• Title/Summary/Keyword: Long-term characteristics

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Clinicopathologic features and prognosis of childhood IgA nephropathy (소아 IgA 신병증의 임상병리학적 양상과 예후)

  • Woo, Sung Il;Bae, Keun Wook;Lee, Joo Hoon;Park, Young Seo;Cho, Yong Mee
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.170-177
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    • 2007
  • Purpose : Clinicopathological features were investigated to clarify the outcome and prognostic indicators for patients with IgA nephropathy in Korean children. Methods : We reviewed the outcomes of 61 patients in whom IgA nephropathy was diagnosed before the age of 15 years from 1991 to 2005 and followed-up at least for one year. All patients were confirmed by renal biopsy. Results : After mean follow-up of 5.2 years from onset, 24 patients of 61 (39.3%) were in clinical remission at the last examination. Thirty patients (49.2%) had hematuria or mild proteinuria (<$1g/m^2/d$), five (8.2%) had severe proteinuria (${\geq}1g/m^2/d$), and two (3.3%) had chronic renal failure. By univariate analysis, initial presentation at onset and Haas classification were less concordant with outcome. Hypertension during follow-up, rather than hypertension at presentation, was significantly correlated with outcomes (P<0.01). Sixty percent of patients who had more than 20% of glomerular sclerosis or crescent progressed to severe proteinuria or chronic renal failure, as compared with 7.1% of those who did not (P<0.01). Conclusion : Prognosis of childhood IgA nephropathy had a relatively benign course during a mean follow-up of 5.2 years. Persistent hypertension during follow-up and more than 20% of glomerular sclerosis or crescent were strong predictors of a progressive course of IgA nephropathy. A new histologic classification according to characteristics of childhood IgA nephropathy must be established to assess prognosis. Further efforts should be made to understand the prognosis of IgA nephropathy through long-term follow-up.

Surgical Outcome of Biventricular Repair for Double-outlet Right Ventricle: A 18-Year Experience (양대혈관우심실기시증에 대한 양심실 교정의 수술 성적: 18년 치험)

  • 이정렬;황호영;임홍국;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.566-575
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    • 2003
  • We reviewed our 18-year surgical experience of biventricular repair for double-outlet right ventricle. Material and Method: One hundred twelve consecutive patients (80 males and 32 females) who underwent biventricular repair for double-outlet right ventricle between May 1986 and September 2002 were included. We assessed risk factors for early mortality and reoperation. Reoperation-free survival rate and actual survival rate were analysed. Result: Most common type of ventricular septal defect was subaortic (n=58, 52%) and non-committed type was second most common (n=32, 29%). Four different surgical methods were used: intraventricular baffle repair (n=71 , 63%): right ventricle to pulmonary ariery conduit interposition or REV with left ventricle to aorta baffle repair (n=24, 21 .4%): arierial switch operation with left ventricle to pulmonary artery baffle (n=14, 12.5%): Senning atrial switch operation with left ventricle to pulmonary artery baffle (n=3, 2.7%). Thirty four patients(30%) underwent palliative procedures before definite repair. Twenty three patients (21%) required reoperations. There were 12 (10.7%) early deaths and 4 late deaths. Age younger than 3 months at repair (p=0.003), cardiopulmonary bypass and aortic cross clamp time (p=0.015, p=0.067), type of operation (arterial switch operation) (p <0.001) and type of ventricular septal defect (subpulmonic type) (p=0.002) were revealed as risk factors for early death in univariate analysis, while age under 3 months was the only significant risk factor in multivariate analysis. Patients younger than 1 year of age (p=0.02), pulmonary artery angioplasty at definitive repair (p=0.024), type of ventricular septal defect (non-committed) (p=0.001), type of operation (right ventricle to pulmonary artery conduit interposition and REV operation) (p=0.028, p=0.017) were risk factors for reoperation in univariate analysis but there was no significant risk factor in multivariate analysis. Follow-up was available on 91 survivals with a mean duration of 110.8$\pm$56.4 (2~201) months. 5, 10 and 15 year survival rates were 86.5%, 85% and 85% and reoperation free survival were 85%, 71.5%, 70%. Conclusion: Age under 3 months at repair, subpulmonic ventricular septal defect and arterial switch operation were significant risk factors for early mortality. Patients with non-committed ventricular septal defect and who underwent conduit interposition or REV operation were risk factors for reoperation. With careful attention to chose best timing and surgical approach depending on morphologic characteristics, biventricular repair for double outlet right ventricle can be achieved with good long-term outcome.

Trophic State Characteristics in Topjeong Reservoir and Their Relations among Major Quality Parameters (탑정저수지의 부영양화 특성 및 주요 변수 간의 상호관계)

  • Park, Yu-Mi;Lee, Eui-Haeng;Lee, Sang-Jae;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.42 no.3
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    • pp.382-393
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    • 2009
  • The objectives of this study were to characterize long-term annual and seasonal trophic state of Topjeong Reservoir using conventional variables of Trophic State Index (TSI) and to determine the empirical relations between the trophic parameters. For the analysis, we used water quality dataset of 1995$\sim$2007, which is obtained from the Ministry of Environment, Korea and the number of parameters was 9. Annual ambient mean values of TN and TP were 1.78 mg $L^{-1}$ and 0.03 mg $L^{-1}$, respectively and TN : TP ratios averaged 76, indicating that this system was nitrogen-rich hypertrophic, and was probably phosphorus-limitation for algal growth. Therefore, nitrogen varied little with seasons and years, and total phosphorus (TP) varied depending on season and year. Monsoon dilutions of TP occurred in August and monthly fluctuations of suspended solid (SS) was similar to those of chlorophyll-$\alpha$ (CHL). Annual mean values of BOD and $COD_{Mn}$ were 1.61 mg $L^{-1}$ and 4.23 mg $L^{-1}$, respectively and the interannual values were directly influenced by the intensity of annual rainfall. There were no significant differences in the trophic variables between the two sampling sites. Mean values of Trophic State Index (TSI, Carlson, 1977), based on TN, TP, CHL, and SD (Secchi depth), turned out as eutrophic state, except for the TN (hypertrophic). Regression analyses of log-transformed seasonal CHL against TP and TN showed that variation of the CHL was explained 37% by the variation of TP ($R^2$=0.37, p<0.001, r=0.616), but not by TN ($R^2$=0.03, p>0.05). Regression coefficient of $Log_{10}$CHL vs $Log_{10}SD$ was 0.330 (p<0.003, r=0.580), indicating that transparency is regulated by the organic matter in the system. Results, data suggest that one of the ways controlling the eutrophication would be a reduction of phosphorus from the watershed.

The Effect of working Noise Exposure and Military Background on the Hearing Threshold (특수병과의 과거 군 소음 노출이 소음 노출 작업자의 청력에 미치는 영향)

  • Chung, Ho-Keun;Kim, Kyoo-Sang
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.2
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    • pp.137-146
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    • 2003
  • Objectives : Impaired hearing is a prevalent occupational hazard, not only in industry, but also in the armed forces. In military life, noise has unusual characteristics, and constitutes a serious hazard to hearing. The aim of this study was to analyze the hearing threshold data in order to compare the hearing loss among shipyard workers, representing different workers, and a military service background. Methods : A cross-sectional audiological survey, combined with a questionnaire study, was conducted on a stratified random sample of 440 shipyard workers, with long-term exposure to noise. The employees were divided into four groups, according to their working and military service backgrounds, in relation to their exposure to noise. Results : As expected, the working and military noise exposure group (Group I) had significantly poorer hearing than the other groups. The high frequencies (2-8 kHz) showed the greatest difference in terms of poorer fearing in both ears. The prevalence of noise-induced hearing loss (NIHL) was highest in Group I. A logistic regression analysis was applied to determine the dependence of the NIHL in relation to age, smoking, drinking, working duration, ear protection, past history of ear diseases, and working and military sonics backgrounds, on the noise exposure The important factors found to be related to the NIHL, in relation to noise exposure were: age, work duration, and working and military service backgrounds. The adjusted odds ratio estimates for NIML in the right ear were 4.5 times greater (95% CI 1.7-11.6) for the military noise exposed group, and 7.9 times greater (95% CI 2.0-31.3) for the working noise exposed group than in the controls. The hearing thresholds at the pure-tone average and 4 kHz were significantly increased with age and work duration with both the working and military service backgrounds. Conclusions : From these results, specific preventive programs were planned, which should be assessed by epidemiological surveillance of the military noise exposed population.

Role of Citrate Synthase in Acetate Utilization and Protection from Stress-Induced Apoptosis

  • Lee, Yong-Joo;Kang, Hong-Yong;Maeng, Pil Jae
    • Proceedings of the Microbiological Society of Korea Conference
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    • 2008.05a
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    • pp.39-41
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    • 2008
  • The yeast Saccharomyces cerevisiae has been shown to contain three isoforms of citrate synthase (CS). The mitochondrial CS, Cit1, catalyzes the first reaction of the TCA cycle, i.e., condensation of acetyl-CoA and oxaloacetate to form citrate [1]. The peroxisomal CS, Cit2, participates in the glyoxylate cycle [2]. The third CS is a minor mitochondrial isofunctional enzyme, Cit3, and related to glycerol metabolism. However, the level of its intracellular activity is low and insufficient for metabolic needs of cells [3]. It has been reported that ${\Delta}cit1$ strain is not able to grow with acetate as a sole carbon source on either rich or minimal medium and that it shows a lag in attaining parental growth rates on nonfermentable carbon sources [2, 4, 5]. Cells of ${\Delta}cit2$, on the other hand, have similar growth phenotype as wild-type on various carbon sources. Thus, the biochemical basis of carbon metabolism in the yeast cells with deletion of CIT1 or CIT2 gene has not been clearly addressed yet. In the present study, we focused our efforts on understanding the function of Cit2 in utilizing $C_2$ carbon sources and then found that ${\Delta}cit1$ cells can grow on minimal medium containing $C_2$ carbon sources, such as acetate. We also analyzed that the characteristics of mutant strains defective in each of the genes encoding the enzymes involved in TCA and glyoxylate cycles and membrane carriers for metabolite transport. Our results suggest that citrate produced by peroxisomal CS can be utilized via glyoxylate cycle, and moreover that the glyoxylate cycle by itself functions as a fully competent metabolic pathway for acetate utilization in S. cerevisiae. We also studied the relationship between Cit1 and apoptosis in S. cerevisiae [6]. In multicellular organisms, apoptosis is a highly regulated process of cell death that allows a cell to self-degrade in order for the body to eliminate potentially threatening or undesired cells, and thus is a crucial event for common defense mechanisms and in development [7]. The process of cellular suicide is also present in unicellular organisms such as yeast Saccharomyces cerevisiae [8]. When unicellular organisms are exposed to harsh conditions, apoptosis may serve as a defense mechanism for the preservation of cell populations through the sacrifice of some members of a population to promote the survival of others [9]. Apoptosis in S. cerevisiae shows some typical features of mammalian apoptosis such as flipping of phosphatidylserine, membrane blebbing, chromatin condensation and margination, and DNA cleavage [10]. Yeast cells with ${\Delta}cit1$ deletion showed a temperature-sensitive growth phenotype, and displayed a rapid loss in viability associated with typical apoptotic hallmarks, i.e., ROS accumulation, nuclear fragmentation, DNA breakage, and phosphatidylserine translocation, when exposed to heat stress. Upon long-term cultivation, ${\Delta}cit1$ cells showed increased potentials for both aging-induced apoptosis and adaptive regrowth. Activation of the metacaspase Yca1 was detected during heat- or aging-induced apoptosis in ${\Delta}cit1$ cells, and accordingly, deletion of YCA1 suppressed the apoptotic phenotype caused by ${\Delta}cit1$ mutation. Cells with ${\Delta}cit1$ deletion showed higher tendency toward glutathione (GSH) depletion and subsequent ROS accumulation than the wild-type, which was rescued by exogenous GSH, glutamate, or glutathione disulfide (GSSG). Beside Cit1, other enzymes of TCA cycle and glutamate dehydrogenases (GDHs) were found to be involved in stress-induced apoptosis. Deletion of the genes encoding the TCA cycle enzymes and one of the three GDHs, Gdh3, caused increased sensitivity to heat stress. These results lead us to conclude that GSH deficiency in ${\Delta}cit1$ cells is caused by an insufficient supply of glutamate necessary for biosynthesis of GSH rather than the depletion of reducing power required for reduction of GSSG to GSH.

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Biological Stream Health and Physico-chemical Characteristics in the Keum-Ho River Watershed (금호강 수계에서 생물학적 하천 건강도 및 이화학적 특성)

  • Kwon, Young-Soo;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.39 no.2 s.116
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    • pp.145-156
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    • 2006
  • The objective of this study was to evaluate biological health conditions and physicochemical status using multi-metric models at five sites of the Keum-Ho River during August 2004 and June 2005. The research approach was based on a qualitative habitat evaluation index (QHEI), index of biological integrity (IBI) using fish assemblage, and long-term chemical data (1995 ${\sim}$ 2004), which was obtained from the Ministry of Environment, Korea. For the biological health assessments, regional model of the IBI in Korea (An,2003), was applied for this study. Mean IBI in the river was 30 and varied from 23 to 48 depending on the sampling sites. The river health was judged to be "fair condition", according to the stream health criteria of US EPA (1993) and Barbour et al. (1999). According to the analysis of the chemical water quality data of the river, BOD, COD, conductivity, TP, TN, and TSS largely varied epending on the sampling sites, seasons and years. Variabilities of some parameters including BOD, COD, TP, TN, and conductivity were greater in the downstream than in the upstream reach. This phenomenon was evident in the dilution by the rain during the monsoon. This indicates that precipitation is a very important factor of the chemical variations of water quality. Community analyses showed that species diversity index was highest (H=0.78) in the site 1, while community dominance index was highest in the site 3, where Opsariichthys uncirostris largely dominated. In contrast, the proportions of omnivore and tolerant species were greater in the downstream reach, than in the upstream reach. Overall, this study suggests that some sites in the downstream reach may need to restore the aquatic ecosystem for better biological health.

Spatial Patterns and Temporal Variability of the Haines Index related to the Wildland Fire Growth Potential over the Korean Peninsula (한반도 산불 확장 잠재도와 관련된 Haines Index의 시.공간적 특징)

  • Choi Cwang-Yong;Kim Jun-Su;Won Myoung-Soo
    • Journal of the Korean Geographical Society
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    • v.41 no.2 s.113
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    • pp.168-187
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    • 2006
  • Windy meteorological conditions and dried fire fuels due to higher atmospheric instability and dryness in the lower troposphere can exacerbate fire controls and result in more losses of forest resources and residential properties due to enhanced large wildland fires. Long-term (1979-2005) climatology of the Haines Index reconstructed in this study reveals that spatial patterns and intra-annual variability of the atmospheric instability and dryness in the lower troposphere affect the frequency of wildland fire incidences over the Korean Peninsula. Exponential regression models verify that daily high Haines Index and its monthly frequency has statistically significant correlations with the frequency of the wildland fire occurrences during the fire season (December-April) in South Korea. According to the climatic maps of the Haines Index created by the Geographic Information System (GIS) using the Digital Elevation Model (DEM), the lowlands below 500m from the mean sea level in the northwestern regions of the Korean Peninsula demonstrates the high frequency of the Haines Index equal to or greater than five in April and May. The annual frequency of the high Haines Index represents an increasing trend across the Korean Peninsula since the mid-1990s, particularly in Gyeongsangbuk-do and along the eastern coastal areas. The composite of synoptic weather maps at 500hPa for extreme events, in which the high Haines Index lasted for several days consecutively, illustrates that the cold low pressure system developed around the Sea of Okhotsk in the extreme event period enhances the pressure gradient and westerly wind speed over the Korean Peninsula. These results demonstrate the need for further consideration of the spatial-temporal characteristics of vertical atmospheric components, such as atmospheric instability and dryness, in the current Korean fire prediction system.

Patterns of Cash Payments for Care : Cross-National Comparative Study (장기요양 현금급여 정책의 국가간 비교 연구)

  • Seok, Jae-Eun
    • Korean Journal of Social Welfare
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    • v.58 no.2
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    • pp.273-302
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    • 2006
  • The introduction of cash payments for care is a distinct trend that characterizes changes in care policies since the 1990s. Recently, many developed countries have newly introduced or extended cash payments for care that allow care users to be able to plan themselves for their cares instead of receiving direct care services from the state. Cash payments for care can be said to be one of the alternative policies by which user choices are extended, and it becomes possible to establish demand-cantered care delivery systems more economically and effectively, hence addressing the issue of the financial limitations and rigid systems that are common in modern welfare states, which make it difficult to response to various needs. However, the design and administration of cash for care vary across different countries. Such variations of cash for care policies influence on the combination of consumerism (based on liberal market values intrinsic in the care market) and citizenship based on social solidarity. Those variations eventually produce impacts on the balance of responsibilities and the roles of families, the state and market regarding care in other words, balancing of welfare pluralism. This paper has attempted to find general meanings and particularity of cash for care polices in modem welfare states by means of looking at the characteristics of cash for care policies of four different countries (Netherlands, France, Germany and Italy) and their impacts on their care market. If the four countries are ranked by the degree that they emphasize citizenship in light with social rights, the Netherlands, France, Germany and Italy could be placed in due order. From an economic point of view and in terms of cost containment, those countries will be placed in an inverse order, It is apparent that in the course of planting cash for care policies in the existing social systems involving different socio-cultural conditions and labour markets, sometimes more emphasis is placed on the citizenship of care users, family carers and care providers than on cost containment issue, and sometimes vice versa. Behind this lies the process of different social valuation on what care is about; who can better deliver care; who should be responsible for care; how responsibilities should be shared and so on.

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Conservative Surgery and Primary Radiotherapy for Early Bresst Cancer: Yonsei Cancer Center Experience (조기 유방암에서 보존적 수술후 방사선치료: 연세암센터 경험)

  • Suh Chang Ok;Lee Hy De;Lee Kyung Sik;Jung Woo Hee;Oh Ki Keun;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.337-347
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    • 1994
  • Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

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A Study on the Compensatory Education for the Disadvantaged Children in Preschool Age (Focussed on the Programs of Compensatory Education in the U.S.A. and Japan) (불리(不利)한 환경(環境)의 학령전(學齡前) 아동(兒童)을 위한 보상교육(補償敎育)에 관(關)한 연구(硏究) - 미국(美國) 및 일본(日本)의 보상교육(補償敎育)·프로그램을 중심(中心)으로 -)

  • Chong, Young-Sook;Lee, Hee-Ja
    • Korean Journal of Child Studies
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    • v.1
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    • pp.65-81
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    • 1980
  • This study is aimed at investigating the compensatory education which was already implemented or is being implemented in the U.S.A. and Japan; and at studying the types of programs and their characteristics; and at sounding out the possibilities of the application of such programs in family and social conditions is Korea. In order to achieve the above mentioned objectives, the established items for the study are as follows: (1) Various types of early children's education (2) Programs of compensatory education for the disadvantaged Children (3) Head Start Program, Early Training Project and Montessori School (4) Integrated Preschool Programs (5) Day-Care Center for employed mothers We investigated the various compensatory education programs for the preschool children who are in economically, socially, culturally disadvantaged conditions. Head Start Programs were federally supported programs for preschool children and opened as summer programs in 1965 for the first time. The purpose of Head Start has been to give preschool children the kinds of experiences they need in preparation for school. The Head Start children were found to be significantly better prepared for school than the normal children. However, after six to eight months, their initial advantages had virtually. disappeared and then the simple problem with Head Start and other such programs was that little long-term good could be evidenced unless the high quality educational environment was maintained. Therefore, to solve this problem, three other programs were funded as part of the overall Head Start. These three programs are the Parent-Child Center, Home Start, and the Child and Family Resources Program. The Early Training Project for disadvantaged children was implemented by Klaus and Gray of Peabody College in 1962. The program was a field research study concerned with the development and testing over time of procedures for improving the educability of young children from low income homes. Its major concern was to study whether it was possible to offset the progressive retardation observed in the public schooling careers of children, living in deprived circumstances. Children, who were trained through the Early Training Project were superior to control groups in the test of IQ and vocabulary as well as linguistic abilities, and preparation for reading. This project showed the possibilities which could prevent preschool children from being disadvantaged socially, culturally and mentally. In 1907, Montessori School was established by Maria Montessori in Italy and her school program has been introduced at present to several countries in the world as one compensatory educations. She first began her experimental methods with retarded children, followed by disadvantaged children from the tenements of Rome. The Montessori approach futures a prepared environment and carefully designed, self-correcting materials. The Montessori curriculum presents tastes that feature sequence, order, and regularity, in addition to those that develop motor and sensory skills. She was interested in children's intellectual development and in developing good work habits. One of the latest developed programs for disadvantaged children is "Integrated Preschool Program" which has successfully integrated handicapped and nonhandicapped children. Several studies have showed that handicapped children in integrated school environments are accepted by and interact with their nonhandicapped peers. In fact, this program provides a number of potential, and perhaps opportunities for nonhandicapped children to serve as valuable resources in fostering the development of their handicapped peers. Next we turn to Japanese programs which are divided into two different types. One is Day-Care Center which was established by Child Welfare Law and the other is kindergarten organized by School Education Law. The kindergarten opened in 1876 and it has been part of school systems since 1947 by the implementation of education law, and the Day-Care Center which started in 1890 for the employed mothers. was changed into Day-Nursery by the enactment of child welfare law in 1947. The laws and operational regulations for the Day-Nursery were set up and were put in effect by the establishment standard acts of children welfare facilities, and the Day-Nursery has been operated in various types by the increasing demand, chiefly because of the socio-economical changes of family structures in both urban and suburban areas. Nursery education for physically and mentally disadvantaged children is for those who are blind, deaf and dumb, mentally retarded; physically disadvantaged by accidents or diseases. Montessori education in Japan was started in 1968 and many research groups for studying Montessori were organized. In 1977, Montessori remedial education society was also organized in which they started a number of studies; a study for developing materials; in-service training for the remedial education; and seminars and lectures, etc It is strongly suggested that we study the early educations that are being implemented in Japan and a variety of compensatory educations that were already implemented in the U.S.A. and modify them for the organization of our own model and properly accommodate them to our social needs.

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