• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.165-173
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• 2005

Purpose : We performed the study to evaluate the value of the follow-up echocardiogram performed 6 months to 1 year after the onset of Kawasaki disease(KD), as recommended by American Heart Association(AHA) guidelines, when echocardiograms in the convalescent period were normal. Methods : Patients were selected from 147 cases diagnosed with KD at Pusan Paik hospital from January 2000 to October 2003. A total of 45 KD patients belonged to AHA risk level I and II were performed follow-up echocardiography. The patient's medical records and echocardiogram were reviewed. Additionally, we sought the opinion of pediatric cardiologists on the subject by means of a multiple-choice survey. Results : 37 children were belonged to AHA risk level I and the remaining 8 patients were belonged to risk level II. Of these 45 children, none were noted to have abnormalities on later follow-up echocardiogram. In the results of questionnaire, 37 percent of the participants advocate no follow-up after convalescent period for risk level I, and 33.3 percent favor periodic follow-up with echocardiography for risk level II up to one year. But there were no consensus about the diagnostic criteria of coronary abnormalities and how to follow-up these patients. Conclusion : All children with KD should have an echocardiogram at present and a follow-up study 6 to 8 weeks after the onset of fever. However, additional echocardiographies are not justified if the 6- to 8-week follow-up echocardiogram is normal. We would recommend that the more reasonable diagnostic criteria for coronary abnormalities and the Korean guidelines for long-term cardiovascular management and follow-up of KD need to be established.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1577-1584
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• 2002

Purpose : Airway inflammation is considered to be a characteristic feature of asthma, and eosinophils are recognized as the most important inflammatory cells. This study aims to assess the importance of blood eosinophil count and serum eosinophil cationic protein(ECP) levels as a noninvasive marker of bronchial hyperresponsiveness(BHR) in children with suspected asthma. Methods : This study used data from 87 subjects with asthma-like symptoms(6-18 years old). The $FEV_1$ and provocative concentration producing a 20% fall in $FEV_1(PC_{20})$ on methacholin inhalation challenge test were measured. Four groups were classified based on $PC_{20}$[Group I : <2 mg/mL; Group II : 2-8 mg/mL; Group III : 8-18 mg/mL; Group IV : (18 mg/mL], and blood eosinophil count and serum ECP levels were analyzed. In addition, subjects were classified based on the cutoff value of $PC_{20}$(BHR positive group : <18 mg/mL; BHR negative group : (18 mg/mL). Then blood eosinophil count and serum ECP level were compared between these two groups. Results : Likelihood ratio test for trends revealed a significant association between the blood eosinophil count or serum ECP level, and the degree of BHR as measured by methacholine $PC_{20}$. Blood eosinophil count or serum ECP level was significantly higher in the BHR(+) group than in the BHR(-) group. Blood eosinophil count had a positive correlation with serum ECP level. Conclusion : Blood eosinophil count and serum ECP level may be a useful non-invasive clinical marker of BHR in subjects with suspected asthma. This supports the hypothesis that BHR in asthma is a consequence of airway eosinophilic inflammation.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.138-146
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• 2019

Objectives : This study examined the association between depression and survival time in terminal cancer patients admitted to the palliative care unit. Emotional problems are important for terminal cancer patients in the palliative care unit, and evaluation of patients' depression plays an important role in treatment planning. Methods : From October 2015 to August 2018, we conducted a retrospective study of 291 terminal cancer patients admitted to a palliative care unit at a university hospital and evaluated depression with PHQ-9 at admission. Of the 291 patients, 146 (50.2%) completed PHQ-9 but 145 (49.8%) were not evaluated due to loss of consciousness or rejection. Results : 4-week survival rate in the Kaplan-Meier survival analysis were 45.4% in the non-depressed group (PHQ-9<10) and 18.7% in the depressed group (PHQ-9≥10). According to the severity of depression, in the Cox proportional hazard model, the risk of mortality in moderate, moderately sever and severe group was 2.778, 1.882 and 3.423 times higher than minimal group, respectively. Conclusions : Of the patients with terminal cancer who were admitted to the palliative care unit, the survival time was shorter in the depressed group than in the non-depressed group. Further research is needed to determine if treatment of depression increase the survival in terminal cancer patients.

• The Korean Journal of Quaternary Research
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• v.16 no.1
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• pp.1-16
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• 2002

A total of 4 muddy sediment samples collected from the Central Yellow Sea were analyzed for chemical composition. The results are compared with the previously published Huanghe, Changjiang and Keum River geochemical data in order to understand provenance and sedimentation of fine-grained mud, and the sediment accumulation rates estimated. The sandy sediment facies is distributed in the eastern area, a patch of fine-grained mud exists in the western central prat, and the sandy mud and clay sedimentary facies shot. north to south zonal distribution in the central region. The content of calcium carbonate ranges from 2.8 to 10.5%, and its distributional trends to be more concentrated on the western muddy sediments near toward the China side rather than on the eastern sandy sediments. The accumulation rates obtained using Pb-210 geochronologies for the muddy sediments in the Central Yellow Sea showed ranges from 0.21 to 0.68 cm/yr or 0.176 to 0.714 g/$\textrm{cm}^2$. yr. The sedimentation rate from core CY96010 located in the eastern near side of Shandong Peninsula which is affected by the Huanghe River shows 0.68 cm/yr or 0.714 g/$\textrm{cm}^2$ . yr. The sediment cores CY96008 and CY96002 in the Central Yellow Sea, the estimated of sediment accumulation rates shows 0.21~0.23cm1yr or 0.176~0.220 9/$\textrm{cm}^2$.Vr respectively, which are much lower than above samples. These indicate that the muddy sediments in central area of the Yellow Sea may have received influence of the sediment discharge from the Huanghe River. The concentrations of Ca, Na, Sr, Ho, La, Tb, Ta and Ca/Ti ratio of the muddy sediments in the Central Yellow Sea are higher than those of the Changjiang sediments and lower than those of the Huanghe sediments. However, these element values showed similar concentration patterns than those of the Huanghe sediment. The element contents such as Fe, Ti, Nl, Co, Cr, Cu, Pb, Sc, Ce, Nd, Sm, Eu, Cd and Dy in the study area are higher than those of the Huanghe sediments and lower than the Changjiang River sediments, but these values showed close to resemblance content trends those of the Changjiang sediment. The concentration of Mn, K and Sr in sediments of the study area are similar to those of the Keum River and eastern Yellow Sea sediment. They are rich in Zn, Rb, Cd, U, Cs and Li than those of the other comparison legions. Therefore, the terrigenous materials sources of the muddy sediment in the Central Yellow Sea comes mainly from Huanghe River in the past and present, and also have party derived from the Changjiang and Keum River, while the biological deposit in this area are carried by the Yellow Sea Warm Current.

• Journal of Distribution Science
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• v.14 no.3
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• pp.55-62
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• 2016

Purpose - Average using time of smart-phone for Korean people is 3 hours 39 minutes and most people who are using a computer at home and their workplace can be affected over force to neck and shoulder due to unstable body posture. musculoskeletal disorders which caused by unstable body posture can affect strongly to decrease work efficiency. So this research is designed to measure the effect of using computer & smart-phone on decreased work efficiency due to musculoskeletal disorders and mediating effect between decreased work efficiency and musculoskeletal disorders. Research Design, Data, and Methodology - The author has developed a questionnaire with 6 hypothesis on the basis of previous research result with 5 constructs. The questionnaires were also made by interview and E-mail. 300 copies of questionnaires were distributed and 282 questionnaire were used for the analysis as valid data responses. SPSS ver.21.0 were used and made Cronbach's α and reliability test, correlation, Baron & Kenny 3 step mediated regression analysis. Result - Cronbach's α shows 0.770~0.954 and C.R. is 0.963~0.997 which is higher than 0.7. and AVE was 0.867~0.933. So the data are all acceptable condition. Using for a long time of a computer & smart-phone has a positive effect on musculoskeletal disorders. This means, it can cause musculoskeletal disorders if people use a computer & smart-phone for a long time due to unstable body posture. And musculoskeletal disorders can effect strongly decrease work efficiency. This study also found out that a long time of using computer can cause musculoskeletal disorders rather than using smart-phone a long time. To check mediate effect of musculoskeletal disorders between using a computer & smart-phone and Decreased Work Efficiency, author used 3-step mediated regression analysis of Baron & Kenny (1986). Using a computer for a long time mediate partially and using a smart-phone for a long time mediate completely. This means that using a smart-phone a long time is not the actual reason to decrease work efficiency. But using level of smart-phone is increasing rapidly day by day. So we need to make additional research about this matter seriously. Conclusion - Nowadays, people can not live on without a computer & smart-phone even a moment. But, using a computer for a long time will affect to cause musculoskeletal disorders and it will effect strongly to decrease work efficiency. Before, we thought over that musculoskeletal disorders were diseases of elder people. But, we found out from this study that musculoskeletal disorders can be happen to any people, even children, or workers in heavy industry or engaged in brain work. So we need to be careful when we use a computer for a long time. People also need to be careful to keep correct body posture when using both a computer and smart-phone since a smart-phone became more popular and using time level became longer. Due to increased income and living standard of people, physical growth of young people is so rapid. But the physical environment of society is not suitable for them since it can not follow up the speed of growth. Suitable work table is very important to prevent musculoskeletal disorder which can affect decrease work efficiency. For a person, a society or country, increased productivity is very important since it can directly connected to the job satisfaction. Education and reeducation for the people is also important, but to teach them how to keep good condition of health will be more important since it can increase the quality of work efficiency and quality of life. Computer and Smart-phone is one the best invention of modern society, but it can cause mental and physical disease which can affect decrease work efficiency and productivity. So it is necessary to observe attentively for the situation continually.

• Korean Journal of Animal Reproduction
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• v.24 no.4
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• pp.357-364
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• 2000

Members of the glycoprotein family, which includes CG, LH, FSH and TSH, comprise two noncovalently linked $\alpha$- and $\beta$-subunits. Equine chorionic gonadotropin (eCG), known as PMSG, has a number of interesting and unique characteristics since it appears to be a single molecule that possesses both LH- and FSH-like activities in other species than the horse. This dual activity of eCG in heterologous species is of fundamental interest to the study of the structure-function relationships of gonadotropins and their receptors. CG and LH $\beta$ genes are different in primates. In horse, however, a single gene encodes both eCG and eLH $\beta$ -subunits. The subunit mRNA levels seem to be independently regulated and their imbalance may account for differences in the quantities of $\alpha$ - and $\beta$-subunits in the placenta and pituitary. The dual activities of eCG could be separated by removal of the N-linked oligosaccharide on the $\alpha$-subunit Asn 56 or CTP-associated O-linked oligosaccharides. The tethered-eCG was efficiently secreted and showed similar LH-like activity to the dimeric eCG. Interestingly, the FSH-like activity of the tethered-eCG was increased markedly in comparison with the native and wild type eCG. These results also suggest that this molecular can implay particular models of FSH-like activity not LH-like activity in the eCG/indicate that the constructs of tethered molecule will be useful in the study of mutants that affect subunit association and/or secretion. A single-chain analog can also be constructed to include additional hormone-specific bioactive generating potentially efficacious compounds that have only FSH-like activity. The LH/CG receptor (LH/CGR), a membrane glycoprotein that is present on testicular Leydig cells and ovarian theca, granulosa, luteal, and interstitial cells, plays a pivotal role in the regulation of gonadal development and function in males as well as in nonpregnant and pregnant females. The LH/CGR is a member of the family of G protein-coupled receptors and its structure is predicted to of a large extracellular domain connected to a bundle of seven membrane-spanning a-helices. The LH/CGR phosphorylation can be induced with a phorbol ester, but not with a calcium ionophore. The truncated form of LHR also was down-regulated normally in response to hCG stimulation. In contrast, the cell lines expressing LHR-t631 or LHR-628, the two phosphorylation-negative receptor mutant, showed a delay in the early phase of hCG-induced desensitization, a complete loss of PMA-induced desensitization, and an increase in the rate of hCG-induced receptor down-regulation. These results clearly show that residues 632~653 in the C-terminal tail of the LHR are involved in PMA-induced desensitization, hCG-induced desensitization, and hCG-induced down-regulation. Recently, constitutively activating mutations of the receptor have been identified that are associated with familial male-precocious puberty. Cells expressing LHR-D556Y bind hCG with normal affinity, exhibit a 25-fold increase in basal cAMP and respond to hCG with a normal increase in cAMP accumulation. This mutation enhances the internalization of the free and agoinst-occupied receptors ~2- and ~17- fold, respectively. We conclude that the state of activation of the LHR can modulate its basal and/or agonist-stimulated internalization. Since the internalization of hCG is involved in the termination of hCG actions, we suggest that the lack of responsiveness detected in cells expressing LHR-L435R is due to the fast rate of internalization of the bound hCG. This statement is supported by the finding that hCG responsiveness is restored when the cells are lysed and signal transduction is measured in a subcellular fraction (membranes) that cannot internalize the bound hormone.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1165-1171
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• 2008

Purpose : This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. Methods : The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg-negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. Results : The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non-responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). Conclusion : The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.

• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.959-964
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• 2007

Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1217-1221
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• 2008

Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

• Korean Security Journal
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• no.26
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• pp.121-144
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• 2011

The Framework Act on the Management of Disasters and Safety 2004(FAMDS) currently underpins Korean civil protection system, and under this FAMDS, Korean civil protection establishes a three-tiered government structure for dealing with crises and disasters: central government, provincial & metropolitan government, and local government tiers. In particular, the concept of Integrated Emergency Management(IEM) emphasizes that emergency response organizations should work and act together to respond to crises and disasters effectively, based on the coordination and cooperation model, not the command and control model. In tune with this trend, civil protection matters are, first, dealt with by local responders at the local level without direct involvement of central or federal government in the UK or USA. In other words, central government intervention is usually implemented in the UK and the USA, only when the scale or complexity of a civil protection issue is so vast, and thus requires a degree of central government coordination and support, resting on the severity and impact of the event. In contrast, it appears that civil protection mechanism in Korea has adopted a rigid centralized system within the command and control model, and for this reason, central government can easily interfere with regional or local command and control arrangements; there is a high level of central government decision-making remote from a local area. The principle of subsidiarity tends to be ignored. Under these circumstances, it is questionable whether such top-down arrangements of civil protection in Korea can manage uncertainty, unfamiliarity and unexpectedness in the age of Risk Society and Post-modern society, where interactive complexity is increasingly growing. In this context, the study argues that Korean civil protection system should move towards the decentralized model, based on coordination and cooperation between responding organizations, loosening the command and control structure, as with the UK or the USA emergency management arrangements. For this argument, the study basically explores mechanisms of civil protection arrangements in Korea under current legislation, and then finally attempts to make theoretical suggestions for the future of the Korean civil protection system.