• Journal of Genetic Medicine
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• v.7 no.2
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• pp.125-132
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• 2010

Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.3
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• pp.380-391
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• 2015

Objectives: The objective of this study is to assess airborne particulate matter pollution and its effect on health of residents living near Ansim Briquette Fuel Complex and its vicinities. Also, this study measured and analyzed the concentration of TSP, $PM_{10}$, $PM_{2.5}$, and heavy metals which influences on the environmental and respiratory disease in Ansim Briquette Fuel Complex, Daegu, Korea. Methods: In this study, we analyzed various environmental pollutants such as particulate matter and heavy metals from Ansim Briquette Fuel Complex that adversely affected local residents's health. In particular, we verified the concentration distribution and characteristics of exposure for TSP, $PM_{10}$, and $PM_{2.5}$ among particulate matters, and heavy metals(Cd, Cr, Cu, Mn, Ni, Pb, Fe, Zn, and Mg). In that regard, the official test method on air pollution in Korea for analysis of particulate matter and heavy metal in atmosphere were conducted. The large capacity air sampling method by the official test method on air pollution in Korea were applied for sampling of heavy metals in atmosphere. In addition, we evaluated the concentration of seasonal environmental pollutants for each point of residence in Ansim Briquette Fuel Complex and surrounding area. The sampling measured periods for air pollutants were from August 11, 2013 to February 21, 2014. Furthermore, we measured and analyzed the seasonal concentrations(summer, autumn and winter). Results: The average concentration for TSP, $PM_{10}$, and $PM_{2.5}$ by direct influence area at Ansim Briquette Fuel Complex were 1.7, 1.4 and 1.9 times higher than reference region. In analysis results of seasonal concentrations for particulate matter in four direct influence and reference area, concentration levels for winter were generally somewhat higher than concentrations for summer and autumn. The average concentrations for Cd, Cr, Mn, Ni, Pb, Fe, and Zn in direct influence area at Ansim Briquette Fuel Complex were $0.0008{\pm}0.0004{\mu}g/Sm^3$, $0.0141{\pm}0.0163{\mu}g/Sm^3$, $0.0248{\pm}0.0059{\mu}g/Sm^3$, $0.0026{\pm}0.0011{\mu}g/Sm^3$, $0.0272{\pm}0.0084{\mu}g/Sm^3$, $0.4855{\pm}0.1862{\mu}g/Sm^3$, and $0.3068{\pm}0.0631{\mu}g/Sm^3$, respectively. In particularly, the average concentrations for Cd, Cr, Mn, Ni, Pb, Fe, and Zn in direct influence area at Ansim Briquette Fuel Complex were 1.9, 3.6, 2.1, 1.9, 1.4, 2.6, and 1.2 times higher than reference area, respectively. The continuous monitoring and management were required for some heavy metals such as Cr and Ni. Moreover, the average concentration in winter for particulate matter in direct influence area at Ansim Briquette Fuel Complex were generally higher than concentrations in summer and autumn. Also, average concentrations for TSP, $PM_{10}$, and $PM_{2.5}$ were from 1.5 to 2.0 times, 1.2 to 1.8 times, and 1.1 to 2.3 times higher than reference area, respectively. In results for seasonal atmospheric environment, TSP, $PM_{10}$, $PM_{2.5}$, and heavy metal concentrations in direct influence area were higher than reference area. Especially, the concentrations in C station were a high level in comparison with other area. Conclusions: In the results, some particulate matters and heavy metals were relatively high concentration, in order to understand the environmental pollution level and health effect in surrounding area at Ansim Briquette Fuel Complex. The concentration of some heavy metals emitted from direct influence area at Ansim Briquette Fuel Complex were relatively higher than reference area. In particular, average concentration for heavy metals in this study were higher than average concentrations in air quality monitoring station for heavy metal for 7 years in Deagu metropolitan region. Especially, the residents near Ansim Briquette Fuel Complex may be exposed to the pollutants(TSP, $PM_{10}$, $PM_{2.5}$, and heavy metals, etc) emitted from the factories in Ansim Briquette Fuel Complex.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.385-394
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• 2002

Background : Flexible fiberoptic bronchoscopy(FFB) has become a widely performed technique for diagnosing and managing pulmonary disease because of its low complication and mortality rate. Since the use of FFB can in patients with severely depressed cardiorespiratory function is increasing and hypoxemia during the FFB can induce significant cardiac arrhythmias, the early detection and adequate management of hypoxemia during FFB is clinically important. Method : To evaluate the necessity of the continuous monitoring of the oxygen saturation($SaO_2$) during the FFB, the $SaO_2$ was continuously monitored from the finger tip using pulse oximetry before, during and after the FFB in 379 patient. The patients were then divided into two groups, those with and without hypoxemia($SaO_2$<90%). The baseline pulmonary function data and the clinical characteristics of the two groups were compared. Results : The mean baseline $SaO_2$ was $96.9{\pm}2.85%$. An $SaO_2$ <90% was recorded at some point in 62(16.4%) out of 379 patients, with 12 out of 62 experiencing this prior to the FFB, in 37 out of 62 during the FFB, and in 13 out of 62 after the FFB. No differences were observed in the smoking and sex distribution between those with and without hypoxemia. The mean age was older in those with hypoxemia than in those without. Significant differences were observed in the mean baseline $SaO_2$ and the mean time for the procedure between the two groups. The $FEV_1$ was significantly lower in those with hypoxemia, and both the FVC and $FEV_1/FVC$ also tended to decrease in this group. Managing hypoxemia included deep breathing in 20 patients, a supplemental oxygen supply in 39 patients, and the abortion of the procedure in 3 patients. Conclusion : These results suggest that the continuous monitoring of the oxygen saturation is necessary during fiberoptic bronchoscopy, and it should be performed in patients with a depressed pulmonay function in order for the early detection and adequate management of hypoxemia.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.353-377
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• 2000

This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.280-287
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• 2007

Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.

• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.464-470
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• 2009

Purpose : This study assessed the incidence and outcome of congenital anomalies of the kidney and urinary tract (CAKUT) detected by prenatal ultrasonography Methods : There were 906 cases of CAKUT detected by prenatal ultrasonography and postnatally confirmed at the Asan Medical Center from October 1989 to October 2007. We investigated the incidence and outcome of these cases by reviewing medical records retrospectively. Results : The order of incidence was hydronephrosis, multicystic dysplastic kidney (MCDK), duplex kidney, vesico-ureteral reflux (VUR), single kidney, hydroureteronephrosis, ectopic kidney, polycystic kidney, ureterocele, and posterior urethral valve (PUV). There were 520 cases (57.4%) of hydronephrosis, and 20% of these needed an operation due to significant obstruction. MCDK was associated with other CAKUT in 25.4% of all cases. Approximately 57.9% of duplex kidney cases needed surgical treatment due to ureterocele and VUR. VUR had a male: female ratio of 10:1. Two out of seven cases of autosomal recessive polycystic kidney had progressed to chronic renal failure. Patients with PUV were relatively uncommon, and one out of nine cases progressed to end-stage renal disease. Conclusion : CAKUTs detected by prenatal ultrasonography were composed of various anomalies, and almost all of them had a good outcome without any intervention. However, in some cases, recurrent urinary tract infection or renal failure occurred, especially in bilateral cases. For further management, a long-term multicenter study is needed to investigate the precise incidence and outcome of each anomaly in the general population.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Tuberculosis and Respiratory Diseases
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• v.80 no.2
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• pp.169-178
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• 2017

Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

• Journal of The Korean Society of Grassland and Forage Science
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• v.38 no.2
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• pp.106-111
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• 2018

This study was conducted to investigate the relationship between changes of rumen microflora and bloat in Jersey cow. Jersey cows (control age: 42 months, control weight: 558kg; treatment age: 29 months, treatment weight 507kg) were fed on the basis of dairy feeding management at dairy science division in National Institute of Animal Science. The change of microbial population in rumen was analyzed by using next generation sequencing (NGS) technologies due to metabolic disease. The diversity of Ruminococcus bromii, Bifidobacterium pseudolongum, Bifidobacterium merycicum and Butyrivibrio fibrisolvens known as major starch fermenting bacteria was increased more than 36-fold in bloated Jersey, while cellulolytic bacteria community such as Fibrobacter succinogenes, Ruminococcus albus and Ruminococcus flavefaciens was increased more than 12-fold in non-bloated Jersey. The proportion of bacteroidetes and firmicutes was 33.4% and 39.6% in non-bloated Jersey's rumen, while bacteroidetes and firmicutes were 24.9% and 55.1% in bloated Jersey's. In conclusion, the change of rumen microbial community, in particular the increase in starch fermenting bacteria, might have an effect to occur the bloat in Jersey cow.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1063-1071
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• 1997

Backgroung : The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. Method : The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at interval. Absolutely, no steroid was taken during pretreatment period of 10days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or 1000micrograms for 12days. The dose was delivered by metered dose inhaler(MDI). Results : The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. Conclusion : These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.