• Journal of Korean Public Health Nursing
• /
• v.3 no.1
• /
• pp.18-37
• /
• 1989

This study was done in order to analyze the factors which influenced the performance level of community health practitioners' task. Interview survey was done during the period from August to October, 1986. Interviewee were 166 CHPs among total of 217 CHPs in Kyonggi province area. Multiple stepwise regression and canonical correlation analysis were used to identify major factors influenced to perform community health practitioners' task. The results of this study were summarized as follows: 1. General characteristics of CHPs 1) Personal characteristics The average age of CHPs was 37.8 years and their marital status was $77.6\%$ of married, educational back-ground was $65.3\%$ of junior college graduation. Their job career was $38.6\%$ of between 1-3 years, $33.3\%$ of between 3-5 years, $22.2\%$ of less than 1 years. Most of CHPs$(62.8\%)$ were fully satisfied with their job, $33.3\%$ were moderately, and $3.8\%$ were not satisfied. 2) Working environmental condition Only $31.7%$ of CHPs were satisfied with their working condition of primary health post, $26.6\%$ were not satisfied. Half of CHPs$(52.5\%)$ replied having good cooperation with health center, $10.1\%$ replied bad. Cooperation with health subcenter was good in $32.9\%$, and bad in $21.9%$. Cooperation with private health institutions was good in $34.2\%$, bad in $21.6%$. 2. Performance level of community health practitioners' task Among a total of 52 contents of their functions medical history taking. physical examination, referral of diagnostic laboratory work-up($(86.4\%)$, health assessment of pregnant women$(82.1\%)$, development of health information system$(79.4\%)$, supervision of health workers $(78.4\%)$, follow-up of family planning acceptors$(77.3\%)$, and follow-up of family planning acceptors' side effects$(77.3\%)$ were actively performed. Diagnosis of pregnancy$(62.1\%)$, sampling of drinking water for quality test$(52.5\%)$, making list of equipment' & supplies $(51.5\%)$, evaluation of primary health post activities $(37.6\%)$, organization of village health workers$(32.4\%)$ and management of village health workers $(30.1\%)$ were poorly performed. 3. Stepwise multiple regression analysis of job function The factors which influenced the performance level of community health practitioners' function were age, marital status, educational level, job career, job satisfaction, satisfaction of working environment of primary health post, cooperation of health center, cooperation of health center, cooperation of private health instiutions in orders. These 9 variables were able to explain job function from $25.7\%$ of program planning to $6.7\%$ of management of common disease. 4. Canonical correlation analysis between the performance of function and general characteristics of CHPs. Cooperation of private health institutions was found to be the factor influencing task performance of community organization, management of primary health post, technical supervision of health personnels. Job satisfaction of CHPs was also found to be the factor influencing task performance of family planning, management of common disease and maintenance of health information system.

• Journal of Genetic Medicine
• /
• v.16 no.2
• /
• pp.67-70
• /
• 2019

Limb-girdle muscular dystrophy (LGMD) is a group of muscular dystrophies that has extremely heterogeneous clinical features and genetic background. The caveolin-3 gene (CAV3) is one of the causative genes. LGMD appears as a clinical continuum, from isolated skeletal muscle involvement to long QT syndrome. Here we report two patients without apparent muscle weakness in a family with CAV3 mutation. A 7-month-old Korean boy visited our muscle clinic because of an incidental finding of elevated serum creatine kinase (CK) concentration (680 IU/L, reference range, 20-270 IU/L) without clinical symptoms. The patient was born after an uneventful pregnancy and showed normal developmental milestones. He developed pseudohypertrophy of his calf muscle during the follow-up. We obtained a muscle biopsy at age 14 months, which showed size variations and degenerating/regenerating myofibers with endomysial fibrosis and immunohistochemical evidence of normal dystrophin. Under the impression of LGMD, we performed target panel sequencing and identified a heterozygous in-frame mutation of CAV3, c.307_312delGTGGTG (p.Val103_Val104del). Immunohistochemical staining of muscle indicated complete loss of caveolin-3 compared with normal control muscle, which supported the variant's pathogenicity. We performed segregation analysis and found that the patient's mother had the same variant with elevated serum CK level (972 IU/L). We report on autosomal dominant familial caveolinopathy caused by a pathogenic variant in CAV3, which was asymptomatic until the fourth decade. This case highlights the utility of next generation sequencing in the diagnosis of muscular dystrophies and the additive role of muscle biopsy to confirm the variants.

• Toxicological Research
• /
• v.29 no.1
• /
• pp.53-60
• /
• 2013

Studies on milk transfer of drugs in non-human primates (NHPs) are among the crucial components in the assessment of peri- and postnatal toxicity because of the similarity between NHPs and humans. To evaluate the milk transfer of valproic acid (VPA) in NHPs, the toxicokinetics of VPA, an antiepileptic drug, were studied in pregnant cynomolgus monkeys. VPA was administered once daily to pregnant cynomolgus monkeys at doses of 0, 30, 90, and 270 mg/kg by oral gavage from Day 100 of gestation (GD 100) to Day 31 of lactation (LD 31). Concentrations of VPA and its metabolite, 4-ene-VPA, in the maternal plasma on GD 100, GD 140, and LD 30, and concentrations of VPA and 4-ene-VPA in the offspring plasma and milk on LDs 30 and 31, respectively, were quantified using liquid chromatography tandem mass spectrometry (LC/MS/MS). After administration of a single oral dose of VPA to pregnant monkeys on GD 100, the concentrations of VPA and 4-ene-VPA were generally quantifiable in the plasma of all treatment groups up to 24 hr after administration, which showed that VPA was absorbed and that the monkeys were systemically exposed to VPA and 4-ene-VPA. After administration of multiple doses of VPA to the monkeys, VPA was detected in the pup's plasma and in milk taken on LD 30 and LD 31, respectively, which showed that VPA was transferred via milk, and the pup was exposed to VPA. Further, the concentration of VPA in the milk increased with an increase in the dose. Extremely low concentrations of 4-ene VPA were detected in the milk and in the pup plasma. In conclusion, pregnant monkeys were exposed to VPA and 4-ene-VPA after oral administration of VPA at doses of 30, 90, and 270 mg/kg/day from GD 100 to LD 31. VPA was transferred via milk, and the VPA exposure to the pup increased with an increase in the dose of VPA. The metabolite, 4-ene VPA, was present in extremely low concentrations (< 0.5 ${\mu}g/ml$) in the milk and in the pup plasma. In this study, we established methods to confirm milk transfer in NHPs, such as mating and diagnosis of pregnancy by examining gestational sac with ultrasonography, collection of milk and pup plasma and determination of toxicokinetics, using cynomolgus monkeys.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.17
• /
• pp.7467-7472
• /
• 2015

Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.22 no.1
• /
• pp.32-50
• /
• 2008

This study is concerned with examining the causes and symptoms of Woman various diseases and clearing up the situations of pulses and their treatment. Woman various diseases are said to be various kinds of diseases including the disorder of menstruation and genitals except pregnancy and postpartum diseases. The main contents are the penetration of heat into worm, the discharge of much blood, stomachache, and the postpartum cyst diseases. Among them, the nature of the diseases which often occur in the gynecology, such as the menstrual diseases and stomachache, were described comparatively in detail. The reason why heat penetrates into the worm is that the external germs come into it under its weakness. To treat it, heat should be removed and lumping blood should be sent out of body. Especially only after whether the disease is serious or not is examined, and just after the process of the disease is examined, the lumping blood can be eliminated. The ways to cure it by sweating a patient too much, getting him or her to vomit, or forcing him or her to be urinated too much, should be avoided. The disorder of menstruation, as the disease which most often occur among the diseases of gynecology, includes menstrual irregularity and blood discharge, and non-menstruation. Among them, non-menstruation and blood discharge are comparatively often discussed. When they are treated, lumping blood and cold energy should be cured well through getting rid of the lumping blood and making the blood vessel flow well. The difficult urination after childbirth, which comes from the weak urinary cist, makes symptoms such as the stuffy chest, the difficulty of lying down, and breathing with his or her back something. To urinate better, the ability of the urinary cist should be supplemented and improved. The principle of the treatment for Woman various diseases is to examine the situation of the pulse closely, then set up the way to treat it, and prescribe a patient. In this study, besides the treatment of Chinese herb medicine, the medicine for washing genitals and the medicine placed in the worm were used to cure Woman various diseases. This treatment is the beginning of the surgical treatment in the gynecology.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.32 no.1
• /
• pp.73-84
• /
• 2019

Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

• Journal of Embryo Transfer
• /
• v.31 no.3
• /
• pp.255-260
• /
• 2016

The aim of this study is to evaluate the effects of vitamin or mineral supplements on the conception rates of dairy heifers when replacing the last injection of GnRH with hCG in ovsynch protocol (experiment 1) and also to investigate whether the estrus synchronization treatment in the heifer stage affects the conception rates after $1^{st}$ parturition (experiment 2). In experiment 1, 50 heifers were randomly assigned into 3 groups: 20 heifers each in groups 1 and 2, and 10 in group 3. All three groups were treated with an intramuscular injection of GnRH on day 0 (day 0 = the day of program start), $PGF_{2{\alpha}}$ on day 7 and hCG on day 9, and were inseminated on day 10, 12~16h after hCG injection. In group 1 (vitamin group), the heifers were treated with an intramuscular injection of 5 ml of vitamin-ADE $500^{(R)}$, and group 2 (mineral group) was treated twice with an intramuscular injection of 30 ml of mineral supplement-LAPTOVET$^{(R)}$ on a one-week interval beginning on the day of hormone treatment (day 0 and day 7 respectively). Group 3 (control) was treated only with hormones. Pregnancy diagnosis was performed by ultrasonography through a rectal probe. First service conception rates (FSCR) and average services per conception (ASPC) were recorded for all subjects. Of the total 50 heifers, 6 (2 in group 1, 3 in group 2, and 1 in group 3) heifers were eliminated due to accidents during experiment 1. FSCRs were 58.8% (10/17), 66.7% (12/18) and 44.4% (4/9) in groups 1, 2 and 3, respectively. ASPCs were $1.53{\pm}0.72$, $1.27{\pm}0.59$ and $1.63{\pm}0.74$ in groups 1, 2 and 3, respectively. Although there were no significant difference between the groups, relatively good results (higher FSCR and lower ASPC) were obtained in both group 1 and 2. In experiment 2, 11 primiparous cows from group 2 of experiment 1 in heifer stage which had been treated both with the hormones for estrus synchronizing and mineral supplements (ES group), and 12 primiparous cows treated only with minerals (non-ES group) were compared to examine the effects of estrus synchronization program on conception rates after $1^{st}$ parturition. Following the examination, postpartum ASPCs were $1.55{\pm}0.82$ and $2.17{\pm}1.47$ in ES group and non-ES group, respectively. The postpartum average days open (ADO) were $116{\pm}56$ and $197{\pm}93$ in ES group and non-ES group, respectively. Although there were no significant difference between the two groups, desirable results (lower ASPC and shorter ADO) were found in ES group after $1^{st}$ parturiton. In conclusion, experiment 1 indicates that vitamin or mineral supplement with ovsynch protocol may have some positive effect on FSCR and ASPC of dairy heifers, and in experiment 2, ES program in heifer stage had a positive effect on ASPC and ADO following $1^{st}$ parturition.

• Journal of the Korean Society of Radiology
• /
• v.6 no.6
• /
• pp.441-445
• /
• 2012

X-ray Chest P-A is very important and basic diagnosis examination for pregnant women. For a pregnancy period pregnant women should be treated very carefully not to be exposed to any radiation which might cause harmful damage to women and babies as well. Lead apron is one of the effective methods to protect pregnant women from the X-ray radiation. However, it is difficult to obtain the accurate position of pregnant women during X-ray Chest P-A since conventional lead apron method forces pregnant women to hold the apron by themselves only to make pregnant women very uncomfortable and hard to maintain accurate position during radiation. As a consequence, it is common to get low quality images of X-ray Chest P-A due to the overlap of apex of lung and scapular. In order to fix this problem, we made new design lead apron that allowed pregnant women to be more comfortable to maintain accurate position during X-ray Chest P-A position. Finally, with this new design lead apron, it was possible to get the best optimized images of X-ray Chest P-A of pregnant women by minimizing overlapping apex of lung and scapular.

• Journal of Genetic Medicine
• /
• v.17 no.1
• /
• pp.11-15
• /
• 2020

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12⁺¹ (9⁺³ to 27⁺¹) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion: NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.

• Journal of Genetic Medicine
• /
• v.8 no.2
• /
• pp.135-138
• /
• 2011

The authors of the present study report the prenatal detection of a chromosomal abnormality with additional satellites on the distal short arm of chromosome 8. A 35-year-old woman was referred for amniocentesis because of her advanced maternal age and positive result for maternal serum screening test. Cytogenetic analysis of cultured amniocytes showed a satellite 8p chromosome. The satellite 8p chromosome was positive for nucleolus organizer region (NOR) staining. The parents' karyotypes were normal. Fluorescence in situ hybridization (FISH) study for metaphases of fetal amniocytes revealed a cryptic translocation of chromosomes 8p and 22p. The fetal karyotype was described as 46,XY,8ps.ish t(8;22)(p23.3;p11.2) (D8S504-;D8S504+)dn. The parents decided to continue the pregnancy and a phenotypically normal boy was born at 38 weeks of gestation. In case of de novo terminal NORs detected prenatally, more accurate cytogenetic and molecular analysis should be performed in order to rule out cryptic chromosomal rearrangement among other chromosomes.