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Use of Noninvasive Mechanical Ventilation in Acute Hypercapnic versus Hypoxic Respiratory Failure (급성 환기부전과 산소화부전에서 비침습적 환기법의 비교)

  • Lee, Sung Soon;Lim, Chae-Man;Kim, Baek-Nam;Koh, Younsuck;Park, Pyung Hwan;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.987-996
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    • 1996
  • Background : We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods : Twenty-six out of 106 patients with either acute ventilatory failure (VF: $PaCO_2$ > 43 mm Hg with pH < 7.35) or oxygenation failure (OF: $PaO_2/AO_2$ < 300 mm Hg with $pH{\geq}7.35$) requiring mechanical ventilation were managed by NIV (CPAP + pressure suppon, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M : F=7 : $55.4{\pm}14.6$ yrs) and 15 out of 87 cases with OF (17.2%) (M : F=12 : 3, $50.6{\pm}15.6$ yrs) were s uilable for NIY. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of YF and 40% (6/15) of OF were successfully managed on NIV and were weruled from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV ($34{\pm}9$ /min pre-NIV, $26{\pm}6$ /min at 12 hour of NIV, p=0.045), while $PaCO_2$ ($87.3{\pm}20.6$ mm Hg pre-NIV, $81.2{\pm}9.1$ mm Hg at 24 hour of NIV) and pH ($7.26{\pm}0.04$, $7.32{\pm}0.02$, respectively, p <0.05) were both significantly decreased at 24 hour of NIV In NIV for oxygenation failure, $PaCO_2$ were not different between the successful and the failed cases at pre-NIV and till 12 hours after NIV. The $PaO_2/FIO_2$ ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6 : at baseline, 0.5h, 6h, 12h : $120.0{\pm}19.6$, $218.9{\pm}98.3$, $191.3{\pm}55.2$, $232.8{\pm}17.6$ mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9 : $127.9{\pm}63.0$, $116.8{\pm}24.4$, $100.6{\pm}34.6$, $129.8{\pm}50.3$ mm Hg, respectively, p=0.5319). Conclusion : From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rale before the reduction in $PaCO_2$ level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of $PaO_2/FIO_2$ ratio at 0.5h after application is thought to be a predictor of successful NIV.

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The Effect of Interferon-γ on Bleomycin Induced Pulmonary Fibrosis in the Rat (Interferon-γ 투여가 쥐에서의 Bleomycin 유도 폐 섬유화에 미치는 영향)

  • Yoon, Hyoung Kyu;Kim, Yong Hyun;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyung;Moon, Hwa Sik;Park, Sung Hak;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.51-66
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    • 2004
  • Objectives : The matrix metalloproteinases (MMPs) that participate in the extracellular matrix metabolism play a important role in the progression of pulmonary fibrosis. The effects of the MMPs are regulated by several factors including Th-1 cytokines, $interferon-{\gamma}$ ($IFN-{\gamma}$). Up to now, $IFN-{\gamma}$ is known to inhibit pulmonary fibrosis, but little is known regarding the exact effect of $IFN-{\gamma}$ on the regulation of the MMPs. This study investigated the effects of $interferon-{\gamma}$ on the pulmonary fibrosis and the expression of the lung MMP-2,-9, TIMP-1,-2, and Th-2 cytokines in aa rat model of bleomycin induced pulmonary fibrosis. Materials and methods : Male, specific pathogen-free Sprague-Dawley rats were subjected to an intratracheal bleomycin instillation. The rats were randomized to a saline control, a bleomycin treated, and a bleomycin+$IFN-{\gamma}$ treated group. The bleomycin+$IFN-{\gamma}$ treated group was subjected to an intramuscular injection of $IFN-{\gamma}$ for 14 days. At 3, 7, 14, and 28 days after the bleomycin instillation, the rats were sacrificed and the lungs were harvested. In order to evaluate the effects of the $IFN-{\gamma}$ on lung fibrosis and inflammation, the lung hydroxyproline content, inflammation and fibrosis score were measured. Western blotting, zymography and reverse zymography were performed at 3, 7, 14, 28 days after bleomycin instillation in order to evaluate the MMP-2,-9, and TIMP-1,-2 expression level. ELISA was performed to determine the IL-4 and IL-13 level in a lung homogenate. Results : 1. 7 days after bleomycin instillation, inflammatory changes were more severe in the bleomycin+$IFN-{\gamma}$ group than the bleomycin group (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$2.08{\pm}0.15:2.74{\pm}0.29$, P<0.05), but 28 days after bleomycin instillation, lung fibrosis was significantly reduced as a result of the $IFN-{\gamma}$ treatment (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$3.94{\pm}0.43:2.64{\pm}0.13$, P<0.05). 2. 28 days after bleomycin instillation, the lung hydroxyproline content was significantly reduced as a result of $IFN-{\gamma}$ treatment (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$294.04{\pm}31.73{\mu}g/g:194.92{\pm}15.51{\mu}g/g$, P<0.05). 3. Western blotting showed that the MMP-2 level was increased as a result of the bleomycin instillation and highest in the 14 days after bleomycin instillation. 4. In zymography, the active forms of MMP-2 were significantly increased as a result of the $IFN-{\gamma}$ treatment 3 days after the bleomycin instillation, bleomycin+$IFN-{\gamma}$ group (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$209.63{\pm}7.60%:407.66{\pm}85.34%$, P<0.05), but 14 days after the bleomycin instillation, the active forms of MMP-2 were significantly reduced as a result of the $IFN-{\gamma}$ treatment (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$159.36{\pm}20.93%:97.23{\pm}12.50%$, P<0.05). 5. The IL-4 levels were lower in the bleomycin and bleomycin+$IFN-{\gamma}$ groups but this was not significant, and the IL-13 levels showed no difference between the experiment groups. Conclusion : The author found that lung inflammation was increased in the early period but the pulmonary fibrosis was inhibited in the late stage as a result of $IFN-{\gamma}$. The inhibition of pulmonary fibrosis by $IFN-{\gamma}$ appeared to be associated with the inhibition of MMP-2 activation by $IFN-{\gamma}$. Further studies on the mechanism of the regulation of MMP-2 activation and the effects of MMP-2 activation on pulmonary fibrosis is warranted in the future.

Effect of Smoking and Drinking Habits on the Nutrient Intakes and Health of Middle and High School Boy Students (남자 중.고생의 흡연과 음주습관이 영양소 섭취 및 건강상태에 미치는 영향)

  • Shin, Kyung-Ok;An, Chang-Hun;Hwang, Hyo-Jeong;Choi, Kyung-Soon;Chung, Keun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.6
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    • pp.694-708
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    • 2009
  • The principal objective of this study was to determine the effects of smoking & drinking on the diet, nutrient intake, and overall health. A sample of 262 youths, aged 16 to 18 year-old, was randomly selected from Seoul and its vicinity. The subjects participated by answering survey questions including general questions, questions regarding health, smoking & drinking habits, dietary habits, nutrient intake, physical characteristics, and smoking cessation plans. The average height, weight, and BMI of the subjects were $173.5{\pm}6.8\;cm$, $64.8{\pm}11.8\;kg$, and $21.4{\pm}3.7\;kg/m^2$, respectively. Among the subjects, 88% appeared to be interested in health and 43.5% of youth asserted that the best way to keep healthy was to engage in regular exercise. Among 63 smokers, 52 students (82.5%) used alcoholic beverages while 11 students (17.5%) did not use alcoholic beverages, meaning that smoking was a causative factor in drinking. 55.6% of youth reported beginning to smoke in middle school, and 38.1% of them asserted that curiosity was the motive for smoking. The youth reported that the craving for smoking was highest when hungry, and the best place to smoke was the restroom. 20 students (69.0%) answered that the only way to quit smoking was just to stop. 12 students (44.4%) reported that the main reason for failures in smoking cessation attempts was a lack of intention or willpower. 87.1% of all subjects answered that they were inclined to quit smoking, and 56.7% of them would be interested in attending a smoking cessation program if they had the opportunity. Among the smoking and drinking group, 50% of drinkers began to drink in high school, and the reason for drinking given was peer pressure-40% of drinkers answered that they wished to quit drinking. 34.4% of students appeared to have breakfast everyday, but 16.4% of students answered that they had quit eating breakfast. 52.5% of all students reported that the principal reason for overeating was the presence of one's favorite food, and the smoking and drinking group reported overeating more frequently than other groups (p<0.05). 72.6% of all subjects reported eating interim meals $1{\sim}2$ times daily, 36.4% of smokers ate carbonated beverages, 38.5% ate ice cream as a interim meal, and 38.5% of the drinking and smoking groups ate fruits, 26.9% of them ate fried foods, and some of them ate fast foods as a interim meal. Among smokers, the ratio of eating fat-rich foods, and meats such as kalbi and samgyupsal more than two times per week was higher, and 54.3% of smokers ate ice cream, cookies, and carbonated beverages more than two times per week (p<0.05). The total nutrient intake of the $15{\sim}19$-year youth group was much higher than the standard value. The energy intake of the smoking group and the drinking and smoking group was significantly higher than that of the normal group (p<0.05). Intakes of phosphorus (p<0.05), cholesterol (p<0.05), and sodium (p<0.05) were the highest among all groups. Accordingly, it is recommended that practical education programs be implemented to teach young students to resist peer pressures to smoke and drink. Additionally, education that acknowledges the importance of nutrition is necessary to avoid preferential eating and overeating due to smoking and drinking.such education can also teach students to eat a balanced diet and improve their physical development.

Hepatitis Complicated with Mycoplasma pneumoniae Infection in Children (소아의 Mycoplasma pneumoniae 폐렴에 합병된 간염)

  • Lee, Seung Min;Lee, Sung Moon;Tchah, Hann;Jeon, In Sang;Ryoo, Eell;Cho, Kang Ho;Seon, Yong Han;Son, Dong Woo;Hong, Hee Joo
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.832-838
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    • 2005
  • Purpose : Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has been reported rarely in Korea. Methods : A clinical study was performed on 556 patients of M. pneumoniae pneumonia diagnosed serologically at Gil hospital from January 2001 to December 2004. We reviewed 65 cases among these patients, who had elevated level of serum AST and ALT greater than 50 IU/L respectively without evidence of hepatitis A, B, C, Cytomegalovirus and Ebstein-Barr virus infections. Results : Hepatitis occurred in 11.7% of Mycoplasma pneumoniae pneumonia, especially in fall and winter times. Male to female ratio was 1.2 : 1 and the mean age was 4 years and 3 months. Besides hepatitis, cough(95.4%), sputum(52.3%) and dyspnea(12.3%) were common as pulmonary manifestations. And among gastrointestinal manifestations, nausea/vomiting(26.2%) was the most common symptom, followed by poor oral intake(12.3%), diarrhea(12.3%) and abdominal pain(6.2%). In addition to hepatomegaly(4.6%) and splenomegaly(4.6%), coarse breathing sound was the most common physical manifestation, followed by rale(63.1%), pharyngeal injection(26.2%), and rash(10.8%). Anemia was noted in 20.0%, neutrophilia in 10.8%, eosinphilia in 38.5% and thrombocytosis in 6.2%, respectively. Mean level of ESR and CRP was 32.02 mm/hr and 6.69 mg/dL, respectively. Mean level of AST and ALT was 293.80 IU/L and 181.48 IU/L, respectively. Hyperbilirubinemia was noted in 7.7% and hypoalbuminemia was noted in 58.5%. Lobar or lobular pneumonia(78.5%) was the most common finding in chest X-ray and left lower lobe(39.2%) was most commonly affected. Pleural effusion was noted in 26.2%. Mean duration of hospitalization was 9.91 days. Serum AST/ALT level was normalized within 9.94 days and pulmonary consolidation resolved within 14.29 days. Conclusion : The prognosis of M. pneumoniae hepatitis is good. However, liver function should be considerately checked in M. pneumoniae infection because its incidence is not so low.

The Obligation of Return Unjust Enrichment or Compensation for the Use of Flight Safety Zone -Seoul High Court Judgment 2018Na2034474, decided on 2018. 10. 11.- (비행안전구역의 사용에 대한 부당이득반환·손실 보상 의무의 존부 -서울고등법원 2018. 10. 11. 선고 2018나2034474 판결-)

  • Kwon, Chang-Young;Park, Soo-Jin
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.1
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    • pp.63-101
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    • 2020
  • 'Flight safety zone' means a zone that the Minister of National Defense designates under Articles 4 and 6 of the Protection of Military Bases and Installations Act (hereinafter 'PMBIA') for the safety of flight during takeoff and landing of military aircrafts. The purpose of flight safety zone is to contribute to the national security by providing necessary measures for the protection of military bases and installations and smooth conduct of military operations. In this case, when the state set and used the flight safety zone, the landowner claimed restitution of unjust enrichment against the country. This article is an analysis based on the existing legal theory regarding the legitimacy of plaintiff's claim, and the summary of the discussion is as follows. A person who without any legal ground derives a benefit from the property or services of another and thereby causes loss to the latter shall be bound to return such benefit (Article 741 of the Civil Act). Since the subject matter is an infringing profit, the defendant must prove that he has a legitimate right to retain the profit. The State reserves the right to use over the land designated as a flight safety zone in accordance with legitimate procedures established by the PMBIA for the safe takeoff and landing of military aircrafts. Therefore, it cannot be said that the State gained an unjust enrichment equivalent to the rent over the land without legal cause. Expropriation, use or restriction of private property from public necessity and compensation therefor shall be governed by Act: provided, that in such a case, just compensation shall be paid (Article 23 (1) of the Constitution of The Republic of KOREA). Since there is not any provision in the PMBIA for loss compensation for the case where a flight safety zone is set over land as in this case, next question would be whether or not it is unconstitutional. Even if it is designated as a flight safety zone and the use and profits of the land are limited, the justification of the purpose of the flight safety zone system, the appropriateness of the means, the minimization of infringement, and the balance of legal interests are still recognized; thus just not having any loss compensation clause does not make the act unconstitutional. In conclusion, plaintiff's claim for loss compensation based on the 'Act on Acquisition of and Compensation for land, etc. for Public Works Projects', which has no provision for loss compensation due to public limits, is unjust.

The Evaluations of Phoria and AC/A Ratio by Watching 3D TV at Near (3D TV 근거리 시청에 따른 사위도와 조절성폭주비 평가)

  • Son, Jeong-Sik;Kim, Dong-Su;Kim, Jung-Ho;Kim, Jae-Do;Hamacher, Alaric;Yu, Dong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.3
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    • pp.319-324
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    • 2015
  • Purpose: This study was designed to evaluate the changes of phoria and calculated AC/A ratio, and their recovery time points by watching 3D television (3D TV). Methods: 50 subjects (male 30, female 20) of 20s to 40s ages who can watch 3D, were measured phoria using a Howell phoria card at 3 m for distance and 40 cm for near. The phoria was evaluated before watching 3D TV and every 10 minutes from starting of watching 3D TV for 30 minutes, and every 5 minutes after finishing of watching 3D TV for 30 minutes again. Results: For the distance phoria during and after watching 3D TV, it was increased to more exophoria $-0.98{\pm}1.37{\Delta}$ (prism diopters) after 10 minutes from starting of 3D TV watching (p=0.063) and increased to more exophoria $-1.00{\pm}1.28{\Delta}$ after 30 minutes (p=0.024), and started to decrease after finishing of watching 3D TV and recovered to the level of before 3D TV watching ($-0.78{\pm}1.11{\Delta}$) after 20 minutes (p=0.32) with comparing to phoria of before watching 3D TV ($-0.80{\pm}1.12{\Delta}$). For the near phoria, it was also increased to more exophoria $-5.71{\pm}4.45{\Delta}$ after 10 minutes from starting of watching 3D TV (p=0.000) and $-6.58{\pm}4.36{\Delta}$ after 30 minutes (p=0.000), and started to decrease after finishing of watching 3D TV and recovered to the level of before watching 3D TV after 20 minutes ($-4.34{\pm}3.67{\Delta}$) (p=0.32) with comparing to the phoria of before watching 3D TV ($-4.36{\pm}3.66{\Delta}$). AC/A ratio was decreased from $4.92{\pm}1.17{\Delta}/D$ for before 3D TV watching to $4.11{\pm}1.50{\Delta}/D$ for after 30 minutes from starting of watching 3D TV (p=0.000), and increased after the end of watching 3D TV and recovered to the level of before 3D TV watching ($4.93{\pm}1.18{\Delta}/D$) after 25 minutes (p=0.598). Conclusions: During watching 3D TV at near, it showed a tendency of convergence insufficiency by decrease of calculated AC/A ratio as result that exophoria at near was higher increased than exophoria at distance. However, the increased exophoria at both near and distance was recovered to the level of base line after 25 minutes from the end of watching 3D TV. Through this study, it seems to need rational proposals of advice for watching 3D TV.

A New Exploratory Research on Franchisor's Provision of Exclusive Territories (가맹본부의 배타적 영업지역보호에 대한 탐색적 연구)

  • Lim, Young-Kyun;Lee, Su-Dong;Kim, Ju-Young
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.37-63
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    • 2012
  • In franchise business, exclusive sales territory (sometimes EST in table) protection is a very important issue from an economic, social and political point of view. It affects the growth and survival of both franchisor and franchisee and often raises issues of social and political conflicts. When franchisee is not familiar with related laws and regulations, franchisor has high chance to utilize it. Exclusive sales territory protection by the manufacturer and distributors (wholesalers or retailers) means sales area restriction by which only certain distributors have right to sell products or services. The distributor, who has been granted exclusive sales territories, can protect its own territory, whereas he may be prohibited from entering in other regions. Even though exclusive sales territory is a quite critical problem in franchise business, there is not much rigorous research about the reason, results, evaluation, and future direction based on empirical data. This paper tries to address this problem not only from logical and nomological validity, but from empirical validation. While we purse an empirical analysis, we take into account the difficulties of real data collection and statistical analysis techniques. We use a set of disclosure document data collected by Korea Fair Trade Commission, instead of conventional survey method which is usually criticized for its measurement error. Existing theories about exclusive sales territory can be summarized into two groups as shown in the table below. The first one is about the effectiveness of exclusive sales territory from both franchisor and franchisee point of view. In fact, output of exclusive sales territory can be positive for franchisors but negative for franchisees. Also, it can be positive in terms of sales but negative in terms of profit. Therefore, variables and viewpoints should be set properly. The other one is about the motive or reason why exclusive sales territory is protected. The reasons can be classified into four groups - industry characteristics, franchise systems characteristics, capability to maintain exclusive sales territory, and strategic decision. Within four groups of reasons, there are more specific variables and theories as below. Based on these theories, we develop nine hypotheses which are briefly shown in the last table below with the results. In order to validate the hypothesis, data is collected from government (FTC) homepage which is open source. The sample consists of 1,896 franchisors and it contains about three year operation data, from 2006 to 2008. Within the samples, 627 have exclusive sales territory protection policy and the one with exclusive sales territory policy is not evenly distributed over 19 representative industries. Additional data are also collected from another government agency homepage, like Statistics Korea. Also, we combine data from various secondary sources to create meaningful variables as shown in the table below. All variables are dichotomized by mean or median split if they are not inherently dichotomized by its definition, since each hypothesis is composed by multiple variables and there is no solid statistical technique to incorporate all these conditions to test the hypotheses. This paper uses a simple chi-square test because hypotheses and theories are built upon quite specific conditions such as industry type, economic condition, company history and various strategic purposes. It is almost impossible to find all those samples to satisfy them and it can't be manipulated in experimental settings. However, more advanced statistical techniques are very good on clean data without exogenous variables, but not good with real complex data. The chi-square test is applied in a way that samples are grouped into four with two criteria, whether they use exclusive sales territory protection or not, and whether they satisfy conditions of each hypothesis. So the proportion of sample franchisors which satisfy conditions and protect exclusive sales territory, does significantly exceed the proportion of samples that satisfy condition and do not protect. In fact, chi-square test is equivalent with the Poisson regression which allows more flexible application. As results, only three hypotheses are accepted. When attitude toward the risk is high so loyalty fee is determined according to sales performance, EST protection makes poor results as expected. And when franchisor protects EST in order to recruit franchisee easily, EST protection makes better results. Also, when EST protection is to improve the efficiency of franchise system as a whole, it shows better performances. High efficiency is achieved as EST prohibits the free riding of franchisee who exploits other's marketing efforts, and it encourages proper investments and distributes franchisee into multiple regions evenly. Other hypotheses are not supported in the results of significance testing. Exclusive sales territory should be protected from proper motives and administered for mutual benefits. Legal restrictions driven by the government agency like FTC could be misused and cause mis-understandings. So there need more careful monitoring on real practices and more rigorous studies by both academicians and practitioners.

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Graves' Disease in Prepubertal Children Compared with Pubertal Children (소아 Graves병의 임상적 고찰 : 사춘기 이전군과 사춘기군의 비교)

  • Kim, Hyun Mi;Yoon, Ju Yun;Jung, Min Ho;Suh, Byung Kyu;Lee, Byung Churl
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.76-82
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    • 2003
  • Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.

Customer perception and expert assessment in restaurant food environment by region - Focused on restaurants in Suwon, Hwaseong city - (도시와 농촌의 한식 음식점 식생활 환경에 대한 고객 인식 및 전문가 평가 비교 - 수원, 화성지역 음식점을 중심으로 -)

  • Oh, Mi Hyun;Choe, Jeong-Sook;Kim, Young;Lee, Sang Eun;Paik, Hee Young;Jang, Mi Jin
    • Journal of Nutrition and Health
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    • v.47 no.6
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    • pp.463-474
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    • 2014
  • Purpose: The aim of this study was to assess the food environment, particularly focusing on restaurants in three areas (Suwon city, Hwaseong Byeongieom-dong, and Bibong-myun). Methods: A total of 662 persons were surveyed on customers' perceptions of the food environment in restaurants. A structured questionnaire composed of 30 questions on 7 factors, sanitation (4 items), displaying information (5), food quality (12), information on nutritional and healthy food choice (6), restaurant's accessibility (1), availability (1), and affordability (1) was used. In addition, an expert assessment of restaurant sanitation, and information on nutritional healthy food choice was conducted through visiting 126 restaurants. Results: Scores (range of score : 1~7) for each factors assessing the restaurant food environment were 5.06 for sanitation factors, 5.05 for displaying information factors, 5.13 for taste appearance factors, and 4.35 for healthy menu factors. Informations on nutritional healthy food choice showed a low rate: only 16.24% of the subjects answered that there is a message encouraging choice of healthy foods and 27.4% answered that menus contain nutritional information. Significant differences in food environment were observed by region (city, town, rural). The restaurants food environment in the rural area turned out to be poorer than that of the other two areas. In comparison of customer perception and expert assessment, significant differences were observed for 'Employee appearances and uniforms are clean and tidy' (p < .05), and 'There is a message encouraging the choice of healthy foods' (p < .05). Conclusion: This study provided evidence for differences of restaurant food environment by regions. In the rural area, there is a problem in restaurant's accessibility, availability, and affordability because of a lack of variety in menu items and restaurants. This results suggest that there is a need for more healthy food restaurants in the rural area.

The Effects of Environment-Friendly Agricultural Materials on Soil and the Quality of 'Niitaka' pear's Orchad (친환경농자재 처리가 배과수원 토양 및 과실품질에 미치는 영향)

  • Yoon, Seong-Tak;Xu, Zhen-Yu;Zhang, Qing-Yu;Kim, Tae-Ho;Nam, Jung-Chang;Park, Sang-Hun;Kwak, No-Il;Mun, Su-Hak;Lee, Hyuk-Jae;Choi, Jin-Ho
    • Korean Journal of Organic Agriculture
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    • v.18 no.4
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    • pp.613-626
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    • 2010
  • Coming with the well-being era, consumer's demand for safe agricultural products is increasing. It is urgent to develop an environment-friendly pear production system. Accordingly, this study was conducted to develop an environment-friendly pear production system by using several environment-friendly agricultural materials which is known to be effective in agricultural production. In the effects of environment-friendly agricultural materials on the soil chemical characteristics in pear orchard, the content of total carbon, organic matter, Ca and Mg increased a little respectively compared with those of 2008, and 2nd treatment showed the highest EC and Mg content in the soil among treatments. The content of leaf N, P and Ca in 2009 decreased compared with those of 2008, while Mg content showed no difference between 2008 and 2009 years. Average pear weight in 2009 was 31g higher than that of 2008 (682g) and 2nd treatment showed the highest pear weight (738g) among treatments. The average sugar content was higher in 2009 (12.6$^{\circ}Bx$) compared with that of 2008 (12.2$^{\circ}Bx$) and the plot of 2nd treatment highest sugar content (12.6$^{\circ}Bx$) among treatments. There were no difference in hunter value of L among treatments, but hunter value of a showed higher 1.62 in 2009 than that of 2008 (3.73). The highest of gumminess and cohesiveness of fruits were obtained from 1st treatment and adhesiveness and chewiness of fruits were obtained from 3rd and 1st treatment respectively. Firmness of fruit increased a little in 2009 compared with that of 2008, while the highest firmness was obtained from 3rd treatment with 1.63kg/5mm$\oint$ among treatments. Phosphate content in the peel of 'Niitaka' pear of fruit skin in 2009 (0.97g/kg) showed 0.06g/kg more content than that of 2008 (0.91g/kg), while the highest content was obtained from 3rd treatment (1.15g/kg). Potassium content in the peel of 'Niitaka' pear in 2009 was 8.20g/kg, which is 0.06g/kg more content than that of 2008 (7.82g/kg) and the highest content was obtained from 1st treatment (8.34g/kg) among treatments. The highest nitrogen content in the flesh of 'Niitaka' pear was obtained from 3rd treatment (4.32mg/g), while it was the lowest in control plot (3.10mg/g). Phosphate content in the flesh of 'Niitaka' pear in 2009 (8.20g/kg) showed 0.06g/kg more content than that of 2008 (7.82g/kg), while the highest content was obtained from 1st treatment (8.34g/kg). There were no difference of the potassium content in the fruit peel of 'Niitaka' pear between years, but 1st treatment showed the highest content (11.81g/kg) among treatments, while the lowest was obtained from the control plot (10.83g/kg).