• Korean Chemical Engineering Research
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• v.56 no.4
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• pp.479-495
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• 2018

This study was carried out to research the multimedia fate modeling, concentration distribution and impact assessment of polycyclic aromatic hydrocarbons (PAHs) emitted from automobiles, which are known as carcinogenic and mutation chemicals. The amount of emissions of PAHs was determined based on the census data of automobiles at a target S-city and emission factors of PAHs, where multimedia fugacity modeling was conducted by the restriction of PAHs transfer between air-soil at the impervious area. PAHs' Concentrations and their distributions at several environmental media were predicted by multimedia fugacity model (level III). The residual amounts and the distributions of PAHs through mass transfer of PAHs between environment media were used to assess the health risk of PAHs at unsteady state (level IV), where the sensitivity analyses of the model parameter of each variable were conducted based on Monte Carlo simulation. The experimental result at S-city showed that Fluoranthene among PAHs substances are the highest residual concentrations (60%, 53%, 32% and 34%) at all mediums (atmospheric, water, soil, sediment), respectively, where most of the PAHs were highly accumulated in the sediment media (more than 80%). A result of PAHs concentration changes in S-city over the past 34 years identified that PAHs emissions from all environmental media increased from 1983 to 2005 and decreased until 2016, where the emission of heavy-duty vehicle including truck revealed the largest contribution to the automotive emissions of PAHs at all environment media. The PAHs concentrations in soil and water for the last 34 years showed the less value than the legal standards of PAHs, but the PAHs in air exceeded the air quality standards from 1996 to 2016. The result of this study is expected to contribute the effective management and monitoring of toxic chemicals of PAHs at various environment media of Metropolitan city.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.617-622
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• 2006

Purpose : High-Sensitivity C-reactive protein(hs-CRP) has been recognized as a very useful and sensitive predictor of the future risk of myocardial infarction. But the clinical significance of hs-CRP in children remains uncertain. To confirm the existence of obesity-induced vascular inflammation and the association between metabolic syndromes and elevation of CRP in children, we investigated the relationship among CRP, obesity, blood pressure(BP), and serum lipids in schoolboys. Methods : Twenty-eight obese(BMI $29.61{\pm}3.29kg/m^2$) and 93 non-obese(BMI $18.99{\pm}2.21kg/m^2$) boys aged 14 years were examined. Serum CRP levels was measured by the high sensitive latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dL were adopted to avoid the influence of acute infection. Results : Obese children had significantly higher hs-CRP levels than their non-obese group($0.104{\pm}0.075$ vs. $0.054{\pm}0.005mg/dL$). In the obese group, BMI, systolic blood pressure, diastolic blood pressure, apolipoprotein B, atherogenic index, and triglyceride were significantly higher than in nonobese. The BMI, diastolic blood pressure, apolipoprotein E, atherognic index, and triglyceride showed positive correlation with log CRP by simple regression. Multiple regression analysis indicated that BMI and apolipoprotein E were strongly related to CRP. Conclusion : This study revealed that obese children tended to have higher levels of serum hsCRP, BP elevation and dyslipidemia than the control group and that BMI and apolipoprotein E were strongly related to CRP. These results indicate that obesity related metabolic syndrome can be developed in children.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.2
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• pp.153-163
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• 2001

This study was attempted to investigate the discriminant validity of Korean version of Eating Attitude Test-26(KEAT-26) and to provide the sensitivity, specificity and efficiency according to cutting score, which may be useful to determine the optimal cutoff point on various purposes. The KEAT-26 was administered to 108 female patients with eating disorders, 179 female participants in body slimming center, 120 female athletic college students, 227 female college students, and 183 healthy normal women. Validity was tested by ANOVA and ROC curve analysis. The results revealed that the total score of the KEAT-26 showed a statistically significance between groups and that the score of the KEAT-26 of eating disorders group was significantly higher than that of the other groups in post hoc test. In comparison of the 4 subfactor score of the KEAT-26 between groups, significant differences in main effect within groups were found in all subfactors except factor IV. ROC curve analysis showed 80% of efficiency to discriminate eating disorders group from normal control group using cutoff score on maximum discriminant efficiency and 69% of efficiency to discriminate eating disorders group from high risk groups for eating disorders. Each cutoff score on maximum in efficiency was as follows ; 25 between eating disorders group and participants in body slimming center, 19 between eating disorders group and healthy normal woman, 23 between eating disorders group and athletic college students, 21 between eating disorders group and college students. Using 22(T score 65) of the KEAT-26 as the cutoff score, sensitivity was 54%, specificity was 84%, and overall efficiency was 80%. These results indicate that the KEAT-26 has a good discriminant validity in Korean population and also suggest that the KEAT-26 may be useful assessment tool to screen the disordered eating problems on clinical and epidemiological purposes.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.278-286
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• 2006

Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.153-160
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• 2008

Purpose : To evaluate if at the time of diagnosis of Legg-Calve-Perthes disease, MR imaging is superior to radiographs for identifying patients with a favorable long term prognosis as determined by maintenance of a spherical configuration of the femoral head epiphysis on follow-up radiographs. Materials and Methods : We retrospectively analyzed plain radiographs and MR images of 48 femoral heads in 41 patients with Legg-Calve-Perthes disease at time of diagnosis. Femoral head involvement was estimated on initial plain radiographs and MR images using the Catterall classification. Prognosis as determined by maximum femoral head deformity was determined on follow-up radiographs evaluated according to Stulberg classification. Results: Catterall classification of greater than 1 at MR imaging had 100% sensitivity (14/14) for detecting patients with a poor prognosis as indicated by deformity of the femoral head on follow-up radiographs (Stulberg class > 2). Initial radiographs had a lower sensitivity of 57% (8/14) for detecting patients with poor prognosis. Specificity for MR imaging was 21% (7/34) which was not significantly different from 32% (11/34) specificity for initial radiographs. Conclusion: Catterall group 1 at initial MR imaging indicates favorable prognosis for Legg-Calve-Perthes disease. Patients with more extensive involvement of the femoral head can have a good outcome, however they are at risk for loss of spherical configuration of the femoral head and subsequent osteoarthritis in adulthood. MR imaging may be superior to radiographs for identifying a subgroup of patients with favorable prognosis.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.741-751
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• 1997

Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known ,well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is $100{\mu}g/d\ell$ which is supposed to match the level of $40{\mu}g/d\ell$ of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level $(100{\mu}g/d\ell)$ of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over $40{\mu}g/d\ell$. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin (Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were $79.5{\pm}46.7{\mu}g/d\ell,\;38.7{\pm}15.1{\mu}g/d\ell,\;and\;14.8{\pm}1.2g/d\ell$, respectively. There were significant differences in blood ZPP, PbB and Hb by industry (P<0.01). 2. The percents of lead workers whose blood ZPP were above $100{\mu}g/d\ell$ in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above $40{\mu}g/d\ell$ in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below $40{\mu}g/d\ell$, $40-59{\mu}g/d\ell$ and above $60{\mu}g/d\ell$ were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below $100{\mu}g/d\ell$, $100-149{\mu}g/d\ell$ and above $150{\mu}g/d\ell$ were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant (P<0.01) and as PbB was $40{\mu}g/d\ell$, blood ZPP was $82.1{\mu}g/d\ell$. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB eve. $40{\mu}g/d\ell$ were observed in the cut-off level of $50{\mu}g/d\ell$ and $100{\mu}g/d\ell$ of blood ZPP, respectively, the highest validity (sensitivity+specificity) of blood ZPP to detect lead workers with PbB over $40{\mu}g/d\ell$ was observed in the cut-off level of around $70{\mu}g/d\ell$ of blood ZPP. But even with optimal cut-off level of around $70{\mu}g/d\ell$ of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from $100{\mu}g/d\ell$ to somewhat lower level such as around $70{\mu}g/d\ell$ and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.

• The Journal of Korean Society for Radiation Therapy
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• v.21 no.1
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• pp.17-23
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• 2009

Purpose: In treating head and neck cancer, it is very important to irradiate uniform dose on the junction of the bilateral irradiation field of the upper head and neck and the anterior irradiation field of the lower neck. In order to improve dose distribution on the junction, this study attempted to correct non uniform dose resulting from under dose and over dose using the field-in-field technique in treating the anterior irradiation field of the lower neck and to apply the technique to the treatment of head and neck cancer through comparison with conventional treatment. Materials and Methods: In order to examine dose difference between the entry point and the exit point where beam diffusion happens in bilateral irradiation on the upper head and neck, we used an anthropomorphic phantom. Computer Tomography was applied to the anthropomorphic phantom, the dose of interest points was compared in radiation treatment planning, and it was corrected by calculating the dose ratio at the junction of the lower neck. Dose distribution on the junction of the irradiated field was determined by placing low-sensitivity film on the junction of the lower neck and measuring dose distribution on the conventional bilateral irradiation of the upper head and neck and on the anterior irradiation of the lower neck. In addition, using the field-in-field technique, which takes into account beam diffusion resulting from the bilateral irradiation of the upper head and neck, we measured difference in dose distribution on the junction in the anterior irradiation of the lower neck. In order to examine the dose at interest points on the junction, we compared and analyzed the change of dose at the interest points on the anthropomorphic phantom using a thermoluminescence dosimeter. Results: In case of dose sum with the bilateral irradiation of the upper head and neck when the field-in-field technique is applied to the junction of the lower neck in radiation treatment planning, The dose of under dose areas increased by 4.7~8.65%. The dose of over dose areas also decreased by 2.75~10.45%. Moreover, in the measurement using low-sensitivity film, the dose of under dose areas increased by 11.3%, and that of over dose areas decreased by 5.3%. In the measurement of interest point dose using a thermoluminescence dosimeter, the application of the field-in-field technique corrected under dose by minimum 7.5% and maximum 17.6%. Thus, with the technique, we could improve non.uniform dose distribution. Conclusion: By applying the field-in-field technique, which takes into account beam divergence in radiation treatment planning, we could reduce cold spots and hot spots through the correction of dose on the junction and, in particular, we could correct under dose at the entry point resulting from beam divergence. This study suggests that the clinical application of the field-in-field technique may reduce the risk of lymph node metastasis caused by under dose on the cervical lymph node.

• The Korean Journal of Nuclear Medicine
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• v.33 no.2
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• pp.131-142
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• 1999

Purpose: Either gated myocardial perfusion SPECT or attenuation corrected SPECT can be used to improve specificity in the diagnosis of coronary artery disease. We investigated in this study whether gating or attenuation correction improved diagnostic performance of rest/stress perfusion SPECT in patients having intermediate pre-test likelihood of coronary artery disease. Materials and Methods: Sixty-eight patients underwent rest attenuation-corrected T1-20l/dipyridamole stress gated attenuation-corrected Tc-99m -MIBI SPECT using an ADAC vertex camera (M:F=29:39, aged $59{\pm}12$ years, coronary artery stenosis ${\geq}70%$, one vessel: 13, two vessel: 18, three vessel: 8, normal: 29). Using a five-point scale, three physicians graded the post-test likelihood of coronary artery disease for each arterial territory (1:normal, 2: possibly normal, 3:equivocal, 4. possibly abnormal, 5: abnormal). Sensitivity, specificity and area under receiver-operating-characteristic curves were compared for each operator between three methods : (A) non-attenuation-corrected SPECT; (B) gated SPECT added to (A): and (C) attenuation-corrected SPECT added to (B). Results: When grade 3 was used as the criteria for coronary artery disease, no differences in sensitivity and specificity were found between the three methods for each operator. Areas under receiver-operating-characteristic curves for diagnosis of coronary artery disease revealed no differences between each modality (p>0.05). Conclusion: In patients at intermediate risk of coronary artery disease, gated SPECT and attenuation- corrected SPECT did not improve diagnostic performance.

• Journal of Nutrition and Health
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• v.47 no.2
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• pp.124-133
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• 2014

Purpose: The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospitalized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002. Methods: Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGSGA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hematocrit, and changes in body weight and food intake, were statistically selected as variables for SMST. Results: According to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, ${\kappa}$ = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, ${\kappa}$ = 0.505), respectively, indicating that SMST held high inter-methods reliability. Conclusion: In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.162-170
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• 2007

Purpose : While cases of vancomycin-resistant enterococci (VRE) have increasingly been reported worldwide since it was first reported in the late 1980s, there have been few systemic studies on the pediatric population. The purpose of this study is to contribute to the planning of VRE prevention by investigating the prevalence, risk factors and transmission of VRE infection. Methods : We studied 230 patients under age 15 years who were isolated VRE between January 2001 and December 2006 retrospectively. The patients were classified into the intensive care unit (ICU) and the non-ICU groups. We reviewed the procedures before VRE detection as well as antibiotic sensitivity of detected organisms. Results : The number of VRE-isolation cases was higher in the ICU group than the non-ICU group. Instances of VRE-isolation were also more prevalent in patients who underwent operations or active procedures while taking 3rd-generation cephalosporins or glycopeptides. Almost all antibiotics except tetracycline were resistant to VRE. The proportion of 3rd-generation cephalosporin use was higher than those of any other antibiotics before VRE detection. Additionally, the use of 3rd-generation cephalosporins has increased annually, but that of glycopeptides had decreased in 2006. Also, the rates of VRE isolation have been increasing since 1998. Conclusion : VRE infection is increasing in pediatric population. Strict adherence to appropriate infection control guidelines for the prevention of VRE transmission in hospitals, and tracking of VRE colonization through active surveillance in high risk units are recommended.