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Surgery Alone and Surgery Plus Postoperative Radiation Therapy for Patients with pT3N0 Non-small Cell Lung Cancer Invading the Chest Wall (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 단독과 수술 후 방사선치료)

  • 박영제;임도훈;김관민;김진국;심영목;안용찬
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.845-855
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    • 2004
  • Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (+) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (+) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (+) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (+) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (+) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

Antecedents of Manufacturer's Private Label Program Engagement : A Focus on Strategic Market Management Perspective (제조업체 Private Labels 도입의 선행요인 : 전략적 시장관리 관점을 중심으로)

  • Lim, Chae-Un;Yi, Ho-Taek
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.65-86
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    • 2012
  • The $20^{th}$ century was the era of manufacturer brands which built higher brand equity for consumers. Consumers moved from generic products of inconsistent quality produced by local factories in the $19^{th}$ century to branded products from global manufacturers and manufacturer brands reached consumers through distributors and retailers. Retailers were relatively small compared to their largest suppliers. However, sometime in the 1970s, things began to slowly change as retailers started to develop their own national chains and began international expansion, and consolidation of the retail industry from mom-and-pop stores to global players was well under way (Kumar and Steenkamp 2007, p.2) In South Korea, since the middle of the 1990s, the bulking up of retailers that started then has changed the balance of power between manufacturers and retailers. Retailer private labels, generally referred to as own labels, store brands, distributors own private-label, home brand or own label brand have also been performing strongly in every single local market (Bushman 1993; De Wulf et al. 2005). Private labels now account for one out of every five items sold every day in U.S. supermarkets, drug chains, and mass merchandisers (Kumar and Steenkamp 2007), and the market share in Western Europe is even larger (Euromonitor 2007). In the UK, grocery market share of private labels grew from 39% of sales in 2008 to 41% in 2010 (Marian 2010). Planet Retail (2007, p.1) recently concluded that "[PLs] are set for accelerated growth, with the majority of the world's leading grocers increasing their own label penetration." Private labels have gained wide attention both in the academic literature and popular business press and there is a glowing academic research to the perspective of manufacturers and retailers. Empirical research on private labels has mainly studies the factors explaining private labels market shares across product categories and/or retail chains (Dahr and Hoch 1997; Hoch and Banerji, 1993), factors influencing the private labels proneness of consumers (Baltas and Doyle 1998; Burton et al. 1998; Richardson et al. 1996) and factors how to react brand manufacturers towards PLs (Dunne and Narasimhan 1999; Hoch 1996; Quelch and Harding 1996; Verhoef et al. 2000). Nevertheless, empirical research on factors influencing the production in terms of a manufacturer-retailer is rather anecdotal than theory-based. The objective of this paper is to bridge the gap in these two types of research and explore the factors which influence on manufacturer's private label production based on two competing theories: S-C-P (Structure - Conduct - Performance) paradigm and resource-based theory. In order to do so, the authors used in-depth interview with marketing managers, reviewed retail press and research and presents the conceptual framework that integrates the major determinants of private labels production. From a manufacturer's perspective, supplying private labels often starts on a strategic basis. When a manufacturer engages in private labels, the manufacturer does not have to spend on advertising, retailer promotions or maintain a dedicated sales force. Moreover, if a manufacturer has weak marketing capabilities, the manufacturer can make use of retailer's marketing capability to produce private labels and lessen its marketing cost and increases its profit margin. Figure 1. is the theoretical framework based on a strategic market management perspective, integrated concept of both S-C-P paradigm and resource-based theory. The model includes one mediate variable, marketing capabilities, and the other moderate variable, competitive intensity. Manufacturer's national brand reputation, firm's marketing investment, and product portfolio, which are hypothesized to positively affected manufacturer's marketing capabilities. Then, marketing capabilities has negatively effected on private label production. Moderating effects of competitive intensity are hypothesized on the relationship between marketing capabilities and private label production. To verify the proposed research model and hypotheses, data were collected from 192 manufacturers (212 responses) who are producing private labels in South Korea. Cronbach's alpha test, explanatory / comfirmatory factor analysis, and correlation analysis were employed to validate hypotheses. The following results were drawing using structural equation modeling and all hypotheses are supported. Findings indicate that manufacturer's private label production is strongly related to its marketing capabilities. Consumer marketing capabilities, in turn, is directly connected with the 3 strategic factors (e.g., marketing investment, manufacturer's national brand reputation, and product portfolio). It is moderated by competitive intensity between marketing capabilities and private label production. In conclusion, this research may be the first study to investigate the reasons manufacturers engage in private labels based on two competing theoretic views, S-C-P paradigm and resource-based theory. The private label phenomenon has received growing attention by marketing scholars. In many industries, private labels represent formidable competition to manufacturer brands and manufacturers have a dilemma with selling to as well as competing with their retailers. The current study suggests key factors when manufacturers consider engaging in private label production.

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The Impact of e-Store Personality on e-Store Loyalty-Focus on the Mediating Role of Identification, Trust, and Engagement (온라인에서 점포 개성이 점포 충성도에 미치는 영향-동일시, 신뢰, 인게이지먼트의 매개 역할을 중심으로)

  • Park, Hyo-Hyun;Jung, Gang-Ok;Lee, Seung-Chang
    • Journal of Distribution Research
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    • v.16 no.2
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    • pp.57-94
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    • 2011
  • Nowadays, it is common that most consumers are purchasing goods in e-stores. The e-stores eager to attract, revisit, retain, and finally convert them into loyal customers. The e-store marketers have planned and executed numerous marketing efforts. As one of the marketing activities, e-store managers attempt to build web sites that meet customers' functional and psychological needs. A wide array of studies has been done to identify factors that could affect customers' response of web sites. Majority of studies were conducted to verify technology-related and functional variables of the website which facilitate transactions and enhance customer responses such as purchase intention and website loyalty. However, there has been little research on the external cues of website and psychological variables of consumer that could have positive influences on customer response. The purpose of this study is to investigate the influence of e-store personality on e-store loyalty through mediating variables such as e-store identification, e-store trust, and e-store engagement. The authors of this study develop the model and set up the six main hypotheses and a set of sub-hypotheses based on a literature review, shown in

    . This model is composed of four paths such as dimensions of e-store personality${\rightarrow}$e-store identification, e-store identification${\rightarrow}$e-store loyalty, e-store identification ${\rightarrow}$e-store trust${\rightarrow}$e-store loyalty, and e-store identification${\rightarrow}$e-store engagement${\rightarrow}$e-store loyalty. II. Research Method Ladies under 30s were the respondents of this survey. Data were collected from January 20th to February 26th in 2010. A total of 200 questionnaires were distributed and 169 respondents were analysed finally to test hypotheses because 31 questionnaires had incorrect or missing responses. SPSS 12.0 and LISREL 7.0 program were used to test frequency, reliability, factor, and structural equation modeling analysis. III. Result and Conclusion According to results from factor analysis, eigen value was over 1.0 and items which were below 0.6 were deleted. Consequently, 9 factors(% of total variance is 72.011%) were searched. All Cronbach's ${\alpha}$ values are over the recommended level(${\alpha}$ > 0.7). The overall fit indices are acceptable such as ${\chi}^2$=2028.36(p=0.00), GFI=0.87, AGFI=0.82, CFI=0.81, IFI=0.92, RMR=0.075. All factor loadings were over the recommended level. As the result of discriminant validity check with chi-square difference test between paired constructs, each construct has good discriminant validity. The overall fit indices of final model are acceptable such as ${\chi}^2$=340.73(df=36, p=0.00), GFI=0.92, AGFI=0.81, CFI=0.91, IFI=0.91, RMR=0.085. As test results, 5 out of 6 hypotheses are supported because there are statistically significant casual relationships in structural equation model, shown in . First of all, hypothesis 1 is partially supported because sub-hypothesis 1-1 and 1-2 are supported, whereas sub-hypothesis 1-3, 1-4, and 1-5 are rejected. Specifically, it reveals that warmth and sophistication dimensions in e-store personality have positive influence on e-store identification, however, activity, progressiveness, and strictness does not have any significant relationship on e-store identification. Secondly, hypothesis 2 was supported. Therefore, it can be said that e-store identification has a positive impact on e-store trust. Thirdly, hypothesis 3 is also supported. Hence, there is a positive relationship between e-store identification and e-store engagement. Fourthly, hypothesis 4 is supported too. e-store identification has a positive influence on e-store loyalty. Fifthly, hypothesis 5 is also accepted. This indicates that e-store trust is a precedent variable which positively affects e-store loyalty. Lastly, it reveals that e-store engagement has a positive impact on e-store loyalty. Therefore, hypothesis 6 is supported. The findings of the study imply that some dimensions of e-store personality have a positive influence on e-store identification, and that e-store identification has direct and indirect influence on e-store loyalty through e-store trust and e-store engagement positively. These results also suggest that the e-store identification in e-store personality is a precedent variable which positively affects e-store loyalty directly and indirectly through e-store trust and engagement as a mediating variable. Therefore, e-store marketers need to implement website strategy based on e-store personality, e-store identification, e-store trust, and e-store engagement to meet customers' psychological needs and enhance e-store loyalty. Finally, the limitations and future study directions based on this study are discussed.

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  • The Effect of TGF-{\beta}_1 on Cellular Activity of Periodontal Ligament Cells activated by PDGF-BB (PDGF-BB에 의한 치주인대세포활성에 대한 TGF-{\beta}의 효과)

    • Baek, Sang-Churl;Park, Jin-Woo;Suh, Jo-Young
      • Journal of Periodontal and Implant Science
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      • v.32 no.3
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      • pp.457-473
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      • 2002
    • The purposes of this study is to evaluate the combination effects of TGF-${\beta}_1$ and PDGF-BB on the periodontal ligament cells to use as a regeneration promoting agent of periodontal tissue. Human periodontal ligament cells were prepared from the first premolar tooth extracted for the orthodontic treatment and were cultured in DMEM/100% FBS at the $37^{\circ}C$, 5% $CO_2$ incubator. Authors measured the DNA synthesis, total protein, collagen and noncollagenous protein synthesis according to the concentration of TGF-${\beta}_1$,(1,5ng/ml) and PDGF-BB (1,10 ng/ml) in combination. To explore further this delayed effect of TGF-${\beta}_1$, we preincubated human periodontal ligament cells with TGF-${\beta}_1$ for 4 or 24 hours before PDGF-BB stimulation. The results were as follows: The DNA synthetic activity was increased dose dependently by TGF-${\beta}_1$, PDGF-BB. The combination of TGF-${\beta}_1$ and PDGF-BB consistently enhanced the DNA synthetic activity to PDGF-BB alone. The ability of TGF-${\beta}_1$ to enhance DNA synthetic activity in PDGF-BB treated periodontal ligament cells was dose dependent. The maximum mitogenic effect was at the 5ng/ml of TGF-${\beta}_1$ and l0ng/ml of PDGF-BB. Preincubation of cell with TGF-${\beta}_1$ resulted in significantly greater response to PDGF-BB at all TGF-${\beta}_1$ concentration studied, and may be useful for clinical application in periodontal regenerative procedures. The total protein, collagen and noncollagen synthesis was increased dose pendently by TGF-${\beta}_1$, PDGF-BB. The % of collagen was slightly decreased according to the concentration of TGF-${\beta}_1$, PDGF-BB. The effect of TGF-${\beta}_1$, PDGF-BB were not specific for collagen synthesis since it also increased noncollagenous protein synthesis. This study demonstrates that PDGF-BB is major mitogens for human periodontal ligament cells in vitro, and supports a role for TGF-${\beta}_1$ as a regulation of the mitogenic and total protein formation to PDGF-BB in these cells.

    The Effect of External Radiation Therapy in Management of Malignant Obstructive Jaundice due to Porta Hepatis Metastasis from Stomach Cancer (위암의 간문맥 전이로 발생한 악성 폐쇄성 황달에 대한 외부 방사선치료 효과)

    • Yang, Kwang-Mo;Kim, Joon-Hee;Kim, Chul-Soo;Suh, Hyun-Suk;Kim, Re-Hwe
      • Radiation Oncology Journal
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      • v.13 no.4
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      • pp.339-348
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      • 1995
    • Purpose : Since 1983, authors have conducted a study to evaluate the effect of external radiation therapy and to determine affected factors in management of the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. Materials and Methods : Thirty two patients with malignant obstructive jaundice due to porta hepatis metastasis from gastric cancer were presented. We have analysed 23 patients who were treated with external radiation therapy of more than 3000cGy. The radiation dose, disease extent at developement of jaundice, total bilirubin levels before radiation therapy, differentiation of histology, combind treatment, intent of primary surgery, initial stage of gastric cancer were analyzed to determine affected factors in radiation therapy. External radiation therapy was delivered with a daily dose of 180-300cGy, 5 times a week fractionation using 4 MeV linear accelerator. The radiation field included the porta hepatis with tumor mass by the abdominal ultrasonography or CT scan. In twenty three patients received more than 3000cGy, total irradiation dose was ranged from 3000cGy to 5480cGy, median 3770cGy. Among 23 patients, 13 patients were delivered more than equivalant dose of TDF 65(4140cGy/23fx). Results : Among 23 patients, complete, partial and no response were observed in 13, 5, 5 patients, respectively. The median survival for all patients was 5 momths. The significant prolongation of median survival was observed in complete responders(11 months) as compared to partial and no responders(5 months, 5 months respectively) Out of 13 patients with complete response, 6 patients lived more than a year Among 13 patients receiving more than 4140cGy equivalent dose, complete, partial and no response were observed in 10, 2 and 1 patients, respectively. The median survival for all these patients was 9.5 months. The median survival for complete responders(10/13) was 11.5 months. Among 10 patients receiving less than 4140cGy equivalent dose, complete, partial and no response were observed in 3, 3, 4 patients, respetively. The median survival for all these patients was 4.3 months Therefore, the radiation dose affected the results of treatment. For the complete response with prolongation of survival duration, at least 4140cGy equivalant dose should be delivered to porta hepatis. In evaluation of the disease extent, 7 patients of 13 complete responders showed localized disease in porta hepatis or peripancreatic area, but all patients with partial and no response showed wide extensive disease or persistant disease of primary gastric cancer. Therefore. the patients with the localized disease were the higher probability of complete response and long term survival. This study suggested that the radiation dose and the disease extent at developement of jaundice affected in radiation therapy for malignant obstructive jaundice. There were no serious complications related to external radiation therapy. Conclusion : External radiation therapy only could achieve the palliative effect in the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. This study suggested that the prolongation of survival duration could be achived in complete responders and radiation dose, extent of disease affected the results of treatment of malignant obstructive jaundice.

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    Hyperfractionated Radiotherapy Following Induction Chemotherapy for Stage III Non-Small Cell Lung Cancer -Randomized for Adjuvant Chemotherapy vs. Observation- (절제 불가능한 제 3 기 비소세포 폐암의 MVP 복합 항암요법과 다분할 방사선 치료 -추가 항암요법에 대한 임의 선택 -)

    • Choi, Eun-Kyung;Chang, Hye-Sook;Ahn, Seung-Do;Yang, Kwang-Mo;Suh, Cheol-Won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Ko, Youn-Suk;Kim, Woo-Sung;Kim, Won-Dong;Song, Koun-Sik;Sohn, Kwang-Hyun
      • Radiation Oncology Journal
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      • v.11 no.2
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      • pp.295-301
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      • 1993
    • Since Jan. 1991 a prospective randomized study for Stage III unresectable non small cell lung cancer (NSCLC) has been conducted to evaluate the response rate and tolerance of induction chemotherapy with MVP followed by hyperfractionated radiotherapy and evaluate the efficacy of maintenance chemotherapy in Asan Medical Center. All patients in this study were treated with hyperfractionated radiotherapy (120 cGy/fx BID, 6480 cGy/54 fx) following 3 cycles of induction chemotherapy, MVP (Mitomycin C 6 $mg/m^2,$ Vinblastin 6 $mg/m^2,$ Cisplatin 60 $mg/m^2$) and then the partial and complete responders from induction chemotherapy were randomized to 3 cycles of adjuvant MVP chemotherapy group and observation group. 48 patients were registered to this study until December 1992; among 48 patients 3 refused further treatment after induction chemotherapy and 6 received incomplete radiation therapy because of patient's refusal, 39 completed planned therapy. Twenty-three $(58\%)$ patients including 2 complete responders showed response from induction chemotherapy. Among the 21 patients who achieved a partial response after induction chemotherapy,1 patient rendered complete clearance of disease and 10 patients showed further regression of tumor following hyperfractionated radiotherapy. Remaining 10 patients showed stable disease or progression after radiotherapy. Of the sixteen patients judged to have stable disease or progression after induction chemotherapy, seven showed more than partial remission after radiotherapy but nine showed no response in spite of radiotherapy. Of the 39 patients who completed induction chemotherapy and radiotherapy, 25 patients $(64\%)$ including 3 complete responders showed more than partial remission. Nineteen patients were randomized after radio-therapy. Nine Patients were allocated to adjuvant chemotherapy group and 4/9 showed further regression of tumor after adjuvant chemotherapy. For the time being, there is no suggestion of a difference between the adjuvant chemotherapy group and observation group in distant metastasis rate and survival. Median survival time was 13 months. Actuarial survival rates at 6,12 and 18 months of 39 patients who completed this study were $84.6\%,\;53.7\%\;and\;40.3\%,$ respectively. The partial and complete responders from induction chemotherapy showed significantly better survival than non-responders (p=0.028). Incidence of radiation pneumonitis in this study group was less than that in historical control group inspite of induction chemotherapy. All patients tolerated hypertractionated radiotherapy without definite increase of acute complications compared with conventional radiotherapy group. The longer follow up is needed to evaluate the efficacies of induction and maintenance chemotherapy and survival advantage by hyperfractionated radiotherapy but authors are encouraged with an excellent tolerance, higher response rate and improvement of one year survival rate in patients of this study.

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    The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

    • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
      • Tuberculosis and Respiratory Diseases
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      • v.43 no.5
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      • pp.671-682
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      • 1996
    • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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    An Analysis of the Psychiatric Characteristics of the Alopecia Areata in Female (여성 탈모증의 정신의학적 특성 분석)

    • Lee, Kil-Hong;Na, Chul;Lee, Young-Sik;Lee, Chang-Hoon;No, Byung-In;Hong, Chang-Kwon
      • Korean Journal of Psychosomatic Medicine
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      • v.8 no.1
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      • pp.31-45
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      • 2000
    • Objectives : The present study was performed to reveal differences between female and male cases of alopecia in their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment, and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analysis the gender difference in hair losses, the subjects were divided into two subgroups as the 51 cases of female alopecia and the 42 cases of male alopecia, who had visited to the department of psychiatry consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and analysis of varaiance, through SPSS-$PC^+$ 9.0V. Results : 1) Female subjects were more likely showed lower socio-economical level including lower eonomical level, lower educational level, or lower occupational level in their parent's job, were more likely to have larger number of siblings and to have many sisters comparison to the male cases. 2) Female subjects were more likely visited to the department of dermatology, more history of alopecia in their female family members, lesser history of alopecia in their male family members, more loss of hairs in vertex or frontal region of scalp, lesser loss of hairs in occipital region, and lesser nail changes in comparison to the male cases. 3) Female subjects were more suffered from intra-familial conflicts and economical changes, or their introverted personality makeup, lesser likely suffered from changes of business and health changes, and showed lesser conflicts related with poorer adaptaion in their job life. 4) Female subjects were more likely diagnosed as depression or conversion disorders, more frequently complaint anxiety symptoms or depressive symptoms, higher level of anxiety index, lesser complaint somatization or obsessive compulsive symptoms, and lesser diagnosed as anxiety disorder in comparison to the male cases. 5) Female subjects were more likely tended to show personality makeup such as the introverted, the lie, the repressed, or the feminine trends than the male cases. 6) Female subjects were more significantly treated by antianxiety drug such as etizolam and dermatological therapies include tretinoin, and lesser treated by clotiazepam and prednicarbonate in comparison to the male cases. Conclusion : From the facts that The most important factors in developing hair loss in the female subjects in comparison to the male cases seems to be closely correlated with the serious psychopathology such as the presence of mental disorders including depression, the presence of complaining anxiety or depressive symptomatology, the presence of stressful life events such as intrafamilial life changes, and the presence of personality makeup such as the introverted, the lie, the repressed, or the feminine trends, the authors confirmed that dermatologists act as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for female patients with the alopecia with psychiatrists.

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    A Literature Study of Ophthalmotolaryngologic Diseases from the Viewpoint of Onbyeong; On the Basis of Imjeungjinamuian (溫病學에서의 眼耳鼻咽喉科 疾患에 대한 文獻考察;臨證指南醫案을 중심으로)

    • Cho, Jae-Hun;Chae, Byung-Yoon;Kim, Yoon-Bum
      • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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      • v.15 no.1
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      • pp.198-218
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      • 2002
    • On the basis of Imjeungjinamuian(臨證指南醫案), authors investigated the pathogenesis and treatment of ophthalmotolaryngobgic diseases from the viewpoint of Onbyeong(溫病). 1. The symptoms and diseases investigated according to department were as follows;. 1) Ophthalmology : blepharitis, blepharedema, lacrimal hypersecretion, hyperemia, ophthalmalgla, photopsia, visual disturbance, mydriasis 2) Otology : full-feeling, otorrhea, otalgla, mastoiditis, tinnitus, hearing disturbance, vertigo 3) Rhinology : rhinorrhea, nasal obstruction, sinusitis, epistaxis 4) Laryngology : sore throat, hoarseness 5) The Others : headache, cough, asthma 2. The pathogenesis and treatment of ophthalmotolaryngologic diseases were as follows. 1) When the pathogenesis of hyperemia, otorrhea, otalgia, mastoiditis, hearing disturhance. epistaxis, sore throat, headache and cough are wind-stagnanc(風鬱), wind-warm(風溫), wind-fire(風火), wind-dryness(風燥), dryness-heat(燥熱), the treatment of pungent-cool-evaporating(辛凉解表) with Dajosan(茶調散), Mori Folium(桑葉), Lonicerae Flos(金銀花), Forsythiae Fructus(連翹), Viticis Fructus(蔓荊子), Prunellae Spica(夏枯草), Arctii Fructus(牛蒡子), etc can be applied. 2) When the pathogenesis of hoarseness, cough and asthma are cold(寒), cold with endogenous heat(寒包熱, 外冷內熱), water retention(水邪), fluid retention(伏飮), impairment of YangKi by overexertion(勞傷陽氣), the treatment of pungent-warm-evaporating(辛溫解表) with Mahaenggamseoktang(麻杏甘石湯), Socheongryongtang(小靑龍湯), Jeongryeokdaejosapyetang(정력대조사폐탕), Gyejitang(桂枝湯), Armeniacae Amarum Semen(杏仁), etc can be applied. 3) When the pathogenesis of photopsia, otorrhea, otalgia, rhinorrhea, sinusitis, epistaxis, sore throat, hoarseness, headache and cough are stagnancy-induced heat(鬱熱), wind-dryness(風燥), wind-heat(風熱), summer heat(暑熱), summer wind(暑風), insidious summer heat(伏暑), autumn heat(秋暑), autumn wind(秋風), autumn dryness(秋燥), dryness-heat(燥熱), heat in Ki system(氣分熱), insidious warm(溫伏), brain discharge by fire in Ki system(氣火 腦熱), heat in stomach(胃熱), endogenous fire by deficiency of Yin(陰虛內火), deficiency of Yin in stomach(胃陰虛), the treatment of Ki-cooling(淸氣) with Bangpungtongseongsan(防風通聖散), Ikweonsan(益元散), Gyejibaekhotang(桂枝白虎湯), Geumgwemaekmundongtang(금궤맥문동탕), Gyeongokgo(瓊玉膏), Sojae Semen Praeparatum(두시), Scutellariae Radix(黃芩), Phyllostachys Folium(竹葉), Adenophorae Radix(沙參), Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), etc can be applied. 4) When the pathogenesis of blepharitis, hyperemia, ophthalmalgia, full-feeling, otorrhea, otalgia, tinnitus, hearing disturbance, sinusitis, hoarseness, headache and cough are fire in liver(肝火), fire in gallbladder(膽火), ministerial fire in Soyang system(少陽相火), wind-stagnancy(風鬱), stagnancy-induced fire(鬱火), brain discharge by phlegm-fire(痰火 腦熱), the treatment of mediation(和解) with Gardeniae Fructus(梔子), Moutan Cortex(牧丹皮), Saigae Tataricae Cornu(羚羊角), Artemisiae Annuae Herba(靑蒿), Cyperi Rhizoma(香附子), Poria(적복령), etc can be applied. 5) When the pathogenesis of blepharedema and cough are dampness in both spleen and lung(脾肺濕) damp-heat(濕熱), damp-phlegm(濕痰), the treatment of dampness-resolving(化濕) with Poria(백복령), Coicis Semen(薏苡仁), Tetrapanacis Medulla(通草), Armeniacae Amarum Semen(杏仁), Talcum(滑石), etc can be applied. 6) When the pathogenesis of vertigo and cough are deficiency of Yong(營虛), heat in Yong, system(營熱), the treatment of Yong-cooling(淸營) with Rehmanniae Radix(生地黃), Liriopis Tuber(麥門冬), Biotae Semen(柏子仁), Lilii Bulbus(百合), Phyllostachys Folium(竹葉), etc can be applied. 7) When the pathogenesis of epistaxis are heat in blood system of heart(心血熱), reversed flow of fire(火上逆), overexertion(努力), the treatment of blood-cooling(凉血) with Rhinoceri Cornu(犀角), Rehmanniae Radix(生地黃), Moutan Cortex(牧丹皮), Salviae Miltiorrhizae Radix(丹參), Scrophulariae Radix(玄蔘), etc can be applied. 8) When the pathogenesis of nasal obstruction is pathogen-stagnancy(邪鬱), the treatment of resuscitation(開竅) with Sosang(少商, LU11) acupuncture can be applied. When the pathogenesis of hoarseness is evil Ki(穢濁), the treatment of resuscitation(開竅) with Arctii Fructus(牛蒡子), Lasiosphaera Seu Calvatia(馬勃), Curcumae Radix(鬱金), etc can be applied. When the pathogenesis of headache is stasis of both Ki and blood(氣血瘀痺), the treatment of resuscitation(開竅) with Cnidii Rhizoma(川芎), Asari Herba Cum Radice(細辛), Scorpio(全蝎), moxibustion(灸), etc can be applied. 9) When the pathogenesis of lacrimal hypersecretion, visual disturbance, mydriasis, tinnitus, hearing disturbance, sinusitis, epistaxis, hoarseness and cough are deficiency of Yin(陰虛), deficiency of kidney(腎虛), deficiency of both liver and kidney(肝腎虛), deficiency of both heart and kidney(心腎虛), brain discharge by deficiency of Yin(陰虛 腦熱), exuberance of Yang in liver(肝陽上亢), overexertion(勞損), the treatment of Yin-replenishing(滋陰) with Yukmijihwanghwan(六味地黃丸), Hojamhwan(虎潛丸), Jeobutang(猪膚湯), Lycii Fructus(枸杞子), Polygoni Multiflori Radix(何首烏), Rehmanniae Radix(生地黃), Schizandrae Fructus(五味子), Liriopis Tuber(麥門冬), Asini Gelatinum(阿膠), etc can be applied. 10) When the pathogenesis of ophthalmalgia, mydriasis, vertigo and headache are deficiency of Yin in liver(肝陰虛), exuberance of Yang in liver(肝陽上亢), endogenous wind(內風), excess in upper and deficiency in lower part(上實下虛), the treatment of Yin-replenishing(滋陰) and endogenous wind-calming(熄風) with Rehmanniae Radix Preparat(熟地黃), Lycii Fructus(枸杞子), Polygoni Multiflori Radix(何首烏), Paeoniae Radix Alba(白芍藥), Ostreae Concha(牡蠣), Saigae Tataricae Cornu(羚羊角), Chrysanthemi Flos(菊花), etc be applied. 11) When the pathogenesis of mydriasis, sinusitis, hoarseness, headache, cough and asthma are exhaustion of vital essence(精氣無收藏), brain discharge(腦髓不固), floating Yang(陽虛浮), exsanguination(失血), deficiency of both Yin and Yang(陰陽不足), overexertion(勞損), deficiency of Yang in kidney(腎陽虛), the treatment of Yang-restoring and exhaustion-arresting(回陽固脫) with Yangyeongtang(養營湯), Cheonjinhwan(天眞丸), Bokmaektang(복맥탕), Geonjungtang(建中湯), Dogihwan(都氣丸), Singihwan(腎氣丸), Jinmutang(眞武湯), Ostreae Concha(牡蠣), Nelumbinis Semen(蓮子肉), etc can be applied. 12) When the pathogenesis of lacrimal hypersecretion, vertigo and headache are deficiency of stomach and endogenous wind(胃虛內風), endogenous wind with phlegm(內風挾痰), liver check of stomach(肝木橫擾), the treatment of concomitant-treating of both liver and stomach(肝胃同治) with Paeoniae Radix Alba(白芍藥), Uncariae Ramulus Et Uncus(釣鉤藤), Gastrodiae Rhizoma(天麻), Astragali Radix(황기), Pinelliae Rhizoma(半夏), etc can be applied. When the pathogenesis of asthma is failure of kidney to promote inspiration(腎不納氣), the treatment of kidney-tonifing and inspiration-promoting(補腎納氣) with Singihwan(腎氣丸), Psoraleae Fructus(補骨脂), Juglandis Semen(胡桃), Aquilariae Resinatum Lignum(沈香), etc can be applied. When the pathogenesis of asthma is deficiency of Ki(氣虛), the treatment of Ki-reinforcing(補氣) with Sagunjatang(四君子湯), Insamgeonjungtang(人參建中湯), etc can be applied.

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    The influence of the four noted physicians of Geum-Won era on the completion of the medicine in the Chosun dynasty (금원사대가의학(金元四大家醫學)이 조선조의학(朝鮮朝醫學) 형성(形成)에 미친 영향(影響))

    • Cheong, Myeon;Hong, Won Sik
      • Journal of Korean Medical classics
      • /
      • v.9
      • /
      • pp.432-552
      • /
      • 1996
    • The influence of the four noted physicians of Geum-Won era(金元代) on the completion of the medicine in the Chosun dynasty(朝鮮朝) can be summarized as follows. 1. The four noted physicians of Geum-Won era were Yoo-Wan-So(劉完素), Jang-Jong-Jung(張從正), Lee-Go(李杲), Ju-Jin-Heung(朱震亨). 2. Yoo-Wan-So(劉完索) made his theory on the basic of Nae-Kyung("內經") and Sane-Han-Lon("傷寒論"), his idea of medicine was characterized in his books, for exemple, application of O-Oon-Yuk-Ki(五運六氣), Ju-Wha theory(主火論) and hang-hae-seng-je theory(亢害承制論). from his theory and method of study, many deviations of oriental medicine occurred. He made an effort for study of Nae-Kyung, which had been depressed for many years, on the contrary of the way old study that Nae-Kyung had been only explained or revised, he applied the theory of Nae-Kyung to clinical care. The theory of Yuk-Gi-Byung-Gi(六氣病機) and On-Yeul-Byung(溫熱病) had much influenced on his students and posterities, not to mention Jang-Ja-Wha and Ju-Jin-Heung, who were among the four noted physicians therefore he became the father of Yuk-Gi(六氣) and On-Yeul(溫熱) schools. 3. Jang-Jong-Jung(張從正) emulated Yoo-Wan-So as a model, and followed his Yuk-Gi-Chi-Byung(六氣致病) theory, but he insisted on the use of the chiaphoretic, the emetic and the paregoric to get rid of the causes, specially he insisted on the use of the paregoric, so they called him Gong-Ha-Pa(攻下派). He insisted on the theory that if we would strenthen ourselves we should use food, id get rid of cause, should use the paregoric, emetic and diaphoretic. Jang-Jong-Jung'S Gang-Sim-Wha(降心火) theory, which he improved Yoo-Wan-So's Han-Ryang(寒凉) theory influenced to originate Ju-Jin-Heung'S Ja-Eum-Gang-Wha(滋陰降火) theory. 4. Lee-Go(李杲) insisted on the theory that Bi-Wi(脾胃) played a loading role in the physiological function and pathological change, and that the internal disease was originated by the need of Gi(氣) came from the disorder of digestive organs, and that the causes of internal disease were the irregular meal, the overwork, and mental shock. Lee-Go made an effort for study about the struggle of Jung-Sa(正邪) and in the theory of the prescription he asserted the method of Seung-Yang-Bo-Gi(升陽補氣), but he also used the method of Go-Han-Gang-Wha(苦寒降火). 5. The authors of Eui-Hak-Jung-Jun("醫學正傳"), Eui-Hak-Ib-Moon("醫學入門"), and Man-Byung-Whoi-Choon("萬病回春") analyzed the medical theory of the four noted physicians and added their own experiences. They helped organizing existing complicated theories of the four noted physicians imported in our country, and affected the formation of medical science in the Choson dynasty largely. Eui-Hak-Jung-Jun("醫學正傳") was written by Woo-Dan(虞槫), in this book, he quoted the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, especially, Ju-Jin-Heung was respected by him, it affected the writing of Eui-Lim-Choal-Yo("醫林撮要"). Eui-Hak-ib-Moon("醫學入門"), written by Lee-Chun(李杲), followed the medical science of Lee-Go and ju-jin-heung from the four noted physicians of Geum-Won era. Its characteristics of Taoism, idea of caring of health, and organization affected Dong-Eui-Bo-Kham("東醫寶鑑"). Gong-Jung-Hyun(龔延賢) wrote Man-Byung-Whoi-Choon("萬病回春") using the best part of the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, this book affected Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") partly. 6. our medical science was developed from the experience of the treatment of disease obtained from human life, these medical knowledge was arranged and organized in Hyang-Yak-Jib-Sung-Bang("鄕藥集成方"), medical books imported from China was organized in Eui-Bang-Yoo-Chwi("醫方類聚"), which formed the base of medical development in the Chosun dynasty. 7. Eui-Lim-Choal-Yo("醫林撮要") was written by Jung-Kyung-Sun(鄭敬先) and revised by Yang-Yui-Soo(楊禮壽). It was written on the base of Woo-Dan's Eui-Jung-Jun, which compiled the medical science of the four noted physicians of Geum-Won era. It contained confusing theories of the four noted physicians of Geum-Won era and organized medical books of Myung era, therefore it completed the basic form of Byun-Geung-Non-Chi (辨證論治) influenced the writing of Dong-Eui-Bo-Kham("東醫寶鑑"). 8. Dong-Eui-Bo-Kham("東醫寶鑑") was written on the base of basic theory of Eum-Yang-O-Haeng(陰陽五行) and the theory of respondence of heaven and man(天人相應說) in Nae-Kyung. It contained several theories and knowledge, such as the theory of Essence(精), vitalforce(氣), and spirit(神) of Taoism, medical science of geum-won era, our original medical knowledge and experience. It had established the basic organization of our medical science and completed the Byun-Geung-Non-Chi (辨證論治). Dong-Eui-Bo-Kham developed medical science from simple medical treatment to protective medical science by caring of health. And it also discussed human cultivation and Huh-Joon's(許浚) own view of human life through the book. Dong-Eui-Bo-Kham adopted most part of Lee-Go(李杲) and Ju-Jin-Heung's(朱震亨) theory and new theory of "The kidney is the basis of apriority. The spleen is the basis of posterior", so it emphasized the role of spleen and kidney(脾腎) for Jang-Boo-Byung-Gi(臟腑病機). It contained Ju-Jin-Heung's theory of the cause and treatment of disease by colour or fatness of man(black or white, fat or thin). It also contained Ju-Jin-Heung's theory of "phlegm break out fever, fever break out palsy"(痰生熱 熱生風) and the theory of Sang-Wha(相火論). Dong-Eui-Bo-Kham contained Lee-Go's theory of Wha-Yu-Won-Bool-Yang-Lib (火與元氣不兩立論) quoted the theory of Bi-Wi(脾胃論) and the theory of Nae-Oi-Sang-Byun(內外傷辨). For the use of medicine, it followed the theory by Lee-Go. lt used Yoo-Wan-So'S theory of Oh-Gi-Kwa-Keug-Gae-Wi-Yul-Byung(五志過極皆爲熱病) for the treatment of hurt-spirit(傷神) because fever was considered as the cause of disease. It also used Jang-Jons-Jung's theory of Saeng-Keug-Je-Seung(生克制勝) for the treatment of mental disease. 9. Lee-je-ma's Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") adopted medical theories of Song-Won-Myung era and analyzed these theories using the physical constitutional theory of Sa-Sang-In(四象人). It added Dong-Mu's main idea to complete the theory and clinics of Sa-Sang-Eui-Hak(四象醫學). Lee-Je-Ma didn't quote the four noted physicians of Geum-Won era to discuss that the physical constitutional theory of disease and medicine from Tae-Eum-In(太陰人), So-Yang-In(少陽人), So-Eum-In(少陰人), and Tae-Yang-In(太陽人) was invented from their theories.

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