• Journal of Oriental Neuropsychiatry
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• v.23 no.1
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• pp.59-82
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• 2012

Objectives : We purposed to objectify the pattern diagnosis of Tic disorders through factor and reliability analysis regarding a pattern identification questionnaire concerning Tic disorders in children. Methods : We chose and studied 144 children who were pattern-diagnosed out of 200 tic disordered children who visited H hospital in Seoul from January 2006 to April 2011. Results : 1. TTD (50%) was the most common type and the occurrence rate in male children was higher(4.76:1). Also, the rate of hospital visits was highest at the age 8(23.6%). 2. In results concering pattern diagnosis, Gan-poong-nae-dong was most frequently diagnosed in 53 patients (36.8%), and Dam-hwa-yo-sin (42 patients), Gan-sin-um-her (30 patients), and Bee-her-gan-wang (6 patients). 3. In an attempt to verify the reliability of the questionnaire, the coefficient regarding the whole questions (Cronbach ${\alpha}$) came to 0.909. Moreover, the reliability coefficient foreach sub factor was 0.687 in Ganpoong-nae-dong, 0.817 in Dam-hwa-yo-sin, 0.851 in Bee-her-gan-wang, and 0.726 in Gan-sin-um-her, respectively. Thus, their consistency was ensured. 4. In exploratory factor analysis concerning the most common five questions in the questionnaire, the questions of Dam-hwa-yo-sin and Gan-poong-nae-dong appeared to be part of different factors. While, Gan-sin-um-her and Bee-her-gan-wang questions showed that they belong to the same factors. 5. In factor analysis excluding both Gan-sin-um-her and Bee-her-gan-wang questions, both showed significant results; however, the one excluding Gan-sin-um-her showed improved results. Conclusions : From the above results concerning the Pattern Identification Questionnaire for Tic Disordered children, three separated patterns of Bee-her-gan-wang, Dam-hwa-yo-sin, Gan-poong-nae-dong are thought to be available for clinical use. However, further validity studies are needed.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.7 no.2
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• pp.105-111
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• 2021

⁸⁹Zr is a positron-emitting radioisotope, which has known as well-suited radioisotope for use in a monoclonal antibody-based imaging agent for immuno-PET. The purpose of this study was to quantitatively evaluate the diagnostic ability of general trastuzumab and thio-trastuzumab as HER2 positive receptors based on Df hexadentate iron chelator. Desferrioxamine-p-SCN (Df-Bz-NCS) and desferroixamine-maleimide (Df-Mal) were purchased from Macrocyclics (Dallas, TX, USA). The trastuzumab was purchased from Roche (Schweiz), and thio-trastuzumab was obtained from professor Hyo-Jeong Hong group (Kangwon National University). The radioisotope ⁸⁹Zr was produced by domestic purification system and KIRAMS using medical cyclotron (50 MeV, Scantronix). The conjugates of Df-trastuzumab and Df-thio-trastuzumab were prepared with Df-Bz-NCS and Df-Mal under basic aqueous solution (pH 8-9) at room temperature, respectively. The conjugates purified by PD-10 column were mixed with dried ⁸⁹Zr chloride. ⁸⁹Zr-labeled conjugates were purified and concentrated by Amicon ultra centrifugal filter. The preparation step and time of ⁸⁹Zr-labeled conjugates was shorted as 4 steps within 2 hours. ⁸⁹Zr-labeled conjugates showed the highly radiochemical purity of over 98%, and were very stable until 7 days by the analysis of radio-ITLC method. Each radio-labeled conjugates were also exhibited the highly stability in both PBS buffer and mouse serum. Immuno-PET imaging of ⁸⁹Zr-labeled conjugates in mice bearing gastric cancer xenograft tumors with HER2 expression showed high tumor uptake in the NCI-N87 HER2-expressing. However, ⁸⁹Zr-Df-Mal-thio-trastuzumab showed a relatively lower tumor-to-background ratio than ⁸⁹Zr-Df-Bz-trastuzumab, as well as whole-body distribution. In the results, ⁸⁹Zr-Df-Bz-trastuzumab was evaluated to have a relatively higher HER2 diagnostic ability than ⁸⁹Zr-Df-Mal-thio-trastuzumab.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10277-10280
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• 2015

Background and Aim: Breast cancer (BC) is a heterogeneous disease and cell proliferation markers may help to identify subtypes of clinical interest. We here analyzed the correlation between cell proliferation determined by Ki67 and HG in BC patients undergoing preoperative chemotherapy (PCT). Materials and Methods: We obtained clinical/pathological data from patients with invasive BC treated at our institution from 1999 until 2012. Expression of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor type 2 (HER2) and Ki67 were determined by immuno-histochemistry (IHC). Clinicopathological subtypes were defined as: Luminal A, ER and/or PR positive, HER2 negative, HG 1 or 2; Luminal B, ER and/or PR positive, HER2 negative or positive and/or HG 3; triple negative (TN), ER, PR and HER2 negative independent of HG; HER2 positive, ER, PR negative and HER2 positive, independent of HG. By using Ki67, a value of 14% separated Luminal A and B tumors, independently of the histological grade. We analyzed correlations between Ki67 and HG, to define BC subtypes and their predictive value for response to PCT. Results: 1,560 BC patients were treated in the period, 147 receiving PCT (9.5%). Some 57 had sufficient clinicopathological information to be included in the study. Median age was 52 years (26-72), with 87.7% invasive ductal carcinomas (n=50). We performed IHC for Ki67 in 40 core biopsies and 50 surgical biopsies, 37 paired samples with Ki67 before and after chemotherapy being available. There was no significant correlation between Ki67 and HG (p=0.237), both categorizing patients into different subtypes. In most cases Ki67 decreased after PCT (65.8%). Only 3 patients had pathologic complete response (cPR). Conclusions: In our experience we did not find associations between Ki67 and HG. Determination of clinicopathological luminal subtypes differs by using Ki67 or HG.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.609-621
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• 2023

Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.

• Child Health Nursing Research
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• v.2 no.1
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• pp.13-26
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• 1996

This descriptive study was done to detect the possibilities of the development of the advocacy concept in nursing. The subjects consisted of 3 nurses who had agreed to participate to the study, working at nursery room in a general hospital. Data was collected from May 22 to June 13 in 1995 through tape recorded intensive-interview, and written down, then content analyzed qualitatively related to the infant advocacy. 1. Derivation fo the meaning about advocacy concept 1) The situations in need of infant advocacy were 12 categories : malpractice, overcharing, negligence, unnecessary services, and services without consent, and so on. 2) Fourteen categories of advocacy activities percived by nurses were derived from participants' statements. Protesting infant or his /her families against their counterpart, providing informations to families, cooperating with medical staffs for her patient, then calling medical staff not so as to be maleficient to her patient in its rank. 3) The expected result of advocacy activities perceived by nurses was respectively positive to her patient or families, but negative to nurse. 4) The feelings of nurses in the sitution of advocacy were expressed in to concern, comprehension, regret, powerlessness, charity, desire, and so on. 5) Nurses perceived that advocacy activities could be influenced positively by factors related to nurses' qualification and negatively by factors related to doctor's overdo and nurse's underdo. 2. Categorization of the meaning and their relationships In case of antecedental situation in need of infant advocacy, nurse perceives her patients need the advocacy to get a benefit through nurse's information, intervention speaking, building cooperations. The expected factors to influence advocacy activities perceived by nurses, are the power imbalance between medical staffs, the nurse's qualification, and the nurse's feeling from the situation. The above results suggest that the infant care situation will be recommendable field work place for concept development of advocacy with hybride model when it involves infant's families.

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.24-28
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• 2013

The five-year survival for patients with gastric cancer improved only modestly over the last 50 years. So, several studies about molecular target chemotherapy were investigated. We reviewed about molecular target chemotherapy for advanced unresectable and metastatic gastric cancer, which has developed recently. EGFR (Epidermal growth factor receptor), HER (Human epidermal growth factor receptor), VEGF (Vascular endothelial growth factor receptor) can be the target of therapy for gastric cancer. Patients with advanced gastric adenocarcinoma who are potential candidates for trastuzumab should have their tumors assayed for the presence of HER2 overexpression utilizing tumor-specific criteria and/or gene amplification. We suggest the addition of trastuzumab to chemotherapy in patients with HER2-positive tumors (as defined by 3+ immunohistochemical staining or FISH positivity), as long as they do not have a contraindication to trastuzumab. Except for trastuzumab, we summarized several studies for molecular target agents which were not validated yet.

• The Korean Journal of Air & Space Law and Policy
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• v.34 no.1
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• pp.39-77
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• 2019

Crew members engaged in international air transportation provide work in many countries due to the nature of their work. According to the Private International Act, the place where the employee habitually carries out his/her work plays an important role in the determination of the governing law of the international labor contract (Article 28, Paragraph 2) and in the decision of international jurisdiction (Article 28, Paragraphs 3 and 4). The concept of the place where the employee habitually carries out his/her work was proposed by the EU to determine international jurisdiction and governing law. In international aviation law, the legislative purpose of the place where the employee habitually carries out his/her work is different from that of home base, which is a concept introduced for fatigue management of the crew in order to secure the aviation safety; thus the place where the employee habitually carries out his/her work and home base are not the same concept. In order to determine the place where the employee habitually carries out his/her work, following matters should be considered comprehensively; (i) where the crew starts and ends work, (ii) where the aircraft the crew is performing work on is primarily parked, (iii) where the crew is informed of the instructions and organizes his/her work activities, (iv) where the crew is obliged to reside according to the labor contract, (v) where there is an office provided by the employer and available to the crew, (vi) where the crew is obliged to be when he/she is ineligible for the work or subject to discipline. However, since all of the above items are the same as the location of the home base, it is reasonable to consider the home base as the most important factor when deciding on the place where the employee habitually carries out his/her work. In contrast, the state where the aircraft is registered (Article 17 of the Chicago Convention), should not be regarded as a place of where the employee habitually carries out his/her work. In this case, CJEU provided the first judging standard for the concept of the place where the employee engaged in international air transportation habitually carries out his/her work. It is the interpretation of the Brussels regulations which became a model -for the Korean Private International Act,- so it would be helpful to understand the concept of the place where the employee habitually carries out his/her work.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.1
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• pp.26-31
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• 2008

Cerebrovascular Accident(stroke) is that a sudden, nonconvulsive loss of neurologic function due to an ischemic or hemorrhagic intracranial vascular event. If stroke happens at the portion of trigeminal motor nucleus or its control part of cerebral cortex, masticatory muscles will be atrophy or paralyzed. So it is possible that dental occlusion changes after stroke. A 74-aged woman recurred mild stroke 2 month ago, who had experienced severe stroke 2 years ago. After recurrence, suddenly her upper full denture was dropped when lower denture contacted upper one. According to the her occlusion exam, her lower jaw moved back slightly compared with the occlusion of old denture. And her face had asymmetry and lower jaw dislocated to paralyzed side. A 50-aged man was treated because many cervical caries, which would occur because of an aftereffect of stroke, long-herm hospitalization and limits of self oral-care. 6 years ago he had cerebral hemorrhage and he claimed that he cannot bite exactly. Just two pairs of teeth was contact on biting, his lower jaw was located back, too. This two case suggests that dental occlusion can change after stroke.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.2 no.1
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• pp.56-62
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• 1991

The author reported treatment experiences of 4 cases with test anxiety. The first one was a 15 year old boy with problem of mild attention deficit which caused test anxiety and academic underachievement around the 8th grade in middle school. The second and the third cases were brother and sister. The test anxiety was caused basically due to the problem of mother child relationship. their mother expected too much of her son and always urged him to study and never left him alone. The mothers practically gave up her whole life to devote to oversee her son's academic achievement and her daughter experienced affectional deprivation. The fourth case, a 16 year old boy, was a borderline personality disorder with extreme anger and hostility toward his parents who controled him too much. Different therapeutic approaches appropriate for different cases were described and the relationship between test anxiety and various psychopathology was discussed.