• Journal of Chest Surgery
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• v.36 no.5
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• pp.348-355
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• 2003

Background: The prognostic significance of lymph node micrometastasis in non-small cell lung cancer remains controversial. We therefore investigated the clinicopathologic factors related to lymph node micrometastsis and evaluated the clinical relevance of micrometastasis with regard to recurrence. Material and Method: Five hundred six lymph nodes were obtained from 41 patients with stage 1 non-small ceil lung cancer who underwent curative resection between 1994 and 1998. Immunohistochemical staining using anti-cytokeratin Ab was used to detect micrometastasis in these lymph nodes. Result: Micrometastatic tumor cells were identified in pN0 lymph nodes in 14 (34.1%) of 41 patients. The presence of lymph node micrometastasis was not related to any clinicopathoiogic factor (p) 0.05). The recurrence rate was higher in patients with micrometastasis (57.1%) than in those without (37.0%), but the difference was not significant (p=0.22). Patients with micrometastasis had a lower 5-year recurrence-free survival rate (48.2%) than those without micrometastasis (64.1%), with a borderline significance (p=0.11), The S-year recurrence-free survival rate (25.0%) in the patients with 2 or more micrometastatic lymph nodes was significantly lower than that in the patients with no or single micrometastasis (p=0.02). In multivariate analysis, multiple lymph node micromestasis us was a significant independent predictor of recurrence (p=0.028, Risk ratio=3.568). Conclusion: Immunehistochemical anti-cytokeratin staining was a rapid, sensitive, and easy way of detecting lymph node micrometastasis. The presence of lymph node micrometastasis was not significantly associated with the recurrence, but had a tendency toward a poor prognosis in stage 1 non-small cell lung cancer. Especially, the presence of multiple micrometastatic lymph nodes was a significant and independent predictor of recurrence.

• Journal of Ginseng Research
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• v.1 no.1
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• pp.33-50
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• 1976

As a continuation of series of works on the pharmacological actions of Panax ginseng. three kinds of behavioral experiments were carried out using rats and mice. The occurrence of component Posterns of general behavioral activity in rat was examined by visual scanning using the ting sample method in the ad lib. And he hunger deprivated situation. In normal ad lib. situation, the eating behavior of rat treated with 100mg/kg of ginseng saponin was significantly more frequent than that of saline control at the night and throughout the 24 hr period. But grooming was less frequent than the control at the same period. In the hunger situation followed by 90~120 hrs of feed deprivation, the locomotive activity and rearing awe significantly more often and sleeping was less frequent in the two dosage g roups of ginseng saponin (10 and 100 mg/kg) than in the saline group though out the observation period. Training of avoidance conditioning in rats was done in a two-way shuttle box. The number of conditioned response (CR) in which the animal avoided sucessfully an electric shock by running in to the other compartment of the hex was regarded as an index of learning performance. Ginseng saponin in doses of 2.5 mg/kg Produced a significantly increased CR in total avoidance tria1s compared with the control. Although other dosage groups of ginseng saponin (5.0, 50mg and 100 mg/kg) showed no significant statistical difference from the normal control, it tended to increase in CR in the ginseng groups than in the control. An aggressive behavior in mice was observed in n shock-generating fighting box. The occurrence of reflexive fighting between two animals induced by an electric shock applied to the feet war checked as an index of aggression. The occurrence of reciprocal fighting episode immediately after the onset. Of the shock was significantly decreased in the dosage group of 400 mg/kg ginseng saponin, but it did net differ in the 100 mg/kg group of ginseng saponin from the control group. The dose, 400 mg/kg of ginseng saponin, inhibited fighting behavior in more than 80% of the Pairs. but 100 mg/kg of ginseng did inhibit it in less than 20% of the pairs.

• Journal of the Korean Society of Food Science and Nutrition
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• v.35 no.10
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• pp.1356-1362
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• 2006

The purpose of the present study was to investigate the effect of enzymatic hydrolysate (extract) of Salicomia herbacea L. (Korean name: Hamcho) on antioxidative defense system in rats fed high cholesterol diet. Rats were divided into six experimental groups which are composed of normal diet group, normal diet group supplemented with 2% Hamcho extract, high cholesterol diet group, high cholesterol diet groups supplemented with 1%, 2% and 4% Hamcho extracts. The activity of serum glutamate oxaloacetae transaminase in rats was not different among all experimental groups, while the activity of glutamate pyruvate transaminase in groups supplemented with Hamcho extract was significantly lower than that of high cholesterol control group. Supplementation of Hamcho extract (SHE) to the high cholesterol fed rats resulted in increased activities of hepatic superoxide dismutase and glutathione peioxidase. However, there was no significant difference in the activity of hepatic catalase among all experimental groups. SHE also resulted in decreased levels of hepatic thiobarbituric acid reactive substances and mitochondrial carbonyl values. Those effects were higher to some extent in 2% and 4% Hamcho extract groups than those of high cholesterol control group. These results suggest that enzymatic hydrolysate of Hamcho may reduce oxidative damage by activation of antioxidative defense system in rats fed high cholesterol diets.

• Food Science and Preservation
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• v.24 no.1
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• pp.27-35
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• 2017

Microbiological, physicochemical, and organoleptic properties of fresh-cut vegetables (FVs), carrots, green peppers, cherry tomatoes, and paprika after X-ray irradiation were evaluated to verify food quality suitable for the immune-depressed patients. Total concentrations of aerobic bacteria in non-irradiated samples, except for cherry tomatoes, were 1.63-3.34 log CFU/g. Irradiation dose exceed 0.4 kGy was used for carrots and green peppers whereas the sterilization dose of 0.2 kGy was used for both cherry tomatoes and paprika. A dose of 0.4 kGy was tentatively determined as the minimum allowable dose for sterilization of the FVs, based on $D_{10}$-values of X-ray irradiation (0.11-0.32 kGy) for Escherichia coli, Listeria monocytogenes, and Salmonella Typhimurium inoculated on the samples. With respect to the physiological properties, only hardness was significantly decreased as the absorbed dose increased; however, there were no significant differences in hardness of the sterilized samples using X-rays at 0.4 kGy compared with those of non-irradiated samples (p<0.05). Moreover, overall acceptance scores of the sterilized FVs were higher than 5.0 points on a 7-point scale, indicating a good organoleptic quality. In a survey on preference of hospitalized patients with cancer (n=50), the average scores for the sterilized FVs, except for carrots, were higher than 4.0 points. In conclusion, it is considered that the FVs, except for carrots, sterilized using X-rays at 0.4 kGy could be served to immune-depressed patients as hygienically safe foods with acceptable organoleptic properties.

• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.261-268
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• 2004

Background : The resurgence of tuberculosis and outbreaks of multidrug resistant (MDR) tuberculosis have increased the emphasis for the development of new susceptibility testing of the Mycobacterium tuberculosis for the effective treatment and control of the disease. Conventional drug susceptibility testings, such as those using egg-based or agar-based media have some limits, such as the time required and difficulties in determining critical inhibitory concentrations, but these are still being used in many diagnostic laboratories because of no better lternatives, considering cost and accuracy. To overcome these limits, a rapid and simple method for new susceptibility testing, using live and dead assays, was applied for a bacterial cell viability assay to distinguish dead from live bacterial cells based on two-color fluorescence. Materials and Methods Strains : Forty strains were used in this study, 20 susceptible to all antituberculosis drugs and the other 20 resistant to the four first line antituberculosis drugs isoniazid, rifampicin, streptomycin and ethambutol. Antibiotics : The four antibiotics were dissolved in 7H9 broth to make the following solutions: $0.1{\mu}g\;isoniazid(INH)/m{\ell}$, $0.4{\mu}g\;rifampicin(RMP)/m{\ell}$, $4.0{\mu}g\;streptomycin(SM)/m{\ell}$ and $4.0{\mu}g\;ethambutol(EMB)/m{\ell}$. Results : Live and dead Mycobacterium tuberculosis cells fluoresced green and red with the acridin (Syto 9) and propidium treatments, respectively. These results are very well accorded with conventional drug susceptibility testing by proportional method on Lowensen-Jensen media (L-J) containing 4 drugs (INH, RMP, EMB and SM), showing a 93.7 % accordance rate in susceptible strains and 95% in resistant strains. Conclusion : The results of the drug susceptibility testing using the live and dead bacterial cell assay showed high accordance rates compared with the conventional proportion method on L-J. This finding suggests that the live and dead bacterial cell assay can be used as an alternative to conventional drug susceptibility testing for M. tuberculosis strains.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.6
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• pp.546-552
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• 2007

Purpose: In the breast cancer patient, lymphatic mapping and sentinel lymph node biopsy are the most important procedure for axillary lymph node staging. We aimed to compare the three radiocolloids [$^{99m}Tc$-antimony trisulfide colloid (ASC), $^{99m}Tc$-tin colloid (TC), and $^{99m}Tc$-human serum albumin (HSA)] for sentinel lymph node mapping. Subjects and Methods: Totally, 397 patients with clinically N0 stage were enrolled. $^{99m}Tc$-ASC was injected in 202 out of 397 patients, $^{99m}Tc$-TC was injected in 120 patients, and $^{99m}Tc$-HSA was injected in the remaining 75 patients. The sentinel lymph nodes were localized by lymphoscintigraphy and selected using intraoperative gamma probe. All sentinel lymph nodes were investigated by intraoperative pathologic consultation. The axillary lymph nodes which were harvested by the lymph node dissection were also investigated. Results: The patients of each group showed similar clinical characteristics. There were no significant differences (p>0.05) in the identification rate of sentinel lymph nodes (IR), false negative rate (FNR), and negative predictive value (NPV). The axillary lymphadenectomy revealed axillary lymph node metastases in those three groups (ASC-33.2%, TC-31.7%, HSA-22.7%). The IR, FNR, and NPV were not significantly different among those groups. Conclusion: Those three $^{99m}Tc$-labeled radiocolloids showed equivalent results in sentinel lymph node mapping of breast cancer.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.235-261
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• 2018

The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.135-152
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• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• Journal of the Korean Society of Food Science and Nutrition
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• v.29 no.5
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• pp.935-942
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• 2000

This study was designed to investigate the effect of flower of Pueraria lobata on liped peroxidation and activities of alcohol metabolic enzymes in alcohol-treated rats. Male Spra gue-Dawley rats were given 25% ethanol (Alcohol), 25% ethanol and 5 mg tectorigenin/kg B.W.(Alc.-Tec), 25% ethanol and 5mg kaikasaponin III/kg B.W. (Alc-Kai). The contents of serum total lipid, triglyceride and phospholipid were increased by ethanol treatment and were lower in the Alc.-Tec and Alc.-Kai group than in the Alcohol group. Decreased serum HDL-cholesterol by alcohol treatment was recovered by tectorigenin and kaikasaponin III. Microsomal cytochrome P-450, aniline hydroxylase and aminopyrine N-demethylase activities were increased by ethanol and were lower in the Alc. Tec and Alc.-Kai group than in the Alcohol group. Activity of hepatic alcohol dehydrogenase was increased by ethanol and was higher in the Alc.-Tec and Alc.-Kai group than in the Alcohol group. Microsomal ethanol oxidizing system activity was higher in Alc.-Tec group than in the other group. No significant difference was found in catalase activity among treatment groups. These data indicate that tectorigenin and kaikasaponin III were effected alcohol metabolic enzyme system and the liver damage associated with chronic ethanol consumption.

• Journal of dental hygiene science
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• v.12 no.6
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• pp.675-681
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• 2012

Korean Ministry of Health and Welfare started to implement oral health hub center to provide oral health preventive program and dental treatment to public, especially dental vulnerable class in 2006. But, there is no applicant area to implement it regardless of national budget arrangement in 2012. This study is aimed to investigate the reason not to be implemented and requirements of implementation. 293 among 1,000 public dental hygienists in the area where have not implemented oral health hub center were surveyed in Korea from April to July in 2012 through convenience sampling. The questionnaire consisted of the reason why oral health hub center have not been implemented, the requirement of implementation, duty area and duty position et al. After removal of insufficient responses, 217 questionnaires were analyzed by t-test and ANOVA using SPSS 20.0. The reason why oral health hub center have not been implemented were deficiency of the priority list as compared with other health program (72.4%), space insufficiency (71.4%), regional budget insufficiency (70.5%), will insufficiency of oral health promotion (70.5%) and manpower insufficiency (62.7%). The first requirement of implementation were space expansion and regional budget expansion, followed by reduction of record-originated and administrative tasks, understanding on oral health program of higher ranking public officials in health center, manpower expansion, reduction of other tasks than oral health program and volunteer source expansion. Budget insufficiency and manpower insufficiency in Metropolis were ranked higher than other area (p<0.05). The group not to discuss oral health hub center graded each reason not to be implemented significantly higher than the other group (p<0.05). We suggested that to promote the importance of public oral health program be needed to public and higher ranking public officials to implement oral health hub center. In addition, we insisted that more dental manpower and budget be needed for reduction of oral health inequity in metropolis.