• Title/Summary/Keyword: 성장배경

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The Influence of Small Enterprise Workplace Learning on Management Performance: The Mediating Effect of Job Satisfaction (소상공인 일터학습이 경영성과에 미치는 영향 직무만족을 매개로)

  • Choi, Jeong-Hee;Bae, Byung Yun;Hyun, Byung-Hwan
    • Journal of Digital Convergence
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    • v.18 no.10
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    • pp.81-93
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    • 2020
  • This study is based on workplace learning, which has revealed its significant influence in the previous enterprise case studies. Why do small business owners have the opportunity to participate in workplace learning based on authenticity? It was intended to clarify whether it was necessary and to increase the growth and development potential of small business owners based on its contents. Moreover, this study is focused on identifying the influence of workplace learning on management performance through this series of processes. In order to investigate the influence of small enterprise workplace learning on management performance, research hypotheses were set based on a review of previous studies, and empirical analysis was carried out. A total of 203 questionnaires were empirically analyzed using SPSS 18.0 program. As a result, first, workplace learning had partially significant positive influence on job satisfaction. Second, workplace learning had significant positive influence on management performance. Third, job satisfaction had significant positive influence on management performance. Fourth, job satisfaction had partial mediating effect in the relationship between workplace learning and management performance. The analysis result showed that among sub-factors of workplace learning, only formal learning did not affect job satisfaction and that job satisfaction did not have mediating effect in the relationship between formal learning and management performance. According to analysis, this was because in poor small enterprise environments, opportunities to participate in formal learning like external training or in-house training were not kept. In other words, poor small enterprise environments were plainly revealed from the managerial, economic and social standpoint. Therefore, there is a need to establish the foundation of growth for them to solve problems and develop win-win development capabilities and an institutional system that can make a contribution to policy and education, and management, by helping small enterprises keep opportunities to participate in workplace learning. In spite of these significant study results, there can be a limitation. For improving this limitation, further research will need to target diverse fields focusing on samples, which can explain relations of many different variables. Also, working-level relation research connected to studies that can highly enhance management performance will be required.

Relationship between S-Phase Fraction and Survival Time in Patients with Primary Squamous Lung Cancer (편평상피성 폐암에 있어서 S-Phase Fraction과 생존기간과의 관계)

  • Jung, Byung-Hak;Kang, Jeong-Seong;Chang, Keun;Jeong, Eun-Taik;Chung, Hun-Taeg;Moon, Hyung-Bae
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.669-676
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    • 1993
  • Background: DNA content analysis of human solid tumor is now widely performed by flow cytometric study. One of the most interesting and potentially important observation in this field is that proliferative activity(S-Phase fraction of cell cycle) may profoundly affect prognosis. Method: S-Phase fraction(SPF) have been measured by flow cytometric method using tumor cells isolated from paraffin embedded tissue. To evaluate the prognostic significance, SPF of squamous lung cancer cell was assessed in 21 patients who died without any specific treatment. Results: 1) Mean survival time of squamous lung cancer patients was 225(${\pm}162$) days. Survival time were shortened, when TNM stage and PS scale were advanced. 2) Mean value of SPF of squamous lung cancer patients was 23.4(${\pm}11.3$)%. SPF had nothing to do with advance of TNM stage and PS scale. 3) Mean survival time of high SPF group(more than 20% of cell proliferation cycle) and low SPF group were 153(${\pm}99$) days and 342(${\pm}180$) days(p<0.01). In each identical TNM stage and PS scale, there were also statistic significant differences in mean survival time between high and low SPF group. Conclusion: On multivariate analysis including TNM stage and performance status, SPF was the significant and independent prognostic factor in the primary squamous lung cancer patients group.

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Echocardiographic Follow-up after Arterial Switch Operation for Transposition of the Great Arteries (동맥전환술을 시행한 대혈관전위 환자에서 심초음파를 이용한 술후 추적)

  • 한승세;정태은;이동협;오정훈;이정철
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.754-762
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    • 2001
  • Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

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Role of Growth Factors and Cytokines on Bleomycin Induced Pulmonary Fibrosis (Bleomycin 유도 폐 섬유화에 있어서 성장인자 및 Cytokine의 역할)

  • Lee, Yong-Hee;Jung, Soon-Hee;Ahn, Chul-Min;Kim, Sung-Kyu;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.871-888
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    • 1997
  • Background : It is now thought that the earliest manifestation of idiopathic pulmonary fibrosis is alveolitis, that is, an accumulation of inflammatory and immune effector cells within alveolar walls and spaces. Inflammatory cells including alveolar macrophages and resident normal pulmonary tissue cells participate through the release of many variable mediators such as inflammatory growth factors and cytokines, which contribute to tissue damage and finally cause chronic pulmonary inflammation and fibrosis. This study was performed to investigate the source and distribution pattern of transforming growth factor-${\beta}_1$(TGF-${\beta}_1$), platelet derived growth factor(PDGF), basic fibroblast growth factor(bFGF), interleukin 1(IL-1), interleukin 6(IL-6), tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and the role of these mediators on bleomycin(BLM)-induced pulmonary injury and fibrosis in rats. Method : Wistar rats were divided into three groups(control group, BLM treated group, BLM and vitamine E treated group). Animals were sacrificed periodically at 1, 2, 3, 4, 5, 7, 14, 21, 28 days after saline or BLM administration. The effects were compared to the results of bronchoalveolar lavage fluid analysis, light microscopic findings, immunohistochemical stains for six different mediators(TGF-${\beta}_1$, PDGF, bFGF, IL-1, IL-6 and TNF-$\alpha$) and mRNA in situ hybridization for TGF-${\beta}_1$. Results : IL-1 and IL-6 are maximally expressed at postbleomycin 1~7th day which are mainly produced by neutrophils and bronchiolar epithelium. It is thought that they induce recruitment of inflammatory cells at the injury site. The expression of IL-1 and IL-6 at the bronchiolar epithelium within 7th day is an indirect evidence of contribution of bronchiolar epithelial cells to promote and maintain the inflammatory and immune responses adjacent to the airways. TNF-$\alpha$ is mainly produced by neutrophils and bronchiolar epithelial cells during 1~5th day, alveolar macrophages during 7~28th day. At the earlier period, TNF-$\alpha$ causes recruitment of inflammatory cells at the injury site and later stimulates pulmonary fibrosis. The main secreting cells of TGF-${\beta}_1$ are alveolar macrophages and bronchiolar epithelium and the target is pulmonary fibroblasts and extracellular matrix. TGF-${\beta}_1$ and PDGF stimulate proliferation of pulmonary fibroblasts and TGF-${\beta}_1$ and bFGF incite the fibroblasts to produce extracellular matrix. The vitamine E and BLM treated group shows few positive cells(p<0.05). Conclusion : After endothelial and epithelial injury, the neutrophils and bronchiolar epithelium secrete IL-1, IL-6, TNF-$\alpha$ which induce infiltration of many neutrophils. It is thought that variable enzymes and $O_2$ radicals released by these neutrophils cause destruction of normal lung architecture and progression of pulmonary fibrosis. At the 7~28th day, TGF-${\beta}_1$, PDGF, bFGF, TNF-$\alpha$ secreted by alveolar macrophages sting pulmonary fibroblasts into proliferating with increased production of extracellular matrix and finally, they make progression of pulmonary fibrosis. TNF-$\alpha$ compares quite important with TGF-${\beta}_1$ to cause pulmonary fibrosis. Vitamine E seems to decrease the extent of BLM induced pulmonary fibrosis.

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Study about the clinical features and Pulmonary function Tst of Endobronchial Tuberculosis (기관지결핵의 임상상 및 폐기능검사에 관한 연구)

  • Chung, Hee-Soon;Lee, Jae-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.147-158
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    • 1996
  • Background : Endobronchial tuberculosis(ET) is known to affect frequently young female and serious complication like bronchial stenosis would occur if early diagnosis and treatment for ET is not performed immediately. But ET shows normal chest roentgenogram in about 10% of patients, and is often confused with bronchial asthma because ET presents clinical features like cough, dyspnea, wheezing in history and physical examination. The pulmonary function test(PFT) feature of ET is not well known, but when we consider the fact that ET is pathophysiologically different from bronchial asthma, if there is any feature of PFT in ET, and we know it, PFT will be very helpful for diagnosis and follow up of ET. Methods : We performed both PFT and bronchoscopy in 68 ET patients who visited Boramae hospital, and were confirmed as ET by bronchoscopic biopsy and were followed prospectively from November 1991 to March 1995. After history taking and physical examination, we performed chest roentgenogram, complete blood count, sputum AFB stain and culture, and also performed PFT before anti-tuberculosis chemotherapy. PFT was classified as restrictive, if only PVC was reduced below 80%, and obstructive, if only FEV1 was reduced below 75%. In the case of both FVC and FEV1 were reduced, PFT was classified as restrictive if FEY1/FVC was greater than 75%, and mixed if FEV1/FVC was reduced below 75%. We repeated the PFT and bronchoscopy for 68 ET patients who were proven by biopsy in the first month and sixth month after starting anti-tuberculosis chemotherapy, and studied the feature and change of PFT of the ET and the relation between PFT and the bronchoscopic finding, and obtained following results. Results: 1) Number of male patients was 12, and that of female patient was 56, and mean age was $35.4{\pm}17yr$.(17-74yr). Clinical symptom was in the order of cough(86.8%), dyspnea(63.2%), fever(17.6%) and hemoptysis (10.3%), and the wheezing and stridor were audible among the 40 patients(58.4%) in the physical examination. 2) Hemoglobin level was below 12g/dl among 25 patients (36.8%), and WBC level was above $10,000/mm^3$ among 9 patients(13.2%) and ESR was above 20 among 46 patients (67.6%) and AFB stain and culture were positive among 50 patients(73.5%). 3) The dominant roentgenographic finding of ET was fibronodular feature in 35 patients(51.5%), pneumonic feature in 14 patients (20.6%), collapse in 11 patients(16.2%), mass-like lesion in 3 patients(4.4%), cavitary lesion in 2 patients(2.9%), and normal in 3 patients(4.4%). 4) PFT feature at the time of diagnosis of ET was normal in 16 patients(23.5%), restrictive pattern in 32 patients (47%), obstructive in 4 patients(5.8%), and mixed in 14 patients(23.5%). So restrictive pattern was the dominate feature of ET. 5) The PFT feature was little correlated with the gross finding of bronchoscopy, but the change of PFT during treatment of ET showed relatively good correlation with the change of bronchoscopic finding. 6) FVC(2.30L vs. 2.61L) and FEV1(1.74L vs. 2.06L) increased significantly (p < 0.01), but FEV1/FVC(82% vs. 83%) and PEF(3.45L/sec vs. 3.95L/sec) did not change significantly after 1 month of treatment (p > 0.01), and there was no significant change among all parameters during first and sixth month of treatment(p > 0.01). Conclusion : PFT may be useful in the diagnosis and treatment follow up of ET but further study would be needed to confirm it.

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Collision of New and Old Control Ideologies, Witnessed through the Moving of Jeong-regun (Tomb of Queen Sindeok) and Repair of Gwangtong-gyo (정릉(貞陵) 이장과 광통교(廣通橋) 개수를 통해 본 조선 초기 지배 이데올로기의 대립)

  • Nam, Hohyun
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.234-249
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    • 2020
  • The dispute involving the construction of the Tomb of Queen Sindeok (hereinafter "Jeongreung"), King Taejo's wife in Seoul, and the moving of that tomb, represents the most clearly demonstrated case for the collision of new and old ideologies between political powers in the early period of Joseon. Jeongreung, the tomb of Queen Sindeok from the Kang Clan, was built inside the capital fortress, but in 1409, King Taejong forced the tomb to be moved outside the capital, and the stone relics remaining at the original location were used to build the stone bridge, Gwangtong-gyo. In an unofficial story, King Taejong moved the tomb outside the capital and used the stone items there to make the Cheonggyecheon Gwang-gyo so that the people would step upon the area in order to curse Lady Kang. In the final year of King Taejo, Lady Kang and King Taejong were in a politically conflictual relationship, but they were close to being political partners until King Taejo became the king. Sillok records pertaining to the establishment of Jeongreung or Gwangtong-gyo in fact state things more plainly, indicating that the moving of Jeongreung was a result of following the sangeon (a written statement to the king) of Uijeongbu (the highest administrative agency in Joseon), which stated that having the tomb of a king or queen in the capital was inappropriate, and since it was close to the official quarter of envoys, it had to be moved. The assertion that it was aimed at degrading Jeongreung in order to repair Gwangtong-gyo thus does not reflect the factual relationship. This article presents the possibility that the use of stone items from Jeongreung to repair Gwangtong-gyo reflected an emerging need for efficient material procurement that accompanied a drastic increase in demand for materials required in civil works both in- and outside the capital. The cause for constructing Jeongreung within the capital and the cause of moving the tomb outside the capital would therefore be attributable to the heterogeneity of the ideological backgrounds of King Taejo and King Taejong. King Taejo was the ruler of the Confucius state, as he reigned through the Yeokseong Revolution, but he constructed the tomb and Hongcheon-sa, the temple in the capital for his wife Queen Sindeok. In this respect, it is considered that, with the power of Buddhism, there was an attempt to rally supporters and gather the force needed to establish the authority of Queen Sindeok. Yi Seong-gye, who was raised in the Dorugachi clan of Yuan, lived as a military man in the border area, and so he would not have had a high level of understanding in Confucian scholarship. Rather, he was a man of the old system with its 'Buddhist" tendency. On the other hand, King Taejong Yi Bang-won was an elite Confucian student who passed the national examination at the end of the Goryeo era, and he is also known to have held a profound understanding of Neo-Confucianism. To state it differently, it would be reasonable to say that the understanding of symbolic implications for the capital would be more profound in a Confucian state. Since the national system that was ruled by laws had been established following the Three-Kingdom era, the principle of burial outside of the capital that would have seen a grave constructed on the outskirts of the capital was not upheld, without exception. Jeongreung was built inside the capital due to the strong individual desire of King Taejo, but since he was a Confucian scholar prior to becoming king, it would not have been accepted as desirable. After taking the throne, King Taejong took the initiative to begin overhauling the capital in order to reflect his intent to clearly realize Confucian ideology emphasizing 'Yechi' ("ruling with good manners") with the scenic view of the Capital's Hanyang river. It would be reasonable to conclude accordingly that the moving of Jeongreung was undertaken in the context of such a historic background.

The actual aspects of North Korea's 1950s Changgeuk through the Chunhyangjeon in the film Moranbong(1958) and the album Corée Moranbong(1960) (영화 <모란봉>(1958)과 음반 (1960) 수록 <춘향전>을 통해 본 1950년대 북한 창극의 실제적 양상)

  • Song, Mi-Kyoung
    • (The) Research of the performance art and culture
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    • no.43
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    • pp.5-46
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    • 2021
  • The film Moranbong is the product of a trip to North Korea in 1958, when Armangati, Chris Marker, Claude Lantzmann, Francis Lemarck and Jean-Claude Bonardo left at the invitation of Joseon Film. However, for political reasons, the film was not immediately released, and it was not until 2010 that it was rediscovered and received attention. The movie consists of the narratives of Young-ran and Dong-il, set in the Korean War, that are folded into the narratives of Chunhyang and Mongryong in the classic Chunhyangjeon of Joseon. At this time, Joseon's classics are reproduced in the form of the drama Chunhyangjeon, which shares the time zone with the two main characters, and the two narratives are covered in a total of six scenes. There are two layers of middle-story frames in the movie, and if the same narrative is set in North Korea in the 1950s, there is an epic produced by the producers and actors of the Changgeuk Chunhyangjeon and the Changgeuk Chunhyangjeon as a complete work. In the outermost frame of the movie, Dong-il is the main character, but in the inner double frame, Young-ran, who is an actor growing up with the Changgeuk Chunhyangjeon and a character in the Changgeuk Chunhyangjeon, is the center. The following three OST albums are Corée Moranbong released in France in 1960, Musique de corée released in 1970, and 朝鮮の伝統音樂-唱劇 「春香伝」と伝統樂器- released in 1968 in Japan. While Corée Moranbong consists only of the music from the film Moranbong, the two subsequent albums included additional songs collected and recorded by Pyongyang National Broadcasting System. However, there is no information about the movie Moranbong on the album released in Japan. Under the circumstances, it is highly likely that the author of the record label or music commentary has not confirmed the existence of the movie Moranbong, and may have intentionally excluded related contents due to the background of the film's ban on its release. The results of analyzing the detailed scenes of the Changgeuk Chunhyangjeon, Farewell Song, Sipjang-ga, Chundangsigwa, Bakseokti and Prison Song in the movie Moranbong or OST album in the 1950s are as follows. First, the process of establishing the North Korean Changgeuk Chunhyangjeon in the 1950s was confirmed. The play, compiled in 1955 through the Joseon Changgeuk Collection, was settled in the form of a Changgeuk that can be performed in the late 1950s by the Changgeuk Chunhyangjeon between 1956 and 1958. Since the 1960s, Chunhyangjeon has no longer been performed as a traditional pansori-style Changgeuk, so the film Moranbong and the album Corée moranbong are almost the last records to capture the Changgeuk Chunhyangjeon and its music. Second, we confirmed the responses of the actors to the controversy over Takseong in the North Korean creative world in the 1950s. Until 1959, there was a voice of criticism surrounding Takseong and a voice of advocacy that it was also a national characteristic. Shin Woo-sun, who almost eliminated Takseong with clear and high-pitched phrases, air man who changed according to the situation, who chose Takseong but did not actively remove Takseong, Lim So-hyang, who tried to maintain his own tone while accepting some of modern vocalization. Although Cho Sang-sun and Lim So-hyang were also guaranteed roles to continue their voices, the selection/exclusion patterns in the movie Moranbong were linked to the Takseong removal guidelines required by North Korean musicians in the name of Dang and People in the 1950s. Second, Changgeuk actors' response to the controversy over the turbidity of the North Korean Changgeuk community in the 1950s was confirmed. Until 1959, there were voices of criticism and support surrounding Taksung in North Korea. Shin Woo-sun, who showed consistent performance in removing turbidity with clear, high-pitched vocal sounds, Gong Gi-nam, who did not actively remove turbidity depending on the situation, Cho Sang-sun, who accepted some of the vocalization required by the party, while maintaining his original tone. On the other hand, Cho Sang-seon and Lim So-hyang were guaranteed roles to continue their sounds, but the selection/exclusion patterns of Moranbong was independently linked to the guidelines for removing turbidity that the Gugak musicians who crossed to North Korea had been asked for.

Therapeutic Angiogenesis by Intramyocardial Injection of pCK-VEGF165 in Pigs (돼지에서 pCK-VEGF165의 심근내 주입에 의한 치료적 혈관조성)

  • Choi Jae-Sung;Han Woong;Kim Dong Sik;Park Jin Sik;Lee Jong Jin;Lee Dong Soo;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.323-334
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    • 2005
  • Background: Gene therapy is a new and promising option for the treatment of severe myocardial ischemia by therapeutic angiogenesis. The goal of this study was to elucidate the efficacy of therapeutic angiogenesis by using VEGF165 in large animals. Material and Method: Twenty-one pigs that underwent ligation of the distal left anterior descending coronary artery were randomly allocated to one of two treatments: intramyocardial injection of pCK-VEGF (VEGF) or intramyocardial injection of pCK-Null (Control). Injections were administered 30 days after ligation. Seven pigs died during the trial, but eight pigs from VEGF and six from Control survived. Echo-cardiography was performed on day 0 (preoperative) and on days 30 and 60 following coronary ligation. Gated myocardial single photon emission computed tomography imaging (SPECT) with $^{99m}Tc-labeled$ sestamibi was performed on days 30 and 60. Myocardial perfusion was assessed from the uptake of $^{99m}Tc-labeled$ sestamibi at rest. Global and regional myocardial function as well as post-infarction left ventricular remodeling were assessed from segmental wall thickening; left ventricular ejection fraction (EF); end systolic volume (ESV); and end diastolic volume (EDV) using gated SPECT and echocardiography. Myocardium of the ischemic border zone into which pCK plasmid vector had been injected was also sampled to assess micro-capillary density. Result: Micro-capillary density was significantly higher in the VEGF than in Control ($386\pm110/mm^{2}\;vs.\;291\pm127/mm^{2};\;p<0.001$). Segmental perfusion increased significantly from day 30 to day 60 after intramyocardial injection of plasmid vector in VEGF ($48.4\pm15.2\%\;vs.\;53.8\pm19.6\%;\;p<0.001$), while no significant change was observed in the Control ($45.1\pm17.0\%\;vs.\;43.4\pm17.7\%;\;p=0.186$). This resulted in a significant difference in the percentage changes between the two groups ($11.4\pm27.0\%\;increase\;vs.\;2.7\pm19.0\%\;decrease;\;p=0.003$). Segmental wall thickening increased significantly from day 30 to day 60 in both groups; the increments did not differ between groups. ESV measured using echocardiography increased significantly from day 0 to day 30 in VEGF ($22.9\pm9.9\;mL\;vs.\;32.3\pm9.1\;mL;\; p=0.006$) and in Control ($26.3\pm12.0\;mL\;vs.\;36.8\pm9.7\;mL;\;p=0.046$). EF decreased significantly in VEGF ($52.0\pm7.7\%\;vs.\;46.5\pm7.4\%;\;p=0.004$) and in Control ($48.2\pm9.2\%\;vs.\;41.6\pm10.0\%;\;p=0.028$). There was no significant change in EDV. The interval changes (days $30\~60$) of EF, ESV, and EDV did not differ significantly between groups both by gated SPECT and by echocardiography. Conclusion: Intramyocardial injection of pCK-VEGF165 induced therapeutic angiogenesis and improved myocardial perfusion. However, post-infarction remodeling and global myocardial function were not improved.

Effect of the Changing the Lower Limits of Normal and the Interpretative Strategies for Lung Function Tests (폐기능검사 해석에 정상하한치 변화와 새 해석흐름도가 미치는 영향)

  • Ra, Seung Won;Oh, Ji Seon;Hong, Sang-Bum;Shim, Tae Sun;Lim, Chae Man;Koh, Youn Suck;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.129-136
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    • 2006
  • Background: To interpret lung function tests, it is necessary to determine the lower limits of normal (LLN) and to derive a consensus on the interpretative algorithm. '0.7 of LLN for the $FEV_1$/FVC' was suggested by the COPD International Guideline (GOLD) for defining obstructive disease. A consensus on a new interpretative algorithm was recently achieved by ATS/ERS in 2005. We evaluated the accuracy of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases, and we also determined the effect of the new algorithm on diagnosing ventilatory defects. Methods: We obtained the age, gender, height, weight, $FEV_1$, FVC, and $FEV_1$/FVC from 7362 subjects who underwent spirometry in 2005 at the Asan Medical Center, Korea. For diagnosing obstructive diseases, the accuracy of '0.7 of LLN for the $FEV_1$/FVC' was evaluated in reference to the $5^{th}$ percentile of the LLN. By applying the new algorithm, we determined how many more subjects should have lung volumes testing performed. Evaluation of 1611 patients who had lung volumes testing performed as well as spirometry during the period showed how many more subjects were diagnosed with obstructive diseases according to the new algorithm. Results: 1) The sensitivity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases increased according to age, but the specificity was decreased according to age; the positive predictive value decreased, but the negative predictive value increased. 2) By applying the new algorithm, 34.5% (2540/7362) more subjects should have lung volumes testing performed. 3) By applying the new algorithm, 13% (205/1611) more subjects were diagnosed with obstructive diseases; these subjects corresponded to 30% (205/681) of the subjects who had been diagnosed with restrictive diseases by the old interpretative algorithm. Conclusion: The sensitivity and specificity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases changes according to age. By applying the new interpretative algorithm, it was shown that more subjects should have lung volumes testing performed, and there was a higher probability of being diagnosed with obstructive diseases.

Prognostic Value of the Expression of p53 and bcl-2 in Non-Small Cell Lung Cancer (비소세포폐암에서 p53과 bcl-2의 발현이 예후에 미치는 영향)

  • Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Keum, Joo-Seob;Kong, Gu;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.962-974
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    • 1998
  • Background: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects cells from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is still obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose: The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method: 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2. Results : The histologic classification of the tumor was based on WHO criteria., and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1 %). p53 immunoreactivity was noted in 47 cases of 84 cases(56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases(17.9%). The mean survival duration was $64.23{\pm}10.73$ months in bcl-2 positive group and $35.28{\pm}4$. 39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was $34.71{\pm}6.12$ months in p53 positive group and $45.35{\pm}6.30$ months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2 expression in our study. Conclusions : The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small cell lung cancer.

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