• Title/Summary/Keyword: 안전성 상태

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Phase II Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma (비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과)

  • Lee, EunJoo;Ha, EunSil;Park, SangHoon;Hur, GyuYoung;Jung, KiHwan;Jeong, HyeCheol;Lee, SungYong;Kim, JeHyeong;Lee, SangYeub;Sin, Chol;Shim, JaeJeong;In, KwangHo;Kang, KyungHo;Yoo, SeHwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.510-516
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    • 2005
  • Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.

Risk Factor Analysis for Preventing Foodborne Illness in Restaurants and the Development of Food Safety Training Materials (레스토랑 식중독 예방을 위한 위해 요소 규명 및 위생교육 매체 개발)

  • Park, Sung-Hee;Noh, Jae-Min;Chang, Hye-Ja;Kang, Young-Jae;Kwak, Tong-Kyung
    • Korean journal of food and cookery science
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    • v.23 no.5
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    • pp.589-600
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    • 2007
  • Recently, with the rapid expansion of the franchise restaurants, ensuring food safety has become essential for restaurant growth. Consequently, the need for food safety training and related material is in increasing demand. In this study, we identified potentially hazardous risk factors for ensuring food safety in restaurants through a food safety monitoring tool, and developed training materials for restaurant employees based on the results. The surveyed restaurants, consisting of 6 Korean restaurants and 1 Japanese restaurant were located in Seoul. Their average check was 15,500 won, ranging from 9,000 to 23,000 won. The range of their total space was 297.5 to $1322.4m^2$, and the amount of kitchen space per total area ranged from 4.4 to 30 percent. The mean score for food safety management performance was 57 out of 100 points, with a range of 51 to 73 points. For risk factor analysis, the most frequently cited sanitary violations involved the handwashing methods/handwashing facilities supplies (7.5%), receiving activities (7.5%), checking and recording of frozen/refrigerated foods temperature (0%), holding foods off the floor (0%), washing of fruits and vegetables (42%), planning and supervising facility cleaning and maintaining programs of facilities (50%), pest control (13%), and toilet equipped/cleaned (13%). Base on these results, the main points that were addressed in the hygiene training of restaurant employees included 4 principles and 8 concepts. The four principles consisted of personal hygiene, prevention of food contamination, time/temperature control, and refrigerator storage. The eight concepts included: (1) personal hygiene and cleanliness with proper handwashing, (2) approved food source and receiving management (3) refrigerator and freezer control, (4) storage management, (5) labeling, (6) prevention of food contamination, (7) cooking and reheating control, and (8) cleaning, sanitation, and plumbing control. Finally, a hygiene training manual and poster leaflets were developed as a food safety training materials for restaurants employees.

Study for Diagnostic Efficacy of Minibronchoalveolar Lavage in the Detection of Etiologic Agents of Ventilator-associated Pneumonia in Patients Receiving Antibiotics (항생제를 사용하고 있었던 인공호흡기 연관 폐렴환자에서의 원인균 발견을 위한 소량 기관지폐포세척술의 진단적 효용성에 관한 연구)

  • Moon, Doo-Seop;Lim, Chae-Man;Pai, Chik-Hyun;Kim, Mi-Na;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.321-330
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    • 1999
  • Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

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A Study of the Functional Improvement for Comfortable Expressway Service Areas - Metropolitan Expressway Service Areas - (고속도로 휴게소 환경개선을 위한 기능 증진 방안 연구 - 수도권 휴게소를 중심으로 -)

  • Lee, Won-Myoung;Han, Bong-Ho;Kim, Jong-Yup;Park, Seok-Cheol
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.3
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    • pp.63-76
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    • 2015
  • This study was carried out to suggest improvement plans for problems with the landscape areas of highway service areas. The survey factors were land use, placement of green area and land coverage in terms of spatial and environmental property. Noise and topographic structure in detached green areas were surveyed in terms of impact factor. The status of the planting area around each service area was analysed in regards to planting structure and planting landscape. As a result, the mean of rations of land use were 81.6% building and 18.4% green areas, which were composed of 5.4% landscape area, 9.1% buffer area, etc. Planting areas as usable space accounted for only 0.7%, and the result of noise measurement was different according to the distribution of highway and service area and type of detached green area. The mean of ratio of planting area was 18.4%, which consists of 6.7% landscape planting, 3.4% other green area, 4.6% buffer area, 2.0% buffer and landscape area, 1.1% shade planting and 0.5% landscape and shade planting. Most planting areas aim at landscape appreciation and areas in which visitors can relax and gain recreation were insufficient. The planting structures of service areas were 52.2% canopy layer, 11.8% shrubs and 9.4% canopy and shrub layers, and most of the planting areas were a single layer of green area. Multi-layered planting structures in the landscape and buffer areas were required and a shade planting area was needed to improve amenities as planting canopy layered trees. This study suggested improvement methods for based environments, spatial function and planting function in landscape areas.

Effect of bronchial artery embolization in the management of massive hemoptysis : factors influencing rebleeding (대량객혈 환자에서 기관지 동맥색전술의 효과 : 색전술후 재발의 원인과 예측인자)

  • 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
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    • v.43 no.4
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    • pp.590-599
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    • 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.

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Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

Differences in Root Growth Characteristics of Creeping Bentgrass and Kentucky Bluegrass Sod (크리핑 벤트그래스와 켄터키 블루그래스 뗏장의 뿌리생육 특성 차이)

  • Woo, Jong-Goo;Lee, Dong-Ik;Lee, Song-Ho
    • Asian Journal of Turfgrass Science
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    • v.21 no.1
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    • pp.23-37
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    • 2007
  • This study was carried out to investigate the characteristics of root growth in Kentucky bluegrass sod(KBS) and creeping bentgrass sod(BGS) transplanted in summer(August 9) and fall(September 19), respectively. Hydroponic system was also used to observe rooting development in the study. Root development differed in KBS by transplanting time. It reached to more than 5 cm after 100 days In summer and 50 days in fall. However, BGS's root grew over 6cm after 40 days, regardless of the season. There was no significant differences in BGS, regardless of any cutting treatment. In the case of KBS, it was best with sod culled with 0.5cm deep and 1.5cm long. But it grew beyond 5 cm in root growth under any treatment after 40 days in transplanting. In a hydroponic study, BGS produced root over 100cm for 80 days through a summer season. However, the root of KBS did only grow in condition below $20^{\circ}C$. These results indicated that root growth characteristics were variable in BGS and KBS. It was considered that rooting development of BGS might be improved with sufficient irrigation in summer, and KBS grows well in lower temperature of $10{\sim}18^{\circ}C$, as compared with BGS. As to establishing the lawn with a sodding method, it should be careful in transplanting time, especially KBS.

Design of Truck Escape Ramps (자동차 긴급 피난 차선의 계획 설계)

  • 구본충
    • Journal of the Korean Professional Engineers Association
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    • v.28 no.4
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    • pp.54-75
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    • 1995
  • This synthesis has been prepared from a review of literature on Truck Escape Ramps technology and a survey of current practice by state department of transportation. Their locations have been determined usually from a combination of accident experience and en-gineering judgement, but new tools are emerging that can identify needs and sites without waiting for catastrophic accidents to happen. The Grade Severity Rating Systems holds promise in this regard. Design Procedures for truck excape ramps continue to evolve. Gravel arrester beds are clearly the preferred choice across the country Rounded aggregate, uniformly graded in the approximate size range of 13 to 18mm. Tech-nical publications typically have dassified TER types as paved gravity, sandpile, and ar-rester bed ramps. The design speed for vehicle entry into the ramp in critical to the deter-mination of ramp length. An escape ramp should be designed for a minimum entry speed of 130km/hr, a 145km/hr design being preferred. The ramps should be straight and their angle to the roadway align-ment should be as possible. The grade of truck escape ramps show the adjustment of ramp design to local topography, such as the tradeoff of ramp length against earthwork requirements. A width of 9 to 12m would more safety acommodate two or more outof con-trol vehicles. Reguarding comments on the most effective material, most respondents cited their own specification or referred to single graded, rounded pea gravel. The consensus essentially Is that single graded, well -rounded gravel is the most desirable material for use in arrester beds. The arrester beds should be constructed with a minimum aggregate depth of 30cm. Successful ramps have used depths between 30 and 90cm.

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Transcatheter Arterial Embolization for Hemoptysis (객혈환자에서 동맥 색전술의 효과)

  • Yoo, Byung-Su;Ryu, Jeong-Seon;Lee, Won-Yeon;Song, Kwang-Seon;Ahn, Kang-Hyun;Yong, Suk-Joong;Shin, Kye-Chul;Kim, Young-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.50-57
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    • 1995
  • Background: Transcather arterial embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function such as postpneumonectomy patients and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization and analysed the correlation of the clinical and angiographic characteristics and investigated the clinical course and outcome after arterial embolization in the patients with significant hemoptysis. Method: 58 patients with massive or recurrent hemoptysis underwent transcatheter arterial embolization for the treatment of hemoptysis from April 1992 to Sept. 1993. Results: Most common cause of hemoptysis was pulmonary tuberculosis(34 cases, 58.3%). Embolized vessels responsible for hemoptysis were 56 bronchial arteries and 32 nonbronchial systemic arteries. Initial most common angiographic findings were hypervascularity and shunt. Initial success rate of hemoptysis control revealed 81.1%. However, 15 of 58 patients(25.9%) showed recurrence of hemoptysis after transcatheter arterial embolization. The complications(18 cases, 31%) such as chest pain, fever, voiding difficulty, atelectasis, paralytic ileus and unwanted embolization were occured. Conclusion: Transcatheter arterial embolization is useful and relatively safe treatment modality for immediate bleeding control of patients with massive hemoptysis or inoperable cases. The further evaluation of the long term results according to the embolized material and underlying pulmonary disease will be required.

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A Comparative Study on Foodservices and Their Satisfactions between Kindergartens with and without Dietitians in Chungnam (충남지역 유치원의 영양사 배치 유무에 따른 급식실태와 학부모의 급식 만족도 비교)

  • Lee, Kyoung-Hee;Kim, Myung-Hee;Choi, Mi-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.2
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    • pp.278-285
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    • 2013
  • We investigated foodservices and levels of their satisfaction from parents of children in kindergartens with and without dietitians. Foodservice facilities consisted of kitchens and cafeterias for all kindergartens with a dietitian (KWD) and only kitchens for all kindergartens without a dietitian (KWOD) (p<0.001). Children consumed lunch in a lunchroom for all KWD and in a classroom for all KWOD (p<0.001). The person in charge of the diet menu was a dietitian for all KWD and a director for 52.2% of KWOD (p<0.001). About 48% of total kindergartens were served different amounts according to the child's age and body size. About 30% of parents from total kindergartens responded that a difficulty of foodservice management was children's safety while distributing the lunch. The majority of respondents claimed that foodservices need a more balanced menu and active instructions on proper dietary habits. Parents who visited and participated in foodservice were significantly higher from KWD than KWOD. Also, the desire to participate in foodservices was significantly higher in the parents from KWD (p<0.01). Sixty one percent of parents from KWD and 19% of parents from KWOD considered foodservices when choosing a kindergarten (p<0.001). The satisfaction in foodservices of parents from KWD was significantly higher from all points of view in terms of the quality of foodservice, nutrition, and hygiene. In conclusion, we found that foodservices and their levels of satisfaction from parents of kindergartens with dietitians were better and higher than those without dietitians. Therefore, all kindergartens should consider having a dietitian exclusively in charge of foodservices.