• Journal of Chest Surgery
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• v.43 no.3
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• pp.246-253
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• 2010

Background: Our objective was to review the long-term prognosis of patients with preoperative mild to moderate ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting. Material and Method: We prospectively followed 1,000 consecutive and systematic off-pump coronary artery bypass grafting patients who were operated on between September 1996 and March 2004; follow-up was achieved for 97%. Sixty-seven patients (6.7%) had mild to moderate ischemic mitral regurgitation at the time of surgery. Operative mortality, actuarial survival and major adverse cardiac event free survival were compared to assess the effect of ischemic mitral regurgitation. Result: Average follow-up was $66{\pm}22$ months. Patients with ischemic mitral regurgitation were older (p<0.001), had lower ejection fractions (p<0.001) and more comorbidities. Significantly more female patients presented with ischemic mitral regurgitation (p=0.002). There was no significant difference in operative mortality and perioperative myocardial infarction in ischemic mitral regurgitation patients (p=0.25). Eight-year survival was decreased in ischemic mitral regurgitation patients ($39.6{\pm}11.8%$ vs $76.7{\pm}2.2$, p<0.001). However, after correcting for risk factors, mild to moderate ischemic mitral regurgitation was not found to be a significant independent risk factor for long-term mortality (p=0.42). Major adverse cardiac event free survival at 8 years was significantly lower in ischemic mitral regurgitation patients ($53.12{\pm}12%$ vs $77{\pm}2%$, p<0.001). After correction for risk factors, ischemic mitral regurgitation remained a significant independent cause of major adverse cardiac events (HR: 2.31), especially congestive heart failure and recurrent myocardial infarction. Conclusion: In our series, patients with preoperative mild to moderate ischemic mitral regurgitation had a higher prevalence of preoperative risk factors than patients without ischemic mitral regurgitation. They had comparable perioperative mortality and morbidity, but, in the long term, were found to be at elevated risk for recurrent cardiac events.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.319-327
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• 1994

Background: The pathogenetic mechanism of adult respiratory distress syndrome(ARDS) is not clearly defined yet, but it is well known that increased pulmonary capillary permeabilty is characteristic feature of ARDS. The increased alveolar-capillary permeability is usually preceded by damage of pulmonary artery endothelial cells. The released enzymes and oxygen free radicals from the activated neutrophils seem to play a predominant role in endothelial cell cytotoxicity. The activated neutrophils, however, probably are not the sole contributing factor in this type of damage because many cases of ARDS have been reported in severe neutropenia. Bacterial endotoxin perse and/or oxygen free radicals released from endothelial cells are suggested to be possible factors that contribute to the development of ARDS. The purpose of this study is to investigate the direct cytotoxicity of endotoxin and the role of oxygen free radicals released from the endothelial cells in endotoxin-induced endothelial cell cytotoxicity. Methods: First, to investigate whether endotoxin is cytotoxic to HUVE by itself, various doses of endotoxin were added to culture medium and cytotoxicity was measured. Second, to evaluate the possible role of oxygen free radical in endotoxin-induced HUVE cytotoxicity, various antioxidants were added on the endotoxin-induced HUVE cytotoxicity and cytotoxicity was measured. Third, to verify the release of oxygen free radicals from HUVE, the concentrations of hydrogen peroxide in the endotoxin-treated culture supernatant were measured. Finally, to observe the cytotoxic effect of hydrogen peroxide, HUVE cytotoxicity in the presence of various doses of hydrogen peroxide was measured. The fourth generations of subcultured HUVE from primary culture were used. The cell cytotoxicity was quantified by the chromium-51 release assay. Results: 1) Endotoxin alone showed HUVE cytotoxicity in a dose-dependent fashion. 2) Endotoxin-induced HUVE cytotoxicity was significantly attenuated by the pretreatment of catalase and DMTU. 3) Hydrogen peroxide was released from HUVE after endotoxin treatment in a dose-dependent fashion. 4) Exogenous hydrogen peroxide also showed HUVE cytotoxicity in a dose-dependent fashion. Conclusion: These results suggest that endotoxin alone can directly injure HUVE, and, oxygen-free radicals released from HUVE in response to endotoxin may also participate in the endotoxin-induced HUVE cytotoxicity.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.137-155
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• 1999

The purpose of this study was to assess the effect of sex education on knowledge and attitude related to sex. The subjects were taken from by 199 students in 3 classes from 1st grade in H girl's junior high school as the study group, and 2 classes from 1st grade in S girl's junior high school as control group. During the survey period(September 21, 1998 to September 30, 1998), 6 times in terms of one-hour class for sex education were taught to the study group. A pre-test was executed on September 19, 1998 and the post-test on September 30. The findings were as follows. 1. According to the research, 20.1％ of the subjects have experienced sex education from parents and 89.9％ from teacher. They have mostly obtained the sex-related information from teachers(59.8％), following movie, radio, TV, or video tape(40.7％), friends(35.2％), reading materials such as books, cartoons, news papers and magazines(31.7％), parents(15.6％), siblings(7.0％), PC(1.5％) and telephone service(1.5％). 2. 27.1％ of the subjects reported that they had sex-related worry concerning from friendship with the opposite sex, following physiological phenomenon(31.5％), sex violence(11.1％), physical characteristics(7.4％), VD and contraception(5.6％), sexual impulse(5.6％), pregnancy and delivery(5.5％), and sexual behaviour(3.7％). The research showed that the adolescents usually solved their problems through the consultation with theifriends(44.4％). However, 16.7％ of the subjects were turned out not to request any solution. The other minor routes to settle their problems were written materials such as books, magazines(13.0％), parents(13.0％), movie, radio, TV, or video tape(5.5％), acquainted female elders(3.7％) and teachers(3.7％). 3. The most interesting part regarding sex was the friendship with the opposite sex(61.8％), following adolescent's emotion(55.8％), physiological differences between two genders(52.8％), AIDS(48.7％), VD(46.7％), pregnancy(45.2％), contraception(45.2％), abortion(41.7％), intercourse(41.7％), masturbation(41.2％), sex violence(41.2％) and genital structure and secondary sexual characteristics(28.6％). 4. In regard to characteristics of the subjects influencing sex-related knowledge, the higher educational career of mother, living with at least either parent and the experience of sex education by teachers were statistically significant factors(p〈0.05). 5. In regard to characteristics of the subjects influencing attitudes toward sex, the experience of sex education by parents or teachers was a statistically significant factor(p〈0.05). 6. The analysis of knowledge score comparing results before and after sex education showed that control group's score decreased from 12.5 to 12.44 while the study group's score increased from 12.33 to 21.31, which was statistically significant(p〈0.001). 7. The analysis of the attitude scores before and after sex education showed that the control group's score slightly increased from 55.57 to 56.36, while the study group's score increased from 54.79 to 61.95, which was statistically significant(p〈0.001). 8. The level of sex-related concerns of the study group after sex education marked both the increase in some items and the decrease in others. 9. Most instructive session among the sex education was the third “to be a good friend to the opposite sex”(27.0％).

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.443-454
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• 2008

Statement of problem: A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment. Purpose: This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer. Material and methods: At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed. Results: 1. There was significant difference between visual and spectrophotometric assessment (mean ${\Delta}E$ values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ${\Delta}E$ values). Conclusion: Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems.

• Journal of The Korean Association For Science Education
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• v.32 no.4
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• pp.570-585
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• 2012

The Korean national curriculum for secondary school emphasizes scientific problem solving. In line with the national curriculum, many educational studies have been conducted in relation to science education. The objects of these studies were well-defined and well-structured problems. The studies were criticized for overlooking ill-defined and ill-structured problems. Some research has dealt with problem finding in ill-structured problems, which is related to creativity. There is a need for a study of scientific problem finding process in an ill-structured problem situation, because this study will help teachers wanting to teach scientific problem-finding in an ill-structured problem situation. The objective of this study was to conduct an empirical study on the scientific problem finding process in an ill-structured problem situation. One task of scientific problem finding in an ill-structured problem situation was assigned to 92 university students; thereafter, 32 of them participated in the research through interviews. Results indicated that the scientific problem finding process depended on initial clues and tentative solutions. Initial clues were affected by students' experiences, such as major classes, films, and novels. Tentative solutions were influenced by background knowledge of the tasks. Students screened information browsed on the Internet. They applied some standards for selection, particularly emphasized reliability standards, which are supposed to be studied in other contexts. All the students used assumptions to make their problems appear probable, which could be a useful tool to articulate.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.2
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• pp.210-218
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• 2010

This study was carried out to investigate the effect of Yacon (Polymnia sonchifolia Poepp. & Endl.) powder on cholesterol-lowering and anti-obesity effects in rats fed a high fat-high cholesterol diet for 4 weeks to induce hyperlipidemic and obese rat model. Weight-matched male Sprague-Dawley rats were assigned to four groups according to dietary fat, cholesterol levels and Yacon powder levels. Experimental groups were normal diet group (N), high fat-high cholesterol diet group (HFC), high fat-high cholesterol diet with 5% Yacon powder group (HFC-PSL) and high fat-high cholesterol diet with 10% Yacon powder group (HFC-PSH). The body weight gain and FER were increased by a high fat-high cholesterol diet, but gradually decreased in the Yacon powder fed groups compared with the HFC group. Food intake was lower in HFC groups compared with N group. The liver and adipose tissue weights of HFC group were heavier than those of N group, whereas those of groups administered Yacon powder were gradually decreased. The serum ALT, AST, ALP and LDH activities elevated by a high fat-high cholesterol diet were significantly decreased by Yacon powder administration. Levels of serum total cholesterol, LDL-cholesterol, atherogenic index and cardiac risk factor showed a decreasing tendency in the Yacon powder fed groups compared with HFC group. The serum HDL-cholesterol level decreased in the HFC group and markedly increased in the Yacon powder fed groups. Levels of total cholesterol and triglyceride in liver and adipose tissues were lower in Yacon powder administered groups than those in HFC group. These results suggest that Yacon powder may improve lipid metabolism of serum, liver, and adipose tissue and potentially reduce lipid storage.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.42-50
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• 2003

Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.505-512
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• 2017

The purpose of this study was to determine the quality of life according to the level of subjective perception as well as to analyze the influencing factors and improve the subjective perception to improve the quality of life. The results of the survey for adult patients in hospitals and neighborhood clinics in the region of Busan for nine months from December 2015 were as follows. Regarding the total symptoms, the women had a score of 1.41, and the younger respondents felt they suffered from no symptoms. An analysis of the quality of life by the general characteristics showed that the respondents who were better educated and had no systemic diseases had a higher score of 54.71 on the OHIP-14. The respondents who were better educated and had no systemic diseases had a higher score of 6.48 when a single item was used to determine their happiness index, and the respondents who were better educated and had no systemic diseases had a higher score of 3.82 when five items were used to rate their happiness index. The factor with the greatest influence on their scores on the OHIP-14 was the total symptoms, followed in order by the happiness index and self-rated oral health status. The variable that exerted the largest influence on the happiness index was the OHIP-14, followed by the self-rated health status, high-school or lower education, and the presence or absence of one or more chronic disease. Therefore, an improvement in the subjective awareness level is required to boost the quality of life, and a variety of health education programs should be prepared to raise the awareness level. In addition, there should be a chance to convey accurate information.

• Journal of the Korean Society of Food Science and Nutrition
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• v.31 no.6
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• pp.1134-1141
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• 2002

Adhesion of leukocytes to the activated vascular endothelium and their subsequent recruitment/migration into the artery wall are key features in the pathogenesis of atherosclerosis and inflammatory diseases. These features have been mediated by cell adhesion molecules including vascular cell adhesion molecule-1 (VCAM-1) and in tracellular cell adhesion molecule-1 (ICAM-1). This study examined whether flavonoids inhibit the pro-inflammatory cytokine TNF-$\alpha$-induced monocyte adhesion via a modulation of the protein expression of VCAM-1 and ICAM-1 of human umbilical vein endothelial cells (HUVECs). TNF-$\alpha$ markedly increased the adhesion of THP-1 monocytes to endothelial cells and induced the expression of VCAM-1, ICAM-1 and E-selectin proteins in HUVECs. Micromolar concentrations of the flavones luteolin and apigenin and the flavonol quercetin near completely blocked the monocyte adhesion to the activated endothelial cells and the induction of these adhesion molecules. However, equimicromolar catechins of (-)epigallocatechin gallate and (+)catechin, the flavonol myr- icetin and the flavanones of naringin and hesperidin had no effect on TNF-$\alpha$-activated monocyte adhesion. (-)Epigallocatechin gallate, (+) catechin, and naringin did not attenuate the TNF-$\alpha$ induction of these adhesion molecules. Furthermore, culture with luteolin and apigenin strongly blocked the expression of TNF-$\alpha$-induced VCAM-1 mRNA and modestly attenuated ICAM-1 mRNA. Quercetin modestly decreased the TNF-$\alpha$-activated VCAM-1 and ICAM-1 mRNAs. These results demonstrate that flavonoids classified as flavones and flavonols may inhibit monocyte adhesion to the TNF-$\alpha$-activated endothelium, most likely due to a blockade of expression of functional adhesion molecules down-regulated at the transcriptional level, indicating a definite linkage between the chemical structure of flavonoids and the expression of cell adhesion molecules. Furthermore, the antiathero-genic feature of flavonoids appears to be independent of their antioxidant activity.