• Clinical and Experimental Vaccine Research
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• v.13 no.2
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• pp.91-104
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• 2024

This narrative review describes genomic characteristic, serotyping, immunogenicity, and vaccine development of Streptococcus pneumoniae capsular polysaccharide (CPS). CPS is a primary virulence factor of S. pneumoniae. The genomic characteristics of S. pneumoniae CPS, including the role of biosynthetic gene and genetic variation within cps (capsule polysaccharide) locus which may lead to serotype replacement are still being investigated. One hundred unique serotypes of S. pneumoniae have been identified through various methods of serotyping using phenotypic and genotypic approach. The advantages and limitations of each method are various, emphasizing the need for accurate and comprehensive serotyping for effective disease surveillance and vaccine targeting. In addition, we elaborate the critical role of CPS in vaccine development by providing an overview of immunogenicity, ongoing research of pneumococcal vaccines, and the impact on disease burden.

• The Korean Journal of Medicine
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• v.99 no.2
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• pp.61-68
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• 2024

Chronic Kidney Disease (CKD) is a major global health burden. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated potential in slowing CKD progression. We evaluated the expanding role of SGLT2 inhibitors, emphasizing their renoprotective benefits in diabetic and non-diabetic CKD patients. We also investigated the underlying mechanisms, including the reduction of glomerular hypertension via modulation of tubuloglomerular feedback. Our study critically analyzed current indications for SGLT2 inhibitor therapy based on recent clinical trial data. To optimize patient outcomes, we present a comprehensive analysis of practical considerations for the prescription of SGLT2 inhibitors, including the potential initial decline in the estimated glomerular filtration rate and a review of adverse events.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.184-190
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• 2021

Objectives : Dementia is one of the most distressing mental health problems in the older population. Caregivers also experienced physical, psychological, and emotional stress from taking care of dementia patients. So, we developed program for supporting dementia caregiver and evaluated its efficacy on reducing caregiver burden. Methods : We provided 5 sessions of dementia caregiver supporting program to 30 caregivers who were taking care of dementia patient in their home. Program was held in Cheonan Center for Alzheimer's disease and other dementia that was established by Cheonan city government for supporting dementia patients and their caregivers. We evaluated caregiver burden using short Zarit burden inventory consisted of 12 items scoring 0 (no burden) to 4 (everyday burden) before and after program. We evaluated satisfaction of caregiver about program using satisfaction survey consisted of 10 items scoring 0 (very dissatisfy) to 4 (very satisfy) after program. Results : Mean age of caregiver was 61.9. 40.0% (n=12) of caregivers were spouse. 53.3% (n=16) of caregivers were son or daughter. Caregiver burden that was estimated by short Zarit burden inventory were significantly decreased after program (p<0.001). When each item was compared, 4 items (7, 10, 11 and 12) were significantly decreased after program (p=0.036, p=0.018, p=0.01, p=0.024). All mean scores of 10 items about satisfaction were over 3 meaning that participants generally satisfied to program. Conclusions : Our study suggested that dementia caregiver supporting program could reduce caregiver burden and provide satisfaction. Therefore, programs for supporting dementia caregivers might be important as well as treating dementia patients. So, we should be interested in developing and providing efficiently this kind of program to reduce caregiver burden.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.344-357
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• 1998

This study was designed to construct a model that predicts the quality of life of family caregivers with a chronically ill patient. The hypothetical model was developed based on the findings from past studies on quality of life and on the family with a chronically ill patient. Data were collected by self-reported questionnaires from 200 family caregivers in Seoul & Kyung Gi-Do, from May 1 to July 21, 1997. Data were analyzed using descriptive statistics and correlation analysis. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which predicts causal relationships among variables. The results are as follows : 1. The overall fit of the hypothetical model to the data was moderate [X$^2$=31.54(df=23, p=.11), GFI=.96, AGFI=.91, RMR=.04]. 2. Paths of the model were modified by considering both its theoretical implication and the statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data expect chi-square value(GFI=.95, AGFI=.91, RMR=.04). 3. Some of predictive factors, especially economic status, physical ability to perform daily-life activity, period after disease-onset, social support and fatigue revealed indirect effects on the quality of life of family caregivers with a chronically ill patient. 4. The factors, burden and role satisfaction revealed significant direct effects on the quality of life of family caregivers with a chronically ill patient. 5. All predictive variables of quality of life of family caregivers with a chronically ill patient, especially economic status, physical ability to perform daily-life activity, period after disease-onset, social support, fatigue, burden and role satisfaction explained 38.0% of the total variance in the model. In conclusion, the derived model in this study is considered appropriate in explaining and predicting quality of life of family caregivers with a chronically ill patient. Therefore it can effectively be used as a reference model for further studies and suggests direction in nursing practice.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.154-164
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• 2017

Purpose: Measurement of the root surface area (RSA) is important in periodontal treatment and for the evaluation of periodontal disease as a risk factor for systemic disease. The aim of this study was to measure the RSA at 6 mm below the cementoenamel junction (CEJ) using the Mimics software (Materialise, Leuven, Belgium). Methods: We obtained cone-beam computed tomography (CBCT) data from 33 patients who had visited the Department of Oral and Maxillofacial Radiology of Dankook University Dental Hospital. The patients comprised 17 men and 16 women aged from 20 to 35 years, with a mean age of 24.4 years. Only morphologically intact teeth were included in our data. Because the third molars of the maxilla and mandible have a high deformation rate and were absent in some participants, they were not included in our research material. Results: The CBCT data were reconstructed into 3-dimensional (3D) teeth models using the Mimics software, and the RSA at 6 mm below the CEJ was separated and measured using 3-Matic (Materialise). In total, 924 3D teeth models were created, and the area at 6 mm below the CEJ could be isolated in all the models. The area at 6 mm below the CEJ was measured in all teeth from the 33 patients and compared based on sex and position (maxilla vs. mandible). Conclusions: In this study, we demonstrated that it was feasible to generate 3D data and to evaluate RSA values using CBCT and the Mimics software. These results provide deeper insights into the relationship between periodontal inflammatory burden and systemic diseases.

• Safety and Health at Work
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• v.4 no.2
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• pp.77-83
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• 2013

There is still a considerable burden of occupational diseases and injuries in the world. It is not well known which interventions can effectively reduce the exposures at work that cause this burden. The objective of this article is to summarize evidence from systematic reviews of interventions to prevent occupational diseases and injuries. We included systematic reviews of interventions to reduce the incidence of work-related cancer, dust-related diseases, occupational asthma, chronic obstructive pulmonary disease, noise induced hearing loss, back pain, and occupational injuries. We searched Medline and Embase with predefined search strategies to locate systematic reviews of these interventions. We found 23 systematic reviews of which the results are also applicable to low- and middle income countries. Effective measures to reduce exposure leading to work-related cancer, dust-related diseases, asthma, chronic obstructive pulmonary disease, noise, and injuries are available. However, better implementation of these measures is needed. Regulation, enforcement of regulation, and incentives for employers are effective interventions to achieve this goal. There is evidence that feedback and rewards for workers help in reducing occupational injuries. There is no evidence in many studies that back pain can be prevented. Personal protective equipment technically has the potential to reduce exposure but this is difficult to put into effect. There is no evidence in the studies regarding the effectiveness of education and training, preventive drugs, or health examinations. There is evidence that the implementation of technical measures enforced by regulation can prevent occupational diseases and injuries. For other interventions such as education or health examinations, there is no evidence that supports their effectiveness. More systematic reviews are needed in the area of injury prevention.

• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.141-148
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• 2021

There are very scant data on the epidemiology of primary immunodeficiency diseases (PIDs) in Korea. Here we attempted to estimate the PID epidemiology and disease burden in Korea. A systematic review was performed of studies retrieved from the PubMed, KoreaMed, and Google Scholar databases. Studies on PIDs published in Korean or English between January 2001 and November 2018 were analyzed. The number of PID patients and the healthcare costs were estimated from Health Insurance Review and Assessment Service (HIRA) Korea data for 2017. A total of 398 PID patients were identified from 101 reports. Immunodeficiencies affecting cellular and humoral immunity were reported in 11 patients, combined immunodeficiency with associated or syndromic features in 40, predominantly antibody deficiencies in 144, diseases of immune dysregulation in 58, congenital defects of phagocytes in 104, defects in the intrinsic and innate immunity in 1, auto-inflammatory disorders in 4, complement deficiencies in 36, and phenocopies of PID in none. From the HIRA reimbursement data, a total of 1,162 outpatients and 306 inpatients were treated for 8,166 and 6,149 days, respectively. In addition, reimbursement was requested for 8,200 outpatient and 1,090 inpatient cases and $1,924,000 and $4,715,000 were reimbursed in 2017, respectively. This study systematically reviewed published studies on PID and analyzed the national open data system of the HIRA to estimate the disease burden of PID, for the first time in Korea.

• Health Policy and Management
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• v.31 no.1
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• pp.100-113
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• 2021

Background: This study aims to figure out the gaps in health status by estimating amenable mortality rate by region, reflecting the characteristics of Korea, and estimating the years of life lost (YLL) per capita by disease. Methods: People who died from amenable diseases between 2008 and 2018 were extracted from the cause of death statistics provided by Statistics Korea. The age-standardized amenable mortality rates were estimated to compare the health status of 229 regions. YLL per capita was calculated to compute the burden of diseases caused by treatable deaths by region. The YLL per capita by region was calculated to identify the burden of disease caused by amenable deaths. Results: First, while the annual amenable mortality rate in Korea is on a steady decline, but there is still a considerable gap between urban and rural areas when comparing the mortality rates of 229 areas. Second, YLL per capita due to the amenable deaths is approximately 14 person-years during the analysis period (2008-2018). Conclusion: Although the health status of Koreans has continuously improved, there is still a gap in health status region by region in terms of amenable mortality rates. Amenable death accounts for a loss of life equivalent to 14 person-years per year. Since the amenable mortality rate is an indicator that can measure the performance of the health care system, efforts at each local area are required to lower it.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4639-4643
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• 2012

The burden of lung cancer in terms of mortality is the highest among all types of cancers globally. The present study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lung cancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010. A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer cases in 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above 50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smoking habit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accounted for 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasis and the remainder had regional lymph node involvement. However, no statistically significant difference was observed for secondary site of tumor according to gender. As majority of the cases reported at MCC were in an advanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was taken for diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondary prevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lung cancer burden in Kerala.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.1-9
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• 1988

The left atrial [LA] dimension and atrial fibrillation [AF] in patients with mitral valvular heart diseases have been thought to be related to hemodynamic burden to the LA depending on severity of stenosis or regurgitation of mitral valve, left ventricular contractility and the heart conditions. If hemodynamic burden persists long, it can affect the LA wall and structural change of the LA wall itself can developed. So the structural change of the LA wall could be thought to be related to the LA dimension and AF. To verify this relation, the LA wall biopsy was performed in 26 patients with rheumatic mitral valvular heart disease at the left atriotomy incision margin which was posterior to the interatrial groove after completion of surgery to the mitral valve such as valve replacement or commissurotomy. Relation of the pathological state of the LA wall to AF and the LA dimension measured by M-mode echocardiography was studied. The conclusions were as follow. 1. There was tendency that degree of fibrosis of myocardium of the LA wall was related to the LA dimension. 2. There was more chance that patients who had severe fibrosis of myocardium of the LA wall had pre and postoperative AF. 3. There was no relation between reduction rate of the LA dimension before and after surgery and degree of fibrosis of myocardium of the LA wall.