• Title/Summary/Keyword: Analysis Factors

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High VPP Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer (진행된 비소세포 폐암에 대한 High-VPP 복합화학요법의 효과)

  • Hong, Seok-Cheol;Han, Pyo-Seong;Lee, Jong-Jin;Cho, Hai-Jeong;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.367-377
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    • 1993
  • Background: The benefits of combination chemotherapy in unresectable non-small cell lung cancer remain uncertain. But, according to the recent reports, the response rates of cisplatin-based polychemotherapy regimens are higher than those of single agent. Also, the response rates of high-dose cisplatin group are higher than those of low-dose cisplatin group. In attemp to answer the question whether treatments, combination chemotherapy (high VPP) and combination chemotherapy with radiation therapy, improve survival in advanced non-small cell lung cancer, we begin to study. Method: Thirty-five patients above stage III, diagnosed histologically as non-small cell lung cancer, were enrolled. Among them, nineteen received a combination chemotherapy consisting of VP-16 & high-dose cisplatin (100 $mg/m^2$) and/or radiation therapy. The other group (16 subjects) received no therapy. To investigate the differences of survival and response rates between two groups and the side effects related to therapy, we reviewed patients' records. Results: 1) The overall objective response rate was 47%(9/19) with one complete remission. 2) In patients who received polychemotherapy and radiation therapy, the response rate was 60%(6/10) with one complete remission and survival rates of 3 months, 6 months and 12 months were 100%, 70% and 40%. 3) In patients who received polychemotherapy, the response rate was 33% (3/9) with no complete remission and survival rates of 3 months, 6 months and 12 months were 78%, 67% and 33%. 4) Overall, treated patients survived significantly longer (p<0.05) than non-treated patients (median survival 307 days versus 95 days). 5) Analysis of the various prognostic factors disclosed that good performance status, stage III and squamous cell type showed the good response rates. 6) The toxicities were nausea and/or vomiting (100%), alopecia (90%), anemia (79%), leukopenia (69%), thrombocytopenia (2%), increased creatinine (16%) and neurotoxicity (5%). Conclusion: According to above results, there are relatively good results that high VPP combination chemotherapy in advanced non-small cell lung cancer improves survival in the treated group than in the non-treated group. Thus, it is considerd that we select the patients with proper indications and treat them with effective chemotherpy and radiation therapy. But, because improvement related to high VPP ploychemotherapy is not marked in this study, it is necessary that we should investigate follow-up studies in many cases.

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Dysfunction of Autonomic Nervous System in Patients with Chronic Obstructive Pulmonary Diseases (만성 폐쇄성 폐질환 환자의 자율신경 장애)

  • Shin, Kyeong-Cheol;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Chang-Jin;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.317-326
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    • 1999
  • Background: Neural control of airway function is through parasympathetic, sympathetic and non-adrenergic, non-cholinergic mechanisms. The autonomic nervous system controls the airway smooth muscle tone, mucociliary system, permeability and blood flow in the bronchial circulation and release of mediators from the mast cells and other inflammatory cells. The cardiovascular and respiratory autonomic efferent fibers have a common central origin, so altered cardiovascular autonomic reflexes could reflect the altered respiratory autonomic status. Therefore, we performed this study to assess the autonomic abnormality and determine the correlating factors of severity of autonomic neuropathy in patients with chronic obstructive pulmonary disease(COPD) using easily reproducible cardiovascular autonomic reflex function test. Method: The study included 20 patients with COPD and 20 healthy persons obtained on Health Promotion Center in Yeungnam university hospital. All the patients had history and clinical features of COPD as defined by the American Thoracic Society. Any patients with myocardial ischemia, cardiac arrythmia, hypertension, central or peripheral nervous system disease, diabetes mellitus, or any other diseases known to produce autonomic neuropathy, has excluded. The autonomic nervous system function tests included three tests evaluating the parasympathetic system and two tests evaluating the sympathetic system. And also all subjects were subjected to pulmonary function test and arterial blood gas analysis. Results: Autonomic dysfunction was more commonly associated with patients with COPD than healthy person The parasympathetic dysfunction was frequent in patient with COPD, but sympathetic dysfunction seemed preserved. The severity of parasympathetic dysfunction in patients with COPD was correlated with the degree of duration of disease, smoking, reductions in the value of $FEV_1$ and FVC, and arterial hypoxemia but no such correlation existed for age, type of COPD, $FEV_1$/FVC, or $PaCO_s$. Conclusion: There is high frequency of parasympathetic dysfunction associated with COPD and the parasympathetic abnormality in COPD is increased in proportion to severity of airway disease. In COPD, parasympathetic dysfunction probably does not the cause of disease, but it may be an effect of disease progression.

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Altered Expression of Peroxiredoxin and Thioredoxin in Septic Animal Model (패혈증 동물 모델에서 Peroxiredoxin 및 Thioredoxin의 발현 변화)

  • Kim, Hyung-Jung;Chae, Ho-Zoon;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.451-459
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    • 1999
  • Background : In sepsis, excessive generation of reactive oxygen species plays key roles in the pathogenesis of acute lung injury. The serum antioxidants such as catalase and MnSOD are elevated in sepsis and considered as predictors of acute respiratory distress syndrome(ARDS) and prognostic factors of sepsis. Peroxiredoxin(Prx) has recently been known as an unique and major intracellular antioxidant. In this study, we evaluated the expression of Prx I and Prx II in mouse monocyte-macrophage cells(RAW 267.7) after treatment of oxidative stress and endotoxin and measured the amount of Prx I, Prx II and thioredoxin(Trx) in peritoneal and bronchoalveolar lavage fluid of septic animal model. Methods : Using immunoblot analysis with specific antibodies against Prx I, Prx II and Trx, we evaluated the distribution of Prx I and Prx II in human neutrophil, alveolar macrophage and red blood cell. We evaluated the expression of Prx I and Prx II in mouse monocyte-macrophage cells after treatment of $5\;{\mu}M$ menadione and $1\;{\mu}g/ml$ lipopolysaccharide(LPS) and measured the amount of Prx I, Prx II and Trx in peritoneal lavage fluid of intraperitoneal septic animals(septic animal model induced with intraperitoneal 6 mg/Kg LPS injection) and those in bronchoalveolar lavage fluid of intraperitoneal septic animals and intravenous septic animals(septic animal model induced with intravenous 5 mg/Kg LPS injection) and compared with the severity of lung inflammation. Results : The distribution of Prx I and Prx II were so different among human neutrophil, alveolar macrophage and red blood cell. The expression of Prx I in mouse monocyte-macrophage cells was increased after treatment of $5\;{\mu}M$ menadione and $1\;{\mu}g/ml$ lipopolysaccharide but that of Prx II was not increased. The amount of Prx I, Prx II and Trx were increased in peritoneal lavage fluid of intraperitoneal septic animals but were not increased in bronchoalveolar lavage fluid of intraperitoneal and intravenous septic animals regardless of the severity of lung inflammation. Conclusion : As intracellular antioxidant, the expression of Prx I is increased in mouse monocyte-macrophage cells after treatment of oxidative stress and endotoxin. The amount of Prx I, Prx II and Trx are increased in local inflammatory site but not increased in injured lung of septic animal model.

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Pleural Fluid Analysis in Tuberculous Pleurisy Progressing into Severe Pleural Thickening Underwent Pleural Decortication (심한 흉막비후로 진행하여 흉막박피술을 시행받은 결핵성 흉막염 환자들의 흉막액 분석)

  • Chung, Jae Ho;Park, Moo Suk;Kim, Se Kyu;Chang, Joon;Chung, Kyung Young;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.353-360
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    • 2003
  • Background : Although most patients with tuberculous pleurisy respond well to anti-tuberculous drugs, some are known to progress into severe pleural thickening which needs decortication despite adequate anti-tuberculous treatment. Therefore, the purpose of this study was to identify factors associated with the development of severe pleural thickening in patients who finally underwent pleural decortication in tuberculous pleurisy. Patients and Methods : From retrospective medical records review, 121 patients initially diagnosed as tuberculous pleurisy without initial pleural fluid loculation were enrolled between January 1998 and December 2002. They were separated into two groups: 85 patients in group 1 who improved by anti-tuberculous drugs only, and 36 patients in group 2 who had progressed into pleural adhesion and finally underwent pleural decortication despite adequate (more than 6 months) anti-tuberculous treatment. Results : Males were more common in group 2 (M/F=31/5) than in group 1 (M/F=53/32) (p=0.010). Group 2 patients tended to have lower pleural fluid glucose level ($58{\pm}4$ mg/dL) than group 1 ($89{\pm}3$ mg/dL) (p=0.001) and higher pleural fluid adenosine deaminase level ($86{\pm}5$ IU/L) than group 1 ($76{\pm}3$ IU/L), (p=0.038). There were no significant differences in age, symptom duration, pleural fluid amount, or pleural fluid LDH level between groups 1 and 2. Conclusions : There was a relative risk of tuberculous pleurisy progression into severe pleural thickening which needed decortication in the case of male patients, low pleural fluid glucose or high adenosine deaminase level. But further, large-scale, prospective studies should be investigated.

Development of Prediction Equation of Diffusing Capacity of Lung for Koreans

  • Hwang, Yong Il;Park, Yong Bum;Yoon, Hyoung Kyu;Lim, Seong Yong;Kim, Tae-Hyung;Park, Joo Hun;Lee, Won-Yeon;Park, Seong Ju;Lee, Sei Won;Kim, Woo Jin;Kim, Ki Uk;Shin, Kyeong Cheol;Kim, Do Jin;Kim, Hui Jung;Kim, Tae-Eun;Yoo, Kwang Ha;Shim, Jae Jeong
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.42-48
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    • 2018
  • Background: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. Methods: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. Results: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=-10.4433-0.1434${\times}$age (year)+0.2482${\times}$heights (cm); DLco/alveolar volume (VA)=6.01507-0.02374${\times}$age (year)-0.00233${\times}$heights (cm). For women the prediction equations were described as followed: DLco=-12.8895-0.0532${\times}$age (year)+0.2145${\times}$heights (cm) and DLco/VA=7.69516-0.02219${\times}$age (year)-0.01377${\times}$heights (cm). All equations were internally validated by k-fold cross validation method. Conclusion: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.

A Reliability Analysis of Shallow Foundations using a Single-Mode Performance Function (단일형 거동함수에 의한 얕은 기초의 신뢰도 해석 -임해퇴적층의 토성자료를 중심으로-)

  • 김용필;임병조
    • Geotechnical Engineering
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    • v.2 no.1
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    • pp.27-44
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    • 1986
  • The measured soil data are analyzed to the descriptive statistics and classified into the four models of uncorrelated-normal (UNNO), uncorrelated-nonnormal (VNNN), correlatedonnormal(CONN), and correlated-nonnormal(CONN) . This paper presents the comparisons of reliability index and check points using the advanced first-order second-moment method with respect to the four models as well as BASIC Program. A sin91e-mode Performance function is consisted of the basic design variables of bearing capacity and settlements on shallow foundations and input the above analyzed soil informations. The main conclusions obtained in this study are summarized as follows: 1. In the bearing capacity mode, cohesion and bearing-capacity factors by C-U test are accepted for normal and lognormal distribution, respectively, and negatively low correlated to each other. Since the reliability index of the CONN model is the lowest one of the four model, which could be recommended a reliability.based design, whereas the other model might overestimate the geotechnical conditions. 2. In the case of settlements mode, the virgin compression ratio and preccnsolidation pressure are fitted for normal and lognormal distribution, respectively. Constraining settlements to the lower ones computed by deterministic method, The CONN model is the lowest reliability of the four models.

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Middle School Home Economics Teaching·Learning Course Plan Development of Unification Education (중학교 가정교과 통일교육 교수·학습 과정안 개발)

  • Yoon, Nam-Hee;Sohn, Sang-Hee
    • Journal of Korean Home Economics Education Association
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    • v.30 no.1
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    • pp.43-63
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    • 2018
  • The purpose of this study is to examine the various contexts affecting life culture through practical reasoning process and to select the goal and contents system of unification education in middle school home economics to form healthy unification community and to develop teaching and learning process. Based on the Unification Education Guidelines, Unification Education Pre-Study, Pre-Study on North Korean Defectors, and Analysis of the 2015 Revision Home Economics Curriculum in Korea, Goal and content system. Based on this, we developed a teaching and learning process and a student activity place applying practical reasoning process after extracting practical problems, and prepared a final development plan based on the results of two expert group evaluations. The results of this study are summarized as follows. First, the goal of unification education in the middle school home economics class is to 'Based on the social-cultural context, we develop the ability to cultivate healthy reunification by respecting the differences between the cultures of the two Koreas and discovering common values in a unified society and resolving practical issues in a unified society.'. Second, the content system of middle school home economics unification education was selected as the core theme of 'Unification Education Focused on the Living Culture'. The content elements were comprehending the socio - cultural context that affects the life culture of the two Koreas, Related language, maintenance of diversity of dietary culture in each region including North Korean food, social norms and attire, correct housing value and common living etiquette. Based on the goals of unification education in the middle school home school curriculum, we selected practical issues as 'What should we do to create a healthy unified community?'. Third, the teaching and learning process of unification education in junior high school home economics education is to recognize the problem of unification, to analyze the factors affecting the life culture of the two Koreas, to grasp the effect of the action and the ripple effects, to select alternative methods, And 4 subjects for 8 teaching learning course plan, and 35 teaching materials.

Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

Learning Material Bookmarking Service based on Collective Intelligence (집단지성 기반 학습자료 북마킹 서비스 시스템)

  • Jang, Jincheul;Jung, Sukhwan;Lee, Seulki;Jung, Chihoon;Yoon, Wan Chul;Yi, Mun Yong
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.179-192
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    • 2014
  • Keeping in line with the recent changes in the information technology environment, the online learning environment that supports multiple users' participation such as MOOC (Massive Open Online Courses) has become important. One of the largest professional associations in Information Technology, IEEE Computer Society, announced that "Supporting New Learning Styles" is a crucial trend in 2014. Popular MOOC services, CourseRa and edX, have continued to build active learning environment with a large number of lectures accessible anywhere using smart devices, and have been used by an increasing number of users. In addition, collaborative web services (e.g., blogs and Wikipedia) also support the creation of various user-uploaded learning materials, resulting in a vast amount of new lectures and learning materials being created every day in the online space. However, it is difficult for an online educational system to keep a learner' motivation as learning occurs remotely, with limited capability to share knowledge among the learners. Thus, it is essential to understand which materials are needed for each learner and how to motivate learners to actively participate in online learning system. To overcome these issues, leveraging the constructivism theory and collective intelligence, we have developed a social bookmarking system called WeStudy, which supports learning material sharing among the users and provides personalized learning material recommendations. Constructivism theory argues that knowledge is being constructed while learners interact with the world. Collective intelligence can be separated into two types: (1) collaborative collective intelligence, which can be built on the basis of direct collaboration among the participants (e.g., Wikipedia), and (2) integrative collective intelligence, which produces new forms of knowledge by combining independent and distributed information through highly advanced technologies and algorithms (e.g., Google PageRank, Recommender systems). Recommender system, one of the examples of integrative collective intelligence, is to utilize online activities of the users and recommend what users may be interested in. Our system included both collaborative collective intelligence functions and integrative collective intelligence functions. We analyzed well-known Web services based on collective intelligence such as Wikipedia, Slideshare, and Videolectures to identify main design factors that support collective intelligence. Based on this analysis, in addition to sharing online resources through social bookmarking, we selected three essential functions for our system: 1) multimodal visualization of learning materials through two forms (e.g., list and graph), 2) personalized recommendation of learning materials, and 3) explicit designation of learners of their interest. After developing web-based WeStudy system, we conducted usability testing through the heuristic evaluation method that included seven heuristic indices: features and functionality, cognitive page, navigation, search and filtering, control and feedback, forms, context and text. We recruited 10 experts who majored in Human Computer Interaction and worked in the same field, and requested both quantitative and qualitative evaluation of the system. The evaluation results show that, relative to the other functions evaluated, the list/graph page produced higher scores on all indices except for contexts & text. In case of contexts & text, learning material page produced the best score, compared with the other functions. In general, the explicit designation of learners of their interests, one of the distinctive functions, received lower scores on all usability indices because of its unfamiliar functionality to the users. In summary, the evaluation results show that our system has achieved high usability with good performance with some minor issues, which need to be fully addressed before the public release of the system to large-scale users. The study findings provide practical guidelines for the design and development of various systems that utilize collective intelligence.

Relationships of Achievement Goal Orientation with Academic Self-efficacy of Specialized High School Students (특성화고등학교 학생의 성취목표지향성과 학업적 자기효능감의 관계)

  • Yang, Jin-Sik;Song, Nak-Hyun;Lee, Chang-Hoon
    • 대한공업교육학회지
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    • v.43 no.2
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    • pp.79-96
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    • 2018
  • In this study, we look at the effect that the achievement goal of specialized high school students has on academic self-efficacy and the difference in academic self-efficacy depending on achievement goal orientation. The purpose of this research is to help students to efficiently increase their academic self-efficacy, develop research and study life guidance measures to improve negative factors, and select professors and learning methods. To achieve the purpose, survey was conducted with achievement goal orientation measurement tools(26 questions) and academic self-efficacy measurement tools(28 questions) for 745 students of 18 specialized technical high school students in 5 districts. The results of this study are as follows. First, preference to task difficulty and self-controlling efficacy have highly positive correlations with mastery goal orientation and confidence and mastery avoidance goal orientation have highly negative correlations each other. Second, achievement goal orientation form of specialized high school students were divided into 5 forms; 'execution avoidance(34.8%)', 'mastery orientation(20.8%)', 'approach(17%)', 'avoidance competition(14.9%)', and'mastery avoidance(12.5%)'. In preference to task difficulty, 'approach'group showed the highest average point and 'mastery avoidance'showed the lowest average point. The average point of 'approach' group was higher than other groups in confidence, but 'mastery orientation' group showed the highest average point. Through the results of this study, academic self-efficacy makes an effect by a certain direction in accordance with achievement goal orientation and it's necessary to access academic problems differently according to student's goal directivity. Therefore, it's necessary to provide educational method by student type based on explanation about academic self-efficacy of achievement goal orientation of specialized high school students and analysis on achievement goal orientation form.