• Tuberculosis and Respiratory Diseases
• /
• v.45 no.4
• /
• pp.754-759
• /
• 1998

Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.6
• /
• pp.1178-1187
• /
• 1998

Background : Recently the incidence of tuberculosis is increasing in many countries and control of the disease is further threatened by the emergence of multi-drug resistant tuberculosis. So rapid detection of drug resistance is very important. Pyrazinamide (PZA) is a first-line chemotherapeutic agent for tuberculosis. Now in Korea, we perform PZase activity test instead of actual pyrazinamide susceptibility test for the detection of PZA resistant M. tuberculosis. Recently the pncA gene, encoding the PZase of M. tuberculosis, was completely sequenced. And it was reported that the mutation of pncA gene would be associated with PZA resistance of M. tuberculosis. Therefore we performed this study to evaluate the possibility for the rapid detection of PZA resistant M. tuberculosis using PCR-SSCP of pncA gene. Method : 44 cultured clinical isolates of M. tuberculosis, BCG Tokyo strain. BCG French strain, and one M. bovis isolate were studied. We used H37Rv as the reference strain, The PZase activity test was done at the reference laboratory of Korean Tuberculosis Institute. DNA was extracted by bead-beater method and 561 bp fragment including pncA gene was amplified by PCR. The PCR product were digested by BstB I enzyme. SSCP was done using MDE gel. Of the 44 strains of M. tuberculosis, 22 strains were PZase-positive and other 22 strains were PZase negative. Results : Of the 22 PZase positive strains, 18 strains(82%) showed the same mobility compared with that of H37Rv and 4(18%) showed different mobility. Of the 22 PZase-negative strains, 19(86%) strains showed the same mobility pattern compared with that of H37Rv and 3(14%) showed different mobility. Naturally PZA-resistant BeG-French strain, BCG-Tokyo strain, and one M. bovis isolate showed the same band pattern each other, but their mobility were different from that of H37Rv. The results of PZase activity test and PCR-SSCP of pncA of M. tuberculosis were statistically significantly correlated each other (p<0.01). Conclusion : The PCR-SSCP after BstB I restriction of pncA gene of M. tuberculosis may be a useful method for the rapid detection of PZA-resistant M. tuberculosis.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.4
• /
• pp.776-784
• /
• 1998

Background: The cyclin D1 gene is one of the most frequently amplified chromosomal regions(11q13) in human carcinomas. In laryngeal and head and neck carcinomas, its overexpression has been shown to be associated with advanced local invasion and presence of lymph node metastases. Cyclin D1 may therefore playa key role in cell growth regulation and tumorigenesis. Lung cancer is a worldwide problem and in many contries it is the most lethal malignancy. As relapse is frequent after resection of early stage non-small cell lung cancer, there is an urgent need to define prognostic factors. Purpose: This study was undertaken to evaluate the prognostic value of the cyclin D1, that is one the G1 cyclins which control cell cycle progression by allowing G1 to S phase transition, on the patients in radically resected non-small cell lung cancer. Method: Total 81 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from January 1, 1983 to July 31, 1995 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for cyclin D1. Results : The histologic classification of the tumor was based on WHO criteria, and the specimens included 45 squamous cell carcinomas, 25 adenocarcinomas and 11 large cell carcinomas. Cyclin D1 overexpression was noted in 26 cases of 81 cases tested (30.9%). Cyclin D1 expression was not significantly associated with cell types of the tumor, pathological staging and the size of the tumor. But cyclin D1 overexpression was significantly correlated with positive lymph node metastasis(p=0.035). The mean survival duration was $22.76{\pm}3.50$ months in cyclin D1 positive group and $45.38{\pm}5.64$ months in eyclin D1 negative group. There was a nearly significant difference in overall survival between cyclin D1 positive and negative groups(p=0.0515) in radically resected non-small cell lung cancer. Conclusion: Based on this study, cyelin D1 overexpression appears an important poor prognostic indicator in non-small cell lung cancer and may have diagnostic and prognostic importance in the treatment of resectable non-small cell lung cancer.

• The Transactions of the Korea Information Processing Society
• /
• v.1 no.3
• /
• pp.367-379
• /
• 1994

This paper describes scheduling algorithms of the UNIX operating system and shows an analytical approach to approximate the average conditional response time for a process in the UNIX operating system. The average conditional response time is the average time between the submittal of a process requiring a certain amount of the CPU time and the completion of the process. The process scheduling algorithms in thr UNIX system are based on the priority service disciplines. That is, the behavior of a process is governed by the UNIX process schuduling algorithms that (ⅰ) the time-shared computer usage is obtained by allotting each request a quantum until it completes its required CPU time, (ⅱ) the nonpreemptive switching in system mode and the preemptive switching in user mode are applied to determine the quantum, (ⅲ) the first-come-first-serve discipline is applied within the same priority level, and (ⅳ) after completing an allotted quantum the process is placed at the end of either the runnable queue corresponding to its priority or the disk queue where it sleeps. These process scheduling algorithms create the round-robin effect in user mode. Using the round-robin effect and the preemptive switching, we approximate a process delay in user mode. Using the nonpreemptive switching, we approximate a process delay in system mode. We also consider a process delay due to the disk input and output operations. The average conditional response time is then obtained by approximating the total process delay. The results show an excellent response time for the processes requiring system time at the expense of the processes requiring user time.

• Korean Journal of Biological Psychiatry
• /
• v.14 no.2
• /
• pp.91-98
• /
• 2007

Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

• Journal of dental hygiene science
• /
• v.6 no.2
• /
• pp.55-63
• /
• 2006

The purpose of this study was to provide the basic data for preventing dental caries, and maintaining and enhancing oral health. The subjects of this study were 138 male and female students who were in the 6th grade of elementary schools in Gimpo city. This study investigated the number of decayed tooth and the factors related to the number of decayed tooth, by using the results of questionnaire and oral health survey over such subjects. So, this study obtained the following conclusions. 1. For the number of decayed tooth, 'nothing(D = 0)' was the highest as 37.7%, and 'from two to three' was 23.9%, 'more than four' was 21%, and 'one' was 17.4% in order. 2. For the frequency of visiting dental clinics within the last one year, 'one to two times' was the highest as 52.2%, and the children who have not visited dental clinics even one time during one year were 23.9%. 3. For average daily tooth brushing frequency, 'two times' was the highest as 71.7%. For the use of oral health devices besides toothbrushes, 'I don't use' was the highest as 54.3%. For the experience of sealant and fluoride application, 'nothing' was the highest as 86.9% and 71.3% respectively. For the recognition on the use of fluoride dentifrice, 'I don't know' was the highest as 66.9%. 4. The socio-demographic factors related to the number of decayed tooth were mother's age, mother's background, mother's employment, and after-school fosterer(p > 0.05). 5. The oral health care factors related to the number of decayed tooth were average daily tooth brushing frequency, the use of oral health devices besides toothbrushes, and the experience of fluoride application.(p > 0.05) 6. The snack intake factors related to the number of decayed tooth were tooth care foods intake frequency and decaying foods intake frequency(p > 0.05). 7. The oral health belief item related to the number of decayed tooth was susceptibility(p > 0.05). 8. According to the results of regression analysis, the less mother was employed, the more the average daily tooth brushing frequency was, the more the tooth care foods intake frequency was, the less the decaying foods intake frequency was, and the higher susceptibility was, the lower the number of decayed tooth. 9. In order to prevent and cure early the dental caries which occur frequently in elementary school students, the establishment of oral health centers within schools should be expanded to promote tooth brushing instruction, fluoride solution rinsing, diet control, periodic oral examination.

• Journal of agricultural medicine and community health
• /
• v.31 no.3
• /
• pp.263-273
• /
• 2006

Objectives: This study was conducted to investigate the trend of health statue of the elderly living in rural area according to drinking patterns. Methods: This study was conducted with 2,421 elderly people (male 1,273 and female 1,148) residing in the selected 25 villages, with exclusion of a few elderly people who were in hospital, out for a long time or had an unknown address. This study were carried out, face-to-face interviews with the subjects were made from January to March 2002. Results: The investigation of drinking state showed that for male subjects, drinkers accounted for 48.8%, nondrinkers 35.1% and abstainers from drinking 16.1%, whereas for female subjects, drinkers accounted 15.3%, nondrinkers 80.2% and abstainers from drinking 4.5%. The health status was analyzed according to drinking pattern. For elderly men, abstainers from drinking showed worse health state than nondrinkers and drinkers. Elderly women showed the same result. It is widely known that drinking are the important causes of chronic diseases. Therefore, it is needed to provide the elderly with education on control of preventable health risk factors and effect of living state on health, in order to prevent aggravation of health level of the elder population aged 65 and over. This will also help them promote their health. It will be desirable that for the elderly, the objective will focus on health promotion rather than treatment of diseases. Conclusions: Carry out health plan for rural communities and health maintenance programs and health promotion of the elderly in those communities shall be developed. In addition, preventive education and health examination shall be conducted more frequently with the elderly who drink but are still healthy.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.6
• /
• pp.1245-1255
• /
• 1997

Background : Rifampicin(RFP) is a key component of the antituberculous short-course chemotherapy and the RFP resistance is a marker of multi-drug resistant(MDR) tuberculosis. RPoB gene encodes the $\beta$-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. And rpoB gene mutations are the cause of RFP resistance of M. tuberculosis. Although several reports showed that PCR-SSCP would be a rapid diagnostic method for identifying the RFP resistance, there were few reports Performed using direct, clinical specimens. So we Performed PCR-SSCP analysis of rpoB gene of M. tuberculosis in direct, clinical specimens. Methods : 75 clinical specimens were collected from patients at Asan Medical Center from June to August 1996. After PCR of IS 6110 fragments, 43 both AFB smear-positive and IS6110 fragment PCR-positive specimens were evaluated. The RFP susceptibility test was referred to the referral laboratory of the Korean Tuberculosis Institute. DNA was extracted by bead beater method. And heminested PCR was done using 0.1ul(1uCi) [$\alpha-^{32}P$]-dCTP. SSCP analysis was done using non-denaturating MDE gel electrophoresis. Results : The results of PCR of IS6110 fragments of M. tuberculosis were positive in 55(73%) cases of 75 AFB smear-positive clinical specimens. Of the 55 specimens, RFP susceptibility was confirmed in only 43 specimens. Of the 43 AFB smear-positive and IS6110 fragment-positive specimens, 29 were RFP susceptible and 14 were RFP resistant. All the RFP susceptible 29 strains showed the same mobility compared with that of RFP sensitive H37Rv in SSCP analysis of ropB gene. And all the other RFP resistant 13 strains showed the different mobility. In other words they showed 100% identical results between PCR-SSCP analysis and traditional susceptibility test. Conclusion : The PCR-sseP analysis of rpoB gene in direct clinical specimens could be used as a rapid diagnostic method for detecting RFP resistant M. tuberculosis.

• Journal of Gastric Cancer
• /
• v.8 no.4
• /
• pp.250-255
• /
• 2008

Purpose: The purpose of this study was to assess the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for detecting the lymph node (LN) metastasis of gastric cancer. Materials and Methods: 119 patients (M : F=89 : 30; mean age: 64) with gastric cancer were referred for preoperative FDG-PET/CT scanning and spiral enhanced abdominal pelvic CT from June 2006 to July 2008, and these were the subjects of our study. All the patients underwent curative radical gastrectomy and lymph node dissection. A final diagnosis was made for all the patients by the histology of the surgical specimens. Results: Both PET/CT and enhanced CT showed similar sensitivity for detecting regional lymph node metastasis (32.6% vs 39.5%, respectively). PET/CT was more accurate than enhanced CT for detecting regional lymph node metastasis (67.2% vs 63.0%, respectively), and PET/CT showed better specificity (86.8% vs 76.3, respectively) and a better positive predictive value (PPV) (58.3% vs 48.6%, respectively). PET/CT showed better specificity (98.0% vs 88.2%, respectively) and accuracy (79.4% vs 73.9%, respectively) than enhanced CT for detecting early gastric cancer. PET/CT showed better specificity (64.0% vs 52.0%, respectively), a better PPV (60.9% vs 57.1%), a better negative predictive value (NPV) (48.5% vs 46.4%, respectively) and better accuracy (53.6% vs 51.8%, respectively) than enhanced CT for detecting advanced gastric cancer. Conclusion: FDG-PET/CT is more usefulness than enhanced CT for making the preoperative diagnosis of regional LN metastases from gastric cancers.

• Pediatric Infection and Vaccine
• /
• v.22 no.3
• /
• pp.154-163
• /
• 2015

Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.