• Clinical and Experimental Pediatrics
• /
• v.45 no.11
• /
• pp.1373-1380
• /
• 2002

Purpose : Acute measles encephalitis(ME) is characterized by an abrupt onset of fever and obtundation, frequently accompanied by seizures and multifocal neurological signs. The aim of this study was to clarify the clinical manifestation, progression and the brain SPECT patterns in patients with acute ME. Methods : This study included 11 children with acute ME admitted to Chonbuk National University Hospital. Ten patients received a first dose of measles vaccine, one patient did not receive a first dose, and no patients received a second dose. ME was diagnosed based on characteristic clinical pictures, measles antibodies by ELISA and abnormal CSF findings. Brain MRI and brain SPECT were performed in 11 patients with acute ME. Results : There were four males and seven females whose ages at onset ranged between 18 months and 14 years(mean : 10.5 years). The main clinical neurologic pictures were loss of consciousness( 10) and seizure(five). The titer of IgG and IgM antimeasles antibodies in serum were positive in 10 patients. In CSF, nine patients had IgG antibodies and one patient had IgM antibodies. The concentration of protein(mean : $124{\pm}60mg/dL$) and WBC counts(mean : $158{\pm}157/{\mu}L$) in CSF were elevated in all patients. In electroencephalographic examination, nine patients showed increased slow waves. Seven of 11 patients(63.6%) revealed high signal intensity on the brain MRI. In contrast, all patients showed hypoperfusion in brain SPECT examination. According to brain SPECT, the perfusion deficits were frequently observed in the frontal lobe(nine), temporal (nine), parietal(eight) and thalamus(eight). Conclusion : Brain SPECT is more sensitive than MRI for the evaluation of brain damage in early stages of acute ME.

• Korean Journal of Fisheries and Aquatic Sciences
• /
• v.29 no.4
• /
• pp.527-536
• /
• 1996

The patterns of diel horizontal migration (DHM) of 7 copepod species are compared as part of a general investigation of the zooplankton adaptations to the surf zone habitats. In a sandy shore surf zone of Yongil Bay, 3 sites such as the bottom and surface of 1 m water depth and water's edge are sampled with a sledge net(n=108). The surf zone copepod assemblage is dominated by 7 species; Acartia hudsonica, Fseudodiaptomus marinus, Paracalanus indicus, Calanus sinicus, Oithona similis, Sinocalanus tenellus and Labidocera bipinnata. Threefold variations in copepod abundance are observed within a diel cycle. Abundances of 7 dominant species and total copepods captured in the surface exhibit significant diel differences, but those taken in the bottom are not significantly affected by diel period. It is shown that about $90\%$ of the surf zone copepods performed DHM. The nocturnal high densities of copepods occurred for a neap tide when the offshore winds prevailed, suggesting the animals' ability for horizontal orientation and an active locomotion without invoking passive transportation by currents. Photoreactive behavior of copepods triggered by relative changes in light intensity may be a primary factor inducing DHM by aggregating in the surf zone during the night and spreading out at day; then copepods may reduce encounters with visual predators. In A. hudsonica, ontogenetic variations in timings of DHM are evident. Such variations are likely to minimize intraspecific competition for diets. Data on shoreward migration of copepods indicate that A. hudsonica, P. indicus, O. similis and S. tenellus can maintain swimming velocities of about $20m\;h^{-1}$ for durations of more than an hour. Our observations of strong diel difference in abundances point out the need for both day and night samplings in surf zone habitats, if the importance of these habitats to planktonic copepods are to be fully understood.

• The Journal of Korean Society for Radiation Therapy
• /
• v.18 no.1
• /
• pp.1-5
• /
• 2006

Purpose: IMRT quality assurance(Q.A) is consist of the absolute dosimetry using ionization chamber and relative dosimetry using the film. We have in general used 0.015 cc ionization chamber, because small size and measure the point dose. But this ionization chamber is too small to give an accurate measurement value. In this study, we have examined the degree of calculated to measured dose difference in intensity modulated radiotherapy(IMRT) based on the observed/expected ratio using various kinds of ion chambers, which were used for absolute dosimetry. Materials and Methods: we peformed the 6 cases of IMRT sliding-window method for head and neck cases. Radiation was delivered by using a Clinac 21EX unit(Varian, USA) generating a 6 MV x-ray beam, which is equipped with an integrated multileaf collimator. The dose rate for IMRT treatment is set to 300 MU/min. The ion chamber was located 5cm below the surface of phantom giving 100cm as a source-axis distance(SAD). The various types of ion chambers were used including 0.015cc(pin point type 31014, PTW. Germany), 0.125 cc(micro type 31002, PTW, Germany) and 0.6 cc(famer type 30002, PTW, Germany). The measurement point was carefully chosen to be located at low-gradient area. Results: The experimental results show that the average differences between plan value and measured value are ${\pm}0.91%$ for 0.015 cc pin point chamber, ${\pm}0.52%$ for 0.125 cc micro type chamber and ${\pm}0.76%$ for farmer type 0.6cc chamber. The 0.125 cc micro type chamber is appropriate size for dose measure in IMRT. Conclusion: IMRT Q.A is the important procedure. Based on the various types of ion chamber measurements, we have demonstrated that the dose discrepancy between calculated dose distribution and measured dose distribution for IMRT plans is dependent on the size of ion chambers. The reason is small size ionization chamber have the high signal-to-noise ratio and big size ionization chamber is not located accurate measurement point. Therefore our results suggest the 0.125 cc farmer type chamber is appropriate size for dose measure in IMRT.

• The Korean Society of Law and Medicine
• /
• v.15 no.1
• /
• pp.335-373
• /
• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.2
• /
• pp.206-213
• /
• 1994

We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.12 no.1
• /
• pp.14-22
• /
• 2012

Objectives: This study was performed to review clinical manifestations of hyperphenylalaninemia patients in Korean. Methods: 178 cases of hyperphenyalaninemia were diagnosed at department of pediatrics, Soonchunhyang University Hospital from January, 1983 to August. We reviewed DNA analysis, MR imaging, EEG, radiography of the left hand and wrist, bone densitometry (BMD), IQ test of hyperphenyalaninemia patients. Results: Out of 178 cases, 161 cases were diagnosed classic phenylketonuria and 17 cases were diagnosed BH4 deficiency. 122 cases performed DNA analysis. R243Q (10.3%), Y204C (9.9%), and IVS4-1G>A (8.1%) mutations were predominant. 22 cases underwent MR imaging. Varying degrees of symmetrical high signal intensity were noted on T2-weighted sequences in the periventricular deep white matter of 15 cases. 23 cases were performed EEG. 12 cases (52.3%) showed abnormal pattern. EEG abnormalities showed in 11 cases. On lumbar BMD four of 11 cases (36%) showed reduced bone density of more than 1 S.D. in four of 11 cases, bone age was less than chronological age by at least one year. 18 cases were performed IQ test. Mean IQ scores was $84{\pm}21.6$. Among older than 15 years (9 cases), Mean IQ scores was $72{\pm}21.2$. PTPS deficiency was 14 cases, DHPR deficiency was 2 cases, and GTPCH deficiency was 1 case. Conclusion: We confirmed there were varieties of DNA mutations. And MR imaging and EEG were nonspecific in PKU patients. Older children showed lower IQ score. Low phenylalanine diet prevents brain damage in PKU patient. Not only first few years of life but also lifetime, Keeping low phenylalanine diet is important.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.14 no.11
• /
• pp.5682-5688
• /
• 2013

The purpose of this study is to maximize diagnositc usefulness with increasing signal to noise ratio(SNR) and contrast to noise ratio(CNR) by using a 1mmol/mL gadolinium contrast agent. From January 2012 to June 2013 fourty-seven patients were underwent the MRI scanning to investigate the contrast difference in gadolinium content. Twenty of the patients were injencted the commercial contrast agent containing 0.5mmol/mL gadolinium and the rest of them were injected the new contrast agent containing 1mmol/mL gadolinium called gadobutrol. We measured and evaluated each SNR and CNR of the hip joint space, iliopsoas muscle and femoral head. As a result, using the 1mmol/mL gadolinium contrast agent had the higher SNR results than using the 0.5mmol/mL agent(27% in the hip joint, 30.01% in the femoral head). Also CNR using the 1mmol/mL gadolinium agent was proved to be higher than that of using 0.5mmol/mL agent(28.31% in the ilopsoas muscle and 26.74% in the femoral head). Therefore, the contrast agent containing more gadolinium like 1mmol/mL used in this study is more effective to shorten T1 relaxation time, so it increases the signal intensity and CNR and furthermore maximizes diagnostic value. This study reports the usefulness of the 1mmol/mL contrast agent in the contrast-enhanced magnetic resonance hip arthrography for the first. Therefore, it can be considered to have an meaningful academic value as showing the method for increasing the diagnostic usefulness by using the 1mmol/mL contrast agent.

• Journal of Wetlands Research
• /
• v.12 no.3
• /
• pp.21-37
• /
• 2010

The abiotic factors and the vegetation naturalness of the 13 tributary wetlands around Namgang-River were assessed to investigate the present state and to present the conservation counter plan for the wetland ecosystem of the tributaries. Assessment indices for the abiotic factors were estimated based on the dominant land use types of the riparian zone, ecological function of the upper levee, levee slope structure, artificiality and utilization intensity of the waterfront, artificiality of the revetment structure, diversity of the substrate, and severance of the transverse. The assessment index of Omi-cheon is the highest among 13 tributaries. The second was Banseong-cheon and third was Hyangyang-cheon, followed by Nabul-cheon and Yeongcheon-gang and Sugok-cheon, Jungchon- cheon, and Daegok-cheon in their order and Munsan-cheon got the lowest assessment index. Assessment indices for the vegetation naturalness were estimated based on the vegetation diversity, exotic species dominance, annual herb dominance, naturalness and peculiarity of the vegetation, and species diversity. The assessment index of Omi-cheon is the highest among 13 tributaries. The second was Sugok-cheon and third was Banseong-cheon, followed by Yeongcheon-gang, Jungchon- cheon, Jinae-cheon, Nabul-cheon, and Jisu-cheon in their order, and Yonga-cheon got the lowest assessment index. The grades of the stream naturalness were estimated based on the the naturalness indices for the abiotic factors and the vegetation naturalness. The grades of Omi-cheon is the highest among 13 tributaries as the grade I. Those of Banseong-cheon, Sugok-cheon, Yeongcheon-gang, Nabul-cheon and Jungchon-cheon, Hyangyang-cheon, Jinae-cheon, Jisu-cheon, Daegok-cheone, and Munsan-cheon and Doksan-cheon were grade II in their order, and Yonga-cheon got the lowest as the grade III. It was suggested that restoration of the simple and flat substrate, create the natural vegetation on the levee slope constructed with concrete or stone wall, and rehabilitation of the eco-bridge were demanded to improve the grades of the stream naturalness through the restoration of the tributaries for the diverse aquatic wildlife, high vegetation diversity and species diversity with the vegetation consisted of perennial herbs and trees.

• Korean Journal of Ecology and Environment
• /
• v.44 no.1
• /
• pp.31-41
• /
• 2011

To optimize the natural chemical agents against nuisance phytoplankton, we examined algal removal activity (ABA) of Plant-Mineral Composite (PMC), which already developed by our teams (Kim et al., 2010), on various conditions. The PMC are consisted of extracted-mixtures with indigenous plants (Camellia sinensis, Quercusacutissima and Castanea crenata) and minerals (Loess, Quartz porphyry, and natural zeolite), and characterized by coagulation and floating of low-density suspended solids. A simple extraction process was adopted, such as drying and grinding of raw material, water-extraction by high temperature-sonication and filtering. All tests were performed in 3 L plastic chambers varying conditions; six different concentrations ($0{\sim}1.0\;mL\;L^{-1}$), six light intensities ($8{\sim}1,400\;{\mu}mol\;m^{-2}s^{-1}$), three temperatures ($10{\sim}30^{\circ}C$), four pHs (7~10), five water depths (10~50 cm), and three different waters dominated by cyanobacteria, diatom, and green algae, respectively. Results indicate that the highest ABA of PMC was seen at $0.05\;mL\;L^{-1}$ in treatment concentrations, where showed a reduction of more than 80% of control phytoplankton biomass, while $1,400\;{\mu}mol\;m^{-2}s^{-1}$ in light intensity (>90%), $20{\sim}30^{\circ}C$ temperature (>60%), 7~9 in pH (>90%), below 50 cm in water depth (>90%), and cyanobacterial dominating waters (>80%), respectively. Over the test, ABA of PMC were more obvious on the algal biomass (chlorophyll-${\alpha}$) than suspended solids, suggesting a selectivity of PMC to particle size or natures. These results suggest that PMC agents can play an important role as natural agents to remove the nuisant algal aggregates or seston of eutrophic lake, where occur cyanobacterial bloom in a shallow shore of lake during warm season.

• Korean Journal of Food Science and Technology
• /
• v.42 no.1
• /
• pp.33-38
• /
• 2010

This study was conducted to compare the physicochemical properties of powdered green teas produced in Korea and Japan including particle size, color, chlorophyll, caffeine and theanine. The average particle size of Korean powered green tea ($14.63-25.39\;{\mu}m$) was similar to that of Japanese powdered green tea ($15.46-21.02\;{\mu}m$). The surface color of shade-cultivated Haenam Green Tea (HN-1) had the highest negative 'a' value, which represents 'green' color. When the TCD (total color difference value) was measured in the samples, HN-1 was most similar to the premium powdered green tea of Japan (JA-1). Domestic shade-cultivated powdered green teas had 1.5-2 times greater chlorophyll content than powdered green teas produced from plants that were not cultivated in the shade. The presence of chlorophyll a resulted in a higher intensity of green color than the presence of chlorophyll b. A significant negative correlation was also observed between the color and the chlorophyll a, chlorophyll b and total chlorophyll contents. Specifically, chlorophyll a had the greatest impact on the green color of powdered green tea. The content of catechins, caffeine and theanine in Korean powdered green teas ranged from 14.679-20.128, 1.496-3.237 and 0.926-1.977 g/100 g, respectively. The caffeine and theanine contents were high in shade-cultivated powdered green teas. Based on the above results, domestic powdered green teas cultivated under shaded conditions had a quality similar to that of medium-quality green teas produced in Japan, and the overall quality of Korean powdered green tea was poorer than that of Japanese powdered green tea.