• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• Korean Journal of Soil Science and Fertilizer
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• v.11 no.2
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• pp.97-104
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• 1979

According to Soil Taxonomy which has been developed over the past 20 years in the soil conservation service of the U. S. D. A, Soils in Korea are classified. This system is well suited for the classification of the most of soils. But paddy field soils have some difficulties in classification because Soil Taxonomy states no proposals have yet been developed for classifying artificially irrigated soils. This paper discusses some problems in the application of Taxonomy and suggestes the classification of paddy field soils in Korea. Following is the summary of the paper. 1. Anthro aquic, Aquic Udipsamments : The top soils of these soils are saturated with irrigated water at some time of year and have mottles of low chroma(2 or less) more than 50cm of the soil surface. (Ex. Sadu, Geumcheon series) 2. Anthroaquic Udipsamments : These sails are like Anthroaquic, Aquic Udipsamments except for the mottles of low chroma within 50cm of the soil surface. (Ex. Baegsu series) 3. Halic Psammaquents : These soils contain enough salts as distributed in the profile that they interfere with the growth of most crop plants and located on the coastal dunes. The water table fluctuates with the tides. (Ex. Nagcheon series) 4. Anthroaquic, Aquic Udifluvents : They have some mottles that have chroma of 2 or less in more than 50cm of the surface. The upper horizon is saturated with irrigated water at sometime. (Ex. Maryeong series) 5. Anthro aquic Udifluvents : These soils are saturated with irrigated water at some time of year and have mottles of low chroma(2 or less) within 50cm of the surface soils. (Ex. Haenggog series) 6. Fluventic Haplaquepts : These soils have a content of organic carbon that decreases irregularly with depth and do not have an argillic horizon in any part of the pedon. Since ground water occur on the surface or near the surface, they are dominantly gray soils in a thick mineral regolith. (Ex Baeggu, Hagseong series) 7. Fluventic Thapto-Histic Haplaquepts : These soils have a buried organic matter layer and the upper boundary is within 1m of the surface. Other properties are same as Fluventic Haplaquepts. (Ex. Gongdeog, Seotan series) 8. Fluventic Aeric Haplaquepts : These soils have a horizon that has chroma too high for Fluventic Haplaquepts. The higher chroma is thought to indicate either a shorter period of saturation of the whole soils with water or some what deeper ground water than in the Fluventic Haplaquepts. The correlation of color with soil drainage classes is imperfect. (Ex. Mangyeong, Jeonbug series) 9. Fluventic Thapto-Histic Aeric Haplaquepts : These soils are similar to Fluventic Thapto Histic Haplaquepts except for the deeper ground water. (Ex. Bongnam series) 10. Fluventic Aeric Sulfic Haplaquepts : These soils are similar to Fluventic Aeric Haplaquepts except for the yellow mottles and low pH (<4.0) in some part between 50 and 150cm of the surface. (Ex. Deunggu series) 11. Fluventic Sulfaquepts : These soils are extremely acid and toxic to most plant. Their horizons are mostly dark gray and have yellow mottles of iron sulfate with in 50cm of the soil surface. They occur mainly in coastal marshes near the mouth of rivers. (Ex. Bongrim, Haecheog series) 12. Fluventic Aeric Sulfaquepts : They have a horizon that has chroma too high for Fluventic Sulfaquepts. Other properties are same as Fluventic Sulfaquepts. (Ex. Gimhae series) 13. Anthroaquic Fluvaquentic Eutrochrepts : These soils have mottles of low chroma in more than 50cm of the surface due to irrigated water. The base saturation is 60 percent or more in some subhroizon that is between depth of 25 and 75cm below the surface. (Ex. Jangyu, Chilgog series) 14. Anthroaquic Dystric Fluventic Eutrochrepts : These soils are similar to Anthroaquic Fluvaquentic Eutrochrepts except for the low chroma within 50cm of the surface. (Ex. Weolgog, Gyeongsan series) 15. Anthroaquic Fluventic Dystrochrepts : These soils have mottles that have chroma of 2 or less within 50cm of the soil surface due to artificial irrigation. They have lower base saturation (<60 percert) in all subhorizons between depths of 25 and 75cm below the soil surface. (Ex. Gocheon, Bigog series) 16. Anthro aquic Eutrandepts : These soils are similar to Anthroaquic Dystric Fluventic Eutrochrepts except for lower bulk density in the horizon. (Ex. Daejeong series) 17. Anthroaquic Hapludalfs : These soils' have a surface that is saturated with irrigated water at some time and have chroma of 2 or less in the matrix and higher chroma of mottles within 50cm of the surface. (Ex. Hwadong, Yongsu series) 18. Anthro aquic, Aquic Hapludalfs : These soils are similar to Anthro aquic Hapludalfs except for the matrix that has chroma 2 or less and higher chroma of mottles in more than 50cm of the surface. (Ex. Geugrag, Deogpyeong se ries)