• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.1-10
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• 2019

Purpose: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. Methods: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for ${\beta}-lactams$ and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. Results: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. Conclusions: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.

• The Korean Journal of Vision Science
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• v.20 no.4
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• pp.497-504
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• 2018

Purpose : The purpose of this study was to investigate the temperature changes of the ocular surface before and after cataract surgery using thermography of a thermal imaging camera. Methods : The study included 75 patients (75 eyes) aged from 50 to 79 years who underwent cataract surgery. In the past, those who underwent corneal-related surgery, wearing contact lens, disorder of tear secretion and taking medication for systemic disease were excluded from this study. The temperature changes of the eyeball surface were measured using a thermal imager (Cox CX series, Answer, Korea) following Tear Break Up Time (TBUT) test, Mcmonnies questionnaire and Schirmer's Test in real time, Results : While the temperature of preoperative ocular surface was $35.20{\pm}0.54^{\circ}C$ and that of postoperative temperature was $35.30{\pm}0.53^{\circ}C$, the difference was not significant. The temperature changes in the ocular surface were statistically significant at $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) before the surgery and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) after the surgery. In comparison of the age groups, it was shown that the changes in the surface temperature before the surgery were from $-0.19{\pm}0.05{\Delta}$ ($^{\circ}C/sec$) to $-0.14{\pm}0.09{\Delta}$ ($^{\circ}C/sec$) in the 50s group, and from $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) to $-0.15{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) in 60s group, and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C$) to $-0.12{\pm}0.08{\Delta}/sec$) in the 70s group, showing significant changes in the ocular surface temperature at all ages. Conclusion : Following the cataract surgery, all the indicators of dry eye syndrome were decreased, and eye surface temperature changes were significant. The thermography technique of the ocular surface would be expected to be useful for the evaluation of various dry eye syndromes because it is easy to evaluate dry eye syndrome noninvasively and can be quantified.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.540-546
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• 2018

Purpose: The purpose of this study was to suggest a multimodal diagnostic approach to determine the cause of the disease in patients diagnosed with synovitis of the wrist and who underwent synovectomy. Materials and Methods: Twenty-nine patients, who underwent contrast magnetic resonance imaging (MRI) preoperatively and synovectomy from January 2000 to December 2013, were reviewed retrospectively. Among them, 17 patients underwent a $Tc^{99m}$ white blood cell (WBC) scan preoperatively. In patients who met the diagnostic criteria of rheumatoid arthritis (RA), the diagnosis was confirmed as RA if the MRI finding or histology was compatible with RA. If the MRI finding and histology were disparate, the final diagnosis was made based on the histologic finding. Results: Of the nine patients who met the diagnostic criteria of RA, seven patients were finally diagnosed as RA and two patients as tuberculous arthritis. Of the 20 patients who did not meet the diagnostic criteria of RA, the MRI findings and histology were consistent with the same disease in 12 patients. In the remaining eight patients, five were diagnosed with nonspecific chronic synovitis, one with RA, and two with tuberculous arthritis based on the clinical findings, MRI, and histology findings. Conclusion: MRI and a WBC scan are very useful imaging modalities for diagnosing the causative condition of the wrist synovitis. A histology evaluation after synovectomy can also be useful in cases with a difficult diagnosis or are refractory to medications.

• Journal of vocational education research
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• v.37 no.2
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• pp.39-75
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• 2018

The purpose of this study is to verify the general characteristics in the previous studies and the magnitude of the correlation between the learner's satisfaction and the academic achievement in the education and training program. To do this, we searched relevant literature from 2000 to 2016, and conducted a systematic review of the literature on the final 31 studies through the selection criteria and quality evaluation. Among them, 27 meta-analysis of the literature was conducted. The finding of the study were as follows. First, a total of 31 studies were conducted from 2000 to 2016, and more than half of them(16) were conducted for the last 4 years(2009~2012). In terms of education and training students, there are 18 college students, 9 workers, and 4 elementary students in order of study. In terms of methods, 15 collective education, 14 distance education, 2 blended education. In terms of learner's participation, 22 the general participation, 9 the active participation. Second, as a result of the meta-analysis, the magnitude of the correlation between satisfaction and achievement was moderate(ZCOR=.297, 95%: CI .210~.383). Third, as a result of verifying the difference in the magnitude of the correlation effect between satisfaction and achievement according to the characteristics of the education and training program, there was no difference between the groups in the student object and education method, but there was a difference in the magnitude of the correlation effect depending on the participant type(Q=15.40, df=1, p<.0001). The active participation showed a correlation effect size larger(ZCOR=.588, 95%: CI .422~.754). The effect size of the general participation was lower than the median(ZCOR=.211, 95%: CI .12 ~.300).

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.42-49
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• 2019

Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.

• Korean Journal of Heritage: History & Science
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• v.44 no.4
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• pp.18-41
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• 2011

The Safeguarding of Intangible Cultural Heritage in Korea has begun since1962 when the Cultural Properties Protection Act was established. Korean ICH Safeguarding system is initially derived from Cultural Properties Protection Act in Japan. Japan has started Important ICH Designation System in 1954 to concede the skills and artistic talents holders, thus it could implement the multilateral system management for adopting different ICH protection systems such as Important Intangible Folklore Properties, Selection and Preservation Techniques, and Documenting Records. However, Korea has solely adopted Important ICH Designation System since Cultural Properties Protection Act was introduced. Korean ICH Safeguarding System represented by the Certification System of ICH Skill Holders is to ensure skills and artistic holders who perform the elements of Intangible Cultural Heritage, and manage the safeguarding of intangible cultural heritage in order to let the skills and artistic holders instruct inheritors. As a result, it could build up the internal foundation for the diffusion of inheritors and established the related organizations. However, the inheritor-centered protection system has caused many problems as it is being lasted for more than fifty years. Fragmented designation measures, the cultural power of skill holders, and the research and evaluation methods have pointed out the difficulties of safeguarding and preservation measures of ICH. Moreover,the legitimacy of safeguarding system related in the authenticity of transmission in ICH has emerged to review the safeguarding system of ICH with diverse viewpoints. Therefore, this paper will review the implementation process and achievement of ICH safeguarding system to examine the problem and causes of the safeguarding system. The conference records of Cultural Property Association and articles of cultural properties policies directors, Cultural Property Association members, and professional experts are being used for the initial materials of this paper, and it is examined for the contents of designation system of Important Cultural Heritage, rather than overall cases. Thus such problems the limitation of expansion in ICH lists as inheritor-centered designation system, hierarchical and exclusive transmission system, inappropriate concept of archetype as the principle of ICH transmission are derived from the root of Important ICH designation system. Thus this paper demonstrates that this system must be revised for the expansion of ICH safeguarding system in Korea and points out multilateral protection system should be established as well as Certification System of Important ICH skill holders.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.29-34
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• 2019

Purpose An examination guide is a useful medium to provide the patient with an overview, pre- and post-test preparation, and precautions of nuclear testing. The design and arrangement of existing written texts and announcements were evaluated to elucidate the comprehension of patients undergoing testing. Materials and Methods Informational material describing bone scanning and $^{201}thallium$ myocardium perfusion single-photon emission computed tomography (SPECT), as a secondary examination, which accounts for the largest portion of gamma imaging at Asan Hospital (Seoul, South Korea), was selected as an improvement target in consultation with a national innovation center. Existing informational material was dispensed to patients scheduled for bone scans from November 2016 to February 2017 and the revised material was issued from March 2017 to May 2017. A survey was conducted of 200 patients who underwent $^{201}thallium$ myocardium perfusion SPECT before and after the revisions (n = 100 each time period) to assess the patients' understanding of the informational material. Results When comparing the use of the conventional vs. revised material, the number of patients who received treatment before bone scanning had decreased from 130 to 60, while the number of those who required additional imaging decreased from 53 to 14. Prior to the revision, 43% of patients underwent testing before preparation and 18% underwent additional testing. The decreased need for additional image acquisition after revision of the informational material resulted in a decrease in acquisition time of about 2 min, from 16.5 to 14.2 min. In the case of $^{201}thallium$ myocardium perfusion SPECT, patient comprehension of all five items surveyed had increased, while the number of patients who had repeatedly asked about various facets of the procedure pre- and post-testing had decreased from 36% to 16% and 31% to 14%, respectively. Conclusion Lower patient comprehension is accompanied by a decrease in image quality due to non-compliance during pre-testing and may lead to repetitive questions from the patient, which may also negatively affect the fatigue and work efficiency of the examiner. Improved readability and visibility of informational material through visualization was correlated with greater patient comprehension as well as improved image quality and acquisition time.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.81-88
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• 2019

Purpose: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). Methods: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at $-70^{\circ}C$ until use. Tests with Ribotest $Mycoplasma^{(R)}$ were performed and interpreted independently by two investigators who were blinded to the culture results. Results: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$. When culture was used as the standard test, the sensitivity and specificity of Ribotest $Mycoplasma^{(R)}$ were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest $Mycoplasma^{(R)}$ were 94.9%, 67.2%, and 77.2%, respectively. Conclusions: A positive test result of Ribotest $Mycoplasma^{(R)}$ suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.2
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• pp.29-37
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• 2019

Purpose DMIDR(Discovery Molecular Imaging Digital Ready, General Electric Healthcare, USA) is a PET/CT scanner designed to allow application of PSF(Point Spread Function), TOF(Time of Flight) and Q.Clear algorithm. Especially, Q.Clear is a reconstruction algorithm which can overcome the limitation of OSEM(Ordered Subset Expectation Maximization) and reduce the image noise based on voxel unit. The aim of this paper is to evaluate the performance of reconstruction algorithms and optimize the algorithm combination to improve the accurate SUV(Standardized Uptake Value) measurement and lesion detectability. Materials and Methods PET phantom was filled with $^{18}F-FDG$ radioactivity concentration ratio of hot to background was in a ratio of 2:1, 4:1 and 8:1. Scan was performed using the NEMA protocols. Scan data was reconstructed using combination of (1)VPFX(VUE point FX(TOF)), (2)VPHD-S(VUE Point HD+PSF), (3)VPFX-S (TOF+PSF), (4)QCHD-S-400((VUE Point HD+Q.Clear(${\beta}-strength$ 400)+PSF), (5)QCFX-S-400(TOF +Q.Clear(${\beta}-strength$ 400)+PSF), (6)QCHD-S-50(VUE Point HD+Q.Clear(${\beta}-strength$ 50)+PSF) and (7)QCFX-S-50(TOF+Q.Clear(${\beta}-strength$ 50)+PSF). CR(Contrast Recovery) and BV(Background Variability) were compared. Also, SNR(Signal to Noise Ratio) and RC(Recovery Coefficient) of counts and SUV were compared respectively. Results VPFX-S showed the highest CR value in sphere size of 10 and 13 mm, and QCFX-S-50 showed the highest value in spheres greater than 17 mm. In comparison of BV and SNR, QCFX-S-400 and QCHD-S-400 showed good results. The results of SUV measurement were proportional to the H/B ratio. RC for SUV is in inverse proportion to the H/B ratio and QCFX-S-50 showed highest value. In addition, reconstruction algorithm of Q.Clear using 400 of ${\beta}-strength$ showed lower value. Conclusion When higher ${\beta}-strength$ was applied Q.Clear showed better image quality by reducing the noise. On the contrary, lower ${\beta}-strength$ was applied Q.Clear showed that sharpness increase and PVE(Partial Volume Effect) decrease, so it is possible to measure SUV based on high RC comparing to conventional reconstruction conditions. An appropriate choice of these reconstruction algorithm can improve the accuracy and lesion detectability. In this reason, it is necessary to optimize the algorithm parameter according to the purpose.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.2
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• pp.20-24
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• 2019

Purpose Molecular Breast Imaging (MBI) scan is used in nuclear medicine, for which $^{99m}Tc-sestaMIBI$ is administered by intravenous injection. However, the breast uptake rate of $^{99m}Tc-sestaMIBI$ is less than 1% of the total dose administered, relying on blood flow conditions of organs. The purpose of this study is to evaluate the impact of changes to body temperature on the uptake of $^{99m}Tc-sestaMIBI$ in breast tissue. Materials and Methods We investigated 30 breast cancer patients who performed more than one follow-up MBI scan. All scans were acquired by Discovery 750B (Genral Electric Healthcare, USA). $^{99m}Tc-sestaMIBI$ injected with 740 MBq (20 mCi), after 60 minutes, gained bilateral breast CC (CranioCaudal), MLO (Medio Lateral Oblique) View. The follow-up examination was then classified into 15 body temperature control group and 15 body temperature non-control group, and gained breast image in the same way as before. The breast uptake rate was analyzed in the MLO View of the opposite side of the lesion, and blind images were evaluated. Results The breast uptake rate increased by 30.31% in the body temperature control group and it was statistically significant(P<0.05), and 0.96% in the body temperature non-control group, and it was not statistically significant(P=0.955). There was a significant difference in the uptake rate between the body temperature control and the non-control group of P value of 0.01. Evaluation of blind images showed significant results in terms of the quality of the images. Conclusion Increased breast tissue uptake was observed when the subject was kept warm. When the body temperature was raised after injection, dilation of the peripheral blood vessels can be achieved. As a result, the blood flow became smooth and the breast uptake rate increased. In addition, an increase in breast tissue uptake will improve the quality of images.