• Korean Journal of Clinical Laboratory Science
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• v.43 no.4
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• pp.171-178
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• 2011

Glycated hemoglobin ($HbA_{1c}$) is a most preferably used baseline of diabetes, implicating average blood glucose levels over a 2-3 month period of time. Recently the American Diabetes Association has recommended the $HbA_{1c}$ assay as one of the criteria for diabetes. Although some studies provide data with "estimated average glucose", by converting the $HbA_{1c}$ results from simple linear regression, the results are not applicable to whole diabetes. We compared the relationship between $HbA_{1c}$ and estimated average glucose by anemia degree of diabetic patients in Korea. The data from the 2008~2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,257 diabetes subjects with $HbA_{1c}$ results. The distribution of subjects was 34.1% in 60's, 25.9% in 70's, 21,6% in 50's, showing that there was more than 80% in over 50's. To take a close look of the differences depending on the anemic degree, we applied WHO criteria (hemoglobin<13.0 in men and hemoglobin<12.0 in women) and divided anemia degree. The regression equation for A1c and estimated average glucose was $eAG_{mg/dL}=24.3{\times}A1c-32.0$ ($R^2=0.54$, p<0.001) in all subjects, $eAG_{mg/dL}=33.1{\times}A1c-96.1$ ($R^2=0.52$, p<0.001) in slight anemia ($11.0{\leq}$Hb<13.0 in men, $10.0{\leq}$Hb<12.0 in women), and $eAG_{mg/dL}=13.5{\times}A1c+34.9$ ($R^2=0.12$, p =0.075) in moderate anemia (Hb<11.0 in men, Hb<10.0 in women). The regression was not significant in moderate anemia. The relationship between HbA1c and eAG was lower correlation than ADAG study, and eAG showed lower value in all ranges among $HbA_{1c}$ 5~13%. Such as a korea where, there are many diabetic patients among the old aged and higher prevalence rate of anemia, we should be extra careful when we reflect eAG using $HbA_{1c}$ and need to establish criteria which can be applicable to koreans.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1217-1221
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• 1998

Background: The advent of EEA stapler has lowered the leakage rate of esophagogastric anastomoses and thereby contributed to a decrease in the operative mortality of the easophageal resection. Recent surgical reports, however, have documented 10% to 20% prevalence of benign anastomotic stricture formation after the use of EEA stapler to construct an esophagogastric anastomosis. We analyzed the cases of anastomotic strictures to reduce the incidence of anastomotic strictures with EEA stapled esophagogastrostomy. Material and Method: EEA stapled esophagogastrostomy was performed in 195 parients during the period of over 11 years from Jan. 1986 to Dec. 1996 in Kosin Medical Center. Ten patients of them died in the early postoperative days. In the remaining 185 patients, we studied the incidence and the onset time of anastomotic strictures, relationship between the patients' ages, the anastomotic sites, and the size of the cartridges with incidence of anastomotic stricture. We also studied the method of treatment and its effect in the anastomotic strictures. Result: Benign anastomotic strictures occurred in 39 cases among 185 patients(21%), 25 cases(64.1%) of the 39 cases developed in one to three months postoperatively. The patients' ages and the anastomotic sites did not effect with the incidence of anastomotic stricture, but high incidence of anastomotic stricture in EEA stapled esophagogastrostomy(p=0.04)was observed in small cartridge sizes. One or two balloon dilatation(89%) relieved the anastomotic strictures. Conclusion: We conclude that a larger size cartridge is recommended in EEA stapled esophagogastrostomy to reduce the incidence of anastomotic stricture if possible, and one or two balloon dilatation would seem to be a safe and reliable method in treating anastomotic stricture when the anastomotic stricture was occurrs.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.174-184
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• 2005

For the purpose of investigating the etiologic factors of early childhood caries in 18-month old infants which is an important period in pediatric dentistry, 234 infants of 18-month age and their first care-givers (mothers in most cases) who visited Ilsin Christian Hospital in Busan for the baby-care counseling and vaccination were examined. The oral examination was performed on the infants and their care-givers were individually interviewed about various items, and the data was statistically processed to yield the results as follows : 1. The prevalence rate of early childhood caries was 27.4%. 2. The percentage of the eldest child, the education level of the mother and monthly income were revealed lower in caries group infants. 3. The percentage of prolonged breast-feeding and the frequency of daily nursing was higher in early childhood caries group. 4. In early childhood caries group, the between-meal snacks were tend to be provided irregularly without predetermined time, and sugar containing snacks such as chocolates and candies were ranked in higher order whereas the fruits and milks were in lower ranks. 5. In early childhood caries group, the percentage of those performing the oral hygienic care was lower and the timing to start the toothbrushing was comparatively later. From the above results, it can be concluded that prolonged breast-feeding, poor snack habits and lower socioeconomic status act an important role in early childhood caries in 18-month old infants.

• Child Health Nursing Research
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• v.6 no.2
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• pp.158-166
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• 2000

The purpose of this study was to confirm the efficient umbilical cord care of healthy newborns in nursery. In order to determine the efficient care, the time of umbilical cord separation and the skin condition of periumbilical area were evaluated. The data were collected in sample of 529 normal, healthy newborns of C hospital in Seoul, from September 1st, 1999 to January 16th, 2000. The babies were randomly selected and allocated into four groups-alcohol swab/tub bath, alcohol swab/partial bath, natural dry/tub bath, natural dry/partial bath- by the methods of care. The mothers of babies were also surveyed by questionnaire about general characteristics. The data were analyzed by SAS program. The results of this study were as follows : 1. The average gestation period of newborns was 39+3 weeks. The average birth weight was 3.27Kg. In gender of babies, boys were 51.7% and girls were 48.3%. The 65% of newborns were born normal vaginal delivery, 35% were C-section. The feeding methods were 55.3% of the babies fed by mixed type, 22.9% by breast, and 21.8% by bottle. There was no significance among four groups by general characteristics. 2. The average time of umbilical cord separation was 8.27 days(SD=2.3). The time was no difference significantly among four groups(F=1.68, P=0.17). 3. The prevalence of the umbilical care complication did not show differences among four groups( 2=3.93, P=0.27). In conclusion, Nurses have preferred the traditional alcohol swab/partial bath method in care of newborns. But there was no difference among the ways to take care of umbilicus according to this study. The way to naturally is more efficient due to reduce the time and expense in umbilical care for normal babies of nursery. This also matched the change in approach to healthy population from intervention to nonintervention way. This could be suggested in education for normal and healthy babies care at home and nursery as a useful way. Endly, the further study about bacterial colony nda infection rate at umbilicus by ways of care is needed.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.129-136
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• 2009

The incidence of ectopic pregnancy is increased since in vitro fertilization-embryo transfer (IVF-ET) has started. And because of the possibility of combined pregnancy after IVF-ET, bilateral adnexal area and other portion of pelvis should be examined carefully by transvaginal ultrasonography during follow-up period. The rate of combined pregnancy after IVF is estimated to be as high as 0.2~1%. Since the incidence of combined pregnancies is markedly higher with IVF, special attention to this possibility after ET is warranted. According to a recent report, the occurrence of interstitial pregnancy is estimated to be 1:3600 for all pregnancies achieved with IVF. The prevalence of interstitial pregnancies is 2~4% of ectopic pregnancies. Interstitial pregnancies tend to be diagnosed later than most other ectopic pregnancies, and if uterine rupture occurs, the resulting hemorrhage can be severe. Currently, about 2% to 3% of interstitial pregnancies are thought to carry a maternal death, which is twice that of other tubal gestations. We report a case of simultaneous left tubal and right interstitial pregnancies after IVF-ET with a brief review of literature.

• Journal of agricultural medicine and community health
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• v.10 no.1
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• pp.26-35
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• 1985

The present study was undertaken to evaluate the prevalence rate of Taenia species infection and distribution of taeniasis caused by Taenia solium among Koreans in Seoul and Cheju Do In Korea during the period from August to December 1984. A total of 4,256 stool specimens from the students of Mapo Ku and 360 stool specimens from the inhabitants of Guro-Ku in Seoul was collected and examined by cellophane thick smear technique. On the other hand 1,015 stool specimens from the students of Jocheon Myun and 265 specimens from the students of Jocheon Myun and 265 specimens from the inhabitants of Aeweol Myun and Gujwa Myun in Cheju Do were also examined. The results were summarized as follows ; Four (0.1%) out of 4.256 students were positive and 2 (0.6%) out of 360 inhabitants in Seoul were positive (Table 1, 2). Positive rates of taeniasis in Cheju Do were 1.7% (17) out of 1,015 students and 12.5% (33) out of 5 villagers (Table 3, 4). In order to observe the distribution of Taenia solium infection, the scolex or a part of Taenia spp. were collected from the stool of positive cases by anthelmintic treatment. For the species identification, expelled proglottides were examined microscopically by the number of branches of the uterus, presence of vaginal sphincter or the accessory ovarian lobe etc. Three cases were infected with Taenia solium among 6 egg positive cases in Seoul. But only 1 case was infected with Taenia solium out of 7 students taking anthelmintics voluntarily by recommendation of Korean Association for Parasite Eradication (KAFPE). On the other hand, among 32 cases of egg positive cases of this study and 26 cases of KAFPE in Cheju Do, 13 cases (22.4%) were infected with Taenia solium. But 13 cases who were not examined and complained expulsion of proglottides in their stool were infected with Taenia saginata (Table 5). Among 62 persons infected with Taenia saginata, only 4 cases did not know their infection of this worm. Rut in 17 cases with Taenia solium, 7 persons did not know their infection until stool examinations were performed (Table 6).

• Tuberculosis and Respiratory Diseases
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• v.73 no.1
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• pp.38-47
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• 2012

Background: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. Methods: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). Results: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. Conclusion: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.425-435
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• 1989

The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.317-325
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• 2021

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

• Fisheries and Aquatic Sciences
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• v.25 no.5
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• pp.287-297
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• 2022

The objective of this study was to evaluate the probability of norovirus foodborne illness by raw oyster consumption. One hundred fifty-six oyster samples were collected to examine the norovirus prevalence. The oyster samples were inoculated with murine norovirus and stored at 4℃-25℃. A plaque assay determined norovirus titers. The norovirus titers were fitted with the Baranyi model to calculate shoulder period (h) and death rate (Log PFU/g/h). These kinetic parameters were fitted to a polynomial model as a function of temperature. Distribution temperature and time were surveyed, and consumption data were surveyed. A dose-response model was also searched through literature. The simulation model was prepared with these data in @RISK to estimate the probability of norovirus foodborne. One sample of 156 samples was norovirus positive. Thus, the initial contamination level was estimated by the Beta distribution (2, 156), and the level was -5.3 Log PFU/g. The developed predictive models showed that the norovirus titers decreased in oysters under the storage conditions simulated with the Uniform distribution (0.325, 1.643) for time and the Pert distribution (10, 18, 25) for temperature. Consumption ratio of raw oyster was 0.98%, and average consumption amount was 1.82 g, calculated by the Pert distribution [Pert {1.8200, 1.8200, 335.30, Truncate (0, 236.8)}]. ₁F₁ hypergeometric dose-response model [1 - (1 + 2.55 × 10^-3 × dose)^-0.086] was appropriate to evaluate dose-response. The simulation showed that the probability of norovirus foodborne illness by raw oyster consumption was 5.90 × 10^-10 per person per day. The annual socioeconomic cost of consuming raw oysters contaminated with norovirus was not very high.