• Title/Summary/Keyword: failure factor

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Growth responses to growth hormone therapy in children with attenuated growth who showed normal growth hormone response to stimulation tests (성장호르몬 자극검사가 정상인 성장 장애 소아 환자에게서 성장호르몬 투여에 따른 성장속도의 변화)

  • Kim, Jae-Hyun;Chung, Hye-Rim;Lee, Young-Ah;Lee, Sun-Hee;Kim, Ji-Hyun;Shin, Choong-Ho;Yang, Sei-Won
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.922-929
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    • 2009
  • Purpose : The aim was to investigate the clinical characteristics and responses to growth hormone (GH) therapy in children with attenuated growth who showed normal GH responses to GH stimulation tests (GHST). Methods : The study included 39 patients with height velocity (HV) of less than 4 cm/yr and normal GHST results. Clinical characteristics of patients were analyzed retrospectively. Results : Eleven were born as small for gestational age (SGA) and 28 as appropriate for age (AGA). In the SGA group, the standard deviation score (SDS) of age and height measured at their first visit was significantly low. Sixteen patients were treated with GH and six of 23 without GH therapy were followed for 1 year after GHST. The mean (range) of HV was 7.7 (4.9 to 11.1) cm/yr in patients with GH therapy and 3.7 (2.7 to 4.5) cm/yr in those without GH therapy, which was statistically significant (P<0.001). In the GH-treated group, HV and difference in height SDS during the treatment increased significantly (P<0.001; P< 0.001, respectively). HV increased after 1 year of GH therapy in the SGA and AGA groups (SGA, P=0.043; AGA, P=0.003). The level of Insulin-like growth factor-I was significantly lower in GH-treated patients with height SDS <-3 than those with ${\geq}3$ (P=0.023). Conclusion : In children with growth failure and normal GHST, HV increases significantly by short-term GH therapy. The assessment of long-term effects of GH therapy is necessary. Moreover, further studies should be considered to evaluate the GH-IGF-I axis due to the possibility of GH insensitivity syndrome.

Clinical characteristics of severe meconium aspiration syndrome (중증 태변흡입증후군의 임상적 특성)

  • Choi, Chang Won;Kim, Beyong Il;Lee, Hyun Ju;Joung, Kyoung Eun;Shim, Gyu Hong;Lim, In Suk;Lee, Jin-A;Kim, Ee-Kyung;Kim, Han-Suk;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.713-721
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    • 2008
  • Purpose : This study aims to describe the clinical characteristics of severe meconium aspiration syndrome (MAS) which required mechanical ventilation over 48 h and to delineate the progress of respiratory failure and radiographic findings in severe MAS. Methods : Twelve infants admitted to the Neonatal Intensive Care Unit (NICU) of the Seoul National University Bundang Hospital diagnosed with severe MAS from January 2004 to July 2007 were analyzed retrospectively. Results : The presence of persistent pulmonary hypertension of the newborn (PPHN) is the only independently significant risk factor for a longer hospital stay and longer duration of mechanical ventilation. Surfactant replacement therapy (SRT) was not randomized but only performed in infants with radiographic findings for respiratory distress syndrome (RDS). In the presence of radiographic findings for RDS, the duration of high-frequency oscillatory ventilation was significantly longer. PPHN developed in 8 infants (75%). The PPHN group had a significantly longer duration of mechanical ventilation. All infants who received SRT showed radiographic improvement within 12 h, but there was no significant change in the severity score during the same period. Infants without the PPHN complications showed significant decrease in the severity score within 12 h after SRT, whereas infants with PPHN complications did not. Conclusion : The clinical course of severe MAS differed significantly depending on the development of PPHN. SRT conferred radiographic improvement in infants who showed radiographic findings for RDS, but did not influence the clinical course of MAS significantly.

Therapeutic compliance and its related factors in pediatrics patients (소아 환자의 치료 순응도 및 이에 영향을 미치는 요인)

  • Park, Ki Soo;Kam, Sin;Kim, Heung Sik;Lee, Jeong Kwon;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.584-596
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    • 2008
  • Purpose : This study was conducted to investigate treatment compliance and related factors in pediatric patients. Methods : Three hundred and fifty-five patients diagnosed with various acute diseases at a teaching hospital or clinic in October 2003 were enrolled. Data were analyzed using the Health Belief Model, which includes items on self-efficacy and family assistance. Results : The study found that 62.9% of pediatric patients adhered faithfully to agreed-upon hospital revisits, 41.6% complied with dose timings instructions, 65.8% precisely took medication, and 27.2% complied with all of these requirements. According to ${\chi}^2$ test analysis, the factors found to be related to therapeutic compliance (the taking of medicines requested) were; susceptibility, severity, benefit, barriers, mother's self-efficacy, and family assistance (P<.05). Multiple logistic analysis and path analysis showed that susceptibility, severity, barriers, and mother's self-efficacy were related to therapeutic compliance (P<.05). Moreover, mother's self-efficacy was identified as the most important factor. Conclusion : To improve therapeutic compliance among pediatric patients, parental education is necessary, and a health care professional must take a thorough history of how the medication was taken before it is assumed that treatment failure is attributable to the medication prescribed. Furthermore, the type of device recommended for dosing should be determined by clinicians. In addition, it is important that pediatric medications be discussed in relation to their palatability and internal acceptability.

A Study on the Factors that Determine the Initial Success of Start-Up (스타트업의 초기 성공을 결정하는 요인에 관한 연구)

  • Lee, Hyun Ho;Yun, Hwangbo;Gong, Chang-Hoon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.1
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    • pp.1-13
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    • 2017
  • The purpose of this study is to find out which factors determine the success of start-up in the initial market and what are the most important determinants. For the empirical analysis, the questionnaire related to the analysis of success factors for start-up success was designed according to the quantitative analysis (AHP technique). First, we selected 8 representative success factors for successful start-up in the initial market. In order to determine the degree of priority among these factors, we surveyed 12 entrepreneurs who are interested in entrepreneurship, universities, research institutes, and public officials. As a result of the empirical analysis, 51% of the funds in the tier 1 were ranked as the top priority to determine success factors. Followed by research and development (32.5%), management (8.7%) and marketing (7.8%). In particular, when each of the four items is calculated as 100 according to the result of the tier 1, and the tier 2 is converted, the foreign investment is analyzed as 43.7%. It was followed by 15.14% of R & D facilities, 14.07% of ideas, 8.7% of managerial ability, 7.29% of domestic investment, 5.85% of buyer feedback, 3.3% of development strategy and 1.95% of marketing strategy. Among the eight success factors, overseas investment items showed the closest preference to half, and it was the most important variable that determines the success or failure of market entry. The implication of this study is that many start-ups in Korea expect to receive investment and support from overseas accelerators. This means that overseas investment itself has been recognized as a start-up that makes services and products that can be used in the global market. A high preference for attracting foreign investment is due to the fact that the amount of investment is larger than that of Korea and that it can flexibly cope with the pressure on the performance compared to domestic investors. In this study, it was meaningful that we could confirm this fact through questionnaires of start-up experts. In future research, we need to find a viable alternative through studying how to provide start-up to foreign direct investment at the national level.

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Risk Factors for Atrophic Renal Scar (위축성 신반흔의 위험인자)

  • Lee, Jung-Won;Kim, Hyun-Jin;Lee, Seoung-Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.193-200
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    • 2005
  • Purpose : An atrophic renal scar(RS) is one of the underlying causes for childhood hyper tension and chronic renal failure. The risk factors for atrophic renal scar were evaluated. Methods : 41 children, who presented with first febrile urinary tract Infection at the Ewha Womans University Hospital between 1995 and 2003 and had generalized atrophic RS on $^{99m}Tc-DMSA$ renal scan, were retrospectively studied. Atrophic RS was divided into severe atrophic RS(n=14) if relative uptake on renal scan was below 10$\%$, or mild atrophic RS(n=27) if relative uptake on renal scan was between 10-35$\%$. RS was defined as congenital if the scar was detected on the first renal scan, and as acquired if the scar developed on the follow-up renal scan from acute pyelonephritis of the first renal scan. The control group was consisted of randomly selected 41 children with segmental RS. The risk factors for atrophic RS such as the generation time, VUR, gender and ACE gene polymorphism were evaluated. Results : The age distribution of atrophic RS and segmental RS did not differ significantly (P>0.05). The rate of congenital RS in atrophic RS was 61.0$\%$(25/41), which was significantly higher than 9.8$\%$(4/41) of segmental RS(P<0.01). Atrophic RS developed mote frequently in male children(M:F 68.3$\%$ 31.7$\%$) than segmental RS(M:F 41.4$\%$ .58.5$\%$)(P<0.05). Vesicoureteral reflux(VUR) was found in 92.7$\%$(38/41) of 4he atrophic RS, which was significantly higher than 53.7$\%$(22/41) of segmental RS(P<0.05). In children without VUR, the male to female ratio did not differ between atrophic RS and segmental RS(P>0.05) But in children with VUR, there was a higher proportion of males with severe atrophic RS than segmental RS($85.7\%:45.5\%$) ACE gene polymorphism did not differ between the atrophic and segmental RS groups, irrespective of the presence of VUR(P>0.05). Conclusion : Most atrophic RSs were congenital which could not be preventable postnatally and the major risk factors were VUR and the male gender. ACE gene polymorphism was not the significant risk factor for an atrophic RS. (J Korean Soc Pedialr Nephrol 2005;9:193-200)

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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Effects of Smoking on Oral Health : Preliminary Evaluation for a Long-Term Study of a Group with Good Oral Hygiene (흡연이 구강 건강에 미치는 영향 : 구강 위생이 양호한 집단의 장기적 연구를 위한 예비 평가)

  • Lee, Hyun-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.225-234
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    • 2011
  • Tobacco smoking is a major risk factor of systemic health and also impairs oral health, which is related to development of oral cancers, periodontitis, delayed wound healing, tooth loss, failure of implant, etc. Aside from smoking, many other risk factors can be related to oral health and long-term effects of smoking on salivary flow and taste threshold are still in controversy. Authors considered dental students to be an appropriate group with good oral hygiene for a long-term study to reveal effects of smoking on oral health. This study was performed to compare smoking patterns and current oral health conditions between smokers and nonsmokers in dental students prior to long-term evaluation. 192 volunteers (85.7%) of 224 male dental students in Dankook University were evaluated through questionnaires and clinical examination in 2010. Questionnaires included smoking pattern, alcohol use, nicotine dependence, preventive care, psychological profile and clinical examinations comprised assessment of teeth or periodontal status, nicotine pigmentation, salivary flow, electrical taste thresholds and halitosis. From the study, (current) smokers were older, and drank more frequently with more alcohol intake compared to former smokers and nonsmokers(p<0.05). There was no significant difference among them in salivary flow rate, halitosis and electrical taste threshold. However, there was significant difference in DMFT rate, periodontal treatment need, nicotinic pigmentation between smokers and nonsmokers(p<0.05), irrespective of their levels of preventive care. The smokers in this study, who are young dental students with relatively shorter duration of smoking, less use of cigarettes and low level of nicotine dependence, did not reveal significant impairment of oral health. However, their oral health was found to be relatively impaired compared to nonsmokers', which suggests negative effect of smoking on the oral health and a need of smoking cessation.

The Early Prognosis of Burn Patients with Elevated Initial Arterial Carboxyhemoglobin Level (초기 동맥혈 Carboxyhemoglobin 농도가 높았던 화상 환자들의 예후지표에 관한 연구)

  • Choi, Chang Soon;Kim, Cheal Hong;Kim, Keun Sook;Lee, Tae-Yu;Chung, Youn Son;Eom, Kwang Seok;Park, Young Bum;Jang, Seung Hun;Kim, Dong Gyu;Park, Myung Jae;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Kim, Jong Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.188-197
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    • 2003
  • Background : Smoke inhalation injury is an important determinant of mortality in burn patients. The early detection of inhalation injury in burn patients is important because the incidence of respiratory failure after inhalation injury was known to be high, with hypoxemia, pneumonia, and prolonged ventilatory support being commonplace. Acute carbon monoxide poisoning was one feature of smoke inhalation. The purpose of our study were to investigate the clinical characteristics of burn patients whose initial arterial carboxyhemoglobin (COHb) level had been elevated, to assess the clinical impact of COHb for smoke inhalation injury. Methods : Among 1,416 burn patients had been admitted at our institution from August 1, 2001 to July 31, 2002, 39 patients whose initial arterial COHb level have been more than 5% were included. We compared clinical scoring system for inhalation injury, percent total body surface area (%TBSA) burn, initial chest X-ray findings, APACHE II scores and SAPS II scores between survivors (n=27) and non-survivors (n=12) retrospectively. Results : COHb level were 9.7(5.71% and 10.3(8.81% in survivors and in non-survivors (p>0.05). Mean %TBSA burn of survivors and non-survivors were $16.6{\pm}17.8%$ and $60.7{\pm}28.8%$ (p<0.001). We did not find any difference in clinical scoring system, initial chest X-ray findings in survivors and in non-survivors. But %TBSA burn, APACHE II and SAPS II scores were high in non-survivors than in survivors significantly. Important factors associated with death were %TBSA burn, APACHE II scores, SAPS II scores, and the most important factor in predicting mortality was %TBSA burn. Conclusion : Burn patients with elevated initial arterial COHb level showed poor prognosis, but further study may be performed to know that the effect of COHb on prognosis in burn patients accompanying smoke inhalation.

An Empirical Study of the Effects of Mentoring Functions on Entrepreneurship - Focusing on Moderating Effect of the Business Start-up Preparation Period - (멘토링기능이 기업가정신에 미치는 영향에 관한 실증연구 -창업준비기간의 조절효과를 중심으로-)

  • Oh, Jaiwoo;KO, Boksoo;Kang, Jinkyu
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.1
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    • pp.129-141
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    • 2015
  • The mentoring program, conducted as part of an entrepreneurship education program by the Business Incubator, has been acknowledged to help entrepreneurs feel less anxious and fearful of embarking on new business endeavors and the possibility of failure and gain a positive view toward starting new businesses. For this reason, the investment into and the contents of the program have been reinforced. Accordingly, this study aims to examine the effects of mentoring functions on the improvement of the entrepreneurial mindset of young entrepreneurs and verify the moderating effect of the start-up preparation period between the mentoring functions and start-up competence as a means to analyze the interaction effect of the business start-up preparation period between the mentoring functions and entrepreneurship. For the purpose of this study, the SPSS 18.0 statistical program was used to perform validity, reliability and hierarchical factor analyses of the survey data obtained from 156 subjects, who took part in the entrepreneurship mentoring program. The results of the analyses showed that the mentoring functions had a positive impact on the progressiveness and risk-taking aspects of entrepreneurship and a negative impact on innovativeness. On the other hand, the business start-up preparation period had a significant moderating effect between the mentoring functions and the progressiveness and risk-taking aspects. Based on these results, it was deemed that while the mentoring functions efficiently improved the progressive and risk-taking characteristics of potential entrepreneurs, they were not efficient in improving their innovativeness. Also, the application of the entrepreneurship mentoring program according to the start-up preparation period had an interaction effect in which the progressiveness and risking-taking aspects of entrepreneurship were improved. Based on these findings, a proposal was made in regard to the development of a tailored mentoring program that reflects the various characteristics of the entrepreneurs and their start-up preparation periods as a means to improve their entrepreneurial mindset.

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Detection of Multidrug Resistance Using Molecular Nuclear Technique (분자핵의학 기법을 이용한 다약제내성 진단)

  • Lee, Jae-Tae;Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.2
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    • pp.180-189
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    • 2004
  • Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. $^{99m}Tc$-MIBI and other $^{99m}Tc$-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of PgP-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with $^{11}C$ have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and $N-[^{11}C]acetyl-leukotriene$ E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo.