OBJECTIVE: We researched contraceptive practice and attitudes in Chungju, Korea by questionnaires. METHODS: We gave questionnaires to 316 reproductive women who visited Local Corporation Chungju Medical Center and public health center in Chungju city from August 2002 to December 2002. Items of the survey contained general characteristics, methods, level of satisfaction and side effects of contraception, contraceptive failure methods when failed. RESULTS: We studied questionnaires of 305 cases excluding questionnaires of 11 cases which were either incomplete or uncertain. Of the 298 cases who were not trying to get pregnant, 268 (89.9%) used contraceptive methods. The most common method was tubal ligation (23.2%), followed by condoms (21.8%), Intrauterine devices (17.1%), vasectomy (15.4%), periodic abstinence (8.1%), coitus interruptus (2.3%) and oral contraceptives (1.7%). In the 30-34 age group, the practice rate of contraceptive methods was the highest. Satisfactory rate of contraceptive methods was 76.9%. Intrauterine devices had the most frequent side effects. Of 305 cases, who practiced contraception, 70 (22.9%) cases failed and got pregnant and they commonly used periodic abstinence. CONCLUSION: In comparison with the past, practice rate of contraceptive methods increased. Because of the low efficiency of contraception, despite of high practice rate of them, women who had failed the contraception were considerable and the rate of artificial abortion was high. In order to overcome this phenomenon, it is necessary to induce efficient and correct practice of contraceptive methods through further definite and continuous education including oral contraceptives.
Chungcheongbuk-do* ; Coitus Interruptus ; Condoms ; Contraception ; Contraceptives, Oral ; Education ; Female ; Humans ; Intrauterine Devices ; Korea* ; Natural Family Planning Methods ; Public Health ; Surveys and Questionnaire ; Sterilization, Tubal ; Vasectomy

OBJECTIVE: We researched contraceptive practice and attitudes in Chungju, Korea by questionnaires. METHODS: We gave questionnaires to 316 reproductive women who visited Local Corporation Chungju Medical Center and public health center in Chungju city from August 2002 to December 2002. Items of the survey contained general characteristics, methods, level of satisfaction and side effects of contraception, contraceptive failure methods when failed. RESULTS: We studied questionnaires of 305 cases excluding questionnaires of 11 cases which were either incomplete or uncertain. Of the 298 cases who were not trying to get pregnant, 268 (89.9%) used contraceptive methods. The most common method was tubal ligation (23.2%), followed by condoms (21.8%), Intrauterine devices (17.1%), vasectomy (15.4%), periodic abstinence (8.1%), coitus interruptus (2.3%) and oral contraceptives (1.7%). In the 30-34 age group, the practice rate of contraceptive methods was the highest. Satisfactory rate of contraceptive methods was 76.9%. Intrauterine devices had the most frequent side effects. Of 305 cases, who practiced contraception, 70 (22.9%) cases failed and got pregnant and they commonly used periodic abstinence. CONCLUSION: In comparison with the past, practice rate of contraceptive methods increased. Because of the low efficiency of contraception, despite of high practice rate of them, women who had failed the contraception were considerable and the rate of artificial abortion was high. In order to overcome this phenomenon, it is necessary to induce efficient and correct practice of contraceptive methods through further definite and continuous education including oral contraceptives.
Chungcheongbuk-do* ; Coitus Interruptus ; Condoms ; Contraception ; Contraceptives, Oral ; Education ; Female ; Humans ; Intrauterine Devices ; Korea* ; Natural Family Planning Methods ; Public Health ; Surveys and Questionnaire ; Sterilization, Tubal ; Vasectomy

OBJECTIVE: To determine the prevalence of osteoporosis based on the measurement of bone mineral density (BMD) and to examine the effect of menopausal status on BMD in Korean women. METHODS: Ultra-distal and distal radius BMD was measured by dual energy X ray absorptiometry (osteoplan p-DXA) in 296 women. The result was analysed, retrospectively. We diagnosed osteopenia and osteoporosis according to the WHO criteria. RESULTS: The ultra-distal and distal radius BMD and T score decreased significantly with increase of age. Of women in their thirties, the prevalence of ultra-distal and distal radial osteoporosis were 0%, 6.2%, and in their forties, they were 7.6%, 3.4% and in their fifties, they were 26.6%, 27.9% and of women in their sixties, they were 81.7%, 87.8%. Of women in their forties and fifties, premenopausal women had a higher BMD result than postmenopausal women in the same age group. Of premenopausal women in their forties, the prevalence of osteoporosis were 4.6%, 2.3% and of postmenopausal women in that age, they were 15.6%, 6.3%. Of premenopausal women in their fifties, the prevalence of osteoporosis were 8.3%, 8.3% and of postmenopausal women in that age, they were 29.9%, 31.3%. CONCLUSION: With increasing age, the prevalence of osteoporosis increased and the BMD decreased. In the postmenopausal state, this difference became larger.
Absorptiometry, Photon ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Humans ; Menopause* ; Osteoporosis* ; Prevalence* ; Radius* ; Retrospective Studies

Background: This study aimed to identify the incidence rate of episodes diagnosed with influenza and the effects of age-period-cohort (APC) in Koreans. Methods: The 2009–2018 National Health Insurance Research Database was used for analysis. All time-related claims connected relatively short window period in 100 days. The case definition was defined by all codes diagnosed with J09, J10, and J11. Calculation of the incidence rate and APC analysis adjusted income levels by insurance type, metropolitan city was performed to identify the characteristics of episodes diagnosed with influenza. Results: Incidence rate by age and cohort gradually increased since 2014. The incidence rate of males aged 0–4 years was 171.02 and that of females was 173.31 in 2015–2016 season. In males, 29.19 in 1963 cohort and 243.79 in 2013 cohort were confirmed as high incidence rates in 2017–2018 season. In the females, a high incidence was confirmed in 1953–1967 cohort and 1978–1987 cohort, and the incidence was 251.38 in 2013–2017 cohort. APC effects showed a high relative risk in the infants, the pandemic influenza season in 2010 (1/7/2009 to 30/6/2010) and the adults of 1978–1987 cohort. Conclusion Since 2014, influenza outbreaks have been increasing every year. The start year of free vaccination decreased the incidence in infants and adults over 65 years of age but the incidence increased from the following year. Because influenza can be primarily prevented by vaccination, reinforcement of vaccination in infants may reduce the disease burden in their parents, and also the risk of infection caused by family transmission. A new vaccination strategy is needed to reduce the incidence and burden of diseases caused by influenza infection.

Over the last decade, physiologically based pharmacokinetics (PBPK) application has been extended significantly not only to predicting preclinical/human PK but also to evaluating the drug-drug interaction (DDI) liability at the drug discovery or development stage. Herein, we describe a case study to illustrate the use of PBPK approach in predicting human PK as well as DDI using in silico, in vivo and in vitro derived parameters. This case was composed of five steps such as: simulation, verification, understanding of parameter sensitivity, optimization of the parameter and final evaluation. Caffeine and ciprofloxacin were used as tool compounds to demonstrate the “fit for purpose” application of PBPK modeling and simulation for this study. Compared to caffeine, the PBPK modeling for ciprofloxacin was challenging due to several factors including solubility, permeability, clearance and tissue distribution etc. Therefore, intensive parameter sensitivity analysis (PSA) was conducted to optimize the PBPK model for ciprofloxacin. Overall, the increase in C(max) of caffeine by ciprofloxacin was not significant. However, the increase in AUC was observed and was proportional to the administered dose of ciprofloxacin. The predicted DDI and PK results were comparable to observed clinical data published in the literatures. This approach would be helpful in identifying potential key factors that could lead to significant impact on PBPK modeling and simulation for challenging compounds.
Area Under Curve ; Caffeine* ; Ciprofloxacin* ; Computer Simulation ; Drug Discovery ; Humans ; In Vitro Techniques ; Permeability ; Pharmacokinetics* ; Solubility ; Tissue Distribution

Background: This study aimed to investigate the effect of antiviral therapy following influenza outpatient episodes on the incidence of hospitalized pneumonia episodes, one of secondary complications of influenza. Methods: In the National Health Insurance Research Database, data from July 2013 to June 2018 were used. All of the claim data with diagnoses of influenza and pneumonia were converted to episodes of care after applying 100 days of window period. With the 100-day episodes of care, the characteristics of influenza outpatient episodes and antiviral therapy for influenza, the incidence of hospitalized pneumonia episodes following influenza, and the effect of antiviral therapy for influenza on hospitalized pneumonia episodes were investigated. Results: The crude incidence rate of hospitalized pneumonia after influenza infection was 0.57% in both males and females. Factors affecting hospitalized pneumonia included age, income level except self-employed highest (only in females), municipality, medical institution type, precedent chronic diseases except hepatitis (only in females) and antiviral therapy. In the 2017 flu season, the relative risk was 0.38 (95% confidence interval [CI], 0.29–0.50) in males aged 0–9 and 0.43 (95% CI, 0.32–0.57) in females aged 0–9 without chronic diseases, and it was 0.51 (95% CI, 0.42–0.61) in males aged 0–9 and 0.42 (95% CI, 0.35–0.50) in females aged 0–9 with one or more chronic diseases in the aspect of the effect of antiviral therapy on pneumonia. It suggests that antiviral therapy may decrease the incidence of pneumonia after influenza infection. Conclusion After outpatient episode incidence of influenza, antiviral treatment has been shown to reduce the incidence of hospitalized pneumonia, especially in infants and children, during pandemic season 2017. Antiviral therapy for influenza is recommended to minimize burden caused by influenza virus infection and to reduce pneumonia. In addition, medical costs of hospitalization may decrease by antiviral therapy, especially in infants and children.

Purpose: The purpose of this study was to understand the experience of exercise participation among patients following transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction surgery. Methods: A phenomenological method was used in this study. Exercise experiences for twelve patients, who had undergone TRAM flap breast reconstruction, were collected through focus group interviews. Results: The factors that contributed to exercise barriers in the experience of TRAM flap breast reconstruction patient exercise participation were categorized into 3 groups: ‘fear of exercise after surgery’, ‘weakened emotional condition’, and ‘lack of exercise information’. Exercise facilitators after TRAM flap breast reconstruction were also categorized into 3 groups: ‘desire to improve appearance’, ‘feasiable exercise program’, and ‘exercise experience’. Conclusion The results of this study reveal the exercise barriers and facilitators for patients following TRAM flap breast reconstruction, which should be considered to develop effective exercise programs.

Mucormycosis is a rare opportunistic infection caused by fungi of the nrder Mucorales. It occurs almost exclusively in immunocompromised patients, and the prognosis is grave. Rhinocerebral and pulmonary diseases are the most comrnon forms. Gastric mucormycosis is very rare and the manifestations range from colonization of peptic ulcers to infiltrative disease with vascular invasion and dissemination. Only one case of gastric mucormycosis was reported in Korean literature. We recently experienced a case of gastric mucormycosis in a renal transplant recipient. The 29-year-old male patient received a renal transplant from his rnother seven years ago, and had been on immunosuppressive therapy. He experienced intermittent epigastric pain for one week, and a gastroscopy revealed a huge gastric ulcer covered with black necrotic material. The diagnosis of gastric mucormycosis was confirmed on a histologic examination, and amphctericin B was administered. Despite two weeks of intensive medical therapy he expired due to shock and multiorgan failure. This is the first case of gastric mucormycosis in an organ transplant recipient in Koren.
Adult ; Colon ; Diagnosis ; Fungi ; Gastroscopy ; Humans ; Immunocompromised Host ; Kidney Transplantation ; Lung Diseases ; Male ; Mucorales ; Mucormycosis* ; Opportunistic Infections ; Peptic Ulcer ; Prognosis ; Shock ; Stomach ; Stomach Ulcer ; Transplantation* ; Transplants

BACKGROUND/AIMS: Cyclooxygenase-2 (COX-2), 15-hydroxyprostaglandin dehydrogenase (15-PGDH), and microsomal prostaglandin E synthase-1 (mPGEs-1) regulate prostaglandin E₂ (PGE₂) expression and are involved in colon carcinogenesis. We investigated the expression of PGE₂ and its regulating genes in sporadic human colon tumors and matched normal tissues. METHODS: Twenty colonic adenomas and 27 colonic adenocarcinomas were evaluated. COX-2 and 15-PGDH expression was quantified by real-time polymerase chain reaction. The expression of PGE₂ and mPGEs-1 was measured using enzyme-linked immunosorbent assay and Western blotting, respectively. RESULTS: The expression of COX-2, mPGEs-1, and PGE₂ did not differ between the adenomas and matched distant normal tissues. 15-PGDH expression was lower in adenomas than in the matched normal colonic tissues (P<0.001). In adenocarcinomas, mPGEs-1 and PGE₂ expression was significantly higher (P<0.001 and P=0.020, respectively), and COX-2 expression did not differ from that in normal tissues (P=0.207). 15-PGDH expression was significantly lower in the normal colonic mucosa from adenocarcinoma patients than in the normal mucosa from adenoma patients (P=0.018). CONCLUSIONS: Early inactivation of 15-PGDH, followed by activation of COX-2 and mPGEs-1, contributes to PGE₂ production, leading to colon carcinogenesis. 15-PGDH might be a novel candidate marker for early detection of field defects in colon carcinogenesis.
Adenocarcinoma ; Adenoma ; Blotting, Western ; Carcinogenesis* ; Colon* ; Cyclooxygenase 2 ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Mucous Membrane ; Oxidoreductases* ; Real-Time Polymerase Chain Reaction