• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.522-529
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• 2005

Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.247-294
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• 1996

By means of the statistical data which has been collected with newly revised QSCC made use of the outpatient group examined at Kyung-Hee Medical Center and an open ordinary person group, the author proceeded statistical analysis for the validation study of the revised questionnaire itself. First, check the accurate discrimination rate by performing discriminant analysis on the statistical data of the patient group. And next, sought T-score by applying the norms gained in process of standadization of the open ordinary person group to the Sasang scale score of the outpatient group and investigated the distinctive feature between the subpopulations which was devided in the process of multivarite cluster analysis. The result was summarized as follows ; 1. The validity of the questionnaire was established through the fact that the accurate discrimination rate the ratio between predicted group and actual group was figured out 70.08%. 2. At the profile analysis the response to the relevant scale showed notable upward tendency in each constitutional group and therefore it seems to be pertinent in the field of constitutional discrimination. 3. In the observation of the power of expression through the profile analysis of each constitutional group the Soyang group demonstrated the most remarkable outcome, the Soeum group was the most inferior and the Taieum group revealed a sort of dual property. 4. What is called the group of seceder out of three subpopulation of each constitutional group distinguished definitely from the contrasted groups at the point of the distinctive profile feature and the content is like following description. (1) The seceder group of Soyang-in showed considerably passive disposition differently from general character of ordinary Soyang group and an appearance attracting the attention is that they demonstrated comparatively higher response at Soeum scale (2) The seceder group of Taieum-in gained low scores in general that informed the passive disposition of the group and the other way of the general property of Taieum group which showed accompanied ascension in Taiyang-Taieum scales they demonstrated sharply declined score at Taiyang scale (3) The seceder group of Soeum-in demonstrated distinctive property similar to the profile feature of Soyang group and it notifies that the passive property of Soeum group was diluted for the most part. According to the above result, the validity of newly revised questionnaire has been proven successfully and the property of seceder groups could be noticed to some degree through the profile analysis on the course of this study. The result of this study is expected to use as a research materials to produce next edition of the questionnaire and it is regarded that further inquisition about the difference between the seceder group and the contrasted group is required for the promotion of the questionnaire as it refered several times in the contents of the main discourse.

• Tuberculosis and Respiratory Diseases
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• v.48 no.1
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• pp.14-23
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• 2000

Background: The evaluation of candidates for successful lung resection is important. Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. Method; Between October 1, 1995 and August 31, 1997, 36 lung resection candidates for lung cancer with $FEV_1$ of less than 2L or 60% of predicted value were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(l to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo) pulmonary factors such as ppo-$FEV_1$ ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}$ppo-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also measured. Results: There were 31 men and 5 women with the median age of 65 years(range, 44 to 82) and a mean $FEV_1$ of $1.78{\pm}0.06L$. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients; cardiac complications in 3, other complications(empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-$VO_2$max was less than 10 ml/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictor for the post operative death in this study. Conclusions: Based on the results, MVV was the useful predictor for postoperative pulmonary complications in lung cancer resection candidates with impaired lung function In addition, ppo-$VO_2$max value less than 10 ml/kg/min was associated with postoperative death, so exercise pulmonary function test could be useful as preoperative test. But further studies are needed to validate this result.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.247-256
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• 2008

Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.

• Korean Journal of Soil Science and Fertilizer
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• v.12 no.4
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• pp.189-213
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• 1980

1. Aiming at supply of basic informations on tree species siting and forest fertilization by understanding of soil properties that are demanded by each tree species through studies of forest soil's morphological, physical and chemical properties in relation to tree growth in our country, the necessary data have been collected in the last 10 years, are quantified according to quantification theory and are analyzed in accordance with multi-variate analysis. 2. Test species, larch and the Korean white pine, are plantable in extensive areas from mid to north in the temperate zone and are the two most recommended reforestation tree species in Korea. However, their respective site demands are not known and they have been in confusion or considered demanding the same site during reforestation. When the Korean white pine is planted in larch sites, it has shown relatively good growth. But, when larch is planted in the Korean white pine site it can be hardly said that the larch growth is good. To understand on such a difference soil factors have been studied so as to see how the soil's morphological, physical and chemical factors affect tree growth helped with the electronic computer. 3. All the stands examined are man-made mature forests. From 294 larch plots and 259 white pine plots dominant trees are cut as samples and through stem analysis site index is determined. For each site index soil profiles are made in the related forest-land for analysis. Soil samples are taken from each profile horizon and forest-land productivity classification tables are worked out through physical and chemical analysis of the soil samples for each tree species for the study of relationships between physical, chemical and the combined physical/chemical properties of soil and tree growth. 4. In the study of relationships between physical properties of soil and tree growth it is found out that larch growth is influenced by the following factors in the order of deposit form, soil depth, soil moisture, altitude, relief, soil type, depth of A-horizon, soil consistency content of organic matter soil texture bed rock gravel content aspect and slope. For the Korean white pine the influencing factors' order is soil type, soil consistency bed rock aspect depth of A-horizon soil moisture altitude relief deposit form soil depth soil texture gravel content and slope. 5. In the study of relationships between chemical properties of soil and tree growth it is found out that larch growth is influenced by the following factors in the order of base saturation organic matter CaO C/N ratio, effective $P_2O_5$ PH.exchangeable $K_2O$ T-N MgO C E C Total Base and Na. For the Korean white pine the influencing factors' order is effective $P_2O_5$ Total Base T-N Na C/N ratio PH CaO base saturation organic matter exchangeable $K_2O$ C E C and MgO. 6. In the study of relationships between the combined physical and chemical properties of soil and tree growth it is found out that larch growth is influenced by the following factors in the order of soil depth deposit form soil moisture PH relief soil type altitude T-N soil consistency effective $P_2O_5$ soil texture depth of A-horizon Total Base exchangeable $K_2O$ and base saturation. For the Korean white pine the influencing factors' order is soil type soil consistency aspect effective $P_2O_5$ depth of A-horizon exchangeable $K_2O$ soil moisture Total Base altitude soil depth base saturation relief T-N C/N ratio and deposit from. 7. In the multiple regression of forest soil's physical properties larch's correlation coefficient is 0.9272 and for the Korean white pine it is 0.8996. With chemical properties larch has 0.7474 and the Korean white pine has 0.7365. So, the soil's physical properties are found out more closely related with tree growth than chemical properties. However, this seems due to inadequate expression of soil's chemical factors and it is proved that the chemical properties are not less important than the physical properties. In the multiple regression of the combined physical and chemical properties consisting of important morphological and physical factors as well as chemical factors of forest soils larch's multiple correlation coefficient is found out to be 0.9434 and for the Korean white pine it is 0.9103 leading to the highest correlation. 8. As shown in the partial correlation coefficients larch needs deeper soil depth than the Korean white pine and in the deposit form colluvial and creeping soils are demanded by the larch. Adequately moist to too moist should be soil moisture and PH should be from 5.5 to 6.1 for the larch. Demands of T-N soil texture and soil nutrients are higher for the larch than the Korean white pine. Thus, soil depth, deposit form, relief soil moisture PH N altitude and soil texture are good indicators for species sitings with larch and the Korean white pine while soil type and soil consistency are indicative only limitedly of species sitings due to their wide variation as plantation environments. For larch siting soil depth deposit form relief soil moisture PH soil type N and soil texture are indicators of good growth and for Korean white pine they are soil type soil consistency effective $P_2O_5$ and exchangeable $K_2O$, which is demanded more by the Korean white pine than larch generally. 9. Physical properties of soil has been known as affecting tree growth to greatest extent so far. However, as a result of this study it is proved through computer analysis that chemical properties of soil are not less important factors for tree growth than chemical properties and site demands for larch and the Korean white pine that have been uncertain So far could be clarified.

• Journal of Korean Society of Forest Science
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• v.53 no.1
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• pp.1-26
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• 1981

1. Aiming at supply of basic informations on tree species siting and forest fertilization by understanding of soil properties that are demanded by each tree species through studies of forest soil's morphological, physical and chemical properties in relation to tree growth in our country, the necessary data have been collected in the last 10 years, are quantified according to quantification theory and are analyzed in sccordance with multi-variate analysis. 2. Test species, japanese larch (Larix leptolepis Gord) and the Korean white pine, (pinus koraiensis S et Z.) are plantable in extensive areas from mid to north in the temperate forest zone and are the two most recommended reforestation tree species in Korea. However, their respective site demands are little known and they have been in confusion or considered demanding the same site during reforestation. When the Korean white pine is planted in larch sites, it has shown relatively good growth, but, when Japanese larch is planted in Korean white pine site it can be hardly said that the Japanese Larch growth is good. To understand on such a difference soil factors have been studied so as to see how th soil's morphological, physical and chemical factors affect tree growth helped with the electronic computer. 3. All the stands examined are man-made mature forests. From 294 Japanese larch plots and 259 Korean white pine plots dominant trees are cut as samples and through stem analysis site index is determined. For each site index soil profiles are made in the related forest-land for analysis. Soil samples are taken from each profile horizon and forest-land productivity classification tables are worked out through physical and chemical analyses of the soil samples for each tree species for the study of relationships between physical, chemical and the combined physical/properties of soil and tree growth. 4. In the study of relationships between physical properties of soil and tree growth it is found out that Japanese larch growth is influenced by the following factors in the decreasing order of weight deposit form, soil depth, soil moisture, altitude, relief, soil type, depth a A-horizon, soil consistency, content of organic matter, soil texture, bed rock, gravel content, aspect and slope. For the Korean white pine the influencing factors' order is soil type, soil consistency, bed rock, aspect, depth of A-horizon, soil moisture, altitude, relief, deposit form, soil depth, soil texture, gravel content and slope. 5. In the study of relationships between chemical properties of soil and tree growth it is found out that Japanese larch growth is influenced by the following factors in the order of base saturation, organic matter, CaO, C/N ratio, effective $P_2O_5$, PH, exchangeable, $K_2O$, T-N, MgO, CEC, Total Base and Na. For the Korean white pine the influencing factors' order is effective $P_2O_5$, Total Base, T-N, Na, C/N ratio, PH, CaO, base saturation, organic matter, exchangeable $K_2O$, CEC and MgO. 6. In the study of relationships between the combined physical and chemical properties of soil and tree growth it is found out that Japanese larch growth is influenced by the following factors in the order of soil depth, deposit form, soil moisture, PH, relief, soil type altitude, T-N, soil consistency, effective $P_2O_5$, soil texture, depth of A-horizon, Total Base, exchangeable $K_2O$ and base saturation. For the Korean white pine the influencing factors' order is soil type, soil consistency, aspect, effective $P_2O_5$, depth of A-horizon, exchangeable $K_2O$, soil moisture, Total Base, altitude, soil depth, base saturation, relief, T-N, C/N ratio and deposit form. 7. In the multiple correlation of forest soil's physical properties larch's correlation coefficient for Japanese Larch is 0.9272 and for Korean white pine, 0.8996. With chemical properties larch has 0.7474 and Korean white pine has 0.7365. So, the soil's physical properties are found out more closely related with tree growth than chemical properties. However, this seems due to inadequate expression of soil's chemical factors and it is proved that the chemical properities are not less important than the physical properties. In the multiple correlation of the combined physical and chemical properties consisting of important morphological and physical factors as well as chemical factors of forest soils larch's multiple correlation coefficient is found out to be 0.9434 and for Korean white pine it is 0.9103 leading to the highest correlation. 8. As shown in the partial correlation coefficients Japanese larch needs deeper soil depth than Korean white pine and in the deposit form of colluvial and creeping soils are demanded by the larch. Moderately moist to not moist should be soil moisture and PH should be from 5.5 to 6.1 for the larch. Demands of T-N, soil texture and soil nutrients are higher for the larch than the Korean white pine. Thus, soil depth, deposit form, relief, soil moisture, PH, N, altitude and soil texture are good indicators for species sitings with larch and the Korean white pine while soil type and soil consistency are indicative only limitedly of species sitings due to their wide variations as plantation environments. For the larch siting soil depth, deposit form, relief, soil moisture, pH, soil type, N and soil texture are indicators of good growth and for the Korean white pine they are soil type, soil consistency, effective $P_2O_5$ and exchangeable $K_2O$. In soil nutrients larch has been found out demanding more than the Korean white pine except $K_2O$, which is demanded more by the Korean white pine than Japanese larch generally. 9. Physical properties of soil has been known as affecting tree growth to the greatest extent so far. However, as a result of this study it is proved through computer analysis that chemical properties of soil are not less important factors for tree growth than chemical properties and site demands for the Japanese larch and the Korean white pine that have been uncertain so far could be clarified.