Streptococcus pneumoniae is a major etiology of serious bacterial infection among children worldwide. Among the 91 serotypes, the majority of invasive infections are caused by 10 common serotypes, 14, 16, 18, 19, 23, 4, 9, 7, 1, and 3. However, the ranking and serotype prevalence differ by age group and country. The heptavalent pneumococcal conjugate vaccine (PCV7) was licensed for use among infants and young children in many countries including Korea. The routine use of PCV7 has resulted in a decreased incidence of invasive pneumococcal disease by the vaccine serotypes among the vaccines (direct effect). However, it is notable that substantial declines in invasive diseases among older children and adults ensued through indirect effects on transmission (i.e., herd immunity). In addition, there are increasing evidences to suggest that routine immunization with PCV7 is changing the epidemiology of pneumococcal diseases such as serotype distribution of invasive disease, nasopharyngeal colonization, and antibiotic resistance patterns. In contrast, there is a small increase in the number of invasive diseases caused by nonvaccine serotypes, so called 'replacement phenomenon', though it is still minor compared with overall declines of vaccine-serotype diseases. Of those, the increase in the 19A-related disease has become most prominent. In Korea, a remarkable increase of 19A was noted before the introduction of PCV7. The emergence of resistance and replacement of disease by nonvaccine strains should be closely monitored.
Adult ; Bacterial Infections ; Child ; Colon ; Drug Resistance, Microbial ; Heptavalent Pneumococcal Conjugate Vaccine ; Humans ; Immunization ; Incidence ; Infant ; Korea ; Nasopharyngeal Diseases ; Pneumococcal Vaccines ; Prevalence ; Streptococcus pneumoniae ; Vaccines

Nerve root anomalies are frequently underrecognized regardless of the advances in imaging studies; they are also underappreciated and underreported when encountered surgically. The classification of conjoined nerve roots is based on whether the nerve root emerges at an abnormal level or from an anastomotic branch. In the present report, we describe case with a conjoined nerve root that emerged at a more caudal level than that normally observed that was an undiagnosed on preoperative imaging studies. We also discuss the atypical imaging features obtained through preoperative imaging studies. As observed in the present case, preoperative recognition and diagnosis of such anomalies offer the best opportunity of performing a successful procedure and preventing inadvertent damage to nerve roots intraoperatively.
Classification ; Diagnosis

BACKGROUND: This study is intended to propose not only to introduce and evaluate the 2 years Clinical Research Coordinator (CRC) professional on-the-job training program that has been implemented in Samsung Medical Center on September of 2009, but also to develop the CRC future education program. METHODS: It is surveyed with self-report type for the 53 trainees, 18 non-trainees, and 17 investigators, the participants worked in Samsung Medical Center, and the major contents of the survey were general characteristics, training program evaluations, CRC qualification evaluation, and job satisfaction. The collected data was analyzed at the 0.05 level of significance by using SAS 9.1 version. RESULTS: The training program is conducted as 4 phases, each phase assessed separately. The Professional A course got the highest satisfaction, and it was deal with quality control (Mean=4.11 ~ 4.33). Most of the investigators answered that the trainees have high priority to be hired in the future (very much=82.45). The non-trainees answered that the training program would be helpful to improve the job competency and qualification (very much=22.2 %, somewhat=55.6 %) and 88.9 % of them answered that they have intention to participate in the training program. Finally, compared to non-trainees, the trainees have more job attachment (P=0.0036) and intention to continue CRC (P=0.0045). CONCLUSION: The CRC professional training program in Samsung Medical Center, as on the job training for 2 years, satisfies the investigators and trainees with positive effect on CRC job satisfaction and job stability. Based on this study, the education program with good quality should be developed considering the characteristics for each institution and close research field.
Humans ; Inservice Training ; Intention ; Job Satisfaction ; Korea ; Phenothiazines ; Quality Control ; Research Personnel