• Advances in pediatric surgery
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• v.19 no.2
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• pp.81-89
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• 2013

The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.203-212
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• 2020

Background: This research evaluated the numbness produced by lignocaine at an equal or higher concentration than that of 4% articaine through a single point of injection for maxillary third molar surgery. This randomized double-blind study was conducted to compare the anesthetic efficiency of 4% lignocaine with that of 4% articaine in impacted maxillary third molar surgery using a single buccal infiltration alone. Methods: The study participants were 30 healthy patients requiring the bilateral surgical removal of symmetrically-positioned maxillary third molars. Using a split-mouth design, each patient randomly received buccal infiltration of 1.7 ml of 4% lignocaine and 1.7 ml of 4% articaine during two separate appointments. After 15 minutes of anesthetic injection, surgery was performed by the same surgeon using a consistent technique on both sides. Pinprick test pain scores of the buccal and palatal gingiva of the maxillary third molar after 10 minutes and 15 minutes latencies, pain scores during the surgery, the need for supplemental anesthesia, and patients' satisfaction with anesthetic efficiency were recorded. Surgery performed without supplemental anesthesia was categorized as successful. Results: The success rates of 4% lignocaine and 4% articaine (83.34% vs. 86.67%, P = 1.00) were not significantly different. Only 5 cases (4 cases in the articaine group and 1 case in the lignocaine group) reported mild pain and pressure sensation (NRS ≤ 1) on probing at the palatal side after 15 minutes of latency (P = 0.25). The pain scores of maxillary third molar surgery in the two groups were not significantly different (P > 0.05). Moreover, the statistical analysis confirmed the comparable patient satisfaction of two study groups (P = 0.284). Conclusion: This study provides evidence that single buccal infiltrations of 4% lignocaine and 4% articaine have comparable anesthetic efficacy and success rates for impacted maxillary third molar surgery. Both 4% lignocaine and 4% articaine can produce effective palatal anesthesia and pain control using buccal infiltration alone after 15 minutes of latency.

• Korean Journal of Social Welfare
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• v.57 no.1
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• pp.5-30
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• 2005

This article attempts to restructurize the current arguments on how to change the method of financing child care programme, which is currently under discussion in Korea. There has been a series of changes in Korean child care policy, such as the amendment of Child Care Act, the transition of its responsible administrations, adoption the child care policy as a national agenda. In these changes, new needs for child care financing method comes out with a new direction of child care policy and a plan of expansion of finances. That's the transition from 'facility-centered subsidy' to 'child-centered subsidy'. This article redefine it as the arguments about 'supply-side subsidy' vs. 'demand-side subsidy'. To analyse the different traits of two branches of arguments, this article reviews the social welfare models, and has come to the conclusion that the Burchardt's model is appropriate to explain the financing debates. Thus, the analysis the traits of the two perspectives is based on three dimensions i. e. service provision, financing and decision making according to the Burchardt's model. This also examines how the two sides is connected to the discussion of publicity and quality improvement of child care service. Through this approaches and analysis, this helps us restructurize the debates on the method of financing from the present superficial arguments.

• Tuberculosis and Respiratory Diseases
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• v.79 no.1
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• pp.22-30
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• 2016

Background: The purpose of this study was to document outcomes following withdrawal of a single inhaler (step-down) in chronic obstructive pulmonary disease (COPD) patients on triple therapy (long-acting muscarinic antagonist and a combination of long-acting ${\beta}2$-agonists and inhaled corticosteroid), which a common treatment strategy in clinical practice. Methods: Through a retrospective observational study, COPD patients receiving triple therapy over 2 years (triple group; n=109) were compared with those who had undergone triple therapy for at least 1 year and subsequently, over 9 months, initiated inhaler withdrawal (step-down group, n=39). The index time was defined as the time of withdrawal in the step-down group and as 1 year after the start of triple therapy in the triple group. Results: Lung function at the index time was superior and the previous exacerbation frequency was lower in the step-down group than in the triple group. Step-down resulted in aggravating disease symptoms, a reduced overall quality of life, decreasing exercise performance, and accelerated forced expiratory volume in 1 second ($FEV_1$) decline ($54.7{\pm}15.7mL/yr$ vs. $10.7{\pm}7.1mL/yr$, p=0.007), but there was no observed increase in the frequency of exacerbations. Conclusion: Withdrawal of a single inhaler during triple therapy in COPD patients should be conducted with caution as it may impair the exercise capacity and quality of life while accelerating $FEV_1$ decline.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.10-19
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• 1998

The SPECT radiopharmaceuticals labeled with I-123 for dopamine transporter imaging have been used to measure dopamine transporters in patients with movement disorders. However, a cyclotron produced I-123 limits its availiability and ease of use as a radioisotope to be labeled with pharmaceuticals in routine clinical diagnostic procedures. Recently, new radiophannaceuticals for Tc-99m which has optimal characteristic for SPECT imaging have been developed to overcome the limits of using I-123. The purpose of this study was to compare the quality of [Tc-99m]TRODAT-1 with [I-123]IPT SPECT data and then to evaluate the usefulness of [Tc-99m]TRODAT-1 SPECT by using three noninvasive simplified quantitative methods. TRODAT-1 labeled with Tc-99m($15.93{\pm}0.82mCi$) and IPT labeled with I-123($6.60{\pm}0.11mCi$) were injected into five normal controls. Dynamic [Tc-99m]TRODAT-1 SPECT scans of brain were performed for 10 minutes each over 180 minnutes, and for 20 minutes at 4 hrs and 5 hrs. [I-123]IPT SPECT scans were performed for 5 minutes each over 120 minutes. Time activity curves were generated for the left basal ganglia(LBG), right basal ganglia(RBG), and occipital cortex(OCC). Dopamine transporter parameters were ohtained using (BG-OCC)/OCC, graphical method($R_V$), and area ratio method($R_A$). TRODAT-1 and IPT SPECT imaging showed high uptake at the level of the basal ganglia. (BG-OCC)/OCC ratios for TRODAT-1 and IPT were $0.80{\pm}0.14$, and $3.22{\pm}0.81$, $R_Vs$ were $0.62{\pm}0.12$, and $2.30{\pm}0.35$, and $R_As$ were $0.37{\pm}0.08$ and $1.73{\pm}0.31$, respectively. In conclusion, further improvement of [Tc-99m]TRODAT-1 imaging characteristics may be required to estimate the dopamine transporter concentrations in human brains although it shows clear BG localization.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.1
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• pp.135-141
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• 1997

The early studies demonstrated that the relative amount of FSH was important for stimulating normal ovarian activity and demonstrated the existence of a threshold level for FSH, above which follicular growth was activated. It was found that only a modest increase in circulating FSH level above the threshold (between 10 and 30%) was required to stimulate folliculogenesis. In addition, FSH is primary responsible for initiating estradiol production through the activation of the aromatase enzyme system in granulosa cells, follicular secretion and growth. LH on the other hand, plays a supportive role in ovarian steroidogenesis, stimulating the ovarian thecal cells to produce androgen, the precursor for estradiol synthesis. But there is now an increasing number of reports in the literature demonstrating an adverse effect of LH on fertility and miscarriage in infertile and fertile women. So HP-FSH is the drug of a highly purified FSH preparation which has a higher specific activity and far fewer impurities than FSH. This study was performed to evaluate the efficacy and safety of HP-FSH administered (SC; subcutaneous) versus FSH(IM; intramuscular) for ovulation induction. 20 candidates patients for ovulation induction were participated. All patients underwent pituitary desensitizing with a long gonadotropin-releasing hormone (GnRH) agonist protocol and ovulation induction was started with HP-FSH SC (10 patients; group I) or FSH IM (10 patients; group II). After ovulation, outcome of ovulation induction and local reaction of injection site were compared. There were no difference of outcome of ovulation in two groups except pregnancy rate/embryo transfer. Group I had a higher pregnancy rate/ embryo transfer than Group II (44.4% Vs 28.6%). Pain, redness, tenderness, bruising and itching when the injection received on the first 5 days of treated (50 SC and 50 IM injections) were assessed. There were no significant difference (P>0.05) in the incidence of tenderness, bruising and itching between the IM and SC injection. But IM injection (FSH) had a tendency of higher above incidence. The number of reports of pain, redness were significantly increased in IM injection group (P<0.05). These results indicate that SC administration of HP-FSH has been shown to be as effect for superovulation as traditional gonadotropins, with an improved safety profile due to the removal of extaneous proteins.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1311-1315
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• 2012

Objectives: Thrombotic risk is increased in patients with cancer and there are important implications for those who suffer a venous thromboembolism (VTE). We undertook this study to determine the frequency, clinical patterns, and outcome of VTE in Saudi patients with cancer. Methods: Cancer (solid tumors and lymphoma) patients who developed VTE from January 2004 to January 2009 were studied retrospectively. Demographics and clinical characteristics related to thrombosis and cancer were evaluated. Results: A total of 701 patients with cancer were seen during the study period. VTE was diagnosed in 47 (6.7%) patients (median age 52, range 18-80 years). Lower limb DVT was the most common type, seen in 47% patients, followed by PE in 19%, and 19% patients had both DVT & PE. Thrombosis was symptomatic in 72% patients while it was an incidental finding on routine workup in 28%. Cancer and VTE were diagnosed at the same time in 38% of patients, and 47% patients developed VTE during the course of disease after the cancer diagnosis. The majority of VTE post cancer diagnoses occurred during the first year (median 4 months, range 1-14). Additional risk factors for VTE were present in 22 (47%) patients and 14 (30%) of these patients were receiving chemotherapy at the time of thrombosis. Only 5 (10.6%) patients were receiving thrombo-prophylaxis at the time of VTE diagnosis. Most common types of tumors associated with thrombosis were breast cancer, non-Hodgkin's lymphoma and lung cancer. The majority of the affected patients (79%) had advanced stage of cancer. After a median follow-up of 13 (range 0.5-60) months, 38 (81%) patients had died. There was no difference in the mortality of patients with symptomatic or asymptomatic thrombosis (82% vs 78.6%). Conclusions: Thrombotic complications can develop in a significant number of patients with cancer, and almost half of the patients have additional risk factors for VTE. Thrombosis is usually associated with advanced disease and can be asymptomatic in more than a quarter of cases. Thromboprophylaxis in cancer patients is under-utilized. Community based studies are needed to accurately define the extent of this problem and to develop effective prophylactic strategies.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7891-7895
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• 2014

Background: Tobacco products continue to be used in large quantities in India despite the mandatory inclusion of pictorial health warnings (PHWs) on all tobacco packaging. The circumstances as to how people could continue the use of tobacco to the point of developing head and neck cancer despite enhanced awareness about the ill effects of tobacco is the main focus of this study. Materials and Methods: This study concerned patients with least 5-years history of tobacco use, having been diagnosed with histopathologically proven malignancies of the hypopharynx, larynx, oropharynx and oral cavity presenting at the Government Medical College-Haldwani, Nainital, India. A total of 183 patients were eligible for inclusion during July 1 2013 - June 30 2014. Of these, 59 patients used smoked tobacco exclusively, 22 patients used smokeless tobacco exclusively, and 102 patients used both forms of tobacco. Among users of smoked forms, 75.2% (n=121) were beedi users, and 24.8% (n=40) were cigarette users. Patients were asked direct questions as to whether they had noticed the presence of PHWs upon tobacco products. The reasons as to why PHWs were not effective in stopping the patients from tobacco use were investigated. Results: Of the 183 patients, 146 reported being aware about the presence of PHWs, and when they were asked reasons as to why they continued tobacco despite being aware of ill-effects, the commonest reason chosen (by 53.4%) was that patients had not regarded themselves as using tobacco heavy enough to cause cancer. Among the 36 patients who reported as being oblivious to the presence of PHWs on tobacco products, 63.9% reported that the products they used never displayed any PHWs, and 36.1% reported never having paid attention to the packaging. The awareness about PHWs was higher among cigarette smokers in comparison to beedi smokers (100% vs 76.1%, p=0.0002). Conclusions: Locally produced and marketed tobacco products such as beedis and oral tobacco often fail to display PHWs. The presence of PHWs without doubt enhances awareness about the carcinogenic risks of tobacco. However, enhanced awareness alone may not be enough, and as elucidated by this study, some persons continue to use tobacco to the point of developing malignancies. The need of the hour is the implementation of legal and economic sanctions discouraging the use of tobacco products.

• Journal of Fisheries and Marine Sciences Education
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• v.28 no.3
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• pp.611-618
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• 2016

A $3{\times}2$ factorial experiment was conducted to investigate effects of water temperature and feeding rate on growth and body composition of olive flounder. Triplicate groups of fish (initial body weight of 118 g) fed a extruded pellet (55% protein and 4708 cal/g) to satiation and at restricted feeding rates of 0.25 and 0.4% body weight per day (BW/d) at the different water temperatures (13 and $18^{\circ}C$) for 9 weeks. Weight gain increased significantly with increase in feeding rates at each temperature. Weight gain of fish fed to satiation was significantly higher at 18 than $13^{\circ}C$, whereas, that of fish fed at 0.25 and 0.4% BW/d were significantly or slightly lower at 18 than $13^{\circ}C$. Feed efficiency and protein efficiency ratio of fish fed to satiation were not significantly different between 13 and $18^{\circ}C$, but those of fish fed at 0.25 and 0.4% BW/d were significantly higher at 13 than $18^{\circ}C$. The major finding of this study is that satiation feeding is efficient for optimal growth and feed efficiency of grower oliver flounder (116-164 g) in suboptimal water temperatures. The maintenance feeding ration which is zero growth performance, were 0.30 and 0.41% BW/day at 13 and $18^{\circ}C$, respectively. In the restricted feeding regime, compromised growth of fish were worsen in higher water temperature ($18^{\circ}C$ vs. $13^{\circ}C$). It might be related to high metabolic rate of fish that spend more energy for maintenance metabolism. Based on these results, we suggest that a satiation feeding regime is recommended for a productive growth of grower olive flounder in the suboptimal temperature.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.431-441
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• 1988

The purpose of this study was to compare the difference of two survey methods for health services research. Data were collected by means of two types of household survey conducted from March 11 to September 19, 1985. A probability sample of 30,613 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. The sample was divided into two groups systematically. One group was surveyed by the self-administered questionnaire and the other group was interviewed. Response rates were 81.4% and 90.6% respectively. The data were analysed by the ratio of the results of the self-administered survey to those of the interview survey. No difference was observed in sex, age, residence, or occupation between the two groups. However the respondents' characteristics were statistically different between the two groups. The major findings of this study are as follows : 1. The morbidity rate was 142.5 per 1,000 persons during the two week period by the self-administered questionnaire survey and 74.3 per 1,000 persons with the interview survey method. The ratio of the morbidity rate by the self-administered questionnaire to that by the interview was 1.92, and the difference between the two rates were due to the personal characteristics. 2. The out-patient utilization rate was 10.2 visits per person per year by the self-administered questionnaire survey and 5.4 by the interview survey, and the ratio was 1.89; the admission rate was 3.2 times per 100 persons per year by the self-administered questionnaire survey and 1.9 times by the interview survey, and the ratio was 1.68. Differences due to the sociodemographic characteristics were greater in the out-patient utilization rates than in the adimssion rates. 3. Percentages of effective medical care demand were 90.2% in the self-administered survey and 92.3% in the interview survey; the ratio was 0.98 which was less than that of the morbidity rate and medical care utilization. But, differences of effective medical care demand occurred in persons with no occupation, and aged or low educated respondents. 4. Respiratory illness had the highest frequency in the two survey methods. But there was a slight difference between the two survey methods in morbidity composition. 5. It was concluded that data collected by the interview survey were inclined to be underestimated and this problem can be corrected by a modified self-administered survey.