• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.44-51
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• 1997

Background : The changes of the composition in the T-lymphocyte are important as an immunological abnormality in the pathogenesis of tuberculosis. Previously, the second type of TCR dimer(${\gamma}{\delta}$ T lymphocyte) that did not express CD4 or CD8 molecules was found. In other reports the presence of this type of lymphocytes was increased in the initial stage of tuberculous infections. Method : To determine whether there are some differences in the T-lymphocyte subsets in the peripheral blood or pleural effusion between pleural tuberculosis and other pleurisy. Thirty patients with pleural effusion among the forty-nine patients were examined T-lymphocyte subset analysis(CD4+T-cell,CD8+ T-cell,${\gamma}{\delta}$ T-lymphocytes) with anti- Leu4, anti-Leu3a, anti-Lea2a, anti HLA-DR and anti-TCR-${\gamma}{\delta}$-1(Becton & Dickinson Co.). Results : The average age of the patients was 50 years old(17-81year). There were 33 males and 16 female patients. Patiensts with tuberculosis are 30cases(tuberculous pleurisy 15), lung cancer 12cases(malignant effusion 9) and pneumonia 7cases(parapneumonic effusion 6cases) In T lymphocyte subsets of pleural effusion, helper T lymphocyte(54.6 + 13.8 %) of tuberculous pleurisy was higher than that(36.2 + 25.3 %) of non-tuberculous pleurisy(p=0.04). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes in tuberculousis was insignificantly higher than non-tuberculous patients(p= 0.24). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes and pleural ${\gamma}{\delta}$ T-Iymphocytes in tuberculous pleurisy was insignificantly higher than in non-tuberculous pleurisy(p= 0.16, p= 0.12). Conclusion : The percentage of -${\gamma}{\delta}$ T lymphocytes among the total T-lymphocytes is not significantly increased in the peripheral blood or pleural effusion of the pleural tuberculosis. ${\gamma}{\delta}$ T lymphocytes is less useful as a diagnostic method of pleural tuberculosis.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.93-106
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• 2003

Objectives: This study was conducted to investigate the treatment status and its related factors of the rural hypertensives. Methods: A questionnaire survey was performed to 618 rural hypertensives during September, 2002. Results: The proportion of those who were compliant to the antihypertensive medication was 68.9%. The compliance rate to the antihypertensive medication was significantly related with sex and economic status(p<0.05). That is, if they were female, higher economic level, the regular antihypertensive medication rate was higher. The regular antihypertensive medication rate was higher when they had higher knowledge for hypertension, higher severity for hypertension of him or her(p<0.01). And the compliance rate to the antihypertensive medication was significantly related with hypertensives' own explanatory model for hypertension(p<0.01). The rate of drug use except antihypertensives was 12.5%. The rate of drug use except antihypertensives was higher when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rate of medical equipment use was 18.9%. The utilization rate of medical equipment such as jade mat, germanium material was significantly related with age, experience of side effects of antihypertensive drug, medication status for antihypertensive drug(p<0.05). The rate of folk therapy use was 16.2%. The rate of folk therapy use was higher when they had no family, when they had knowledge about hypertension on the average, when they had hypertension over 10 years(p<0.05), and when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rates of drug use except antihypertensives, medical equipment use, and folk therapy were significantly related with hypertensives' own explanatory model for hypertension(p<0.05). Conclusions: On consideration of above findings, it would be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• Journal of Distribution Research
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• v.16 no.4
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• pp.1-27
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• 2011

Introduction: Sales of private labels(PU have been growing m recent years. Globally, PLs have already achieved 20% share, although between 25 and 50% share in most of the European markets(AC. Nielson, 2005). These products are aimed to have comparable quality and prices as national brand(NB) products and have been continuously eroding manufacturer's national brand market share. Stores have also started introducing premium PLs that are of higher-quality and more reasonably priced compared to NBs. Worldwide, many retailers already have a multiple-tier private label architecture. Consumers as a consequence are now able to have a more diverse brand choice in store than ever before. Since premium PLs are priced higher than regular PLs and even, in some cases, above NBs, stores can expect to generate higher profits. Brand extensions and private label have been extensively studied in the marketing field. However, less attention has been paid to the private label extension. Therefore, this research focuses on private label extension using the Multi-Attribute Attitude Model(Fishbein and Ajzen, 1975). Especially there are few studies that consider the hierarchical effect of the PL's two parent brands: store brand and the original PL. We assume that the attitude toward each of the two parent brands affects the attitude towards the extended PL. The influence from each parent brand toward extended PL will vary according to the perceived fit between each parent brand and the extended PL. This research focuses on how these two parent brands act as reference points to one another in the consumers' choice consideration. Specifically we seek to understand how store image and attitude towards original PL affect consumer perceptions of extended premium PL. How consumers perceive extended premium PLs could provide strategic suggestions for retailer managers with specific suggestions on whether it is more effective: to position extended premium PL similarly or dissimilarly to original PL especially on the quality dimension and congruency with store image. There is an extensive body of research on branding and brand extensions (e.g. Aaker and Keller, 1990) and more recently on PLs(e.g. Kumar and Steenkamp, 2007). However there are no studies to date that look at the upgrading and influence of original PLs and attitude towards store on the premium PL extension. This research wishes to make a contribution to this gap using the perceived fit difference between parent brands and extended premium PL as the context. In order to meet the above objectives, we investigate which factors heighten consumers' positive attitude toward premium PL extension. Research Model and Hypotheses: When considering the attitude towards the premium PL extension, we expect four factors to have an influence: attitude towards store; attitude towards original PL; perceived congruity between the store image and the premium PL; perceived similarity between the original PL and the premium PL. We expect that all these factors have an influence on consumer attitude towards premium PL extension. Figure 1 gives the research model and hypotheses. Method: Data were collected by an intercept survey conducted on consumers at discount stores. 403 survey responses were attained (total 59.8% female, across all age ranges). Respondents were asked to respond to a series of Questions measured on 7 point likert-type scales. The survey consisted of Questions that measured: the trust towards store and the original PL; the satisfaction towards store and the original PL; the attitudes towards store, the original PL, and the extended premium PL; the perceived similarity of the original PL and the extended premium PL; the perceived congruity between the store image and the extended premium PL. Product images with specific explanations of the features of premium PL, regular PL and NB we reused as the stimuli for the Question response. We developed scales to measure the research constructs. Cronbach's alphaw as measured each construct with the reliability for all constructs exceeding the .70 standard(Nunnally, 1978). Results: To test the hypotheses, path analysis was conducted using LISREL 8.30. The path analysis for verification of the model produced satisfactory results. The validity index shows acceptable results(${\chi}^2=427.00$(P=0.00), GFI= .90, AGFI= .87, NFI= .91, RMSEA= .062, RMR= .047). With the increasing retailer use of premium PLBs, the intention of this research was to examine how consumers use original PL and store image as reference points as to the attitude towards premium PL extension. Results(see table 1 & 2) show that the attitude of each parent brand (attitudes toward store and original pL) influences the attitude towards extended PL and their perceived fit moderates these influences. Attitude toward the extended PL was influenced by the relative level of perceived fit. Discussion of results and future direction: These results suggest that the future strategy for the PL extension needs to consider that positive parent brand attitude is more strongly associated with the attitude toward PL extensions. Specifically, to improve attitude towards PL extension, building and maintaining positive attitude towards original PL is necessary. Positioning premium PL congruently to store image is also important for positive attitude. In order to improve this research, the following alternatives should also be considered. To improve the research model's predictive power, more diverse products should be included in study. Other attributes of product should also be included such as design, brand name since we only considered trust and satisfaction as factors to build consumer attitudes.

• Journal of the Korean association of regional geographers
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• v.3 no.2
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• pp.163-193
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• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

• Asia Marketing Journal
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• v.14 no.2
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• pp.157-176
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• 2012

Brand switching data frequently used in market structure analysis is adequate to analyze non- durable goods, because it can capture competition between specific two brands. But brand switching data sometimes can not be used to analyze goods like automobiles having long term duration because one of main assumptions that consumer preference toward brand attributes is not changed against time can be violated. Therefore a new type of data which can precisely capture competition among durable goods is needed. Another problem of using brand switching data collected from actual purchase behavior is short of explanation why consumers consider different set of brands. Considering above problems, main purpose of this study is to analyze market structure for durable goods with consideration set. The author uses exploratory approach and latent class clustering to identify market structure based on heterogeneous consideration set among consumers. Then the relationship between some factors and consideration set formation is analyzed. Some benefits and two demographic variables - age and income - are selected as factors based on consumer behavior theory. The author analyzed USA automotive market with top 11 brands using exploratory approach and latent class clustering. 2,500 respondents are randomly selected from the total sample and used for analysis. Six models concerning market structure are established to test. Model 1 means non-structured market and model 6 means market structure composed of six sub-markets. It is exploratory approach because any hypothetical market structure is not defined. The result showed that model 1 is insufficient to fit data. It implies that USA automotive market is a structured market. Model 3 with three market structures is significant and identified as the optimal market structure in USA automotive market. Three sub markets are named as USA brands, Asian Brands, and European Brands. And it implies that country of origin effect may exist in USA automotive market. Comparison between modal classification by derived market structures and probabilistic classification by research model was conducted to test how model 3 can correctly classify respondents. The model classify 97% of respondents exactly. The result of this study is different from those of previous research. Previous research used confirmatory approach. Car type and price were chosen as criteria for market structuring and car type-price structure was revealed as the optimal structure for USA automotive market. But this research used exploratory approach without hypothetical market structures. It is not concluded yet which approach is superior. For confirmatory approach, hypothetical market structures should be established exhaustively, because the optimal market structure is selected among hypothetical structures. On the other hand, exploratory approach has a potential problem that validity for derived optimal market structure is somewhat difficult to verify. There also exist market boundary difference between this research and previous research. While previous research analyzed seven car brands, this research analyzed eleven car brands. Both researches seemed to represent entire car market, because cumulative market shares for analyzed brands exceeds 50%. But market boundary difference might affect the different results. Though both researches showed different results, it is obvious that country of origin effect among brands should be considered as important criteria to analyze USA automotive market structure. This research tried to explain heterogeneity of consideration sets among consumers using benefits and two demographic factors, sex and income. Benefit works as a key variable for consumer decision process, and also works as an important criterion in market segmentation. Three factors - trust/safety, image/fun to drive, and economy - are identified among nine benefit related measure. Then the relationship between market structures and independent variables is analyzed using multinomial regression. Independent variables are three benefit factors and two demographic factors. The result showed that all independent variables can be used to explain why there exist different market structures in USA automotive market. For example, a male consumer who perceives all benefits important and has lower income tends to consider domestic brands more than European brands. And the result also showed benefits, sex, and income have an effect to consideration set formation. Though it is generally perceived that a consumer who has higher income is likely to purchase a high priced car, it is notable that American consumers perceived benefits of domestic brands much positive regardless of income. Male consumers especially showed higher loyalty for domestic brands. Managerial implications of this research are as follow. Though implication may be confined to the USA automotive market, the effect of sex on automotive buying behavior should be analyzed. The automotive market is traditionally conceived as male consumers oriented market. But the proportion of female consumers has grown over the years in the automotive market. It is natural outcome that Volvo and Hyundai motors recently developed new cars which are targeted for women market. Secondly, the model used in this research can be applied easier than that of previous researches. Exploratory approach has many advantages except difficulty to apply for practice, because it tends to accompany with complicated model and to require various types of data. The data needed for the model in this research are a few items such as purchased brands, consideration set, some benefits, and some demographic factors and easy to collect from consumers.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.674-684
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• 1999

Background : It has been generally known that the incidence of lung cancer is higher in the patients with idopathic pumonary fibrosis (IPF) than those in general population. The reported incidence was variable from 4.8 to 43.2%. There were controversies on the most frequent cell type (squamous cell carcinoma vs. adenocarcinoma) and no study was done about the real concordance of cancer and the fibrotic lesion. And the pulmonary fibrosis may influence not only the development of cancer but also the treatment and prognosis of the cancer, but there was no report on that point. Method : Total 63 patients ($66.8{\pm}7.8$ year, M : F=61 : 2) were diagnosed as IPF combined with lung cancer (IFF-CA) at Asan Medical Center. A retrospective analysis was done about the risk factors of the lung cancer, pulmonary function test, the site of cancer(especially the relationship of the cancer with the fibrotic lesion), the histologic types, and the stage of cancer. The histologic types were compared with those of 2,660 patients with lung cancer who were diagnosed at the same institute for the same period. The effect of IPF on the treatment of the cancer was evaluated with the survival time after the detection of lung cancer. Results : The lung cancer was found in 63(22.9%) out of 281 patients with IPF. But in most of them(45 patients), lung cancer was detected at the same time with IPF and only in 18 patients, the cancer was diagnosed during the follow-up($25.2{\pm}17.7$ months) of IPF. So in our study, 6.7% of patients with IPF developed lung cancer during the course of the disease. The age ($66.8{\pm}7.84$ vs. $63.4{\pm}11.1$ years), percentage of smoker (88.9 vs. 67.2%), and the male gender (96.8 vs. 67.6%) were significantly higher in IPF-CA compared with lone IPF (p<0.05). The odds ratio of smoking was 4.7 compared with non smoking IPF controls. The lung cancer was located more frequently in the upper lobe and 55.5% was in the periphery of lung. The cancer was developed in the fibrotic lesion in 23 patients (35.9%), and in the majority of the patients, the cancer was separated from the fibrosis. The cell type of the lung cancer in IPF-CA was squamous cell carcinoma 34.9%, adenocarcinoma 30.2%, small cell carcinoma 19.0%, large cell undifferenciated carcinoma 6.3%, and others 9.5%. No significant difference in the distribution of histologic type of the lung cancer was found between IPF-CA and lone lung cancer. There was no significant difference in demographic features, cell types, location and the stage of the cancer between the group with concurrent IPF-CA and the group with cancer diagnosed during the follow up of IPF. There was a tendency (but statistically not significant : p=0.081) of higher incidence of adenocarcinoma among the cancers developed in the fibrotic area(43.5%) (F-CA) than in the cancers in non-fibrotic area (22.5%) (NF-CA). The prognosis of the patients with F-CA was poor (median survival : 4 months) compared with the patients with NF-CA (7 months, p=0.013), partly because the prevalence of severe IPF (the extent of fibrosis in HRCT 50%) was higher in F-CA group. Conclusion : These data suggest that the lung cancer in the patients with IPF has similar features to the ordinary lung cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.30-40
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• 2000

Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.100-107
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• 1999

Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.1-10
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• 1994

Background: Patients with mitral stenosis(MS) have been demonstrated to have a variable degree of pulmonary dysfunction and exercise impairment. The hemodynamic changes of MS can be reversed after percutaneous mitral balloon valvuloplasty(PMV), but the extent and time course of the imporvement in pulmonary function and exercise capacity are not defined. Methods: In order to investigate the early(3 weeks or less)and late(3 months or more) effects of PMV on pulmonary function and determine if the pulmonary dysfunction is reversible even in patients with moderate to severe pulmonary hypertension, we performed the spirometry, measurements of diffusing capacity and lung volumes, and incremental exercise tests in patients with MS before and after PMV. Results: In 46 patients with MS(age: $40{\pm}12$years, male to female ratio: 1:2, mitral valve area: $0.8{\pm}0.2cm^2$) there was a significant increase in FVC(P<0.0025), $FEV_1$(P<0.001), $FEF_{25-75%}$(P<0.001, $FEF_{50%}$(P<0.001), PEF(P<0.0005), MVV(P<0.005), $\dot{V}O_2$max (P<0.0001), and AT(P<0.0001) after average 10 days of PMV. Also there was a significant decrease in DLco(P<0.0001) and DL/VA(P<0.0001). At later($5{\pm}2$months) follow-up in 11 patients, there was no further improvement in any parameters of pulmonary function and exercise test. Twenty nine patients with sinus rhythm were divided into 16 patients with pulmonary arterial pressure(PAP) more than 35mmHg and/or tricuspid regurgitation grade n or more(group A) and 13 patients with PAP less than 35mmHg(group B). Group A Patients had significantly lower FVC(P<0.001), $FEV_1$(P<0.001), DLco(P<0.05), $\dot{V}O_2$ max(P<0.025) and mitral valve area(P<0.025) than group B patients. Group A patients after PMV, showed significant increase in FVC(P<0.001), maximum $O_2$ pulse(P<0.00001) and $\dot{V}O_2$ max(P<0.00025). Both group showed an increase in AT(P<0.0001, P<0.005), but group A showed greater decrease in $\dot{V}E/\dot{V}O_2$ and $\dot{V}E/\dot{V}CO_2$ both at AT(P<0.001, P<0.001) and $\dot{V}O_2$ max(P<0.0001, P<0.0001) after PMV compared with group B. Conclusion: These data suggest that patients with MS can show increased pulmonary function and exercise performance within 1 month after PMV. Patients with moderate to severe pulmonary hypertension had a significant increase in exercise performance compared with those with mild to no pulmonary hypertension and it is thought to be related to a significat decrease of ventilation for a given oxygen consumption at maximum exercise.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.79-92
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• 2007

[ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.