Background: The adverse effects of the phosphodiesterase-4 inhibitor roflumilast, appear to be more frequent in clinical practice than what was observed in chronic obstructive pulmonary disease (COPD) clinical trials. Thus, we designed this study to determine whether adverse effects could be reduced by starting roflumilast at half the dose, and then increasing a few weeks later to $500{\mu}g$ daily. Methods: We retrospectively investigated 85 patients with COPD who had taken either $500{\mu}g$ roflumilast, or a starting dose of $250{\mu}g$ and then increased to $500{\mu}g$. We analyzed all adverse events and assessed differences between patients who continued taking the drug after dose escalation and those who had stopped. Results: Adverse events were reported by 22 of the 85 patients (25.9%). The most common adverse event was diarrhea (10.6%). Of the 52 patients who had increased from a starting dose of $250{\mu}g$ roflumilast to $500{\mu}g$, 43 (82.7%) successfully maintained the $500{\mu}g$ roflumilast dose. No difference in factors likely to affect the risk of adverse effects, was detected between the dose-escalated and the discontinued groups. Of the 26 patients who started with the $500{\mu}g$ roflumilast regimen, seven (26.9%) discontinued because of adverse effects. There was no statistically significant difference in discontinuation rate between the dose-escalated and the control groups (p=0.22). Conclusion: Escalating the roflumilast dose may reduce treatment-related adverse effects and improve tolerance to the full dose. This study suggests that the dose-escalated regimen reduced the rate of discontinuation. However, longer-term and larger-scale studies are needed to support the full benefit of a dose escalation strategy.
Park, Jae-Hong;Kim, Myung-Jung;Park, Je-Min;Kim, Yong-Ki;Han, Kwi-Won;Park, Seong-Hwa;Yun, Kyung-Il;Chung, Young-In;Kim, Sung-Gon
Korean Journal of Psychosomatic Medicine
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v.6
no.1
/
pp.22-27
/
1998
Thirteen female patients of somatization disorder, undifferentiated somatoform disorder and somatoform disorder, NOS, diagnosed by DSM-IV were studied for their pain threshold and serum testosterone and the results were compared with the respective data of 20 control females. The results are as follows : 1) The pain threshold as measured by Variable Weight Pressure Algometer was significantly lower in the patient group(153.8${\pm}$39.5 gm/$0.05mm^2$) as compared to the control group(197.5${\pm}$66.7 gm/$0.05mm^2$)(p<0.05). 2) There was no significant difference of serum testosterone between the patient(0.175${\pm}$0.081 ng/ml) and the control(0.174${\pm}$0.108 ng/ml) groups. 3) A significant positive correlation was noted between the pain threshold and serum testosterone in the patient group(r=0.632, p<0.05, two tailed, Pearson's correlation test), but not in the normal control group(r= -0.405). From these results, it was suggested that the role of testosterone in endogenous pain control system might be more important in somatoform disorders than normals.
Kim, Ji-hyun;Kwon, Oh-yun;Jeon, Hye-seon;Hwang, Ui-jae;Gwak, Kyeong-tae;Yoon, Hyeo-bin;Park, Eun-young
Physical Therapy Korea
/
v.26
no.3
/
pp.67-75
/
2019
Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.
Jae Yeon Jang;Youngkyung Jeon ;Sun Young Jeong ;Sung Hee Lim ;Won Ki Kang;Jeeyun Lee ;Seung Tae Kim
Journal of Gastric Cancer
/
v.23
no.3
/
pp.476-486
/
2023
Purpose: The optimal tumor mutational burden (TMB) value for predicting treatment response to programmed cell death-1 (PD-1) checkpoint inhibitors in advanced gastric cancer (AGC) remains unclear. We aimed to investigate the optimal TMB cutoff value that could predict the efficacy of PD-1 checkpoint inhibitors in AGC. Materials and Methods: Patients with AGC who received pembrolizumab or nivolumab between October 1, 2020, and July 27, 2021, at Samsung Medical Center in Korea were retrospectively analyzed. The TMB levels were measured using a next-generation sequencing assay. Based on receiver operating characteristic curve analysis, the TMB cutoff value was determined. Results: A total 53 patients were analyzed. The TMB cutoff value for predicting the overall response rate (ORR) to PD-1 checkpoint inhibitors was defined as 13.31 mutations per megabase (mt/Mb) with 56% sensitivity and 95% specificity. Based on this definition, 7 (13.2%) patients were TMB-high (TMB-H). The ORR differed between the TMB-low (TMB-L) and TMB-H (8.7% vs. 71.4%, P=0.001). The progression-free survival and overall survival (OS) for 53 patients were 1.93 (95% confidence interval [CI], 1.600-2.268) and 4.26 months (95% CI, 2.992-5.532). The median OS was longer in the TMB-H (20.8 months; 95% CI, 2.292-39.281) than in the TMB-L (3.31 months; 95% CI, 1.604-5.019; P=0.049). Conclusions: The TMB cutoff value for predicting treatment response in AGC patients who received PD-1 checkpoint inhibitor monotherapy as salvage treatment was 13.31 mt/Mb. When applying the programmed death ligand-1 status to TMB-H, patients who would benefit from PD-1 checkpoint inhibitors can be selected.
Hyuk Kwon;Jandee Lee;Soon Won Hong;Hyeong Ju Kwon;Jin Young Kwak;Jung Hyun Yoon
Journal of the Korean Society of Radiology
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v.83
no.3
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pp.645-657
/
2022
Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.
Flores, Precious Eureka D.;Maniquiz-Redillas, Marla C.;Geronimo, Franz Kevin F.;Alihan, Jawara Christian P.;Kim, Lee-Hyung
Journal of Wetlands Research
/
v.18
no.4
/
pp.481-487
/
2016
In this research, a pilot scale hybrid rain garden system was developed in order to investigate the efficiency in the different components of the hybrid rain garden system and at the same time evaluate the initial efficiency of the system in treating urban stormwater runoff prior to its actual use in the field. Experimental runs were conducted using synthetic runoff having target concentrations similar to that of the typical runoff characteristics found in different countries and in Korea. With the employment of the hybrid rain garden system, hydrologic improvement was observed as the system demonstrates an approximately 95% reduction in the influent runoff volume with 80% retained in the system, and 15% recharged to groundwater. The reduction was contributed by the retention capabilities of ST and infiltration capabilities in PB and IT. With the combined mechanisms such as filtration-infiltration, biological uptake from plants and soil and phytoremediation that are incorporated in PB and IT, the system effectively reduces the amount of pollutant concentration wherein the initial mean removal efficiency for TSS is 87%, while an approximate mean removal efficiency of 76%, 46% and 56% was observed in terms of organics, nutrients and heavy metal, respectively. With these findings, the research helps in the further improvement, innovation and optimization of rain garden systems and other facilities as well.
Jung, Hyo Yeon;Park, Eun Young;Choi, Jin Young;Lee, Soo Jin;Noh, Bong Soo
Korean Journal of Food Science and Technology
/
v.49
no.1
/
pp.14-19
/
2017
The objective of this study was to analyze the volatile changes occurring in retort pouches during heating using a mass spectrometry-based electronic nose. The data obtained by the electronic nose analysis was used to generate a discriminant function analysis plot. The plot showed that volatile compounds of the heated water in the retort pouch were increased by the interaction between container and water as the heating time increased. Conversely, volatile compounds of the container itself decreased when only the container was measured separately. This result means that volatile compounds from the packaging material migrated into the water. In the case of heated beef bone soup, volatile compounds were increased compared to the unheated beef bone soup after 20 min of heating. According to the results of GC/MS, nonanal and 3,5-di-tert-butyl-4-hydroxytoluene (BHT) were detected in the heated water and nonanal, heptanal, octanal, and BHT were detected in the heated beef bone soup.
This retrospective clinical study was done based under the delivery records of 146 cases of twin pregnancies in Yonsei University, Severance Hospital and Wonju Christian Hospital from 1977 through 1980 with particular interest in the second twins. Clinical factors, Apgar scores related to neonatal prognosis, and perinatal mortality rate were statistically analyzed and the following results were obtained. The mean - birthweight for A (first) twins was 2,377 grams and for B (second) twins 2,296 grams. In comparison of the percentage of low-birth-weight (less than 2,500 grams) infants, there were more small B twins, but the difference was statistically not significant. Because there were no significant statistical differences in birth weight-grouping between A and B twins, they could be compared with the comprehensive Apgar scores, but this method was also shown to be statistically not significant. In comparison of the percentage of breech deliveries in A and B twins, the percentage was more than three times in B twin (A twin, 7.5 per cent; B twin, 24.0 per cent), and the difference was statistically very significant (p < 0.0005). There were no significant statistical differences between the Apgar scores of A and B twins in reference to the manner of delivery. According to the manner of delivery of B twins, spontaneous vertex delivery and total breech extraction revealed higher infant mortality rate than others. B twins presented by the vertex in 88 cases (61.0 per cent), by the breech in 55 cases (37.0 per cent), and by the shoulder in 3 cases (2.0 per cent). And this therefore disclosed no significant statistical differences in Apgar scores in relation to the presentation. The duration of labor appeared to have no clear correlation with the Apgar scores and the perinatal mortality of A and B twins. The delivery interval between A and B twins was 11.9 minutes on an. averge, varying from 3 to 65 minutes. The length of this interval was not found to have any significant effect on the Apgar scores and the perinatal mortality rate of B twin.
Park, Yong-Wook;Yoo, Jung-Han;Park, Hong-Jun;Cho, Yang-Bum;Yu, Sun-O;Lee, Ho-Jin
Journal of Korean Foot and Ankle Society
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v.6
no.1
/
pp.40-45
/
2002
Purpose: To analyze the radiographic results between the simple bone excision and simple bone excision and posterior tibial tendon advancement for prehallux. Materials and Methods: Thirty-four patients who underwent operative treatment for prehallux between 1995 and 2000 were reviewed. Twenty-six patients who underwent simple bone excision and posterior tibial tendon advancement and eight patients who underwent simple bone excision were available for follow-up. Follow-up averaged 44 months(15-59 months). We evaluated and compared the cuboidal height and the talo-1st metatarsal angle in the preoperative and postoperative radiography. Results: The average span of disappearing pain is 3.7 months(2-7 months) after the operation. Mean cuboidal height and talo-1st metatarsal angle were increased $6.7{\pm}1.8mm$, $5.0{\pm}2.1^{\circ}$ before to $7.8{\pm}0.2mm$, $5.6{\pm}0.7^{\circ}$ after simple bone excision and posterior tibial tendon advancement. Mean cuboidal height and talo-1st metatarsal angle were increased $6.6{\pm}0.7mm$, $4.6{\pm}1.1^{\circ}$ before to $7.7{\pm}0.9mm$, $5.1{\pm}0.4^{\circ}$ after simple bone excision and posterior tibial tendon advancement. One case of extra-osseous migration of the Mitek anchor inserted into navicula was seen during the follow-up period. Conclusion: This study shows that the remarkable differences between the two procedures are not found. So, simple bone excision without advancement of posterior tibial tendon for prehallux can generate relatively good results.
Journal of the Korean BIBLIA Society for library and Information Science
/
v.5
no.1
/
pp.37-84
/
1981
Korean private colleges under the period of Japanese control was the kernel for the educational resistance, one of the save-the-nation movements because of inculcating in Koreans the spirit of independence and self-respect under that period. Posung College Library building, erected in Commemoration of the 30th Anniversary of the Foundation, especially, was the result of Koreans systematizing ability and iron will of independence for the future generations. In this paper, an attempt to study the Korean private college libraries under the period of Japanese control is provided. The main institutions in this study are Posung College library, Chosen Christian College library (Yunhee College Library), and Ewha College Library. This study will focus to review the followings: 1. The historical background of above mentioned libraries. 2. The educational resistance under that period. 3. The comparative and analytical study of these private college libraries and Keijo Imperial University library. 4. The facilities and the basic collection development plan on the basis of presentation. 5. library services including readers services. 6. The impact of these libraries on the present private university libraries. 7. The organization and staffing pattern, and budget of these private college libraries. The followings are the outlines conclusions: 1. Korean private college libraries had been established in order to perform the educational resistance. They are one of the supporting agencies for the research activities, among the most important means of social education, and provide, no doubt, the full nutriment for hungry soul under that period. 2. These libraries have not outstripped Keijo Imperial University in collection of books as well as man power, but their collection of books coincided, in general, with their curricula, and had feature to perform the save-the-nation-movement by education. 3. The library services were appeared in the forms such as the Circulation Library, Lectures on the Use of Books and Libraries, Library Week, and Training Course for the Librarians, etc. It is thought that these activities contributed to the social and cultural development of Korea indirectly. 4. The library administration of the private colleges depended upon the director of library because of the frequent changes of staffs and the simple functional system without its middle class. 5. The Japanese Government-General in Korea gave no financial assistance to the private colleges though they were in financial difficulties more than Keijo Imperial University. 6. The ambitious ideal for foundation of universities in reality as well as in name was not achieved during that period because of the monstrous obstacle so-called the Japanese Government-General in Korea, but its ideal had a desirable effect upon these college libraries development, in particular, before and after 1935.
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