• Journal of Preventive Medicine and Public Health
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• v.25 no.2 s.38
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• pp.127-140
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• 1992

This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at $-20^{\circ}C$ in polypropylene tubes further copper and zinc analysis. Mean of serum coppper levels was $91.97{\pm}4.76{\mu}g/dl$ in control, $106.21{\pm}2.73{\mu}g/dl$ in cirrhosis and $127.05{\pm}0.77{\mu}g/dl$ in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were $110.82{\pm}7.24{\mu}g/dl$ in control, $68.10{\pm}5.43{\mu}g/dl$ in cirrhosis and $63.78{\pm}2.20{\mu}g/dl$ in HCC. The values of cirrhosis and HCC were statistically significantly lower than that of control(p<0.05). The Cu/Zn ratio was statiatically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistical significance on the cirrhosis and the HCC, but that of serum sinc was statistically significant as 0.951 and 0.952(p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. H\Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of 'grouped' cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.62-66
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• 2013

Purpose: I-131 is a radioisotope widely used for thyroid gland treatments. The physical half life is 8.01 and characterized by emitting beta and gamma rays which is used in clinical practice for the purpose of acquiring treatment and images. In order to reduce the recurrence rate after surgery in high-risk thyroid cancer patients, the remaining thyroid tissue is either removed or the I-131 is used for treatment during relapse. In cases of using a high dosage of radioactive iodine requiring hospitalization, the patient is administered dosage in the hospital isolation ward over a certain period of time preventing I-131 exposure to others. By checking the radiation amount emitted from patients before discharge, the patients are discharged after checking whether they meet the legal standards (50 uSv/h). After patients are discharged from the hospital, the contamination level is checked in many parts of the ward before the next patients are hospitalized and when necessary, decontamination operations are performed. It is expected that there is exposure to radiation when measuring the ward contamination level and dose check emitted from patients at the time of discharge whereby the radiation exposure by health workers that come from the patients in this process is the main factor. This study analyzed the correlation between discharge dose of patients and ward contamination level through a variety of factors such as renal functions, gender, age, dosage, etc.). Materials and Method: The study was conducted on 151 patients who received high-dosage radioactive iodine treatment at Soon Chun Hyang University Hospital during the period between 8/1/2011~5/31/2012 (Male: Female: 31:120, $47.5{\pm}11.9$, average dosage of $138{\pm}22.4$ mCi). As various factors expected to influence the patient discharge dose & ward contamination such as the beds, floors, bathroom floors, and washbasins, the patient renal function (GFR), age, gender, dosage, and the correlation between the expected Tg & Tg-Tb expected to reflect the remaining tissue in patients were analyzed. Results: In terms of the discharge dose and GFR, a low correlation was shown in the patient discharge dose as the GFR was higher (p < 0.0001). When comparing the group with a dosage of over 150mCi and the group with a lower dosage, the lower dosage group showed a significantly lower discharge dose ($24{\pm}10.4uSv/h$ vs $28.7{\pm}11.8uSv/h$, p<0.05). Age, gender, Tg, Tg-Tb did not show a significant relationship with discharge dose (p> 0.05). The contamination level in each spot of the treatment ward showed no significant relationship with GFR, Tg, Tg-Tb, age, gender, and dosage (p>0.05 ). Conclusion: This study says that discharge of the dose in the patient's body is low in GFR higher and Dosage 150mCi under lower. There was no case of contamination of the treatment ward, depending on the dose and renal association. This suggests that patients' lifestyles or be affected by a variety of other factors.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.6
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• pp.861-869
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• 2012

This study was conducted to investigate the purchasing status and to compare supplier performance evaluations between competitive bidding and negotiated contracts in school foodservice in Changwon, Korea. A total of 190 questionnaires were distributed and 167 (return rate 87.9%) were collected from June 29 to September 28, 2010, and then a total of 151 (analysis rate 79.5%) were used for the final analysis. First, 91.4% of food product purchases for school meals were contracted through competitive bidding, especially limited competitive bidding. It mainly consisted of agricultural products, processed food, and eco-friendly agricultural products (fruit). Second, 78.8% of schools purchased food products by negotiated contracts, while single negotiation accounted for 59.7%. Food products by negotiated contract consisted of meat, kimchi, and fish. Third, the purchase status of competitive bidding and negotiated contracts showed a significant difference in agricultural products (p<0.001), fish (p<0.001), meats (p<0.001), poultry (p<0.001), antibiotic-free poultry (p<0.001), eco-friendly grain (p<0.001), eco-friendly agricultural products (fruit) (p<0.001), eco-friendly processed food (p<0.001), processed products (p<0.001), milk (p<0.001) and general grain (p<0.001) except for kimchi. Fourth, comparative analysis of supplier performance evaluation (on a 5-point Likert scale) of school foodservice showed that price of product of competitive bidding (3.73) was significantly higher than that of negotiated contract (2.95) (p<0.001), and the overall performance level of the negotiated contract (3.85) was significantly higher than that of competitive bidding (3.61) (p<0.01). The supplier performance evaluation levels of product packaging (p<0.01), product quality at the time of delivery (p<0.001), hygiene of products (p<0.001), consistency to specification (p<0.001), swiftness of return and exchange (p<0.001), emergency delivery (p<0.001), service of delivery staff (p<0.05), and handling of complaints (p<0.001) of negotiated contracts were significantly higher than those of competitive bidding of school foodservice. In conclusion, school foodservice selected food suppliers both by adopting competitive bidding and negotiated contracts. And there was a significant difference of school foodservice supplier performance between competitive bidding and negotiated contracts in Changwon, Korea.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.1-11
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• 2006

Background: CD44 is a glycoprotein on the cell surface which is involved in the cell-to-cell and cell-to-matrix interaction. The standard form, CD44s and multiple isoforms are determined by alternative splicing of 10 exons. Recent studies have suggested that CD44 may help invasion and metastasis of various epithelial tumors as well as activation of Iymphocytes and monocytes. The expression pattern of CD44 can be different according to tumor types. The author studied the expression pattern of CD44s and one of its variants, CD44v6 in non-small cell lung carcinomas (NSCLC) to find their implications on clinicopathologic aspects, including the survival of the patients. Material and Method: A total of 89 primary NSCLSs (48 squamous cell carcinomas, 33 adenocarcinomas, and 8 undifferentiated large cell carcinomas) were retrieved during the years between 1985 to 1994. The immunohisto chemistry was done by using monoclonal antibodies and the CD44 expression for angiogenesis was evaluated by counting the number of tumor microvessels. Result: Seventy-one (79.8$\%$) and 64 (71 .9$\%$) among 89 NSCLSs revealed the expression of CD44s and CD44v6, respectively. The expression of CD44s was well correlated with that of CD44v6 (r=0.710, p < 0.0001). The expression of CD44s and CD44v6 was associated with the histopathologic type of the NSCLCs, and squamous cell carcinoma was the type that showed the highest expression of CD44s and CD44v6 (p < 0.0001). Microvessel count was the highest in adenocarcinomas (113.6$\pm$69.7 on 200-fold magnification and 54.8$\pm$41.1 on 400-fold magnification) and correlated with the tumor size of TNM system (r=0.217, p=0.043) and CD44s expression (r=0.218, p=0.040). In adenocarcinoma, the patients with higher CD44s expression survived shorter than those with lower CD44s expression (p=0.0194) but there was no statistical significance on multivariate analysis(p=0.3298). Conclusion: The expression of both CD44s and CD44v6 may be associated with the squamous differentiation in non-small cell lung carcinomas. The relationship of CD44s expression with micro-vessel density of the tumor suggests an involvement of CD44s in tumor angiogenesis, which in turn would help tumor growth.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.95-103
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• 1996

Reverse redistribution(RRD) refers to a perfusion defect that develops or becomes more evident on rest imaging compared with the stress imaging. This phenomenon was not uncommonly noted on myocardial perfusion single photon emission computed tomography (SPECT). However, the clinical significance and pathophysiological mechanism of RRD were unclear. The aim of this study was to evaluate the incidence and clinical significance of RRD on either dipyridamole T1-201 or Tc-99m MIBI myocardial perfusion SPECT. RRD was defined as ${\geq}10%$ decrease in relative T1-201 and Tc-99m MIBI uptakes on rest images compared to the stress images or as an appearance of new perfusion defects on rest images. It was observed in both T1-201 (44/463, 9.5%) and Tc-99m MIBI (124/999, 12.4%) myocardial SPECTs similarly, with an overall incidence of 11.5%(168/1462). Many apparent)y unrelated disease groups showed the finding: post-revascularization(53.9%), coronary artery disease(24.6%), myocardial infarction(12.3%), and those with normal coro-nary arteries (9.2%). Clinical and angiographic characteristics of 65 consecutive patients who underwent coronary arteriography in 168 patients who had RRD on myocardial perfusion SPECT were reviewed. Tc-99m MIBI was used in 44 patients, and T1-201 was used in 21 patients. Of the 81 myocardial segments analyzed which showed RRD, 32 segments(39.5%) were in septum, 24(29.5%) in inferior wallL, 12(14.8%) in anterior wall, 7(8.7%) in apex and 6(7.4%) in lateral wall. There was no clear association between RRD and coronary arterial stenosis or Presence of collateral circulations. Ventriculographical wall motion was evaluated in 27 regions with RRD; it was normal in 12 regions, hypokinetic in 12 regions and dyskinetic in 3 regions. In 14 of 21 patients who showed RRD on T1-201 myocardial SPECT, T1-201 reinjection was performed immediately after the 3-4 hour redistribution studies. Ten of 14 (71.4%) showed enhanced T1-201 activity(${\geq}10%$ increased) after reinjection. We conclude that RRD is not related to mode of stress or radiopharmaceuticals. RRD might represent many inhomogeneous pathophysiological processes.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.522-529
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• 2005

Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

• Journal of Gastric Cancer
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• v.5 no.1
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• pp.10-15
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• 2005

Purpose: Recently the role of vitamins, folate in particular, has been emphasized in the maintenance of health. Folate deficiency is known to give rise to developmental delay, immature vascular disease, neural tube defect, acute leukemia, atherosclerotic vascular disease, delivery defects, breast cancer, and particularly gastrointestinal neoplasia. Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme in folate metaboism, and influences DNA synthesis and DNA methylation. Generally, folate deficiency is associated with gastrointestinal neoplasms. The amino-acid- changing and enzyme-activity-reducing nucleotide polymorphism (766C$\rightarrow$T/ Ala222Val) has been described in the MTHFR polymorphism and leads to low enzyme activity that may reduce the capacity of DNA methylation and possibly uracil mis-incorporation into DNA. These processes may be critical in the oncogenic transformation of human cells, especially in colorectal carcinomas. We investigated the relationship between the MTHFR polymorphism in gastric cancer and the tumor site, the smoking history, and the alcoholic history. Materials and Methods: Ninety-six (96) individuals with gastric cancer and 287 healthy persons were analyzed. Blood sampling was performed, PCR-RFLP was analyzed, and MTHFR polymorphism genotypes of C/C, C/T, and T/T were obtained and analyzed statistically for their correlation. Results: In the gastric cancer group there were 69 ($72\%$) males and 27 ($28\%$) females. There were also 58 cases ($60\%$) involving the gastric lower body, 20 cases ($21\%$) the gastric mid-body, and 18 cases ($19\%$) the gastric upper body. In the control group there were 169 ($59\%$) males and 118 ($41\%$) females. Among the gastric cancer, 56 ($61\%$) smoking patients, 40 ($39\%$) non-smoking patients, 45($47\%$) alcoholic patients, 51 ($53\%$) non-alcoholic patients. In the gastric cancer group, MTHER polymorphisms were C/C in 18 ($19\%$) cases, C/T in 59 ($61\%$) cases, T/T in 19 ($20\%$) cases. In the control group polymorphisms were C/C 116 ($40\%$) cases, C/T 103 ($36\%$) cases, and T/T 68 ($24\%$) cases (P=0.045). In cases of lower gastric body cancer, polymorphisms were C/C in 16 ($24\%$) C/C in 16 ($24\%$) cases and C/T or T/T in 42 ($72\%$) cases. In cases of upper and mid-body cancer, polymorphisms were C/C in 2 ($5\%$) cases and C/T or T/T 36 ($95\%$) cases (P=0.006). In the non-smoking patient group, polymorphisms were C/C in 5 (12%) cases and C/T or T/T in 35 ($88\%$) cases. In the smoking patient group, C/C in 13 ($23\%$) cases and C/T or T/T in 43 ($77\%$) cases (P=0.189). In the non-alcoholic patient group, polymorphisms were C/C in 6 ($12\%$) cases and C/T or T/T in 45 ($88\%$) cases. In the alcoholic patient group, polymorphisms were C/C in 12 ($26\%$) cases and C/T or T/T in 33 ($74\%$) cases (P=0.063) Conclusion: MTHFR polymorphisms are associated with gastric cancer and tumor site, but not with smoking and alcohol drinking.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.147-158
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• 1996

Background : Endobronchial tuberculosis(ET) is known to affect frequently young female and serious complication like bronchial stenosis would occur if early diagnosis and treatment for ET is not performed immediately. But ET shows normal chest roentgenogram in about 10% of patients, and is often confused with bronchial asthma because ET presents clinical features like cough, dyspnea, wheezing in history and physical examination. The pulmonary function test(PFT) feature of ET is not well known, but when we consider the fact that ET is pathophysiologically different from bronchial asthma, if there is any feature of PFT in ET, and we know it, PFT will be very helpful for diagnosis and follow up of ET. Methods : We performed both PFT and bronchoscopy in 68 ET patients who visited Boramae hospital, and were confirmed as ET by bronchoscopic biopsy and were followed prospectively from November 1991 to March 1995. After history taking and physical examination, we performed chest roentgenogram, complete blood count, sputum AFB stain and culture, and also performed PFT before anti-tuberculosis chemotherapy. PFT was classified as restrictive, if only PVC was reduced below 80%, and obstructive, if only FEV1 was reduced below 75%. In the case of both FVC and FEV1 were reduced, PFT was classified as restrictive if FEY1/FVC was greater than 75%, and mixed if FEV1/FVC was reduced below 75%. We repeated the PFT and bronchoscopy for 68 ET patients who were proven by biopsy in the first month and sixth month after starting anti-tuberculosis chemotherapy, and studied the feature and change of PFT of the ET and the relation between PFT and the bronchoscopic finding, and obtained following results. Results: 1) Number of male patients was 12, and that of female patient was 56, and mean age was $35.4{\pm}17yr$.(17-74yr). Clinical symptom was in the order of cough(86.8%), dyspnea(63.2%), fever(17.6%) and hemoptysis (10.3%), and the wheezing and stridor were audible among the 40 patients(58.4%) in the physical examination. 2) Hemoglobin level was below 12g/dl among 25 patients (36.8%), and WBC level was above $10,000/mm^3$ among 9 patients(13.2%) and ESR was above 20 among 46 patients (67.6%) and AFB stain and culture were positive among 50 patients(73.5%). 3) The dominant roentgenographic finding of ET was fibronodular feature in 35 patients(51.5%), pneumonic feature in 14 patients (20.6%), collapse in 11 patients(16.2%), mass-like lesion in 3 patients(4.4%), cavitary lesion in 2 patients(2.9%), and normal in 3 patients(4.4%). 4) PFT feature at the time of diagnosis of ET was normal in 16 patients(23.5%), restrictive pattern in 32 patients (47%), obstructive in 4 patients(5.8%), and mixed in 14 patients(23.5%). So restrictive pattern was the dominate feature of ET. 5) The PFT feature was little correlated with the gross finding of bronchoscopy, but the change of PFT during treatment of ET showed relatively good correlation with the change of bronchoscopic finding. 6) FVC(2.30L vs. 2.61L) and FEV1(1.74L vs. 2.06L) increased significantly (p < 0.01), but FEV1/FVC(82% vs. 83%) and PEF(3.45L/sec vs. 3.95L/sec) did not change significantly after 1 month of treatment (p > 0.01), and there was no significant change among all parameters during first and sixth month of treatment(p > 0.01). Conclusion : PFT may be useful in the diagnosis and treatment follow up of ET but further study would be needed to confirm it.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.878-887
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• 1995

Background: It is reported that frequency of pulmonary involvement in the patients with rheumatoid arthritis reaches 10 to 50% and pulmonary involvement is a principal cause of death. As immunology and radiology has developed, interest for the early diagnosis of pulmonary involvement is increasing. Method: Among the patients at Hanyang University Hospital from March, 1990 to July, 1995, we compared the 29 patients having pulmonary involvement with the 18 patients controls in clinical and chest high resolution computed tomography(HRCT) findings by immunological markers and findings of pulmonary function test. We sought useful markers for early diagnosis of pulmonary involvement with noninvasive investigations. Results: The ratio of males to females was 14 : 15 in the group of pulmonary involvement, and all of the 18 patients were females in the control group. Smoking history was 31%(9/29) in the former group and none in the latter group. Rheumatoid factor(RF) was positive in 95.5%(28/29) of the pulmonary involvement group and in 100%(18/18) of the control group(p=0.12). Antiperinuclear factor(APF) showed a significant difference: 86.9%(20/23, average value: 2.0) was positive in the pulmonary involvement group and 50%(8/16, average value: 1.1) in the control group(p=0.04). Antinuclear antibody(ANA) was positive in 60.7%(17/28) of the pulmonary involvement group and in 72.2%(13/18) of the control group(p=0.33). Cryoglobulin also showed a significant difference: 72%(18/25) in the pulmonary involvement group was positive and 56.2%(9/16) in the control group was positive(p=0.02). Bony erosion was positive in 61.5%(16/26) of the pulmonary involvement group and in 77.7%(14/18) of the control group(p=0.8). On the pulmonary function test, the average value of alveolar volume corrected diffusion capacity and residual volume in the pulmonary involvement group and in the control group were 1.07mmol/rnin/KPa(predicted value: 64.2%), 1.32L(predicted value: 70%) and 1.44mmol/min/KPa, 3.75L(predicted value: 86.6%), respectively(p=0.003, p=0.004), showing a significant difference. Conclusion: APF or cryoglobulin on the serological test, the measurement of residual volume and alveolar volume corrected diffusion capacity may be used as effective markers in the diagnosis of pulmonary involvement of the patients with rheumatoid arthritis.

• Journal of Preventive Medicine and Public Health
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• v.4 no.1
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• pp.77-87
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• 1971

A study of the knowledge, attitude and practices about the maternal and child health of 305 married women residing in apartments at the Yonsei Community Health area was conducted during the period from November to December 1970 using designed questionnaire with well trained interviewers. The results and findings obtained from the study are summarized as follows: A. Pregnancy and Birth Questions were asked about their last child. 1. 16.4% of the women were pregnant. 2. Among 281 women who had experienced delivery, 48.0% were assisted by doctor or midwisves for their last delivery, while the rest of women delivered their last baby at home without any professional's assistance. The higher the level of education or the greater exposure to mass communication, the more the deliveries were assisted by doctors or midwives. Those women who were born and raised in cities had more deliveries assisted by doctors and midwives than those who were not. 3. Kinds of delivery sheets used. Among 141 cases of home delivery 68% used cement bag paper or vinyl sheets. Three% used nothing and remained used unsterile materials. 4. Among 141 cases of home delivery, 70.2% used scissors. The rest of them used other methods. 5. 47.3% of the women had a rest for one month or more after birth. The higher the level of education, the longer the period of rest was observed. 6. 52.4% of the women fed the colostrum to their babies. This was not related to the mother's education. 7 About half(42.9%) of the women had poor knowledge about a proper diet for the pre and post natal period. B. Child Health 1. Knowledge and practice regarding to the immunization for their children: Most of the women (93.2%) could name at least one kind of immunization. 20.3% could name 6 kinds of immunization. Mothers education level did not influence their ability to name immunizations. 85.2% of children had been immunized at least once. 2. Morbidity of last born children: 48.1% of their last born children were found to have been sick during the last year. Less than half(41.5%) of the sick children were seen by doctor. 3. Counselling at well baby clinic: Most of the women(76.5%) had no counselling for their children. Registration rate at the well baby clinic at the Severance Hospital was 13.2%. 45.9% wanted to visit to the well baby clinic at the Severance Hospital. 4. Weaning Period: 44.6% said that the beginning of the weaning for their last born children was from 6 months to twelve months of age. The most important reason of weaning was the health of both mothers and children. 5. Knowledge and Practice regarding birth and death Registration: 64.6% of the women could name correctly the Ku-office as the place for the registration. Only 29.2% registered the birth of their last born children within 14 days. C. Knowledge, Attitude and Practice regarding to family planning Most: of the women accepted the idea of family planning. 97.7% could name at least one contraceptive method. 35.4% were found to be current users of contraceptive methods. The ideal number of children was 3.1 in average.