• 제목/요약/키워드: 위험의 분류

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Clinical Characteristics and Abnormal p53 Expression of Lung Cancer Associated with Multiple Primary Cancer (다발성 악성종양에 동반된 폐암의 임상 특징과 변이형 p53 발현)

  • Shin, Chang-Jin;Park, Hye-Jung;Shin, Kyeong-Cheol;Shim, Young-Ran;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • 제47권3호
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    • pp.331-338
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    • 1999
  • Background: Nearly 10% of cancer patients will develop a second primary cancer within ten years after surgical removal of the primary tumor. The detection of risk factors for developing multiple primary tumors would be important This study was conducted to evaluate the clinical characteristics and abnormal p53 expression of lung cancer associated with multiple primary cancer(MPC). Method: Clinical characteristics and abnormal p53 expression were compared between 20 cases of lung cancer(NSCLC ; 16 cases, SCLC ; 4 cases) associated with MPC and 26 cases of primary non-small cell lung cancer. Result: MPC associated with lung cancer was gastric cancer(8), lung cancer(2), esophageal cancer(2), colon cancer(2), laryngeal cancer(1), bladder cancer(1), small bowel cancer(l), adrenal cancer(1), hepatocellular carcinoma(1), and breast cancer (1) in order. The clinical stage of primary NSCLC was relatively advanced, but NSCLC associated with MPC was even distribution at each stage. The detected incidences of abnormal p53 expressions were 62.5% in NSCLC associated with MPC and 76.9% in primary NSCLC(p>0.05). Conclusion: There was no difference in abnormal p53 expression between non-small cell carcinoma associated with multiple primary cancer and primary non-small cell carcinoma.

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Lung Complications After Allogenic Bone Marrow Transplantaion (동종골수이식 후 폐합병증)

  • JeGal, Yang-Jin;Lee, Je-Hwan;Lee, Kyoo-Hyung;Kim, Woo-Kun;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • 제49권2호
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    • pp.207-216
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    • 2000
  • Background : The occurrence of lung complications after allogenic bone marrow transplantation(BMT) has been reported as 40-60 percent. The risk factors for lung complications are whole body irradiation, high dose chemotherapy, graft versus host disease, old age and CMV infection. The prevalence of graft versus host disease is less in Korea than in Western countries, but frequency of CMV infection is higher. Therefore, the pattern of lung complications may be different in Korea from those in Western countries. Methods : A retrospective cohort study was performed on one hundred consecutive adult patients who underwent allogenic bone marrow transplantation from December, 1993 to May, 1999 at Asan Medical Center. Lung complications were divided into two groups by the time of development, within 30days (pre-engraftment) and beyond 30 days (post-engraftment), and then subdivided into infectious and non-infectious complication. Infectious complications were defined as having the organism in blood, BAL fluid, pleural fluid or sputum, or compatible clinical findings in patients, which improved with antibiotics or an anti-fungal therapy. Result: 1) Eighty three episodes of lung complications had occurred in 54 patients. 2) Within thirty days after BMT, non-infectious complications were more common than infections, but this pattern was reversed after 30 days. After one year post-BMT, there was no infectious complication except in cases of recurrence of underlying disease or development of chronic GVHD. 3) Among the non-infectious complications, pleural effusion (27 episodes) was most common, followed by pulmonary edema (8 episodes), bronchiolitis obliterans(2 episodes), diffuse alveolar hemorrhage (1 episode) and bronchiloitis obliterans with organizing pneumonia (1 episode). 4) The infectious complications were pneumonia (bacterial: 9 episodes, viral: 4 episodes, fungal : 5 episodes, pneumocystis carinii : 1 episode), pulmonary tuberculosis(3 episodes) and tuberculous pleurisy (3 episodes). 5) Lung complications were more frequent in CMV positive patients and in patients with delayed recovery of neutrophil count. 6) The mortality was higher in the patients with lung complications. Conclusion : Lung complications developed in 54% after allogenic BMT and were associated with higher mortality.

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H-T-P reaction Study on differences between the juvenile delinquents groups classified by the family system type for Creative happy Education management (창의적 행복학교 교육경영을 위한 HTP 검사 반응 연구)

  • Park, Soon Marn;Choi, Chong Myoung;Kim, Jin Nyo;Byun, Sang Hae
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • 제8권3호
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    • pp.157-163
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    • 2013
  • This study is to notify differences of H-T-P reactions between Juvenile delinquents groups classified by family system type. This study aims to know reaction of 'House' on each juvenile delinquents and apply to creative school education administration. The research was performed as below: First, Measuring and descriptive statistical analysis were performed. One hundred and twenty subjects who were youths disposed of Seoul nambu youth alternative education center. Data were collected from July to October in 2012. Then There were classified Two groups following subjects; 'parents family' and 'single parent family'. Second, Questionaries assessing demographic and H-T-P by Buck, N. Third, statistical analysis was done by SPSS for Window 18.0. To Verify the reliability of the measures and correlations between two groups, and to find out the difference of the reaction of 'House', were used frequency analysis and Pearson Chi-Square. The results of this is significant personality types of juvenile delinquents are followings; The Juvenile delinquents living 'Single parent family' have frustrations for their past and current family. Also they have mental conflicts for their family better than another group.

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A Studs on Exposure to Organic Dust and Ammonia in Poultry Confinement Buildings (일부 육용 양계 농업인의 유기먼지와 암모니아 노출에 관한 연구)

  • Shin, Cheol-Lim;Lee, Kyung-Suk;Kim, Kyung-Ran;Kang, Tae-Sun;Paik, Nam-Won
    • Journal of agricultural medicine and community health
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    • 제29권2호
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    • pp.303-314
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    • 2004
  • Objectives: This study was carried out to assess exposure levels of organic dusts and ammonia in poultry farms in Korea. Methods: A total of six poultry farms were investigated. The farms were located in Namwon, Chonlabuk-do and in Kae-San, Chungchongbuk-do. This study consisted of a questionnaire and measuring organic dusts and ammonia. The questionnaire included the characteristics of the farms, work patterns and the tasks of the poultry farms. Results and Conclusions: The farmers raised the chickens 45 times a year and the average number of years in the poultry farm were eight years ranging from 2 to 12 years. They worked for seven days per week and the average hours spent caring the chickens are 6.3 hours per day. The duration of staying in the confinement buildings was 3.3 hours per day. The work time in summer was longest. The feed and the water supply systems were automatic and the control of ventilation windows used "winch curtain" was semiautomatic. They used mechanical ventilation system in winter and used dilution ventilation system in the other seasons. The geometric mean concentration of total and respirable dust sampled in the poultry confinement buildings was 4.0 mg/$m^3$and 0.9 mg/$m^3$ respectively. The ratio of respirable to total dusts range from 9 to 49 percent. There was no sample exceeding the criteria 10 mg/$m^3$ for total dust and 3 mg/$m^3$ for respirable dust in farms. The criteria have been recommended by Korean Ministry of Labor and American Conference of Governmental Industrial Hygienist. The personal respirable dusts measured during a circle work averaged geometric mean concentration 1.4 mg/$m^3$ Two personal samples were exceeded the threshold 3 mg/$m^3$. There was a positive relation between an index and the personal samples of respirable dusts($R^2$=0.98). The index is calculated by multipling the total number of chickens in the farm by the age of the chickens and then dividing by the volume of the confinement building. The geometric mean concentration of area and personal ammonia samples was 23.3 ppm and 22.2 ppm, respectively. Some of the ammonia samples, both area and personal samples, exceeded the short term exposure limit value 35 ppm.

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Identification of Quaternary Faults and shallow gas pockets through high-resolution reprocessing in the East Sea, Korea (탄성파 자료 고해상도 재처리를 통한 동해해역의 제4기 단층 및 천부 가스 인지)

  • Jeong, Mi Suk;Kim, Gi Yeong;Heo, Sik;Kim, Han Jun
    • Journal of the Korean Geophysical Society
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    • 제2권1호
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    • pp.39-44
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    • 1999
  • High-resolution images are drawn from existing seismic data which were originally obtained by Korea Ocean Research & Development Institute (KORDI) during 1994-1997 for deep seismic studies on the East Sea of Korea. These images are analyzed for mapping Quaternary faults and near-bottom gas pockets. First 12 channels are selected from shot gathers for reprocessing. The processing sequence adopted for high-resolution seismic images comprises data copy, trace editing, true amplitude recovery, common-midpoint sorting, initial muting, prestack deconvolution, bandpass filtering, stacking, highpass filtering, poststack deconvolution, f-x migration, and automatic gain control (AGC). Among these processing steps, predictive deconvolution, highpass filtering, and short window AGC are the most significant in enhancement of resolution. More than 200 Quaternanry faults are interpreted on the migrated sections in the shallow depths beneath the seafloor. Although numerous faults are found mostly at the western continental slope and boundaries of the Ulleung Basin, significant amount of the faults are also indicated within the basin. Many of these faults are believed to be formed with reactivation of basement, from geotectonic activities including volcanism, and often originated in Tertiary, indicating that the tectonic regime of the East Sea might be unstable. Existence of shallow gas pockets casts real hazardous warnings to deep-sea drillings and/or to underwater constructions such as inter-island cables and gas pipelines. On the other hand, discovery of these gas pockets heightens the interests in developing natural resources in the East Sea. Reprocessed seismic sections, however, show no typical seismic characteristics for gas hydrates such as bottom-simulating reflectors in the western continental slope and ocean floor.

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Analysis of Epidemiological Characteristics, PFGE Typing and Antibiotic Resistance of Pathogenic Escherichia coli Strains Isolated from Gyeonggi-do (경기도에서 분리한 병원성대장균의 역학적 특성 및 PFGE, 항생제 내성 연구)

  • Kim, Kyung-A;Yong, Kum-Chan;Jeong, Jin-A;Huh, Jeong-Weon;Hur, Eun-Seon;Park, Sung-Hee;Choi, Yun-Sook;Yoon, Mi-Hye;Lee, Jong-Bok
    • Korean Journal of Microbiology
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    • 제50권4호
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    • pp.285-295
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    • 2014
  • This study was conducted to survey the epidemiological characteristics and the isolated strains for pathogenic E. coli which was the major causative organisms for food poisoning occurred at school food services in the Gyeonggi-do area during the past three years. We investigated 19 accidents of food-borne disease outbreaks by pathogenic E. coli at school food services from 2010 to 2012. Food-borne disease outbreaks by pathogenic E. coli were usually occurred at direct management type (18 accidents, 95%) and high schools. For the seasonal factors, 13 accidents (65%) were occurred in June to September, especially the end of August and September after the summer holidays. The first patients were occurred on Wednesday (7 accidents, 37%) and Thursday (7 accidents, 37%), and they were mainly reported on Thursday (7 accidents, 37%) and Friday (5 accidents, 26%). The exposure of risk was estimated in Monday (4 accidents, 21%), Tuesday (7 accidents, 37%) and Wednesday (4 accidents, 21%), and kimchi (5 accidents, 50%) was estimated as the food of the high risk responsible for the outbreaks. 98 isolates of pathogenic E. coli consisted of PEC (50%), ETEC (34%), EAEC (15%), and EHEC (1%). The antibiotic resistance of pathogenic E. coli showed in the descending order of ampicilline (40%), nalidixic acid (37%), trimethoprim/sulfamethoxazole (24%), and tetracycline (19%). The antibiotics of second and third generation cephalosporins, cabarpenem, aminoglycosides, and second generation quinolones had antimicrobial susceptibilities and cefalotin, ampicillin/sulbactam and chloramphenicol showed medium resistance at 29%, 25%, and 6% respectively, and 70% of isolates were resistant to more than one antibiotic. By the PFGE analysis, they were classified into nine major groups and 31 profiles with 57% pattern similarity. It was very difficult to find the correlation of antimicrobial susceptibilities and genotype in the small scale-food poisoning, but the similarity of antimicrobial resistance and PFGE patterns in the large scale-food poisoning enabled the outbreaks to estimate the same pathotype of E. coli derived from identical origins.

Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • 제38C권9호
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

Relationship of sodium consumption with obesity in Korean adults based on Korea National Health and Nutrition Examination Survey 2010~2014 (2010년~2014년 국민건강영양조사 자료를 이용한 성인의 나트륨 섭취와 비만과의 관련성)

  • Cheon, Se Young;Wang, Hye Won;Lee, Hwa Jung;Hwang, Kyung Mi;Yoon, Hae Seong;Kang, Yoon Jung
    • Journal of Nutrition and Health
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    • 제50권1호
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    • pp.64-73
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    • 2017
  • Purpose: Excess sodium intake may contribute to the etiology of hypertension and cardiovascular disease risk. World Health Organization (WHO) recommends a daily sodium intake of less than 2 g. The aim of this study was to estimate the association of sodium intake with obesity in Korean adults. Methods: This study used Dietary intake and Health data on 22,321 subjects aged 30 years and over from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010~2014. Information on dietary intake was obtained by the one day 24-hour recall method in KNHANES, and sodium intake was classified into five groups (< 2,000 mg, 2,000~4,000 mg, 4,000~6,000 mg, 6,000~8,000 mg, ${\geq}8,000mg$). Obesity was defined as having a body mass index (BMI) higher than $25kg/m^2$. Intake of sodium and obesity status were analyzed by logistic regression with SPSS Statistics 23. Results: Men tended to have a higher sodium intake than women (p < 0.001). After adjusting for age, sex, year, daily energy intake, education level, smoking status, drinking status, physical activity, and chronic diseases and comparing the highest sodium intake group (${\geq}8,000mg$) with the lowest intake group (< 2,000 mg), the OR of obesity was 1.351 (95% CI: 1.032~1.767) in men. The OR of obesity in the sodium intake group (4,000~6,000 mg) was 1.232 (95% CI: 1.063~1.427) in women. Conclusion: Our findings suggest an independent relationship between sodium intake and as increased risk of obesity in Korean adults, implying the necessity for future research on low-sodium diet intervention in relation to obesity.

Coronary Artery Bypass Graft in Patient with Advanced Left Ventricular Dysfunction (중등도 이상의 좌심실 기능 부전 환자에서의 관상동 우회술의 임상 분석)

  • 정종필;김승우;신제균
    • Journal of Chest Surgery
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    • 제34권12호
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    • pp.901-908
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    • 2001
  • Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

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Preoperative Risk Factors for the Prognosis of Mitral Regurgitation in Patients with Coronary Artery Stenosis and Mitral Regurgitation Who Underwent Coronary Artery Bypass Surgery Alone (승모판폐쇄부전증을 동반한 관상동맥협착증 환자에서 시행한 단독 관상동맥우회술 후 승모판폐쇄부전증의 예후에 영향을 미치는 수술 전 요인)

  • Jin, Ung;Park, Chan-Beom;Choi, Si-Young;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • 제37권5호
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    • pp.410-415
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    • 2004
  • Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.