Background : The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. Method : A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. Results : In comparison with the data reported in 1995, the mean age was increased by 3.6 years ($44.1{\pm}14.6$ vs $47.7{\pm}16.4$, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from $2.0{\pm}1.7$ and $6.1{\pm}2.3$ to $1.7{\pm}1.8$ and $4.6{\pm}3.6$(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). Conclusion : The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.
Introduction : Diffuse interstitial lung diseases (DILD) comprise of a large group of lung diseases with diverse etiologies. They are classified into four categories based on the etiology and pathological findings. In Korea, epidemiological data on DILD has never been reported in a prospective manner. Method : From May 2002 to April 2004, total 487 patients with DILD were prospectively registered at Samsung Medical Center. The prospective observational analysis of the etiologies, its classification based on 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) guidelines, as well as diagnostic tests and the retrospective analysis of the treatment modalities were carried out. Any infectious and malignant causes were excluded. Results : 1) The patients were classified into idiopathic interstitial pneumonia (IIP) in 269 patients (55.2%), known causes of DILD in 168 patients (34.5%), sarcoidosis in 27 patients (5.5%), other forms of DILD in 14 patients (2.9%), and undetermined DILD in 9 patients (1.9%). 2) The diagnostic test showed that most patients had undergone chest high resolution computed tomography (HRCT) and pulmonary function test (PFT) (97%, 89%). Transbronchial lung biopsy (TBLB) and surgical lung biopsy (SLB) were performed in limited patients (38%, 29%). 3) Among 269 patients with IIP, 220 (82%) had idiopathic pulmonary fibrosis (IPF) while 23 (9%) had nonspecific interstitial pneumonia. SLB was carried out in 36% of patients with IIP. 4) Symptomatic supportive care was given to 67% of IPF, but specific medical treatment including corticosteroids was administered to 89% of non-IPF patients. Conclusion : A nationwide registry of DILD patients is required to determine the annual incidence, etiology, and practice pattern of diagnosis and treatment in Korea.
This study was conducted to understand the control mechanism of Sika deer (Cervus nippon taiouanus) populations which are adapted to the natural forest areas and the semi-natural forest areas of Korea. We monitored and analyzed the behaviour patterns and habitat characteristics of Sika deers. After we released 12 Sika deers (male 3, female 9) each at the two study areas in and around Seoul under the approval of Korean government, we monitored them through our survey researchers' naked eyes from May 2011 to January 2012. We discriminated their habitat patterns to 4 major places - eating food place, drinking water place, daytime rest place, and nighttime rest place. Our results showed that Sika deer preferred the open grassland habitats for feeding and resting in daytime but the closed bushland for their protection and sleep. We also found the recommended sex ratio of adult male to female in a herd was 1 : 4~9 for breeding and they had few cubs in a herd. The average amount of food for 1 adult deer was 391.62 kg of fresh grasses and 286.90 kg of hay per year. Our results suggest that the amount of drinking water required for a deer when grazed on grasses during spring and summer seasons is 256.8 L and when a deer feeds on dry food during autumn and winter seasons, 209.8 L of water is required. From these results, we observe that the amount of drinking water was affected substantially by the moisture content of their food. This observational study must be very valuable for land managers to judge the number of deers that should be released in natural areas without high risk and to ascertain the sex ratio of large mammals including Sika deer. Therefore, we conclude that this population control mechanism study consists of efficient basic data and their values must be very effective for various purposes.
Purpose: Constipation in childhood is a significant problem, however, understanding of its epidemiology has been limited in Korea. The aim of this study was to investigate the prevalence and risk factors of constipation in school-aged children, helping to manage and prevent it. Methods: This cross-sectional, descripsive observational prevalence study included children (2grade, 1st and 6th grade) who were attending two elementary schools in Gwangju. The prevalence of constipation, associated symptoms, and risk factors were evaluated by questionnaire. A child was considered to be constipated when he or she defecated two or less times per week. Results: The prevalence of constipation was 15.4%. There is no significant difference between both sexes and grades. Of the causes of constipation, there was statistically significant difference in exercise deficiency, frequent intake of convenience food, long-time watching TV, unbalanced diet and enuresis history between constipation and normal group. Especially, long-time watching TV, exercise deficiency, and enuresis history were risk factors for development of constipation. Only 27.1% of children with constipation were treated by laxative and enema. Conclusion: Even though the prevalence of constipation was high, more than half of them was not treated at all. We should endeavor to educate the children and their parents to prevent constipation by evaluating the feeding and behavioral habit completely, and treating them properly.
Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.
Journal of The Korean Society of Inherited Metabolic disease
/
v.18
no.3
/
pp.78-86
/
2018
Purpose: We aimed to delineate clinical spectrum and short-term effects after enzyme replacement therapy (ERT) for 5 mucopolysaccharidosis type II (MPS II). Methods: Five patients were diagnosed with MPS II by clinical findings, enzyme activity, and genetic testing. Idursulfase was administered by intravenous infusion at a dose of 0.5 mg/kg every week. Observational chart analysis of patients, who underwent systematic investigations more than 12 months after initiation of ERT was done retrospectively. Results: Three patients were classified as having the attenuated type, and 2 patients were classified as having the severe type. The median age at the diagnosis was 9.6 years (range 3.4-26 years). Four different mutations in 5 Korean patients (4 families) with MPS II were identified, among which two were novel mutations (1 small insertion mutation: p.Thr409Hisfs*22, and 1 missense mutation: p.Gly134Glu). Two severe type sibling patients with the same mutation had different clinical manifestation. Urinary glycosaminoglycan excretion decreased within the twelve months of ERT (P=0.043). Liver and spleen volumes showed reductions that were maintained in all patients (P=0.043 and P=0.043, respectively). Improvements were also noted in left ventricular mass index (P=0.042), shoulder flexion (P=0.043), shoulder abduction (P=0.039), knee flexion (P=0.043), elbow flexion (P=0.042), and respiratory distress index (P=0.041). Conclusion: This study demonstrates that Korean patients with MPS II are clinically heterogeneous and indicates that idursulfase is relatively effective in several clinical parameters including heart size and respiratory distress index without infusion-related reactions in patients with MPS II.
Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
Journal of The Korean Society of Emergency Medicine
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v.29
no.5
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pp.465-473
/
2018
Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.
An, Soon-Il;Ha, Kyung-Ja;Seo, Kyong-Hwan;Yeh, Sang-Wook;Min, Seung-Ki;Ho, Chang-Hoi
Journal of Climate Change Research
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v.2
no.4
/
pp.237-251
/
2011
This study presents a review on the recent climate change over the Korean peninsula, which has experienced a significant change due to the human-induced global warming more strongly than other regions. The recent measurement of carbon dioxide concentrations over the Korean peninsula shows a faster rise than the global average, and the increasing trend in surface temperature over this region is much larger than the global mean trend. Recent observational studies reporting the weakened cold extremes and intensified warm extremes over the region support consistently the increase of mean temperature. Surface vegetation greenness in spring has also progressed relatively more quickly. Summer precipitation over the Korean peninsula has increased by about 15% since 1990 compared to the previous period. This was mainly due to an increase in August. On the other hand, a slight decrease in the precipitation (about 5%) during Changma period (rainy season of the East Asian summer monsoon), was observed. The heavy rainfall amounts exhibit an increasing trend particularly since the late 1970s, and a consecutive dry-day has also increased primarily over the southern area. This indicates that the duration of precipitation events has shortened, while their intensity became stronger. During the past decades, there have been more stronger typhoons affecting the Korean peninsula with landing more preferentially over the southeastern area. Meanwhile, the urbanization effect is likely to contribute to the rapid warming, explaining about 28% of total temperature increase during the past 55 years. The impact of El Nino on seasonal climate over the Korean peninsula has been well established - winter [summer] temperatures was generally higher [lower] than normal, and summer rainfall tends to increase during El-Nino years. It is suggested that more frequent occurrence of the 'central-Pacific El-Nino' during recent decades may have induced warmer summer and fall over the Korean peninsula. In short, detection and attribution studies provided fundamental information that needed to construct more reliable projections of future climate changes, and therefore more comprehensive researches are required for better understanding of past climate variations.
Kim, Sang-Wan;Han, Ahrim;Cho, Keunhoo;Kim, Donghan;Park, Sang-Eun
Korean Journal of Remote Sensing
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v.35
no.3
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pp.457-470
/
2019
Automatic Target Recognition (ATR) using Synthetic Aperture Radar (SAR) has been attracted attention in the fields of surveillance, reconnaissance, and national security due to its advantage of all-weather and day-and-night imaging capabilities. However, there have been some difficulties in automatically identifying targets in real situation due to various observational and environmental conditions. In this paper, ATR problems in Extended Operating Conditions (EOC) were investigated. In particular, we considered partial occlusions of the target (10% to 50%) and differences in the depression angle between training ($17^{\circ}$) and test data ($30^{\circ}$ and $45^{\circ}$). To simulate various occlusion conditions, SARBake algorithm was applied to Moving and Stationary Target Acquisition and Recognition (MSTAR) images. The ATR accuracies were evaluated by using the template matching and Adaboost algorithms. Experimental results on the depression angle showed that the target identification rate of the two algorithms decreased by more than 30% from the depression angle of $45^{\circ}$ to $30^{\circ}$. The accuracy of template matching was about 75.88% while Adaboost showed better results with an accuracy of about 86.80%. In the case of partial occlusion, the accuracy of template matching decreased significantly even in the slight occlusion (from 95.77% under no occlusion to 52.69% under 10% occlusion). The Adaboost algorithm showed better performance with an accuracy of 85.16% in no occlusion condition and 68.48% in 10% occlusion condition. Even in the 50% occlusion condition, the Adaboost provided an accuracy of 52.48%, which was much higher than the template matching (less than 30% under 50% occlusion).
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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v.24
no.2
/
pp.332-350
/
2019
Zonal hydrographic section measurements at $39.7^{\circ}N$ were conducted between $129.0^{\circ}E$ and $131.3^{\circ}E$ from August 7 to 25 in 2017 using an underwater glider. The glider traveled about 440 km for about 18 days along the 106 line of the regular shipboard measurements in the National Institute of Fishery Science (NIFS) and obtained twice a hydrographic section with high horizontal resolution. Even under the strong East Korea Warm Current with maximum speed of 0.8 m/s across the section, the glider successfully maintained the designated path within an RMS distance of 400 m. By comparing with the NIFS shipboard hydrographic section, it is confirmed that high spatial resolution measurements obtained from a glider were necessary to properly observe front and eddy variability in the East Sea where a typical spatial scale is smaller than the open oceans. From the glider section measurements, a new lens-shaped eddy was found in the thermocline. The lens-shaped anticyclonic eddy had 10~13 km in horizonal width and about 200 m in height like a typical submesoscale eddy resided within the thermocline, which was firstly named as Korea intrathermocline eddy (Keddy). The Keddy has the distinguishing characteristics of a typical intrathermocline eddy, such as a central core with anomalously weak stratification, a convex shaped lens bounded by the stratification anomaly, an interior maximum of velocity at 170 m, no surface appearance of the geopotential field, a small or comparable horizontal width relative to the first baroclinic Rossby radius of deformation, and the Rossby nubmer of 0.7.
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