• 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.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.65-73
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• 2007

Purpose : Short stature is an important complication that impairs the quality of life in survivors of childhood brain tumors. We studied their final adult height (FAH) to evaluate risk factors for short stature. Methods : We reviewed the medical data of 95 survivors of childhood brain tumors (64 males and 31 females) who had been followed up from 1982 to 2006, reached FAH, and had a more than five year-disease-free survival. Results : Final adult height standard deviation score (FAHTSDS: $mean{\pm}SD$) of the patients was lower than those of general population ($-1.15{\pm}1.72$), HTSDS at diagnosis ($-0.13{\pm}1.57$), and target HTSDS ($-0.49{\pm}0.69$). FAHTSDS of craniopharyngioma patients did not decrease ($0.57{\pm}1.17$), but those of germ cell tumor and medulloblastoma patients were significantly reduced ($-1.20{\pm}1.45$, $-2.70{\pm}1.46$; P<0.05). The patients treated with craniospinal radiation or chemotherapy had lower FAHTSDS ($-1.93{\pm}1.58$, $-2.27{\pm}1.44$; P<0.01). In the spinal irradiation group, the younger the age at diagnosis was, the more the loss of FAH (r=0.442, P<0.01). Growth hormone replacement (GHR) didn't improve FAHTSDS, but starting GHR under 12 years was an independent factor for improving FAH once treatment methods were taken into account (P=0.01). Conclusion : The younger age at diagnosis, spinal radiation and chemotherapy were all important risk factors of height loss, and height gain was expected in patients who received GHR under the age of 12 years. Therefore, regular check-ups of growth and early intervention with growth hormones are needed for high risk groups to improve FAH.

• Korean Journal of Environment and Ecology
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• v.29 no.5
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• pp.764-776
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• 2015

This study aims to identify the structure of the plant community, and the ecological succession sere and the change in the forest ecosystem in Jungdaesa-Birobong area, Odaesan National Park_(i._e., located at high altitudes(over 1,000m)). It seeks to offer the basic data for the planning of vegetation management. In order to verify the status of the forest vegetation between Jungdaesa-Birobong, seventeen plots(size is $20m{\times}20m$) were set up as research sites at high altitudes. Importance value, distribution by diameter at breast height(DBH), the growth volume and age of the sample trees, similarity index and species diversity index of each survey plot were analysed. According to the results of DCA(Detrended Correspondence Analysis), one of the multivariate statistical techniques. It was found that the plant communities were classified into five groups: community I_(Quercus mongolica-Tilia amurensis community), community II_(Q. mongolica-Deciduous broad-leaved community), community III_(Q. mongolica-Pinus koraiensis community), community IV_(Abies holophylla-Q. mongolica community) and community V_(A. holophylla-Deciduous broad-leaved community). Community I which is dominated by Quercus mongolica and Deciduous broad-leaved communities is located at an altitude of over 1,300 meters(ranging from 1,335m to 1,495m), the community IV and V which are dominated by Abies holophylla are located at an altitude of under 1,200 meters(ranging from 1,115m to 1,175m) and the community II and III which include the main species of Quercus mongolica, Pinus koraiensis and Abies holophylla are located at an altitude of between 1,160 meters and 1,300 meters. The results showed that Quercus mongolica tends to have a higher importance value of woody species at a higher altitude while Abies holophylla tends to have higher importance value at a lower altitude. For the importance value woody species and -DBH class distribution, the communites I, II and III are expected to continuously maintain the present status. Whereas, for the influence of communities IV and V, Q. mongolica is predicted to be weakened. The age of sample trees was between 85 and 161; the average age was 123. The index of Shannon's Species diversity (H') showed heterogeneity was found among community I_(i._e., located at high altitude) and communities IV and V_(i._e., located at low altitude). As a results of analysing the index of Shannon's Species diversity (H': unit: $400m^2$), community III showed the highest diversity intex with 1.1109 followed by community II with 1.0475, community I with 1.0125, community IV with 0.9918 and community V with 0.8686. This study verified that the index of Shannon's species was significantly different by plant communities. For instance, when comparing the index of Shannon's species diversity in Quercus mongolica communities of this study and that of past relevant research, the value of index is very similar. However, the diversity index for the community which is dominated by Abies holophylla showed lower value when compared to the results from past relevant research.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.74-82
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• 2007

Purpose : To analyze the clinical characteristics, spontaneous resolution rate and predictive factors of resolution in children with primary vesicoureteral reflux(VUR). Methods : Between October 1991 and July 2003, 149 children diagnosed with primary VUR at Chonbuk National University Hospital were reviewed retrospectively. All of the patients were maintained on low-dose antibiotic prophylaxis and underwent radionuclide cystograms at 1 year intervals over 3 years after the initial diagnosis of VUR by voiding cystourethrogram was made. Results : The median time to resolution of VUR was 24 months and the total 3 year-cumulative resolution rate of VUR was 61.7%. The following variables were associated with resolution of VUR according to univariate analysis-; age<1 year, male gender, mild grade of reflux, unilateral reflux, congenital hydronephrosis as clinical presentation at time of diagnosis of VUR, absence of focal defects in the renal scan at diagnosis, absence of recurrent UTI, renal scars and small kidney during follow-up. After adjustment by Cox regression model, five variables remained as independent predictors of VUR resolution; age<1 yew, relative risk 1.77(P<0.05), VUR grade I+II 2.98(P<0.05), absence of renal scars 2.23(P<0.05), and absence of small kidney 5.20(P<0.01) during follow-up. Conclusion : In this study, spontaneous resolution rate of VUR, even high grade reflux, is high in infants during medical management, and it was related to age, reflux grade at diagnosis, absence of renal scars and small kidney during follow-up. Therefore early surgical intervention should be avoided and reserved for the selected groups.

• Journal of Korean Society of Forest Science
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• v.95 no.1
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• pp.102-112
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• 2006

The change of species composition and stand structure along altitudinal gradients in different aged stands was studied in five natural stands located each at 400 m, 800 m, 1,000 m, and two at 1,300 m above sea level (asl) in the western part of Mt. Chiri in Korea. Trees larger than 2.5 cm DBH were inventoried in 3 to 8 $20m{\times}20m$ quadrats in each study site. Stand ages were estimated based on the ages of Pinus densiflora Siebold & Zucc. and Abies koreana Wilson, and used to analyze the changes in species composition and stand structure including diameter and height distributions. Species composition was changed along altitudinal gradients as P. densiflora dominated stands at 400 m asl while A. koreana dominated stands at 1,300 m asl. Major species of Quercus also changed along altitudinal gradients as Quercus variabilis Blume at 400 m asl, Quercus serrata Thunb. ex Murray at 800 m asl, and Quercus mongolica Fisch. ex Ledeb. at higher than 1,000 m asl. The diameter distribution did not show significant differences among stands of different altitudes. However, the height distributions of upper crown layers were significantly different among stands at below and above 1,000 m as) (P < 0.0001). Trees taller than 20 m rarely appeared in stands over 1,000 m asl. P. densiflora dominant stands at 400 m asl developed two clumped age groups as one in 30-40 ages and the other around 70 years old. Q. serrata dominant stands at 800 m asl, Q. mongolica dominant stands at 1,300 m asl and A. koreana dominant stands at 1,300 m asl were estimated to be around 30, 70, and over 140 years old after major disturbances, respectively. The diameter distribution with age structure indicated that P. densiflora at 1,300 m asl might be replaced by Q. mongolica, and Q. mongolica might be replaced by A. koreana and Pinus koraiensis later. A. koreana dominant stand seemed to stay its dominance quite long if the large disturbance would be absent.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.349-357
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• 2010

Purpose : Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN). Methods : The medical records of 107 newborns, >$35^{+0}$ weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ${\geq}72$ hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors. Results : Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, $FiO_2$ >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and $FiO_2$ >0.4 within 6 hours of life. Conclusion : When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of $FiO_2$ within 6 hours of life, the infant is at high risk of having persistent tachypnea ${\geq}72$ hours. We need further study to find the way to reduce PTTN.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.737-744
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• 2006

Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.

• Korea Science and Art Forum
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• v.19
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• pp.281-292
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• 2015

For this study, I conducted a survey investigating current situation, user preference, and field experiment. Hospitals utilizing digital sign systems at least five years were selected, which are connected with visual elements (layout, typo, color) used in waiting areas and elements of the systems (time, video time line). The results obtained from the field survey showed that digital sign systems used the color of typo and background contrasted to one another to increase explicitness and to ensure easy understanding of contents. In addition, the Gothic typo with relatively high legibility was adopted. Time and video timeline, which characterize digital sign systems, showed the advertising screens of the hospitals and the guidance of medical treatment at regular intervals. Moreover, survey results on user satisfaction showed that a majority of respondents indicated they had difficulty in understanding digital information conveyed from digital sign systems due to time setting for rotational speed or the small size of typo although most of the users had previous experience with digital sign systems. The highest proportion of respondents (n=86, 86%) answered that information related to medical departments was what they sought most frequently and that this kind of information should be importantly considered in digital sign systems. For the experiment, new samples with restructured contents of current digital sign systems were created and tested while keeping its design unchanged as well as applying these new samples. Study participants were in their 20s through 50s. When the size of typo was larger under the same conditions for all age groups, study participants found the desired information approximately 3.5 seconds faster. In addition, those in their 20-30s and 40-50s showed the time difference of 4.7 seconds for small typo and 6 seconds for large typo, which suggested that there was a difference by age in the amount of time taken in the experiment to find the desired information from the rotating digital sign system regardless of age and the size of typo.

• Tuberculosis and Respiratory Diseases
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• v.50 no.4
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• pp.426-436
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• 2001

Background : Chronic obstructive pulmonary disease(COPD) is one of the major contributors to morbidity and mortality among the adult population. Cigarette smoking(CS) is undoubtedly the single most important factor in the pathogenesis of COPD. However, its mechanism is unclear. The current hypothesis regarding the pathogenesis of COPD postulates that an imbalance between proteases and antiproteases leads to the destructive changes in the lung parenchyma. This study had two aims. First, to evaluate the effect of CS exposure on histologic changes of the lung parenchyme, and second, to evaluate the effect of CS exposure on the expression of the gelatinolytic enzymes in BAL fluid cells in guinea pigs. Methods : Two groups of five guinea pigs were exposed to the whole smoke of 20 commercial cigarettes per day, 5 hours/day, 5 days/week, for 6weeks, and 12 weeks, respectively, using a smoking apparatus. Five age-matched guinea pigs exposed to room air were used as controls. Five or more sections were microscopically extamined(${\times}400$) and the number of cellular infiltration of the alveolar wall was measured in order to evaluate the effect of CS exposure on the histologic changes of lung parenchyme. The statistical significance was analyzed by a linear regression method. To evaluate the expression of the gelatinolytic enzymes in intraalveolar cells, BAL fluid was obtained and the intraalveolar cells were separated by centrifugation (500 g for 10 min at $4^{\circ}C$). Two sets of culture plates were loaded with $1{\times}10^6$ intraalveolar cells. One plate, contained O.1mM EDTA, a inhibitor of matrix metalloproteases(MMPs), and the other plate had no EDTA. Both plates were incubated for 48 hours at $37^{\circ}C$. After incubation, gelatinolytic protease expression in the supernatants was analyzed by gelatin zymography. Results : At the end of CS exposure, the level of blood carboxy Hb had increased significantly(4.1g/dl in control group, 24g/dl immediately after CS exposure, 18g/dl 30 min after CS exposure, 15g/dl 1 hour after CS exposure). Alveolar inflammatory cells were identified in the CS exposed guinea pigs. The number of alveolar cellular cells observed in a microscopic field ($400{\times}$) was $121.4{\pm}7.2$, $158.0{\pm}20.2$, $196.8{\pm}32.8$, in the control, the 6 weeks, and the 12 weeks group, respectively. The increased extent of inflammatory cellular infiltration of the lung parenchema showed a statistically significant linear relationship with the duration of CS exposure(p=0.001, $r^2=0.675$). Several types of gelatinolytic enzymes in the intraalveolar cells of CS exposed guinea pigs were expressed, of which some were inhibited by EDT A. However, the gelatinolytic enzymes were not expressed in the control groups. Conclusion : CS exposure increases inflammatory cellular infiltration of the alveolar wall and the expression of gelatinolytic proteases in guinea pigs. EDTA inhibits some of the gelatinolytic proteases. These findings suggest a possibility that CS exposure may increase MMP expression in the lungs of guinea pigs.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.2
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• pp.229-236
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• 2007

This study was conducted to determine effects of different selenium (Se) sources on performance, carcass characteristics, blood measures (whole blood Se concentration and plasma glutathione peroxidase (GSH-Px) activity), and Se concentrations in tissues of finishing Hanwoo steers (Korean native steers). Twenty finishing Hanwoo steers (average body weight=536${\pm}$23.4 kg, average age=approximately 20 months) were allotted to treatments in four groups of five steers per pen for 16 weeks preceding slaughter. Treatments were control (CON), spent mushroom composts from Se-enriched mushrooms (Se-SMC), selenized yeast (Se-Y), and sodium selenite (SS). Dietary Se levels of all treatments except CON were 0.9 mg Se/kg on the dry matter basis. Body weight was measured at the first and final day of trial, and blood samples were collected to analyze whole blood Se concentration and plasma GSH-Px activity at 2, 4, 8, and 16 weeks. At the end of trial, steers were slaughtered to collect muscle and liver samples for their Se analyses, and carcass data were recorded. In terms of dry matter intake, body weight gain and carcass characteristics, no significant differences among treatments were observed. Whole blood Se concentrations were significantly higher (p<0.05) for Se-SMC and Se-Y treatments than for CON at each collection period, with no significant difference between SS and CON. For weeks 2 and 8, there was no significant difference for whole blood Se concentration between Se-SMC and Se-Y, but for weeks 4 and 16, Se-Y treatments were significantly higher (p<0.05) than Se-SMC. No differences were observed for plasma GSH-Px activity between Se-SMC and Se-Y. The Se concentrations in hind leg and liver were significantly different among treatments (p<0.05) and those in both tissues ranked the greatest in Se-Y, followed by Se-SMC, SS, and CON treatments. However, tissue Se concentration for SS was not different from that for CON. These results showed that feeding organic Se sources such as Se-SMC and Se-Y enhanced Se concentration in tissues, while SS, the most common supplement of inorganic Se, was inefficient in Se deposition. Even though Se-Y had a higher Se concentration in tissues than Se-SMC, replacing Se-Y with Se-SMC in diets of beef steers would be an inexpensive way to increase Se concentration in beef.