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Radiotherapy in Medically Inoperable Early Stage Non-small Cell Lung Cancer (내과적 문제로 수술이 불가능한 조기 비소세포성 폐암에서의 방사선치료)

  • Kim, Bo-Kyoung;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.257-264
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    • 2000
  • Purpose: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. Materials and Method : We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wail invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included souamous (24), adenocarcinoma (6) and unclassiried squamous cell (2). The clinical stages of the patients were 71 in 5, 72 in 25, 73 in 2 patients. Initial tumor size was 3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. Ail patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 0.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. Results : The overall survival rate was 44.6$\%$ at 2 years and 24.5$\%$ at 5 years, with the median survival time of 23 months. of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0$\%$ at 2 years and 33.5$\%$ at 5 years. The disease-free survival rate was 38.9$\%$ at 2 years and 28.3$\%$ at 5 years. The local-relapse-free survival rate was 35.1$\%$, 28.1$\%$, respectively. On univariate analysis, tumor size was significant variable of overall survival (p=0.0015, 95$\%$ C.1.; 1.4814-5.2815), disease-free survival (P=0.0022, 95$\%$ C.1., 1.4707-5.7780) and local-relapse-free survival (p=0.0015, 95$\%$ C.1., 1.2910- 4.1197). 7 stage was significant variable of overall survival (p=0.0395, 95$\%$ C.1.; 1.1084-55.9112) and had borderline significance on disease-free survival (p=0.0649, 95$\%$ C.1.; 0.8888-50.7123) and local-relapse-free survival (p=0.0582, 95$\%$ C,1.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival (p=0.6919, 955 C.1., 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95$\%$ C.1.; 0.9720-4.9657). Tumor size was also significant variable of disease-free survival (p=0.0317, 95% C.1.; 1.1028-8.4968). Conclusion : Radical radiotherapy is an effective treatment for small (71 or f3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hypefractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.

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Gelatinization Properties of Starch Dough with Moisture Content, Heating Temperature and Heating Time (수분함량, 가열온도 및 가열시간에 따른 전분 반죽의 호화특성)

  • Lee, Boo-Yong;Lee, Chang-Ho;Lee, Cherl-Ho
    • Korean Journal of Food Science and Technology
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    • v.27 no.3
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    • pp.428-438
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    • 1995
  • The gelatinization properties of corn and waxy corn starch doughs were examined at various moisture contents, heating temperatures and heating times. The onset temperatures of gelatinization with 1% CMC using Brabender Amylograph were $64^{\circ}C$ for both corn and waxy corn starch. In the gelatinization properties using DSC, onset temperature$(T_o)$, maximum peak temperature$(T_p)$, completion temperature$(T_c)$ and enthalpy of the corn starch were $68.15^{\circ}C,\;74.01^{\circ}C,\;85.65^{\circ}C$ and $3.2\;cal/gram$ respectively. While those of the waxy corn starch were $68.24^{\circ}C,\;75.43^{\circ}C,\;93^{\circ}C$ and $4.2\;cal/gram$ respectively. In enzymatic analysis, when the moisture content increased from 36% to 52% and heating temperature from $60^{\circ}C$ to $100^{\circ}C$, the gelatinization degree of starch dough increased from about 10% to about 62%. The gelatinization degree of waxy corn starch dough was $15{\sim}20%$ higher than that of corn starch dough under the same gelatinization conditions. The regression equations of gelatinization degree (Y) of starch dough in the range of $36{\sim}52%$ moisture content $(X_1)\;60{\sim}100^{\circ}C$ heating temperature $(X_2)\;and\;0{\sim}2.0$ min heating time $(X_3)$ were examined using response surface analysis. The regression equation of corn starch dough was: $Y=28.659+8.638\;X_}+15.675\;X_2+7.770\;X_3-1.620\;{X_1}^2+10.790\;X_1X_2-4.220\;{X_2}^2+0.510\;X_1X_3+1.980\;X_2X_3-6.850\;{X_3}^2\;(R^2=0.9714)$ and that of waxy corn starch dough was: $Y=32.617+12.535\;X_1+20.470\;X_2+8.608\;X_3+4.093\;{X_1}^2+13.550\;X_1X_2-4.467\;{X_2}^2+1.560\;X_1X_3+2.160\;X_2X_3-9.527\;{X_3}^2$\;(R^2=0.9621)$. As the moisture content, heating temperature and heating time increased, the reaction rate constant(k) of gelatinization increased. The greatest reaction rate constant was observed at initial 0.5 min heating time of 1st gelatinization stage. At the heating temperature of $90^{\circ}C$, gelatinization of starch dough was completed almost in the initial 0.5 min heating time. The reaction rate constant of waxy corn starch dough was higher than that of corn starch dough under the same gelatinization conditions. At the 52% moisture content, the regression equation between reaction rate constant(k) and heating temperature(T) for corn starch dough was $log\;k=11.1140-4.1226{\times}10^3(1/T)$ (r=-0.9520) and that of waxy corn starch dough was $log\;k=10.1195-3.7090{\times}10^3(1/T)$ (r=-0.9064).

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Impacts of Climate Change on Rice Production and Adaptation Method in Korea as Evaluated by Simulation Study (생육모의 연구에 의한 한반도에서의 기후변화에 따른 벼 생산성 및 적응기술 평가)

  • Lee, Chung-Kuen;Kim, Junwhan;Shon, Jiyoung;Yang, Woon-Ho;Yoon, Young-Hwan;Choi, Kyung-Jin;Kim, Kwang-Soo
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.14 no.4
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    • pp.207-221
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    • 2012
  • Air temperature in Korea has increased by $1.5^{\circ}C$ over the last 100 years, which is nearly twice the global average rate during the same period. Moreover, it is projected that such change in temperature will continue in the 21st century. The objective of this study was to evaluate the potential impacts of future climate change on the rice production and adaptation methods in Korea. Climate data for the baseline (1971~2000) and the three future climate (2011~2040, 2041~2070, and 2071~2100) at fifty six sites in South Korea under IPCC SRES A1B scenario were used as the input to the rice crop model ORYZA2000. Six experimental schemes were carried out to evaluate the combined effects of climatic warming, $CO_2$ fertilization, and cropping season on rice production. We found that the average production in 2071~2100 would decrease by 23%, 27%, and 29% for early, middle, and middle-late rice maturing type, respectively, when cropping seasons were fixed. In contrast, predicted yield reduction was ~0%, 6%, and 7%, for early, middle, and middle-late rice maturing type, respectively, when cropping seasons were changed. Analysis of variation suggested that climatic warming, $CO_2$ fertilization, cropping season, and rice maturing type contributed 60, 10, 12, and 2% of rice yield, respectively. In addition, regression analysis suggested 14~46 and 53~86% of variations in rice yield were explained by grain number and filled grain ratio, respectively, when cropping season was fixed. On the other hand, 46~78 and 22~53% of variations were explained respectively with changing cropping season. It was projected that sterility caused by high temperature would have no effect on rice yield. As a result, rice yield reduction in the future climate in Korea would resulted from low filled grain ratio due to high growing temperature during grain-filling period because the $CO_2$ fertilization was insufficient to negate the negative effect of climatic warming. However, adjusting cropping seasons to future climate change may alleviate the rice production reduction by minimizing negative effect of climatic warming without altering positive effect of $CO_2$ fertilization, which improves weather condition during the grain-filling period.

Development of Adjustable Head holder Couch in H&N Cancer Radiation Therapy (두경부암 방사선 치료 시 Set-Up 조정 Head Holder 장치의 개발)

  • Shim, JaeGoo;Song, KiWon;Kim, JinMan;Park, MyoungHwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.43-50
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    • 2014
  • In case of all patients who receive radiation therapy, a treatment plan is established and all steps of treatment are planned in the same geometrical condition. In case of head and neck cancer patients who undergo simulated treatment through computed tomography (CT), patients are fixed onto a table for planning, but laid on the top of the treatment table in the radiation therapy room. This study excogitated and fabricated an adjustable holder for head and neck cancer patients to fix patient's position and geometrical discrepancies when performing radiation therapy on head and neck cancer patients, and compared the error before and after adjusting the position of patients due to difference in weight to evaluate the correlation between patients' weight and range of error. Computed tomography system(High Advantage, GE, USA) is used for phantom to maintain the supine position to acquire the images of the therapy site for IMRT. IMRT 4MV X-rays was used by applying the LINAC(21EX, Varian, U.S.A). Treatment planning system (Pinnacle, ver. 9.1h, Philips, Madison, USA) was used. The setup accuracy was compared with each measurement was repeated five times for each weight (0, 15, and 30Kg) and CBCT was performed 30 times to find the mean and standard deviation of errors before and after the adjustment of each weight. SPSS ver.19.0(SPSS Inc., Chicago, IL,USA) statistics program was used to perform the Wilcoxon Rank test for significance evaluation and the Spearman analysis was used as the tool to analyze the significance evaluation of the correlation of weight. As a result of measuring the error values from CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.4{\pm}0.8mm$, $0.8{\pm}0.4mm$, 0 for 0Kg before the adjustment. In 15Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.2{\pm}0.8mm$, $1.2{\pm}0.4mm$, $2.0{\pm}0.4mm$. After adjusting position was X,Y,Z axis was $0.2{\pm}0.4mm$, $0.4{\pm}0.5mm$, $0.4{\pm}0.5mm$. In 30Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.8{\pm}0.4mm$, $2.4{\pm}0.5mm$, $4.4{\pm}0.8mm$. After adjusting position was X,Y,Z axis was $0.6{\pm}0.5mm$, $1.0{\pm}0mm$, $0.6{\pm}0.5mm$. When the holder for the head and neck cancer was used to adjust the ab.0ove error value, the error values from CBCT were $0.2{\pm}0.8mm$ for the X axis, $0.40{\pm}0.54mm$ for Y axis, and 0 for Z axis. As a result of statistically analyzing each value before and after the adjustment the value was significant with p<0.034 at the Z axis with 15Kg of weight and with p<0.038 and p<0.041 at the Y and Z axes respectively with 30Kg of weight. There was a significant difference with p<0.008 when the analysis was performed through Kruscal-Wallis in terms of the difference in the adjusted values of the three weight groups. As it could reduce the errors, patients' reproduction could be improved for more precise and accurate radiation therapy. Development of an adjustable device for head and neck cancer patients is significant because it improves the reproduction of existing equipment by reducing the errors in patients' position.

Dose verification for Gated Volumetric Modulated Arc Therapy according to Respiratory period (호흡연동 용적변조 회전방사선치료에서 호흡주기에 따른 선량전달 정확성 검증)

  • Jeon, Soo Dong;Bae, Sun Myung;Yoon, In Ha;Kang, Tae Young;Baek, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.137-147
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    • 2014
  • Purpose : The purpose of this study is to verify the accuracy of dose delivery according to the patient's breathing cycle in Gated Volumetric Modulated Arc Therapy Materials and Methods : TrueBeam STxTM(Varian Medical System, Palo Alto, CA) was used in this experiment. The Computed tomography(CT) images that were acquired with RANDO Phantom(Alderson Research Laboratories Inc. Stamford. CT, USA), using Computerized treatment planning system(Eclipse 10.0, Varian, USA), were used to create VMAT plans using 10MV FFF with 1500 cGy/fx (case 1, 2, 3) and 220 cGy/fx(case 4, 5, 6) of doserate of 1200 MU/min. The regular respiratory period of 1.5, 2.5, 3.5 and 4.5 sec and the patients respiratory period of 2.2 and 3.5 sec were reproduced with the $QUASAR^{TM}$ Respiratory Motion Phantom(Modus Medical Devices Inc), and it was set up to deliver radiation at the phase mode between the ranges of 30 to 70%. The results were measured at respective respiratory conditions by a 2-Dimensional ion chamber array detector(I'mRT Matrixx, IBA Dosimetry, Germany) and a MultiCube Phantom(IBA Dosimetry, Germany), and the Gamma pass rate(3 mm, 3%) were compared by the IMRT analysis program(OmniPro I'mRT system software Version 1.7b, IBA Dosimetry, Germany) Results : The gamma pass rates of Case 1, 2, 3, 4, 5 and 6 were the results of 100.0, 97.6, 98.1, 96.3, 93.0, 94.8% at a regular respiratory period of 1.5 sec and 98.8, 99.5, 97.5, 99.5, 98.3, 99.6% at 2.5 sec, 99.6, 96.6, 97.5, 99.2, 97.8, 99.1% at 3.5 sec and 99.4, 96.3, 97.2, 99.0, 98.0, 99.3% at 4.5 sec, respectively. When a patient's respiration was reproduced, 97.7, 95.4, 96.2, 98.9, 96.2, 98.4% at average respiratory period of 2.2 sec, and 97.3, 97.5, 96.8, 100.0, 99.3, 99.8% at 3.5 sec, respectively. Conclusion : The experiment showed clinically reliable results of a Gamma pass rate of 95% or more when 2.5 sec or more of a regular breathing period and the patient's breathing were reproduced. While it showed the results of 93.0% and 94.8% at a regular breathing period of 1.5 sec of Case 5 and 6, it could be confirmed that the accurate dose delivery could be possible on the most respiratory conditions because based on the results of 100 patients's respiratory period analysis as no one sustained a respiration of 1.5 sec. But, pretreatment dose verification should be precede because we can't exclude the possibility of error occurrence due to extremely short respiratory period, also a training at the simulation and careful monitoring are necessary for a patient to maintain stable breathing. Consequently, more reliable and accurate treatments can be administered.

An Analysis of the Landscape Cognitive Characteristics of 'Gugok Streams' in the First Half of the 18th Century Based on the Comparison of China's 『Wuyi-Gugok Painting』 (중국 『무이구곡도』 3폭(幅)의 비교 분석을 통해 본 18세기 무이산 구곡계(九曲溪)의 경물 인지특성)

  • Cheng, Zhao-Xia;Rho, Jae-Hyun;Jiang, Cheng
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.37 no.3
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    • pp.62-82
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    • 2019
  • Taking the three Wuyi-Gugok Drawings, 『A Picture Showing the Boundary Between Mountains and Rivers: A』, 『Landscape of the Jiuqu River in the Wuyi Mountain: B』 and 『Eighteen Sceneries of Wuyi Mountain: C』, which were produced in the mid-Qing Dynasty as the research objects and after investigating the names recorded in the paintings, this paper tries to analyze the scenic spots, scene types and images in the literature survey. Also, based on the number of Scenic type and the number of Scenic name in each Gok, landscape richness(LR) and landscape similarity(LS) of the Gugok scenic spots, the cognitive characteristics of the landscape in the 18th century were carefully observed. The results are as follows. Firstly, according to the description statistics of scenic spot types in Wuyi Mountain Chronicle, there were 41 descriptions of scenery names in the three paintings, among which rock, peak and stone accounted for the majority. According to the data, the number of rocks, peaks and stones in Wuyi-Gugok landscape accounted for more than half, which reflected the characteristics of geological landscape such as Danxia landform in Wuyi-Gugok landscape. Secondly, the landscape of Gugok Stream(九曲溪) was diverse and full of images. The 1st Gok Daewangbong(大王峰) and Manjeongbong(幔亭峰), the 2nd Gok Oknyeobong(玉女峰), the 3rd Gok Sojangbong(小藏峰), the 4th Gok Daejangbong(大藏峰), the 5th Gok Daeeunbyeong(大隱屛) and Muijeongsa(武夷精舍), the 6th Gok Seonjangbong(仙掌峰) and Cheonyubong(天游峰) all had outstanding landscape in each Gok. However, the landscape features of the 7th~9th Gok were relatively low. Thirdly, according to the landscape image survey of each Gok, the image formation of Gugok cultural landscape originates from the specificity of the myths and legends related to Wuyi Mountain, and the landscape is highly well-known. Due to the specificity, the landscape recognition was very high. In particular, the 1st Gok and the 5th Gok closely related to the Taoist culture based on Muigun, the Stone Carving culture and the Boat Tour culture related to neo-confucianism culture of Zhu Xi. Fourthly, according to the analysis results of landscape similarity of 41 landscape types shown in the figure, the similarity of A and C was very high. The morphological description and the relationship of distant and near performance was very similar. Therefore, it could be judged that this was obviously influenced by one painting. As a whole, the names of the scenes depicted in the three paintings were formed at least in the first half of 18th century through a long history of inheritance, accumulated myths and legends, and the names of the scenes. The order of the scenery names in three Drawings had some differences. But among the scenery names appearing in all three Drawings, there were 21 stones, 20 rocks and 17 peaks. Stones, rocks and peaks guided the landscape of Gugok Streams in Wuyi Mountain. Fifthly, Seonjodae(仙釣臺) in A and C was described in the 4th Gok, but what deserved attention was that it was known as the scenery name of the 3rd Gok in Korean. In addition, Seungjindong(升眞洞) in the 1st Gok and Seokdangsa(石堂寺) in the 7th Gok were not described in Drawings A, B and C. This is a special point that needs to be studied in the future.

Analysis of Manganese Contents in 30 Korean Common Foods (한국인 상용식품 중 30종류 식품의 망간 함량 분석)

  • 최미경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.8
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    • pp.1408-1413
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    • 2003
  • This study was conducted to analyze manganese contents of Korean common foods. Contents of manganese in 30 foods were analyzed by ICP spectrometer. And daily manganese intake through 30 common foods was calculated using analysis data of this study and daily food intakes cited from report on 1998 national health and nutrition survey. The average manganese contents of foods analyzed were 949.6 $\mu\textrm{g}$ for rice, 236.1 $\mu\textrm{g}$ for Korean chinese cabbage kimchi, 27.2 $\mu\textrm{g}$ for citrus fruit, 2.6 $\mu\textrm{g}$ for milk, 214.6 $\mu\textrm{g}$ for radish root, 40.0 $\mu\textrm{g}$ for apple, 60.4 $\mu\textrm{g}$ for persimmon, 13.9 $\mu\textrm{g}$ for pork, 9.5 $\mu\textrm{g}$ for beef, 638.3 $\mu\textrm{g}$ for soybean curd, 184.0 $\mu\textrm{g}$ for radish kimchi, 56.0 $\mu\textrm{g}$ for pear, 18.4 $\mu\textrm{g}$ for beer, 11.3 $\mu\textrm{g}$ for egg, 9.5 $\mu\textrm{g}$ for carbonated beverage, 345.0 $\mu\textrm{g}$ for bread, 50.7 $\mu\textrm{g}$ for soju, 270.3 $\mu\textrm{g}$ for potato, 236.1 $\mu\textrm{g}$ for sweet potato, 91.2 $\mu\textrm{g}$ for ramyeon, 32.5 $\mu\textrm{g}$ for onion, 68.0 $\mu\textrm{g}$ for nabak kimchi, 538.2 $\mu\textrm{g}$ for soybean sprout, 112.5 $\mu\textrm{g}$ for welsh onion, 336.7 $\mu\textrm{g}$ for rice cake, 589.9 $\mu\textrm{g}$ for Korean chinese cabbage, 430.4 $\mu\textrm{g}$ for somyeon, 144.3 $\mu\textrm{g}$ for pumpkin, 3.0 $\mu\textrm{g}$ for yoghurt, and 614.4 $\mu\textrm{g}$ for spinach per 100 g of each food. The daily manganese intake through 30 common foods of Koreans in 1998 was 3420.7 $\mu\textrm{g}$. Major sources of dietary manganese were rice, kimchi, and soybean curd. Especially, rice supplied 68.1% of total dietary manganese intake through 30 common foods. Further studies are required to establish database and RDA of manganese.

Factors Related with the Compliance and Treatment in Patients with Pulmonary Tuberculosis in Urban and Suburb Area (도시와 농촌지역의 폐결핵 환자 순응도 및 치료에 관련된 요인)

  • Kim, Sang-Soon;Kim, Yoon-Ock
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.69-79
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    • 1996
  • To investigate the factors related with the compliance and the treatment of the patients with pulmonary tuberculosis in urban and suburb area, we followed up all the 755 registered patients(at urban Public Health Office 544, at suburb 210) as follow from January 1,1992 to December 31, 1993. We describe the general characteristics and the characteristics related with the disease of the patients according to the area as follow. 150 patients(27.5%) were at their age of 20 to 29 years in the urban area, whereas 45 patients (21.4%) were 60 to 69 years and another 45 patients(21.4%) were 70 to 79 years in the suburb area. According to the first chest X -ray examination, 54.5% of all cases were proved to be mild in the urban area. But in the suburb area, moderate cases (44.3%) were more than mild cases(p<0.01). Follow-up X-ray's were performed more properly(p<0.05) in the urban area(94.3%) than in the suburb area(90.0%). Most cases were found in the chest X -ray examination performed by Public Health Office (p<0.01) : payable chest X-ray in the urban area (56.7%) and free chest X-ray in the suburb area(35.2%). More patients were cured in the urban area(90.8%) than in the suburb area(87.1%). The presence of supporting family member were significantly higher(p<0.05) in the urban area(79.1%) than in the suburb area(88.1%). In the analysis of the treatment efficacy, more cure ate were found in the patients cytologically confirmed to be culture (+). In the urban area, 201 culture (+) patients (93.5%) 294 culture (-) patients (89.1%) were cured. In the suburb area, 99 culture (+) patients(91.7%) and 84 culture (-) patients(82.4%) were cured. Age, the presence of supporting family member, and the socioeconomic status of the patient had significant association with the prescription compliance related with the general characteristics of the patients. Whereas, X-ray finding and AFB culture finding were the significant factors associated with the prescription compliance related with pulmonary tuberculosis (p<0.05). The cumulative compliance in the survival analysis was 92.5% in the urban area and 88.1% in suburb area, at sixth month of follow-up. Failure rate for regular drug receipt was highest at second month in the urban area(3.75%) and at fourth month in the suburb area(4.15%). In logistic regression of the factors related with the tratment result, first X-ray examination and prescription compliance were significantly associated in the urban area(p<0.05). However, there is no factor significantly associated with the treatment result in the suburb area. It could be explained by too small size of the sample. In logistic regression of the factors related with the prescription compliance, first chest X-ray, sputum culture outcome and the presence of supporting family member were significant variables in the urban area(p<0.05). Most patients with family member were proved to be compliant with the prescription. This shows that it is important for the patients with long-lasting ilnesses to have supporting family member. Therefore, to improve prescription compliance we should strengthen the health education before the initiation of treatment and take special interest in the patients without supporting family member.

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Characteristics and Distribution Pattern of Carbonate Rock Resources in Kangwon Area: The Gabsan Formation around the Mt. Gachang Area, Chungbuk, Korea (강원 지역에 분포하는 석회석 자원의 특성과 부존환경: 충북 가창산 지역의 갑산층을 중심으로)

  • Park, Soo-In;Lee, Hee-Kwon;Lee, Sang-Hun
    • Journal of the Korean earth science society
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    • v.21 no.4
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    • pp.437-448
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    • 2000
  • The Middle Carboniferous Gabsan Formation is distributed in the Cheongrim area of southern Yeongwol and the Mt. Gachang area of Chungbuk Province. This study was carried out to investigate the lithological characters and geochemical composition of the limestones and to find out controlling structures of the limestones of the formation. The limestones of the Gabsan Formation are characterized by the light gray to light brown in color and fine and dense textures. The limestone grains are composed of crinoid fragments, small foraminfers, fusulinids, gastropods, ostracods, etc. Due to the recrystallization, some limestones consist of fine crystalline calcites. The chemical analysis of limestones of the formation was conducted to find out the contents of CaO, MgO, Al$_2$O$_3$, Fe$_2$O$_3$ and SiO$_2$. The content of CaO ranges from 49.78-60.63% and the content of MgO ranges from 0.74 to 4.63% The contents of Al$_2$O$_3$ and Fe$_2$O$_3$ are 0.02-0.55% and 0.02${\sim}$0.84% , respectively. The content of SiO$_2$ varies from 1.55 to 4.80%, but some samples contain more than 6.0%. The limestones of the formation can be grouped into two according to the CaO content: One is a group of which CaO content ranges from 49.78 to 56.26% and the other is a group of which CaO content varies from 59.36 to 60.38%. In the first group, the contents of Al$_2$O$_3$, Fe$_2$O$_3$ and SiO$_2$ range very irregularly according to the CaO content. In the second group, the values of MgO, Al$_2$O$_3$, Fe$_2$O$_3$ and SiO$_2$ are nearly same. Detailed structural analysis of mesoscopic structures and microstructures indicates the five phase of deformation in the study area. The first phase of deformation(D$_1$) is characterized by regional scale isoclinal folds, and bedding parallel S$_1$ axial plane foliation which is locally developed in the mudstone and sandstone. Based on the observations of microstructures, S$_1$ foliations appear to be developed by grain preferred orientation accompanying pressure-solution. During second phase of deformation, outcrop scale E-W trending folds with associated foliations and lineations are developed. Microstructural observations indicate that crenulation foliations were formed by pressure-solution, grain boundary sliding and grain rotation. NNW and SSE trending outcrop scale folds, axial plane foliations, crenulation foliations, crenulation lineations, intersection lineations are developed during the third phase of deformation. On the microscale F$_3$ fold, axial plane foliations which are formed by pressure solution are well developed. Fourth phase of deformation is characterized by map scale NNW trending folds. The pre-existing planar and linear structures are reoriented by F$_4$ folds. Fifth phase of deformation developed joints and faults. The distribution pattern of the limestones is mostly controlled by F$_1$ and F$_4$ folds.

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Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Chul-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.241-250
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    • 1997
  • Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

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