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A Study on Kiosk Satisfaction Level Improvement: Focusing on Kano, Timko, and PCSI Methodology (키오스크 소비자의 만족수준 연구: Kano, Timko, PCSI 방법론을 중심으로)

  • Choi, Jaehoon;Kim, Pansoo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.4
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    • pp.193-204
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    • 2022
  • This study analyzed the degree of influence of measurement and improvement of customer satisfaction level targeting kiosk users. In modern times, due to the development of technology and the improvement of the online environment, the probability that simple labor tasks will disappear after 10 years is close to 90%. Even in domestic research, it is predicted that 'simple labor jobs' will disappear due to the influence of advanced technology with a probability of about 36%. there is. In particular, as the demand for non-face-to-face services increases due to the Corona 19 virus, which is recently spreading globally, the trend of introducing kiosks has accelerated, and the global market will grow to 83.5 billion won in 2021, showing an average annual growth rate of 8.9%. there is. However, due to the unmanned nature of these kiosks, some consumers still have difficulties in using them, and consumers who are not familiar with the use of these technologies have a negative attitude towards service co-producers due to rejection of non-face-to-face services and anxiety about service errors. Lack of understanding leads to role conflicts between sales clerks and consumers, or inequality is being created in terms of service provision and generations accustomed to using technology. In addition, since kiosk is a representative technology-based self-service industry, if the user feels uncomfortable or requires additional labor, the overall service value decreases and the growth of the kiosk industry itself can be suppressed. It is important. Therefore, interviews were conducted on the main points of direct use with actual users centered on display color scheme, text size, device design, device size, internal UI (interface), amount of information, recognition sensor (barcode, NFC, etc.), Display brightness, self-event, and reaction speed items were extracted. Afterwards, using the questionnaire, the Kano model quality attribute classification of each expected evaluation item was carried out, and Timko's customer satisfaction coefficient, which can be calculated with accurate numerical values The PCSI Index analysis was additionally performed to determine the improvement priorities by finally classifying the improvement impact of the kiosk expected evaluation items through research. As a result, the impact of improvement appears in the order of internal UI (interface), text size, recognition sensor (barcode, NFC, etc.), reaction speed, self-event, display brightness, amount of information, device size, device design, and display color scheme. Through this, we intend to contribute to a comprehensive comparison of kiosk-based research in each field and to set the direction for improvement in the venture industry.

Sedimentary Characters of the Core Sediments and Their Stratigraphy Using $^{87}Sr/^{86}Sr$ Ratio in the Korea Plateau, East Sea (동해 한국대지 코어퇴적물의 특성과 $^{87}Sr/^{86}Sr$ 초기비를 이용한 퇴적시기 규명)

  • Kim, Jin-Kyoung;Woo, Kyung-Sik;Yoon, Seok-Hoon;Suk, Bong-Chool
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.4
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    • pp.328-336
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    • 2007
  • A piston core (587 cm long) was recovered from the upper slope of a seamount in the Korea Plateau. Three episodes of sedimentation were identified based on sedimentary facies, grain size distribution, carbonate constituents and initial $^{87}Sr/^{86}Sr$ ratio of carbonates. The lower part of the core, Unit I-a (core depth $465{\sim}587cm$) is composed of shallow marine carbonate sediments the deposited by storm surges, and is about $13{\sim}15Ma$ (Middle Miocene) based on $^{87}Sr/^{86}Sr$ initial ratio. This suggests that the depositional environment was relatively shallow enough to be influenced by storm activities. Unit I-b (core depth $431{\sim}465cm$) is mostly composed of turbidites, and Sr isotope ages of bivalves and planktonic formaminifera are about $11{\sim}14\;and\;6{\sim}13Ma$, respectively. This indicates that the Korea Plateau maintained shallow water condition until 11 Ma, and began to subside since then. However, planktonic foraminifera were deposited after 11 Ma and redeposited as turbidites as a mixture of planktonic foraminifera and older shallow marine carbonates about 6 Ma ago. Unit II (core depth $0{\sim}431cm$) is composed of pelagic sediments, and the Sr isotope age is younger than 1 Ma, thus the time gap is about 5 Ma at the unconformity. About 1 Ma ago, the Korea Plateau subsided down to a water depth of about 600 m. The sampling locality was intermittently influenced by debris flows and/or turbidity currents along the slope, resulting the deposition of re-transported coarse shallow marine and volcaniclastic sediments.

The Role of Ref-1 in the Differentiation Process of Monocytic THP-1 Cells (단핵구세포주 THP-1의 분화과정에서 Ref-1의 역할)

  • Da Sol Kim;Kang Mi Kim;Koanhoi Kim;Young Chul Park
    • Journal of Life Science
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    • v.34 no.4
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    • pp.271-278
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    • 2024
  • Redox factor (Ref)-1, a ubiquitously expressed protein, acts as a modulator of redox-sensitive tran- scription factors and as an endonuclease in the repair pathway of damaged DNA. However, the function of Ref-1 in the differentiation of monocytes into macrophages has not been defined. In this study, we investigated the effects of Ref-1 on the monocyte differentiation process using the human monocytic cell line THP-1. The differentiation agent PMA increased cell adhesion over time and showed a sig- nificant increase in phagocytic function but decreased the intracellular amount of Ref-1. Ref-1 inhibitor E3330 and Ref-1 knockdown using the siRNA technique reduced cell adhesion and the expression of differentiation markers, such as CD14, ICAM-1, and CD11b, by PMA stimulation. This means that the role of Ref-1 is absolutely necessary in the initial process of differentiating THP-1 cells stimulated by PMA. Next, the distribution of Ref-1 was examined in the cytoplasm and nucleus of THP-1 cells stimulated with PMA. Surprisingly, PMA stimulation resulted in the rapid translocation of Ref-1 to the nucleus. To prove that movement of Ref-1 to the nucleus is required for monocyte differentiation, a Ref-1 vector with the nuclear localization sequence (NLS) deleted was used. As a result, overexpression of ∆NLS Ref-1, which restricted movement to the nucleus, suppressed the expression of differentiation markers and notably reduced phagocytic function in PMA-stimulated THP-1 cells. In conclusion, these data suggest that the differentiation of monocytic THP-1 cells requires Ref-1 nuclear translocation during the initial process of biochemical events following stimulation from PMA.

The Concept of 'the Former World and the Later World' in Daesoon Thought as Introduced via the Diagrams of The Comprehensive Mirror of Taegeukdo (『태극도통감』의 도상을 통해 본 대순사상의 '선·후천' 개념)

  • Lee Bong-ho
    • Journal of the Daesoon Academy of Sciences
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    • v.47
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    • pp.65-103
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    • 2023
  • In The Canonical Scripture (典經), the core scripture of Daesoon Thought, the Former World and the Later World are divided into the Era of Mutual Contention and the Era of Mutual Beneficence. This concept of the Former World and the Later World appears in diagrams on I-Ching Studies (易學) in the text titled, The Comprehensive Mirror of Taegeukdo (太極道通鑑). In I-Ching Studies, Anterior Heaven (先天) and Posterior Heaven (後天) are the main concepts in Song Dynasty diagram books on I-Ching Studies. Among the diagrams of I-Ching Studies, Fuxi's Diagram of the Sequence of the Eight Trigrams, Fuxi's Diagram of the Positions of the Eight Trigrams, Fuxi's Diagram of the Sequence of the 64 Hexagrams, and Fuxi's Diagram of the Positions of the 64 Hexagrams correspond to the Anterior Heaven, and King Wen's Diagram of the Sequence of the Eight Trigrams and King Wen's Diagram of the Positions of the Eight Trigrams correspond to Posterior Heaven. In The Comprehensive Mirror of Taegeukdo, the diagrams of I-Ching Studies are reinterpreted according to Daesoon Thought. The Diagram of the Eight Trigrams of King Wen's Era corresponds to King Wen's Diagram of the Eight Trigrams in I-Ching Studies. This diagram was drawn according to the text in Chapter Five of the Treatise of Remarks on the Trigrams. This diagram corresponds to "the Era of the Nobility of Earth (地尊時代)" centered on the trigram kun (坤 / ☷ ground). Fuxi's Diagram of the Positions of the Eight Trigrams in I-Ching Studies corresponds to The Diagram of the Positions of the Eight Trigrams of Fuxi's Era in Daesoon Thought. The most significant feature of this diagram is that the trigrams assigned to the directions of north and south match the hexagram indicating the obstruction of Heaven and Earth. This is hexagram 12 (否), meaning "obstruction," and it depicts no exchange or communication between Yin and Yang. Naturally, this symbolizes mutual destruction overtaking Yin and Yang. Daesoon Thought expresses this as "the Era of the Nobility of Heaven (天尊時代)." The most significant feature of The Diagram of the Eight Trigrams of the Corrected Book of Changes in The Comprehensive Mirror of Taegeukdo is that the trigrams assigned to the directions of south and north are indicative of hexagram 11, Peace on Earth and in Heaven (泰). This is a diagram in which mutual destruction is resolved through the Five Phases because the trigrams for water (坎 / ☵) and fire (離 / ☲) are in a corrected orientation. Therefore, this diagram symbolizes a world "free from Mutual Contention" and "the Era of Human Nobility (人尊時代)." According to the contents of The Canonical Scripture, the Supreme God performed the Reordering Works of the Three Realms to correct the Mutual Contention of the Former World, and as a result, the Mutual Contention of the Former World will give way to the implementation of the Dao of Mutual Beneficence. The Supreme God's Reordering Works of the Three Realms have been completed in the realm of divine beings, but in the Later World, they appear as an Earthly Paradise where the Dao of Mutual Beneficence is realized. The diagram depicting the Later World is The Diagram of the Eight Trigrams of the Era of the Corrected Book of Changes in The Comprehensive Mirror of Taegeukdo.

Report about First Repeated Sectional Measurements of Water Property in the East Sea using Underwater Glider (수중글라이더를 활용한 동해 최초 연속 물성 단면 관측 보고)

  • GYUCHANG LIM;JONGJIN PARK
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.29 no.1
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    • pp.56-76
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    • 2024
  • We for the first time made a successful longest continuous sectional observation in the East Sea by an underwater glider during 95 days from September 18 to December 21 2020 in the Korea along the 106 Line (129.1 °E ~ 131.5 °E at 37.9 °N) of the regular shipboard measurements by the National Institute of Fishery Science (NIFS) and obtained twelve hydrographic sections with high spatiotemporal resolution. The glider was deployed at 129.1 °E in September 18 and conducted 88-days flight from September 19 to December 15 2020, yielding twelve hydrographic sections, and then recovered at 129.2 °E in December 21 after the last 6 days virtual mooring operation. During the total traveled distance of 2550 km, the estimated deviation from the predetermined zonal path had an average RMS distance of 262 m. Based on these high-resolution long-term glider measurements, we conducted a comparative study with the bi-monthly NIFS measurements in terms of spatial and temporal resolutions, and found distinguished features. One is that spatial features of sub-mesoscale such as sub-mesoscale frontal structure and intensified thermocline were detected only in the glider measurements, mainly due to glider's high spatial resolution. The other is the detection of intramonthly variations from the weekly time series of temperature and salinity, which were extracted from glider's continuous sections. Lastly, there were deviations and bias in measurements from both platforms. We argued these deviations in terms of the time scale of variation, the spatial scale of fixed-point observation, and the calibration status of CTD devices of both platforms.

Effects of Benzo〔a〕pyrene on Growth and Photosynthesis of Phytoplankton (식물플랑크톤의 성장과 광합성에 대한 benzo〔a〕pyrene의 영향)

  • Kim, Sun-Ju;Shin, Kyung-Soon;Moon, Chang-Ho;Park, Dong-Won;Chang, Man
    • Korean Journal of Environmental Biology
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    • v.22
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    • pp.54-62
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    • 2004
  • We examined the impacts of anthyopogenic pollutant (benzo〔a〕pyrene) on the growth and photosynthesis of five marine phytoplankton species (Skeletonema costatum, Heterosigma akashiwo, Prorocentrum dentatum, P. minimum, Aknshiwo sanguinea), which are dominant in Korean coastal water. After the 72 h exposure to benzo〔a〕pyrene, the dramatic decrease in cell numbers was observed in the range of 1 to 10 $\mu\textrm{g}$ L$^{-1}$ for S. costatum, P. minimum, P. dentatum, whereas for A. sanguinea and H. akashiwo at the low concentrations 0.1 to 1 $\mu\textrm{g}$ L$^{-1}$ . Among the 5 phytoplankton species, the highest growth inhibition concentration ($IC_{50}$/) was 6.20 $\mu\textrm{g}$ L$^{-1}$ for P. minimum, followed by 2.14 $\mu\textrm{g}$ L$^{-1}$ for P. dentatum, 1.68 $\mu\textrm{g}$ L$^{-1}$ for S. costatum, 0.74 $\mu\textrm{g}$ L$^{-1}$ for H. akashiwo, 0.10 $\mu\textrm{g}$ L$^{-1}$ for A. sanguinea. The five species exposed to the low concentration of 1 $\mu\textrm{g}$ L$^{-1}$ were recovered after transferring to new media, but the species exposed to the high concentrations of 10 and 100 $\mu\textrm{g}$ L$^{-1}$ were not recovered, with the exception of P. minimum. Those results indicate that the thecate dinoflagellate P. minimum is most tolerant to the chemical and the athecate dinoflagellate A. sanguinea is not. Geneyally, the cell-specific photosynthetic capacity of H. akashiwo exposed to the low concentrations of 0.1 and 1 $\mu\textrm{g}$ L$^{-1}$ was higher than that of the cells in the control, whereas the cells exposed to the high concentrations of 5 and 10 $\mu\textrm{g}$ L$^{-1}$ showed the negligible photosynthetic level by the first few days of the experiment. In the case of the cells exposed to the concentration of 5 $\mu\textrm{g}$ L$^{-1}$ , after 12 days of the experiment the photosynthetic capacity was increased toward the end of the experiment. This indicates that H. akashiwo may utilize the benzo〔a〕pyrene as a carton source for its growth when exposed to low concentrations. Results suggest that anthropogenic pollutants such as benzo〔a〕pyrene may have significant influence on the succession of phytoplankton species composition and the primary production in coastal marine environments.

Recent Research for the Seismic Activities and Crustal Velocity Structure (국내 지진활동 및 지각구조 연구동향)

  • Kim, Sung-Kyun;Jun, Myung-Soon;Jeon, Jeong-Soo
    • Economic and Environmental Geology
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    • v.39 no.4 s.179
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    • pp.369-384
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    • 2006
  • Korean Peninsula, located on the southeastern part of Eurasian plate, belongs to the intraplate region. The characteristics of intraplate earthquake show the low and rare seismicity and the sparse and irregular distribution of epicenters comparing to interplate earthquake. To evaluate the exact seismic activity in intraplate region, long-term seismic data including historical earthquake data should be archived. Fortunately the long-term historical earthquake records about 2,000 years are available in Korea Peninsula. By the analysis of this historical and instrumental earthquake data, seismic activity was very high in 16-18 centuries and is more active at the Yellow sea area than East sea area. Comparing to the high seismic activity of the north-eastern China in 16-18 centuries, it is inferred that seismic activity in two regions shows close relationship. Also general trend of epicenter distribution shows the SE-NW direction. In Korea Peninsula, the first seismic station was installed at Incheon in 1905 and 5 additional seismic stations were installed till 1943. There was no seismic station from 1945 to 1962, but a World Wide Standardized Seismograph was installed at Seoul in 1963. In 1990, Korean Meteorological Adminstration(KMA) had established centralized modem seismic network in real-time, consisted of 12 stations. After that time, many institutes tried to expand their own seismic networks in Korea Peninsula. Now KMA operates 35 velocity-type seismic stations and 75 accelerometers and Korea Institute of Geoscience and Mineral Resources operates 32 and 16 stations, respectively. Korea Institute of Nuclear Safety and Korea Electric Power Research Institute operate 4 and 13 stations, consisted of velocity-type and accelerometer. In and around the Korean Peninsula, 27 intraplate earthquake mechanisms since 1936 were analyzed to understand the regional stress orientation and tectonics. These earthquakes are largest ones in this century and may represent the characteristics of earthquake in this region. Focal mechanism of these earthquakes show predominant strike-slip faulting with small amount of thrust components. The average P-axis is almost horizontal ENE-WSW. In north-eastern China, strike-slip faulting is dominant and nearly horizontal average P-axis in ENE-WSW is very similar with the Korean Peninsula. On the other hand, in the eastern part of East Sea, thrust faulting is dominant and average P-axis is horizontal with ESE-WNW. This indicate that not only the subducting Pacific Plate in east but also the indenting Indian Plate controls earthquake mechanism in the far east of the Eurasian Plate. Crustal velocity model is very important to determine the hypocenters of the local earthquakes. But the crust model in and around Korean Peninsula is not clear till now, because the sufficient seismic data could not accumulated. To solve this problem, reflection and refraction seismic survey and seismic wave analysis method were simultaneously applied to two long cross-section traversing the southern Korean Peninsula since 2002. This survey should be continuously conducted.

A Study on Garden Design Principles in "Sakuteiki(作庭記)" - Focused on the "Fungsu Theory"(風水論) - (「사쿠테이키(作庭記)」의 작정원리 연구 - 풍수론(風水論)을 중심으로 -)

  • Kim, Seung-Yoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.6
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    • pp.1-19
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    • 2013
  • This study tries to review 'Sakuteiki(作庭記)', the Book of Garden Making, compiled at the end of the 11th Century during the Heian Period of Japan, from the East-Asian perspective. 'Sakuteiki' is a Garden Theory Book, the oldest in the world as well as in Asia, and it contains the traditional knowledge of Japanese ancient garden culture, which originated from the continent(Korea and China). Traditional knowledge related to East-Asian garden culture reviewed in this paper is "Fungsu Theory"(風水, Asian traditional ecology: Fengshui in Chinese; Fusui in Japanese), stemmed from the culture to seek sound and blessed places to live in. Viewed from modern landscape architecture, the Fungsu Theory corresponds to ecology(science). The Fungsu Theory was established around the Han Dynasty of China together with the Yinyangwuxing(陰陽五行) Theory and widely used for making human residences including gardens. It was transmitted to Japan via Korea as well as through direct transaction between Japan and China. This study reinterprets garden design principles represented in Sakuteiki, which were selected in 5 key words according to the Fungsu Theory. The 5 key words for the Fungsu Theory are "the place in harmony of four guardian gods(四神相應地)", "planting trees in the four cardinal directions", "flow of Chi(氣)", "curved line and asymmetry", and "mountain is the king, water is the people". Garden design principles of "the place in harmony of four guardian gods(四神相應地)" and "planting trees in the four cardinal directions" are corresponding to "Myeongdang-ron(明堂論, Theory of propitious site)". The place in harmony of four guardian gods mentioned in Sakuteiki is a landform surrounded by the flow of water to the east, the great path to the west, the pond to the south, and the hill to the north. And the Theory originated from Zhaijing(宅經, Classic of dwelling Sites) of China. According to this principle, the city was planned and as a miniature model, the residence of the aristocrat during the Heian period was made. At the residence the location of the garden surrounded by the four gods(the flow of water, the great path, the pond, and the hill) is the Myeongdang(明堂, the propitious site: Mingtang in Chinese; Meido in Japanese). Sakuteiki explains how to substitute for the four gods by planting trees in the four cardinal directions when they were not given by nature. This way of planting originated from Zhaijing(宅經) and also goes back to Qiminyaoshu (齊民要術), compiled in the 6th Century of China. In this way of planting, the number of trees suggested in Sakuteiki is related to Hetu(河圖) and Luoshu(洛書), which are iconography of Yi(易), the philosophy of change, in ancient China. Such way of planting corresponds to that of Yongdoseo(龍圖墅, the villa based on the principle of Hetu) presented in Sanrimgyeongje (山林經濟), an encyclopedia on agriculture and living in the 17th Century of Korea. And garden design principles of "the flow of Chi(氣)", "curved line and asymmetry" is connected to "Saenggi Theory(生氣論, Theory of vitality)". Sakuteiki explains the right flow of Chi(氣) through the proper flow and the reverse flow of the garden stream and also suggests the curved line of the garden stream, asymmetric arrangement of bridges and stones in the garden, and indented shape of pond edges, which are ways of accumulating Chi(氣) and therefore lead to "Saenggi Theory" of the Fungsu Theory. The last design principle, "mountain is the king, water is the people", is related to "Hyeongguk Theory(形局論, Theory of form)" of the Fungsu Theory. Sakuteiki explains the meaning of garden through a metaphor, which views mountain as king, water as the people, and stones as king's retainers. It compares the situation in which the king governs the people with the help of his retainers to the ecological phenomena in which mountain(earth) controls water with the help of stones. This principle befits "Hyeongguk Theory(形局論, Theory of form)" of the Fungsu Theory which explains landform on the analogy of social systems, people, animals and things. As above, major garden design principles represented in Sakuteiki can be interpreted in the context of the Fungsu Theory, the traditional knowledge system in East Asia. Therefore, we can find the significance of Sakuteiki in that the wisdom of ancient garden culture in East-Asia was integrated in it, although it described the knowhow of a specific garden style in a specific period of Japan.

Spatio-temporal Fluctuations with Influences of Inflowing Tributary Streams on Water Quality in Daecheong Reservoir (대청호의 시공간적 수질 변화 특성 및 호수내 유입지천의 영향)

  • Kim, Gyung-Hyun;Lee, Jae-Hoon;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.45 no.2
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    • pp.158-173
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    • 2012
  • The objectives of this study were to analyze the longitudinal gradient and temporal variations of water quality in Daecheong Reservoir in relation to the major inflowing streams from the watershed, during 2001~2010. For the study, we selected 7 main-stream sites of the reservoir along the main axis of the reservoir, from the headwater to the dam and 8 tributary streams. In-reservoir nutrients of TN and TP showed longitudinal declines from the headwater to the dam, which results in a distinct zonation of the riverine ($R_z$, M1~M3), transition ($T_z$, M4~M6), and lacustrine zone ($L_z$, M7) in water quality, as shown in other foreign reservoirs. Chlorophyll-a (CHL) and BOD as an indicator of organic matter, were maximum in the $T_z$. Concentration of total phosphorus (TP) was the highest (8.52 $mg\;L^{-1}$) on March in the $R_z$, and was the highest (165 ${\mu}g\;L^{-1}$) in the $L_z$ on July. Values of TN was the maximum (377 ${\mu}g\;L^{-1}$) on August in the $R_z$, and was the highest (3.76 $mg\;L^{-1}$) in the $L_z$ on August. Ionic dilution was evident during September~October, after the monsoon rain. The mean ratios of TN : TP, as an indicator of limiting factor, were 88, which indicates that nitrogen is a surplus for phytoplankton growth in this system. Nutrient analysis of inflowing streams showed that major nutrient sources were headwater streams of T1~T2 and Ockcheon-Stream of T5, and the most influential inflowing stream to the reservoir was T5, which is located in the mid-reservoir, and is directly influenced by the waste-water treatment plants. The key parameters, influenced by the monsoon rain, were TP and suspended solids (SS). Empirical models of trophic variables indicated that variations of CHL in the $R_z$ ($R^2$=0.044, p=0.264) and $T_z$ ($R^2$=0.126, p=0.054) were not accounted by TN, but were significant (p=0.032) in the $L_z$. The variation of the log-transformed $I_r$-CHL was not accounted ($R^2$=0.258, p=0.110) by $I_w$-TN of inflowing streams, but was determined ($R^2$=0.567, p=0.005) by $I_w$-TP of inflowing streams. In other words, TP inputs from the inflowing streams were the major determinants on the in-reservoir phytoplankton growth. Regression analysis of TN : TP suggested that the ratio was determined by P, rather than N. Overall, our data suggest that TP and suspended solids, during the summer flood period, should be reduced from the eutrophication control and P-input from Ockcheon-Stream should be controlled for water quality improvement.

Role of Invasive Procedures in the Diagnosis and Management of Pulmonary Infiltrates in Patients with Leukemia (백혈병 환자에서 발생한 폐침윤의 진단 및 치료에 있어 침습적 검사의 역할)

  • Kang, Soo-Jung;Park, Sang-Joon;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.448-463
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    • 2000
  • Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

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