• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.85-88
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• 2016

Background: Cervical cancer is the second most common malignancy among women worldwide, and women of reproductive age in Thailand. However, information on the behavior regarding cervical cancer in rural community Thailand is sparse. Objective: To assess the knowledge, attitude, and practice regarding cervical cancer (CC) among rural community women in Nakhon Ratchasima, Thailand, using predesigned structured questionnaires. Materials and Methods: A cross-sectional survey was conducted in 8 villages of Non Sung district, Nakhon Ratchasima province, Thailand, during January to April 2015. Bloom's taxonomy was used as a framework for the study. 265 women aged between 30-60 years old were selected by simple random sampling. All participants completed predesigned questionnaires with 4 parts: demographic data, knowledge, attitude, and practice regarding cervical cancer. Descriptive statistics were used for analysis in this study. Results: The majority of participants were in the age group of 41-50 years old (42.6%) with senior secondary school level of education (32.1%), marriage status (85.0%), agricultural employment (59.6%), and family income between 6,000-10,000 baht per month (54.3%). Some 63.4% and 68.7% participants had high knowledge and moderate level of attitudes regarding CC, while 41.1%, 48.7%, and 10.2% had neem regularly, irregularly or never screened for CC, respectively. The main reasons for not screening were were shyness (44.4%) and no time (55.6%). Vaginal discharge and itching were the common signs and symptoms of participants who were screened at a health promotion hospital of sub-district. Conclusions: CC is still a health problem in the rural community. Therefore, health education is required, particularly for those who have never undergone screening.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5957-5961
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• 2015

Background: We designed this randomized controlled trial (RCT) to assess whether lobaplatin-based concurrent chemotherapy might be superior to cisplatin-based concurrent chemotherapy for FIGO stage II and III cervical cancer in terms of efficacy and safety. Materials and Methods: This prospective, open-label RCT aims to enroll 180 patients with FIGO stage II and III cervical cancer, randomly allocated to one of the three treatment groups (cisplatin $15mg/m^2$, cisplatin $20mg/m^2$ and lobaplatin $35mg/m^2$), with 60 patients in each group. All patients will receive external beam irradiation (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT). Patients in cisplatin $15mg/m^2$ and $20mg/m^2$ groups will be administered four cycles of $15mg/m^2$ or $20mg/m^2$ cisplatin intravenously once weekly from the second week to the fifth week during EBRT, while patients inthe lobaplatin $35mg/m^2$ group will be administered two cycles of $35mg/m^2$ lobaplatin intravenously in the second and fifth week respectively during pelvic EBRT. All participants will be followed up for at least 12 months. Complete remission rate and progression-free survival (PFS) will be the primary endpoints. Overall survival (OS), incidence of adverse events (AEs), and quality of life will be the secondary endpoints. Results: Between March 2013 and March 2014, a total of 61 patients with FIGO stage II and III cervical cancer were randomly assigned to cisplatin $15mg/m^2$ group (n=21), cisplatin $20mg/m^2$ group (n=21) and lobaplatin $35mg/m^2$ group (n=19). We conducted a preliminary analysis of the results. Similar rates of complete remission and grades 3-4 gastrointestinal reactions were observed for the three treatment groups (P=0.801 and 0.793, respectively). Grade 3-4 hematologic toxicity was more frequent in the lobaplatin group than the cisplatin group. Conclusions: This proposed study will be the first RCT to evaluate whether lobaplatin-based chemoraiotherapy will have beneficial effects, compared with cisplatin-based chemoradiotherapy, on complete remission rate, PFS, OS, AEs and quality of life for FIGO stage II and III cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5013-5018
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• 2015

Background: Myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell disorders characterized by proliferation of one or more myeloid lineages. Polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) are classical Philadelphia chromosome (Ph)-negative MPN that have a Janus Kinase 2 (JAK2) mutation, especially JAK2V617F in the majority of patients. The major complications of Ph-negative MPNs are thrombosis, hemorrhage, and leukemic transformation. Objective: To study clinical manifestations including symptoms, signs, laboratory findings, and JAK2V617F mutations of Ph-negative MPN (PV, ET and PMF) as well as their complications. Materials and Methods: All Ph-negative MPN (PV, ET and PMF) patients who attended the Hematology Clinic at Maharaj Nakorn Chiang Mai Hospital from January, 1 2003 through December, 31 2013 were retrospectively reviewed for demographic data, clinical characteristics, complete blood count, JAK2V617F mutation analysis, treatment, and complications. Results: One hundred and fifty seven patients were included in the study. They were classified as PV, ET and PMF for 68, 83 and 6 with median ages of 60, 61, and 68 years, respectively. JAK2V617F mutations were detected in 88%, 69%, and 100% of PV, ET and PMF patients. PV had the highest incidence of thrombosis (PV 29%, ET 14%, and PMF 0%) that occurred in both arterial and venous sites whereas PMF had the highest incidence of bleeding (PMF 17%, ET 11%, and PV 7%). During follow up, there was one ET patient that transformed to acute leukemia and five cases that developed thrombosis (three ET and two PV patients). No secondary myelofibrosis and death cases were encountered. Conclusions: Ph-negative MPNs have various clinical manifestations. JAK2V617F mutations are present in the majority of PV, ET, and PMF patients. This study confirmed that thrombosis and bleeding are the most significant complications in patients with Ph-negative MPN.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6011-6017
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• 2015

Purpose: To investigate the efficacy and safety of selective radiotherapy after distant metastasis of nasopharyngeal carcinoma (NPC) treated with dose-dense cisplatin plus fluorouracil. Materials and Methods: Eligible patients were randomly assigned to a study group treated with dose-dense cisplatin plus fluorouracil following selective radiotherapy and a control group receiving traditional cisplatin plus fluorouracil following selective radiotherapy according to a 1:1 distribution using a digital random table method. The primary endpoint was overall survival (OS). Secondary endpoints were progression-free survival (PFS), objective response rate, relapse or progression rate in the radiation field and treatment toxicity. Results: Of 52 patients in the study group, 20 cases underwent radiotherapy., while in the control group of 51 patients, 16 underwent radiotherapy. The median PFS, median OS, survival rates in 1, 2 and 3 years in study and control group were 20.9 vs 12.7months, 28.3 vs 18.8months, 85.2%vs 65.9%, 62.2% vs 18.3%, and 36.6%vs 5.2% (p values of 0.00, 0.00, 0.04, 0.00 and 0.00, respectively). Subgroup analysis showed that the median OS and survival rates of 1, 2, 3 years for patients undergoing radiotherapy in the study group better than that in control group( 43.2vs24.1 months, 94.1% vs 86.7%, 82.4% vs 43.3%, 64.7% vs 17.3%, (p=0.00, 0.57, 0.04 and 0.01, respectively). The complete response rate, objective response rate after chemotherapy and three months after radiotherapy, relapse or progression rate in radiation field in study group and in control group were 19.2% vs 3.9%, 86.5% vs 56.9%, 85% vs 50%, 95% vs 81.3% and 41.3% vs 66.7% (p =0.03, 0.00, 0.03,0.30, 0.01 respectively). The grade 3-4 acute adverse reactions in the study group were significantly higher than in the control group (53.8% vs 9.8%, p=0.00). Conclusions: The survival of patients benefits from selective radiotherapy after distant metastasis of NPC treated with dose-dense cisplatin plus fluorouracil.

• Journal of the Korean School Mathematics Society
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• v.17 no.4
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• pp.717-746
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• 2014

The study aimed to explore how to improve mathematical thinking through metacognitive learning by stressing metacognitive abilities as a core strategy to increase mathematical creativity and problem-solving abilities. Theoretical exploration was followed by an analysis of correlations between metacognitive abilities and various ways of mathematical thinking. Various metacognitive teaching and learning methods used by many teachers at school were integrated for sharing. Also, the methods of learning application and assessment of metacognitive thinking were explored. The results are as follows: First, metacognitive abilities were positively related to 'reasoning, communication, creative problem solving and commitment' with direct and indirect effects on mathematical thinking. Second, various megacognitive ability-applied teaching and learning methods had positive impacts on definitive areas such as 'anxiety over Mathematics, self-efficacy, learning habit, interest, confidence and trust' as well as cognitive areas such as 'learning performance, reasoning, problem solving, metacognitive ability, communication and expression', which is a result applicable to top, middle and low-performance students at primary and secondary education facilities. Third, 'metacognitive activities, metaproblem-solving process, personal strength and weakness management project, metacognitive notes, observation tables and metacognitive checklists' for metacognitive learning were suggested as alternatives to performance assessment covering problem-solving and thinking processes. Various metacognitive learning methods helped to improve creative and systemic problem solving and increase mathematical thinking. They did not only imitate uniform problem-solving methods suggested by a teacher but also induced direct experiences of mathematical thinking as well as adjustment and control of the thinking process. The study will help teachers recognize the importance of metacognition, devise and apply teaching or learning models for their teaching environments, improving students' metacognitive ability as well as mathematical and creative thinking.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.71-79
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• 2015

Background: Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. Methods: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. Results: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. Conclusion: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

• Atmosphere
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• v.27 no.1
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• pp.41-54
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• 2017

Organic carbon (OC) and elemental carbon (EC) in $PM_{2.5}$ were measured using Sunset OC/EC Field Analyzer at Seoul Hwangsa Monitoring Center from March to April, 2016. The mean concentrations of OC and EC during the entire period were $4.4{\pm}2.0{\mu}gC\;m^{-3}$ and $1.4{\pm}0.6{\mu}gC\;m^{-3}$, respectively. OC/EC ratio was $3.4{\pm}1.0$. The average concentrations of $PM_{10}$ and $PM_{2.5}$ were $57.4{\pm}25.9$ and $39.7{\pm}19.8{\mu}g\;m^{-3}$, respectively, which were detected by an optical particle counter. The OC and EC peaks were observed in the morning, which were impacted by vehicle emission, however, their diurnal variations were not noticeable. This is determined to be contributed by the long-range transported OC or secondary formation via photochemical reaction by volatile organic compounds at afternoon. A conditional probability function (CPF) model was used to identify the local source of pollution. High concentrations of $PM_{10}$ and $PM_{2.5}$ were observed from the westerly wind, regardless of wind speed. When wind velocity was high, a mixing plume of dust and pollution during long-range transport from China in spring was observed. In contrast, pollution in low wind velocity was from local source, regardless of direction. To know the effect of long-range transport on pollution, a concentration weighted trajectory (CWT) model was analyzed based on a potential source contribution function (PSCF) model in which 75 percentiles high concentration was picked out for CWT analysis. $PM_{10}$, $PM_{2.5}$, OC, and EC were dominantly contributed from China in spring, and EC results were similar in both PSCF and CWT. In conclusion, Seoul air quality in spring was mainly affected by a mixture of local pollution and anthropogenic pollutants originated in China than the Asian dust.

• Journal of Distribution Science
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• v.13 no.4
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• pp.35-43
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• 2015

Purpose - This study aims to seek various plans to maintain the advancement of the overseas and domestic employment scenario through a case analysis of the Japanese industry, which maintains domestic employment while promoting the overseas advancement of companies despite having a similar industrial structure as Korea. The study further intends to derive insightful implications for Japanese manufacturing companies and government policies. Research design, data, and methodology - We selected four companies from the Japanese manufacturing industry. Being companies that were successful in increasing the domestic employment scenario while advancing in overseas markets. We utilized several secondary data sources including Japanese newspapers and report literature. Results - Previous studies have shown a negative relationship between Foreign Direct Investment (FDI) or offshoring and domestic employment. However, our results showed this relationship with respect to the Japanese manufacturing industry as follows: 1. FDI for developing overseas markets does not decrease domestic production. If Japanese companies change their strategy from exports to overseas production, there will be a consequent decrease in domestic employment of Multinational Enterprises (MNEs). However, the local production that plans the sales expansion of a foreign market does not substitute domestic production. 2. Several case studies illustrate that, as the production of final goods is expanded in foreign countries, there is a corresponding increase in the export of intermediary goods from Japan. In this case, if the production process of Japanese companies is promoted in foreign markets, the amount of exported material and parts from Japan will consequently increase. 3. It is difficult to consider that the establishment of subsidiary companies in foreign countries by manufacturing companies for wholesale, retail, and services decreases domestic employment. This is because the international development of these industries needs expatriates, expatriate training organizations, and research and development (R&D) activities. 4. When there is overseas demand, the growth of local management activities is expected to increase the work of the overseas business department in the head office in Japan, if competitiveness can be secured for better localization and management speed. 5. The conversion of the domestic manufacturing industry into high value-added production is necessary. The relocation of domestic production to foreign markets decreases domestic employment. To prevent this, the upgradation of domestic production bases, including high value-added production, and R&D capability need to be strengthened. Technology-based companies must develop new technology, patents, processes, and so forth, which require extensive human resources for R&D. Conclusions - Domestic medium-sized companies that are capable of consistently supplying high value-added products should be actively encouraged to deploy into and develop overseas markets. Further, this paper considers the necessity of a guidance policy that provides suggestions for overseas deployment, by the initiation of the government, to companies that cannot do so due to the lack of foreign experience or decisions by the CEO, despite having the relevant capability and technologies to supply high value-added products.

• Clinical and Experimental Pediatrics
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• v.57 no.1
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• pp.50-53
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• 2014

Hemophagocytic lymphohistiocytosis (HLH) occurs in the primary form (genetic or familial) or secondary form (acquired). The familial form of HLH (FHL) is a potentially fatal autosomal recessive disorder that occurs because of constitutional defects in cell-mediated cytotoxicity. Here, we report a fatal neonatal case of type 2 FHL (FHL2) that involved a novel frameshift mutation. Clinically, the newborn presented with severe sepsis-like features and required mechanical ventilation and continuous venovenous hemodiafiltration. Flow cytometry analysis showed marked HLH and complete absence of intracytoplasmic perforin expression in cytotoxic cells; therefore, we performed molecular genetic analyses for PRF1 mutations, which showed that the patient had a compound heterozygous mutation in PRF1, that is, c.65delC ($p.Pro22Argfs^*2$) and c.1090_1091delCT ($p.Leu364Glufs^*93$). Clinical and genetic assessments for FHL are required for neonates with refractory fever and progressive multiple organ failure, particularly when there is no evidence of microbiological or metabolic cause.

• Journal of Korean Society for Atmospheric Environment
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• v.32 no.1
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• pp.67-81
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• 2016

In order to examine the variation characteristics of chemical compositions in accordance with the different meteorological conditions, $PM_{10}$ and $PM_{2.5}$ were collected at Gosan site of Jeju Island in 2014, and then their ionic and elemental species were analyzed. The concentrations of nss-$SO{_4}^{2-}$ and $NH_4{^+}$ were respectively 4.3 and 3.3 times higher in fine particle mode ($PM_{2.5}$) compared to coarse particle mode ($PM_{10-2.5}$), however $NO_3{^-}$ concentration was 1.6 times higher in coarse mode compared to fine particle mode. During Asian dust days, the concentrations of nss-$Ca^{2+}$ and $NO_3{^-}$ increased highly as 7.7 and 4.5 times in coarse particle mode, and 3.0 and 4.9 times higher in fine particles, respectively. Especially, the concentrations of the crustal species (Al, Fe, Ca, K, Mn, Ba, Sr, etc.) indicated a noticeable increase during the Asian dust days. For the haze days, the concentrations of secondary pollutants increased 2.2~2.7 and 2.9~6.0 times in coarse and fine particles, respectively, and they were 0.8~1.1 and 1.8~2.4 times, respectively, during the mist days. The aerosols were acidified largely by sulfuric and nitric acids, and neutralized mainly by ammonia in fine particle mode during the haze days, but neutralized by calcium carbonate in coarse particle mode during the Asian dust days. The clustered back trajectory analysis showed that the concentrations of nss-$SO{_4}^{2-}$, $NO_3{^-}$, and $NH_4{^+}$ were relatively high when the inflow pathway of air mass was from the southern part of China.