• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.95-100
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• 1999

Objectives. This study surveyed medical students attending clerkship to assess their attitude toward and knowledge about breastfeeding, and self-confidence to manage common breastfeeding problems. Methods. A self-report questionnaire was administered to the 323 medical students at four medical colleges in Taegu in May 1997. The response rate was 92.9%, but the respondents used in the final data analysis were 245 (75.8%) due to missing variables. Results. Overall, respondents showed equivocal attitudes toward breastfeeding (mean score 2.9 on a 6-point scale). Knowledge about breastfeeding was substantially low with the median % correct 39.2%. Of nine knowledge areas, weak areas were especially 'contraindications and barriers to breastfeeding', 'use of breastfeeding aids', 'expression and storage of breast milk'. Those reported to be confident to manage common breastfeeding problems were only 25.7%. Correlations between knowledge and self-confidence were not statistically significant except in college A (r=0.35, p<0.05). Correlations between knowledge and attitude were not significant. Conclusions. These results suggest that medical students attending clerkship in Taegu show equivocal attitudes toward breastfeeding, low self-confidence to manage common breastfeeding problems and have substantially limited level of knowledge. There should be more concerted efforts to improve this situation on the part of those involved in breastfeeding education.

• The Journal of Advanced Prosthodontics
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• v.8 no.3
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• pp.194-200
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• 2016

PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.145-152
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• 1995

A retrospective analysis was performed to ascertain the relationship between the treatment modalities and their treatment results. From July 1980 to June 1993, 115 patients with squamous cell carcinoma of the maxillary sinus were: treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 88 men and 27 women with median age of 57 years. According to AJCC TNM system of 1992. eight patients of T2, 54 patients of T3 and 53 patients of T4 were available, respectively. Cervical lymph node metastases at diagnosis was observed in 11 patients. 87 patients were treated with radiotherapy and 28 patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32 %, patients that were treated with radiotherapy alone had a 5 year survival rate 24.3 % and patients who were treated with combination of surgery and radiation therapy had a 5 year survival rate of 52.8 % (p<0.05). Combination of surgery and radiotherapy resulted in a better treatment modality for squamous cell carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced maxillary sinus carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.28 no.2
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• pp.118-121
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• 2012

Backgrounds : To evaluated the use of FDG PET/CT for the identification of extracapsular spread(ECS) with histologic correlation in laryngeal cancer. Methods : We reviewed 79 medical records of patients who underwent of FDG PET/CT for laryngeal cancer before surgery. Results : ECS was present in 41.9%(18/43) dissected necks and in 34.5%(20/58) dissected cervical levels. There was a significant difference in the SUVmax between cervical lymph nodes with ECS and without ECS($6.39{\pm}4.53$ vs. $1.19{\pm}1.64$, p<0.001). The cut-off value for the SUVmax for differentiating with ECS from without ECS was 2.8 with the sensitivity of 85.7% and the specificity of 85.6%. Conclusion : The median SUVmax cut-off values of FDG PET/CT higher than 2.8 was associated with greater risk cervical lymph node metastasis with ECS in patients with laryngeal cancer.

• Journal of Preventive Medicine and Public Health
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• v.51 no.4
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• pp.205-212
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• 2018

Objectives: The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods: A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. Results: Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. Conclusions: Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.463-470
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• 2018

Objectives: The aim of this study was to identify the validity of phase angle as a prognostic factor for survival in patients with metastatic cancer. Methods: Data of patients with metastatic cancer who visited the Korean medicine cancer center at Kyung Hee University Hospital in Gangdong from April 2016 to February 2018 were collected for this study. The values of phase angle (PhA) and blood hemoglobin (Hb), C-reactive protein (CRP), and serum albumin levels were also investigated by bioelectrical impedance analysis (BIA). Results: In total, 86 patients were analyzed. The cut-off value of the phase angle was determined as 5.0. Univariate and multivariate analysis revealed that phase angle (HR 3.15, 95% CI 1.79-5.54) and CRP (HR 2.15, 95% CI 1.24-3.73) predicted survival with statistical significance. The median overall survival of the low PhA group ($PhA{\leq}5.0$) was 1.8 months (95% CI 0.6-2.9 months) and 7.2 months (95% CI 5.2-9.2 months) in the high PhA group (PhA>5.0)(p<0.001). Conclusions: The phase angle could be an independent prognostic factor for patients with metastatic cancer. Further research is required to confirm these findings and their correlation with other indexes.

• Journal of the Korean Society of School Health
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• v.31 no.2
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• pp.59-69
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• 2018

Purpose: The purpose of this study is to identify and compare the factors associated with human papillomavirus (HPV) vaccination intention between male and female high school students. The focus is on the knowledge, attitudes and health beliefs related to HPV. Methods: The participants were 246 male and 298 female students from an academic high school located in Seoul. Data were collected in June 2017, which were analyzed using descriptive statistics, the chi-test, t test, Mann-Whitney U test, Pearson correlation coefficients and logistic regression with SPSS for Windows 21.0. Results: 47.6% of the male participants and 86.2% of the female participants indicated HPV vaccination intention. The median score of the HPV knowledge level was 0 (total score:16) in the boys and 3 in the girls (p<.001). There were significant differences in attitudes and health beliefs related to HPV by gender. Religion (OR=0.50), sexual experience (OR=0.09), safety concerns (OR=0.65), perceived needs (OR=1.59), importance of prevention (OR=1.78) and perceived susceptibility (OR=1.80) determined HPV vaccination intention in the male students, whereas awareness of HVP vaccination (OR=2.25) and importance of prevention (OR=1.92) significantly predicted HPV vaccination intention in the female students. Conclusion: The results of this study suggest that different strategies need to be taken for different genders: education focusing on safety concerns as well as perceived needs, importance of prevention and perceived susceptibility for male students and education emphasizing importance of prevention for female students.

• Korean Journal of Clinical Pharmacy
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• v.27 no.4
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• pp.250-257
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• 2017

Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.193-199
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• 2012

Objective : The objective of study is to evaluate the incidence of leptomeningeal carcinomatosis (LMC) in breast cancer patients with parenchymal brain metastases (PBM) and clinical risk factors for the development of LMC. Methods : We retrospectively analyzed 27 patients who had undergone surgical resection (SR) and 156 patients with whole brain radiation therapy (WBRT) as an initial treatment for their PBM from breast cancer in our institution and compared the difference of incidence of LMC according to clinical factors. The diagnosis of LMC was made by cerebrospinal fluid cytology and/or magnetic resonance imaging. Results : A total of 27 patients (14%) in the study population developed LMC at a median of 6.0 months (range, 1.0-50). Ten of 27 patients (37%) developed LMC after SR, whereas 17 of 156 (11%) patients who received WBRT were diagnosed with LMC after the index procedure. The incidence of LMC was significantly higher in the SR group compared with the WBRT group and the hazard ratio was 2.95 (95% confidence interval; 1.33-6.54, p<0.01). Three additional factors were identified in the multivariable analysis : the younger age group (<40 years old), the progressing systemic disease showed significantly increased incidence of LMC, whereas the adjuvant chemotherapy reduce the incidence. Conclusion : There is an increased risk of LMC after SR for PBM from breast cancer compared with WBRT. The young age (<40) and systemic burden of cancer in terms of progressing systemic disease without adjuvant chemotherapy could be additional risk factors for the development of LMC.

• ALGAE
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• v.33 no.1
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• pp.21-35
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• 2018

The phototrophic dinoflagellate genus Scrippsiella is known to have a worldwide distribution. Here, we report for the first time, the occurrence of Scrippsiella lachrymosa in Korean waters. Unlike the other stains of S. lachrymosa whose cultures had been established from cysts in the sediments, the clonal culture of the Korean strain of S. lachrymosa was established from motile cells. When the sulcal plates of S. lachrymosa, which have not been fully described to date, were carefully examined using scanning electron microscopy, the Korean strain of S. lachrymosa clearly exhibited the anterior sulcal plate (s.a.), right sulcal plate (s.d.), left sulcal plate (s.s.), median sulcal plate (s.m.), and posterior sulcal plate (s.p.). When properly aligned, the large subunit (LSU) rDNA sequence of the Korean strain of S. lachrymosa was ca. 1% different from those of two Norwegian strains of S. lachrymosa, the only strains for which LSU sequences have been reported. The internal transcribed spacer (ITS) rDNA sequence of the Korean strain of S. lachrymosa was also ca. 1% different from those of the Scottish and Chinese strains and 3% different from those of the Canadian, German, Greek, and Portuguese strains. Thus, the Korean S. lachrymosa strain has unique LSU and ITS sequences. The abundances of S. lachrymosa in the waters of 28 stations, located in the East, West, and South Sea of Korea, were quantified in four seasons from January 2016 to October 2017, using quantitative real-time polymerase chain reaction method and newly designed specific primer-probe sets. Its abundances were >$0.1cells\;mL^{-1}$ at eight stations in January and March 2016 and March 2017, and its highest abundance in Korean waters was $26cells\;mL^{-1}$. Thus, S. lachrymosa has a nationwide distribution in Korean waters as motile cells.