Background : Approximately 10-13% of patients with interstitial lung disease(ILD) die of lung cancer, and patients with ILD have been reported to have a 7 fold higher incidence of lung cancer compared to the normal population. Recently, overexpression of the p53 and p21 proteins were observed in the epithelial cells from pathologic specimens of ILD. Overexpression of these proteins may result from chronic or recurrent DNA damage by unknown causes of inflammation. However, these proteins may also contribute to oncogenesis if other genetic alterations such as K-ras are superimposed. Methods : Immunohistochemical stains for p53 and K-ras proteins were performed with pathologic specimens from 38 cases with ILD(M/F : 27/11, mean agea : $54{\pm}10$ years) and from 10 control subjects. Results : The p53 protein was expressed in 21.1% (8/38 ILD cases) and K-ras protein expression was observed in 65.8% (25/38 ILD cases). However, neither p53 nor the K-ras protein staining was observed in the control subjects. Conclusion : A significant proportion of cases with ILD expressed the p53 and K-ras proteins in their bronchial epithelial cells. These proteins may be potentially oncogenic with the addition of further genetic alterations. However, to clarify the significance of these findings, further studies looking for correlations with the incidence of lung cancer and other genetic changes are needed.
Background : To study the prognosis of patients with lung cancer, many investigators have reported the methods to detect cell proliferation in tissues including PCNA, thymidine autoradiography, flow cytometry and Ki-67. PCNA, also known as cyclin, is a cell related nuclear protein with 36KD intranuclear polypeptide that is maximally elevated in S phase of proliferating cells. In this study, PCNA was identified by paraffin-embedding tissue using immunohistochemistry which has an advantage of simplicity and maintenance of tissue architecture. The variation of PCNA expression is known to be related with proliferating fraction, histologic type, anatomic(TNM) stage, degree of cell differentiation, S-phase fraction and survival rate. We analyzed the correlation between PCNA expression and S-phase fraction, survival. Method : To investigate expression of PCNA in primary lung cancer, we used immunohistochemical stain to paraffin-embedded sections of 57 resected primary non-small cell lung cancer specimen and the results were analyzed according to the cell type, cell differentiation, TNM stage, S-phase fraction and survival. Results : PCNA expression was divided into five group according to degree of staging(-, +, ++, +++, ++++). Squamous cell type showed high positivity than in adenocarcinoma. Nonsignificant difference related to TNM stage was noticed. Nonsignificant difference related to degree of cell differentiation was noticed. S-phase fraction was increased with advance of PCNA positivity, but it could not reach the statistic significance. The 2 year survival rate and median survival time were -50% 13 months, +75% 41.3 months, ++73% 33.6 months, +++67% 29.0 months, ++++25% 9 months with statistic significance (P<0.05, Kaplan-Meier, generalized Wilcox). Conclusion : From this study, PCNA expression was high positive in squamous cell cancer. And, there was no relationship between PCNA positivity and TNM stage, cellular differentiation or S-phase fraction. But, the patients with high positive PCNA staining showed poor survival rate than the patients with lower positive PCNA staining (p<0.05). It was concluded that PCNA immunostaining is a simple and useful method for survival prediction in paraffin embedded tissue of non-small cell lung cancer.
Kim, Byeong Cheol;Kim, Jeong Mee;Kim, Yeon Soo;Kim, Seong Min;Choi, Wan Young;Lee, Kyeong Sang;Yang, Suck Cheol;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee;Kim, Chang Soo;Seo, Heung Suk
Tuberculosis and Respiratory Diseases
/
v.43
no.4
/
pp.590-599
/
1996
Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.
Background: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement or pediatric mitral lesions can cause problems such as a lack of growth potential. There re only limited experiences with mitral valve repair at any institution, so the purpose of his study is to evaluate the outcomes of mitral valve repair n pediatric patients. Material and Method: Sixty-four consecutive children (28 males and 36 females) with a mean age of $5.5{\pm}4.7$ years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without trial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). Result: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there as no significant difference among the groups. The median follow-up was 4.6 years range: $0.5{\sim}12.2$ years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of $2.1{\pm}1.1$ procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there ere significant differences according to the repair strategies. Conclusion: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.
The Korean distribution industry is gearing up for an endless competition. Greeting low growth era, less competitive parties will be challanged seriously for their survival. But for large discount stores, they have shown steady annual growth for years. However, because of the saturation for numbers of stores, the difficulty of gaining new sites, and the changes in the consumer's consumption behavior caused by the recession, now they are seeking for a new customers-based business formats. Accordingly, a large corporate comopanies made supermarkets which are belonged to affiliated companies of large corporate comopanies. They based on the strong buying power, focused on SSM(Super Super Market) ave been aggressively develop nationwide multi-stores. The point is that these stores are threatening at small and medium-sized, community-based private supermarkets. Private supermarkets and retailers, who are using existing old operation systems and their dilapidated facilities, are losing a competitive edge in business. Recent the social effects of large series of corporate supermarkets for traditional markets has been very controversial, and commercial media, academia, and industry associated with it have been held many seminars and public hearings. This may slow down the speed in accordance with the regulations, but will not be the crucial alternative. The reason for this recent surge of enterprise-class SSM up, one of the reasons is a stagnation in their offline discount mart, so they are finding new growth areas. Already in the form of large supermarkets across the country got most of the geographical centre point and is saturated with stages. Targeting small businesses that do not cover discount Mart, in order to expand business in the form of SSM is urgent. By contrast, private supermarkets are going to lose their competitiveness. The vulnerability of individual supermarkets, one of the vulnerabilities is price which economies of scale can not be realized so they are purchasing a small amount of products and difficult to get a quantity discount. The lack of organization and collaboration, and education which is not practical, caused the absencer of service-oriented situations. As a first solution, making specialty shops which are handling agricultures, fruits and vegetables and manufactured goods is recommended. Second, private supermarkets franchisees join the organization for the organization and collaboration is recomaned. It can be meet the scale of economy and can be formed a alternative business formats to a government. Third, the education is needed as a good service will get consumer's awareness. In addition, a psychological stores operating is also one way to stimulate consumer sentiment as SSM can't operate. Japan already has a better conditions of their lives through small chain expression. This study includes the vulnerabilities of private supermarkets, and suggests a competitiveness reinforcement strategies.
Kim, Young-Sam;Kim, Kwang-Ho;Baek, Wan-Ki;Kim, Joung-Taek;Cha, Il-Kyu;Kim, Ji-Hye;Song, Sun-U;Choi, Mi-Sook
Journal of Chest Surgery
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v.43
no.4
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pp.394-398
/
2010
Background: The overexpression of transforming growth factor-beta 1 receptor II (TGF-${\beta}1$RII) and transforming growth factor-beta 1 (TGF-${\beta}1$) ligand may be involved in the formation of a bulla. In this study, we tested if serum TGF-${\beta}1$ ligand levels correlated with the expression level of TGF-${\beta}1$RII and TGF-${\beta}1$ in bullous tissues from patients with spontaneous pneumothorax. Material and Method: Bullous lung tissues and blood samples were obtained from 19 patients with spontaneous pneumothorax, 18 males and 1 female, aged 17 to 35 years old. The bullous tissues were obtained by video-assisted thoracic surgery (VATS), fixed in formalin, embedded in paraffin, and cut into $5{\sim}6{\mu}m$ thick slices. Sections were immunohistochemically stained with primary antibodies against TGF-${\beta}1$ or TGF-${\beta}1$RII, and serum levels of TGF-${\beta}1$ in patients and normal controls was measured by enzyme-linked immunosorbent assay (ELISA). Result: Of the 19 patients, 16 were TGF-${\beta}1$ positive and 10 were TGF-${\beta}1$RII positive. Among the 16 TGF-${\beta}1$ positives, 9 were also TGF-${\beta}1RII$ positive. As seen previously, strong immunohistochemical staining of TGF-${\beta}1$RII and TGF-${\beta}$ was detected in the boundary region between the bullous and normal lung tissues. Average TGF-${\beta}1$ blood levels of both TGF-${\beta}1$ and TGF-${\beta}1$RII positive patients was $38.36{\pm}16.2ng/mL$, and that of five controls was $54.06{\pm}15ng/mL$. Conclusion: These results suggest that overexpression of TGF-${\beta}1$ and TGF-${\beta}1$RII expression may be involved in the formation of bullae. TGF-${\beta}1$ blood levels in patients with primary spontaneous pneumothorax is lower than normal people, suggesting that the high level of local TGF-${\beta}1$ expression in the bullous tissue region, but not in the whole blood, may contribute more in the formation of bullae.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.8
no.2
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pp.232-241
/
1997
The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.
These days, the concept of creating shared value is drawn keen attentions to. This interest comes out of the expectation that Creating Shared Value(CSV) can offer an answer to some social issues by creating societal and economic values on the top of the achievements that existing Corporate Social Responsibility(CSR) has made. However, it is difficult to make a clear distinction between the achievements that the activities of CSR and CSV have made. In this regard, developing a methodology to make an actual proof analysis on the accomplishments of CSV and to verify customer's awareness of and attitude towards the CSV is necessarily required. A company needs to gain a competitive advantage in the marketplace as well as resolve a social issue by innovating value chain. The research has verified the cause and effect relationship between the CSV from the point of view of value chain and the purchase intention aroused by its economic, societal and cultural values through the company image and credibility with actual proof analysis and come up with following results. First, a societal and cultural value resulted in giving positive impact on a company's image, which implies that CSV activities can be the thin end of the wedge through which customers have a good image of the company involved in CSV. Second, a societal value makes a positive influence on the credibility of a company. In this regard, CSV should be recognized not just as a thing that generates a cost, but a way to win-win as well as future development. Third and last, the research results show that both company image and credibility influence on purchase intention. Considering that CSV generates a positive evaluation on a company that will ultimately cause continuous profit-making, the company's ultimate goal of activities, it should be approached from the perspective of making a mid-and-long term strategy.
Background: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. Material and Method: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. Result: There were 21 male and 6 female patients. Mean birth weight was 2.62$\pm$.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). Conclusion: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Background : Angiogenesis is an essential component of tumor growth and metastasis, and the vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. Several solid tumors produce substantial amounts of VEGF, which stimulates proliferation and the migration of endothelial cells, thereby inducing neovasculization by a paracrine mechanism. To evaluate the prognostic roles of angiogenesis and VEGF expression in patients with non-small cell lung cancer, the relationship between VEGF expression in tumor tissues, the clinicopathologic features and the overall survival rate were analysed. Methods : Sixty-nine resected primary non-small cell lung cancer specimens were evaluated. The paraffin-embedded tumor tissues were stained by anti-VEGF polyclonal antibodies using an immunohistochemical method to assess VEGF expression. Results : In Forty-one patients (59%), the VEGF antigen was expressed weakly in their tumor tissue, whereas in twenty-eight patients (41%) the VEGF antigen was expressed strongly. The median survival time of the weak VEGF expression group was 24 months, and that of the strong VEGF expression group was 19 months. The three year-survival rates were 35%, 33%, respectively. The survival difference between both groups was not statistically significant. Conclusion : Although results were not statistically significant, the strong expression group tended to poorer prognosis than the weak expression group.
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