1.Clinical Usefulness of Cervicogram as Primary Screening Test of Cervical Intraepithelial Neoplasia.
Yu Ri KIM ; Young Tae KIM ; Sung Hoon KIM ; Jae Wook KIM ; Bo Sung YOON ; Da Jung CHUNG
Korean Journal of Obstetrics and Gynecology 2004;47(6):1113-1119
OBJECTIVE: The aim of this study is to evaluate the clinical usefulness of cervicogram as primary screening test of cervical intraepithelial neoplasia. METHODS: Total 294 women who had undergone cervicogram and pathologically diagnosed at YUMC between January and July 2003, were selected. Diagnostic accuracy of Pap smear, cervicogram and Pap smear combined with cervicogram were compared with pathologic diagnosis. Statistical analysis was performed by chi-square test (SPSS version 11.0). RESULTS: 1. Among 294 women, Pap smears were normal in 130 cases (44.2%) and abnormal in 164 cases (55.8%). The diagnostic accuracy between Pap smear and histology was as follows; sensitivity 72.0%, specificity 64.6%, positive predictive value 72.0%, negative predictive value 64.6%, false positive rate 28.0%, false negative rate 35.4%. 2. Cervicogram were normal in 202 cases (68.7%) and abnormal in 92 cases (31.3%). The diagnostic accuracy between cervicogram and histology was as follows; sensitivity 39.6%, specificity 79.2%, positive predictive value 70.7%, negative predictive value 31.0%, false positive rate 29.3%, false negative rate 49.0%. 3. Among 130 women with normal Pap smear, cervicogram were normal in 101 cases (77.7%) and abnormal in 29 cases (22.3%). The diagnostic accuracy between cervicogram with normal Pap smear and histology was as follows; sensitivity 26.1%, specificity 79.8%, positive predictive value 41.4%, negative predictive value 66.3%, false positive rate 58.6%, false negative rate 33.7%. 4. Among 164 women with abnormal Pap smear, Cervicograms were normal in 101 cases (61.6%) and abnormal in 63 cases (38.4%). The diagnostic accuracy between cervicogram with abnormal Pap smear and histology was as follows; sensitivity 44.9%, specificity 78.3%, positive predictive value 84.1%, negative predictive value 32.7%, false positive rate 15.9%, false negative rate 67.3%. CONCLUSION: Although adjunctive use of cervicogram to Pap smear in initial screening of cervical intraepithelial neoplasia showed higher specificity, higher negative predictive value and lower false negative rate compared to Pap smear alone, but, consideration in terms of lower sensitivity, lower positive predictive value, higher false positive rate and cost-effectiveness should be given in lieu of clinically applicating cervicogram with Pap smear as initial screening test.
Cervical Intraepithelial Neoplasia*
;
Diagnosis
;
Female
;
Humans
;
Mass Screening*
;
Sensitivity and Specificity
2.Effect of overweight or obesity on lung function and asthma severity in prepubertal asthmatic children
Da Bin JUNG ; Ji Eun JEONG ; Hai Lee CHUNG ; Yoon Young JANG
Allergy, Asthma & Respiratory Disease 2021;9(4):231-237
Purpose:
Cluster analysis on pediatric asthma identifying a cluster characterized by obesity, females, and puberty showed that obesity is an independent risk factor for severe asthma in this cluster. In the present study, we aimed to investigate the effect of overweight/obesity on lung function and asthma severity in prepubertal asthmatic children.
Methods:
One hundred fifty-five prepubertal children (aged 6–10) with asthma were enrolled and divided into 2 groups: the overweight/obese group (body mass index [BMI] ≥ 85th percentile, n = 44) and the normal BMI group ( < 85th percentile, n = 111). We reviewed their medical records and analyzed whether there were any differences in clinical features, lung function and degree of bronchial hyperresponsiveness (BHR) between the 2 groups. The clinical factors associated with asthma severity were also investigated.
Results:
There was no difference in clinical features between the 2 groups. Pulmonary function tests showed that only forced vital capacity in 1 second/forced vital capacity (FEV1/FVC) was significantly lower in the overweight/obese group than in the normal BMI group (P = 0.032). There was no difference in dysanapsis and BHR between the 2 groups. There were significantly more children with moderate-to-severe asthma in the overweight/obese group compared to the normal BMI group (P = 0.018). In multivariate logistic regression analysis, overweight/obesity has been identified as an independent risk factor of affecting asthma severity (odds ratio, 2.44; P = 0.018), in addition to the already known risk factor, FEV1.
Conclusion
Our study showed that overweight/obese prepubertal asthmatic children had lower FEV1/FVC than those with normal BMI. It also suggests that overweight/obesity may be an independent risk factor for severe asthma before puberty.
3.Secondary nipple reconstruction using two surgical techniques
Jae-Ho CHUNG ; Da-Som KIM ; Hyun-Dong YEO ; Seung-Pil JUNG ; Seung-Ha PARK ; Eul-Sik YOON
Archives of Plastic Surgery 2021;48(6):590-598
Background:
Although the initial projection after primary nipple reconstruction is excellent, nipple projection gradually flattens in most cases due to multiple causes. Although various methods have been reported to rebuild the nipple after nipple flattening, the most effective method of secondary nipple reconstruction remains unknown. The aim of this study was to review our institution’s experiences with secondary nipple reconstruction.
Methods:
We conducted a retrospective review from March 2012 to January 2019. We performed secondary nipple reconstruction if the primary reconstructed nipple height differed by more than 6 mm from the normal nipple height. We chose the method of nipple revision according to the degree of tissue scarring and the remaining nipple projection.
Results:
We performed secondary nipple reconstruction on a total of 27 nipples, using pursestring sutures for 19 nipples and star flaps in eight nipples. The median follow-up period was 8 months (range, 6–19 months) after the final nipple reconstruction. Among the 19 nipples reconstructed using purse-string sutures, 10 (53%) demonstrated acceptable projection of more than 5 mm. Among the eight nipples reconstructed using star flaps, six (75%) showed acceptable projection of more than 5 mm. Most of the patients (73%) were satisfied (scores of 4 or 5) with the nipple reconstruction overall.
Conclusions
Few studies have presented favorable outcomes of secondary nipple reconstruction. When the star flap and purse-string suture methods were used depending on the remaining nipple height and scarring, appropriate projection could be achieved.
4.Factors for Completing Case Management of Suicide Attempters: A Coihort Follow-Up Study Based on Data From Case Management of Emergency Room-Based Suicide Attempters
Jae Hyun RYOU ; Yoon Kyung HEO ; Da Seul KIM ; Sun Mi KIM ; Doug Hyun HAN ; Kyoung Joon MIN
Korean Journal of Psychosomatic Medicine 2021;29(2):176-183
Objectives:
:The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program.
Methods:
:Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case program as dependent variables.
Results:
:Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in sui-cide attempts, and had higher proportion of past suicide attempts than those who did not complete the program.
Conclusions
:To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.
5.Bacillus Calmette-Guérin (BCG)-Cell Wall Skeleton as Immunotherapeutic Option for BCG-Refractory Superficial Bladder Cancer
Young Mi WHANG ; Da Hyeon YOON ; Gwang Yong HWANG ; Young Wook CHOI ; In Ho CHANG
Korean Journal of Urological Oncology 2019;17(2):88-95
Although intravesical instillation of Mycobacterium bovis bacillus Calmette-Guérin (BCG) is the most successful cancer immunotherapy for superficial bladder cancer, the serious side effects are frequently arisen by using live mycobacteria. To allow less toxic and more potent immunotherapeutic agents following intravesical BCG treatment for superficial bladder cancer, noninfectious immunotherapeutic drug instead of live BCG would be highly desirable. Recently, immune-enhancing adjuvants are considered an effective vaccine immunotherapy for cancer, providing enhanced antitumor effects and boosted immunity. The BCG-cell wall skeleton (BCG-CWS), the main immune active center of BCG, is a potent candidate as a noninfectious immunotherapeutic drug instead of live BCG against bladder cancer. However, the most limited application for anticancer therapy, it is difficult to formulate a water-soluble BCG-CWS due to the aggregation of BCG-CWS in both aqueous and nonaqueous solvents. To overcome the insolubility and improve the internalization of BCG-CWS into bladder cancer cells, it should be developed the lipid nanoparticulation of BCG-CWS, resulting in improved dispensability, stability, and small size. In addition, powerful technology of delivery systems should be applied to enhance the internalization of BCG-CWS, such as encapsulated into lipid nanoparticles using novel packaging methods. Here, we describe the progress in research on effects of BCG-CWS for cancer immunotherapy, development of lipid-based solvent, and packaging method using nanoparticles with drug delivery system.
Administration, Intravesical
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Bacillus
;
Cell Wall Skeleton
;
Drug Delivery Systems
;
Immunotherapy
;
Methods
;
Mycobacterium bovis
;
Nanoparticles
;
Product Packaging
;
Skeleton
;
Solvents
;
Urinary Bladder Neoplasms
;
Urinary Bladder
6.Effectiveness of premedication and rapid desensitization in hypersensitivity to L-asparaginase.
Da Hye YOON ; Sung Hee KANG ; Hwan Soo KIM ; Jae Wook LEE ; Jong Seo YOON ; Nack Gyun CHUNG ; Bin CHO
Allergy, Asthma & Respiratory Disease 2015;3(4):288-293
PURPOSE: L-asparaginase is a crucial chemotherapeutic agent for the treatment of acute lymphoblastic leukemia. However, hypersensitivity to L-asparaginase is common which limits its clinical use. METHODS: We performed 44 cases of premedication and 3 cases of desensitization in 16 patients with hypersensitivity to L-asparaginase. RESULTS: With premedication, 33 cases completed L-asparaginase injection with no hypersensitivity reactions. Eleven cases showed mild hypersensitivity reactions, such as urticaria. Desensitization was performed in 3 cases: in 2 cases, desensitization was successful, and in 1 case the medication was switched to Erwinia asparaginase. CONCLUSION: Premedication and desensitization appear to be useful in helping patients receive desired doses of L-asparaginase in pediatric patients with acute lymphoblastic leukemia.
Asparaginase
;
Desensitization, Immunologic
;
Drug Hypersensitivity
;
Erwinia
;
Humans
;
Hypersensitivity*
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
Premedication*
;
Urticaria
7.Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists.
Da Yee JEUNG ; Hyun Ok LEE ; Won Gyun CHUNG ; Jin Ha YOON ; Sang Baek KOH ; Chi Yun BACK ; Dae Sung HYUN ; Sei Jin CHANG
Journal of Korean Medical Science 2017;32(9):1423-1430
The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that “overload and conflict in customer service,”“emotional disharmony and hurt,” and “lack of a supportive and protective system in the organization” were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout.
Dental Clinics
;
Dental Hygienists*
;
Female
;
Hospitals, General
;
Humans
;
Korea
;
Linear Models
;
Type A Personality*
8.Effects of Single Vitamin D₃ Injection (200,000 Units) on Serum Fibroblast Growth Factor 23 and Sclerostin Levels in Subjects with Vitamin D Deficiency.
Dongdong ZHANG ; Da Hea SEO ; Han Seok CHOI ; Hye Sun PARK ; Yoon Sok CHUNG ; Sung Kil LIM
Endocrinology and Metabolism 2017;32(4):451-459
BACKGROUND: Vitamin D deficiency remains common in all age groups and affects skeletal and non-skeletal health. Fibroblast growth factor 23 is a bone-derived hormone that regulates phosphate and 1,25-dihydroxyvitamin D homeostasis as a counter regulatory factor. 1,25-Dihydroxyvitamin D stimulates fibroblast growth factor 23 synthesis in bone, while fibroblast growth factor 23 suppresses 1,25-dihydroxyvitamin D production in the kidney. The aim of this study was to evaluate the effects of vitamin D₃ intramuscular injection therapy on serum fibroblast growth factor 23 concentrations, and several other parameters associated with bone metabolism such as sclerostin, dickkopf-1, and parathyroid hormone. METHODS: A total of 34 subjects with vitamin D deficiency (defined by serum 25-hydroxyvitamin D levels below 20 ng/mL) were randomly assigned to either the vitamin D injection group (200,000 units) or placebo treatment group. Serum calcium, phosphate, urine calcium/creatinine, serum 25-hydroxyvitamin D, fibroblast growth factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were serially measured after treatment. RESULTS: Comparing the vitamin D injection group with the placebo group, no significant changes were observed in serum fibroblast growth factor 23, parathyroid hormone, or dickkopf-1 levels. Serum sclerostin concentrations transiently increased at week 4 in the vitamin D group. However, these elevated levels declined later and there were no statistically significant differences as compared with baseline levels. CONCLUSION: Serum fibroblast factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were not affected significantly by single intramuscular injection of vitamin D₃.
Calcium
;
Cholecalciferol
;
Fibroblast Growth Factors*
;
Fibroblasts*
;
Homeostasis
;
Humans
;
Injections, Intramuscular
;
Kidney
;
Metabolism
;
Parathyroid Hormone
;
Vitamin D Deficiency*
;
Vitamin D*
;
Vitamins*
9.Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency.
Han Seok CHOI ; Yoon Sok CHUNG ; Yong Jun CHOI ; Da Hea SEO ; Sung Kil LIM
Osteoporosis and Sarcopenia 2016;2(4):228-237
OBJECTIVE: There has been no prospective study that examined intramuscular injection of high-dose vitamin D in Korean adults. The aim of this study was to assess the efficacy and safety of high-dose vitamin D3 after intramuscular injection in Korean adults with vitamin D deficiency. METHODS: This study was a 24-week, prospective, multicenter, randomized, double-blind, placebo-controlled trial. A total of 84 subjects ≥19 and <65 years of age were randomly allocated to either the vitamin D3 or placebo group in a 2:1 ratio. After randomization, a single injection of plain vitamin D3 200,000 IU or placebo was intramuscularly administered. If serum 25-hydroxyvitamin D (25[OH]D) concentrations were <30 ng/mL on week 12 or thereafter, a repeat injection was administered. RESULTS: After a single intramuscular injection of vitamin D3 to adults with vitamin D deficiency, the proportion of subjects with serum 25(OH)D concentrations ≥30 ng/mL within 12 weeks was 46.4% in the vitamin D3 group and 3.6% in the placebo group (p < 0.0001). The proportion of subjects with serum 25(OH)D concentrations ≥30 ng/mL within 24 weeks was 73.2% in the vitamin D3 group and 3.6% in the placebo group (p < 0.0001). Mean change in serum 25(OH)D concentrations at weeks 12 and 24 after vitamin D3 injection was 12.8 ± 8.1 and 21.5 ± 8.1 ng/mL, respectively, in the vitamin D3 group, with no significant changes in the placebo group. Serum parathyroid hormone concentrations showed a significant decrease in the vitamin D3 group but no change in the placebo group. CONCLUSION: Intramuscular injection of vitamin D3 200,000 IU was superior to placebo in terms of its impact on serum 25(OH)D concentrations, and is considered to be safe and effective in Korean adults with vitamin D deficiency.
Adult*
;
Asian Continental Ancestry Group
;
Cholecalciferol*
;
Humans
;
Injections, Intramuscular*
;
Parathyroid Hormone
;
Prospective Studies
;
Random Allocation
;
Vitamin D Deficiency*
;
Vitamin D*
;
Vitamins*
10.Effect of Nitric Oxide on the Change of Spinal Neuropeptide in the Inflammation Model by Freund's Complete Adjuvant.
Seung Jun HWANG ; Tai Jin CHUNG ; Da Young SHIN ; Hae Nam HONG ; Jung Woo LEEM ; Jai Hyun HWANG ; Yoon CHOI
Korean Journal of Anatomy 2001;34(3):293-302
Injection of Freund's complete adjuvant (FCA) into the plantar surface of the rat induces inflammatory responses with accompanying pain behaviors. Signs of pain behaviors observed in FCA-injected animals are reported to be similar to symptoms seen in patients with inflammatory pain. In the previous study, injection of FCA produced a significant mechanical allodynia over time. The role of substance-P and calcitonin gene-related peptide(CGRP) on allodynia induced by inflammation is still controversial. We investigated the change of spinal neuropeptides and nitric oxide (NO) in rats with inflammation induced by subcutaneous injection of FCA into hind paw. The results are: 1. The number of NADPH-diaphorase and substance P positive neurons increased at ipsilateral spinal ventral horn after FCA injection. No significant changes were found with L-NAME posttreatment. 2. Staining intensity of substance P-immunoreactive area increased at ipsilateral spinal dorsal horn after FCA injection. No significant changes were found with L-NAME posttreatment. 3. CGRP immunoreactivity changed in the same pattern with substance P in all group. The results suggest that spinal neuropeptide substance P and CGRP are involved in the mechanism of the development and maintenance of allodynia in a state of FCA-induced inflammaion. NO may be also involved in the regulation of the quantity of substance P and CGRP in spinal cord.
Animals
;
Calcitonin
;
Horns
;
Humans
;
Hyperalgesia
;
Inflammation*
;
Injections, Subcutaneous
;
Neurons
;
Neuropeptides*
;
NG-Nitroarginine Methyl Ester
;
Nitric Oxide*
;
Rats
;
Spinal Cord
;
Substance P