• Radiation Oncology Journal
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• v.17 no.2
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• pp.172-178
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• 1999

Purpose : To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipments and patient loads between Korea and developed countries. Methods and Materials : Mail serveys we conducted in 1998 and data on treatment machines, personnel and peformed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole country were summarized using Microsoft Excel program. Results: In Korea during 1997, 42 facilities delivered megavoltage radiation theraphy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelators at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator, Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. Conclusions : The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there were a lot of hospitals which did not employ medical physicists.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.75-85
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• 2005

Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.127-135
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• 2000

Purpose: Cyclosporine(CsA) is a potent immunosuppressant but the use of CsA is associated with various side effects, especially nephrotoxicity. In tile kidney, salt depletion activates tile renin-angiotensin-aldosteron(RAS) system and accentuates chronic CsA nephropathy. We postulate that angiotensin converting enzyme inhibitors(ACEI) can prevent chronic CsA nephropathy, since ACEI may inhibit this cascades. This study was aimed to assess the effect of ACEI on chronic cyclosporin nephropathy in salt depleted rats. Methods: 36 Fischer-344 rats were divided into 6 goups. Group I received normal salt diet(NSD). Group II received a low salt diet(LSD). Group III received CsA with a NSD. Group IV received CsA with a LSD. Group V received NSD+CsA with ACEI. Group VI received LSD+CsA with ACEI. Rats were sacrificed after six weeks and the glomerular filtration rate(GFR), serum sodium, potassium and whole blood cyclosporine levels were measured. Renal tissues me sampled for the observation of histological changes. Results: No differences in blood CsA level & serum sodium were found between groups during the course of this experiment. Serum potassium in group VI was significantly increased compared with group IV and V (P<0.05). In groups treated with CsA only and in those where CsA was combined with ACEI, GFR was found to be significantly more decreased in LSD than NSD, and GFR in group V was significantly decreased in comparison with group III (P<0.05). Renal histologic lesions associated with CsA which consisted of cortical interstitial fibrosis, tubular atrophy and hyalinization of arterioles were more severe in tile LSD group. But, no differences were observed between tile groups treated with CsA and ACEI, and the groups treated with only CsA. Conclusion: Salt depletion associated with the activation of the RAS system accentuated chronic CsA nephrotoxicity, but, ACEI could not reduce the functional and morphological changes of salt depleted kidneys, in which nephropathy can be exacerbated in spite of the blocking of the angiotensin II pathway. further studies are required to elucidate whether Am ameliorated the effect of salt-depleted CsA nephrotoxicity upon the effective renal blood flow.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.404-415
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• 1978

The present study was carried out to develop the better measures for safety of open heart surgery under extracorporeal circulation (ECC) with Heart-Lung-Machine by preventing changes in the concentrations of serum electrolytes during and after ECC. For this purpose, the cocentrations of serum electrolytes were measured before, during, and after ECC in 21 patients with congenital and acquired heart diseases who received open heart surger, - under ECC using Heart-Lung-Machine. Also considered was the development of safety measured by which changes in serum electrolyte concentrations were prevented during and after open heart surgery under ECC. The mean values for serum sodium levels were observed to be ; $13.14{\pm}0.47$mEq./L. for the samples obtained before ECC. $139.59{\pm}0.68$mEq./L. for the samples obtained 10 minutes after ECC and $138.0{\pm}0.68$mEq./L. for the samples obt"ined 24 hours after ECC. These results indicate that serum sodium concentrations were \\'ithin normal range during and until 24 hours after ECC. 2) The concentrations of serum chloride were found to be $105.38{\pm}0.70$105.38$\pm$0. 70 mEq./L. for the samples collected before ECC, $105.07{\pm}1.01$mEq./L. for the Simples collected 24 minutes aiter ECC and $101.95{\pm}1.09$mEq./L. for the samples collectect 24 hours afte ECC. As was tile case with serum sodium levels, no significant changes were observed in serum chloride levels during and 24 hours after ECC. 3)With proper provisions of potassium chloride solution during ECC, the concentrations of serum potassium were found to be $4.22{\pm}0.06$mEq./L. for the samples removed before EeC, $4.06{\pm}0.14$mEq./L. for the samples removed 10 minutes after ECC and $4.39{\pm}0.07$ mEq./L. for the samples removed 24 hours after ECC. 4)The concentrations of serum calcium were also maintained within normal during and after ECC; $9.15{\pm}0.14$mg/dl for the serum collected before ECC, $8.36{\pm}0.21$mg/dI for the serum collected 10 minutes after ECC and $8.47{\pm}0.14$mg/dl 21 hours after ECC. The maintenance of serum calcium level within normal throughout ECC was achieved by parenteral administrations of calcium gluconate as frequent as required. 5) As were the cases with serum potassium and calcium, the concentrations of plasma bicarbonate was regulated within normal range during and after ECC, only when sodium bicarbonate solution was admini"tered parenterally as it was required; $23.7{\pm}0.50$mEq./L. for the serum collected before ECC. $22.33{\pm}1.09$mEq.lL. for the serum collected 10 minutes after ECC and $25.3{\pm}0.96$mEq./L. for the serum collected 24 hours after ECC. The above results indicate tha t during and after ECC serum sodium and chloride levels remined unchanged without any provision of normal saline, while serum potassium, calcium, and bicarbonate concentrations were kept within normal limits only when these ealectrolytes were administered through parenteral routes. With these results it can be concluded that serum potassium, calcium, and bicarbonate levels should be determined as often as possible during and after ECC and that in order to maintain serum electrolyte levels within normal these electrolytes in the forms of potassium chloride, calcium gluconate, and sodium bicarbonate shou'd be given parenterally as they were found to be required.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.691-701
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• 2004

Background: Tissue hypoxia is a characteristic of many human malignant neoplasms, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increased oxygen delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1 a has been reported in many human malignancies, but in esophageal squamous cell carcinoma, the influence of HIF-1 a on tumor biology, including neovascularization, is not still defined. Material and Method: The influence of HIF-1 a expression on angiogenic factors, correlation between the tumor proliferation and HIF-1 a expression, interaction of HIF-1 a expression and p53, and correlation between HIF-1 a expression and clinicopathological prognostic parameters were investigated, using immunohistochemical stains for HIF-1 a, VEGF, CD34, p53, and Ki-67 on 77 cases of resected esophageal squamous cell carcinoma. Result: HIF-1 a expression in cancer cells was found in 33 of 77 esophageal squamous cell carcinoma cases. The 33 cases (42.9%) showed positive stain for HIF-1 a. High HIF-1 a expression was significantly associated with several pathological parameters, such as histologic grade (p=0.032), pathological TMN stage (p=0.002), the depth of tumor invasion (p=0.022), regional lymph node metastasis (p=0.002), distant metastasis (p=0.049), and lymphatic invasion (p=0.004). High HIF-1 a expression had significant VEGF immunoreactivity (p=0.008) and Ki-67 labeling index (p<0.001), but was not correlated with microvascular density within tumors (p=0.088). The high HIF-1 a expression was correlated with aberrant p53 accumulation with a marginal significance (p=0.056). The overall 5-year survival rate was 34.9%. The survival rate of patients with a high HIF-1 a expression was worse than that of patients with low-expression tumors (log-rank test, p=0.0001). High HIF-1 a expression was independent unfavorable factors although statistical significance is marginal in multivariate analysis. Conclusion: It is suggested that (1) high HIF-1 a expression in esophageal squamous cell carcinoma is associated with tumor hypoxia, or with genetic alteration in early carcinogenesis and progressive stages, (2) high HIF-1 a expression may be associated with intratumoral neovascularization through HIF-VEGF pathway, and (3) high HIF-1 a expression is associated with poor prognosis in patients with esophageal squamous cell carcinoma and may playa role as biomarker for regional lymph node metastasis.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.175-181
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• 1989

Visual assessment of regional wall motion abnormality (RWMA) by gated blood pol scan (GBPS) serves as an useful parameter in the diagnosis, functional evaluation, and follow up in various clinical settings, but are still subject to some inherent limitations. On important problem may be the interobserver as well as intraobsever variation that may well be present due to the subjective nature of the interpretations. This study was carried out to determine the reliability and reproducibility of visual assessments made in GBPSs, and to observe the degree to which the results would be influenced by observer variation. Fifty two patients with coronary heart disease had resting GBPS and contrast ventriculography within 4 days appall. Contrast ventriculography-showed normal wall motion in 6 patients and the remaining 46 had RWMA in one or more segments. The anterior and left anterolateral views of all 52 GBPSs were analyzed by three independent observers, who selected from 5 scales, their level of confidence that there was RWMA in that segment. Reciever operating characteristic (ROC) curves for each analysis was plotted and the area under the curve $(\theta)$ was used as a parameter representing each observer's performance in his interpretations. The findings of contrast ventriculographies were used as the standard for RWMA. The apical and inferoapical segments showed the best correlation with contrast ventriculography ($\theta=0.90-0.94$, 0.81-0.94, respectively), and the inferior wall showed the poorest correlation $(\theta=0.70-0.74)$. The interpretations of the inferior, septal, apical, and posteroinferior, segments showed no difference between the observers, but there was significantly better performance in assessment by observer A compared to that by B or C for the anterolateral segments ($\theta=0.87$, 0.78, 0.76, respectively. p<0.01 for A vs B, p<0.05 for A vs C), as well as when all segments were considered altogether ($\theta=0.88$, 0.83, 0.82, respectively. both p<0.05). This was also true for the infero-apical segment between A and C ($\theta=0.09$, 0.81, p<0.05). The intraobserver variation, however, did not appear significant, with only the inferior segment for observer B showing any significant difference when observer A and B repeated the analysis 10 days latter. There was no difference in assessing dyskinesia, with all observers showing a high performance ($\theta=0.98$, 0.87, 0.97, respectively). The visual assessment of left ventricular ejection fraction by all three observers correlated well with the calculated value from a semiautomated method (Spearman's r = 0.91, 0.83, 0.83. p<0.01, p<0.05, p < 0.05). The assessment of LV and RV size also correlated well between the three observers (Kendall's w = 0.80, 0.51, p<0.01 for both left and right ventricles). The above findings suggest that RWMA visually assessed by GBPS correlates well with that done by contrast ventriculography. And although the observer's experience or skill may influence the results in certain segments, visual analysis of GBPS may serve as a reliable and reproducible means for evaluating ventricular function.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.40-48
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• 1999

Purpose: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. Materials and Methods: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. Results: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. Conclusion: These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.

• Journal of The Korean Society of Grassland and Forage Science
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• v.35 no.1
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• pp.12-16
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• 2015

This study was carried out to evaluate accurately physical characteristics of total mixed rations (TMR) by investigating the effects of physically effective neutral detergent fiber content on the growth performance and carcass characteristics in fattening steers. Twelve Hanwoo (Bos Taurus coreanae) steers aged 26 months were used in this trial. Steers were offered one of two total mixed ration (TMR) diets - High or Low physically effective neutral detergent fiber (peNDF) content groups-that were differentiated by mixing time. The carcass traits of the experimental animals were evaluated by Korea Institute for Animal Products Quality Evaluation (KAPE) after slaughter. Body weight gain during the experimental period was significantly higher (P<0.05) in the High group ($30.00{\pm}10.27kg$) compared with the Low group ($17.20{\pm}6.34kg$), and daily weight gain was also high in the former. Although there was no significant difference, the carcass weight was higher in the High group ($414.60{\pm}34.28kg$) compared with the Low group ($377.80{\pm}11.97kg$). However, the beef quality grade of the Low group ($1^{++}$) was higher than that of the High group ($1^+$). Increases in body weight gain, daily gain, and carcass weight for the High group were mainly influenced by a high level of dry matter (DM) intake and digestibility; consequently, back-fat thickness increased and the beef quality grade was lowered. Because growth performance and carcass characteristics were affected by the physical traits of the diet, we suggested that proper peNDF content is also needed for fattening steers.

• Journal of The Korean Society of Grassland and Forage Science
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• v.27 no.4
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• pp.297-312
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• 2007

This study is conducted to evaluate economical value of Jeju grassland and validity of its preservation, and draw up several measures to support. To measure its economical value, this study examined its environmental value and social and cultural value. For environmental value, this study used replacement method while it applied CVM method, a widely used method, to assess social and cultural value and two-level two-best choice selection method, which ask questions by assuming virtual circumstances to avoid reflecting some biased opinions. Jeju grassland has multiple functions-environmental functions such as preventing soil corrosion and flood, handling animal excrement, and purifying air, and social and cultural functions such as promoting physical and mental health and providing recreation places. From the results of the feasibility study, Jeju grassland's annual multiple functions are assessed to have a total $397,115{\sim}418,995$ million won worth. In addition, it is found that Jeju visitors recognize Jeju grassland for its functions to contribute to public interests. That is, they think it can provide attractive views and educational and recreational places and promote emotional development. Especially, many people presented their ideas that it be continuously preserved since it is worthwhile for us and our next generations. To preserve grassland's cultural resource, which create a huge economic value like this, the Government has to support a certain amount of financial aid for turning to a better grassland environment and its maintenance to realize environment-friendly livestock farming on Jeju Island and promote its tourism industry and consequently, add more value to Jeju.

• Korean Journal of Ecology and Environment
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• v.38 no.2 s.112
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• pp.196-206
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• 2005

The fish community in the mid-upper region of Gam Stream was examined seasonally from 2001 to 2003 in order to perform an environmental impact assessment prior to a construction of Gamcheon Multipurpose Dam. Additional investigation was conducted in August 2004 to confirm the fish fauna reported and to examine the ecological characteristics of Zacco temminckii population. The total number of fish caught from the study sites was 1,081 fish representing 5 families 14 species. There were 6 Korean endemic species including Coreoleuciscus splendidus, Squalidus gracilis majimae, Microphysogobio yaluensis, Liobagrus mediadiposalis, Coreoperca herzi and Odontobutis platycephala, but no endangered or vulnerable species were found. Length-weight relation, condition factor (K) and relative condition factor (Kn) of Zacco temminckii were compared by the study sites and stream. The equations based on length-weight relation in Buhang and Gam Streams were TW\;=\;0.000004TL^{3.2357}$ and TW\;=\;0.000002TL^{3.3566}$, respectively indicating the fish in Gam Stream became more rotund as length increases. The condition factor (K) and relative condition factor (Kn) against total length of Zacco temminckii at two streams indicated that the fish (>70 mm) in Cam Stream (mean K and Kn= 1.116, 1.21 respectively) had better nutritional condition than those in Buhang Stream (mean K and Ln = 1.046, 1.14 respectively). The results were corresponded with natural disturbances such as drought and intensive rainfall from 2001 to 2003 followed by human activities such as stream repair works. Therefore, it is considered to perform environmental impact assessment with not only confirmation of fish composition but also examination of ecological characteristics in population- level.