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Comparison of Concurrent Chemoradiotherapy with Conventional Radiotherapy in Advanced Non-smal Cell Lung Cancer (진행된 비소세포 폐암 환자에서 Concurrent Chemoradiotherapy와 Conventional Radiotherapy의 비교)

  • Kim, Hui-Jung;Lee, Dong-Soo;Song, So-Hyang;Jung, Su-Mi;Kim, Young-Kyoon;Yoon, Se-Chul;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.493-504
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    • 1997
  • Background : Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stageIII non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it has at most only a modest effect on survival. Recently, cisplatin(cis-diamminedichloroplatinum) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and Method : Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given to times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 times, in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. Results : There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p < 0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p < 0.05) In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. Conclusion : There was no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.

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Analysis of Causes for Primary Treatment Failure of Pulmonary Tuberculosis (폐결핵환자에서 초치료실패에 대한 요인 분석)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1234-1244
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    • 1997
  • Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.

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Factors Affecting the Registration and Access Levels of the Pilot Project for the General Physician System among People with Disabilities (장애인 건강주치의 시범사업 수요자의 등록 및 이용수준 영향 요인 분석)

  • Eunhee Choe;Yeojeong Gu;Seungji Lim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.185-195
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    • 2024
  • Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

A Study on the View on Nature in Ch'o-Jung's Three-Verse Poems(Sijo) (초정(艸丁) 김상옥(金相沃) 시조(時調)에 나타난 자연관(自然觀))

  • Choi, Heung-Yeol
    • Sijohaknonchong
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    • v.30
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    • pp.263-300
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    • 2009
  • Adoration for nature constitutes one of the primary subjects that literature has tackled since the origin of human history. Nature expressed through a poet's subjective imagination is the internalized and reorganized nature. This study examines the view on nature enacted in Ch'o-Jung's three-verse poems (sijo) in light of the traditional views on nature implicated in the ancient three-verse poems (koshijo), which is in line with the long-established Oriental view on nature. To dignitaris(sadaebu) in the Chosun Dynasty, nature appeared as the idealistic subject for moral culture ($shims{\breve{o}}ngsuyang$), which also becomes the literary space where the purity and justice of the world view of Neo-Confucianism(Sungrihak) is contained in the form of the three-verse poem, the lyrical poetic space where the "I" is united with nature by way of "enjoying of wind and moon"($umpungnongw{\breve{o}}i$) and "living in quiet retiremen"($yuyuchaj{\breve{o}}k$), and the object for the poetical perception of the surrounding world. Ch'o-Jung' s three-verse odes are found in Reed pipe ($Ch'oj{\breve{o}}k$), Sixty Five Pieces of Three-Verse Odes (Samhaengshi-$yukshipopy{\breve{o}}n$), Autumn Fragrance ($Hyangginam{\check{u}}n-ga{\check{u}}l$), and The Words of Zelko va Tree ($N{\check{u}}tinamu{\check{u}}i-mal$). This study analyzes 212 pieces of Ch'o-Jung' s three-verse poems chosen from theses books. In Ch'o-Jung's poems, the traditional view on nature expressed in the ancient three-verse poems is rendered in such a way that metaphysical understanding of nature is indirectly transmitted through the objective correlatives found nature. Nature is no longer the object of straightforward utterance, but transformed, displaced, and removed: that way, nature gets objectified to form a complicated and multi-layered structure. In conclusion, the view on nature manifested in Ch'o-Jung's three-verse poems is based on traditional metaphysics. Second, nature is the object of lyrical nostalgia and adoration. Third, nature is imbued with the fundamental affection for parents. Fourth, nature is associated with organic life. Fifth, the nature in Ch'o-Jung's poems reveals the beauty of stillness endorsed in Lao-tse's and Chung-tze's philosophy. And last, nature is the agent for self-realization and meditation.

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An Interpretation of the Korean Fairy-Tale "Borrowed Fortune From Heaven" From the Perspective of Analytical Psychology (한국민담 <하늘에서 빌려온 복>에 대한 분석심리학적 이해)

  • Kihong Baek
    • Sim-seong Yeon-gu
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    • v.38 no.1
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    • pp.112-160
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    • 2023
  • This study examined the Korean folklore "Borrowed Fortune from Heaven" from the perspective of Analytical Psychology, considering it a manifestation of the human psyche, and tried to gain a deeper understanding of what happens in our mind. Through the exploration, the researcher was able to re-identify the ongoing psychological process operating in the depths of our mind, pertaining to the emergence of a new dimension of consciousness. Particularly the researcher was able to gain some insights into how the potential psychic elements for the new consciousness are prepared in the unconscious, how they get integrated into the conscious life, and what is essential for the accomplishment of the process. The tale begins with a poor woodcutter who, in order to escape from poverty, starts gathering twice as much firewood. However, the newly acquired amount disappears overnight, so the woodcutter gets perplexed and curious about where it goes and who is taking it. He seeks to find out the truth, which leads him to an unexpected journey to Heaven. There he learns the truth concerning his very tiny amount of fortune, and discovers another big fortune for an unborn person. By pleading with the ruler of Heaven, the woodcutter borrows that grand fortune, on the condition that he must return it to the owner when the time comes. After that, the woodcutter's life undergoes a series of changes, in which he finally becomes a wealthy farmer, but gradually is reminded more and more that the destined time is approaching. In the end, the fortune is completely transferred to the original owner, resulting in a dramatic twist and the creation of a new life circumstances. The overall plot can be understood as a reflection of the psychological process aiming at the evolution of consciousness through renewal. In this context, the woodcutter can be considered a psychic element that undergoes a continuous transformation in preparation for participating in the upcoming new consciousness. In other words, the changes brought about by this figure can be interpreted as a gradual and increasingly detailed foreshadowing of what the forthcoming new consciousness would be like. Interestingly, as the destined time approaches, the protagonist's anguish in conflict reaches its climax, despite his good performance in his role until then. This effectively portrays the difficulty of achieving a new dimension of consciousness, which requires moving past the last step. All the events in the story ultimately converge at this point. After all, the resolution occurs when the protagonist lets go of everything he has and follows the will of Heaven. This implies what is essential for the renewal of consciousness. Only by completely complying with the entire mind, the potential constituents of the new consciousness that should play important roles in a renewal and evolution of consciousness through experiencing, can participate in the ultimate outcome. As long as they remain trapped in any intermediate stage, the totality of the psyche would develop another detour aiming at the final destination, which means the beginning of another period of suffering carrying a purposeful meaning. The tale suggests that this truth will be applied everywhere that renewal of consciousness is directed, whether for an individual or a society.

Clinical and Bacteriologic Efficacy of Cefprozil on Pharyngitis and Pharyngotonsilitis caused by Group A Beta Hemolytic Streptococci in Children (Group A-beta Hemolytic Streptococci에 의한 소아 인두편도염에 있어서 Cefprozil의 항균력과 임상적 및 세균학적 효과에 관한 연구)

  • Kim, Min-Woo;Ahn, Young-Min;Jang, Seong-Hee;Ma, Sang-Hyuk;Ahn, Byung-Moon;Kim, Jong-Duk;Lee, Jong-Kook;Kim, Mi-Lan;Chang, Jin-Kun;Park, Jin-Young;Bae, Jong-Woo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.206-212
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    • 2001
  • Objective : To determine the clinical and bacteriologic efficacy and safety of Cefprozil in acute pharyngitis and pharyngotonsilitis caused by Group A beta hemolytic streptococci in pediatric patients. Methods : Any patient of 3 to 14 age who visited the hospitals enrolled in this study with the signs and symptoms of pharyngitis or pharyngotonsilitis since July, 2000 to March, 2001, was taken throat culture and given Cefprozil(15 mg/kg/day, in two divided doses) for 10 days. 138 patients of whom showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Any undesirable effect was reported to determine the safety of the drug. Follow up cultures were done at the end of the study and bacteriologic efficacy was determined. Results : 138 of 256 patients who visited the hospitals with the signs and symptoms of pharyngitis or pharyngotonsilitis showed positive growth on throat culture. Mean age of the patients was $6.1{\pm}2.5$ and males and females were equally numbered. 129 of them complained fever on the first visit and 112(86.6%) of them were improved at the end of the study. Cervical lymphadenitis was seen in 58 patients and 44(75.9%) of them improved at the end of the study. Exudative pharyngitis was seen in 96 patients and 81(84.3%) of them improved. The overall clinical effcacy based on this results showed that 110(79.7%) of the patients were cured and 17(12.3%) of them improved. On the cultures and bacteriologic efficacy, 24.6% of them showed documented eradication after treatment and 62.3% of them showed presumptive eradication. Sensitivity test was done by agar dilution method and Cefprozil showed 100% sensitivity. Erythromycin, Clarithromycin and azithromycin showed 87%, 85.6 %, 90.6% sensitivity, respectively. Conclusion : Cefprozil is proved to be effective in controlling group A streptococcal pharyngitis and pharyngotonsilitis in children and showed good sensitivity. Cefprozil can be used as an effective oral cephalosporin in the patients showing penicillin hypersensitivity or patients who other drugs have failed.

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Urinary Protein and Enzyme Excretion of Spot Urine in Children with Vesicoureteral Reflux (방광요관 역류증 환아의 단회뇨에서 요단백 및 효소 배설 측정)

  • Yoon, Jung-Rim;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.56-62
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    • 2009
  • Purpose : The aim of this study was to evaluate the clinical usefulness of measurement of ${\beta}_2$ microglobulin (${\beta}_2$ MG), N-acetyl-$\beta$-D-glucosaminidase (NAG) of spot urine samples as indices of renal tubular damage and microalbumin of spot urine samples as a parameter of glomerular damage in children with vesicoureteral reflux (VUR) or renal defects. Methods : We studied 91 children with previous UTI. The children were classified as 62 children without VUR and renal defects (group I), 10 children with VUR, without renal defects (group II), and 19 children with VUR and renal defects (group III). Patients having VUR were separated according to the degree of VUR (mild VUR: VUR grade I-III, severe VUR: VUR grade IV-V). Urinary excretion of ${\beta}_$ microglobulin (${\beta}_2$ MG), microalbumin, N-acetyl-$\beta$-D-glucosaminidase (NAG), creatinine were measured in samples of morning urine specimens. Children with VUR or renal defects detected by voiding cystourethrography (VCUG) and DMSA renal scan were investigated. Results : Microalbumin/Cr ratio of spot urine was significantly increased in group III compared group I ($42.3{\pm}27.2\;mg/gCr$ vs $25.2{\pm}10.9\;mg/gCr$, P<0.05). NAG/Cr ratio of spot urine was significantly increased in group II compared group I ($3.70{\pm}23.4\;mg/gCr$ vs $18.7{\pm}12.7\;mg/gCr$, P<0.05). There was no statistically significant difference of ${\beta}_2$ MG/Cr ratio among three groups. Conclusion : Urinary microalbumin excretion of morning urine sample may be a simple and reliable clinical indicators for early identification of renal damage in children with VUR and renal defects. Urinary microalbumin excretion may be useful marker to predict the the severity of VUR.

Delayed Parenchymal Transit During Tc-99m MAG3 Renography is a Valuable Sign in Diagnosing Urinary Obstruction in Patients with Early Hydronephrosis (초기의 수신증 환자의 요로폐쇄 진단에 있어 Tc-99m MAG3 신장 스캔시 실질통과지연 소견의 유용성)

  • Lee, Won-Woo;Moon, Dae-Hyuk;Kim, Jae-Seung;Ryu, Jin-Sook;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.306-313
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    • 2002
  • Purpose: Diuretic renography (DR) can be false negative in patients with upper urinary tract obstruction due to low compliance of the renal pelvis. Delayed parenchymal transit (DPT) may be a valuable sign in case of false negative DR. We compared the diagnostic values of DR and DPT during Tc-99m MAG3 diuretic scan in adults with suspected unilateral obstructive uropathy. Materials and Methods: Fifty-four patients(male:female=30:24, age: $40.7{\pm}15.5$ yrs) who underwent Tc-99m MAG3 diuretic scan due to suspicious unilateral obstructive uropathy were analyzed. DR with a $T_{1/2}\;of\;>\;15min$ was considered as positive for obstruction. DPT was considered to be present when there was delayed appearance of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal parenchyma. The renal area ratio was defined as the ratio of pixel number of hydronephrotic kidney over that of normal contralateral at $1{\sim}2min$ images. Definition of obstruction was improved hydronephrosis after intervention, or aggravated hydronephrosis without intervention. Non-obstruction was defined as unchanged hydronephrosis over 6 months. Results: Twenty-six renal units had obstruction and 28 no obstruction. The sensitivities of DR and DPT were 69% (18/26) and 50% (13/26) respectively. Two renal units with DPT but negative DR showed the renal area ratio of <1.1. Among the 20 obstructive renal units with DPT or positive DR, 13 with DPT had lower renal area ratio than 7 renal units without DPT ($0.97{\pm}0.20\;vs\;1.30{\pm}0.41,\;p<0.05$). Differential renal function was not significantly different between these groups. DPT correctly diagnosed all renal units with non-obstruction (specificity 100%), while the specificity of DR was 89% (25/28). Conclusion: DPT during Tc-99m MAG3 diuretic scan may be a valuable sign in diagnosing urinary obstruction especially in patients with false negative DR and early HN.

On the field of domestic studies on Western Art History and Western Art Theory (국내 서양미술사, 서양미술이론 연구 장에 관한 연구)

  • Shim, Sang-Yong
    • The Journal of Art Theory & Practice
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    • no.2
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    • pp.75-120
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    • 2004
  • Studies on western art in Korea has been caught in a dilemma that they could deal with only those things which had been arranged according to their 'historical generalization' in their contexts because of the bounds of time and space. It is not trivial that such conditions affect art studies in Korea. Access to the original texts and to their contexts of production is so restricted that the studies on them are prone to he superficial. And it is not independent on the politics of Korean art scene. Such factors are on the background of Korean art's excessive 'assimilation or accordance' with western art. The domestic studies on western art history and art theory have failed to notice the differences in context and Korean art has simply mediated or reproduced the restricted information by those studies. Also the studies on western art in Korea have been made use of as a justifying method of one's own academic domains. In such situations we should lead the studies on western art history and western art theory to a more reflective direction and confirm that the studies should not have any privileges of the realities. And we should try to reform a scholarship which participates in our life and existence. The field of domestic studies on western art history and western art theory should free itself from the invention of objectivity or the neutrality of mechanical reading and turn its eyes to the realities of life where events happens. Constantly suggesting which way Korean art and world art should go has to be the field's new coordinates.

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Adaptation Test of Scotch Pine (Pinus sylvestris L.) in Korea -Thirty-six-year-old Growth Performance of Twenty-two Provenances- (구주소나무 적응성검정 시험 -22개 산지 36년생 결과-)

  • Ryu, Keun Ok;Han, Mu Seok;Kim, In Sik;Lee, Ju Hwan;Lee, Jae Cheon
    • Korean Journal of Plant Resources
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    • v.26 no.1
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    • pp.26-35
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    • 2013
  • This study was conducted to select superior provenances of Scots pine (Pinus sylvestris L.) well adapted to Korean environment for timber production. In 1976, twenty-two provenances of Scots pine were introduced from Sweden and the seeds were sown in seed beds in March. After one year, the seedlings were transplanted to nursery beds. The resulting 1-1 seedlings of 22 provenances were planted at Whaseong in 1978. Randomized complete block design with 3 replications were used for test plantation. Each provenance was planted with 20-tree row plot in each block and at a spacing of $1.8{\times}1.8m$. The growth performance of each provenance was monitored up to 33-years after planting. There were significant differences among provenances in volume growth. F3001 provenance showed the best volume growth of 33-years after planting ($0.160m^3$), which was 2.2 times greater than that of the lowest provenance W2027 ($0.072m^3$). The ranking of provenances was stabilized after 14 years. Comparing to reference tree species, Japanese red pine (Pinus densiflora), all Scots pine provenances showed poor growth performance. In other words, volume growth of Japanese red pine at age 28 and 33 were 2.1 and 3.3 times greater than that of Scots pine, respectively. Moreover, survival rate of Scots pine was lower than that of Japanese red pine. Based on these results, it was suggested that Scots pine was not suitable to Korean environments. The cause of maladaptation of Scots pine and the implications of introduction breeding were discussed.