• Allergy, Asthma & Immunology Research
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• v.10 no.6
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• pp.614-627
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• 2018

Purpose: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. Methods: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year. First, a hierarchical cluster analysis was performed using Ward's method to generate a dendrogram for the optimum number of clusters using the complete post-FEV1 sets from 448 subjects. Then, a trajectory cluster analysis of serial post-FEV1 sets was performed using the k-means clustering for the longitudinal data trajectory method. Next, trajectory clustering for the serial post-FEV1 sets of a total of 1,679 asthmatics was performed after imputation of missing post-FEV1 values using regression methods. Results: Trajectories 1 and 2 were associated with normal lung function during the study period, and trajectory 3 was associated with a reversal to normal of the moderately decreased baseline FEV1 within 3 months. Trajectories 4 and 5 were associated with severe asthma with a marked reduction in baseline FEV1. However, the FEV1 associated with trajectory 4 was increased at 3 months, whereas the FEV1 associated with trajectory 5 was persistently disturbed over 1 year. Compared with trajectory 4, trajectory 5 was associated with older asthmatics with less atopy, a lower immunoglobulin E (IgE) level, sputum neutrophilia and higher dosages of oral steroids. In contrast, trajectory 4 was associated with higher sputum and blood eosinophil counts and more frequent exacerbations. Conclusions: Trajectory clustering analysis of FEV1 identified 5 distinct types, representing well-preserved to severely decreased FEV1. Persistent airflow obstruction may be related to non-atopy, a low IgE level, and older age accompanied by neutrophilic inflammation and low baseline FEV1 levels.

• Korean Journal of Applied Biomechanics
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• v.31 no.4
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• pp.241-248
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• 2021

Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running. Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data. Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05). Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.129-134
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• 2020

Purpose: This study compared the results of proximal and distal chevron osteotomy in patients with severe hallux valgus. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include severe hallux valgus. Materials and Methods: This study analyzed 127 severe hallux valgus surgeries. Of these, 76 patients (76 feet) were excluded for lack of adequate follow-up and additional procedures (Akin procedure), leaving 51 patients (51 feet) in the study. The mean age of the patients was 58 years (21~83 years), and the mean follow-up duration was 18 months (12~32 months). The patients were divided into two groups. Group 1 underwent distal chevron osteotomy, and group 2 underwent proximal chevron osteotomy performed sequentially by a single surgeon. The patients were interviewed for the American Orthopaedic Foot and Ankle Society (AOFAS) score before and one year after surgery. The anteroposterior weight-bearing radiography of the foot was taken before and one year after surgery. Results: There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and an increase in the AOFAS score. Significant improvement of the hallux valgus and intermetatarsal angle corrections was observed in both groups, and the sesamoid position was similar in each group. More improvement in radiographic correction of intermetatarsal angle was noted in group 2. Both procedures gave similar good clinical and radiological outcomes. Conclusion: This study suggests that a distal chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting severe hallux valgus as a proximal chevron osteotomy with a distal soft-tissue procedure.

• Journal of the Korean Society of Radiology
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• v.15 no.5
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• pp.575-584
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• 2021

The aim of this study was to achieve optimal portal phase while reducing contrast medium by applying weight-based dose protocol compared to standard fixed dose protocol to performing of pediatric abdominal CT examination. Discovery 750HD (General Electric Medical Systems, Milwaukee, USA) was used, and a total of 167 children consisting of 85 men and 82 women under the age of 18 were studied. The group in which the 300 mgI/ml(Xenetix, Guerbet, France) contrast medium was fixedly injected at twice body weight and the group injected with physiological saline while gradually decreasing the injection amount by 10% while applying the weight-based protocol were distinguished. Also, the CT number and SNR of abdominal organs were compared and evaluated while changing the scan delay time. Subjective image quality of enhancement and beam-hardening artifacts of around the heart was assessed with five-point criterion. The group adapted weight-based protocol with 20% reduction in contrast medium was most similar in contrast enhancement in the group with fixed injection at twice body weight. Furthermore, the group with a delay time of 20% had the highest contrast enhancement effect, and the difference in CT attenuation coefficient from the group scanned immediately after injection of the contrast media. Therefore, the appropriate delay time after injection of the contrast agent increased the contrast enhancement of the parenchymal organ. In addition, the weight-based injection protocol with normal saline reduced artifacts around the heart, and the effect of contrast enhancement could be maintained. In conclusion, it is possible to reduce dosage of contrast media through the application of weight-based injection protocols and appropriate latency, and to characterize optimal portal phase imaging on pediatric abdominal CT.

• Journal of the Korean Society of Radiology
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• v.15 no.2
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• pp.93-100
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• 2021

The purpose of this study is to find out the factors that affect the patient's exposure dose during the abdominal CT scan using the bolus tracking technique, and reducing the radiation exposure to the patient during the abdominal CT scan using the bolus tracking technique by adjusting the delay time according to the corresponding factor. The experiment was divided into two parts, and the first experiment was conducted with 300 patients There were 188 males and 112 females, and their average age was 58±12.18(19~85). In the second experiment, 150 subjects (100 males and 50 females) who were undergoing their follow-up examination among the first experiment subjects, and the difference in dose before and after was compared by applying the delay time according to the influencing factor. As a result of the first experiment, there was a relationship between the arrival time of the contrast media and the heart rate, and it was found that the arrival time decreased as the heart rate increased for both men and women. As a result of the second experiment, the average dose of CTDIvol and DLP before/after applying the delay time according to the heart rate decreased 4.98 mGy and 5.33 mGy·cm in the male group, and 3.54 mGy and 3.88 mGy·cm in the female group. By applying proper delay time according to the patient's heart rate during abdominal CT scan with the bolus tracking technique, the radiation exposure dose of the patient can be reduced.

• 한국사회정책
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• v.25 no.3
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• pp.279-303
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• 2018

Since the introduction of the Riester Pension Scheme, the controversy has continued in the policy studies and the political debates. This study evaluates the achievements and limitations of the German Riester pension scheme and tries to derive policy implications for South Korea. As a result of the analysis, the most worthwhile achievement of the Riester Pension is to strengthen the role of the private pension schemes. Unlike other private pension schemes, it included a large part of lower income households. It also opened a new perspective of utilizing private pension schemes to accomplish the goals of the family policy. Despite these attainments, it does not reach the promised coverage rate. It also was revealed that the higher income households have concluded more Riester Pension Contracts than the targeted lower-income households. Due to high administration fee and incomplete information problems, benefit levels are supposed to be much lower than expected. It concludes, above all, despite some achievements, the Riester Pension Scheme will not fill completely the gap of old age income security caused by the reduction of the public pension system. The German case provides fruitful lessons for Korea. The introduction of a subsidized personal pension scheme in South Korea can be realized only when some prerequisites would be satisfied such as the consolidation and maturing of public pension schemes and the strengthening of the transparency in the private pension market.

• Journal of the Korea Institute of Building Construction
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• v.18 no.6
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• pp.507-515
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• 2018

The purpose of this research is to develop a slurry-type accelerator that contains various beneficial properties such as reduction of dust generation, lower alkalinity, early age strength development, etc., and uses such slurry type accelerator to produce high performance shotcrete that present excellent resistant against chloride ion penetration. In this work, shotcrete mixtures of 0.44 and 0.338 water-to-binder ratio (w/b) were produced at construction site using slurry-type accelerator. The mechanical properties and chloride ion penetration resistance of such shotcrete (including base concrete) were evaluated. According to the experimental results, the slurry-type accelerator was successfully used to produce both w/b 0.44 and 0.338 shotcretes. The 1 day and 28 day compressive strength of shotcrete were found to be closer to or higher than 10MPa and 40MPa, respectively. The w/b 0.338 shotcrete that used 40% replacement of blast furnace slag showed lower compressive strength than w/b 0.44 shotcrete without any mineral admixture at 1 day. However, the compressive strength with 40% blast furnace slag increased significantly at 28 day. Moreover, there was more than 50% increase in chloride ion penetration resistance with blast furnace slag, showing its strong potential for higher performance shotcrete application.

• Asian-Australasian Journal of Animal Sciences
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• v.32 no.9
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• pp.1407-1413
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• 2019

Objective: This experiment aimed to investigate the effect of different sources and inclusion levels of dietary fat on productive performance and egg quality in laying hens raised under hot environmental conditions. Methods: A total of 480 Hy-Line Brown laying hens at 31 wk of age were randomly allotted to 1 of 5 experimental diets. The control diet contained 2,800 kcal/kg nitrogen-corrected apparent metabolizable energy with no fat addition. Four additional diets were prepared by adding 2.0% or 4.0% of animal fat (AF) or soybean oil (SO). Energy and nutrient concentrations were consistent among all diets. Diets were fed to hens for 4 weeks. Average daily room temperature and humidity were $26.7^{\circ}C{\pm}1.52^{\circ}C$ and $77.4%{\pm}4.50%$. The heat stress index was approximately 76, indicating that hens were raised under heat stress conditions. Results: Final body weight (BW) was greater (p<0.05) for hens fed diets containing 2.0% or 4.0% AF than for those fed the control diet or diets containing 2.0% or 4.0% SO. The BW gain and feed intake were greater (p<0.05) for hens fed diets containing additional AF or SO than those fed the control diet. Eggshell thickness was the greatest (p<0.05) for hens fed the control diet, but the least (p<0.05) for hens fed diets containing 4.0% SO. Egg yolk color was the greatest (p<0.05) for hens fed the control diet, but the least (p<0.05) for hens fed diets containing 4.0% SO. Conclusion: Inclusion of supplemental fat (AF and SO) in diets exhibits preventative effects on BW loss for hens raised under hot environmental conditions when energy and nutrient concentrations in diets were maintained. The effects were greater for AF than for SO. However, inclusion of supplemental fat in diets decreases eggshell thickness and egg yolk yellowness, possibly due to a reduction in Ca absorption and intake of egg yolk colorants.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.374-383
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• 2018

Background/Aims: There have been numerous efforts to reduce mother-to-child transmission (MTCT) of hepatitis B virus (HBV) with antiviral agents during pregnancy. However, there are limited data regarding the outcomes of pregnant women after delivery. This study was performed to evaluate the efficacy of antiviral agents in preventing MTCT of HBV and maternal long-term outcomes. Methods: The HBV-infected pregnant women treated with antiviral agents to prevent MTCT were retrospectively reviewed. Forty-one pregnant women who received telbivudine or tenofovir during late pregnancy (28-34 week) were analyzed. Hepatitis B virus surface antibody (HBsAb) positivity was tested in 43 infants after 7 months of birth. Eleven mothers were followed >1 year after delivery. Results: The mean HBV DNA titer before antiviral therapy was 8.67 (6.60-9.49) log copies/mL, and the median age at delivery was 32 years (range, 22-40). Eleven patients were treated with tenofovir and 30 with telbivudine. The median duration was 57 days (range, 23-100), and the median HBV DNA titer at birth was 5.06 log copies/mL (range, 2.06-6.50). Antiviral treatments were associated with significant HBV DNA reduction (P<0.001). Among 43 infants (two cases of twins), HBsAb was not detected in two, subsequently confirmed to have HBV infection. Biochemical flare was observed in two of 11 mothers followed >12 months, and an antiviral agent was administered. Conclusions: Antiviral treatment during late pregnancy effectively reduced MTCT. Long-term follow-up should be required in such cases. In addition, given that maternal biochemical flare occurred in 18% of mothers, re-administration of antiviral agents might be required.

• Korean Journal of Construction Engineering and Management
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• v.22 no.2
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• pp.88-96
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• 2021

There have been many efforts to identify and eliminate the direct causes of the construction accident, but many accidents are still occurring in the construction industry. The main reason for the construction accident is not because of ignorance of the causes, but because of safety insensitivity. This paper analyzes why construction workers feel safety insensitivity and how safety insensitivity varies depending on their age and work experience. A survey of 103 construction workers confirmed that systematic safety education is the most important factor in minimizing safety insensitivity of construction workers. On the other hand, economic reasons such as cost reduction were identified as the most tempting factor to increase safety insensitivity. In addition, the survey results showed that those in their 40s and 50s, the largest proportion of construction workers, have a significantly higher level of safety insensitivity than those in their 20s and 60s. These findings are expected to be valuable source that can be used to prevent construction safety accidents.