Purpose : We measured the umbilical cord arterial concentrations of isoprostane($8-iso-PGF_{2{\alpha}}$) and intended to decide whether the umbilical cord arterial concentrations of isoprostane could be used as a useful parameter for lipid peroxidation in newborn infants. Methods : The isoprostane and malondialdehyde(MDA) concentrations of the umbilical cord were measured by enzyme immunoassay and TBARS(thiobarbituric acid reactive substance) assay in 33 preterm and 28 term infants, respectively. The concentrations of isoprostane and MDA were compared between preterm infants and term infants, and were analysed for association with perinatal risk factors and neonatal complications. Results : Umbilical cord arterial concentrations of isoprostane were $704.7{\pm}635.6pg/mL$ and $421.9{\pm}306.5pg/mL$ in preterm and term infants, respectively. Umbilical cord arterial concentrations of MDA were $44.0{\pm}22.9{\mu}M/L$ and $26.2{\pm}10.7{\mu}M/L$ in preterm and term infants, respectively. Umbilical cord arterial concentrations of isoprostane and MDA in preterm infants were significantly higher than those in term infants(P<0.05). The umbilical cord arterial concentrations of isoprostane were significantly associated with perinatal risk factors such as fetal distress, oligohydramnios, and breech delivery in preterm infants and pregnancy-induced hypertension in term infants(P<0.05). Conclusion : Umbilical cord arterial concentrations of isoprostane in preterm infants were higher than those in term infants, and those are significantly associated with some perinatal risk factors.
Purpose: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants. Methods: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated. Results: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants. Conclusion: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.
Purpose: Placental corticotropin-releasing hormone receptor type 1 (CRHR1) expression is reduced in pregnancies with abnormal placental function such as preeclampsia (PE), and the levels and/or function of CRHR1 are genetically influenced. The aim of this study was to investigate the association between the c.33+8199C>T polymorphism in the CRHR1 gene and PE in a Korean population. Materials and Methods: Using a case-control design, the association between the CRHR1 polymorphism and the risk of PE was investigated in 203 individuals with PE and 211 normotensive controls. Genotypes were determined using a SNapShot kit and an ABI Prism 3100 Genetic analyzer. Results: Genotypes and allele frequencies for the CRHR1 polymorphism did not differ between PE and normotensive pregnancies. The variant T allele was more frequent than the ancestral C allele in both of the groups and was more frequent in the controls than in the cases. In risk analysis for PE, there was not an increased risk of preeclampsia in subjects who were concomitant homozygous rare allele genotypes (CC) (OR, 0.3; P=0.15) or heterozygous rare allele genotypes (TC) (OR, 0.8; P=0.29). There were no differences in the complications of PE such as severity or preterm delivery in patients with the CRHR1 polymorphism. Conclusion: Our findings indicate that the CRHR1 polymorphism was not associated with PE in the present Korean study group.
Choi Eun Kyung;Lee Byong Yong;Kang One Chul;Nho Young Ju;Chung Weon Kuu;Ahn Seung Do;Kim Jong Hoon;Chang Hyesook
Radiation Oncology Journal
/
v.16
no.3
/
pp.265-274
/
1998
Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.
Yoon, Yong Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
Clinical and Experimental Pediatrics
/
v.50
no.10
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pp.959-964
/
2007
Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.
The applicability and feasibility of TomoTherapy in the lung radiation surgery was analyzed by comparison of the calculated dose distribution in TomoTherapy planning with the results of conventional IMRS (intensity modulated radiation surgery) using LINAC (linear accelerator). The acquired CT (computed tomograph) images of total 10 patients whose tumors' motion were less than 5 mm were used in the radiation surgery planning and the same prescribed dose and the same dose constraints were used between TomoTherapy and LINAC. The results of TomoTherapy planning fulfilled the dose requirement in GTV (gross tumor volume) and OAR (organ at risk) in the same with the conventional IMRS using LINAC. TomoTherapy was superior in the view point of low dose in the normal lung tissue and conventional LINAC was superior in the dose homogeneity in GTV. The calculated time for treatment beam delivery was long more than two times in TomoTherapy compared with the conventional LINAC. Based on the results in this study, TomoTherapy can be evaluated as an effective way of lung radiation surgery for the patients whose tumor motion is little when the optimal planning is produced considering patient's condition and suitability of dose distribution.
Korea has an economy based on manufacturing industrial fields, which produce high amounts of hazardous wastes, in spite of few landfill candidates, and a significant concern for fine airborne particulates; therefore, traditional waste management is difficult to apply in this country. Moreover, waste collection and accumulation have recently been intensified by the waste import prohibitions or regulations in developing nations, the universalization of delivery services in Korea, and the global COVID-19 crisis. This study thus presents a domestic waste management strategy that aims to address the recent issues on waste. The contents of the strategy as the main results of the study include the (1) improvement of the compatibility of the classification codes between the domestic hazardous waste and the international ones such as those of the Basel Convention; (2) consideration of the mixed hazard indices to represent toxicity from low-content components such as rare earth metals often contained in electrical and electronic equipment waste; (3) management application based on risks throughout the life cycles of waste; (4) establishment of detailed material flow information of waste by integrating the Albaro system, Pollutant Release and Transfer Register (PRTR) system, and online trade databases; (5) real-time monitoring and prediction of the waste movement or discharge using positional sensors and geographic information systems, among others; and (6) selection and implementation of optimal treatment or recycling practices through Life Cycle Assessment (LCA) and clean technologies.
Roder, David;Webster, Fleur;Zorbas, Helen;Sinclair, Sue
Asian Pacific Journal of Cancer Prevention
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v.13
no.1
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pp.147-155
/
2012
Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. Results: After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing; were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment; had an elevated ductal carcinoma in situ but not invasive cancer detection rate; had larger breast cancers; and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Conclusions: Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.
The editorials of the leading newspapers may reflect as well as help formulate the public opinions to a significant degree. Bearing this in mind, this study was carried out to provide information useful in formulating such public health policies that could practically meet the social interests and demands in health appearing in the editorials of the newspapers. This analysis covered the editorials of 5 leading newspapers such as Donga Ilbo, Chungang Ilbo, Hankook Ilto, Chosun Ilbo and Seoul Shinmoon for about 10 years from Jan. 1st, 1970 through Oct. 31th, 1979. The major findings are as follows: 1. The total number of health-concerned editorials in the five daily papers for the period was 1,768 or occupied 6.4% of the total editorials of the same sources. The increasing trend of frequnecy of the health-concerned editorials since 1976 indicates the increment of social interests and demands in health. Analysing the contents, environmental pollution received the greatest attention in those editorials, which was followed by medical affairs, environmental sanitation, and disease control in order in terms of frequency of appearance. However, there was a tendency that the interests in the environmental pollution, medical affairs and social welfare tended to increase year by year, whereas those in environmental hygiene and disease control comparatively decreased. 2. Motives of dealing with the health-concerned editorials were provided by announcement of the governmental policies and implementation for 25.6% and by out-breaks of the relevant events for 23.9%. This tendency coincides with the general characteristics of the editorials that reflect the timely issues. Closely analysing, however, the fact that the motives engendered by the out-breaks of the relevant events or by the season concerned comparatively tended to decrease as years pass by, indicates that the editorials tend more to seek the future-oriented demands in health rather than the current issue-oriented. 3. The editorials appeared to be more concerned with the governmental policies. 95.7% of all the editorials analysed were addressed to the government. This signifies the role of government in the field of public health and medical affairs. Their attitudes toward health-related policies of the government were much more negative than the other editorials that were addressed to the government in other fields. This suggests that the governmental interests in health were neither sufficient nor fair. 4. What the editorials most stressed were; (1) increment of governmental interests in health, (2) improvement of the governmental health administration, (3) enriching the basic statistics, and (4) development of various technologies pertinent to health affairs and disease control, and so forth. However, must of their suggestions were not concrete but rather abstract and conceptual. 5. The editorials also expressed strong interests in research area. The areas of the needed research most suggested by items are; (1) development of effective health care delivery system, (2) establishment of more practical system of calculating medical cost, (3) implementation of effective policies to control degenerative diseases, (4) division of medical care services and pharmaceutical services systems, (5) effective ways to prevent Co poisoning accidents, (6) changing status of environmental pollution and its effects upon health, and (7) status of occupational diseases, and so forth. 6. There were some editorials -not small in quantity -that have risk to mislead the public opinions as well as the health policies due to lack of professional knowledge of the writers. It is desirable to establish some kind of mechanism that screens the erroneous contents of the editorials to help prevent misleading opinions.
In recent years, by utilizing the greatest strengths of process mining, the various research activities have been actively progressed to use auditing work of business organization. On the other hand, there is insufficient research on systematic and efficient analysis of massive data generated under big data environment using process mining, and proactive monitoring of risk management from audit side, which is one of important management activities of corporate organization. In this study, we intend to realize Hadoop-based internal audit integrated real-time monitoring system in order to detect the abnormal symptoms in prevent accidents in advance. Through the integrated real-time monitoring system for purchasing audit, we intend to realize strengthen the delivery management of purchasing materials ordered, reduce cost of purchase, manage competitive companies, prevent fraud, comply with regulations, and adhere to internal control accounting system. As a result, we can provide information that can be immediately executed due to enhanced purchase audit integrated real-time monitoring by analyzing data efficiently using process mining via Hadoop-based systems. From an integrated viewpoint, it is possible to manage the business status, by processing a large amount of work at a high speed faster than the continuous monitoring, the effectiveness of the quality improvement of the purchase audit and the innovation of the purchase process appears.
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