• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.111-115
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• 2011

Purpose: In vitro uses dose response curve with 6 to 7 standard concentrations in every examination to analyze examination results and this use of dose response curve comprises a large portion of the consumption of medicine material. At this present, some ones of in-hospital examination items have shown mostly low result of distribution in the analyzed features and these examinations have been judged that it would be unnecessary to use the last standard concentration. Hence, this study selects those examination items showing low result of distribution and reviews the cases contributed to less consumption of medicine material and revenue growth of hospital by reduction of medicine material used in the place of the last standard concentration. Materials and Methods: The study was made targeting 11 examination items out of total 43 items of the in-hospital examination and since these examination items were mostly low in the features as the examination results of patients or the examination results were distributed to show lower concentration than the previous last standard concentration, it carried out the examination without using the last standard concentration, which could generate the effect to reduce medicine material (examination tube) used in the last standard concentration as many as the number of examination carried out. For this, it examined the number of medicine material reduction by month during the period from July, 2009 to February, 2011 and estimated the reduction amount of medicine material calculated the number of reduction by the unit cost of medicine material as well as the profit generated by the reduced medicine material to use for the medicine material of patient examination. Results: The total number of medicine material reduced during the period from July, 2009 to February, 2011 was 3,131 pieces, which had the effect to reduce the medicine material equivalent to about 31 kits of reagent. To calculate this by the unit cost of the medicine material, it analyzed to reduce about 6.4 million won of medicine material cost. Also the reduced medicine materials were used for medicine materials of patient examination and this was analyzed to generate about 13.75 million won of profit based on the ABC cost accounting. Conclusion: It showed no problem in the analysis of examination result even without using the last standard concentration regarding those examination items with low distribution of the patient examination result. For these examination items, it was able to reduce medicine material used for the last standard as many as the number of examination carried out. Also, the adjustment of concentration range was found to have no problem in the reliability of examination result. Therefore, this case will be applicable in those occasions of when the analysis of patient examination result is mostly distributed at the lower level or when an examination with the distribution of patient results in the range of lower concentration than the previous last standard concentration is carried out and this is considered to increase the efficiency in the use of medicine material in vitro as well as contribute to the profit of hospitals.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.219-233
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• 1999

Purpose : Respiratory syncytial virus(RSV) is the major cause of lower respiratory tract infection in infants and young children. This study was performed to analyze antigenic and genetic variation of G protein of subgroup A RSV. Methods : One hundred seventy-nine strains isolated at the Seoul National University Children's Hospital over 8 years-period from 1990 through 1998 were analysed for antigenic and genetic variability. Analysis was made by reactivity with monoclonal antibodies raised against RSV, and by restriction mapping and, for selected strains, nucleotide sequencing following amplification of full sequence of G gene by reverse transcription-polymerase chain reaction. Results : Restriction fragment analysis of the amplified G protein gene revealed 23 restriction patterns, 12 of which included more than 2 isolate, and the most frequent genetic type comprised 30% of the strains. Indirect immunofluorescent staining with monoclonal antibodies revealed 6 antigenic types with one predominant pattern accounting for 91% of the total strains. The most frequent antigenic type had 21 restriction patterns, and some viruses with same restiction pattern had different monoclonal antibody reaction pattern. Nucleotide sequence homology of subgroup A was 91~93% between reference(A2, Long) and Korean isolates, 93~99% among Korean isolates. Maximum-parsimony analysis demonstrated that Korean isolates were distinct from reference strains and subgroup A strains were clustered in 4 groups. Conclusion : The restriction analysis pattern of G protein gene identified greater diversity within subgroup A than was seen with the monoclonal analysis and a variety of antigenic and genetic types of RSV are circulating in Korea which are different from reference strains or strains isolated from other countries.

• Neonatal Medicine
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• v.16 no.1
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• pp.55-63
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• 2009

Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.31-39
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• 2011

Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.127-134
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• 2012

Objectives : Perceived stress scale is a self-report inventory to estimate the degree of individual perceived stress in daily life. The aim of this study was to introduce this scale and test the reliability and validity of the Korean version of PSS. Methods : The total of 154 female hospital workers were included in this study. The survey questionnaires were conducted for demographic information. All participants were required to complete PSS, Hamilton Anxiety scale and Beck Depression Inventory. Reliability and validity studies were conducted and internal consistency was examined. Results : The mean score of the PSS reported in this sample was $20.69{\pm}4.56$. The overall Cronbach's alpha was 0.819, and the test-retest reliability coefficient was 0.66. PSS had a significant positive correlation with the HAM-A(r=0.49, p<0.01), and the BDI(r=0.55, p<0.01). Factor analysis yielded 2 factors with eigenvalues of 3.924 and 2.608, accounting for 65 percent of variance. Factor 1 represented "stress" and factor 2 represented "control of stress". Conclusions : This study indicates that the PSS is appropriate for estimating the perceived stress levels. These results support the use of PSS in large sections of the population in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4603-4608
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• 2015

Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.

• Journal of dental hygiene science
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• v.6 no.4
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• pp.271-276
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• 2006

This study set out to analyze the relationships between the senior citizens' dental health activities and dental health conditions, to provide basic data to develop a program for their better dental health, and finally to search for the ways to improve their life quality through dental health care. The subjects were 142 senior citizens(58 were male and 84 were female) who were 65 years old or older and visited a dental hospital or clinic in the Seoul metropolitan area from April 17 to April 28, 2006. With the cooperation from the dentists, the investigators examined their dental conditions and conducted one-on-one interviews to collect the information about their demographic characteristics, dental health activities, and subjective dental health conditions. The collected data were analyzed with T-test, ANOVA and Pearson's correlation coefficient using the SPSS WIN 11.5 program. The analysis results were summarized as follows: First, 58 men(40.8%) and 84 women(59.2%) consisted of the subject group, where percentage of the female participants was bigger Those who were aged from 65 to 69 made the biggest age group in the subjects, accounting for 58.5% with 83. Second, those who had three dental caries or less and then didn't treat them or treated them(F) accounted for the biggest percentage with 117(82.4%) and 72(50.7%) respectively. As for the remaining teeth, the biggest number of them(40 subjects, 28.2%) had three or less remaining. Third, it turned out the female subjects had a higher level of dental health activities than their male counterparts(P = 0.00). As for living expenses, those who were paid salary or earned income themselves carried out their dental health activities in a higher level than those who lived on the benefit from the government(p = 0.02). Fourth, the subjects' subjective dental health conditions had negative correlations with their dental caries not treated. And there were positive correlations between their dental caries not treated and dental caries lost and between their dental caries treated and remaining teeth. Fifth, those subjects who earned their living expenses themselves had the most dental caries treated at 5.4(p = 0.02), and there was statistically significant difference with the numbers. Sixth, those subjects who brushed their teeth in their own manner had 11.8 teeth lost(p = 0.05), which was more than the number of those who brushed their teeth in other methods. And there was statistically significant difference among them. The remaining teeth were found most at 17.3(p = 0.00) among those who brushed their upper and lower teeth separately. In addition, those who visited the public health center often had significantly more teeth treated(4.3) than others(p = 0.00).

• Sleep Medicine and Psychophysiology
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• v.10 no.1
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• pp.39-51
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• 2003

Objectives: The Profile of Mood States (POMS) has been used broadly and frequently in various medical studies with various subjects. For the development and application of the Korean edition of POMS, called K-POMS, we translated POMS into Korean and then evaluated the reliability and validity of K-POMS. Methods: The subjects were 161 male students with a mean age of 18.1 years (15-30) and 244 female students with a mean age of 16.6 years (14-23). They were requested to perform K-POMS and SCL-90-R (Korean version) at the same time. Means, reliability coefficients, and test-retest correlations of K-POMS were calculated. Content validities, correlations with SCL-90-R, and discrimination validities in comparison with 76 depressive patients were obtained, and factor analyses were carried out. Results: Mean scores of Total Mood Disturbance (TMD) and some subscales (T, F, C, V factor) showed a significant difference between male and female students. The internal consistency coefficient ($\alpha$) of the total 65 items was 0.93, and ranged from 0.67 to 0.90 for subscales. Test-retest correlations of 43 subjects ranged from 0.27 to 0.63. Seven psychiatrists rated the properness of the content of each item as more than moderate degree (mean scale points=2.66, in the range of 0 to 4). Every subscale of KPOMS exhibited significant correlation with the matching subscale of SCL-90-R. Mean scores of K-POMS of the total 405 subjects were significantly different from those of the 76 depressive subjects after age correction. Six factors were extracted, accounting for 51.2% of total variance. Factor 6 consisted of 6 items which came from various subscales of POMS and represented "uncertainty and helplessness," which may be somewhat different to depression or sadness proper. Conclusion: The validity and reliability of K-POMS could be confirmed. The significant difference in K-POMS scores between depressive subjects and normal subjects suggests that K-POMS can be used clinically for the evaluation and screening of depression. The main structure of K-POMS is very similar to that of POMS, except the Confusion-Bewilderment factor which shows weak factor consistency in K-POMS. This may reflect some emotional characteristic of Koreans such as an undifferentiated aspect of cognitive efficiency. The sixth factor newly extracted from K-POMS also may be indicative of an unique emotional aspect of young Koreans.

• Korean Journal of Agricultural Science
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• v.23 no.1
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• pp.159-176
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• 1996

This study is aimed at reviewing the methods of joint cost allocation and allocating the joint cost of estuary dam with specially repect to Kumgang Large-scale Agricultural Comprehensive Development Project. Apart from the water resource development project propelled by Water Resource Development Corporation in connection with Law of Multipurpose Dam Development, the Largescale Comprehensive Agricultural Development Projects couldn't ins-titutionally be carried out cost allocation of common facilities, even though it were concerned with irrigation, municipal and industrical water supply, flood control, sightseeing and industrial zone development components. To decrease farmer's burden of the project costs and, operation and maintenance costs, the joint costs of common facilities like estuary dam included in agricultural development projects have to be allocated by suitable method as alternative cost-remaining benefit method and the analytical activity should be supported by revising the concerned laws as Rural Development and Promotion and, Rural Rearrangement conpatible with the law for multipurpose dam development. Kumgang Agricultural Comprehensive Development Project was selected as a case study for the estimation of socio-economic benefits by project components and joint cost allocation of the estuary dam. The main results of the study are as follows; Joint cost allocation and unit charges by components 1. The project area will be 25,554ha with total project cost of 624,860 million won including the estuary dam cost of 120,843 million won. The project costs were ex-pressed by 1994 constant price. 2. Total quantity of water was estimated 365 million tons which were consisted of 245 million tons for irrigation, 73 million tons for municipal water and 47 million tons for industrial water. 3. The rates of joint cost allocation were amounted to 34.2% for agriculture, 2.5% for sightseeing, 45.7% for transportation, 11.8% for M & I water supply and 5.8% for flood control respectively. 4. The unit financial charges by project components were estimated at 7.88 won per ton for irrigation, 16.11won for M & I water, 1,686won per vehicle one pass, 977won per Pyeong according to the capital recovery method. The financial charges using straitline method for depreciation were estimated at 7.88won per ton for irrigation, 9.12won per ton for M & I water, 624won per vehicle one pass for transportation and 331won per Pyeong for sightseeing area. 5. The unit economic charges by project components were estimated at 21.1 won per ton for irrigation, 15.2won for M & I water, 977won per vehicle one pass, 977won per Pyeong according to the capital recovery method. The economic charges using straitline method for depreciation were estimated at 11.72won per ton for irrigation, 8.61won per ton for M & I water, 331won per vehicle one pass for transportation. Policy recommendation 1. The unit operation and maintenance costs for irrigation water in the paddy field couldn't be imposed as the water resource cost untreated. 2. The dam costs including investment cost and O & M cost, as a joint cost, had to be allocated by each benefited components as transportation, M & I water supply, flood control, irrigation and drainage, and sightseeing. But the agricultural comprehensive project have been dealt as an irrigation project without any appraisal socio-economic benefits and any allocating the joint cost of estuary dam. 3. All the associated project benefits and costs must be evaluated based on accounting principle and rent recovery rate of the project costs and O & M costs should be regulated by the laws concerned. 4. The rural development and promotion law and rural rearrangement law have to be revised comprising joint cost allocation considering free rider problems. 5. The government subsidy for the agricultural base development project has to be covered all the project costs. In case of common facilities representing joint cost allocation problems, all the allocated casts for other purposes like transportation and M & I water supply etc. should be recovered for formation in investment fund for agricultural base development and to procure O & M costs for irrigation facilities.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.31-35
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• 2006

Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.