrees based on their distributional ranges. The scores differentially given based on the importance of each degree; taxa belonging to the fifth degree are given to 20 scores each, fourth 10, third 5, second 3.3, and first 2.5, respectively. The total assessed scores were ranked as Mt. Halla, Seorak, Jiri, Deokyu, Is. Ulleung, Mt. Sobaek, Odae, Palgong, Chink, Taebaek, Songni, Juwang, Gaya, Duryun, Gaeryong, Bukhan, Naebyeon, Worak, Naejang, Cheongryang, Naeyeon, Myeongii, Jokye, Mudeung, Wolchul, Geumo, Juheul, Biseul, Hwangmae, Jangan, Seonun, Moak, Seonam, Chilgap, and Gibaek, in order, respectively. It is suggested that the natural environments assessing more than 1,000 of total scores such as Mt. Halla and Mt. Deokyu are regarded as the most excellent ones, and those between 700 to 1,000 of total scores such as Is. Ulleung and Mt. Odae are regarded as relatively excellent ones. Natural parks scored between 500 to 700 such as Mt. Palgong and Mt. Gaya are regarded as good ones and parks scored between 300 to 500 such as Mt. Duryun and Mt. Mudeung are regarded as normal ones. The area assessed less than 300 of total scores such as Mt. Wolchul and Mt. Gibaek are regarded as the most inferior ones. The total scores of the national parks are generally higher than those of the provincial and county parks. In addition, Ulleung island has a total of 882.9 scores. Therefore, according to the IUCN the Ulleung island should be included in the criterion of the preservative model of natural ecosystem, suggested by Ministry of Environment. At the same time, Ulleung island should be included to the superior model of natural scenery resources by its uniqueness of topography, geography and natural environments. Ulleung island is assessed as having relatively excellent natural environments as compared with other national parks, suggesting that the island should be designated as a new national park.

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Stream Ecosystem Assessments, based on a Biological Multimetric Parameter Model and Water Chemistry Analysis (생물학적 다변수 모델 적용 및 수화학 분석에 의거한 갑천생태계 평가)

  • Bae, Dae-Yeul;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.39 no.2 s.116
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    • pp.198-208
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    • 2006
  • This research was to apply a multi-metric approach, so called the Index of Biological Integrity (IBI) as a tool for biological evaluations of water environments, to a wadable stream. For the study, we surveyed 5 sampling locations in Kap Stream during August 2004 ${\sim}$ September 2005. We also compared the biological data with long-term water quality data, obtained from the Ministry of Environment, Korea and physical habitat conditions based on the Quantitative Habitat Evaluation Index (QHEI). We used ten metric systems for the IBI model to evaluate biological stream health. Overall IBI values in Kap Stream averaged 24 (range: 20${\sim}$30, n=5), indicating a "fair ${\sim}$ poor" conditions according to the modified criteria of Karr (1981) and US EPA(1993). Exclusive of 4th survey, average IBI values at the upstream reach (S1 ${\sim}$ S3)and downstream reach (S4 ${\sim}$ S5) were 20 and 24, respectively. However, in 4th survey the averages were 21 and 20 in the upstream and downstream reaches, respectively. This difference was larger in the upstream than in the downstream because of physical condition disturbed during summer monsoon. Values of the QHEI varied from 75(fair condition) to 148 (good condition) and values of QHEI in the S3 were significantly (P=0.001, n=5) lower than other sites. Biochemical oxygen demand (BOD), chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) were greater by 3 ${\sim}$ 8 fold in the downstream than in the upstream reach. We believe that present IBI approach applied in this study may be used as a key tool to set up specific goals for restoration of Kap Stream.

A Study on the ICAO international aviation safety policy, a change of paradigm and the government response to the direction (ICAO 국제항공안전정책 패러다임의 변화 분석과 우리나라 신국제항공안전정책 검토)

  • Chang, Man-Heui;Hwang, Ho-Won
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.1
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    • pp.73-96
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    • 2013
  • ICAO's Universal Safety Oversight Audit Programme (USOAP) was initially launched in January 1995, in response to widespread concerns about the adequacy of aviation safety oversight around the world. The recent reduction in aircraft accidents and effective role that is evaluated on the basis of these results, and in 2013 the existing 'snapshot approach' to 'regular monitoring system (USOAP-Continuous Monitoring Approach)' was converted to. ICAO aviation safety assessment of the state in today's international community 'aviation safety credibility' as objective indicators to judge the enormous impact on the aviation industry, the state is not satisfactory, especially if the results of the evaluation and expansion of code-share airline ban, reduced international air transit passengers, including premium increases business and economic penalties should. In addition, ICAO implementation of the existing laws and regulations(Prescriptive Approach), but based on the Risk-based prevention model, Proactive Approach introduced the concept of aviation safety system, including international aviation safety policy has been to switch paradigms. This new ICAO international aviation safety policy also applies to the Government of the Republic of Korea in line with the aviation safey policies have changed. In particular, the systematic implementation of safety management for the existing laws and regulations in the center of the safety oversight system of risk-based introduction of the concept of proactive safety management, and According to international standards ICAO aviation service providers operate their own Safety Management System was set out in Aviation Law ever. In addition, the aviation safety is at the center of the field of the safety of aircraft operations and maintenance for the promotion is promoting various safety policies. This new paradigm shift in the international aviation safety policy in line with our state in the international community with the most exemplary aviation safety system firmly established itself as a model, the Government will strengthen the competitiveness of our aviation plans to support. To do this, the government, airlines, aviation officials try all the practical effect would be expected.

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A Study on Factors Influencing The State of Adaptation of The Hemiplegic Patients (편마비 환자의 퇴원후 적응상태와 관련요인에 대한 분석적 연구)

  • 서문자
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.88-117
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    • 1990
  • The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

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Risk Assessment of Pine Tree Dieback in Sogwang-Ri, Uljin (울진 소광리 금강소나무 고사발생 특성 분석 및 위험지역 평가)

  • Kim, Eun-Sook;Lee, Bora;Kim, Jaebeom;Cho, Nanghyun;Lim, Jong-Hwan
    • Journal of Korean Society of Forest Science
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    • v.109 no.3
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    • pp.259-270
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    • 2020
  • Extreme weather events, such as heat and drought, have occurred frequently over the past two decades. This has led to continuous reports of cases of forest damage due to physiological stress, not pest damage. In 2014, pine trees were collectively damaged in the forest genetic resources reserve of Sogwang-ri, Uljin, South Korea. An investigation was launched to determine the causes of the dieback, so that a forest management plan could be prepared to deal with the current dieback, and to prevent future damage. This study aimedto 1) understand the topographic and structural characteristics of the area which experienced pine tree dieback, 2) identify the main causes of the dieback, and 3) predict future risk areas through the use of machine-learning techniques. A model for identifying risk areas was developed using 14 explanatory variables, including location, elevation, slope, and age class. When three machine-learning techniques-Decision Tree, Random Forest (RF), and Support Vector Machine (SVM) were applied to the model, RF and SVM showed higher predictability scores, with accuracies over 93%. Our analysis of the variable set showed that the topographical areas most vulnerable to pine dieback were those with high altitudes, high daily solar radiation, and limited water availability. We also found that, when it came to forest stand characteristics, pine trees with high vertical stand densities (5-15 m high) and higher age classes experienced a higher risk of dieback. The RF and SVM models predicted that 9.5% or 115 ha of the Geumgang Pine Forest are at high risk for pine dieback. Our study suggests the need for further investigation into the vulnerable areas of the Geumgang Pine Forest, and also for climate change adaptive forest management steps to protect those areas which remain undamaged.

Assessment of Inhalation Dose Sensitivity by Physicochemical Properties of Airborne Particulates Containing Naturally Occurring Radioactive Materials (천연방사성물질을 함유한 공기 중 부유입자 흡입 시 입자의 물리화학적 특성에 따른 호흡방사선량 민감도 평가)

  • Kim, Si Young;Choi, Cheol Kyu;Park, Il;Kim, Yong Geon;Choi, Won Chul;Kim, Kwang Pyo
    • Journal of Radiation Protection and Research
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    • v.40 no.4
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    • pp.216-222
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    • 2015
  • Facilities processing raw materials containing naturally occurring radioactive materials (NORM) may give rise to enhanced radiation dose to workers due to chronic inhalation of airborne particulates. Internal radiation dose due to particulate inhalation varies depending on particulate properties, including size, shape, density, and absorption type. The objective of the present study was to assess inhalation dose sensitivity to physicochemical properties of airborne particulates. Committed effective doses to workers resulting from inhalation of airborne particulates were calculated based on International Commission on Radiological Protection 66 human respiratory tract model. Inhalation dose generally increased with decreasing particulate size. Committed effective doses due to inhalation of $0.01{\mu}m$ sized particulates were higher than doses due to $100{\mu}m$ sized particulates by factors of about 100 and 50 for $^{238}U$ and $^{230}Th$, respectively. Inhalation dose increased with decreasing shape factor. Shape factors of 1 and 2 resulted in dose difference by about 18 %. Inhalation dose increased with particulate mass density. Particulate mass densities of $11g{\cdot}cm^{-3}$ and $0.7g{\cdot}cm^{-3}$ resulted in dose difference by about 60 %. For $^{238}U$, inhalation doses were higher for absorption type of S, M, and F in that sequence. Committed effective dose for absorption type S of $^{238}U$ was about 9 times higher than dose for absorption F. For $^{230}Th$, inhalation doses were higher for absorption type of F, M, and S in that sequence. Committed effective dose for absorption type F of $^{230}Th$ was about 16 times higher than dose for absorption S. Consequently, use of default values for particulate properties without consideration of site specific physiochemical properties may potentially skew radiation dose estimates to unrealistic values up to 1-2 orders of magnitude. For this reason, it is highly recommended to consider site specific working materials and conditions and use the site specific particulate properties to accurately access radiation dose to workers at NORM processing facilities.

Result of Cox Maze Procedure with Bipolar Radiofrequency Electrode and Cryoablator for Persistent Atrial Fibrillation - Compared with Cut-sew Technique - (양극고주파전극과 냉동프로브를 이용한 지속성 심방세동의 수술 결과 - 절개/봉합술식과 비교 -)

  • Lee, Mi-Kyung;Choi, Jong-Bum;Lee, Jung-Moon;Kim, Kyung-Hwa;Kim, Min-Ho
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.710-718
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    • 2009
  • Background: The Cox maze procedure has been used as a standard surgical treatment for atrial fibrillation for about 20 years. Recently, the creators have used a bipolar radiofrequency electrode (Cox maze IV procedure) instead of the incision and suture (cut-sew) technique to make atrial ablation lesions for persistent atrial fibrillation. We investigated clinical outcomes for the Cox maze procedure with a bipolar radiofrequency electrode and cryoablator in patients with persistent atrial fibrillation, and compared results with clinical outcomes of the cut-sew procedure. Material and Method: Between April 2005 and July 2007, 40 patients with persistent atrial fibrillation underwent Cox maze IV procedure with a bipolar radiofrequency electrode and cryoablator (bipolar radiofrequency group). Surgical outcomes were compared with those of 35 patients who had the cut-sew technique for the Cox maze III procedure. All patients had concomitant cardiac surgery. Postoperatively, the patients were followed up every 1 to 2 months. Result: At 6 months postoperatively, the conversion rate to regular sinus rhythm was not significantly different between the two groups: 95.0% for the bipolar radiofrequency ablation group; 97.1% for the cut-sew technique (p=1.0). At the end of the follow-up period, the conversion rate to regular sinus rhythm was also not significantly different (92.5% vs. 91.6%, p=1.0). In multivariate analysis using a Cox-regression model, the postoperative atrial dimension was an independent determinant of sinus conversion in the bipolar radiofrequency ablation group (hazard ratio 31, p=0.005). In the Cox-regression model for both groups, atrial fibrillation at 6 months postoperatively (hazard ratio 92.24, p=0.003) and the postoperative left atrial dimension (hazard ratio 16.05, p=0.019) were independent risk factors of continuance or recurrence of atrial fibrillation after Cox maze procedures. Aortic cross-clamp time and cardiopulmonary bypass time were significantly shorter in the radiofrequency group than in the cut-sew group. Conclusion: In the Cox maze procedure for patients with persistent atrial fibrillation, the use of bipolar radiofrequency ablation and a cryoablator is as good as the cut-sew technique for conversion to sinus rhythm. The postoperative left atrial dimension is an independent determinant of postoperative continuance and recurrence of atrial fibrillation.

The Effect of Cultured Perichondrial Cell Sheet Covered Highly Active Engineered Cartilage: in vivo Comparative Assessment (배양연골막이 피복된 고효능 인공연골의 생체내 효과)

  • Park, Se-Il;Moon, Young-Mi;Jeong, Jae-Ho;Jang, Kwang-Ho;Ahn, Myun-Hwan
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.486-496
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    • 2011
  • A special mesenchymal tissue layer called perichondrium has a chondrogenic capacity and is a candidate tissue for engineering of cartilage. To overcome limited potential for chondrocyte proliferation and re-absorption, we studied a method of cartilage tissue engineering comprising chondrocyte-hydrogel pluronic complex (CPC) and cultured perichondrial cell sheet (cPCs) which entirely cover CPC. For effective cartilage regeneration, cell-sheet engineering technique of high-density culture was used for fabrication of cPCs. Hydrogel pluronic as a biomimetic cell carrier used for stable and maintains the chondrocytes. The human cPCs was cultured as a single layer and entirely covered CPC. The tissue engineered constructs were implanted into the dorsal subcutaneous tissue pocket on nude mice (n = 6). CPC without cPCs were used as a controls (N = 6). Engineered cartilage specimens were harvested at 12 weeks after implantation and evaluated with gross morphology and histological examination. Biological analysis was also performed for glycosaminoglycan (GAG) and type II collagen. Indeed, we performed additional in vivo studies of cartilage regeneration using canine large fullthickness chondrial defect model. The dogs were allocated to the experimental groups as treated chondrocyte sheets with perichondrial cell sheet group (n = 4), and chondrocyte sheets only group (n = 4). The histological and biochemical studies performed 12 weeks later as same manners as nude mouse but additional immunofluorescence study. Grossly, the size of cartilage specimen of cPCs covered group was larger than that of the control. On histological examination, the specimen of cPCs covered group showed typical characteristics of cartilage tissue. The contents of GAG and type II collagen were higher in cPCs covered group than that of the control. These studies demonstrated the potential of such CPC/cPCs constructs to support chondrogenesis in vivo. In conclusion, the method of cartilage tissue engineering using cPCs supposed to be an effective method with higher cartilage tissue gain. We suggest a new method of cartilage tissue engineering using cultured perichondrial cell sheet as a promising strategy for cartilage tissue reconstruction.

Impact of Weather on Prevalence of Febrile Seizures in Children (소아의 열성경련에 날씨가 미치는 영향)

  • Woo, Jung Hee;Oh, Seok Bin;Yim, Chung Hyuk;Byeon, Jung Hye;Eun, Baik-Lin
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.227-232
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    • 2018
  • Purpose: Febrile seizure (FS) is the most common type of seizure in children between 6 months to 5 years of age. A family history of febrile seizures can increase the risk a child will have a FS. Yet, prevalence of FS regarding external environment has not been clearly proved. This study attempts to determine the association between prevalence of FS and weather. Methods: This study included medical records from the Korea National Health Insurance Review and Assessment Service. Data were collected from 29,240 children, born after 2004, diagnosed with FS who were admitted to one of the hospitals in Seoul, Korea, between January 2009 and December 2013. During the corresponding time period, data from the Korea Meteorological Administration on daily monitoring of four meteorological factors (sea-level pressure, amount of precipitation, humidity and temperature) were collected. The relationships of FS prevalence and each meteorological factor will be designed using Poisson generalized additive model (GAM). Also, the contributory effect of viral infections on FS prevalence and weather will be discussed. Results: The amount of precipitation was divided into two groups for comparison: one with less than 5 mm and the other with equal to or more than 5 mm. As a result of Poisson GAM, higher prevalence of FS showed a correlation with smaller amount of precipitation. Smoothing function was used to classify the relationships between three variables (sea-level pressure, humidity, and temperature) and prevalence of FS. FS prevalence was correlated with lower sea-level pressure and lower humidity. FS prevalence was high in two temperature ranges (-7 to $-1^{\circ}C$ and $18-21^{\circ}C$). Conclusion: Low sea-level pressure, small amount of precipitation, and low relative air humidity may increase FS prevalence risk.