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Clinical significance of acanthosis nigricans in children and adolescents with obesity induced metabolic complications (비만으로 인한 대사적 합병증을 가진 소아 및 청소년에서 흑색가시세포증의 임상적 의의)

  • Chueh, Hee Won;Cho, Gyu Rang;Yoo, Jaeho
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.987-994
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    • 2007
  • Purpose : This study investigated the clinical significance of AN in children and adolescents with obesity induced metabolic complications. Methods : Forty-nine patients who had obesity induced metabolic complications were participated in this cross-sectional study. Obesity induced metabolic complications are as follows: hypertension, dyslipidemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), nonalcoholic steatohepatitis (NASH), homeostasis model assessment of insulin resistance (HOMA-IR)>3.16. Clinical characteristics, such as, age, percentage-weight-for-height (PWH), pubertal status, blood pressure (BP), fasting plasma insulin level, fasting and post-oral glucose tolerance test 2-hour glucose levels, liver function test, lipid profile, HOMA-IR were compared according to the presence of AN. Results : Sixty-five percent of patients had AN, 57.1% NASH, 57.1% dyslipidemia, 55.1% hypertension, 46.9% IFG, 24.5% HOMA-IR>3.16 and 16.2% IGT. The patients who were moderately to severely obese with AN had higher incidence of IGT and HOMA-IR>3.16. The patients with AN had significantly higher diastolic BP ($79.4{\pm}6.9$ vs $75.4{\pm}5.6mmHg$), fasting levels of plasma insulin ($10.6{\pm}6.0$ vs $6.2{\pm}5.4{\mu}IU/mL$), HOMA-IR index ($2.6{\pm}1.4$ vs $1.4{\pm}1.3$) and PWH ($42.4{\pm}13.0$ vs $34.3{\pm}1.8%$). The increasing tendency for the presence of AN was significantly related to the cumulative number of obesity induced metabolic complications. Binary logistic regression analysis revealed that the presence of AN was significantly associated with fasting plasma insulin level, PWH and IFG. Conclusion : AN could be useful as a clinical surrogate of obesity induced metabolic complications.

Development of Dust Recycling System and Dust Cleaner in Pipe during Vitrification of Simulated Non-Radioactive Waste (모의 비방사성폐기물의 유리화시 발생 분진의 재순환처리장치 및 배관 내 침적분진에 의한 막힘 방지용 제진장치의 개발)

  • Choi Jong-Seo;You Young-Hwan;Park Seung-Chul;Choi Seok-Mo;Hwang Tae-Won;Shin Sang-Woon
    • Proceedings of the Korean Radioactive Waste Society Conference
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    • 2005.06a
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    • pp.110-120
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    • 2005
  • For utilizing vitrification to treat low and intermediate level waste, industrial pilot plant was designed and constructed in October 1999 at Daejon, Korea through the joint research program among NETEC, MOBIS and SGN. More than 70 tests were performed on simulated IER, DAW etc. including key nuclide surrogate(Cs, Co); this plant has been shown to vitrify the target waste effectively and safely, however, some dust are generated from the HTF(High Temperature Filter) as a secondary waste. In case of long term operation, it is also concerned that pipe plugging can be occurred due to deposited dust in cooling pipe namely, connecting pipe between CCM(Cold Crucible Melter) and HTF. In this regard, we have developed the special complementary system of the off-gas treatment system to recycle the dust from HTF to CCM and to remove the interior dust of cooling pipe. Main concept of the dust recycling is to feed the dust to the CCM as a slurry state; this system is regarded as of an important position in the viewpoint of volume reduction, waste disposal cost and glass melt control in CCM. The role of DRS(Dust Recycling System) is to recycle the major glass components and key nuclides; this system is served to lower glass viscosity and increase waste solubility by recycling B, Na, Li components into glass melt and also to re-entrain and incorporate into glass melt like Cs, Co. Therefore dust recycling is helpful to control the molten glass; it is unnecessary to consider a separate dust treatment system like a cementation equipment. The effects of Dust Cleaner are to prevent the pipe plugging due to dust and to treat the deposited dust by raking the dust into CCM. During the pilot vitrification test, overall performance assessment was successfully performed; DRS and Dust Cleaner are found to be useful and effective for recycling the dust from HTF and also removing the dust in cooling pipe. The obtained operational data and operational experiences will be used as a basis of the commercial facility.

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Analysis of Growth and Hematologic Characteristics of Endangered Korean Native Cattle (멸종위기의 백한우(체세포복제 포함)의 성장 및 혈액학적 특성 분석)

  • Kim, Hyun;Choe, Changyong;Seong, Hwan-Hoo
    • Journal of Embryo Transfer
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    • v.30 no.3
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    • pp.175-181
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    • 2015
  • The objective of this study was to monitor health conditions of genetically identical somatic cells cloned Korean white cattle, endangered indigenous cattle (EIC) and indigenous cattle (IC) by analysis of hematologic characteristics. Naturally ovulated oocytes and donor cells were used for somatic cell nuclear transfer (SCNT). Donor cells and enucleated oocytes were followed by electric fusion, chemical activation and surgical embryo transfer into the oviducts of surrogate females. Two recipients became pregnant; two maintained pregnancy to term, and one live cattle were delivered by caesarean section. The cloned Korean white cattle were genetically identical to the nuclear donor cattle. As a result, the mean values of RBC and platelet of cloned cattle and white cattle were significantly decreased by age (P<0.05). The mean values of RBC, HCT, MCV and MCHC between cloned cattle and IC of the same age (1~2 years) showed the statistical significance (P<0.05). Also, in the WBC of Korean white cattle, the estimated values were decreased according to the age from $12.0{\times}10^3/{\mu}l$ under 1 year to $11.0{\times}10^3/{\mu}l$ over 1 years respectively. Although clone-cattle had lower numbers of RBC than reference range, the most of RBC and WBC related heamatologic results of cloned cattle were not different when compared to reference range. This study suggests that cloned Korean white cattle derived from SCNT did not have remarkable health problems, at least in the growth pattern and hematological parameters. In addition, this study provides a valuable resource for further investigations of the preservation of rare genetic stocks underlying traits of interest in cattle.

Lung cancer, chronic obstructive pulmonary disease and air pollution (대기오염에 의한 폐암 및 만성폐색성호흡기질환 -개인 흡연력을 보정한 만성건강영향평가-)

  • Sung, Joo-Hon;Cho, Soo-Hun;Kang, Dae-Hee;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.585-598
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    • 1997
  • Background : Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of ai. pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. Method : This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i. e., mainly potential environmental diseases. We reconstructed a nested case-control study wit5h Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed? questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects' Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are putative chronic environmental diseases, while controls are mainly acute environmental diseases. for exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, $O_3,\;SO_2$, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results : Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-at-tainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of $O_3$ and CO exceedance counts (to corrected error level -0.017) and less strongly and consistently with $SO_2$ and TSP. $SO_2$ and TSP showed weaker and less consistent relationship. $O_3$ and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). Conclusions : Although not decisive due to potential misclassication of exposure, these results wert drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. $O_3$ might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.

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The Life Experiences of the Deaf Elderly (농아노인의 생활 경험)

  • Park, Ina;Hwang, YoungHee;Kim, Hanho
    • 한국노년학
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    • v.36 no.3
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    • pp.525-540
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    • 2016
  • The purpose of this study was to investigate what kind of experiences the deaf elderly would have in the course of life. It also aimed to promote the understanding of their living difficulties and culture among people with normal hearing and provide basic data to help them live with others as members of the community. Phenomenological qualitative research was conducted as part of the methodology. The subjects include seven deaf old people. Based on the results of in-depth interview and analysis, the life experiences of the deaf elderly were categorized into "unforgettable wounds," "life in the community," "life with the family," "marriage of the deaf elderly", and "living by adjusting to reality." First, the subcategories of "unforgettable wounds" include "receiving no treatment for fever," "damage by the Korean War," "alienation from the family," and "people's cold eyes." It turned out that the deaf elderly had led a life, suffering from the heart wounds that they could not forget. Second, the subcategories of "life in the community" include "inconvenience in life," "disadvantages in life," and "severed life." The deaf elderly were not only subjected to inconvenience and disadvantages in life, but also suffered loneliness, being cut off from the community. Third, the subcategories of "life with the family" include "not communicating with children," "being abandoned again," "being used by the family," "being lonely even with the family," and "wishing to live independently from the family." The deaf elderly were not supported by their families and were abandoned or used by them, leading a solitary life. Fourth, the subcategories of "marriage of the deaf elderly" include"send as a surrogate mother," "frequent remarriage and divorce," "lean on as a married couple." Deaf elderly form their own culture of the marriage and lean on each other. Finally, the subcategories of "living by adjusting to reality" include "getting help from neighbors," "behaving oneself right in life," "learning Hangul," "living by working," "living freely," "living by missing," and "controlling the impulse to end life," "resorting to religion." The deaf elderly made the most alienated and vulnerable group with no access to benefits due to their limitations as a linguistic and social minority, but they made efforts to form their own culture and adjust to reality for themselves. Based on those findings, the study made the following proposals: first, there is a need for practical approaches to heal the ineffaceable wounds in the hearts of deaf elderly. Second, there is a need for policies to help them experience no inconvenience and disadvantages as members of community and communicate with people with normal hearing. Third, there should be practical approaches to enable them to get recognition and support from their families and share love with them. Finally, there should be practical policy approaches to help people with normal hearing understand the culture of deaf elderly and assist the deaf elderly to receive supports from the community and live with others within the community.

The Character of Confucianism, Buddhism and Taoism and Intermixture of Three Religions in Journey to the West (『서유기』에 나타난 유불도의 특징과 삼교회통론)

  • Kim, Kyeong-soo
    • (The)Study of the Eastern Classic
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    • no.69
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    • pp.593-622
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    • 2017
  • The purpose of this study is to investigate the characteristics of Confucianism, Buddhism, and Taoism and to examine the characteristics of Intermixture of Three Religions in Journey to the West. This novel, which has the structure of satire, hope, and surrogate satisfaction while being the center of satire and humor, is a refuge for the people. Even today, it can be said, however, that for the people, Confucianism, Buddhism, and Taoism was not a distinctly separate system of religions. Journey to the West story is about the liberation of Buddhism that is obtained through Taoism training. In the celestial world, not all gods are perfect, and often make mistakes. In such a story, the mistakes of beings living as human beings are simply insignificant. What is not different from the structure of life in this world is still a world of nature. The world is rife with absurdities, both on earth and in heaven. The characteristics of Intermixture of Three Religions can be summarized in several ways. First, the Trip of Samjang is not just to gain the enlightenment of illegal but rather to seek a greater sense of meaning. Second, the means to gain enlightenment is that it does not claim that one is right or good. Third, mercy, goodwill, and respect for life for oppressed and exploited peoples are common to all religions. Fourth, this story suggests that everything from the beginning is already a matter of mind. Fifth, all of the logic of Three Religions in this novel can be said to be "preliminary." Human life implies that it is going on a planned path, perhaps as a fate. But the important thing is, as in all religions, even if the road is a planned one, Journey to the West is strongly and persuasively speaking that it is the way of life as well as the attitude of living silently in carrying out its duties.

Semi-Quantitative Analysis for Determining the Optimal Threshold Value on CT to Measure the Solid Portion of Pulmonary Subsolid Nodules (폐의 아고형결절에서 침습적 병소를 검출하기 위한 반-정량 분석을 통한 최적의 CT 임계 값 결정)

  • Sunyong Lee;Da Hyun Lee;Jae Ho Lee;Sungsoo Lee;Kyunghwa Han;Chul Hwan Park;Tae Hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.670-681
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    • 2021
  • Purpose This study aimed to investigate the optimal threshold value in Hounsfield units (HU) on CT to detect the solid components of pulmonary subsolid nodules using pathologic invasive foci as reference. Materials and Methods Thin-section non-enhanced chest CT scans of 25 patients with pathologically confirmed minimally invasive adenocarcinoma were retrospectively reviewed. On CT images, the solid portion was defined as the area with higher attenuation than various HU thresholds ranging from -600 to -100 HU in 50-HU intervals. The solid portion was measured as the largest diameter on axial images and as the maximum diameter on multiplanar reconstruction images. A linear mixed model was used to evaluate bias in each threshold by using the pathological size of invasive foci as reference. Results At a threshold of -400 HU, the biases were lowest between the largest/maximum diameter of the solid portion of subsolid nodule and the size of invasive foci of the pathological specimen, with 0.388 and -0.0176, respectively. They showed insignificant difference (p = 0.2682, p = 0.963, respectively) at a threshold of -400 HU. Conclusion For quantitative analysis, -400 HU may be the optimal threshold to define the solid portion of subsolid nodules as a surrogate marker of invasive foci.

Fusion of the Guardianship System and Mental Health Law Based on Mental Capacity - Focusing on the Enactment and the Application of the Mental Capacity Act (Northern Ireland) 2016 - (의사능력에 기반한 후견제도와 정신건강복지법의 융합 - 북아일랜드 정신능력법[Mental Capacity Act (Northern Ireland) 2016]의 제정 과정과 그 의의를 중심으로 -)

  • Kihoon You
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.155-206
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    • 2023
  • When a person with diminished mental capacity refuses necessary medical care, normative judgments about when paternalistic intervention can be justified come into question. A typical example is involuntary hospitalization for people with mental disabilities, traditionally governed by mental health law. However, Korean civil law reform in 2011 introduced a new form of involuntary hospitalization through guardianship legislation, leading to a dualized system to involuntary hospitalization. Consequently, a conflict has arisen between the 'best interest and surrogate decision-making' paradigm of civil law and the 'social defense and preventive detention' paradigm of mental health law. Many countries have criticized this dualized system as not only inefficient but also unfair. Moreover, the requirement for the presence of 'mental illness' for involuntary hospitalization under mental health law has faced criticism for unfairly discriminating against people with mental disabilities. In response, attempts have been made to integrate guardianship legislation and mental health law based on mental capacity. This study examines the legislative process and framework of the Mental Capacity Act (Northern Ireland) 2016, which reorganized the mental health care system by fusing guardianship legislation with mental health law based on mental capacity. By analyzing the case of Northern Ireland, which has grappled with conflicts between guardianship legislation and mental health law since the 1990s and recently proposed mental capacity as a single, non-discriminatory standard, we aimed to offer insights for the Korean guardianship and mental health systems.

The detection of collapsible airways contributing to airflow limitation (기류 제한에 영향을 미치는 허탈성 기도의 분석)

  • Kim, Yun Seong;Park, Byung Gyu;Lee, Kyong In;Son, Seok Man;Lee, Hyo Jin;Lee, Min Ki;Son, Choon Hee;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.558-570
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    • 1996
  • Background : The detection of Collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the dormer may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a Component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. Method : To investigate whether volume difference between slow and forced vital Capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. Results : 1) Average and standard deviation of age, height, weight of patients with airflow limitation was $58.3{\pm}7.24$(yr), $166{\pm}8.0$(cm), $59.0{\pm}9.9$(kg) and those of normal subjects was $56.3{\pm}12.47$(yr), $165.9{\pm}6.9$(cm), $64.4{\pm}10.4$(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was $395{\pm}317ml$ in patients group and $154{\pm}176ml$ in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography d the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were $300.4{\pm}306ml$, $144.7{\pm}180ml$ and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thoracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was $257.5{\pm}303ml$, $277.5{\pm}276ml$, respectively and this difference did not reach statistical significance(p>0.05). Conclusion : The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.

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Measuring Intracellular Mycobacterial Killing Using a Human Whole Blood Assay (인체 전혈 모델을 이용한 세포내 결핵균 살균력에 관한 연구)

  • Cheon, Seon-Hee;Song, Ho-Yeon;Lee, Eun-Hee;Oh, Hee-Jung;Kang, In-Sook;Cho, Ji-Yoon;Hong, Young-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.497-509
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    • 2002
  • Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.