• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.131-138
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• 2013

Purpose: This study aimed to study the antibody response of Japanese encephalitis vaccination in children using different kinds of vaccines (inactivated vaccine, live attenuated vaccine or interchanged) and evaluate the effectiveness of the vaccines to provide the basis of efficient immunization schedule of Japanese encephalitis. Methods: Measurement of the neutralization antibody (NTAb) titers following Japanese encephalitis vaccination using different vaccines for 170 children, 2-6 year of age, who visited six university hospitals and are confirmed by immunization records. Results: Among 170 children who were given primary immunization on Japanese encephalitis, 103 children were given inactivated vaccine, 64 children were given live attenuated vaccine and 3 children were given interchangeably. NTAb titers were more than 1:10 in all children of three groups. The geographic mean antibody titer was 322 in inactivated vaccine group and 266 in live attenuated vaccine group. However, there was no significant difference between two groups. In both groups, the NTAb titer showed the peak at 1-4 months after the third immunization and declined. The NTAb titers of three children who were given two kinds of vaccines alternately were 1:135, 1:632, and 1:2511, respectively. Conclusion: According to the results of this study in children younger than 6 years old, there is no significant difference in effectiveness between inactivated and live attenuated vaccines. However, further studies for the changes of antibody titers for a longer period of time on larger population are required.

• Journal of agricultural medicine and community health
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• v.41 no.4
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• pp.205-216
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• 2016

Objectives: We compared the difference of lipid, insulin resistance and metabolic markers based on HCV RNA in Korean adults.Methods: This was a cross-sectional study of 222 subjects visited the health promotion center of Pusan nationaluniversity hospital from 2004 to 2007. Subjects were anti-HCV antibody positive and were performed RT-PCR for HCV RNA. The HCV RNA (+) group were 85 subjects, HCV RNA (-) control group were 115 subjects, and the HCV RNA (-) but past positive group were 22 subjects. We performed anthropometry, anti-HCV, RT-PCR, plasma concentrations of insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride.Results: BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride, HDL cholesterol, insulin resistance such as HOMA-IR and QUICKI were not significantly different between HCV RNA positive and negative groups. The serum total cholesterol and LDL cholesterol level were significantly lower in the HCV RNA positive group than in the negative group ($186.24{\pm}37.63$ vs $197.22{\pm}37.23$ mg/dl, p=0.041, $111.66{\pm}34.06$ vs $121.38{\pm}35.50$ mg/dl, p=0.042). After adjusting age and sex, high total cholesterol (${\geq}200mg/dl$) (adjusted OR=0.51, 95%CI 0.28-0.94, p=0.03) and high LDL cholesterol (${\geq}130mg/dl$) (adjusted OR=0.46, 95%CI 0.24~0.87, p=0.02) were inversely associated with being HCV RNA positive (p<0.05). Conclusion: The serum total cholesterol and LDL-cholesterol level were significantly lower in HCV RNA (+) group than in HCV RNA (-) group, but not in HCV RNA (-) but past positive group. Prospective cohort studies are needed to clarify the relationship between HCV RNA and metabolic markers.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.183-190
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• 2009

Purpose : To evaluate the number and severity of adverse reactions after Japanese Encephalitis (JE) vaccination in children using different vaccines (inactivated vaccine or live attenuated vaccine) and to determine the ability and safety of the vaccines to provide effective immunization for JE. Methods : From August 2006 to February 2007, we conducted a prospective cohort study of the adverse reactions associated with JE immunization in Korea. We investigated common adverse reactions during the 4 days following immunization using telephone collaborations with four public health centers and nine pediatric clinics. Results : The mean age of children receiving the inactivated vaccines and live attenuated vaccines, respectively, were 1.4 y (range: 1 to 8.5) and 1.7 y (range: 1 to 8.3). The number of children that received the inactivated vaccines was 425 (64.6%). A total of 233 (35.4%) received the live attenuated vaccines. Fourteen children (3.3%) had more than one localized adverse event with the inactivated vaccine, and six (2.6%) had more than one event with the live attenuated vaccine (P =0.607). Systemic adverse reactions occurred in 5.2% vs. 8.2%, respectively, of these groups (P =0.131). Fever was more common in the live attenuated vaccine group than in the inactivated vaccine group on the day of vaccination (P =0.026). Conclusions : The rate of adverse events in our study was even lower than that previously reported. No significant difference in outcomes between inactivated vaccine and live attenuated vaccine was found in JE-immunized children. Fever was more common in the live attenuated vaccine group than in the inactivated vaccine group on the day of vaccination.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.210-217
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• 2006

Purpose: Crohn disease (CD) in children is frequently complicated by malnutrition and growth retardation. Conventional treatment with corticosteroid may also affect the growth of children, which may be alleviated by nutritional therapy. Therefore, we performed this study to evaluate the role of nutritional therapy in the treatment of CD in children. Methods: The study cohort consisted of thirty children under the age of 17 years, admitted to the Asan Medical Center from 2001 to 2005. While 11 children received nutritional therapy (NT) with an elemental diet, 19 received conventional corticosteroid therapy (ST). Comparative analysis was performed for the rate of the induction of remission, recurrence, disease activity index of pre and post-treatment, and changes of the growth using mean standard deviation score for weight (zW) and height (zH). Results: Ten of 11 children with NT and 18 of 19 children with ST completed the therapy. Two of them were lost to follow-up during the treatment. All 10 children with NT and 15 of 18 children with ST achieved remission. While there was no recurrence in children with NT, 7 with ST showed recurrence within 1 year. Pre- and post treatment Pediatric Crohn disease Activity Index (PCDAI) did not show a difference between the two groups. There were no differences in zW and zH between the two groups after 1 year of follow-up. Conclusion: This study showed that nutritional therapy could be considered instead of steroid therapy for treatment of children with CD. However, a long-term study will be needed to determine the long-term efficacy.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.4
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• pp.513-522
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• 2017

This study was conducted to examine the relationships between milk and milk product intake and bone health. The data from the 2008~2011 Korean National Health and Nutrition Examination Survey (KNHANES) were used for data analysis. Subjects included 4,626 men and 6,144 women aged 19 to 64 years. Daily intake frequency of milk and milk products was obtained using a food frequency questionnaire and divided into two categories: less than one serving per day and more than one serving per day. Bone mineral density (BMD) values of total femur, femoral neck, and lumbar spine were compared based on daily intake frequency, and relationships between milk and milk product daily intake frequency and osteoporosis risk were evaluated based on logistic regression. In men aged 30~39, BMDs of total femur and femoral neck were significantly higher in the group that consumed milk more than one serving per day (P<0.05). Intake frequency of milk and milk products was also significantly related to both BMDs of total femur and femoral neck. The odds ratio (OR) for milk intake frequency (more than one serving per day) compared to intake frequency less than one serving per day was 0.36 [95% confidence interval (CI) 0.21~0.62], and the OR for milk and milk products intake frequency (more than one serving per day) was 0.49 (95% CI 0.28~0.86) in women aged 50~64. These results indicate that increased consumption of milk and its products is associated with reduced risk of bone health disease, and adequate intakes of milk and milk products might play an important role in maintaining optimum bone health. Further research on the causal relationship and dose-response association between milk intake and bone heath using prospective cohort data is required prior to applying the observed results to programs that prevent bone health problems.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.207-216
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• 2000

Background : The occurrence of lung complications after allogenic bone marrow transplantation(BMT) has been reported as 40-60 percent. The risk factors for lung complications are whole body irradiation, high dose chemotherapy, graft versus host disease, old age and CMV infection. The prevalence of graft versus host disease is less in Korea than in Western countries, but frequency of CMV infection is higher. Therefore, the pattern of lung complications may be different in Korea from those in Western countries. Methods : A retrospective cohort study was performed on one hundred consecutive adult patients who underwent allogenic bone marrow transplantation from December, 1993 to May, 1999 at Asan Medical Center. Lung complications were divided into two groups by the time of development, within 30days (pre-engraftment) and beyond 30 days (post-engraftment), and then subdivided into infectious and non-infectious complication. Infectious complications were defined as having the organism in blood, BAL fluid, pleural fluid or sputum, or compatible clinical findings in patients, which improved with antibiotics or an anti-fungal therapy. Result: 1) Eighty three episodes of lung complications had occurred in 54 patients. 2) Within thirty days after BMT, non-infectious complications were more common than infections, but this pattern was reversed after 30 days. After one year post-BMT, there was no infectious complication except in cases of recurrence of underlying disease or development of chronic GVHD. 3) Among the non-infectious complications, pleural effusion (27 episodes) was most common, followed by pulmonary edema (8 episodes), bronchiolitis obliterans(2 episodes), diffuse alveolar hemorrhage (1 episode) and bronchiloitis obliterans with organizing pneumonia (1 episode). 4) The infectious complications were pneumonia (bacterial: 9 episodes, viral: 4 episodes, fungal : 5 episodes, pneumocystis carinii : 1 episode), pulmonary tuberculosis(3 episodes) and tuberculous pleurisy (3 episodes). 5) Lung complications were more frequent in CMV positive patients and in patients with delayed recovery of neutrophil count. 6) The mortality was higher in the patients with lung complications. Conclusion : Lung complications developed in 54% after allogenic BMT and were associated with higher mortality.

• Journal of health informatics and statistics
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• v.41 no.1
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• pp.49-56
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• 2016

Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.900-910
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• 2023

Purpose To assess normal CT scans with quantitative CT (QCT) analysis based on smoking habits and chronic obstructive pulmonary disease (COPD). Materials and Methods From January 2013 to December 2014, 90 male patients with normal chest CT and quantification analysis results were enrolled in our study [non-COPD never-smokers (n = 38) and smokers (n = 45), COPD smokers (n = 7)]. In addition, an age-matched cohort study was performed for seven smokers with COPD. The square root of the wall area of a hypothetical bronchus of internal perimeter 10 mm (Pi10), skewness, kurtosis, mean lung attenuation (MLA), and percentage of low attenuation area (%LAA) were evaluated. Results Among patients without COPD, the Pi10 of smokers (4.176 ± 0.282) was about 0.1 mm thicker than that of never-smokers (4.070 ± 0.191, p = 0.047), and skewness and kurtosis of smokers (2.628 ± 0.484 and 6.448 ± 3.427) were lower than never-smokers (2.884 ± 0.624, p = 0.038 and 8.594 ± 4.944, p = 0.02). The Pi10 of COPD smokers (4.429 ± 0.435, n = 7) was about 0.4 mm thicker than never-smokers without COPD (3.996 ± 0.115, n = 14, p = 0.005). There were no significant differences in MLA and %LAA between groups (p > 0.05). Conclusion Even on normal CT scans, QCT showed that the airway walls of smokers are thicker than never-smokers regardless of COPD and it preceded lung parenchymal changes.

• Korean Journal of Psychosomatic Medicine
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• v.32 no.1
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• pp.43-51
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• 2024

Objectives : This study aims to explore the prevalence of depressive symptoms among elderly residents in the relatively stable rural areas of Jeju and to examine the relationships between levels of depression, sociodemographic factors, and health habits. Methods : The study site was within rural Jeju, where elderly individuals aged 65 and older were randomly selected from the 'Agricultural Cohort' registered at the Centers for Farmers' Safety and Health Center. Trained interviewers conducted surveys using the Short Form Geriatric Depression Scale (sGDS-K), defining those with scores of 6 or above as experiencing depressive symptoms for the analysis. Other variables such as sex, age, educational level, marital status, annual income, subjective health status, underlying disease, perceived stress levels, smoking, and drinking status were also recorded Results : Out of 533 subjects, the prevalence of depressive symptoms was 35.3%, with 28.5% in male and 45.6% in female (p<0.001). Factors significantly associated with the prevalence of depressive symptoms included marital status (p=0.014), educational level (p<0.001), annual income (p=0.034), subjective health status (p<0.001), perceived stress level (p<0.001), feeling of despair (p<0.001) and suicidal ideas (p<0.001). Multivariate logistic regression analysis revealed that subjective health status, perceived stress level, and feelings of despair were associated with the prevalence of depressive symptoms. Conclusions : The high prevalence of depressive symptoms among the rural elderly in Jeju highlights the need for targeted mental health interventions. Addressing sociocultural factors and improving early detection and intervention strategies can help reduce the socioeconomic impact of depression in this population.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.