• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.488-494
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• 2010

Purpose : A human milk bank collects, processes, eliminates, and stores breast milk from donors and provides breast milk to those in need. The authors hereby present the experiences and the objective lessons obtained through operating a nationwide human milk bank over a period of 2 years. Methods : The characteristics of the donors and the recipients and the amounts of breast milk donated, processed, and received at the East-West Neo Medical Center Human Milk Bank were investigated from August 2007 to August 2009. Results : The donor pool consisted of 131 first-time donors and 39 repeat donors who made 341 and 127 donations, respectively. Seventy-nine percent of the donors resided in the Seoul-Kyunggi area, and 60% of the donors were in their 30s. Most information and motivation came from the Internet (66%) or television (14%). A total of 2,736 L of breast milk was collected, and 1,979 L were processed. The cumulative number of recipients was 160 preterm or full-term infants and 21 adults, each group receiving the breast milk 337 and 41 times, respectively. In total, infants received 1,663 L and adults received 179 L. Conclusion : Through the present study, the role and importance of a human milk bank in collecting, pasteurizing, and storing surplus breast milk in through sanitary, medically proven methods and providing this breast milk to recipients could be appreciated and reevaluated. The authors believe that a national support system is necessary to expand this practice to a nationwide scale.

• Journal of Korean Society of Forest Science
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• v.10 no.1
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• pp.7-16
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• 1970

There are 19 species of bamboo in Korea, among which few are of commercial value. The Phyllostachys has wide range of utilization, for sea weed production, industrial production of various bamboo wares, etc. The total export from Chenla-Namdo to some more than ten countries was recorded 204,000,000 won worth in 1969. As civilization develops so does the techniques of bamboo works, and they in turn accelerate the demand for bamboo wood of better quality. In the light of this trend, the author attempted to make bamboo plants to develope a quadragular culm with elaborate design as disired instead of the original round one, with the expectation that it might be widely welcomed by hand workers, interior decorators. Here are some facts found out in this experiment: 1). The greater the diameter of the shoot at the eye level was, the better result was brought, and as shown in Fig. 5 the rate of success was 72% with the shoots of 7.5 cm thick. 2). The shoots of 30 cm in length showed 100% of success, developing into a desired quadrangular culms without fail(See Fig. 6). 3). The intensity of wood fiber increased as time lapsed, without receiving any influence by the weather (See Fig. 7, 8). 4). During the growing, the culm proved to be flexible enough to bend up to 90 degree (See Fig. 9). 5). In an attempt to promote the value of bamboo by decoration, the author tried to impress rectangular indents on the culm. The indention using a qudangular board 1cm smaller in width than the shoot diameter gave 100% success (See Fig. 10). 6). Design experiment was also successful both in coloration and impressing and the resulting designs delicately depended on the kinds of chemicals used and their combination (Table 2) (See Fig. 12, 13, 14). With the above mentioned findings, the author concludes that the mass production of quadrangular bamboo culm is quite a promissing as an new industry to develope bamboo works to a more valuable one. This research was carried out with the research fund provided by the Ministry of Education in 1969.

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.10
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• pp.1558-1566
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• 2015

The purpose of this study was to examine dietitians' perception of importance about standards of foodservice management associated with long-term care hospital accreditation. This study was carried out through a postal survey consisting of 500 questionnaires, and 157 returned questionnaires were used in the statistical analysis. The results were summarized as follows. Average scores of perception of importance were 4.54/5 points in foodservice production management domain, 4.56/5 points in foodservice facilities management domain, and 4.70/5 points in foodservice sanitation domain. The average scores of importance of long-term care hospitals without accreditation were significantly (P<0.05) lower than those of hospitals with accreditation in items of 'establishment of ventilation equipment in kitchen', 'establishment of hand-washstand in toilet (warm-water, soap)', 'setup of sterilizing foothold in entrance of kitchen and toilet', 'division and use of knife, chopping board, gloves, and utensils before and after cook', 'establishment of cleaning plan and cyclic practice', and 'recording of receiving diary'. Results indicate that there is a need to supplement a casebook of regulations by suggesting detailed and critical limits in the case of below average points of importance. A manual, including HACCP standards for foodservice management of long-term care hospitals, is needed, along with education and webpage for comparing notes on accreditation of long-term care hospitals.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.150-156
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• 2000

Purpose : Stereotactic radiation therapy (SRT) can deliver highly focused radiation to a small and spherical target lesion with very high degree of mechanical accuracy. For non-spherical and large lesions, however, inclusion of the neighboring normal structures within the high dose radiation volume is inevitable in SRT This is to report the beam shaping using the partial closure of the independent jaw in SRT and the verification of dose calculation and the dose display using a home-made soft ware. Materials and Methods : Authors adopted the idea to partially close one or more independent collimator jaw(5) in addition to the circular collimator cones to shield the neighboring normal structures while keeping the target lesion within the radiation beam field at all angles along the arc trajectory. The output factors (OF's) and the tissue-maximum ratios (TMR's) were measured using the micro ion chamber in the water phantom dosimetry system, and were compared with the theoretical calculations. A film dosimetry procedure was peformed to obtain the depth dose profiles at 5 cm, and they were also compared with the theoretical calculations, where the radiation dose would depend on the actual area of irradiation. Authors incorporated this algorithm into the home-made SRT software for the isodose calculation and display, and was tried on an example case with single brain metastasis. The dose-volume histograms (DVH's) of the planning target volume (PTV) and the normal brain derived by the control plan were reciprocally compared with those derived by the plan using the same arc arrangement plus the independent collimator jaw closure. Results : When using 5.0 cm diameter collimator, the measurements of the OF's and the TMR's with one independent jaw set at 30 mm (unblocked), 15.5 mm, 8.6 mm, and 0 mm from th central beam axis showed good correlation to the theoretical calculation within 0.5% and 0.3% error range. The dose profiles at 5 cm depth obtained by the film dosimetry also showed very good correlation to the theoretical calculations. The isodose profiles obtained on the home-made software demonstrated a slightly more conformal dose distribution around the target lesion by using the independent jaw closure, where the DVH's of the PTV were almost equivalent on the two plans, while the DVH's for the normal brain showed that less volume of the normal brain receiving high radiation dose by using this modification than the control plan employing the circular collimator cone only. Conclusions : With the beam shaping modification using the independent jaw closure, authors have realized wider clinical application of SRT with more conformal dose planning. Authors believe that SRT, with beam shaping ideas and efforts, should no longer be limited to the small spherical lesions, but be more widely applied to rather irregularly shaped tumors in the intracranial and the head and neck regions.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.27-31
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• 1994

There are a number of reports suggesting that there may be a correlation between the clinical response to radiotherapy in various tumors and the clonogenic survival of cell lines derived from these tumors following exposure to 2 Gy(SF2). Authors conducted this study to determine SF2 for cells in primary culture from surgical specimens. The tumor tissues with squamous cell carcinoma of uterine cervix and head and neck were obtained. The tumor tissues were disaggregated to single cells by incubating with collagenase type w for 2 hours with constant stirring. Single cell suspensions were inoculated in four 24-well plates precoated with cell adhesive matrix. After 24 hours of incubation at 37$ ^{\circ}C $, rows of four wells were then irradiated, consisting of control set and five other sets each receiving doses of 1,2,3,4, and 6 Gy. After incubation for a total of 13 days, the cultures were stained with crystal violet and survival at each dose was determined by quantitative image analysis system, To determine whether cell growth was of epithelial origin, immunocytochemical staining with a mixture of cytokeratin and epithelial monoclonal antibodies were performed on cell cultures. During the period of this study, we received 5 squamous cell carcinoma specimens of head and neck and 20 of uterine cervical carcinoma. Of these, 15 yielded enough cells for radiosensitivity testing. This resulted an overall success rate of 60$ \% $. The mean SF2 value for 15 tumours was 0.55$\pm$0.17 ranging from 0.20 to 0.79. These results indicate that there is a broad range of sensitivities to radiation in same histologic type. So with a large patient population, we plan to determine whether a different SF2 value is associated with tumours that are controlled with radiotherapy than those that are not.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.261-267
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• 2007

Purpose: To evaluate the association between radiation pneumonitis and dose-volume histogram parameters and to provide practical guidelines to prevent radiation pneumonitis following radiotherapy administered for breast cancer including internal mammary lymph nodes. Materials and Methods: Twenty patients with early breast cancer who underwent a partial mastectomy were involved in this study. The entire breast, supraclavicular lymph nodes, and internal mammary lymph nodes were irradiated with a dose of 50.4 Gy in 28 fractions. Radiation pneumonitis was assessed by both radiological pulmonary change (RPC) and by evaluation of symptomatic radiation pneumonitis. Dose-volume histogram parameters were compared between patients with grade <2 RPC and those with grade ${\geq}$2 RPC. The parameters were the mean lung dose, V10 (percent lung volume receiving equal to and more than 10 Gy), V20, V30, V40, and normal tissue complication probability (NTCP). Results: Of the 20 patients, 9 (45%) developed grade 2 RPC and 11 (55%) did not develop RPC (grade 0). Only one patient developed grade 1 symptomatic radiation pneumonitis. Univariate analysis showed that among the dose-volume histogram parameters, NTCP was significantly different between the two RPC grade groups (p<0.05). Fisher's exact test indicated that an NTCP value of 45% was appropriate as an RPC threshold level. Conclusion: This study shows that NTCP can be used as a predictor of RPC after radiotherapy of the internal mammary lymph nodes in breast cancer. Clinically, it indicates that an RPC is likely to develop when the NTCP is greater than 45%.

• The Korean Society of Law and Medicine
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• v.21 no.1
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• pp.107-152
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• 2020

During the main ruling in 2019, a number of rulings that were of interest or meaningful were handed down, such as just because the complication of medical practice has occurred, there is no presumption of negligence, a case involving a fall accident in which a lot of culpability has recently been made. the death of a well-known singer that caused a sensation, a case about damages caused by MERS in 2015, which is more meaningful in connection with damages caused by COVID-19, an infectious disease that has recently hit the world, including Korea. In preaching the principles of the law, just because there has been a complication caused by medical practice, there is no presumption of negligence, 'The scope of the complication without presumption of negligence' was determined differently by the court, the court was not able to specify the criteria. Specific circumstances were presented to limit the responsibility of the medical institution while acknowledging the malpractice of the medical institution in relation to the fall accident. In relation to the scope of damages, judgment was made on issues related to the calculation of lost profits of medical malpractice; criteria for determining celebrities' daily income, criteria for determining daily income in case of receiving survivor's pension due to medical accident, an incident in which the daily income is denied if the labor capacity is already lost at the time of a medical accident. But, it seems that judgments should be made based on clearer and more reasonable standards. Related to Medical Advertise, specific logic of judgment was presented as to whether it was interpreted as being in accordance with the specific prohibition listed in Article 27 paragraph 3 of the Medical Law, which is the criterion for violation of the Medical Law, or if it constitutes a significant harm to the order of the medical market. In response to the prohibition of operating the multiple medical institutions, the Constitutional Court decided that it was constitutional because it did not violate the regulations on excessive funding, and rationally limited the scope of the prohibited 'redundant operation'. The Supreme Court ruled for the first time that even a medical institution established and operated in violation of the Medical Service Act did not make it impossible to receive all medical care benefits implemented by a medical institution under the National Health Insurance Act. Significant rulings were finalized that recognized the existence of specific protection obligations for the people of the country in the management of infectious diseases.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.109-116
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• 1997

Purpose : Chronic renal failure is often accompanied by severe dyslipidemia, a known risk factor for cardiovascular disease. Lipoprotein(a) [Lp(a)] has recently been characterized as a risk factor for atherosclerosis and thrombosis. Cardiovascular disease is the leading cause of death in adult patients on dialysis. However, there are only limited data available concerning risk factors for atherosclerosis in uremic children. We have measured serum levels of lipids, lipoproteins, apolipoproteins and Lp(a) in uremic children with maintenance dialysis. Methods : Ten uremic children with hemodialysis (HD) and 14 with peritoneal dialysis (PD) in our dialysis unit were included in this study. The mean age of HD patients was $162{\pm}59$ months and the male to female ratio was 7:3. The mean age and sex ratio of PD patients were $123{\pm}63$ months and 6:8, respectively. The levels of cholesterol, triglyceride, lipoproteins, apolipoproteins and Lp(a) were measured from serum sampled after 14 hours of fasting. The normal control levels were cited from 2 articles presenting the normal blood lipid and lipoprotein levels of primary school and middle school children in Korea. Results : There was no difference in age, sex ratio, body mass index and duration of dialysis between the HD and the PD group. The serum concentration of the cholesterol, triglyceride and apolipoprotein B were significantly elevated in dialysis patients compared with normal subjects. The serum level of Lp(a) was significantly elevated in only PD group. The serum Lp(a) level was below 30 mg/dl in 13 and above 30 mg/dl in 11 patients. The serum albumin level was significantly decreased in high Lp(a) group than in low Lp(a) group. Conclusion : The uremic children receiving dialysis reveal abnormal serum lipid and lipoprotein profiles. These results suggest that they have a higher risk for coronary heart disease, although there has been no clinical evidence of coronary heart disease at present. A long-term follow-up study of these children to clarify the suggestion should be started now.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.247-254
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• 2007

Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)

• Childhood Kidney Diseases
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• v.18 no.2
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• pp.64-70
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• 2014

Purpose: The aims of this study were to assess the clinical and laboratory profiles of chronic kidney disease-mineral bone disorder (CKD-MBD) and to assess the effects of treatment of active vitamin D analogs on severe hyperparathyroidism (SHPT) in pediatric patients on chronic peritoneal dialysis. Methods: This is a retrospective study included 53 patients who had been undergoing dialysis for more than 1 year, between January 2003 and December 2012. Results: Even after treatment with phosphate binders and active vitamin D analogs, the $mean{\pm}standard$ deviation of the percentage of time during peritoneal dialysis that the patients' serum concentrations of phosphorus, corrected total calcium, and parathyroid hormone (PTH) fell within the Kidney Disease Outcomes Quality Initiative recommended ranges was $25.06{\pm}17.47%$, $53.30{\pm}23.03%$, and $11.52{\pm}9.51%$, respectively. Clinical symptoms or radiological signs of CKD-MBD were observed in 10 patients (18.9%). There were significant differences in percentage of time that the serum intact PTH concentration was outside of the recommended range between patients with and without symptoms or signs of CKD-MBD (below recommended range, $11.74{\pm}7.37%$ vs. $40.77{\pm}25.39%$, P <0.001; above the recommended range, $63.79{\pm}27.86%$ vs. $37.09{\pm}27.76%$, P =0.022). Of the 25 patients with SHPT, high-dose alfacalcidol treatment was required in 13 patients that controlled SHPT in 7 of these patients, without marked complications. Conclusion: Despite our efforts to manage CKD-MBD, patients' met the recommended ranges from relevant guidelines at a low frequency. The treatment of high-dose active vitamin D analogs was required in about half of the patients with SHPT and effective in about half of them.