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A Study on the Cultural Landscape Metamorphosis of ChoYeon Pavilion's Garden in SoonCheon City (순천 초연정(超然亭) 원림의 문화경관 변용 양상)

  • Kahng, Byung-Seon;Lee, Seung-Yoen;Shin, Sang-Sup
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.35 no.3
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    • pp.13-21
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    • 2017
  • The Cho-yeon Pavilion located in the Wangdae village in Samcheong-ri, Songgwang-myeon, Suncheon-si, was transformed into a place of refuge, a shrine, a vacation home, a lecture hall for kings. Based on the change, the current study has explored the periodic changing placeness and the transformation of cultural landscape and has figured out the meaning. The result of this study is as follows. First, "Cho-yeon", named by Yeonjae Song, Byeong-Seon, originated from Tao Te Ching of Lao Tzu. The concept is found not only in the Cho-yeon Pavilion in Suncheon but also in various places, such as, the Cho-yeon-dae in Pocheon, of the Cho-yeon-dae in Gapyeong, of the Cho-yeon-dae of the embankment behind the Gioheon of Changdeok-gung Garden, Cho-Yeon-Mul-Oe old buildings, including Jung(亭), Dae(臺), Gak(閣), of Ockriukag in Yuseong, etc. This shows that taoistic Poongrhu was naturally grafted onto confucian places, which is one of the examples of the fusion of Confucianism, Buddhism, and Taoism. Second, the placeness of the Cho-yeon Pavilion area is related to a legend that King Gong-min sought refuge here at the end of the Koryo Dynasty. The legend is based on the Wangdae village(king's region), Yu-Gyeong(留京)(the place where kings stayed), rock inscription of Wang-Dae-Sa-Jeok, Oh-Jang-Dae (the place where admiral flags were planted), and the Mohusan Mountain. Third, the Cho-yeon Pavilion not only has a base(the vacation home) that reflects confucian values from the rock inscription(趙鎭忠別業, 趙秉翼, 宋秉璿) of the beautiful rock walls and torrents but also has territoriality as taoistic Abode of the Immortals (there are places where people believe taoist hermits with miraculous powers live within 1km of the pavillion: Wol-Cheong(月靑), Pung-Cheong(風靑), Su-Cheong(水靑), Dong-Cheon(洞天). The Cho-yeon Pavilion also reflects the heaven of Neo-Confucianism for, pursuing study, and improving aesthetic sense by expanding its outer area and establishing the nine Gok: Se-Rok-Gyo(洗鹿橋)., Bong-Il-Dae(捧日臺), Ja-Mi-Gu(紫薇鳩), Un-Mae-Dae(雲梅臺), Wa-Ryong-Chong(臥龍叢), Gwang-Seok-Dae(廣石臺), Eun-Seon-Gul(隱仙窟), Byeok-Ok-Dam(碧玉潭), and Wa-Seok-Po(臥石布). In sum, the Cho-yeon Pavilion is a complex cultural landscape. Fourth, the usage of the Cho-yeon Pavilion was expanded and transformed: (1)Buddhist monastery${\rightarrow}$(2)Confucian vacation home${\rightarrow}$(3)Vacation home+Taoistic Poongrhu Place${\rightarrow}$(4)Vacation Home+Taoistic Poongrhu Place+Lecture Hall(the heaven of Neo-Confucianism). To illustrate, in 7978, the place served as Buddist Monk Kwang-Sa's monastery; in 1863, Cho, Jin-Choong established a vacation home by building a shrine in front of the tomb of his ancestor; in 1864, Cho, Jae-Ho expanded its usage to a vacation home to serve ancestors as a taoistic place by repairing the pavilion with roof tiles; and after 1890, Cho, Jun-Sup received the name of the pavilion, Cho-yeon, from his teacher Song, Byeong-Seon, and used the Pavilion for a lecture hall.

A Study on Developing Customized Bolus using 3D Printers (3D 프린터를 이용한 Customized Bolus 제작에 관한 연구)

  • Jung, Sang Min;Yang, Jin Ho;Lee, Seung Hyun;Kim, Jin Uk;Yeom, Du Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.61-71
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    • 2015
  • Purpose : 3D Printers are used to create three-dimensional models based on blueprints. Based on this characteristic, it is feasible to develop a bolus that can minimize the air gap between skin and bolus in radiotherapy. This study aims to compare and analyze air gap and target dose at the branded 1 cm bolus with the developed customized bolus using 3D printers. Materials and Methods : RANDO phantom with a protruded tumor was used to procure images using CT simulator. CT DICOM file was transferred into the STL file, equivalent to 3D printers. Using this, customized bolus molding box (maintaining the 1 cm width) was created by processing 3D printers, and paraffin was melted to develop the customized bolus. The air gap of customized bolus and the branded 1 cm bolus was checked, and the differences in air gap was used to compare $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$ and $V_{95%}$ in treatment plan through Eclipse. Results : Customized bolus production period took about 3 days. The total volume of air gap was average $3.9cm^3$ at the customized bolus. And it was average $29.6cm^3$ at the branded 1 cm bolus. The customized bolus developed by the 3D printer was more useful in minimizing the air gap than the branded 1 cm bolus. In the 6 MV photon, at the customized bolus, $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of GTV were 102.8%, 88.1%, 99.1%, 95.0%, 94.4% and the $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of branded 1cm bolus were 101.4%, 92.0%, 98.2%, 95.2%, 95.7%, respectively. In the proton, at the customized bolus, $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of GTV were 104.1%, 84.0%, 101.2%, 95.1%, 99.8% and the $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of branded 1cm bolus were 104.8%, 87.9%, 101.5%, 94.9%, 99.9%, respectively. Thus, in treatment plan, there was no significant difference between the customized bolus and 1 cm bolus. However, the normal tissue nearby the GTV showed relatively lower radiation dose. Conclusion : The customized bolus developed by 3D printers was effective in minimizing the air gap, especially when it is used against the treatment area with irregular surface. However, the air gap between branded bolus and skin was not enough to cause a change in target dose. On the other hand, in the chest wall could confirm that dose decrease for small the air gap. Customized bolus production period took about 3 days and the development cost was quite expensive. Therefore, the commercialization of customized bolus developed by 3D printers requires low-cost 3D printer materials, adequate for the use of bolus.

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Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon (직장풍선을 삽입한 전립선암 환자의 수술 후 방사선 치료 시 용적변조와 세기변조방사선치료계획 비교 평가)

  • Jung, hae youn;Seok, jin yong;Hong, joo wan;Chang, nam jun;Choi, byeong don;Park, jin hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.45-52
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    • 2015
  • Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

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The efficacy of continuous positive airway pressure (CPAP) for patient with left breast cancer (좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가)

  • Jung, Il Hun;Ha, Jin Sook;Chang, Won Suk;Jeon, Mi Jin;Kim, Sei Joon;Jung, Jin Wook;Park, Byul Nim;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.43-49
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    • 2019
  • Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

Bioacoustics and Habitat Environment Analysis of Cicadas in Taebaeksan National Park (태백산국립공원에 서식하는 매미류의 생물음향 및 서식환경 분석)

  • Kim, Yoon-Jae;Jung, Tae-Jun;Ki, Kyong-Seok
    • Korean Journal of Environment and Ecology
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    • v.33 no.6
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    • pp.664-676
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    • 2019
  • This study aimed to analyze the bioacoustics and habitat environment of the cicadas inhabiting Taebaeksan National Park, an sub-alpine region in Korea. The mating calls of the cicadas were recorded for approximately 3 months, between July and September of 2018. The recording devices were installed in Daedeoksan valley and Baekcheon valley, inside Taebaeksan National Park, and the sounds were recorded 24 hours a day. In order to obtain the habitat distribution data of the cicadas, the sounds were recorded from 111 spots located in the Taebaeksan National Park trail in August 2018. The daily weather data was obtained from the Taebaek city weather center. The results of the study demonstrated that 5 species of cicadas inhabit Taebaeksan National Park, namely, Leptosemia takanonis, Lyristes intermedius, Kosemia yezoensis, Hyalessa fuscata, and Meimuna opalifera. The time of appearance for L. takanonis was early July to mid-July, and that for L. intermedius, K. yezoensis, H. fuscata, and M. opalifera was mid-July to early September. Analysis of the circadian rhythm revealed that L. intermedius, K. yezoensis, and H. fuscata started producing mating calls between 6:00 and 7:00, which ended at around 19:00 for all the three species. The peak time for producing mating calls was 11:00 for L. intermedius, 12:00 for H. fuscata, and around 13:00 to 14:00 for K. yezoensis. The environmental factors influencing the mating calls of the cicadas inhabiting Taebaeksan National Park were analyzed by logistic regression. The results showed that the probability of producing mating calls increased by 1.192 and 1.279 times in L. intermedius and K. yezoensis, respectively, when the average temperature increased by one degree. When the duration of sunlight increased by one hour, the probability of producing mating calls increased by 4.366 and 2.624 times in L. intermedius and H. fuscata, respectively. Analysis of the interspecific effects revealed that when H. fuscata produced a single mating call, the probability of producing mating calls increased by 14.620 and 2.784 times in L. intermedius and K. yezoensis, respectively. When K. yezoensis and L. intermedius produced mating calls, the probability of producing mating calls in H. fuscata increased by 11.301 and 2.474 times, respectively. L. intermedius and K. yezoensis did not have any effects on each other with respect to the production of mating calls. Analysis of the habitat environment of each species revealed that their habitats were located at altitudes of 1,046 m (780~1,315 m) for L. intermedius, 1,072 m (762~1,361 m) for K. yezoensis, and 976 m (686~1,245 m) for H. fuscata. Unlike H. fuscata, which was found at a low altitude, K. yezoensis and L. intermedius were not found at altitudes lower than 700 m. Analysis of the average aspect of the habitats of each of the cicada species revealed that L. intermedius was found at 166° (125~207°), K. yezoensis was found at 100° (72~128°), and H. fuscata was found at 173° (118~228°). Examination of the distribution of each of the cicada species revealed that they were predominantly distributed in the ridges and slopes located in the southeastern region of Munsubong in Taebaeksan. In summary, L. intermedius and K. yezoensis was found to inhabit higher altitudes in Taebacksan National Park than H. fuscata, which was found throughout the Korean peninsula. Additionally, the main aspect of the cicada habitat was found to be the southeastern region (100~173°), which has good access to daylight.

Factors associated with Experience of Diagnosis and Utilization of Chronic Diseases among Korean Elderly : Focus on Comparing between Urban and Rural Elderly (한국 노인의 만성질환 진단경험 및 의료이용에 관련된 요인 : 도시와 농촌 간 비교를 중심으로)

  • Lee, Min Ji;Kown, Dong Hyun;Kim, Yong Yook;Kim, Jae Han;Moon, Sung Jun;Park, Keon Woo;Park, Il Woo;Park, Jun Young;Baek, Na Yeon;Son, Gi Seok;Ahn, So Yeon;Yeo, In Uk;Woo, Sang Ah;Yoo, Sung Yun;Lee, Gi Beop;Lim, Soo Beom;Jang, Soo Hyun;Jang, In-Deok;Jeon, Jeong-U;Jeong, Su Jin;Jung, Yeon Ju;Cho, Seong Geon;Cha, Jeong Sik;Hwang, Ki Seok;Lee, Tae-Jun;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.165-184
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    • 2019
  • Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

Comparative Study on Wear Resistance and Hardness of Several Artificial Resin Teeth (수종의 인공 레진 치아의 마모저항성과 경도에 관한 비교 연구)

  • Choi, Yu-Sung;Lee, Joon-Seok;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.129-146
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    • 2008
  • The aim of this study was to compare and analyze wear resistance of acrylic resin tooth in denture opposing to different types of restoration materials. Also, it aimed to compare and analyze the hardness of three various types of resin artificial teeth when using five different types of denture detergents. In this study three types of artificial teeth were used. As ordinary acrylic resin tooth $Trubyte^{(R)}Biotone^{(R)}$ (Dentsply, U.S.A.) was used, and as high hardness resin tooth Endura $Posterio^{(R)}$ (Shofu, Japan) and Physio $Duracross^{(R)}$ (Nissin, Japan) were used. To compare wear resistance, gold alloy, dental porcelain, and composite resin were used as opposing restorations. In addition, with three types of resin tooth stated above, five types of denture detergents, which are $Yuhanrox^{(R)}$ (Yuhanclorox, Korea), $Polident^{(R)}$ (Yuhan Co., Korea), $Cidex^{(R)}OPA$ (Johnson & Johnson Medical Co., Korea), $Hexamedin^{(R)}$ (Bukwang Pharm Co., Korea) and Daihan sterile $water^{(R)}$ (Daihan Pharm Co., Korea) were used to compare and analyze the effects denture detergents have on the surface hardness. The results of this study were as follow : 1. When composite resin and dental porcelain were used as the opposing restorations, $Trubyte^{(R)}$ $Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ in ascending order showed decrease of cusp height with significant difference (p<0.05). 2. When gold alloy was used as opposing restoration, there was decrease in the cusp height in order of $Trubyte^{(R)}Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ and $Trubyte^{(R)}$ $Biotone^{(R)}$ especially showed significant decrease in high cusp height as compared to two other types of artificial tooth (p<0.05). 3. When composite resin, gold alloy and dental porcelain were used as opposing restorations, $Trubyte^{(R)}$ $Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ in order decreased greatly in weight and these three materials showed significant difference (p<0.05). 4. Comparing the experiment values, decrease in strength had significant difference in all resin artificial teeth before and after the denture detergents were used (p<0.05). 5. When resin artificial teeth were subsided in $Yuhanrox^{(R)}$, $Cidex^{(R)}OPA$, and $Hexamedin^{(R)}$, $Trubyte^{(R)}$ $Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ in order showed decrease in hardness, and $Trubyte^{(R)}$ $Biotone^{(R)}$ especially showed significant high decrease hardness as to other two types of artificial teeth (p<0.05). Therefore, Physio $Duracross^{(R)}$ seems to have superior wear resistance, and together with Endura $Posterio^{(R)}$, it presents excellent hardness as compared to $Trubyte^{(R)}$ $Biotone^{(R)}$. However, since this study is fragmentary, it should be given careful consideration and more study need to be done before making a definitive conclusion.

Community Ecological Study on the Quercus acuta Forests in Bogildo-Island (보길도(甫吉島) 붉가시나무림(林)의 군락생태학적(群落生態學的) 연구(硏究))

  • Kim, Chong-Young;Lee, Jeong-Seok;Oh, Kwang-In;Jang, Seok-Ki;Park, Jin-Hong
    • Journal of Korean Society of Forest Science
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    • v.89 no.5
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    • pp.618-629
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    • 2000
  • This study was carried out to investigate ecological niche of Quercus acuta communities in Bogildo-island from July to October, 1998. This island is occupied by a subtropical evergreen broad-leaved forests. The study on community ecology of Q. acuta, mostly dominant species of subtropical forests, is very important for successful forest management. Sampling areas were selected in 16 quadrats, dominated by Q. acuta to examine the vegetation characteristics(plant identification, D.B.H.) and environmental elements (microtopography, altitude, slope degree, aspect, illumination and soil physicochemical properties). On the basis of data from field surveys, importance values were calculated for the dominance of Q. acuta and volume growth was analyzed by tree ring widths. The results obtained were as follows ; 1. The lists of vascular plants in the investigations were identified as 54 families, 91 genera, 113 species, 9 varieties, 1 formae. It appeared that 45 kinds were evergreen, 6 kinds(Camellia japonica, Ligustrum japonicum, Eurya japonica, Smilax china, Trachelospermum asiaticum var. intermedium, Carex lanceolata) were commonly observed in all plots and 5 species(Cinnamomum japonicum, Ardisia japonica, Cymbidium goeringii, Dryopteris bissetiana, Viburnum erosum) were most highly observed in all plots(over 80%). 2. The dominating species per strata were, Quercus acuta, Castanopsis cuspidata sp. Quercus salicina, Pinus thunbergii, Prunus sargentii in tree layer, Camellia Japonica, Ligustrum japonicum, Quercus acuta, Eurya japonica, Castanopsis cuspidata sp. in subtree layer, Camellia japonica, Ligustrum japonicum, Smilax china, Cinnamomum japonicum, Viburnum erosum in shrub layer and Trachelospermum asiaticum var. intermedium, Ardisia japonica, Carex lanceolata, Camellia japonica(seedlings), Quercus acuta(seedlings) in herb layer, all in descending orders. 3. Quercus acuta could be suggested as shade intolerant tree, considering the distribution in southern, western, nothern and eastern slopes in the descending orders. 4. Mean relative illumination in the forest is 0.89 % and it is relatively low in brightness. 5. Sustainment of Quercus acuta community couldn't be confirmed by judging from their reverse J curve in even-aged forest, as shown in D.B.H. distribution analysis. 6. The result of annual ring width analysis(mean ; 2.44 mm) showed three stages, such as a gentle increasing(1~12 year ; 2.04 mm), a relatively steep increasing(13~22 year ; 2.95 mm) and decreasing or stagnating(23 year after ; 2.41 mm).

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Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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Usefulness of Tuberculin Skin Test by Tuberculin PPD RT23 2 TU (Tuberculin PPD RT23 2 TU를 이용한 투베르쿨린 피부반응 검사의 의의)

  • Yang, Jong-Wuk;Jeon, Man-Jo;Kim, Sung-Jung;Lee, Hyang-Lim;Lee, Seung-Jun;Lee, Myoung-Goo;Kim, Dong-Gyu;Park, Myoung-Jae;Kang, Min-Jong;Hyoen, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.401-408
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    • 2002
  • Background : Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. Methods : From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. Results : In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60±16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. Conclusion : In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.