• Pediatric Infection and Vaccine
• /
• v.15 no.1
• /
• pp.45-51
• /
• 2008

Purpose : Better understanding of the epidemiology of Streptococcus pneumoniae affects preventive and therapeutic strategies for children with otitis media. This study was undertaken to examine the prevalence of pneumococcal serotypes causing otitis media in children. Methods : Pneumococcal isolates obtained from the ear discharge of children with otitis media between January 2001 and December 2006 were characterized by serotyping and antibiotic susceptibility testing. Results : There were 54 pneumococcal isolates from 54 children with otitis media. The median age of patients was 13 months, and the proportion of children <5 years old was 81%. The predominant serotypes, in order of decreasing frequency, were 19A (44%), 19F(28%), 6B (7%), 6A (4%), 9V (4%), and 1 (4%); 23 isolates (43%) belonged to types included in the heptavalent pneumococcal conjugate vaccine (PCV7). The proportion of serotype 19A and 19F accounted for 72% of overall pneumococcal isolates, which accounted for 84% of pneumococcal isolates from otorrhea of children <5 years old (vs 20% in children ${\geq}5$ years old, P<0.001). All serotypes isolated from 3 vaccinees of PCV7 were 19A. There was no significant diminution in otitis media caused by pneumococcal vaccine serotypes after the introduction of PCV7. The frequency of nonsusceptibility to penicillin, erythromycin, and trimethoprim-sulfamethoxazole was higher in serotype 19A than in other non-vaccine serotypes, respectively. The frequency of multiple drug resistance was 96% in serotype 19A, compared with 29% in other non-vaccine serotypes (P=0.001). Conclusion : 19A was the most common pneumococcal serotype causing otitis media and represented a large proportion of strains with multiple drug resistance in children younger than 5 years of age.

• Radiation Oncology Journal
• /
• v.20 no.4
• /
• pp.343-352
• /
• 2002

Purpose : Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. Materials and Methods : total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The Point A dose from the HDR brachytherapy was 28 Gy to 30 Gy $(4\;Gy\times7,\;or\;5\;Gy\times6)$. The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months $(12\~86\;months)$. Results : The incidence of rectal bleeding was $12.7\%$ (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was $8.5\%$. Most complications $(92.6\%)$ developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding an icruCRBED greater than 100 Gy $(19.7\%\;vs.\;4.2\%)$, an EBRT dose to the parametrium over 55 Gy $(22.1\%\;vs.\;5.1\%)$ and higher stages of III and IV $(31.8\%\;vs.\;10.5\%)$. In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was peformed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. Conclusion : Moderate and several rectal bleeding occurred in $8.5\%$ of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.

• Journal of Korean Home Economics Education Association
• /
• v.27 no.4
• /
• pp.51-65
• /
• 2015

The purpose of this study was to investigate the relation among family strength, creative personality, and career maturity. This subjects were the 508 middle school students living in Gwangju. Data was analyzed for frequency, percentage, mean, standard deviation, cronbach's ${\alpha}$, ANOVA, duncan test, and hierarchical regression analysis using SPSS/PC 18.0 program. The major findings were as follows; First, the middle school students' family strengths, creative personality, and career maturity were higher than median(3.00). Second, career maturity showed significant difference according to all of family strength(family respect and affection, role sharing and problem solving, communication and family bonding, financial stability) and part of creative personality(self-conviction, perseverance/tenacity, openness of thinking, curiosity). Third, the middle school students' career maturity was influenced by self-confidence and humor. And the middle school students' career maturity was explained about 26% by these variables. The outcomes indicated that career maturity of middle school students is affected by creative personality.

• The Journal of the Acoustical Society of Korea
• /
• v.33 no.1
• /
• pp.1-9
• /
• 2014

Coastal water including estuaries has distinctive environmental characteristics where sediments are transported and deposited by flowing river water, providing an environment in which fluid mud layers can be formed. Acoustic method is mostly used to detect or monitor the fluid mud layer. However, since sound propagating in this layer suffers severe attenuation, it is important to estimate the accurate attenuation coefficient for various concentrations of fluid mud layer for the successful use of the acoustic method. In this paper, measurement results of attenuation coefficient for 3.5, 5, and 7.5 MHz ultrasounds were presented. The measurements were made in a small-size water tank in which suspended sediment samples with various sediment concentrations were formed using kaolinite powder. The results were compared to the model predictions obtained by attenuation coefficient model in which the mean grain size (called as Mass-median-diameter, D50) was used as input parameter. There were reasonable agreements between measured attenuation coefficients and model outputs predicted using the particle range of D50 ${\pm}20%$. The comparison results imply that although the suspended sediments consist of various-sized particles, sound attenuation might be greatly influenced by amount of particle with a size which has a larger attenuation than that of any particle in the suspended sediments for the frequency used.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4571-4575
• /
• 2012

Introduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4549-4553
• /
• 2012

This study was designed to investigate the frequency of CYP2D6 polymorphisms and evaluate the association between genetic polymorphisms of CYP2D6 and tamoxifen therapeutic outcome in Thai breast cancer patients. We recruited 48 breast cancer patients who received adjuvant tamoxifen for evaluating CYP2D6 genetic polymorphisms using microarray-based technology. Associations between genotypes-phenotypes and disease free survival were analyzed. Median follow up time was 5.6 years. The mean age of the subjects was 50 years. The 3 common allelic frequencies were 43.8% ($^*10$), 36.5 ($^*1$) and 10.4% ($^*2$) which are related to extensive metabolizer (EM) and intermediate metabolizer (IM) with 70.8% and 29.2 %, respectively. No association between CYP2D6 genotypes and DFS was demonstrated. Nevertheless, exploratory analysis showed statistically significant shorter DFS in the IM group of post-menopause patients (HR, 6.85; 95%CI, 1.48-31.69; P=0.005). Furthermore, we observed statistically significant shorter DFS of homozygous $CYP2D6^*10$ when compared with heterozygous CYP2D6*10 and other genotypes (P=0.005). $CYP2D6^*10$ was the most common genotype in our subjects. Post-menopause patients with homozygous $CYP2D6^*10$ and IM have shorter DFS. To confirm this relationship, larger samples and comprehensively designed trials in Thailand are required.

• Korean Journal of Clinical Pharmacy
• /
• v.30 no.1
• /
• pp.36-43
• /
• 2020

Background: Tacrolimus, a calcineurin inhibitor, is an immunosuppressant used in post-transplantation maintenance therapy. The drug has a narrow therapeutic range and requires periodic therapeutic drug monitoring. Although many studies have reported the effects of intrapatient variability of tacrolimus on survival, rejection, and complications in renal transplant recipients, very few studies have reported these effects in liver transplant recipients. The purpose of this study was to evaluate the effect of intrapatient variability of tacrolimus on clinical outcomes after liver transplantation. Methods: Intrapatient variability was calculated using individual, averaged tacrolimus concentrations. Patients were divided into two groups according to their median variability value: high-variability and low-variability groups. The rate of deviation from the therapeutic range, incidence of acute rejection, post-transplant diabetes, incidence of infection, and estimated glomerular filtration rate (eGFR) after transplantation were compared between the groups. Results: Of the total patients (n=82), the high-variability group (n=41) exhibited significantly greater deviation from the therapeutic range (65.92% vs. 56.84%; p<0.001). There was no significant difference in acute rejection or post-transplantation diabetes incidence or eGFR; however, the number of infection in the first 6 months was significantly lower in the low-variability group (0.4 vs. 0.9 times; p=0.039). Multiple linear regression analysis showed that the number of infection significantly increased as intrapatient variability increased (p=0.015). Conclusion: High intrapatient variability in tacrolimus concentrations was strongly associated with an increased frequency of deviation from the suggested therapeutic range and an increased number of infection.

• Clinical and Experimental Reproductive Medicine
• /
• v.28 no.3
• /
• pp.215-223
• /
• 2001

Objective: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. Materials and Methods : We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. Results: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. Conclusion: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer des ire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.

• Women's Health Nursing
• /
• v.2 no.1
• /
• pp.138-157
• /
• 1996

Recently, there has been increase perception of health promotion with development of the economic state and science. Individual's responsibility and psychosocial factors have impacted on the individual's lifestyle. Health promotion can be maintained or improved through changes of lifestyle of individuals. Also, there has been supported results of health behavior health has been focused on menopausal symptom and reproductive organ. Until recently, little research has been available on the health or health care of midlife women. The purpose of this study was to explain relationship between health promoting lifestyle and hardiness, gender role characteristics. A total of 254 items of data were obtained from randomly selected subjects. The data collected from the interviews were analyzed using SPSS, yielding frequency, mean. t-test, ANOVA, Pearson Correlation, Stepwise multiple regression. The result of this study are as follows : 1) For the health promoting lifestyle, the mean score was 116.3, the highest score was nutrition(3.30) and interpersonal support(2.86), the lowest score was exercise(1.68). The highest subscale for the hardiness was committment(2.44). Also for the gender role characteristics was higher than median score(37.8). 2) There was a statistically difference the demographic variables. A total health promotion lifestyle was predicted by income and marriage satisfaction, hardiness was predicted by education, income, marriage satisfaction, support person and gender role characteristics was predicted by education. 3) With regard to the relationship among health promoting lifestyle, hardiness, gender role characteristics, the correlation coefficient between health promoting lifestyle and hardiness was r=-.48, p<.001. Also there were significant correlation between health promoting lifestyle and gender role characteristics(r=.22, p<.01), hardiness and gender role characteristics(r=-.39, p<.001). 4) A stepwise multiple regression analysis was done on the total health promoting lifestyle score using the demographic variables, hardiness subscale and gender role characteristics for independent variables. A total of 25% of the variance was explained inthe total health promoting lifestyle by the control, challenge and marriage satisfaction. In conclusion, hardiness and gender role characteristics were engaged in health promoting activity in midlife women. This study also provides new information about the health practices that midlife women report they practice. Therefore, nursing intervention to increase women's health have to be planed program that consider on the basis the results of this study.

• Journal of Korean Society of Transportation
• /
• v.28 no.3
• /
• pp.131-143
• /
• 2010

This study has aimed to develop accident modification factor(AMF) for rural two-lane roadway segments. Accident Modification Factor is a coefficient to assess roadway safety as reflecting characteristics of homogeneous roadway. It estimates accident frequency of roadway segments with developed base model and exposure. We found on items of such factors as crosswalk, driveway density, topography characteristic, land use and median through statistical models and literature review. To develop accident modification factors, we used statistical model methods and analyses of applicability and expert judgement method were practiced to validate it. Although expert judgement for land use item was questionable, most items were rated acceptable. Result of comparative analysis revealed crash frequencies of IHSDM and KHSEM were most similar with actual. However, accident distribution of KHSEM was more proper than IHSDM. Also overall estimated values of RSDS were found to be overestimated.