• 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.

• Journal of Preventive Medicine and Public Health
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• v.31 no.1 s.60
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• pp.139-156
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• 1998

Diving related disease including decompression sickness is an important occupational health problem and diving fishermen remain a fairly hazardous occupation in Korea. To prevent diving related disease, we investigate diving patterns, incidence of diving related diseases, and contributing factors of 433 diving fishermen of three coast interviewing and mailing questionnaire in 1996. Mean age of divers was 39.7 years, ranged from 24 to 58 years, 92.8% of these were male, and 58.4% of divers were high school graduates. Mean duration of work as a diver was 12.9 years, ranged from 2 to 40 years. It was found that 70.4% of divers were using hookah system, 22.2% of helmet, and only 2.5% SCUBA. About half of them have learned diving skills from other divers. The peak season of diving was from April to June and mean working days were 20.3 days per month during the peak season. On the average, the divers dived 5-6 times, ranged from 1 to 10 times a day with 51.1 minutes of diving time, ranged from 20 to 120 minutes, at 30 m or 40 m in depth, and 35.5 minute of interval on surface. Most divers ascended slowly making decompression stop, yet the decompression profile used was not based on any scientific knowledge except for their own experiences. It appeared that each diving system had slightly different diving patterns. There were 282(65.0%) divers that suffered from DCS in 1995 and 31.2% of divers were given recompression therapy at a medical facility since they worked as diving fishermen. Skin and musculoskeletal complaints were common symptoms of DCS and 39% of divers experienced a voiding difficulty. In univariate analysis, females have an increased frequency of DCS(93% vs 66% for males). Old age, long duration of work, helmet diving, diving time, diving depth, repetitive diving, and blow up were all contributing factors to DCS. It was found that most diving patterns exceed no decompression limit and did not use the standard decompression table. This suggests that most of divers are at high risk of developing diving related disease with prolonged dives and lengthy repetitive diving in deep depth. Considering the diving patterns and economic aspect of professional diving, the incidence of DCS among diving fishermen in Korea will not decrease in the near future. These findings suggest that periodical health surveillance for divers, and education of health and safety are important for reducing the risk of diving related disease in the population of diving fishermen.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.222-230
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• 2005

Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

• Journal of Preventive Medicine and Public Health
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• v.7 no.2
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• pp.349-354
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• 1974

Survey results concerning the general information on health status of 7,050 inhabitants (1,141 households) which have been selected within Keumsan Gun, Chung Choung Nam Do area are as follws: 1. The average family size is $6.18{\pm}2.17$ persons per household. Tertiary sex ratio is 105.5 population composition of Kumsan Gun shown a pyramidal form consisting of 51.6% of the inhabitants under 20 years of age. 2. Rate of illiteracy amounts to 12.1% and only 4.1% of villagers were graduated from high schools, 80% of the inhabitants have some kind of jobs: 46.1% of them are engaged in agriculture, 95.2% of villagers have their own houses, and remaining 4.8% do not have their own. 3. 72% of households made use of health services provided provided by health centre or subcentres during a period of 1 year from April 1, 1973 to March 31, 1974. 26.8% of them visited health centre of sub-centres 2-4 times annually for the following purposes: 1) Vaccination: 35.7% 2) Diagnosis or treatment: 26.7% 3) Family planning: 24.1% 4) Maternal and child health: 10.5% 4. Utilization rate of health facilities is on an average 4.4 times per household and 0.75 times per capita. 5. Birth rate in the area is 1.91% and death rate is 0.75%, indicating the natural increase rate is only 1.16% that is lower than the nationwide rate of 1.8-2.2% in 1970 and 1.5-1.9% in 1973. 6. 37.7% of fertile women (20-40 years old) in the area are still unmarried, Fertility rate is the highest in the age group of 63-40 years old showing a value of 17.1%. 7. The unmarried population in this area amounts to 61.4% : 61.4% in male and 57.6% in female. 8. Number of inhaibtants who practice family planning is 612 persons(22.6%) among the married (2.771). This value consists of 8.3% of married males and 34.8% of married females. Only 16.0% of the people who put family planning in practice undergo permanent contraceptive methods and remaining 84.0% of them do temporary measures. 9. Only 57.7% of the subjects took vaccinations as follows: 1) B.C.G. vaccination: 82.7% 2) D.P.T. vaccination: 76.2% 3) Poliomyelitis vaccination: 67.9% 4) Smallpox vaccination: 62.6% 10. In the utilization of medical facilities in case of sickness drug stores (32.15%) comes first and hospitals or clinics (28.65%), health centre of health sub-centres (17.96%), herb drug stores (7.36%) and herb gerneral practioners (6.31%), etc., in decreasing order. Sickness that people living in this area suffer from are neuralgia, disease digestive troubles, respiratory diseases and skin lesions, etc.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.78-85
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• 1999

Purpose : Mycoplasma pneumoniae pneumonia has been to be developed frequently in school age children and adolescence and hard to see under 3 year-old children. But it seems to be increased in number of patients with Mycoplasma pneumoniae pneumonia under 3-year old in clinical practice in these days. We have aimed to examine the characteristics of clinical findings of Mycoplasma pneumonia under 3 year-old children. Methods : We had performed retrospective review of medical records of 30 patients with Mycoplasmal pneumonia under 3-year old children who admitted to Department of Pediatrics, Kyunghee University Hospital from Jan. 1994 to Dec. 1997. The diagnostic criteriae was Cold agglutinin titer>1:64 or Mycoplasma antibody titer>1:80. Results : Mycoplasmal pneumonia was 30 out of 235 cases(12.7%) of total pneumonia under 3 year old children. Male female ratio was 1.3 : 1 and age distributions were 0~1y : 0, 1~2y : 8, 2~3y : 22 cases. Clinical symptoms and signs were cough(100.0%), sputum(83.3%), fever(80.0%) rhinorrhea(33.3%), vomiting(33.3%), moist rale(86.7%), decreased breathing sound(26.7%), wheezing(20.0%), and pharyngeal injection(30.0%). Thirteen out of 30 cases(43.3%) had unilateral infiltration, 10 cases(33.4%) had bilateral infiltration, 1 case(3.3%) had pleural effusion, and 6 cases(20.0%) had negative findings on chest radiography and there was no cases of atelectasis. On laboratory findings, 6 out of 30 cases(20.0%) had leukocytosis, 1 case(3.3%) had neutrophilia, 10 cases(30.0%) had eosinophilia, 17 cases(56.7%) had increased ESR, and 18 cases(60.6%) had positive CRP. Positive cold agglutinin titers(>1 : 64) were 19 cases(63.3%), and positive mycoplasma antibody(M-ab) titers(>1 : 80) were 27 cases(93.3%). Mycoplasma antibody test was more valuable than cold agglutinin test for the diagnosis of Mycoplasmal pneumonia and there was no correlation between cold agglutinin titer and mycoplasma antibody titer. Mycoplasma-polymerase chain reaction(M-PCR) was done with 13 cases, 12 out of 13 cases(92.3%) were positive. M-PCR test was valuable to the diagnosis of Mycoplasmal pneumonia but it will be needed to further study for their clinical application. Among 30 cases, 5 cases(16.7%) had complications, 3 cases(10.0%) had skin rash, 1 case(3.3%) had pleural effusion, 1 case(3.3%) had arthralgia, but all complications were mild and recovered without residual sequelae. Conclusion : The occurrence of Mycoplasmal pneumonia under 3 year-old children was not rare from this study. Clinical characteristics of Mycoplasmal pneumonia under 3-year old were normal radiologic findings in many cases, low complication rate, mild clinical course, and tend to rapid recovery compared with general manifestations of Mycoplasmal infectionsin children and adolescence. There were likely to be missed patients with Mycoplasmal pneumonia which did not diagnose by conventional serologic tests that had low sensitivity and specificity. We have to pay attention to the Mycoplasmal infection of the young children with pneumonia during epidemic periods of Mycoplasmal infection.

• Korean Journal of Agricultural Science
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• v.5 no.2
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• pp.93-114
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• 1978

The purpose of the study was to find out possible ways for increasing farm income through the sheep and Korean native goats farming, and to investigate meat productivity, wool productivity; woolskin utility, physiological characteristics and correlation between economical college animal farm of the Chungnam National University and sample farms in the suburbs of Dae jeon City were selected for feeding 20 heads of Corriedale wethers and another 20 heads Korean native kids as research materials for the periods of 5th May-26th November, 1977. The data such as growth rate, carcass, viscera weight, blood picture and plamsa components, hebage intake and economic traits were obtained and analysed. The result of the study are summarized as follows: 1. Meat production and quality 1) After 196days of feeding, the body weight of sheep and Korean native goats was increased by two times of those at the beginning of the trial, i.e. 20kg and 8kg respectively. 2) There was no significance of growth rates of sheep in housing and grazing. 3) The growth rate of Korean native goats were excellent at the mountainous areas of Gong ju-Gun where infectious diseases were not found 4) Accroding to the body measurements of 18-month-old sheep, percentages of hip height, body length, rump length, chest depth, chest width, hip width, chest girth and forearm circumference to the withers height were 103,%, 104%, 33%, 44%, 31%, 23%, 135% and 15% respectively, and those of hip height, body length, chest depth and chest girth of 8-month-old native goats to the withers height were 106%, 109%, 46% and 122,% respecitively. As a result, it was found that the percentage of hip height, body length and chest depth of Korean native goats were higher than those of sheep while that of the chest girth of goats was lower. 5) In the carcass data, 47, $52{\pm}2.27%$ of carcass percentage, $34.61{\pm}1.62%$ of lean meat, $26.07{\pm}2.51%$ of viscera, $9.75{\pm}1.4%$ of bone, and $20.95%{\pm}2.14%$ of woolskin for sheep, and $45.58{\pm}5.63%$ of carcass percentage, $27.62{\p}3.81%$ of meat, $34.86{\pm}4.16%$ of viscera, $11.66{\pm}1.83%$ of bone, $3.63{\pm}1.61%$ of skull and $9.26{\pm}2.41%$ of woolskin for native goats were obtained. 6) The contents of moisture, crude protein, crude fat and crude ash in native goat meat were much similar in both plots of housing and grazing. It was, however, known that the contents of moisture and protein were higher in grazinrg than in housing, while fat content was lower in grazing plots. 7) The weights of visceral organs shown similar tendency for both of sheep and native goats. For the weights of liver, heart, kidney and spleen, significance was not reconized among the treatments. Those of rumen, reticulum, small and large intestine were heavier in grazing than in housing, while the amount of visceral fat was heavier in housing. 2. Wool productivity and woolskin 1) The wool production of sheep for 7 months was $3.88{\pm}1.02kg$, and wool percentage, staple length, straighten length, wool growth per day and number of crimps were $9.27{\pm}1.48%$, 8. $47{\pm}1.00cm$, $10.63{\pm}0.99cm$, $0.40{\pm}0.04cm$ and $2.78{\pm}0.40$ respecitively. 2) The tensile strength and tear strength of woolskin treated by alum tanning were highest on the skin obtained from rump, i.e. $1,351kg/mm^2$ and $2,252kg/mm^2$ respectively, and they are in order of loin and shoulder. 3. Utilization and improvement of pasture. 1) The difference of herbage intake of native goats was not recognized between grazing and tethering, but the intake in the afternoon was s lightly higher than that in the morning. However the hervage intake of sheep was superior in grazing and in the afternoon. 2) The cultivation effect was lower in the native goat plots due to their cultivation abilities, in other words, the establishment rates of pasture by hoof cultivation were 60.25% in the goat plots and 77.35% in the sheep plots. 4. Correlation among economical traits. 1) The correlation between live weight of sheep and daily gain was higher. On the other hand, the correlation between other traits was not significant except that live weight, daily gain and lean meat percentage to the length of thoracic vertebrae. The live weight of native goats and meat production were highly correlated, and high correlation was also found between weights of carcass and meat. However, negative correlation was shown between viscera weight and live weight as well as daily gain. 2) The correlatoin between fleece weight of sheep and other traits such as live weight, daily gain and fleece percentage is very high at the 1% siginficant level, and this means that rapid-growth individuals can produce much fleece. 3) The correlation between the factors such as weights of live body, lean meat and viscera of sheep and body measurements, i. e. chest girth and body length was highest, and weights, of carcass and lean meat was highly correlated to chest width and depth. It will be therefore reasonable that the meat productivity estimates will have to be made on the basis of chest girth and body length. The meat production traits of native goats were highly correlated to the most of body measurement data, and the correlation coefficient between chest girth and weights of live body, carcass, lean meat and bone percentage was very high, i. e. 0.992-0.974 in particular. The correlations of meat production traits to chest depth, forearm circumference, body length were 0.759-0.911, 0.759-0.909 and 0.708-0.872 respectively. Therefore, the meat production of native goats will have to be estimated on the basis of chest data. 5. Blood picture and plasma components. 1) The number of erythrocyte and MCHC of native goats were $12.93{\times}10^6/mm^3$ and 36.14%, and those of sheep were $10.68{\times}10^6/mm^3$ and 36.26 respectively. The values of native goats were significantly higher than those of sheep. 2) The hemoglobin concentration, PVC, MCV and MCR of native goats were 10.92 g/100ml, $23.40{\mu}^3$ and 10.94 pg, and those of sheep were 11.73 g/100ml, 36.25 ml/100ml, $33.97{\mu}^3$ and 30.2 ml/100ml 8.43 pg respectively. The values of native goats were significantly lower those of sheep. 3) The number of leukocytes of native goats was significantly higher than that of sheep, that is, $11.64{\times}10^3/mm^3$ in native goats and $9.32{\times}10^3/mm^3$ in sheep. 4) In differential count of leukocyte, neutrophil was significantly high in native goats while lympocyte in sheep. On the other hand, the basophil, eosinophil and monocyte were not significant between native goats and sheep. 5) The amounts of total protein and glucose in the plasma of native goats were 6.2g/100ml and 53.6mg/100ml, and those of sheep were 5.6g/100ml and 45.7mg/100ml, which means that the values of native goats were significantly higher that those of sheep. The amount of total-lipid of native goats(127.6mg/100ml) was significantly than that of sheep(149.6mg/100ml). 6) The amount of non-protein nitrogen, cholesterol, Ca, P, K, Na and Cl were not different between native goats and sheep. 6. Economic analysis. 1) The gross revenue of a farm which fed native goats and sheep was 4,000won per head and the optimum size for feeding them in a farm as a subsidiary work is 5-10 heads. 2) Since there was no difference between housing and grazing, they can be fed in group for farm's subsidiary work. 3) They can be also fed by youths and house wives in the suburbs of cities, because labour requirement is estimated as only two hours per days for feeding 5 heads of native goats and sheep.