• Neonatal Medicine
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• v.16 no.2
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• pp.146-153
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• 2009

Purpose: The aim of this study is to investigate the current use of dexamethasone rescue therapy (DRT) for bronchopulmonary dysplasia (BPD). Methods: This is a retrospective study of 251 BPD patients managed in the neonatal intensive care units at Seoul National University Childrens Hospital and Seoul National University Bundang Hospital between March 2004 and August 2008. The demographic data and clinical characteristics of the mothers and infants were analyzed. The infants were compared based on DRT responsiveness. The DRT complications were investigated. Results: Ninety-three patients (37.1%) were classified with severe BPD, DRT was only given to patients with severe BPD. Dexamethasone was administered to 24 patients (9.6%) whose respiratory status had precluded extubation, which indicated that conventional BPD management had failed. Fourteen patients (58.3%) who received DRT were responsive. DRT non-responders required more oxygenation and more complicated with pulmonary arterial hypertension (PAH). Responder had shorter length's of hospitalization and lower mortality rates. High dose dexamethasone was no more effective in weaning neonates from the ventilatior than low dose dexamethasone. Sepsis was the most common complication of DRT. Conclusion: DRT is a valuable treatment for severe BPD ahead of PAH development. DRT should not be performed in BPD patients with PAH due to the possibility of complications.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.459-466
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• 2003

Background : Asthma and eosinophilic bronchitis(EB) are eosinophilic inflammatory diseases of the airway. However, EB differs from asthma in that there is no variable airway obstruction or airway hyper-responsiveness. Pathologically, asthma is characterized by the accumulation of eosinophils and CD4+ T lymphocytes in the submucosa. A recent study showed that there was no significant difference between asthma and EB in terms of the submucosal eosinophil and T lymphocyte count. However, it is not known whether or not an infiltration of CD4+ and CD8+ T lymphocytes occurs in the airways of EB patients. The aim of this study was to identify the difference between the two conditions by measuring the submucosal CD4+ and CD8+ T lymphocyte count. Methods : Immunohistochemical analysis of bronchial-biopsy specimens was performed in 17 subjects with asthma and 24 subjects with EB. Results : The CD4+ T lymphocytes count in the asthma subjects and the EB subjects was similar (median, 58.6 vs 50.0 $cells/mm^2$, respectively; P=0.341). In contrast, the number of CD8+ T lymphocytes in the EB subjects was higher than that in the asthma subjects (median, 46.7 vs 11.8 $cells/mm^2$, respectively; P=0.003). Conclusion : The infiltration of submucosal CD8+ T lymphocytes may be associated with the pathophysiology of EB.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.217-224
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• 2000

Background : It is well known that when macrophages are stimulated with endotoxin, they produce a wide variety of cytokine mediators, including TNF-$\alpha$ and IL-1$\beta$. However, there is an alteration in the macrophages' responsiveness when they are challenged with repeated bouts of endotoxin, termed "endotoxin tolerance" which is regarded as a self-protective phenomenon from continuous stimulation. In this study, endotoxin tolerance in the peripheral blood monocytes of sepsis patients was evaluated. Methods : Fourteen patients with organism-documented sepsis were included. The severity of illness was evaluated by APACHE II score. Peripheral blood monocytes were isolated from the patients and diluted to $1{\times}10^5$ well. After stimulation with endotoxin (LPS of E. coli O114 : B4, 100 ng/ml), they were incubated at $37^{\circ}C$ in 5% $CO_2$ incubator for 24 hours. Supernatant was collected for the measurement of TNF-$\alpha$ and IL-1$\beta$ with ELISA method. Peripheral blood monocytes of seven healthy volunteers were used as control. Results : The APACHE II score (mean$\pm$SD) of the patients at the time of blood sampling was 12.2$\pm$5.7. The primary infection foci were urinary tract infection, pneumonia, subacute bacterial endocarditis, and catheter related infection, etc. The causative organisms were gram negative rods (10 cases), gram positive cocci (6 cases) with two cases of mixed infection. Serum TNF-$\alpha$ could be measured in 4 cases with 29.9$\pm$27.7 pg/ml. Serum IL-1$\beta$was measurable in only one patient. The TNF-$\alpha$ level of supernatant of cultured peripheral blood monocytes was 2,703$\pm$2,066 pg/ml in patients and 2,102$\pm$1914 pg/ml in controls. The IL-1$\beta$level of supernatant was 884$\pm$1,050 pg/ml in patients and 575$\pm$558 pg/ml in controls. There was no difference of TNF-$\alpha$ and IL-1$\beta$ level between patients and controls. Conclusion : We cannot prove the phenomenon of endotoxin tolerance in this study. Future study needs to be focused on the more severe sepsis patients who were taken for sampling earlier. Addition of serum to the culture medium could be an another valuable option for the success of this study.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.585-593
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• 2000

Background : International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendation of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. Methods : This study examined the relationship between the symptom score and measurements of $FEV_1$ and PEF when expressed as a percentage of predicted values in asthmatics (n=107). Results : The correlation of $FEV_1$ % with PEFR% was highly significant (r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of $FEV_1$ % and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of $FEV_1$ % and symptom score. 39% of the patients classified as having moderate asthma on the basis of $FEV_1$ % recording would be considered to have severe asthma if symptom score alone were used. Low baseline $FEV_1$ and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. Conclusion : The relationships between the symptom score, PEFR and $FEV_1$ were generally poor. When assessing asthma severity, age, duration, $PC_{20}$, and baseline $FEV_1$ should be considered.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.46-50
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• 1996

This study was designed to examine the basal cyclic AMP levels and the $10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels of lymphocytes, by which ${\beta}$-adrenoceptor function was shown, between to normal controls and 17 drug free patients(8 major depresive patients and 9 dysthymic patients), who were diagnosed by DSM-III-R. The severity of depression was assessed by Hamilton Rating Scale for Depression (HDRS). Cyclic AMP levels were measured by radioimmunoassay(double antibody). The results were as follows ; 1) HDRS score was significantly higher in major depressive patients($41.8{\pm}4.6$) than in dysthymic patients($24.0{\pm}4.2$)(p<005). 2) There was no Significant difference in basal cyclic AMP levels among normal controls($3.9{\pm}1.7pmol/10^6cells/10min$), major depressive patients($2.1{\pm}0.5pmol/10^6cells/10min$), and dysthymic patients($3.9{\pm}1.8pmol/10^6cells/10min$). 3) There was significant difference in net cyclic AMP levels($10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels minus basal cyclic AMP levels) among normal controls($16.5{\pm}6.0pmol/10^6cells/10min$), major depressive patients($3.0{\pm}1.4pmol/10^6cells/10min$), dysthymic patients($10.9{\pm}4.4pmol/10^6cells/10min$)(p <005). 4) The net cyclic AMP levels were significantly correlated with HDRS scores in major depressive patients(${\gamma}=-0.8^6$, p<0.05), but not in dysthymic patients(${\gamma}=0.43$, p=0.25). In conclusion, we suggested that the dysthymic disorder might differ from the molar depressive disorder not only in the severity of depressive symptoms but also in ${\beta}$-adrenergic responsiveness of lymphocytes, which was regarded as a biological marker of depressive disorder.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.167-176
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• 2007

Objectives:A considerable number of pharmacogenetic studies have been performed in recent years to define the association of antipsychotic drug response with dopamine receptor polymorphisms. The purpose of this study was to investigate the relationship between the therapeutic response to antipsychotic drugs and the polymorphisms of the dopamine D2, D3, and D4 receptor genes(DRD2, DRD3 and DRD4, respectively). Methods:We conducted retrospective chart review of 200 consecutively hospitalized patients with the diagnosis of schizophrenia(DSM-IV) who were treated with various antipsychotics(94% atypical antipsychotics) at Bugok National Hospital, Korea. The patients were divided into two groups, responders and non-responders, by responsiveness to antipsychotic drugs according to a four-point scale used in previous studies; responders included moderate to marked responded patients and non-responders included none to minimal responded patients. We analyzed the Ser311Cys polymorphism in the DRD2, the Ser9Gly polymorphism in the DRD3, and the exon III 48 bp repeat polymorphism in the DRD4. Results:Among the total patients of 200, 141(70.5%) were categorized as responders. There were no significant differences in the frequencies of the DRD2, DRD3, and DRD4 alleles and genotypes between responders and non-responders. Conclusion:These results suggest that the Ser311Cys polymorphism in the DRD2, the Ser9Gly polym- orphism in the DRD3, and the exon III 48bp repeat polymorphism in the DRD4 are not associated with the therapeutic response to antipsychotic drugs in Korean schizophrenic patients. A larger prospective study is needed to elucidate the association between antipsychotic response and dopamine receptor gene polymorphism.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.197-208
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• 2015

Objectives : The purposes of this study were to examine the reliability and validity of the Korean version of Social Communication Questionnaire (K-SCQ) and to determine cut-off scores for diagnosis of autism spectrum disorder (ASD). Methods : A total of 166 subjects with ASD and their 186 unaffected siblings were recruited through child psychiatry clinics of university hospitals. Board certified child psychiatrists screened all probands suspected to have ASD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. To confirm the diagnoses, the Korean versions of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised (K-ADI-R) were administered to all the subjects. All parents completed the K-SCQ and Social Responsiveness Scale (SRS). The non-ASD siblings were evaluated with the same instruments as the probands with ASD. We performed a factor analysis to examine the structure of K-SCQ. For testing the validity of K-SCQ, we compared the difference in Lifetime and Current scores of probands with ASD and their non-ASD siblings using t-test and analysis of covariance. Correlations between the K-SCQ and other measurements of ASD symptomatology, including K-ADI-R totals and domain scores and SRS, were examined. Receiver operation characteristic curve analysis was performed to extract cutoff scores discriminating affection status. Results : Four factors were extracted through factor analysis of K-SCQ ; 1) social relation and play, 2) stereotyped behavior, 3) social behavior, and 4) abnormal language. Cronbach's internal consistency was .95 in K-SCQ Lifetime, and .93 in K-SCQ Current. There were significant differences in total score of K-SCQ, both in Lifetime and Current between the ASD group and non-ASD siblings group (p<.05). K-SCQ scores were significantly correlated with K-ADI-R subdomain scores and SRS total scores (p<.05). The best-estimate cut-off scores of K-SCQ for diagnosis of ASD were 12 for 48 months and over, and 10 for below 47 months. Conclusion : Our findings suggest that the K-SCQ is a reliable and valid instrument for screening autistic symptoms in the Korean population. Lower cut-off scores than the original English version might be considered when using it as a screening instrument of ASD.

• Korea journal of population studies
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• v.11 no.1
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• pp.159-184
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• 1988

Race and ethnicity are important factors which influence the elderIy's residential adjustment behaviors, although it is unclear whether this reflects influences unrelated to race and ethnlcity. Culturally, the norm of family supportoften obseved among various minority ethnic groups is likely to provide flexible family suppof for the elderIy. Economically, the life-long hardship ofminority groups is likely to force them to maintain extended family living arrangements simply to reduce expenses via economies of scale. Thecontroversy about the economic need versus the cultural prescription forextended living arrangements remains unresoIved because it fails to articulatethe meaning of family supports among many disadvantaged groups.This study aims to test previous economic and cultural arguments, byexamining ethnic differences iu the eiderIy's responsiveness to their health andeconomic problems. Two hypotheses about cultural influences on the elderly's resideutiai adjustment are examined. First, do elderly minorities receive famiiysupporis for longer periods when they are poor if economic and health status\ulcorner Second, do elderiy minorities receive family supports more often when their health status declines\ulcorner Using the Longitudinal Suvey on Aging from 1984 to 1990. this study employs Markovian multi-state life tables, and discrete and contonuous competing hazard analyses for the transition in living arrangements. The main results provide substantial evidence against the cultural resource thesis. Elderly minorities experience more frequent transition between living alone and living with relatives than white elderly persons when group differences in the extent of mortality and insititutionalization are controlled. The shorter timf of living alone among elderly monorities stems from their greater likehood of joining relatives as well as greater mortality and attrition rates than elderly whites. Coresidence of elderly whites with their relatives is more likely to occur in response to their needs for health care than of elderly whites. it implies that instability. not flezibility. characterrizes elderly minorities living arrangements.

• Cross-Cultural Studies
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• v.48
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• pp.361-389
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• 2017

This essay examines 'precarity politics' by Judith Butler, a well-known gender theorist and queer philosopher, in Notes Towards a Performative Theory of Assembly (2015) focused on concepts as unchosen cohabitation of Hannah Arendt and unwilled proximity of Emmanuel Levinas. Butler's precarity politics is the condition of our dispossessed political beings with fundamental vulnerability and interdependency that cannot choose with whom we will live on this Earth. Butler's political ethics is twofold: on one hand, she examines significance of 'action'' the most significant vita activa in the public area, and 'plurality'' the condition-not only the necessary condition but the possible condition-for a political life suggested by Hannah Arendt in Human Condition; on the other hand, Butler reflects upon global precarity based on a diasporic precarious life in the social world towards freedom and equality. Unchosen cohabitation of plural humans on Earth, and global pervasion of precarity, that indicates "politically induced condition in which certain populations suffer from failing social and economic networks of support and become differentially exposed to injury, violence, and death," so called "differential distribution of precariousness," are practical possibilities of ethical and equal cohabitation of different ethnic groups in the social world. Ethical obligations or ethical demand to respond to others' suffering in distance and proximity originated from precarity politics, mentioned in Precarious Life, Parting Ways, and Frames of War, could be non-foundational joint of plural people living together globally. We should presume the 'reversibility' of distance and proximity in others' suffering, based on responsiveness and responsibility of others, if we want to stay attuned to the pain of others we never chose to live together. That is the significance of Butler's 'precarity politics' with 'ethical obligation' to accept 'unchosen plurality' of living population on Earth, and 'reversibility between of distance and proximity,' in her 'new plural and embodied body politics' or 'new corporeal ontology', through human primary vulnerability, fundamental interdependency, being exposed and responsive to suffering of others.

• Korean Journal of Poultry Science
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• v.46 no.1
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• pp.17-24
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• 2019

Chickens have been considered as well-defined animal bioreactor. The optimized ovalbumin promoter is essential for recombinant protein production in transgenic chicken. Here we try to compare the activity and identify the effect of estrogen on ovalbumin promoter according to each promoter length with estrogen response element (ERE) existence. We cloned two (2.8 and 5.5 kb) ovalbumin promoters that the 5.5 kb contained the ERE but the 2.8 kb did not, and these two promoters were cloned to pGL4.11 vector. Additionally, we constructed another pGL4.11 vector containing of the 4.4 kb (with ERE) ovalbumin promoter deleted with 1 kb between ERE region and the 2.8 kb promoter. For reporter assay, HeLa, MES-SA, LMH/2A, and cEF cells were transfected with all the pGL4.11 vectors. The comparative analysis showed that the mutated 4.4 kb promoter has more potent activity than the 2.8 and 5.5 kb promoters in HeLa, MES-SA, and LMH/2A cells. However, there is no significant difference in cEFs. Also, these cells transfected with the mutated 4.4 kb promoter were treated with the $17{\beta}$-estradiol (0~3,000 nM) and HeLa, MES-SA, and LMH/2A cells showed estrogen responsibilities, but cEFs did not. Besides, the mutated 4.4 kb promoter has still higher activity than the 2.8 and 5.5 kb promoter, and there is no transcriptional induction effect in 2.8 kb promoter at 500 nM estrogen that is blood concentration of laying hens. Hence our study strongly suggested that the mutated 4.4 kb promoter is considered as one of the most efficient length for generating transgenic chicken.