• Clinics in Shoulder and Elbow
• /
• v.15 no.2
• /
• pp.79-85
• /
• 2012

Objective: It has been expected that patient with posttraumatic recurrent anterior shoulder dislocation might have limited daily life activity because of pain and apprehension of dislocation. But there have been only a small number of investigations regarding the rotator strength in this patient. The aim of this study is to find the characteristics about rotator strength of patient with posttraumatic recurrent anterior shoulder dislocation using an isokinetic testing. Method: We enrolled thirteen patients with posttraumatic recurrent anterior shoulder dislocation and fifteen sex, age-matched healthy nonathletic subjects in this controlled study. All participants were male and there were no significant differences between the two groups in age, height, weight, BMI. Isokinetic internal rotator and external rotator strength was evaluated with a Biodex Isokinetic Testing machine (Biodex Medical Systems, Shirley, NY, USA), tests were performed at 60 deg/sec and 180 deg/sec for both sides. Peak torque normalized to body weight, external rotator to internal rotator ratio, total work and fatigue were calculated for each angular velocity. The association between internal rotator and external rotator strength and shoulder instability was analyzed by comparisons with a control group. Results: Any notable differences could not be found between the two groups given all data from no symptomatic left shoulder. There were no significant differences between the two groups statistically in internal rotation strength of right shoulder. However, there has been a tendency that at all angular velocities, external rotator peak torque to body weight, total work and external rotator to internal rotator ratio were significantly lower in the anterior instability group than the control group at all angular velocities. There was no substantial difference between those groups with respect to the fatigue of external rotator and internal rotator in our study. Conclusion: The prominent characteristics of posttraumatic recurrent anterior shoulder dislocation are external rotator weakness and loss of balance with external rotator and internal rotator. Therefore selective training using this information rotator might be helpful in conservative treatment and rehabilitation.

• Clinical and Experimental Pediatrics
• /
• v.51 no.3
• /
• pp.307-314
• /
• 2008

Purpose : Capsaicin, the major pungent ingredient in red pepper, has long been used in spices and food additives. It has been recently shown to induce apoptosis in several cell lines through a not well known mechanism. The aim of this study was to investigate the apoptosis-inducing effect of capsaicin on gastric cancer cells, and to provide valuable information concerning the application of capsaicin for therapeutic purposes. Methods : Cultured SNU-668 cells were treated with capsaicin. We analyzed cell survival by trypan blue and crystal violet analysis, cell cytotoxicity by MTT assay, apoptosis by nuclear condensation and DNA fragmentation, bcl-2 and bax mRNA expression by RT-PCR, and the expression of apoptosis related proteins by Western immunoblot analysis. In order to assess whether the growth inhibitory effect of anticancer drugs is enhanced by capsaicin, we investigated the effects of cell cytotoxicity and the expression of apoptosis related proteins of etoposide and adriamycin treated with capsaicin in cells. Results : Capsaicin inhibited growth of SNU-668 cells in a dose-dependent manner. This inhibitory effect of capsaicin on cell growth was mainly due to the induction of apoptosis as evidenced by DNA fragmentation, nuclear condensation and the expression of apoptosis related proteins. Furthermore, capsaicin prominently reduced the ratio of anti-apoptotic Bcl-2 to pro-apoptotic Bax and consequently increased caspase-3 activity. The cells treated with capsaicin were more sensitive to death induced by etoposide and adriamycin than the cells without capsaicin. Conclusion : These results demonstrate that capsaicin efficiently induced apoptosis in SNU-668 cells through a caspase-3-dependent mechanism and sensitizes cancer cells to anticancer drugs toward apoptotic cell death, which may contribute to its anticancer effect and chemosensitizer function against gastric cancer.

• Journal of the Korean Society for Marine Environment & Energy
• /
• v.13 no.4
• /
• pp.288-295
• /
• 2010

Metal exposure experiments using polychaete (Perinereis nuntia) as a bio-indicator of trace metals contamination were conducted to evaluate the bioaccumulation and the biomarkers responses such as metallothionein-like protein (MTLPs) and glutathione S-transferase (GST) which was simultaneously exposed to Cadmium (Cd) and Copper (Cu). Cu and Cd concentrations in polychaete were enhanced with increasing exposure time and their concentrations of aqueous medium. Initial accumulation of Cd was higher than that of Cu. Our results showed that the bioaccumulation of Cu and Cd were prohibited, especially at higher Cu levels, suggesting the different cellular uptake mechanisms when Cu and Cd are co-exist. Net accumulation rate of Cu was declined with exposure time but it did not show any significant change for Cd. Although the highest MTLPs concentration was observed at 6 hr of exposure time, it did not show any significant change related to exposure times and metals concentrations. An increase of GST activity tended to increase as a function of exposure time and metals concentrations. And GST activities in P. nuntia have similar tendency with bioconcentration factors in high concentration of Cu (treatment group IV) at post 24 h of exposure. Our results provide new information of the bioaccumulation and biomarker responses to understand the effects of co-existing contaminants (Cu and Cd) using polychaete. Further studies are required to elucidate the bioaccumulation and biomarkers responses for various contaminants.

• The Korean Journal of Pharmacology
• /
• v.19 no.1
• /
• pp.15-35
• /
• 1983

Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

• The Journal of Industrial Distribution & Business
• /
• v.1 no.1
• /
• pp.33-41
• /
• 2010

In the age of globalization, effective and efficient corporate management is becoming more important as domestic and international business circumstances changes. In the middle of endless changes in business circumstances, fast reaction to customers and market, and offering customized goods and service became essential. In this respect, CRM designed to utilize customer information scientifically and systematically, has become an essential system and marketing strategy to enhance corporate competitiveness. CRM has placed the importance of customers in the front of marketing and has focused every process and business minds on customers. Recent change in the market and the trend of establishing and introducing CRM system has lead us to concentrate on the introduction of CRM in the financial institutions. This study searched for several views about CRM in academic and industrial papers. Through theoretical approach on CRM, the background of the introduction of CRM, the purpose of CRM, the characteristic and application of CRM, and the expected effect of CRM will be discussed. This study is focused on financial institutions where CRM is widely used. And through documents about examples of the introduction of CRM, the status of the establishment of domestic CRM and the necessity and trend of CRM will be discussed. Also the problem of CRM in the financial institutions and the improvement of CRM in domestic banks will be analyzed. When discussing CRM in the financial area, customers are the main source of corporate profit and through relationship management with the customers enhancing loyalty and maximizing profit can be obtained. Especially in CRM in financial institutions, maintaining existing customers makes higher profit ratio, so repurchasing and cross selling becomes important for obtaining lifetime value of existing customers who contribute to most of the profit of corporations. As a result, CRM should be completely customer oriented. CRM in financial institutions is not merely marketing work, but organizational competence which is made up of standardized work process through total process integration inside the corporation. Corporations which plan to introduce CRM should analyze the characteristics and conditions of corporations and establish purpose and strategy of CRM. And they need long term view to find out the factors which best fit for the introduction of CRM. To enable this, strategy composed of daily marketing activity and CRM concept is necessary. Also continued improvement through drill and training for operating organization should be followed to maintain CRM well. And corporate culture must settle customer as the center of corporate value. The race for introducing and improving CRM has already begun. CRM should not be regarded as a choice. It should be accepted as something essential. In this reality financial institutions should solve subdivision problem of customers and necessity of customers with the mind of 'customer's profit is my profit'. Customer focused management should not be emphasized only by words. Efforts like viewing from the customer's point must be nurtured to provide methods to help customers. That is, we should not just follow what is done in foreign countries. We should solve the problem of our customers according to the situation of our country, our industry, our corporation. Then we can gain the trust of customers, and the value derived from the customers will become the background of CRM which will lead the corporation to success.

• Proceedings of the Korean Society of Postharvest Science and Technology of Agricultural Products Conference
• /
• 1993.12a
• /
• pp.6-9
• /
• 1993

According to changes in population, economic conditions, life-stile and eating habits, the frui ts and vegetables market wi 11 be shi fted from processed (i. e. , canned) to fresh. Undressed fresh produce, consisting of washed, disinfected and peeled fruits and vegetables that either sliced or grated, are currently increased in demand by retail and institutional market which use them as salad components or in ready-to use foods, Main attributes of minimally processed fruits and vegetables are convenience and fresh-like quality. Minimally processed Products readily deteriorate in quality, especially color and texture, as a result of endogeneous enzyme enhanced respiration and microorganisms which lead to reduced shelf Iife. According to changes in population, economic conditions, life-stile and eating habits, the frui ts and vegetables market wi 11 be shi fted from processed (i. e. , canned) to fresh. Undressed fresh produce, consisting of washed, disinfected and peeled fruits and vegetables that either sliced or grated, are currently increased in demand by retail and institutional market which use them as salad components or in ready-to use foods, Main attributes of minimally processed fruits and vegetables are convenience and fresh-like quality. Minimally processed Products readily deteriorate in quality, especially color and texture, as a result of endogeneous enzyme enhanced respiration and microorganisms which lead to reduced shelf Iife. Thus. to prevent these undesirable changes , val'ious techniques such as controlled atmosphere (CA) storage, modified atmosphere OIA) storage, including vacuum packaging have been receiving considerable attention, Although milch research has been done to find optimal conditions for whole intact frui ts and vegetables, only limi ted information is avai lable on fresh cut. and other minimally processed products. 81 iced frui ts exhibi t increas~d ethylene production and respiration compal'ed to whole f, 'uits during distribution in response to tissue damage. As a result, accelerated senescence and enzymatic browning OCCUI', Recent l'esearch on minimally processed fl'uits and vegetables has mainly focused on methods to inhibit browning, due to ban on use of sulfur dioxide, In order to retard or prevent these physiological changes, val'ious al ternatives, reducing agents. acidulants, chelating agents and inol'ganic sal ts have been evaluated for use on fresh cut fl'ui ts. Al though some agents were effective replacement for sulfur dioxide. consum$\textregistered$I'S demandless use of chemical on such products. Shel~ life of minimally processed products has been extended by inhibition of metabolic reactions associated with loss of quality and by inhibition of aerobic spoilage caused by wide variety of microorganisms. Appl ication of ~I.-\ packaging, including vacuum packaging, retards the rate of respiration, prevents growth of aerobic spoilage organisms, inhibits oxidation and color deterioration. Tissue softening is another major problem in minimally processed products because enzymes re 1 a ted to ce 11 wa 11 degrada t i on are not inactivated. Various treatments have been investigated for retardation of the softening of sliced products. Some studies have concentrated on the application of an active packaging system with ~I, l. packaging and calcium infi 1 tration as possible measures to retain firmness of processed products. In my opinion, one important step for production of minimally processed frui ts wi th favorabl e color of cut surface and firm texture is the selection of better cultivar. As the view, changing tendency of fresh color by apple cultivars and relationship between the tendency and PPO activity will be discussed in the seminar. In addition to the topic, research result on quality enhancement of fresh apple slices by heat shock treatment will be introduced.

• Korean Journal of Environment and Ecology
• /
• v.22 no.3
• /
• pp.309-319
• /
• 2008

Roads are an indicator of anthropogenic activity causing ecosystem disturbances and often lead to habitat fragmentation, habitat loss, and habitat isolation. The Hallasan National Park(153.4$km^2$) on Jeju Island being distinguished for its unique geology, topography, and biota has also been designated as a core area of UNESCO Man and the Biosphere(MAB) Reserve. Although the high conservation value of this park has contributed to a rapid growth of tourists and road construction, landscape changes due to roads have not been examined yet. We used GIS systems to examine the fragmentation pattern caused by roads, in relation to its zonation, elevation, and vegetation. When a buffer was applied to roads(112m width for paved roads and 60m width for both legal and illegal trails), the park consisted of 100 fragments. The ten fragments generated after applying buffer to only paved roads and legal trails ranged from $0.002km^2$ to $38.2km^2$ with a mean of $14.2km^2$, and about 7% of both nature conservation zone and nature environment zone of the park were edge. Fragments in both east and west ends of the park and around the summit exhibited relatively high shape indices with means of 5.19(for 100 fragments) and 7.22(for 10 fragments). All five legal trails are connected to the pit crater of the mountain and vegetation changed from broadleaf forests and conifer forests to grasslands with elevation, consequently resulting in dramatic fragment size reduction in grasslands at high elevation, in particular above 1,400m, where endemic and alpine plants are abundant. These results show that in Hallasan National Park the risks of habitat deterioration and habitat loss due to fragmentation may be more severe in the nature conservation zone dominated by Baengnokdam than in the nature environment zone. Therefore, current road networks of the park appear to fall short of the goal of the national park for ecosystem conservation and protection. Considering that the entire Hallasan National Park also serves as a MAB core area, conservation efforts should focus, first of all, on park rezoning and road management to mitigate habitat fragmentation.

• Journal of Home Health Care Nursing
• /
• v.6
• /
• pp.33-45
• /
• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.2
• /
• pp.185-194
• /
• 1999

Background: NF-$\kappa$B is a characteristic transcriptional factor whose functional activity is determined by post-translational modification of protein and subsequent change of subcellular localization. The involvement of the NF-$\kappa$B family of the transcription factors in the control of such vital cellular functions as immune response, acute phase reaction, replication of certain viruses and development and differentiation of cells has been clearly documented in many previous studies. Several recent observations have suggested that the NF-$\kappa$B might also be involved in the carcinogenesis of some hematological and solid tumors. Investigating the possibility that members of the NF-$\kappa$B family participate in the molecular control of malignant cell transformation could provide invaluable information on both molecular pathogenesis and cancer-related gene therapy. Method: To determine the expression patterns and functional roles of NF-$\kappa$B family transcription factors in human lung cancer cell lines NCI-H792, NCI-H709, NCI-H226 and NCI-H157 were analysed by western blot, using their respective antibodies. The nuclear and the cytoplasmic fraction of protein extract of these cell lines were subsequently obtained and NF-$\kappa$B expression in each fraction was again determined by western blot analysis. The type of NF-$\kappa$B complex present in the cells was determined by immunoprecipitation. To detect the binding ability of cell-line nuclear extracts to the KB consensus oligonucleotide, electrophoretic mobility shift assay(EMSA) was performed. Results: In the cultured human lung cancer cell lines tested, transcription factors of the NF-$\kappa$B family, namely the p50 and p65 subunit were expressed and localized in the nuclear fraction of the cellular extract by western blot analysis and immunocytochemistry. Immunoprecipitation assay showed that in the cell, the p50 and p65 subunits made NF-$\kappa$B complex. Finally it was shown by Electrophoretic Mobility Shift Assay(EMSA) that nuclear extracts of lung cancer cell lines are able to bind to NF-$\kappa$B consensus DNA sequences. Conclusion: These data suggest that in human lung cancer cell lines the NF-$\kappa$B p50/p65 complex might be activated. and strengthen the hypothesis that NF-$\kappa$B family transcription factors might be involved in the carcinogenesis of human lung cancer.

• Journal of Genetic Medicine
• /
• v.5 no.1
• /
• pp.26-33
• /
• 2008

Purpose : Phenylketonuria(PKU) is an inborn error of metabolism and a genetic disorder resulting from a deficiency of phenylalanine hydroxylase(PAH) and decreased activity of tetrahydrobiopterin(BH4).In this study the correlation between the DNA mutation and clinical manifestations was investigated and PAH DNA mutations were compared bewteen Asian and Caucasian populations. Methods : DNA was isolated from peripheral leukocytes. The PAH gene was amplified by Polymerase Chain Reaction(PCR) and the sequence was analyzed with Multiplex Ligation-dependent Probe Amplification(MLPA). Results : We characterized the PAH gene of 102 independent Korean patients with PKU. PAH nucleotide sequence analysis revealed 44 different mutations, including 10 novel mutations comprising 9 missense mutations(N207D, K95del, A447P, G344D, P69S, S391I, A202T, G103S, and I306L) and 1 novel splice-site variant mutation(IVS10-3C>G). R243Q was the most prevalent mutation in this study. A259T has not previously been reported in Asian populations, but we found that this mutation had a frequency of 10.1% in our study. Furthermore, the genotypes of $BH_4$ responsive patients were analyzed and were divided into two groups: $BH_4$ medication-only group and $BH_4$ medication with diet therapy group. In the $BH_4$ medication-only group and $BH_4$ medication with diet therapy group, R241C was the most common mutation. Conclusion : Novel mutations in the PAH gene of PKU patients are still being discovered. Additional information as to the frequency of mutations in the tetrahydrobiopterine responsive gene is also accumulating. We anticipate that knowledge of these PKU gene mutations will assist the diagnosis, genetic counseling, and therapeutic treatment of PKU patients in future.