• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1147-1152
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• 2009

Purpose:To characterize the pathogens and their antibiotic susceptibilities in more than 24-month-old children with urinary tract infection (UTI) and to study the Escherichia coli antimicrobial susceptibility trend. Methods:We retrospectively reviewed the record of more than 24-month-old children with UTI between January 2003 and December 2008. Positive results for 1 bacterial species with a colony count of ${\geq}10^5CFU/mL$ was considered statistically significant. We analyzed uropathogens and their antibiotic susceptibilities. To investigate E. coli antibiotic susceptibility trend, we compared 2 study periods (group A: 2003-2005 versus group B: 2006-2008) using the chi-square test for trend. Results:In all, 63 bacterial isolates were identified in children with febrile UTI. The most common pathogen was E. coli (77.8%). There was no difference in the resistance patterns of uropathogens during the 2 study periods (P>0.05). Antibiotic susceptibility of the E. coli isolates to aztreonam, cefotetan, cefotaxime, ceftriaxone, cefepime, amikacin, and imipenem was >90% to trimethoprim/sulfamethoxazol, 49% and to ampicillin and ampicillin/sulbactam, 20-25%. Over the 2 study period, the E. coli susceptibilities to most antibiotics did not change: the susceptibility to cefuroxime increased from 74.1% to 95.5% (P=0.046) and that to ciprofloxacin increased from 59.3% to 86.4% (P=0.039). Conclusion:Empirical treatment with trimethoprim/sulfamethoxazole, ampicillin, and ampicillin/sulbactam alone appeared to be insufficient in childhood UTI because of the high resistance of E. coli and other gram-negative uropathogens. Antibiotics for empirical therapy should be selected based on the sensitivity and resistance pattern of uropathogens found in a particular region.

• Journal of Korean Academy of Nursing
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• v.5 no.2
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• pp.74-91
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• 1975

A purpose of this study was to compare the breast massage and manual expression of the breast before engagement after delivery with the time of engagement, the throbbing pain in breast, the first amount of breast milk and involution of the uterus. The subjects selected for this study were 138 women (experimental group;69, control group :69) who were admitted to the Dept. of Obtest. and Gyneco. of Kyung Hee University Hospital from Jan. 5 to June 5, 1975. The results of study were as follows; 1 The average age of the women 26.9 years old in the experimental group and 27.6 years old in the control group. As to religion, the number of those who had no religion was 58.0 percent and 62.4 percent respectively. Classified according to occupation, there were 87.0 percent in house wives of the booths group. Educational background; 87.0 percent of high school graduates or above, 78.3 percent respectively. The occupation of husband 53.7 percent of company employees stood highest and 42.0 percent respectively. In according to the grade of wards, 55.1 percent and 52.2 percent of four-men room stood highest. 2. Physical condition: Body weight before this Pregnancy(T=0.4962, N.S.), the size of breast(X²df2 = 0.1728, N.S.), the shape of nipple(X²df3 =1.3804, N.S.), hemoglobin's level of the first day after delivery(T=1.2572, N.S.), the above were showed non significant between the experimental group and control group The investigator found any difference between the two groups of the health condition during the pregnancy, 3. The rate of no experience of breast massage during pregnancy was 85 percent and 75.4 percent (X²df1=2.2562, N.S.). 4. As to the meal during hospitalization after delivery: The booth of the groups in ordinary food took usually of meyer soup and milk(X²df8=2.5957, N.S.). 5. The relation between the first step of breast massage, second step of the manual expression of breast before engagement after delivery and time of engagement : average time of engagement in the experimental group (2.1 days±0.8) was shortened than the control group (3.3 days±1.2). (T=-6.9045, P< 0.005). It toot less time in the experimental group of primipara(2.2days±0.7) than in the control group (3.1day±1.2) and it also took less time in the experimental group of multipara (2.0 days±0.9) than in the control group (3.5days±1.4). (Primipara T=-3.9266, 0< 0.005. Multipara T= 5.2356, P<0.005). 6. The relationship between the first step of the massage and second step of manual expression and the throbbing pain at the time of engagement: The experimental group showed less effect than control group (X²df4= 27.3342 P<0.005). The separate study of primipara and multipara showed remarkable difference in the group of primipara)X²df4=20.7285, p<0.005) and little difference in the multipara group (X²df4=8.8351, p< 0. 10). 7. The relationship between the first step of the breast massage, second stop of the manual expression and first amount of breast milk: The average amount of breast milk increased more conspicuously in the experimental group (33.8㎖±23.4) than in the control(29.8㎖±25.3) (T=0.8262, N.S.). No remarkable difference was found in the respective groups that investigated in the groups of primipara and of multipara. (Primipara T=1.1467, N.S., Multipara T=-0.0354, N.S.). 8. The relationship between the first step of breast massage and second step of manual expression of breast and involution of uterus : Average time needed for uttering involution was sooner in the experimental group of primipasa(-3.3 F.B.±1.1), than the control group of primipara (-2.5F. B.±1.2), and it was sooner in the experimental group of muitipara (-3.0 F. B.±l..3), than the control group of multipara(-2.3 F.B±0.9). Primipara T=-2.9272, p< 0.005, Multipara T=2.5557, p< 0.01).

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.425-431
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• 2020

The purpose of this study was to provide nurses with the basic data to prepare nurses for systematic job embeddedness, job stress, and burnout in small and medium-sized hospitals and to identify any correlations. The data were collected between 1 November 2018 and 28 February 2019. The factors and general characteristics influencing the job embeddedness were found to be position (t=3.53, p<.001), total career (F=3.46, p=.034), current career (F=5.59, p=.004), and turnover experience (t=-1.72, p=.008). The job embeddedness was negatively correlated with the awareness of burnout (r=-.570, p<.001) and job stress (r=-.349, p<.001). Burnout (β=-.570, p<.001) and job stress (β=-.552, p<.001) had significant effects on job embeddedness (F=46.21, p<.001); the explanatory power of these variables was 34.9%. In other words, nurses in hospitals with fewer than 200 beds experienced higher job stress because they were exhausted. This suggests that it has a negative effect on job arrival, which is the intention to remain in the current organization. Therefore, it is necessary to manage exhaustion and job stress appropriately for the job.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.261-266
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• 1992

We analyzed retrospectively the patients of granulocytic sarcoma treated with radiotherapy at the Department of Radiation Oncology, Yonsei University College of Medicine from Mar 1987 to Mar.1992 in an attempt to review our experience with irradiation of granulocytic sarcoma and to evaluate the treatment results for the radiation dose response. Fourteen lesions of granulocytic sarcoma in 9 patients were developed in variable clinical settings such as AML, CML and without leukemia. The involved lesions were bone, lymph node, soft tissue and skin in descending order of occurrence. All of the lesions in 9 patients were treated with external beam radiotherapy (Co-60 or electron beam). Both age distribution and clinical settings did not show any correlation with the response to treatment. The response to treatment seemed to be better for lesions in the bone than in other involved lesions. The majority received local irradiation of a total dose of more than 2000 cGy. Radiation dose of more than 2000 cGy showed excellent local control of $100\%$, (11/11), while local control decreased to $33\%$(1/3) with total dose less than 2000 cGy. In conclusion, local radiotherapy seems to be very effective for palliative or curative aim of granulocytic sarcoma, and a radiation dose more than 2000 cGy is highly recommended.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.165-170
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• 2016

Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

• Radiation Oncology Journal
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• v.32 no.3
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• pp.138-146
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• 2014

Purpose: This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. Materials and Methods: A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. Results: After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. Conclusion: The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.

• Proceedings of the Technology Innovation Conference
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• 1998.06a
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• pp.131-163
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• 1998

The interest in the evaluation of government-sponsored research institutes (GRIs) has increased markedly in Korea in 1990s; this is mainly because of the increasing needs 1) to improve the quality of R&D at GRIs, and 2) to reorient the GRIs' strategic position in Korean national innovation systems due to the enhancement of R&D capabilities of private companies and universities during last decade. As a first attempt to diagnose the managerial and strategic issues of GRIs, a Multi-Ministerial Evaluation Committee was established as an ad hoc task force under the Prime Minister's Office in 1991. According to the recommendations of the committee, the Ministry of Science and Technology (MOST) to which most of GRIs were affiliated, made it a rule to evaluate the annual performance of GRIs since 1992. This paper examines the recent experience of MOST's evaluation of Government-sponsored Research Institute in Korea. After several years'efforts of Science & Technology Policy Institute(STEPI) to build prospective evaluation systenL MOST decided to apply two supplementary approaches for the evaluation of GRIs; one is summative annual evaluation and the other is formative 3-year evaluation. The annual evaluation system that is designed as a temporary measure is to monitor and to guide the self-evaluation activities of GRIs. In the process of annual evaluation, MOST tries to minimize its direct involvement, and allows each GRI to develop self-evaluation system that is most appropriate for the unique characteristics of the institute. If there exist urgent issues under scrutiny, however, it can be incorporated and examined by a group of external experts as special issues in the annual evaluation system. The aim of 3-year evaluation is both to examine the past performance of each GRI and to investigate whether the strategic role of each GRI is viable in the future. Its major focus, however, lies not on auditing past performance but on strengthening future strategic position of each GRI. The MOST designates a group of evaluation experts with appropriate knowledge and competence as members of the General Evaluation Committee for one year. With the help of STEPI, a specialized research institute for R&D evaluation, the General Evaluation Committee develops methodology and procedures for the actual evaluation of GRIs. Based on the evaluation reports and recommendations from the General Evaluation Committee, the MOST develops various policy measures for strengthening GRIs.

• Journal of Environmental Health Sciences
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• v.40 no.6
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• pp.492-501
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• 2014

Objectives: The purpose of this study was to assess the validity of self-reported cigarette smoking status and investigate factors associated with the accuracy self-reported and measured urinary cotinine in Korean adults. Methods: We used data from the $1^{st}$ Korean National Environmental Health Survey (2009-2011) among adults aged ${\geq}19$ years (N=6,246). The survey examined self-reported smoking status, and urinary cotinine was regarded as the biomarker of exposure to tobacco smoke. Urinary cotinine was analyzed using a gas chromatography-mass spectrometry (GC/MS) and data analysis was conducted using IBM SPSS version 20.0, which uses the sample weight and calculates variance estimates to adjust for the unequal probability of selection into the survey. Results: We calculated a cut-off point (53.3 ug/L) by using a ROC (Receiver Operating Characteristic) curve. The smoking prevalence was 24.6% based on self-reported data and 28.2% based on urinary cotinine concentrations. When we assessed the agreement between self-reported and urinary cotinine, we found an average agreement of 97.7% among self-reported smokers and 94.5% among self-reported non-smokers. Among self-reported smokers, factors affected the discrepancy were age, household economic status and average number of cigarettes smoked per day. On the other hand, gender, former smoking experience, and exposure to SHS (second hand smoke) were associated with discrepancies among self-reported non-smokers. Conclusion: These results suggest that self-reported data on smoking status provide a valid estimate of actual smoking status. In future research, we will conduct a continuous monitoring study for reliability verification of the data to reduce potential interpretation errors.

• Journal of Sasang Constitutional Medicine
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• v.8 no.2
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• pp.41-68
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• 1996

This thesis is a try for examining the historical characteristics of Constiutional medicine. For this purpose, I have examined their theory, and made a comparison carefully. Through this study, I have obtained several results as following. Both Chang and Lee lived in the time of change, which was unstable and uncertain. Under the condition, they both rejected following the existing trends of learned circles, and developed new thoughts and clinical techniques. They rejected superstitious beliefs and fatalism, and conducted the pursuit of experimental knowledge and rationale idea. Clinical experience was the very base of their study. They both criticized the bad habits of abuse of tonifing medication and health seeking. Especially Lee regarded control of emotion and regulation of a way of life as the best way for preservation of one's health. Chang regarded pathogenic factors as the ultimate factor of diseases, and strived for eliminating pathogenic factors, but L brought to a conclusion that the final factor of diseases was what is called "heart" itself, and emotional changes were the most essential causes of disease. It can be said that the pathogenesis insisted by Chang can be called The insistence that pathologic factors are the very etiology of all the disease (邪氣致病論), or all the diseases result from pathologic factors. And his whole remedy can be summarized as following, A study on the method of eliminating pathogenic factors. But the purpose of Constitutional medicine is to correct imbalance intrinsic to one's internal organs. In this aspect, Constitutional medicine is a "regulatory medicine". Depending on the classification of six vital substances, Chang classified all disease into six categories. These were based on symptoms and sings represented. While classification of diseases made by Lee was likely to rely upon constitutional characteristics. Chang thought that the three remedies made up of perspiration, purgation, vomiting were the most efficient way of eliminating pathogenic factors. Lee, however, thought those weren't methods of eliminating pathogenic factors but the best ways restoring one's self-regulation power. Chang thought that all the febrile disease essentially has a tendency in properties to belong to "heat", but Lee pointed out that pathologic processes are variable in accordance with constitutional features. They both regarded pathogenesis of diabetes as fire. That is to say, fire is the most essential factor of diabetes. And there are many risk factors such as inappropriate foods, drugs, climate, etc., but Lee thought what is most important is heart. Putting all accounts together, medical characteristics of Chang are similar to those of T aiyinjen and Shaoyangjen, and have no relation to those of those of Shaoyinjen. Therefore we can conclude that Chang understood pathologic processes of disease of T aiyinjen and Shaoyangjen, whether he knew about constitutional features or not.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.55-66
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• 2019

Background: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. Methods: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl $700{\mu}g$ was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. Results: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were $4.4{\pm}2.0$ and $3.7{\pm}1.9$ in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was $10.7{\pm}13.7$ and $8.6{\pm}8.5$, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. Conclusion: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.