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Combined Chemotherapy and Radiation Therapy in Limited Disease Small-Cell Lung Cancer (국한성 소세포 폐암에서 항암 화학 및 흉부 방사선치료의 병합요법 적응)

  • Kim Moon Kyung;Ahn Yong Chan;Park Keunchil;Lim Do Hoon;Huh Seung Jae;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Kwon O Jung
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.9-15
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    • 1999
  • Purpose : This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer, Materials and Methods : Firty-six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deli- ver 44 Gy using 1 OMV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylaetic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. Results : The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved En 30 (65$\%$) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50$\%$), anemia in 17 (37$\%$), thrombo- cytopenia in nine (20$\%$), alopecia in nine (20$\%$), nausea/vomiting in five (11$\%$), and peripheral neuropathy in one (2$\%$). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24$\%$) out of the total 246 cycles. No radiation esophagitis over grade 111 was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The overall and progression-free survival rates were 79$\%$ and 55$\%$ in 1 year, and 45'/) and 32% in 2 years, respectively, and the median survival was 23 months. Conclusion : Relatively satisfactory local control and suwival rates were achieved after the combined chemotherapy and radiation therapy with mild to moderate acute morbidities in limited disease small cell lung cancer.

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Individualized Determination of Lower Margin in Pelvic Radiation Field after Low Anterior Resection for Rectal Cancer Resulted in Equivalent Local Control and Radiation Volume Reduction Compared with Traditional Method (하전방 절제술을 시행한 직장암 환자에서 방사선조사 영역 하연의 개별화)

  • Park Suk Won;Ahn Yong Chan;Huh Seung Jae;Chun Ho Kyung;Kang Won Ki;Kim Dae Yong;Lim Do Hoon;Noh Young Ju;Lee Jung Eun
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.194-199
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    • 2000
  • Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.

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Assessing the Damage: An Exploratory Examination of Electronic Word of Mouth (손해평고(损害评估): 대전자구비행소적탐색성고찰(对电子口碑行销的探索性考察))

  • Funches, Venessa Martin;Foxx, William;Park, Eun-Joo;Kim, Eun-Young
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.188-198
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    • 2010
  • This study attempts to examine the influence that negative WOM (NWOM) has in an online context. It specifically focuses on the impact of the service failure description and the perceived intention of the communication provider on consumer evaluations of firm competence, attitude toward the firm, positive word of mouth and behavioral intentions. Studies of communication persuasiveness focus on "who says what; to whom; in which channel; with what effect (Chiu 2007)." In this research study, we examine electronic web posting, particularly focusing on two aspects of "what": the level of service failure communicated and perceived intention of the individual posting. It stands to reason electronic NWOM that appears to be trying to damage a product’s or firm's reputation will be viewed as more biased and will thus be considered as less credible. According to attribution theory, people search for the causes of events especially those that are negative and unexpected (Weiner 2006). Hennig-Thurau and Walsh (2003) state "since the reader has only limited knowledge and trust of the author of an online articulation the quality of the contribution could be expected to serve as a potent moderator of the articulation-behavior relationship. We therefore posit the following hypotheses: H1. Subjects exposed to electronic NWOM describing a high level of service failure will provide lower scores on measures of (a) firm competence, (b) attitude toward the firm, (c) positive word of mouth, and (d) behavioral intention than will subjects exposed to electronic NWOM describing a low level of service failure. H2. Subjects exposed to electronic NWOM with a warning intent will provide lower scores on measures of (a) firm competence, (b) attitude toward the firm, (c) positive word of mouth, and (d) behavioral intention than will subjects exposed to electronic NWOM with a vengeful intent. H3. Level of service failure in electronic NWOM will interact with the perceived intention of the electronic NWOM, such that there will be a decrease in mean response on measures of (a) firm competence, (b) attitude toward the firm, (c) positive word of mouth, and (d) behavioral intention from electronic NWOM with a warning intent to a vengeful intent. The main study involved a2 (service failure severity) x2 (NWOM with warning versus vengeful intent) factorial experiment. Stimuli were presented to subjects online using a mock online web posting. The scenario described a service failure associated with non-acceptance of a gift card in a brick-and-mortar retail establishment. A national sample was recruited through an online research firm. A total of 113 subjects participated in the study. A total of 104 surveys were analyzed. The scenario was perceived to be realistic with 92.3% giving the scenario a greater than average response. Manipulations were satisfactory. Measures were pre-tested and validated. Items were analyzed and found reliable and valid. MANOVA results found the multivariate interaction was not significant, allowing our interpretation to proceed to the main effects. Significant main effects were found for post intent and service failure severity. The post intent main effect was attributable to attitude toward the firm, positive word of mouth and behavioral intention. The service failure severity main effect was attributable to all four dependent variables: firm competence, attitude toward the firm, positive word of mouth and behavioral intention. Specifically, firm competence for electronic NWOM describing high severity of service failure was lower than electronic NWOM describing low severity of service failure. Attitude toward the firm for electronic NWOM describing high severity of service failure was lower than electronic NWOM describing low severity of service failure. Positive word of mouth for electronic NWOM describing high severity of service failure was lower than electronic NWOM describing low severity of service failure. Behavioral intention for electronic NWOM describing high severity of service failure was lower for electronic NWOM describing low severity of service failure. Therefore, H1a, H1b, H1c and H1d were all supported. In addition, attitude toward the firm for electronic NWOM with a warning intent was lower than electronic NWOM with a vengeful intent. Positive word of mouth for electronic NWOM with a warning intent was lower than electronic NWOM with a vengeful intent. Behavioral intention for electronic NWOM with a warning intent was lower than electronic NWOM with a vengeful intent. Thus, H2b, H2c and H2d were supported. However, H2a was not supported though results were in the hypothesized direction. Otherwise, there was no significant multivariate service failure severity by post intent interaction, nor was there a significant univariate service failure severity by post intent interaction for any of the three hypothesized variables. Thus, H3 was not supported for any of the four hypothesized variables. This study has research and managerial implications. The findings of this study support prior research that service failure severity impacts consumer perceptions, attitude, positive word of mouth and behavioral intentions (Weun et al. 2004). Of further relevance, this response is evidenced in the online context, suggesting the need for firms to engage in serious focused service recovery efforts. With respect to perceived intention of electronic NWOM, the findings support prior research suggesting reader's attributions of the intentions of a source influence the strength of its impact on perceptions, attitude, positive word of mouth and behavioral intentions. The implication for managers suggests while consumers do find online communications to be credible and influential, not all communications are weighted the same. A benefit of electronic WOM, even when it may be potentially damaging, is it can be monitored for potential problems and additionally offers the possibility of redress.

Leukocyte count and hypertension in the health screening data of some rural and urban residents (일부 농촌과 도시의 건강선별조사 자료로 본 백혈구수와 고혈압과의 관계)

  • Lee, Choong-Won;Yoon, Nung-Ki;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.363-372
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    • 1991
  • We used the health screening data of some rural and urban residents to examine the cross-sectional association between leukocyte count and hypertension. The 206 male and 203 female rural residents were selected by multi-stage cluster sampling method in Kyungsan-Kun area of Kyungbuk province in 1985 and 600 urban residents were selected by the same sampling method as the rural residents in Daegu city of the same province in 1986 compatible with age-sex distribution of Daegu city of 1985 census, but of whom 384 actually responded. The rest of 600 were replaced by age and sex with those who were members of the medical insurance plan visiting the health management department of the university hospital to get the biannual preventive medical checkups. Excluded in the analysis were those having hypertensive history, diseases and extreme outlying values of the screening tests, leaving 373 rural and 571 urban residents. Leukocyte count was measured with ELT-8 Laser shadow method and the unit $cells/mm^3$, Blood pressures were determined with an aneroid sphygmomanometer with pre-standardized method and hypertensives were defined as those showing systolic blood pressure more than 140mmHg and/or diastolic blood pressure more than 90mmHg. Total residents pooled (N=944) showed a significant difference between hypertensives and normotensives ($6965.93{\pm}1997.01\;vs\;6490.61{\pm}1941.32,\;P=0.00$) and in rural residents was noted the similar significant difference (P=0.03). None of significant differences were noted in any stratum stratified by residency and sex. Compared to the lowest quintile of WBC, 2/5 quintile showed odds ratio 0.99 (95% Confidence interval, Ci 0.62-1.59), 3/5 quintile 1.41 (95% CI 0.90-2.21), 4/5 quintile 1.76 (95% CI. 1.14-2.72), and highest quintile 1.80 (1.15-2.82) in the total residents. Likelihood ratio test for linear trend for it indicated a significant trend ($X^2_{trend}=5.53,\;df=1,\;P<0.05$). There were no other significant odds ratios compared to the lowest quintile of WBC in strata stratified by residency and sex. The odds ratios in total residents which had showed significant odds ratios became nonsignificant and of reduced magnitude after controlling age, frequency of smoking and drinking with multiple logistic. regression. In each stratum, it changed magnitudes of odds ratios slightly and unstably. None of the trend tests showed any significant trend. These results suggest that the Friedman et al's finding of association between leukocyte count and hypertension may be due to an statistical type I error resulting from the data dredging in an exploratory study, in which more than 800 variables were screened as possible predictors of hypertension.

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Results of Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 방사선치료 성적)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.359-368
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    • 1995
  • Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.

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The Evaluation of Non-Coplanar Volumetric Modulated Arc Therapy for Brain stereotactic radiosurgery (뇌 정위적 방사선수술 시 Non-Coplanar Volumetric Modulated Arc Therapy의 유용성 평가)

  • Lee, Doo Sang;Kang, Hyo Seok;Choi, Byoung Joon;Park, Sang Jun;Jung, Da Ee;Lee, Geon Ho;Ahn, Min Woo;Jeon, Myeong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.9-16
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    • 2018
  • Purpose : Brain Stereotactic Radiosurgery can treat non-invasive diseases with high rates of complications due to surgical operations. However, brain stereotactic radiosurgery may be accompanied by radiation induced side effects such as fractionation radiation therapy because it uses radiation. The effects of Coplanar Volumetric Modulated Arc Therapy(C-VMAT) and Non-Coplanar Volumetric Modulated Arc Therapy(NC-VMAT) on surrounding normal tissues were analyzed in order to reduce the side effects caused fractionation radiation therapy such as head and neck. But, brain stereotactic radiosurgery these contents were not analyzed. In this study, we evaluated the usefulness of NC-VMAT by comparing and analyzing C-VMAT and NC-VMAT in patients who underwent brain stereotactic radiosurgery. Methods and materials : With C-VMAT and NC-VMAT, 13 treatment plans for brain stereotactic radiosurgery were established. The Planning Target Volume ranged from a minimum of 0.78 cc to a maximum of 12.26 cc, Prescription doses were prescribed between 15 and 24 Gy. Treatment machine was TrueBeam STx (Varian Medical Systems, USA). The energy used in the treatment plan was 6 MV Flattening Filter Free (6FFF) X-ray. The C-VMAT treatment plan used a half 2 arc or full 2 arc treatment plan, and the NC-VMAT treatment plan used 3 to 7 Arc 40 to 190 degrees. The angle of the couch was planned to be 3-7 angles. Results : The mean value of the maximum dose was $105.1{\pm}1.37%$ in C-VMAT and $105.8{\pm}1.71%$ in NC-VMAT. Conformity index of C-VMAT was $1.08{\pm}0.08$ and homogeneity index was $1.03{\pm}0.01$. Conformity index of NC-VMAT was $1.17{\pm}0.1$ and homogeneity index was $1.04{\pm}0.01$. $V_2$, $V_8$, $V_{12}$, $V_{18}$, $V_{24}$ of the brain were $176{\pm}149.36cc$, $31.50{\pm}25.03cc$, $16.53{\pm}12.63cc$, $8.60{\pm}6.87cc$ and $4.03{\pm}3.43cc$ in the C-VMAT and $135.55{\pm}115.93cc$, $24.34{\pm}17.68cc$, $14.74{\pm}10.97cc$, $8.55{\pm}6.79cc$, $4.23{\pm}3.48cc$. Conclusions : The maximum dose, conformity index, and homogeneity index showed no significant difference between C-VMAT and NC-VMAT. $V_2$ to $V_{18}$ of the brain showed a difference of at least 0.5 % to 48 %. $V_{19}$ to $V_{24}$ of the brain showed a difference of at least 0.4 % to 4.8 %. When we compare the mean value of $V_{12}$ that Radione-crosis begins to generate, NC-VMAT has about 12.2 % less amount than C-VMAT. These results suggest that if NC-VMAT is used, the volume of $V_2$ to $V_{18}$ can be reduced, which can reduce Radionecrosis.

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Regulation of ER Stress Response on 1,2,3-Trichloropropane-Induced Hepatotoxicity of Sprague Dawley Rats (1,2,3-Trichloropropane으로 유도된 SD랫드의 간독성에서 ER 스트레스 반응의 조절)

  • Tae Ryeol Kim;You Jeong Jin;Ji Eun Kim;Hee Jin Song;Yu Jeong Roh;Ayun Seol;Eun Seo Park;Ki Ho Park;Su Jeong Lim;Su Ha Wang;Yong Lim;Dae Youn Hwang
    • Journal of Life Science
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    • v.34 no.2
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    • pp.113-121
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    • 2024
  • Endoplasmic reticulum (ER) stress responses are markedly induced during toxic responses caused by various chemical substances, including difenoconazole, but no research has been conducted on 1,2,3-trichloropropane (TCP), a chemical that is generally used in agriculture and industry, which induces hepatotoxicity. Therefore, in this study, the changes in indicators for hepatotoxicity, apoptosis, and ER stress were analyzed in TCP-treated Sprague Dawley (SD) rats to study the regulatory mechanism of ER stress during the hepatotoxicity. The TCP-treated group decreased in body weight and dietary intake compared to the vehicle-treated group, and necrosis and vacuolation increased significantly in liver histology. In addition, the expression of apoptosis-related factors, including Bax/Bcl-2 and cleaved caspase (Cas)-3/Cas-3 increased significantly in the TCP-treated group compared to the vehicle-treated group. In the analysis of ER stress response indicators, the expression of C/EBP homologous protein (CHOP), phospho-eukaryotic translation initiation factor 2 alpha subunit (eIF2α), and phospho-inositol-requiring enzyme 1α (IRE1α) increased only in the TCP100-treated group and decreased in the TCP200-treated group. However, the transcriptions of growth arrest and DNA damage-34 (GADD34) increased in the TCP200-treated group, while Spliced X-box binding protein-1 (XBP1s) and unspliced XBP1(XBP1u) decreased in the same group. These results suggest that the ER stress response is successfully triggered during the hepatotoxicity induced by TCP treatment through the alternative regulation of the unfolded-protein response (UPR) pathway.

The National Survey of Open Lung Biopsy and Thoracoscopic Lung Biopsy in Korea (개흉 및 흉강경항폐생검의 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.5-19
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    • 1998
  • Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

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Effects of Vitamin $K_1$ on the Developmental and Survival Rate of Porcine In Vitro Fertilized Embryos (Vitamin $K_1$의 첨가가 돼지 체외 수정란의 발달과 생존율에 미치는 효과)

  • Park, Hum-Dai;Zhu, Yi-Chen;Park, Yong-Soo
    • Journal of Embryo Transfer
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    • v.29 no.1
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    • pp.73-81
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    • 2014
  • The in vitro production of porcine embryos was essential to increase of blastocyst development rate and select of high quality blastocyst in early stage. There were a lot of reports about in vitro porcine embryo development, but there was no report about the selection of high quality embryos. Therefore, in this study, we investigated the effect of vitamin $K_1$ (vit $K_1$) on the development and survival rate of porcine in vitro fertilized embryos. When vit $K_1$ was treated for 24 hr at day 1 in vitro culture, blastocyst development rate in the control group ($35.5{\pm}3.2%$) was significantly lower compared to $1.0{\mu}M$, $3.0{\mu}M$, or $6.0{\mu}M$ groups ($14.5{\pm}4.3$, 0.0, or 0.0%; p<0.05). The survival rates of blastocysts at day 8 in $1.0{\mu}M$, $3.0{\mu}M$ or $6.0{\mu}M$ of vit $K_1$ treated groups ($22.2{\pm}2.9$, 0.0 or 0.0%) were significantly lower than that of the control group ($31.8{\pm}2.6%$; p<0.05). We were added at $1.0{\mu}M$, $3.0{\mu}M$ or $6.0{\mu}M$ vit $K_1$ for different durations of time at day 1 in vitro culture. The development rate and survival rate in the group of $1.0{\mu}M$ vit $K_1$ for 6 hr was $26.5{\pm}2.9%$ and $47.2{\pm}2.8%$, respectively, which were differed significantly in the group of 12 hr (p<0.05). In the group of $3.0{\mu}M$ vit $K_1$, the blastocyst development in control group was $36.4{\pm}3.1%$ but, the survival rate $41.7{\pm}3.2%$ in the group of 3.0 hr was significantly higher than that of the control group (p<0.05). In the group of $6.0{\mu}M$ vit $K_1$, the control group's the blastocyst development was $32.0{\pm}2.8%$ and the 0.5 hr supplement group's survival rates was $42.9{\pm}1.8%$ higher than other groups. We added vit $K_1$ at day 1, day 2, day 4 and day 6 of in vitro culture, on the based the results of supplemented concentration and duration. In the group of $1.0{\mu}M$ 6.0 hr addition, the blastocyst development rate of day 4 and the survival rate of day 2 were the highest in each group. In the groups of $3.0{\mu}M$ 3.0 hr addition or $6.0{\mu}M$ 0.5 hr addition, the blastocyst development ($59.5{\pm}4.1%$ and $50.0{\pm}3.6%$) and survival rates ($72.7{\pm}5.4%$ and $79.2{\pm}4.0%$) on day 4 were significantly higher than that of control and other experiment groups (p<0.05). Meanwhile, the number of cells in blastocysts that produced by vit $K_1$ supplementation was $53.4{\pm}5.8$, $49.4{\pm}3.8$ and $51.5{\pm}4.5$ respectively, which were significantly higher than that of $40.2{\pm}2.3$ in the control group (p<0.05). There was no difference of the number of apoptotic cells between control and experiment groups. In addition, gene expression of survival blastocyst, the Bax mRNA expression was similar between the control and the experiment groups. However, Bcl-xL mRNA expression's in the group of $6.0{\mu}M$ 0.5 hr on day 4 was highest among control and experiment groups (p<0.05). In this study suggested that the control of concentration, duration and time was effective on the survival and cell number of porcine blastocyst derived from in vitro. We are not know what the exact reasons of the effect of vit $K_1$ on embryo development and need to fur ther study. However, vit $K_1$ might be using the selection of high quality porcine blastocyst.

The Purpose and background of this study (노인질환에 대한 한양방동시종합검진 결과에 대한 보고)

  • Gwon, Gyeong-Suk;Lee, Tae-Hwan;Song, Jeong-Mo;Kim, In-Seop;Yun, Ho-Yeong;Im, Jun-Gyu
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.9-27
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    • 1994
  • This study is to analyze of senile disease status and the social problem according to increased old ages, and then to find distributions of old man's diseases and health status efficiency of oriental-occidental contemporary health examination. And it is the first oriental-occidental contemporary health examination of old man performed by JeonJu Woosuk University Oriental Medicine Hospital and Woosuk-Clinic in nation. Methods The objects in this research are 641's old man of KimJe Gun's over 60's years performed medical examination at JeonJu Woosuk University Oriental- Mmedicine-Hospital and Woosuk-Clinic by oriental-occidental medical contemporary exam., from 1994, 24th June till 1994. 13th July. The 1st occident medical examination methods were consisted of chest x-ray check. blood and urine exam., measurement of blood pressure, visual power and audiometry. The Oriental medical examination methods were consisted of four diagnostics (望,聞,問,切), present illness. chief complaint, past history, families history, social history by question and SA Sang constitution test index. The results and conclusions The results and conclusions are the next: 1. In order of distribution. the athletic disease (75.8%),the digestive disease(43.4%), the circulatory disease(41.5%), the respiratory disease(22.3%), EENT disease(8.1%), the endocrinopathy(5.6%), and the genito-urinary disease(5.3%) are the results of the object about 641's old man, by the oriental-occidental medicine's contemporay exam. 2. Distribution of disease distiction are lumbago. gastritis and peptic ulcer. knee joint pain. heart disease. hypertension. chronic bronchitis. asthma. anemia. DM. Tbc. visual disturbance. CVA. etc in order. 3. Disease distribution according to age is almost high incident in 60-75years. Disease incidence is decreased except E.E.N.T disease in over 76years. 4. The relationships of disease and family history are: the 25.0% of CVA pts. has family history and the 11.6% of hypertension pts has family history. so they showed high relative family history. In addition the 5.6% of TBC pts. and the 2.6% of DM pts. have family history. 5. The relationships of disease and drinking are: Drinking proportion is the 36.4% in respiratory disease pts. the 34.7% in hypertension pts. the 33.3% in heart disease pts.. the 28.4% in digestive disease pts.. but because of no surveying drinking amount we can't know the absolut relationships of disease and drinking. 6. The relationships of Disease and smoking are: Smoking proportion is the 44.1% in respiratory disease pts.. the 38.0% in Heart disease pts.. the 29.8% in Hypertension pts.. but because of no surveying of smoking amount. we can't know the absolut relationships of disease and smoking. 7. Distribution of Sasang constitution is : Tae-eum-in 44.8%. So-yang-in 30.7%. So-eum-in 24.6%. Tae-yang-in 0.0%. And disease distribution of Sasang constitution distinction is ; Tae-eum-in has high incidence of circulation disease(50.0%) and respiratory disease(23.1%).So-yang-in has high incidence of athletics disease(77.7%) and EENT disease(12.2%), So-eum-in has high incidence of digestive disease(65.8%). 8. Distribution of abnormal result in occidental medical examination and oriental-occidental contemporal exam result is considerably different. This is the reason of needing oriental medicine exam, for characteristics of Senile. I think that the oriental-occidental contemporary examination in old man is much more effecient than only occident medical examination. This oriental-occidental contemporary examination has many defects because it is the first practice. To participate in the public health program efficiently. I think that we must improve lots of problems and present the model of the oriental-occidental contemporary examination and the project of oriental medicine's for public health.

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