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Acute Appendicitis -A Survey by the Korean Association of Pediatric Surgeons in 2006- (급성 충수염 - 2006년 대한소아외과학회회원 대상 전국조사 -)

  • Lee, Suk-Koo;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.G.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, J.T.;Lee, N.H.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Chang, S.I.;Jun, Y.S.;Chung, S.Y.;Chung, S.E.;Chung, U.S.;Jung, P.M.
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.203-211
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    • 2007
  • A nationwide survey on acute appendicitis (AAP) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the 6 months period from the $1^{st}$ October, 2005 to $31^{st}$ March, 2006. Questionnaires were collected from 23 members. Four hundred seventy six patients were registered from 21 hospitals where the members were working. The male to female ratio was 1.67:1. Average age was 9 years and 5 months (range 21 months-20 years). Operations were performed on average 10.4 hours (range 1-230 hours) from arrival at hospital. The average operation time was 59.1 minutes. The average admission days were 5.8 days (range 2-45 days). The most frequent symptoms were abdominal pain (95.1 %), vomiting (50.6 %) and fever (43.7%). The average duration of symptoms was 42.2 hours (range 1 hour-22 days). Leukocytosis (WBC count > 10,000) was found in 85.9%. The most popular diagnostic tools were ultrasonography and CT. Open surgery was performed in 72.1 % and laparoscopic surgery in 27.5 %. Two laparoscopic surgeries were converted to open surgery (0.4 %). Simple appendicitis was found in 54.5 % and complicated appendicitis such as abscess, gangrenous change and perforation in 45.5%. According to the questionnaires 12 hospitals were performing open surgery only in all patients. Four hospitals were performing laparoscopic surgery in all patients. Seven hospitals are performing both surgical methods according to surgeon or occasion. Regarding the use of antibiotics in acute appendicitis, three kinds of antibiotics were used in 40 % of total simple appendicitis patients. The results showed the trend of management in acute appendicitis in Korea. Especially it is necessary for the members to discuss the use of antibiotics for prophylaxis in the simple appendicitis.

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PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

Supplemental Value of the Wrist-Worn Actigraphy in Diagnosing the Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 진단에서 손목부착형 활동기록기의 보조적 진단가치)

  • Im, Mee-Hyang;Shin, Hong-Beom;Lee, Yu-Jin;Lee, Seung-Hi;Won, Chang-Yeon;Lee, Myung-Hee;Lee, Soo-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.32-38
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    • 2005
  • Objectives: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. Methods: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male:female 20: 7;age $47.6{\pm}12.9$ years old;age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. Results: Mean total sleep time on polysomnography was $401.4{\pm}57.8\;min$ (range of 274.0 to 514.1 min). Mean RDI was $21.7{\pm}20.4/hour$. Mean FI was $21.9{\pm}13.0/hour$. RDI and FI showed significant correlation (r=0.55, p<0.01). Conclusions: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.

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Study of Rat Mammary Epithelial Stem Cells In Vivo and In Vitro (생체 및 시험관에서 유선 상피 모세포의 분리와 동정)

  • Nam Deuk Kim;Kee-Joo Paik
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.3
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    • pp.470-486
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    • 1995
  • Mammary epithelial cells contain a subpopulation of cells with a large proliferativ potential which are responsible for the maintenance of glandular cellularity and are the progenitor cells of mammary cancer. These clonogens give rise to multicellular clonal alveolar or ductal units(AU or DU) on transplantation and hormonal stimulation. To isolate putative mammary clonogens, enzymatically monodispersed rat mammary epithelial cells from organoid cultures and from intact glands are sorted by flow cytometry according to their affinity for FITC labeled peanut lectin(PNA) and PE labeled anti-Thy-1.1 antibody(Thy-1.1) into four subpopulations : cells negative to both PNA and Thy-1.1(B-), PNA+cells, Thy-1.1+cells, and cells positive to both reagents(B+). The in vivo transplantation assays indicate that the clonogenic fractions of PNA+cells from out-growths of organoids in primary cultures for three days in complete hormone medium(CHM) are significantly higher than those of cells from other subpopulations derived from cultrues or from intact glands. Extracellular matrix(ECM) is a complex of several proteins that regulated cell function ; its role in cell growth and differentiation and tissue-specific gene expression. It can act as a positive as well as a negative regulator of cellular differentiation depending on the cell type and the genes studied. Regulation by ECM is closely interrelated with the action of other regulators of cellular function, such as growth factors and hormones. Matrigel supports the growth and development of several different multicellular colonies from mammary organoids and from monodispersed epithelial cells in culture. Several types of colonies are observed including stellate colonies, duct-like structures, two- and three-dimensional web structures, squamous organoids, and lobulo-duct colonies. Organoids have the greatest proliferative potential and formation of multi-cellular structures. Phase contrast micrographs demonstrate extensive intracellular lipid accumulation within the web structures and some of duct-like colonies. At the immunocytochemical and electron micrograph level, casein proteins are predominantly localized near the apical surface of the cells or in the lumen of duct-like or lobulo-duct colonies. Squamous colonies are comprised of several layers of squamous epithelium surrounding keratin pearls as is typical fo squamous metaplasia(SM). All-trans retinoic acid(RA) inhibits the growth of SM. The frequency of lobulo-ductal colony formation increased with the augmentation of RA concentration in these culture conditions. The current study models could provide powerful tools not only for understanding cell growth and differentiation of epithelial cells, but also for the isolation and characterization of mammary clonogenic stem cells.

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H2AX Directly Interacts with BRCA1 and BARD1 via its NLS and BRCT Domain Respectively in vitro (H2AX의 BRCA1 NLS domain과 BARD1 BRCT domain 각각과의 in vitro 상호 결합)

  • Bae, Seung-Hee;Lee, Sun-Mi;Kim, Su-Mi;Choe, Tae-Boo;Kim, Cha-Soon;Seong, Ki-Moon;Jin, Young-Woo;An, Sung-Kwan
    • KSBB Journal
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    • v.24 no.4
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    • pp.403-409
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    • 2009
  • H2AX, a crucial component of chromatin, is implicated in DNA repair, cell cycle check point and tumor suppression. The aim of this study was to identify direct binding partners of H2AX to regulate cellular responses to above mechanisms. Literature reviews and bioinformatical tools were attempted intensively to find binding partners of H2AX, which resulted in identifying two potential proteins, breast cancer-1 (BRCA1) and BRCA1-associated RING domain 1 (BARD1). Although it has been reported in vivo that BRCA1 co-localizes with H2AX at the site of DNA damage, their biochemical mechanism for H2AX were however only known that the complex monoubiquitinates histone monomers, including unphosphorylated H2AX in vitro. Therefore, it is important to know whether the complex directly interacts with H2AX, and also which regions of these are specifically mediated for the interaction. Using in vitro GST pull-down assay, we present here that BRCA1 and BARD1 directly bind to H2AX. Moreover, through combinational approaches of domain analysis, fragment clonings and in vitro binding assay, we revealed molecular details of the BRCA1-H2AX and BARD1-H2AX complex. These data provide the potential evidence that each of the BRCA1 nuclear localization signal (NLS) and BARD1 BRCA1 C-terminal (BRCT) repeat domain is the novel mediator of H2AX recognition.

Verifying the Classification Accuracy for Korea's Standardized Classification System of Research F&E by using LDA(Linear Discriminant Analysis) (선형판별분석(LDA)기법을 적용한 국가연구시설장비 표준분류체계의 분류 정확도 검증)

  • Joung, Seokin;Sawng, Yeongwha;Jeong, Euhduck
    • Management & Information Systems Review
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    • v.39 no.1
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    • pp.35-57
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    • 2020
  • Recently, research F&E(Facilities and Equipment) have become very important as tools and means to lead the development of science and technology. The government has been continuously expanding investment budgets for R&D and research F&E, and the need for efficient operation and systematic management of research F&E built up nationwide has increased. In December 2010, The government developed and completed a standardized classification system for national research F&E. However, accuracy and trust of information classification are suspected because information is collected by a method in which a user(researcher) directly selects and registers a classification code in NTIS. Therefore, in the study, we analyzed linearly using linear discriminant analysis(LDA) and analysis of variance(ANOVA), to measure the classification accuracy for the standardized classification system(8 major-classes, 54 sub-classes, 410 small-classes) of the national research facilities and equipment established in 2010, and revised in 2015. For the analysis, we collected and used the information data(50,271 cases) cumulatively registered in NTIS(National Science and Technology Service) for the past 10 years. This is the first case of scientifically verifying the standardized classification system of the national research facilities and equipment, which is based on information of similar classification systems and a few expert reviews in the in-outside of the country. As a result of this study, the discriminant accuracy of major-classes organized hierarchically by sub-classes and small-classes was 92.2 %, which was very high. However, in post hoc verification through analysis of variance, the discrimination power of two classes out of eight major-classes was rather low. It is expected that the standardized classification system of the national research facilities and equipment will be improved through this study.

Research on Visitor Behavior and Satisfaction with the Nature Trail in Hallasan National Park (한라산국립공원 자연학습탐방로의 이용행태와 이용객만족에 관한 연구)

  • Kim, Jeong-Min
    • Korean Journal of Environment and Ecology
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    • v.21 no.3
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    • pp.223-234
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    • 2007
  • The study, executed with Hallasan National Park, which deserves to be a typical ecotourism destination, aims to provide basic information on park management for early establishment of ecotourism in a national park by assessing its visitors' behavior and satisfaction with a nature trail established as a series of an environmental interpretation program. The questionnaire survey was conducted at Eorimok Square in the weekday and on the weekend for two months of August and September in 2006, and finally 144 valid samples were used for the analysis. As a result of the research, it revealed that the demographic characteristics of the visitors to Hallasan National Park tended to coincide with those of the visitors to other national parks In Korea. On the whole, it showed their low recognition level of nature trails built up in national parks and less experience in using them. However, the visitors' satisfaction level and intention of re-visit, and recommendation to others were comparatively higher after actually using the nature trail at the site of Hallasan National Park, which hints at the possibility of national parks' much weightier role as the ground for ecology education and the functional expansion of the environmental interpretation-related facilities and programs. As for the attributes having effects on users' satisfaction with a nature trail, substantial aspects such as accessibility, safety, uniqueness and interest in environmental interpretation, and educational quality as well as physical facility management were revealed to have equal effects on users' satisfaction level, so there still remain a lot of pending issues over the reality of national parks in the initial stage of ecotourism staying at the level of the introduction and establishment of the facilities for environmental interpretation. This research had surveyed visitors to Hallasan National Park and limited to the nature trail only. For more systematic and practical ecological management of a national park, the in-depth understanding of the attributes affecting satisfaction of ecotourists, including nature trails and other environmental interpretation programs, and more sophisticated measuring tools are needed.

Analysis of the Efficiency of Gyeonggi-do Senior Welfare Centers by DEA Model (DEA를 이용한 경기도 노인복지관 효율성 분석)

  • Kim, Keum Hwan;Pak, Ae Kyung;Ryu, Seo Hyun;Lee, Nam Sik
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.165-177
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    • 2013
  • The purpose of this study was to examine the efficiency of senior welfare centers and the cause of differences among senior welfare centers in that regard, and to investigate influential factors for the differences in efficiency and the size of the influence of the factors. What methods would be effective at assessing the efficiency of senior welfare centers by taking into account their circumstances was reviewed, andpost-hoc analyses were made by using data envelopment analysis(DEA) and DAE/AP Modified prosthetic which were useful tools to evaluate relative efficiency. After 20 senior welfare centers located in Gyeonggi-do were selected, their yearly operating data of 2009 were utilized. The purpose of this study was to examine the efficiency of senior welfare centers. The evaluation data released by the Gyeonggi Welfare Foundation were analyzed by DEA, which is one of nonparametric statistics, and it was possible to obtain significant results on the regional operating efficiency of social welfare centers in 14 metropolitan cities and provinces, the causes and degree of their inefficiency and what areas one could refer to. As the data for the counties were utilized in this study, it's not quite possible to produce accurate results on the relative efficiency of senior welfare centers, but this study could be said to be of significance in that it suggested how to evaluate the overall operating efficiency of senior welfare centers in the counties involving the degree of their operating inefficiency, what improvements should be made and what reference groups there might be and provided information on the usefulness of the DEA model.

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The Study about Developing More Rational Valuation Model to the Early Stage Companies (초기기업에 대한 정량적 가치평가 모델 구축에 관한 탐색적 연구)

  • Kang, Sang-Wook;Yang, Young-Seok;Yang, Soo-Hee
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.4
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    • pp.15-24
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    • 2017
  • The major goal of this paper falls on developing new rational valuation model, to help companies and investors in the early stage of growth as to preparing and negotiating valuation of investment, by applying new reasonable discount indexes of calculating Discount Cash Flow in valuation of the start-up which has been recognized the critical fatal flaws of DCF with them. There are three specific studies done in this paper. First, this paper found the solid and viable bases of rational discount indexes as to applying DCF in valuing companies in the early growth stage with reviewing the previous studies including Berkus method, Scorecard Method, and Risk factor Summation method classified the most effective tools of valuing pre-revenue generating companies. Second, this paper quoted and analyzed the previous models and studies, so called, 'DCF-Prime' of applying DCF method as to value companies in the early growth stage by taking all risk factors innate to the companies in the early growth stage as the discount rate Beta coefficient. Third, this paper propose more viable and solid valuation models, so called, 'DCF-Plus'of combing all validated valuation factors in Berkus, Scorecard, and Risk Factor Summation methods into applying separate discount bracket after DCF Valuation over the companies in the early growth stage instead of taking them as the factors of discount rate, beta coefficient, like the previous model of DCF-Prime. DCF-Plus mainly developed in this paper will not only provide more rational valuation bases as to investment negotiation between companies and investors in the early growth stage, but also providing more accountable guidelines to companies in the early growth as to prepare investment raising and accelerating their company's value by themselves.

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Performance Status of Sanitary Management of School Food Service in the Jeonnam Area (전남지역 학교급식의 위생관리 실태)

  • 고무석;정난희;이전옥
    • Korean Journal of Human Ecology
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    • v.7 no.1
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    • pp.51-67
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    • 2004
  • This study analyzed the effects of nutrition technicians' hygiene education on cooking workers' performance of hygiene management in order to ensure the security of school meals. The situation of cooking workers' disposition in subject schools was elementary school(51.1%) and middle school(48.9%) and the type of meals was rural area type(54.2%), urban type(36.5%). and island and isolated area type(9.3%). The methods of meals management were single cooking(88.2%) and joint cooking and management(11.8%). The type of distributing meals was distributing in a dining room(93.5%), in a classroom(3.7%), and in both dining room and classroom(2.8%). Nutrition technicians' employment form included regular(53.5%) and daily(88.2%). Their education was junior college graduate(50.2%), university graduate(44.8%). and graduate school students(5.0%). Cooking workers' employment form included daily(88.2%) and regular (11.1%). suggesting that most were regular. Most cooking workers(77.4%) had at least high school certificate. Regarding the situation of cooking workers' disposition in subject schools, the number of student per one cooking worker was found as 91-120(37.2%), 61-90(22.6%). 60 and under(21.l %). 121-15006.7%). and 151 and over(2.5%). Cooking workers' level of performance of hygiene management was post-working stage(66.37/75 marks), pre-working stage(64.22/75 marks). and working stage(20.34/25 marks), The counting of meals articles in a pre-working stage(20.34/25 marks). temperature and required time in a working stage(18.78/25 marks), and machinery equipment and hygiene in a pre-working stage(21.40/25 marks) showed lowest of performance, which suggest poor service of hygiene. Cooking workers' performance of hygiene management by working stage showed the significant difference with school class(p<.001), type of schools with meals(p<.05). state of cooking workers' employment(p<.001), and cooking worker's disposition(p<.05). A working stage showed the significant difference with type of schools with meals(p<.05). A post-working stage showed the significant difference according to type of schools with meals(p<.05), and the methods of meals management(p<.05), and cooking workers' disposition(p<.05). In the execution of hygiene education, individual hygiene was highest(94.8%), followed by the management of machinery equipment and tools(89.7%), food poisoning and microorganism(94.7%), and the method of food treatment(76.4%). A yearly plan of hygiene education included established(83.9%) and not established(l6.1%). Regular education included not executed(25.1%), 2-3 times a month(l6.1%), and more than 4 a month(4.0%) and occasional education was not executed(57.0%), 1-3 times a month(26.3%), and more than 4 a month(l5.7%). In the methods for hygiene education, oral education(95.7%) was used most, followed by demonstration(10.5%), poster/photo(10.5%), video/slide(3.7%), and computer(3.7%). Frequency of improvement and complement of hygiene education included once a month(56.3%), once a year(20.7%), by quarter(l1.5%), and every six months(1l.5%). Newspaper was used most in materials of hygiene education, followed by internet, TV, nutrition technician's reeducation, information exchange between members, educational office's training, and reference book, and educational office's material. and symposium. Cooking workers' assessment of the effect of hygiene education was conducted through observation(56.8%), check table(l5.2%), question(l4.0%), and examination(14.0%). The reason of cooking workers' low level of performance included habitual custom(53.9%), lack of understanding(20.4%), overwork(l4.6%), and lack of knowledge(l1.l%) and the reason of difficulty in hygiene education included lack of time(55.3%), lack of understanding(27.6%), lack of knowledge and information(8.7%), and lack of budget(48.0%).

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