Impacts and Countermeasures of Climate Change on Food Supply

Kim Chang-gil,Jeong Hak-kyun,Han Suk-ho,Kim Jeong-seung,Moon Dong-hyun 한국농촌경제연구원 2013 한국농촌경제연구원 기본연구보고서 Vol.- No.-

Climate change has become a megatrend that will lead to significant changes in future society. Korean and overseas agencies specializing in climate forecasts predict that average global temperatures will continue to rise. While climate change may potentially have certain positive impacts for crop yields, the overall impact is predicted to be negative for environment and food security. In this context, our study aims to suggest a plan for systematically establishing a stable food supply system in Korea in respose to climate change. Various analytical models were employed, including: a response analysis based on questionnaire for farmers, panel-based analysis of the causes of pests and diseases in rice production, a random-effects model for panel data of extreme weather impact, and an analysis of food supply effects using the Simulation Model for Climate-Agriculture Relations (SIMCAR) integrated model in conjunction with the Crop Estimation through Resource and Environment Synthesis (CERES) model of the Korea Agricultural Simulation Model (KASMO). An analysis was made of major grain yields by means of the KREI-KASMO. This revealed reduced yields and area in comparison with the baseline in 2050, resulting in a reduction of rice production by 17.8%p in the RCP8.5 scenario, and reduction of soybean by 21.2%p and reduction of barley by 13.7%p in the A2 scenario. Self-sufficiency ratio of major grains in 2050 drawn from the SIMCAR revealed that the climate change scenario for rice showed 55.0% to be reduced by 18.3% in comparison with the baseline. It is predicted that selfsufficiency ratio in rice will drop to 50% which means a half of consumed rice should be imported. Key tasks for building a stable food supply system to cope with climate change were developed based on the domestic production capacity, the buffering capacity to climate change, import capacity from other countries, and policy performance capacity with reference to the empirical analysis. First, the suggested key tasks for improving the domestic production capacity include developing and disseminating adaptation technology, conserving farmland and expanding arable land, practicing climate-smart agriculture by using fusion technology, and modernizing infrastructure for agriculture. Second, key tasks for improving buffering capacity to climate change are improving resilience and biodiversity, building a risk management system, and further improving storage of food in Korea and other countries. Third, major tasks for improving the import capacity from other countries are constructing overseas food bases, effectively using the international grain market, and enhancing international cooperation with relevant countries. Finally, key tasks for improving policy performance capacity are refining and applying the climate change impact analysis model with respect to policies, expanding investments in research and development, building a vulnerability assessment system, enhancing education and training, and installing Climate Change Response Center for Agriculture (tentative). In this study, several key challenges were presented in the four different areas related to building a stable food supply system which can help overcome the challenges of climate change. It is expected that the nature of the policies that need to be prioritized and promoted, given the constraints of budget, organization and information will be addressed in future research. Also, in order for the solutions for key challenges to work properly in the field such that policy outcomes will be maximized, a consortium of research bodies in the related fields of agriculture, agricultural meteorology and agricultural economics should be created. As preparation for specific action programs. Furthermore, follow-up studies should be conducted to verify the expenses required for developing reliable climate change impact assessment models and the effectiveness of the enforced policies. Such fie

Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

Kim, Chang-Wook,Hyun, Seung-Jae,Kim, Ki-Jeong The Korean Neurosurgical Society 2021 Journal of Korean neurosurgical society Vol.64 No.6

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

感染性 疾患의 臨床疫學的 硏究

張友鉉,朴熙明,金漢壽,李承薰 現代醫學社 1969 現代醫學 Vol.10 No.4

The advancement of modern medicine, particularly the application of effective chemotherapeutics and preventive measures, have brought significant changes on the ecological aspect of microbial diseases of man. It was thought worthwhile to study the recent trends and present status of microbial infections in this country. Thus, the relative incidences and their etiological relationships of bacterial species, the pattern of drug sensitivities among the strains, and also the cases diagnosed by the serological methods were studied for the patients of SNU Hospital from January 1963 to December 1967. The results might be summarized as follows; 1. Relationships between bacteria and diseases (1) The species and their relative incidences of bacteria, isolated from various abscess, were α-hemolytic streptococcus 26.6%, Staphyloccus aureus 22.6%, paracolon bacilli 9.9%, coliform bacilli 8.1%, Klebsiella pneumoniae 7.6%, E. coil 6.9%, β-hemolytic streptococcus 5.9%. Staphylococcus albus 3.8%. Proteus 3.8%. Alkaligenes fecalis 2.1%, Diplococcus pneumoniae 1.8% and Pseudomonas aeruginosa 1.6%. (2) The species and their relative incidences of bacteria, isolated from the pyelonephritis cases, were E. coli, 39.5%, coliform bacilli 13.5%, Pseudomonas aeruginosa 9.3%, Proteus 7.4%, Staphylococcus albus 4.6%, α-hemolytic streptococcus 4.6%, Staphylococcus aureus 2.8%, Klebsiella pnemoniae 2.8%, and Alkaligenes fecalis 2.8%. (3) The species and their relative incidences of bacteria, isolated from the osteomyelitis cases, were Staphylococcus aureus 46.5%, β-hemolytic streptococcus 12%, Staphyococcus albus 12%, coliform bacilli 6.9%, α-hemolytic streptococcus 6.9%, paracolon bacilli 5.2% and E. coli 3.5%. (4) The species and their relative incidences of bacteria, isolated from the surgical infections were Staphylococcus aureus 33%, E. coli 15.1%, coliform bacilli 11.6%, Pseudomonas aeruginosa 10.7%, paracolon bacilli 9.8%, Proteus 7.1%, α-hemolytic streptococcus 3.5%, Klebsiella pneumoniae 2.7%, and Alkaligenes fecalis 0.9%. (5) The species and their relative incidences of bacteria, isolated from the pneumonia cases, were Diplococcus pneumoniae 14.4%, Klebsiella pneumoniae 9.6%, Staphylococcus aureus 10.3%, β-hemolytic streptococcus 4.8%, paracolon bacilli 4.8%, E. coli 3.4%, coliform bacilli 3.4%, α-hemolytic streptococcus 34.6% and Staphylococcus albus 13.6%. (6) 44 strains of Salmonella group D were isolated. (7) 207 cases of Salmonella typhosa infections, 39 cases of Salmonella paratyphi A infer ctions and 20 cases of Salmonella paratyphi B infections were diagnosed by Widal. Reactions. (8) No significant change in the yearly pattern between the bacterial species isolated and clinical cases was noticed. 2. Drug-sensitivities of the bacterial strains. (1) Percentage of Staphylococcus aureus strains sensitive to streptomycin, chloramphenicol. Or terramycin appeared to have fluctuated by year. Percentages of the strains sensitive to penicillin, erythromycin albamycin, and kanamycin were 25%, 85%, 99% and 99% respectively, without significant change by year. (2) Perentage of E. coil strain's sensitive to streptomycin, erythromycin, chloramphenicol albamycin and kanamycin were 30%, 9% 70%, and 70% respectively, without significant change by year. Percentage of the strains sensitive to terramjcin decreased from 33.3% in 1963 to 11.6% in 1967 to kanamycin increased from 72% in 1963 to 82% in 1967. None of the strains was sensitive to penicillin. (3) Percentage of proteus strains sensitive to penicillin, terramycin, streptomycin and chloramphenicol were 5%, 3%, 36% and 39%, respectively, without significant change by year. Percentage of the strains sensitive to albamycin decreased from 72.5% in 1963 to 50% in 1967 and to kaiiainycin increased from 72% in 1963 to 82% in 1967. None of the strain was sensitive to erythromycin. (4) Percentage of Pseudomonas strains sensitive to penicillin, streptomycin chloramphenicol, terramycin, erythromycin, albamycin and kanamycin were wider 20% (5) Percentage of coliform bacilli strains sensitive to penicillin, streptomycin, chloramn henicol, terramycin, erythromycin and albamycin were 10%, 24%, 28%, 20% and 10% respectively, without significant change by year. Percentage of the strains sensitive to albamycin appeared to have fluctuated by year. The strains sensitive to kanamycin decreased from 80% in 1963 to 56% in 1967. (6) Pereeentage of paracolon bacilli sensitive to penicillin, streptomycin, chloramphenicol, terrahiycin, erythromycin, kanamycin and albamycin were 3%, 27%, 33%, 20%, 8%, 80% and 65% respectively, without significant change by year.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

RCP 8.5 기후변화 시나리오에 따른 소나무림과 굴참나무림의 산림 탄소 동태 변화 추정 연구

이종열 ( Jong Yeol Lee ),한승현 ( Seung Hyun Han ),김성준 ( Seong Jun Kim ),장한나 ( Han Na Chang ),이명종 ( Myong Jong Yi ),박관수 ( Gwan Soo Park ),김춘식 ( Choon Sig Kim ),손영모 ( Yeong Mo Son ),김래현 ( Rae Hyun Kim ),손요환 한국농림기상학회 2015 한국농림기상학회지 Vol.17 No.1

산림은 많은 양의 탄소를 저장하고 있으며, 산림 탄소 동태는 기후변화에 따라 변화할 것으로 예상된다. 본 연구는 우리나라 산림에서 가장 우점하는 침엽수종과 활엽수종인 소나무림과 참나무림을 대상으로 최근 개발 및 개선된 한국형산림토양탄소모델(Korean ForestSoil Carbon model; KFSC model)을 이용하여 두 가지 기후변화 시나리오(2012년 기온이 2100년까지 유지되는 시나리오(CT), Representative Concentration Pathway(RCP) 8.5 시나리오) 하에서의 산림 탄소 동태를 예측하였다. 5차 국가산림자원조사 자료로부터 소나무림과 굴참나무림 조사구들을 추출한 뒤, 이를 행정구역(9개 도, 7개 특별·광역시) 및 영급(1-5영급, 6영급이상)별로 분류하여 탄소 동태 모의 단위를 설정하였다. 탄소 저장고는 2012년을 기준으로 초기화하였으며, 모의 기간인 2012년부터 2100년까지 모든 교란은 고려하지 않았다. 모의 결과 산림 탄소 저장량은 시간이 경과함에 따라 전반적으로 증가하지만, CT 시나리오에 비하여 RCP 8.5 시나리오 하에서 산림 탄소 저장량이 낮게 나타났다. 소나무림의 탄소 저장량(Tg C)은 2012년에 260.4에서 2100년에는 각각 395.3(CT 시나리오) 및 384.1(RCP 8.5 시나리오)로 증가하였다. 굴 참나무림의 탄소 저장량(Tg C)은 2012년에 124.4에서 2100년에는 219.5(CT 시나리오) 및 204.7(RCP 8.5 시나리오)로 각각 증가하였다. 5차 국가산림자원조사 자료와 비교한 결과, 고사유기물 탄소 저장량의 초기값은 타당한 것으로 나타났다. 모의 기간 동안 소나무림과 굴참나무림의 연간 탄소 흡수율(g C m-2 yr-1)은 CT 시나리오 하에서 각각 71.1과 193.5, RCP8.5 시나리오 하에서 각각 65.8과 164.2로 추정된다. 따라서 우리나라 소나무림과 굴참나무림의 탄소 흡수잠재력은 지구 온난화에 의하여 감소할 것으로 예상된다. 비록 모델의 구조와 파라미터로부터 불확실성이 존재하지만 본 연구는 미래 산림 탄소 동태 파악에 기여할 것으로 기대된다. Forests contain a huge amount of carbon (C) and climate change could affect forest C dynamics. This study was conducted to predict the C dynamics of Pinus densiflora and Quercus variabilis forests, which are the most dominant needleleaf and broadleaf forests in Korea, using the Korean Forest Soil Carbon (KFSC) model under the two climate change scenarios (2012-2100; Constant Temperature (CT) scenario and Representative Concentration Pathway (RCP) 8.5 scenario). To construct simulation unit, the forest land areas for those two species in the 5th National Forest Inventory (NFI) data were sorted by administrative district and stand age class. The C pools were initialized at 2012, and any disturbance was not considered during the simulation period. Although the forest C stocks of two species generally increased over time, the forest C stocks under the RCP 8.5 scenario were less than those stocks under the CT scenario. The C stocks of P. densiflora forests increased from 260.4 Tg C in 2012 to 395.3 (CT scenario) or 384.1 Tg C (RCP 8.5 scenario) in 2100. For Q. variabilis forests, the C stocks increased from 124.4 Tg C in 2012 to 219.5 (CT scenario) or 204.7 (RCP 8.5 scenario) Tg C in 2100. Compared to 5th NFI data, the initial value of C stocks in dead organic matter C pools seemed valid. Accordingly, the annual C sequestration rates of the two species over the simulation period under the RCP 8.5 scenario (65.8 and 164.2 g C m-2 yr-1 for P. densiflora and Q. variabilis) were lower than those values under the CT scenario (71.1 and 193.5 g C m-2 yr-1 for P. densiflora and Q. variabilis). We concluded that the C sequestration potential of P. densiflora and Q. variabilis forests could be decreased by climate change. Although there were uncertainties from parameters and model structure, this study could contribute to elucidating the C dynamics of South Korean forests in future.

조기 천장골염의 자기공명영상 소견

김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),심승철 ( Seung Cheol Shim ),장대국 ( Dae Kook Chang ),고회관 ( Hee Kwan Koh ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),전의용 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.2

목적: 천장골염의 유무가 척추 관절염의 진단에 중요한데 단순 골반 검사에서 변화가 없는 환자를 대상으로 MRI를 이용하여 천장골염의 조기변화 소견 및 MRI방법에 따른 장점을 비교하고자 하였다. 대상 및 방법: 단순 골반 검사에서 천장골염 유무가 확실하게 구분되지 않은 혈청 음성 척추 관절염 환자 26명을 대상으로 MRI를 시행하고 염증의 주침범위치를 천측과 장측, 관절의 상하로 구분하고, MRI방법에 따른 변화를 비교하였다. 결과: 모든 예에서 조영 증강되는 판누스를 관찰할 수 있었고, Grade I 이하에서는 장골측과 관절하부, 인대성 관절보다 활막성 관절을 더 많이 침범하였다. Grade II 이상에서도 장골측과 관절 하부에 더 많았으나 인대성 관절을 Grade I이하에서보다 더 많이 침범하였다. 관절 주변 지방 침착역시 장골측과 관절 하부에 더 주로 침범하였고 Grade II 이상에서 약간 더 많았다. 관절 주변 골염은 Grade 0에서는 없었고, Grade I에서는 주로 장골측과 관절 하부에서 92%가 양성이었고, Grade II에서는 93%에서, Grade III에서는 64%에서 양성으로, 장골측을 주로 침범하였으나 관절 상하부의 구분은 없었다. 인대성 천장골 관절은 Grade I 이하에서 38%, II 이상에서는 94%에서 침범하였다. 관절 주변 골염과 지방 침착, 그리고 판누스의 관찰에는 MPGR보다 스핀에코 영상이 좋았고, 관절면의 불규칙성 또는 관절강의 확대와 관절 강직여부의 관찰에는 스핀에코에 비해 MPGR 영상이 좋았고, 연골하 경화는 비슷하였다. 천장골염의 정도와 ESR, CRP와의 연관성은 없었다. 걸론: 천장골 관절에서 염증의 시작은 주로 장골 측과 관절의 하부에서 먼저 시작되고, 관절이 진행될수록 장골측에서 천골측까지로 범위가 확대 되었다. MRI방법에 의한 차이로 초기단계에는 스핀에코 영상이 관절염을 확인하는데 도움이 되고 관절면이 불규칙하게 되고 경화가 되어 병이 진행된 상태에서는 MPGR영상이 진단에 더 도움이 되었다. 염증성 배부 동통이 있는 경우 단순 골반 검사에서 이상이 없는 환자인 경우에도 MRI 검사를 시행하여 천장골염의 유무를 확인하는 것이 중요하다. Objective: The early detection of sacroiliitis on X-ray is important to diagnose spondyloarthropathy(SpA). The conventional radiography, bone scan, and computer tomogram have the problems of sensitivity, specificity, and side effects. We examined sacroiliitis using MR imaging in patients who had inflammatory back pain, but no definite changes in conventional radiogrphy. Other radiologic techniques were compared in detection of early sacroillitis. Methods: Twenty six patients with SpA were examined. The MRI findings of both sacroiliac joints were evaluated in every patients, such as pannus, periarticular osteitis and fat accumulation, subchondral sclerosis, and joint space changes(irregularity, ankylosis). Also we analyzed the changes of sacroiliac joints in sacroiliitis. Results: The predominant sites of involvement were upper aspect and iliac surface of sacroiliac joint in subchondral sclerosis, lower and iliac in pannus, periarticular fat accumulation, and iliac in periarticular osteitis. The MPGR images were superior to spin echo images in evaluation of joint space changes(irregularity, and ankylosis). Conclusions: Sacroiliitis is initiated in iliac side and lower portion of sacroiliac joints. MRI can detect early changes of sacroiliitis in patients with no conventional radiographic changes. MRI seems to be needed in patients with inflammatory back pain.

Expression of cellular retinoic acid-binding protein-I (CRABP-I) in the cerebrospinal fluid of adult onset moyamoya disease and its association with clinical presentation and postoperative haemodynamic change

Jeon, Jin Sue,Ahn, Jun Hyong,Moon, Youn-joo,Cho, Won-Sang,Son, Young-Je,Kim, Seung-Ki,Wang, Kyu-Chang,Bang, Jae Seung,Kang, Hyun-Seung,Kim, Jeong Eun,Oh, Chang Wan BMJ Publishing Group Ltd 2014 Journal of neurology, neurosurgery and psychiatry Vol.85 No.7

<P><B>Objective</B></P><P>The elevation of cellular retinoic acid-binding protein-I (CRABP-I) has been suggested as a candidate in the pathogenesis of paediatric moyamoya disease (MMD). However, few studies have addressed CRABP-I in adult onset MMD. The aim of this study was to examine the expression of CRABP-I in the cerebrospinal fluid (CSF) of adult onset MMD, and to evaluate its association with clinical presentation and postoperative haemodynamic change.</P><P><B>Methods</B></P><P>This study examined the CSF from 103 patients: bilateral MMD, n=58 (56.3%); unilateral MMD, n=19 (18.4%); atherosclerotic cerebrovascular disease (ACVD), n=21 (20.4%); and control group, n=5 (4.9%). The intensity of CRABP-I was confirmed by western blotting and expressed as the median (25th–75th percentile). The differences in CRABP-I expression according to disease entity (unilateral MMD vs bilateral MMD vs ACVD), initial presenting symptoms (haemorrhage vs ischaemia) and postoperative haemodynamic change (vascular reserve in single photon emission CT and basal collateral vessels in digital subtraction angiography) were analysed.</P><P><B>Results</B></P><P>CRABP-I intensities in bilateral MMD (1.45(0.86–2.52)) were significantly higher than in unilateral MMD (0.91(0.78–1.20)) (p=0.044) or ACVD (0.85(0.66–1.11)) (p=0.004). No significant differences were noted based on the initial presenting symptoms (p=0.687). CRABP-I was not associated with improvement in vascular reserve (p=0.327), but with decrease in basal collateral vessels (p=0.023) postoperatively.</P><P><B>Conclusions</B></P><P>Higher CRABP-I in the CSF can be associated with typical bilateral MMD pathogenesis in adults. Additionally, postoperative basal collateral change may be related to the degree of CRABP-I expression.</P>

Eye and Skin Irritation Tests for Cell Wall Glucan and Mannoproteins, from Saccharomyces cerevisiae

Chang Hoon Ha,Hye Young Kim,Cheol Won Youn,Hyun Dong Paik,Seung Wook Kim,Chang Won Kang,Hyo-Ihl Chang 한국실험동물학회 2005 Laboratory Animal Research Vol.21 No.3

Yeast cell wall matrix particles are entirely composed of mannoprotein and β-glucan. Yeast cell wall β-glucans and mannoproteins were isolated and purified from cell wall mutants in the previous study (Ha et al., 2002). The mannoproteins and the alkali-soluble glucan of yeast cell wall have been shown to systemically enhance immune system function. These nonspecific immunostimulators was evaluated for primary skin and eye irritation in male New Zealand White rabbits. In skin irritation test of β-glucans and mannoproteins, body weights were not significantly changed and there were no responses after treatment for 24 hours and the primary irritation index (P.I.I.) was ‘0’. And, in the eye irritation test, there were no chemosis in any rabbits in washing group and non-washing group. Taken together, these results indicate that yeast cell wall β-glucans and mannoproteins may be non-irritant materials.

출산에 따른 그레이브스병의 재발 및 관련이자

임창훈,최현아,한승석,김해성,이창욱,정호연,한기옥,장학철,박원근,윤현구,한인권 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2

Background: Pregnancy affects the course of Graves' Disease (GD), and patients who initially maintain euthyroid function into their middle trimester with minimum doses of antithyroid drugs become exacerbated after delivery. Even patients who are completely cured, requiring no treatment during pregnancy, can relapse after delivery. In this study, we examined the postpartum changes in the thyroid functions of patients with GD, and attempted to determine the factors contributing to these changes. Methods: The study subjects were recruited from pregnant women visiting our outpatient clinic for routine prenatal evaluations. 45 women previously diagnosed with GD, who had been treated and cured with hyperthyroidism, and were no longer taking any thyroid medications, were evaluated for 1 year post delivery. Results: Among 45 patients, 20 (44.4%) developed thyroid disorders following delivery. Postpartum thyroiditis (PPT) developed in 8 patients (17.8%), and GD developed in 12 (26.0%). The onset of the PPT disease 3.1 ± 1.4 months following delivery, which was significantly earlier than the 6.7 ± 2.7 months required for the post delivery onset of GD (p=0.003). The TBII values, measured during the thyrotoxic state in each womaen, were negative in women with PPT and positive in 71.4% of women with GD (p=0.030). The duration of treatment for hyperthyroidism prior or pregnancy, the number of recurrences, and the time interval without treatment, were not associated with the development of postpartum thyroid disorders. Whereas, the mean number of past pregnancies for women who developed PPT was 3.9 ± 2.1, and was significantly higher than the 2.2 ± 1.7 for women developing no thyroid dysfunctions (p=0.044). In 13 women their initial onset of GD occurred within one year postpartum, 7 (53.8%) having had a recurrence, which was significantly higher than in women whose disease onset occurred unrelated to delivery (5 of 32 women: 15.6%). Conclusion: Women with GD developed postpartum thyroid dysfunctions in 44.4% of cases. Women whose initial disease onset occurred within one year postpartum had higher recurrences of GD, and women who developed PPT had a history of higher gravidity compared to the euthyroid women postpartum. Therefore, if women with GD develop postpartum thyroid dysfunctions, the diagnosis should be made, and a treatment modality planned, following careful considerations of the patients' past obstetric history, changes in clinical manifestations and the TBII values

대퇴골 전자간 골절의 압박나사못 고정술 치료에서의 원위 골절부 위치의 중요성

라종득,박현수,박영봉,임창석,김승우 대한골절학회 2003 대한골절학회지 Vol.16 No.4