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Simultaneous Elevation of Serum Parathyroid Hormone(PTH) and Parathyroid Hormone-related Protein(PTHrP) in a Case of Lung Cancer with Hypercalcemia (고칼슘혈증을 보인 폐암환자에서 부갑상선호르몬(PTH)과 부갑상선호르몬관련단백질(PTHrP)이 동시에 증가된 1예)

  • Kim, Yu-Il;Kim, Kyu-Sik;Yu, Young-Kwon;Park, Chang-Min;Rim, Myung-Soo;Ko, Kyung-Haeng;Hwang, Jun-Hwa;Park, Hyeong-Kwan;Lim, Sung-Chul;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.525-532
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    • 1999
  • The parathyroid hormone related protein (PTHrP) is the most common causative peptide of humoral hypercalcemia of malignancy. In contrast, the serum level of parathyroid hormone (PTH) is low to undetectable in the majority of patients with malignancy associated hypercalcemia. Few cases exist in which the production and secretion of PTH by malignant nonparathyroid tumors have been authenticated. To our knowledge, there is very rare case in which a nonparathyroid tumor expressed simultaneously both the PTH and PTHrP. We report a case of squamous cell carcinoma of the lung with hypercalcemia which presented with simultaneous elevation of serum PTH and PTHrP. Severe hypercalcemia (serum calcium, 7.5 mEq/L) was found in a 65-year-old man who had a squamous cell carcinoma of the lung without any bony metastasis and detectable parathyroid abnormalities on isotope scintigraphy. The serum level of intact parathyroid hormone (PTH) con centration was markedly elevated as measured in two site radioimmunoreactive PTH assays (intact PTH 150 pg/mL ; normal 9~55). The serum level of a PTHrP was also increased as measured in C-terminal region specific radioimmunoassay (PTHrP 99.1 pmol/L; normal 13.8~55.3). There are no evidences of coincidental primary hyperparathyroidism in parathyroid MIBI scan and other imaging studies including neck ultrasonography and computed tomography. These results suggest that simultaneous elevation of serum PTH and PTHrP in this patient can be caused by production of both PTHrP and PTH in other nonparathyroid lesions such as squamous cell carcinoma.

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Phase II Study of Induction Irinotecan + Cisplatin Chemotherapy Followed by Concurrent Irinotecan + Cisplatin Plus Twice-Daily Thoracic Radiotherapy (유제한성 병기의 소세포 폐암에서 3주 간격으로 시행된 irinotecan과 cisplatin을 이용한 과다분할 방사선 동시 요법)

  • Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Cho, Moon June;Kim, Jin Hwan;Lee, Choong Sik;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.154-164
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    • 2007
  • Background: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. Irinotecan also can act as a potential radiation sensitizer along with cisplatin. To evaluate efficacy and toxicity of irinotecan plus cisplatin (IP) with concurrent thoracic radiotherapy, we conducted a phase II study of IP followed by concurrent IP plus hyperfractionated thoracic radiotherapy in patients with previously untreated limited-stage small-cell lung cancer. Methods: Twenty-four patients with previously untreated small-cell lung cancer were enrolled onto the study since November 2004. Irinotecan $60mg/m^2$ was administered intravenously on days 1 and 8 in combination with cisplatin $60mg/m^2$ on day1 every 21 days. From the first day of third cycle, twice-daily thoracic irradiation (total 45 Gy) was given. Prophylactic cranial irradiation was given to the patients who showed complete remission after concurrent chemoradiotherapy. Restaging was done after second and sixth cycle with chest CT and/or bronchosocpy. Results: Up to November 2004, 19 patients were assessable. The median follow-up time was 12.5 months. A total of 99 cycles (median 5.2 cycles per patient) were administered. The actual dose intensity values were cisplatin $19.6mg/m^2$/week and irinotecan $38.2mg/m^2$/week. Among the 19 patients, the objective response rate was 95% (19 patients), with 9 patients (47%) having a complete response (CR). The major grade 3/4 hematological toxicities were neutropenia (35% of cycles), anemia (7% of cycles), thrombocytopenia (7% of cycles). Febrile neutropenia was 4% of cycles. The predominant grade 3/4 non-hematological toxicities was diarrhea (5% of cycles). Toxicities was not significantly different with concurrent administration of irinotecan and cisplatin with radiotherapy, except grade 3/4 radiation esophagitis (10% of patients). No treatment-related deaths were observed. The 1-year and 2-year survival rate of eligible patients was 89% (16/18) and 47% (9/18), respectively. Conclusion: Three-week schedule of irinotecan plus cisplatin followed by concurrent IP plus hyperfractionated thoracic radiotherapy is an effective treatment for limited disease small-cell lung cancer, with acceptable toxicity.

Middle School Home Economics Teachers' Performance Conditions of Self Supervision Related to the Home Economics (중학교 가정과 교사의 교과 관련 자기장학에 대한 수행 실태)

  • Nam, Yun-Jin;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.19 no.2
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    • pp.61-75
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    • 2007
  • The method used in this descriptive study is the survey. The purpose of the study is to investigate performances of middle school home economics(HE) teachers regarding the HE subject. Respondents in this study were 177 HE teachers. Questionnaires from HE teachers were collected through e-mails. With the operation of the SPSS/Win (ver10.1) program, the analyses such as mean, standard deviation, frequencies, percents, t-test and ANOVA are done to see the relations between the related variables. The results of this study were as follows. First, the middle school HE teachers performed well above the standards in terms of planning, execution, and evaluation about self supervision related to HE. Second, the HE teachers collected materials for instruction by using literary (books) survey, Internet and mass media. They mainly focused on improving ways of "teaching and learning" and deepening the studies related to contents of textbooks. Third, the HE teachers used various ways to improve self supervision in the following order: mass media, literary (books) survey, participation in societies for researches, meetings, various training and field trip More than half of the middle school HE teachers proceeded to graduate schools, joined meetings for researches and had experiences of taking classes in private institutes. They also made a field trip once or twice a year and depended much on TV programs and education broadcasting programs as ways of improving their performances related to self supervision. While they were actively sharing information with their peer group, they made little effort at analyzing and evaluating their classes and utilizing expert group for their classes. The main problems as to self supervision were that only the half of the HE teachers responded that they were performing self supervision related to their classes well above the standards and the area where they heavily focused on has been "teaching and learning" and "the studies related to contents of textbooks". Therefore, to motivate incentives of the HE teachers for self supervision, meetings for researches should be activated and various training programs should be developed. In addition, government should give administrative and institutional support through a publication of books introducing detailed ways of self supervision and an establishment of centers and institutions for supporting self supervision.

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Utilization of a Ubiquitous Environmental Sculptures Analysis (유비쿼터스 환경 조형물의 이용의식 실태 분석)

  • Kim, Dong-Chan;Cho, Hwee-In
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.3
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    • pp.15-22
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    • 2010
  • Today's rapid shifts toward a new paradigm are combining city spaces with reality and technology, which is known as a ubiquitous environment. An ubiquitous environment means that 'whenever' and 'wherever' become connected. It is a great possibility that this will change our future lifestyle. Korea has the biggest advantage in the implementation of this new environment, such as having an excellent network infrastructure. Using these attributes of a ubiquitous environment, changes are being made toward ubiquitous cities within developing fields of construction, landscaping, streets, art, and the environment. This research is based on background of research that activated media pole in public city space has been done research about reality of digital skill, fusion, and sense of ubitizen, and Kang-Nam U-street applied by ubiquitous technique. While reflecting an environment that can be utilized in a modern digital society, the application of ubiquitous technology to media pole can be a space for the two-way communication of the current paradigm. It would also be meaningful to create a new cultural space through media pole. Through evaluation, citizens of the ubiquitous age are going to interact to raise the satisfaction that media pole in city space can prevent giving direction to develop and trial and error about service ability, identity, and publicity. Finally, the media pole can be used as a fundamental element to suggest directions for change when viewed as future development.

A Study on Dental Caries Activity Test Targeting Female Undergraduates in Their 20s (20대 여대생을 대상으로 한 치아우식활성검사 연구)

  • Yoon, Mi sook;Youn, Hye-jeong
    • Journal of dental hygiene science
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    • v.10 no.6
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    • pp.465-472
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    • 2010
  • This study surveyed salivary flow rate, salivary viscosity, and salivary buffering capacity in order to intensively analyze salivary factors among factors of occurrence in dental caries for finding mutually different factors that function in occurrence of dental caries depending on each individual. Even the acid body within dental plaque has great influence upon dental caries. Thus, the comparative analysis was carried out by surveying the hydrogen ion concentration in dental plaque. The following results were obtained in this study. 1. The average decayed teeth in the survey subjects stood at 1.67 piece. The extracted teeth caused by dental caries stood at 0.47 piece. The filled teeth were indicated to be 6.31 pieces. Accordingly, the average permanent dental caries experience teeth were surveyed to be 8.44 pieces. 2. The results according to dental caries activity test method were indicated to be $12.56{\pm}4.15ml$ for the average stimulated salivary flow rate, $3.89{\pm}1.83ml$ for non-stimulated salivary flow rate, $1.49{\pm}0.69$ for salivary viscosity, and $8.51{\pm}2.44$ for salivary buffering capacity. The hydrogen ion concentration test in dental plaque was indicated to be $5.62{\pm}0.50$ for before brushing teeth, $5.23{\pm}0.58$ for 5 minutes after brushing teeth, $5.25{\pm}0.56$ for 10 minutes after brushing teeth, $5.29{\pm}0.62$ for 15 minutes after brushing teeth, $5.34{\pm}0.58$ for 20 minutes after brushing teeth, $5.40{\pm}0.53$ for 25 minutes after brushing teeth, and $5.61{\pm}0.59$ for 30 minutes after brushing teeth. 3. Stimulated salivary and non-stimulated salivary flow rate, salivary viscosity, and salivary buffering capacity were indicated to be higher in group with non-caries than group with caries. However, it was statistically insignificant. The hydrogen ion concentration in dental plaque showed wholly statistical significant in the relationship with people with dental caries under progression. However, people without dental caries were indicated to be higher than people with dental caries. 4. As for correlation between caries activity test methods, the stimulated salivary flow rate had significantly positive correlation with non-stimulated salivary flow rate(p<0.001). Non-stimulated salivary flow rate showed negative correlation with salivary buffering capacity(p<0.01). The hydrogen ion concentration test in dental plaque showed positive correlation according to the passage of time after brushing teeth. However, there was no significant correlation with salivary viscosity and salivary buffering capacity(p>0.05).

Satisfaction of Elementary School Students's Parents with the Pit & Fissure Sealing Program in Some Regions (일부지역 초등학생 학부모의 치면열구전색에 관한 만족도)

  • Hwang, Ji-Min;Han, Ji-Hyoung
    • Journal of dental hygiene science
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    • v.9 no.4
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    • pp.469-474
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    • 2009
  • The purpose of this study was to examine the satisfaction level of parents with elementary school students in some metropolitan areas with the pit and fissure sealing program in a bid to raise awareness of the importance of the preventive treatment and accelerate the spread of it. The subjects in this study were 231 parents who had school children and resided in Seoul and Gyeonggi Province. After a self-administered survey was conducted in October and November 2008, the collected data were analyzed. The findings of the study were as follows; 1. As to places for receiving the preventive treatment, 111 respondents (48.1%) experienced pit and fissure sealing in dental clinics, and 88 respondents(38.1%) did that in dental hospitals. 177 people(76.6%) received that treatment from dentists, and 16 respondents(11.3%) did that from dental hygienists. 2. Concerning whether to be for or against the pit and fissure sealing program, more than half that numbered 143(61.9%) supported that program, and 88 respondents(38.1%) didn't. As for satisfaction level, they expressed the biggest satisfaction with the preventive effect of that treatment($3.92{\pm}.85$), and were least satisfied with the cost($1.91{\pm}.86$). 3. Regarding links between general characteristics and satisfaction level, they were statistically significantly different in satisfaction level with the cost according to residential area and the number of child, and age made a statistically significant difference to their satisfaction level with the preventive effect of it. 4. As for relationship between warranty term and whether to be for the pit and fissure sealing program or not, 45(31.5%) out of those who supported the program were provided with no warranty, and 32(36.4%) out of those who took a stand against it were provided with no warranty, either. Warranty was provided to 12(8.4%) respondents of the former group without a fixed term, but that's not the case for any of the latter. The warranty term made statistically significant differences to their agreement or disagreement to the program(p<0.05).

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An Analysis into the Characteristics of the High-pass Transportation Data and Information Processing Measures on Urban Roads (도시부도로에서의 하이패스 교통자료 특성분석 및 정보가공방안)

  • Jung, Min-Chul;Kim, Young-Chan;Kim, Dong-Hyo
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.10 no.6
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    • pp.74-83
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    • 2011
  • The high-pass transportation information system directly collects section information by using probe cars and therefore can offer more reliable information to drivers. However, because the running condition and features of probe cars and statistical processing methods affect the reliability of the information and particularly because the section travel time is greatly influenced by whether there has been delay by signals on urban roads or not, there can be much deviation among the collected individual probe data. Accordingly, researches in multilateral directions are necessary in order to enhance the credibility of the section information. Yet, the precedent studies related to high-pass information provision have been conducted on the highway sections with the feature of continuous flow, which has a limit to be applied to the urban roads with the transportational feature of an interrupted flow. Therefore, this research aims at analyzing the features of high-pass transportation data on urban roads and finding a proper processing method. When the characteristics of the high-pass data on urban roads collected from RSE were analyzed by using a time-space diagram, the collected data was proved to have a certain pattern according to the arriving cars' waiting for signals with the period of the signaling cycle of the finish node. Moreover, the number of waiting for signals and the time of waiting caused the deviation in the collected data, and it was bigger in traffic jam. The analysis result showed that it was because the increased number of waiting for signals in traffic jam caused the deviation to be offset partially. The analysis result shows that it is appropriate to use the mean of this collected data of high-pass on urban roads as its representative value to reflect the transportational features by waiting for signals, and the standard of judgment of delay and congestion needs to be changed depending on the features of signals and roads. The results of this research are expected to be the foundation stone to improve the reliability of high-pass information on urban roads.

A Case of Rifampicin Induced Pseudomembranous Colitis (Rifampicin에 의한 위막성 대장염 1예)

  • Yun, Jong-Wook;Hwang, Jung-Hye;Ham, Hyoung-Suk;Lee, Han-Chul;Roh, Gil-Hwan;Kang, Soo-Jung;Suh, Gee-Young;Kim, Ho-Joong;Chung, Man-Pyo;Kwon, O-Jung;Rhee, Chong-H.;Son, Hee-Chung
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.774-779
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    • 2000
  • Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous inflammation, which was compatible with tuberculosis, Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin inpatients with severe diarrhea receiving anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.

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Etiology and Characteristics of Massive Pleural Effusions Investigated at One University Hospital in Korea (대량 흉수의 원인과 성상-국내 한 대학병원의 경험)

  • Park, Song Ree;Kim, Jee Hyun;Ha, Na Rae;Lee, Jae Hyung;Kim, Sang Heon;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Kim, Tae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.456-462
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    • 2006
  • Background: Differential diagnosis is very important in patients with pleural effusions. A few studies on the etiologies of massive pleural effusions have been reported, but these were conducted in different decades and locations. In the present study, the etiologic spectrum of massive pleural effusions in Korea, were evaluated through an investigation at one university hospital. Methods: Retrospective chart reviews were performed in patients having undergone thoracentesis between July 2002 and July 2005. Pleural effusions were deemed to be massive if they occurred in two thirds or more of one hemithorax. The etiologies of massive pleural effusions, pleural fluid findings, serum laboratory findings, and sputum and pleural fluid cytologies were compared. Results: Of 298 pleural effusions cases, 41 (13.8%) had massive pleural effusions. The most frequent causes of massive pleural effusions were malignancy (19; 46.3%) followed by tuberculosis (15; 36.6%), parapneumonic effusion (4; 9.8%) and transudate (3; 7.3%). Compared with massive benign effusions, patients with massive malignant pleural effusions were more likely to have lower adenosine deaminase (ADA) activity, a higher amylase level and higher RBC count in their pleural fluids. Also, compared with non-tuberculosis effusions, patients with massive tuberculous pleural effusions were more likely to have lower RBC and neutrophil counts, but a higher lymphocyte count, adenosine deaminase (ADA) activity and protein level. Conclusion: The most common etiologies of massive pleural effusions in Korea are malignancy and tuberculosis. A high ADA content favors a tuberculous condition, while bloody effusions with a relatively lower ADA content. favors malignancy. The proportion of tuberculosis in massive pleural effusions was higher than in previous reports.

Application of Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure (호흡부전 환자에서 비침습적 양압환기법의 적용)

  • Seol, Young Mi;Park, Young Eun;Kim, Seo Rin;Lee, Jae Hyung;Lee, Su Jin;Kim, Ki Uk;Cho, Jin Hoon;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Young Dae
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.26-33
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    • 2006
  • Background: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. Methods: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. Results: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, $PaO_2$, $PaCO_2$, $SaO_2$ were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. Conclusion: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.