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Mineralogy and Mineral-chemistry of REE Minerals Occurring at Mountain Eorae, Chungju (충주 어래산 일대에서 산출하는 희토류 광물의 광물학적 및 광물화학적 특성)

  • You, Byoung-Woon;Lee, Gill Jae;Koh, Sang Mo
    • Economic and Environmental Geology
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    • v.45 no.6
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    • pp.643-659
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    • 2012
  • The Chungju Fe-REE deposit is located in the Kyemyeongsan Formation of the Ogcheon Group. The Kyemyeongsan Formation includes meta-volcanic rocks and pegmatite hosted REE deposit which show different kind of REE-containing minerals. The meta-volcanic rocks hosted REE deposits' main REE minerals are allanite, zircon, apatite, and sphene, whereas the pegmatite hosted REE deposits is mainly composed of fergusonite, and karnasurtite, zircon, thorite. The meta-volcanic rock hosted major REE mineral is allanite as the form of aggregation and contains 23.89-29.19 wt% TREO (Total Rare Earth Oxide), 4.71-9.92 wt% $La_2O_3$, 11.30-14.33 wt% $Ce_2O_3$, 0.11-0.29 wt% $Y_2O_3$, 0.15-0.94 wt% $ThO_2$, as a formula of (Ca, Y, REE, Th)$_{2.095}$(Mg, Al, Ti, Mn, $Fe^{3+})_{2.770}(SiO_4)_{2.975}(OH)$. Accompanying REE in a coupled substitution for $Ca^{2+}$ (M1 site) and $Al^{3+}-Fe^{2+}$ (M2 site) leads to a large chemical variety. Due to the allanite's high contents of Fe, it belongs to Ferrialanite. The pegmatite hosted deposit's domi-nant REE mineral is fergusonite as prismatic or subhedral grains associated with zircon, fluorite and karnasurtite. Geochemical composition of the fergusonite($YNbO_4$) suggests substitution of Y-REE and Y-Th in A-site, and Nb-Ta-Ti in B-site, furthermore the proportion of $Y_2O_3$ and $Nb_2O_5$ is oddly 1:1.5 comparing to the ideal ratio 1:1 and Nb is higher than Y, also A-site Y actively substitutes with REE. Karnasurtite in pegmatite variously ranges 9.16-22.88 wt% $Ce_2O_3$, 2.15-9.16 wt% and $La_2O_3$, 0.44-10.8 wt% $ThO_2$, as a calculated formula (Y, REE, Th, K, Na, Ca)$_{1.478}(Ti, Nb)_{1.304}$(Mg, Al, Mn, $Fe^{3+})_{0.988}$(Si, P)$_{1.431}O_7(OH)_4{\cdot}3H_2O$. Firstly the 870-860 Ma is the initial age of the supercontinent Rhodinia dispersal and subsequent A-1 type volcanism, which contains Fe, REE, and HFS(High Field Strength elements; Nb, Zr, Y etc.) elements in Fe-rich meta-volcanic rocks dominant Kyemyeongsan Formation, might mineralized allanite. Another synthesis is that regional metamorphism at late Paleozoic 300-280 Ma(Cho et al., 2002) might cause allanite mineralization. Also pegmatite REE mineralization highly related to the granite intrusion over the Chungju area in Jurassic(190 Ma; Koh et al., 2012). Otherwise above all, A-1 type volcanism at the same time of the Kyemyeongsan Formation development, regional metamorphism and pegmatite, might have caused REE mineralization. Although REE ore bodies display a close spatial association, each ore bodies display temporal distinction, different mineral assemblage and environment of ore formation.

Clinical review of acute seizures among children who visited the emergency room in Masan Samsung hospital from 2004 to 2006 (최근 3년간(2004-2006년) 응급실로 내원한 소아환자 중 급성 발작으로 인한 환자들에 대한 임상적 고찰)

  • Lee, Won Deok;Yoo, Jae Wook;Lee, Ju Suk;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.420-425
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    • 2008
  • Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

A Study on the Construction and Landscape Characteristics of Munam Pavilion in Changnyeong(聞巖亭) (창녕 문암정(聞巖亭)의 조영 및 경관특성에 관한 연구)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Ahn, Gye-Bog
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.2
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    • pp.27-41
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    • 2014
  • This study aims to investigate the history, cultural values prototype through literature analysis, characteristics of construction, location, space structure and landscape characteristics by Arc-GIS on the Munam pavilion(聞巖亭) in Changnyeong. The results were as follows. First, Shin-cho((辛礎, 1549~1618) is the builder of the Munam pavilion and builder's view of nature is to go back to nature. The period of formation of Munam pavilion is between 1608-1618 as referred from document of retire from politics and build a pavilion. Secondly, Munam pavilion is surrounded by mountains and located at the top of steep slope. Pavilion was known as scenic site of the area. But damaged in a past landscape is caused by near the bridge, agricultural facilities, town, the Kye-sung stream of masonry and beams. Thirdly, Munam pavilion is divided into the main space, which is located on the pavilion, space in located on the pavilion east and west and the orient space, which is located on the Youngjeonggak. Of these, original form of Munam pavilion is a simple structure composed of pavilion and Munam rock, thus at the time of the composition seems to be a direct entry is possible, unlike the current entrance. Fourth, Spatial composition of Munam pavilion is divided into vegetation such as Lagerstroemia indica trees in Sa-ri in Changnyeong, ornament such as letters carved on the rocks and pavilion containing structure. The vegetation around the building is classified as precincts and outside of the premises. Planting of precincts was limited. Outside of area consists of front on the pavilion, which is covered with Lagerstroemia Indica forest and Pinus densiflora forest at the back of the pavilion. Ofthese,LargeLagerstroemiaIndicaforestcorrespondstothenaturalheritageasHistoricalrecordsofrarespeciesresourcesthatareassociated withbuilder. Letterscarvedontherocksrepresenttheboundaryof space, which is close to the location of the Munam pavilion and those associated with the builder as ornaments. Letters carved on the rocks front on the pavilion are rare cases that are made sequentially with a constant direction and rules as act of record for families to honor the achievements. Fifth, 'The eight famous spots of Munam' is divided into landscape elements that have nothing to do with bearing 4 places and landscape elements that have to do with bearing 4 places. Unrelated bearings of landscape elements are Lagerstroemia indica trees in Sa-ri in Changnyeong, Pinus densiflora forest at the back of the pavilion, Okcheon valley, Gwanryongsa temple and Daeheungsa temple. Bearing that related element of absolute orientation, which is corresponding to the elements are Daeheungsa temple, Hwawangsan mountain, Kye-sung stream and Yeongchwisan mountain. Relative bearing is Gwanryongsa temple, Yeongchwisan mountain and Kye-sung stream Gongjigi hill. At Lagerstroemia indica trees in Sa-ri in Changnyeong, Pinus densiflora forest at the back of the pavilion, Kye-sung stream and Okcheon valley, elements are exsting. Currently, it is difficult to confirm the rest of the landscape elements. Because, it is a generic element that reliable estimate of the target and locations are impossible for element. Munam pavilion is made for turn to nature by Shin-cho(辛礎). That was remained a record such as Munamzip(聞巖集) and Munamchungueirok(聞巖忠義錄) that is relating to construction of pavilion. Munam pavilion located in a unique form, archival culture through the letters carved on the rocks and Large Lagerstroemia indica forest and through eight famous spots, cultural landscape elements can be assumed that those elements are remained.

The Expression of Adhesion Molecules on BAL Cells and Serum Soluble ICAM-1 Level after the Radiotherapy for the Lung Cancer and Its Relationship to the Development of of Radiation Pneumonitis and Fibrosis (방사선 치료후 기관지-폐포세척액내 폐포대식세포 및 임파구의 접착분자발현 변화와 방사선에 의한 폐렴 및 폐섬유증발생의 예측인자로서의 의의)

  • Kim, Dong-Soon;Paik, Sang-Hoon;Choi, Eun-Kyung;Chang, Hye-Sook;Choi, Jung-Eun;Lim, Chae-Man;Koh, Yun-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.75-87
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    • 1996
  • Background: Lung cancer is the second most frequent malignancy in man in Korea. Surgery is the best treatment modality for non-small cell lung cancer, but most patients were presented in far advanced stage. So radiation therapy(RT) with or without chemotherapy is the next choice and radiation-induced pneumonitis and pulmonary fibrosis is the major limiting factor for the curative RT. Radiation pneumonitis is manifested with fever, cough and dyspnea, 2~3 months after the termination of radiotherpy. Chest X ray shows infiltration, typically limited to the radiation field, but occasionally bilateral infiltration was reported. Also Gibson et al reported that BAL lymphocytosis was found in both lungs, even though the radiation was confined to one lung. The aim of this study is to investigate the change of adhesion molecules expression on BAL cells and serum soluble ICAM-1(sICAM-1) level after the RT and its relationship to the development of radiation pneumonitis. The second aim is to confirm the bilaterality of change of BAL cell pattern and adhesion molecule expression. Subjects: BAL and the measurement of sICAM level in serum and BALF were done on 29 patients with lung cancer who received RT with curative intention. The BAL was done before the RT in 16 patients and 1~2 month after RT in 18 patients. 5 patients performed BAL before and after RT. Result: Clinically significant radiation pneumonitis developed in 7 patients. After RT, total cell count in BAL was significantly increased from $(20.2{\pm}10.2){\times}10^6\;cells/ml$ to $(35.3{\pm}21.6){\times}10^6\;cells/ml$ (p=0.0344) and %lymphocyte was also increased from $5.3{\pm}4.2%$ to $39.6{\pm}23.4%$ (p=0.0001) in all patient group. There was no difference between ipsilateral and contraleteral side to RT, and between the patients with and without radiation-pneumonitis. In whole patient group, the level of sICAM-1 showed no significant change after RT(in serum: $378{\pm}148$, $411{\pm}150\;ng/ml$, BALF: $20.2{\pm}12.2$, $45.1{\pm}34.8\;ng/ml$, respectively), but there was a significant difference between the patients with pneumonitis and without pneumonitis (serum: $505{\pm}164$ vs $345{\pm}102\;ng/ml$, p=0.0253, BALF: $67.9{\pm}36.3$ vs $25.2{\pm}17.9\;ng/ml$, p=0.0112). The expression of ICAM-1 on alveolar macrophages (AM) tends to increase after RT (RMFI: from $1.28{\pm}0.479$ to $1.63{\pm}0.539$, p=0.0605), but it was significantly high in patients with pneumonitis ($2.10{\pm}0.390$) compared to the patients without pneumonitis ($1.28{\pm}0.31$, p=0.0002). ICAM-1 expression on lymphocytes and CD 18 (${\beta}2$-integrin) expression tended to be high in the patients with pneumonitis but the difference was statiastically not significant. Conclusion: Subclinical alveolitis on the basis of BAL finding developed bilaterally in all patients after RT. But clinically significant pneumonitis occurred in much smaller fraction and the ICAM-1 expression on AM and the sICAM-1 level in serum were good indicator of it.

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A Study on pluralistic Reformation for Education of Telecommunication -for Establishment of Individual System for Comm. Education- (통신교육의 계열화와 계층화 -고유한 교역의 형성을 위하여-)

  • 조정현
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.3 no.1
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    • pp.28-30
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    • 1978
  • Communication actions as a social band or Human community stick (fast) to human being ceaselessly w without stopping everywhere. All of comm. actions can be kept up and developed by the education of its own. Comm. actions have to include a character of social process, and so for it the social science should t to be some essential part of it. Therefore, Comm. education have to be schemed for achieving with a point of view of synthetical s science including technical and social factor. However, recentry Comm. education be suffered to lose of itowns essential attribute and individual i independence becausing to reduce social weight recklessly in their education It is a prindiple that Comm. science is an integrate science being composed of human, social and t technical subdepartments and so comm. education have to obey for Comm. constuctional theory, i international and social claim. Originally in Korea a educational idea and genealogy forming by the comm. scientific theory has I inherited on orthodoxy. But in 1961, communication college that is only the orthodox model of Comm. education, was f forced to close by some reckless policy and then the national administration for the Comm. education h have been weakened, and so recently it’s education became to degenerate as out of genealogy or n nonsystem alike some scattering Family. On the other side, today comm. science make to it’s modern scientific factor and to keep its l integrate level, therefore, all of educational provisions and administration for the telecomm. should t to be supplement to be fit for their plural chatacters. Comm. education have to occupy an individual educational system through the comm. theory, and t then it can be coexisted with neighbour scientific field equally and can include, connect coordinate o or effect its inference in each subfactor organically. Finally, educational system for telecommunication should to be requested as preeedence that i independent field including pluralism must be formed and sufficient autonomy be guarenteed, and s so Comm. education must be to restored its orthodox genealogy and be recovered individual system a and seIfrestraint field, and then it can be accomplished its own duty for nation and society.

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The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter Drainage in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study (소방이 형성된 결핵성 흉막염 환자에서 경피적 도관을 이용한 유로카나제 치료의 효과 ; 전향적 무작위연구)

  • Lee, Yong-Whan;Kwak, Seung-Min;Kwon, Mee-Young;Bae, In-Young;Park, Chan-Sup;Moon, Tae-Hun;Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Hyong-Lyeol;Roh, Hyung-Keun;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.601-608
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    • 1999
  • Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

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Clinical Features of Acute Nonspecific Mesenteric Lymphadenitis and Factors for Differential Diagnosis with Acute Appendicitis (급성 비특이성 장간막 림프절염의 임상 소견과 급성 충수돌기염과의 감별 인자)

  • Shin, Kyung Hwa;Kim, Gab Cheol;Lee, Jung Kwon;Lee, Young Hwan;Kam, Sin;Hwang, Jin Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.31-39
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    • 2004
  • Purpose: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. Methods: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. Results: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity ($1.5{\pm}0.7$ [1~3]/day vs $4.5{\pm}2.9$ [1~10]/day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was $2.5{\pm}0.5$ (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count ($8,403{\pm}1,737[5,900{\sim}12,300]/mm^3\;vs\;15,471{\pm}3,749[5,400{\sim}20,800]/mm^3$)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. Conclusion: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over $13,500/mm^3$, abdominal ultrasonography is recommended to rule out APPE.

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Prediction of Life Expectancy for Terminally Ill Cancer Patients Based on Clinical Parameters (말기 암 환자에서 임상변수를 이용한 생존 기간 예측)

  • Yeom, Chang-Hwan;Choi, Youn-Seon;Hong, Young-Seon;Park, Yong-Gyu;Lee, Hye-Ree
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.111-124
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    • 2002
  • Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

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Comparison of Adolescent Minimal Change Nephrotic Syndrome with Childhood Minimal Change Nephrotic Syndrome (청소년기와 소아기 미세변화형 신증후군의 임상양상에 대한 비교연구)

  • Choi, Chung-Yun;Kim, Ji-Hong;Kim, Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.11-19
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    • 1999
  • Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. MCNS most commonly appears between the ages of 2 and 10 yr. But the incidence and prognosis in adolescent MCNS are different from those found in young children; the prognosis and the response to therapy is unfavorable with increasing ages. So we compared the prevalence and the clinical manifestations of adolescent MCNS with that of childhood MCNS for management of adolescent MCNS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of the 216 cases with MCNS which were divided into children group and adolescent group by their age of onset; under 12 years(childhood) and between 12-18 years(adolescent). Results: 1) The number of childhood idiopathic nephrotic syndrome was 245 cases, and that of adolescent idiopathic nephrotic syndrome was 55 cases. 188 cases($77\%$) showed MCNS, 30 cases($12\%$) FSGS, 4 cases($1.6\%$) MSPCN in childhood idiopathic nephrotic syndrome; 28 cases($51\%$) showed MCNS, 12 cases($22\%$) FSGS in adolescent idiopathic nephrotic syndrome. 2) The mean onset age was $7.53{\pm}5.5$ years, and the male to female ratio was 3.8:1 in childhood onset and 2.5:1 in adolescent onset with male predominance. 3) Hematuria was associated with $17\%$ of childhood onset and $39.3\%$ of adolescent onset disease(P=0.005). Hypertension appeared in $0.5\%\;and\;7\%$ in each group without significant difference between the groups. 4) 24 hour urine protein, SPI, albumin, BUN, cholesterol level showed no significant difference. 5) The response of childhood onset and adolescent onset MCNS to steroid therapy showed complete remission in $11.7\%\;&\;14.7\%$, infrequent relapsing in $29.2\%\;&\;28.5\%$, frequent relapsing in $23.9\%\;&\;14.7\%$, steroid dependent in $21.8\%\;&\;28.6\%$ each. Steroid resistant showed $13.3\%\;&\;14.7\%$ with no significance. 6) Immunosuppresant therapy was performed $57\%$ in childhood onset and $65\%$ in adolescent onset. 7) Mean number of relapse and duration from onset to first relapse showed no significance between two groups. Conclusion : Our results indicate that the incidence of hematuria, the rate of steroid dependent and frequent relapsing, and the recurrence rate were higher in adolescent MCNS; showed poorer steroid responsiveness and prognosis. Our data also point to the need for a more aggressive therapy to treat and make recommendations for the adolescent population as a whole.

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Long Term Follow Up of Interferon-alpha Treatment in Children with Chronic Hepatitis B (만성 B형간염 환아에 대한 Interferon-alpha 치료결과의 장기 추적관찰)

  • Baek, Seoung-Yon;Eom, Ji-Hyun;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.140-151
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    • 2003
  • Purpose: We tried to evaluate the long term efficacy and positive predictive factors of interferon-alpha treatment in children with chronic hepatitis B. Methods: The study population included 113 children who received interferon therapy between May 1982 and July 2002 (20 years) for chronic hepatitis B in Department of Pediatrics, Yonsei University College of Medicine. Male to female ratio was 2.3 : 1 and the mean age at diagnosis was $11.1{\pm}4.1$ years old. Response to treatment was defined as normalization of alanine aminotransferase (ALT), disappearance of HBeAg and HBV-DNA Eighty two children responded while 32 did not. Interferon-alpha was given intramuscularly for 6 months at a dosage of $3{\times}10^6$ unit, 3 times weekly. In relapsed cases, lamivudine or interferon retreatment was done. Results: Seroconversion rate was 77.0% in terms of HBeAg, 74.3% in terms of HBV-DNA, and 80.5% in terms of ALT normalization after treatment. Seroconversion rate of both HBeAg and HBV-DNA was 72.6%. Analyzed by life table method, the effect of the treatment had been maintained over 10 years after cessation of therapy. Pre-treatment ALT level was the only significant positive predictive factor of response. Eleven cases (13.4%) relapsed, and 2 out of 3 showed response when treated with lamivudine and 1 out of 3 with interferon retreatment. Conclusion: Interferon-alpha showed significant efficacy in the treatment of chronic hepatitis B in our study. Further studies about the effect of interferon therapy on complications of hepatitis such as hepatocarcinoma, cirrhosis are warranted.

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