• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.805-812
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• 1998

Background: Among the variety of opportunistic infections, pneumonia comprises the major morbidity in immunocompromised patients. Pneumocystis carnii pneumonia (PCP) and cytomegalovirus (CMV) pneumonia are common infectious illness of immunocompromised hosts. Although there are many reports regarding to the co-infection of PCP and CMV diagnosed by bronchoalveolar lavage (BAL) fluid examination, the effects of CMV co-infection on the outcome of PCP is still controversial. The purpose of this investigation is to evaluate the effects of CMV detected by BAL fluid examination on the clinical course of PCP in the immunocompromised patients other than human immunodeficiency virus infection. Method: Ten patients with PCP were enrolled and retrospective analysis of their medical records were done. HIV infected persons were excluded. The PCP was diagnosed by BAL fluid examination with Calcofluor-White staining. CMV was detected in BAL fluid by Shell-vial culture system. Chest radiographic findings were reviewed. We used Fisher's exact test and Mann-Whitney U test for statistical analysis of data. Results: The underlying disorders of patients were idiopathic pulmonary fibrosis (n=1), renal transplantation (n=4), necrotizing vasculitis (n=l), systemic lupus erythematosus (n=1), brain tumor (n=1), chronic myelogenous leukemia (n=1), unidentified (n=1). There were no difference in clinical course, APACHE III score, arterial blood gas analysis, white blood cell count, lymphocyte count, serum albumin concentration, chest radiographic findings and mortality between patients with PCP alone (n=4) and those with CMV co-infection (n=6). Univariate analysis regarding to the factors that associated with mortality of PCP were revealed that the application of mechanical ventilation (p=0.028), the level of APACHE III score (p=0.018) and serum albumin concentration (p=0.048) were related to the mortality of patients with PCP. Conclusion: The clinical course of PCP patients co-infected by CMV were not different from PCP only patients. Instead, accompanied respiratory failure, high APACHE III score and poor nutritional status were associated with poor outcome of PCP.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.460-470
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• 1999

Background : In 1993, American Thoracic Society (ATS) recommended a guideline for the initial management of adults with community-acquired pneumonia(CAP). However, etiologic organisms and medical system in Korea seem to be different from those in Western countries. Retrospective analysis was done to evaluate the efficacy of antibiotics chosen by ATS guideline in the treatment of Korean patients with CAP admitted to a tertiary university medical center. Methods : Hospitalized patients with CAP at Samsung Medical Center from April 1997 through March 1998 were retrospectively reviewed. Patients who fulfilled all of the following criteria were included in this study : (1) fever ${\geq}38^{\circ}C$ (2) purulent sputum (3) pulmonary infiltrates on chest X-ray. Patients were classified as : 1) ATS group ; patients whose initial antibiotics were chosen by ATS guideline 2) Non-ATS overuse group ; additional antibiotics administered more than those of ATS guideline, and 3) Non-ATS underuse group ; initial antibiotics were insufficient to ATS guideline. Response of empirical antibiotics and etiologic organisms of 3 groups were identified. Results : Sixty-four patients were enrolled. Thirty-six patients were classified into ATS group, 10 patients Non-ATS overuse group, and 18 patients Non-ATS underuse group. Thirty-three patients of 36 ATS group, 9 patients of 10 Non-ATS overuse group, and 14 patients of 18 Non-ATS underuse group showed improvement by initial empirical antibiotics. There was no statistical difference in antibiotic response between 3 groups (p>0.05). S. pneumoniae (12.5%), K. pneumoniae (9.4%), and P. aeruginosa (4.7%), Mycoplasma (3.1%) were the most commonly isolated organisms. In 18 patients with severe CAP, P. aeruginosa was isolated only in 1 patient and Legionella organism not isolated. Conclusion : Initial empirical antibiotics chosen by ATS guideline were effective in the management of Korean patients with CAP admitted to a tertiary hospital. However, well-designed large-scale prospective study is needed to identify etiologic organisms and choose an adequate initial empirical antibiotics in Korean adults patient with severe CAP.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.478-487
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• 1999

Background : Differential diagnosis of pleural malignant mesothelioma from secondary metastatic adenocarcinoma is often difficult. A variety of pathologic techniques have been developed to make a differential diagnosis of carcinoma from mesothelioma. Immunohistochemistry detecting diverse antigenic substances such as CEA, Leu-M1, Bn-3, S-100 protein, vimentin, CK and EMA has been claimed to be of value as a panel in the differential diagnosis of adenocarcinoma from mesothelioma. The aim of this study was to investigate the suitable antibodies to distinguish mesothelioma from metastatic adenocarcinoma and establish candidate markers in a panel. Methods : Complete, one-hour immunohistochemical staining using antibodies against cytokeratin (CK), epithelial membrane antigen(EMA), S-100 protein, vimentin, B72-3, Leu-M1, and carcino-embryonic antigen(CEA) was applied to cell blocks from 7 mesotheliomas and 7 adenocarcinomas which were confirmed by electron microscopic and histpathologic methods. Results : All adenocarcinomas and 71.4% of mesotheliomas expressed the cytokeratin and EMA. S-100 protein and vimentin were expressed in 57.1% and 42.9% of mesotheliomas and 14.3% and 28.5% of adenocarcinomas, respectively. B72-3 was expressed in all adenocarcinomas, but in none of mesotheliomas. Leu-M1 was positive in 71.4% of the adenocarcinoma and 14.3% of the mesotheliomas. CEA was positive in all adenocarcinomas and 42.9% of mesotheliomas. Leu-M1 and B72-3 were coexpressed in 71.4% of adenocarcinomas but in none of mesothelioma. B72-3 and CEA were coexpressed in all adenocarcinomas, but in none of mesotheliomas. Conclusion : We concluded that B72-3 immunohistochemistry or panel staining of B72-3 and CEA could be recommanded for the differential diagnosis of pleural mesothelioma from metastatic adenocarcinoma.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.365-373
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• 1999

Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.976-986
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• 1996

BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.

• Journal of the Korean Society of Food Science and Nutrition
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• v.13 no.3
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• pp.291-306
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• 1984

The possibility of formation of carcinogenic N-nitrosamines such as nitrosodimethylamine(NDMA), nitrosodiethylamine (NDEA) and nitrosopyrolidine (NPYR) during the fermentation of Kimchi was investigated. Three different types of Kimchi, formulated with chinese cabbage, red pepper powder and garlic, with or without one of both fermented shrimp and anchovy juice, were cured for 75 days at $5^{\circ}C$. The changes in contents of nitrates, nitrites, pH, ascorbic acid, secondary amines, trimethyl-aminoxide (TMAO), trimethylamine (TMA) and NDMA were analyzed periodically during the fermentation. TMAO, TMA. DMA, nitrate, nitrite and ascorbic acid were analyzed by colorimetric methods, and NDMA, NPYR and NDEA were determined by the method of GLC-TEA. Although the total secondary amines markedly increased, no significant changes in the levels of TMAO and TMA were observed during the fermentation Kimchi added with fermented shrimp or anchovy juice. The predominating component of secondary amines was confirmed to be dimethylamine by means of nitrosating technique coupled with gas chromatography. No appreciable increase in the level of nitrites was appeared although nitrate level in the Kimchi apparently decreased. Non detectable or trace level of nitrosamine formation was detected whereas the nitrates fairly decreased during the fermentation of Kimchi. This could be explained by the fact that the lack of nitrites was resulted in the system due to rapid consumption of nitrites formed from nitrates by the reactions with ascorbic acid and amino acids which have been known as inhibitors of nitrosation reaction.

• Journal of Korean Society of Forest Science
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• v.89 no.2
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• pp.275-284
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• 2000

This study was carried out to analyze the mechanical properties of soil and the slope stability on the fill slope of forest road constructed in the regions which consist of igneous and metamorphic rock area. The results were summarized as follows. 1) Soil type by Unified Soil Classification System(USCS) was classified as SW in soil slope, GP in weathered rock slope, GP in soft rock slope for both types of parent rock, but gravelly soil slopes in igneous and metamorphic rock area were classified as SP and GW, respectively. 2) Dry unit weight was $1.34g/cm^2{\sim}1.59g/cm^2$, specific gravity 0.57~0.61, and void ratio 0.66~0.93 in the case of igneous rock area, a dry unit weight was $1.35g/cm^2{\sim}1.51g/cm^2$, specific gravity 2.67~2.77, and void ratio 0.78~1.01 in the case of metamorphic rock area. 3) The strength parameters such as internal friction angle(${\phi}$) and cohesion(c) were selected and tested for slope stability analysis. ${\phi}$ and c of soil in igneous rock area were within the range of $29.51^{\circ}{\sim}41.82^{\circ}$ and $0.03kg/cm^2{\sim}0.38kg/cm^2$, respectively, and $21.43^{\circ}{\sim}41.43^{\circ}$ and $0.05kg/cm^2{\sim}0.44kg/cm^2$ in metamorphic rock area, respectively. 4) Result of the slope stability analysis of forest road showed that, in the weathered rock slope of igneous rock and the weathered rock and soil slope of metamorphic rock area, the possibility of slope failure was high as safety factor was below 1.0.

• Journal of Korean Society of Forest Science
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• v.89 no.3
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• pp.440-451
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• 2000

This study was conducted in order to provide essential data and relevant management proposal to conserve and maintain big and old trees in a rational way. For the field survey, 77 big and old trees preserved by the laws in Chollabuk-do, Korea were investigated. The study results are summarized as follows : 1. To conserve and manage big and old trees, the valuable trees have been designated as natural monument trees and protection-needed trees. There are 141 individuals of 37 species designated as natural monuments and 10,049 individuals of 102 species designated as protection-needed trees. 2. Management budget for natural monument trees was devoted at 70% from the national expenditure, but that for protection-needed trees was devoted at 98% from the local expenditure. 3. Standardized sign boards and sign stones for natural monument trees were well placed and other protection facilities such as fences, branch supports and branch holdings were established. On the other hand, management of protection-needed trees was deficient overall. 4. Problems for designation process and management of protection-needed trees could include items such as insufficient management budget, various development activities, land ownership, misjudgement of tree age and species identification, unsatisfaction of sign board placement, insufficient surgery for damaged trees, pavement around tree root system and environmental pollution around the trees. 5. In order to improve the existing management methods of big and old trees, the following schemes were suggested : the development of practical criteria for natural monument and protection-needed trees, nationwide surveys of big and old tree resources, the security of national budget, securing sufficient spaces for the tree growth, specialization of management systems, extended practices of tree form management, establishment of permanent standard signs and consideration of opinions of village residents.

• Journal of Global Scholars of Marketing Science
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• v.20 no.3
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• pp.249-261
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• 2010

As consumers' concern for the environment has continued to increase, many firms have actively engaged in environmental marketing to achieve their objectives. However, consumers' high concerns about the environment are not always reflected in their purchasing behavior. This indicates the need for an in-depth understanding of the development of green consumption within the individual's belief system. In consideration of psychological approaches, a large body of research has examined the factors underlying ecologically conscious "green" consumer behavior and the interrelationships of these factors. However, most previous studies have concentrated on Western countries. Using a sample of Korean consumers, this study attempts to understand the basis of Korean green consumerism and find universal values that are cross-culturally important in guiding consumers' environmental attitudes and behaviors. To this end, this study relates Schwartz's 10 universal values (Schwartz 1992) to environmental behaviors in a hierarchical model of value-attitude-behavior. With reference to the value-attitude-behavior framework, the conceptual model developed for the study explains what motivations can be manifested in Korean consumers' environmental attitudes, and subsequently how the attitudes affect their green choices. Using the pattern of relationships among values that can be related to environmentalism, the first hypothesis holds that there would be particular relationships between motivational value types and environmental attitudes. Hypothesis 2 assumes that environmental attitudes predict environmental behaviors. On the basis of the claim that favorable attitudes toward the environment may be expressed in many different behaviors, the assumption is that consumers' favorable attitudes toward the environment would be linked to a variety of environmental behaviors because people with high environmental attitudes can be more interested in and knowledgeable about environmental actions. Consistent with H2, H3 hypothesizes that there would be a positive relationship between different types of environmental behavior. A total of 564 university students participated in the study. The sample included 308 men, 254 women, and two participants who did not indicate their gender. The average age of the participants was 22.5 years, with a range of 19 to 39. Regarding majors, special efforts were made to draw the participants from different departments of the university. Data were collected by a survey administered via self-completion questionnaires., which assessed the participants' value priorities, environmental attitudes, and behaviors. Path analysis conducted to test the proposed model found the overall fit to be ${\chi}^2$=72.01 (p=0.00), GFI=0.983, CFI=0.982, NFI=0.970, RMR=0.070, and REMSEA=0.050. Thus, most of the fit measures indicated a good fit of the model with the data, and a hierarchical relationship from values to environmental attitudes to environmental non-purchasing behavior to environmental purchasing behavior was confirmed. An assessment of all the predicted paths by path coefficients led to several major hypothesized effects being confirmed. Out of the ten value types, universalism and power were significantly but conversely related to environmental attitudes. In line with the other studies, these findings confirm that environmental attitudes are an important factor in leading to a variety of green behaviors. Finally, significant relationships were found between environmental purchasing and non-purchasing behaviors. The path analysis supported the idea that universalism values provide a motivation for Korean consumers' greenness and indirectly promote environmental acts through favorable attitudes toward the environment. Participants with high environmental attitudes were found to actively engage in diverse forms of green consumer behavior. This research provides an opportunity to examine cross-cultural differences with respect to values leading to environmentalism, and, further, to verify previous findings. The study also examined the attitude-behavior relationship with respect to three distinct types of environmental behaviors. The different strengths of paths between green attitudes and behaviors suggest that researchers should consider the specificity of behavior explained as an effort to improve the low attitude-behavior correlation. Finally, the findings here illustrate that with increased environmental concerns among people, they come to include more such behaviors in their green portfolios.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.389-396
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• 2002

The purpose of this study was to compare the microtensile bonding strength of chemomechanically excavated dentin($Carisolv^{TM}$) to conventional caries removal(bur). The following adhesive systems were used; AB: All-Bond 2(3M, USA), PB: Prime & Bond 2.1(Dentsply, DE), AQ: AQ Bond(sun medical, Japan). 42 human molars with occlusal caries were assigned to 6 groups. Sequential caries removal was controlled with laser fluorescence. Each group was devided as follows; group A, B, C were $Carisolv^{TM}$ applied, group D,E,F were bur used. In group A and D, AB was used as a dentin adhesive. group B,E and group C,F was AQ and AQ was used each. The cavity was filled with composite resin(Z-100). The specimens were sectioned vertically into multiple serial 0.7 mm thick slabs. And then those slabs were sectioned into rectangular parts under 0.7 mm width. Finally 0.7-1.0 mm a right hexahedron shape stick become. Microtensile bonding test was carried out with testing apparatus at cross-head speed of $0.5\;mm/min^{-1}$ and fractured surfaces were observed with scanning electron microscope(JSM-6400, Jeol, Japan). The obtained results were summarized as follows ; 1. In the group of caries removal with $Carisolv^{TM}$, micro-tensile bonding strength decreased to $75.8{\sim}80$ percent of bur used group. 2. In the group of caries removal with $Carisolv^{TM}$, decreased degree of micro-tensile bonding strength is not so different in 3 kinds of dentin adhesives(p<0.05). 3. In the group of caries removal with $Carisolv^{TM}$, microtensile bonding strength of AB, PB, AQ was 32.6MPa(2.4), 30.1Mpa (1.8), 21.2Mpa(1.9). 4. In the group of caries removal with Bur and $Carisolv^{TM}$, microtensile bonding strength of AQ was significantly lower than that of AB and PB(p<0.01).