• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.157-175
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• 2007

This study was conducted through an interview process in which questionnaires were administered to 293 people. The questionnaires related to the behaviors of oral hygiene care, and disease history related to halitosis, and status of halitosis, halitosis measurement, oral examination, and caries activity tests such as the snyder test, Salivary flow rate test, and Salivary buffering capacity test. Our sample was taken from 293 rural residents within the period from 4th to 21st of January 2006. This was done in order to provide basic data to prepare both policies of halitosis prevention and a device to efficiently measure halitosis status and investigate the factors related therein. The major findings of this study results are as follows: 1. As for frequency of tooth brushing, twice a day occupied the greatest portion at 46.1 % Women exceeded men in frequency of tooth brushing. Tongue brushing everyday produced a 25.6 % result among subjects and The use of auxiliary oral hygiene devices occupied 9.2 %. 2. As for degree of usual self-awareness of halitosis: 62.5 %. This result also demonstrate that the severest time of self-awareness in regards to halitosis is wake up time in the morning. The time period produced the highest portion of 72.7 % in times of self-awareness. In terms of the area in which halitosis was observed, gum resulted in 23.0 %. As for types of halitosis, fetid smell was the most frequent at 37.2 %. 3. As for the result of halitosis measurement, values of OG less than 50 ppm occupied 54.3 % and $50{\sim}100ppm$ occupied 41.6 %. As for $NH_3$ values, $20{\sim}60ppm$ showed the highest value range of 52.6 %. 4. As for OG per disease history related to halitosis, values of OG were significantly high in the ranges of $50{\sim}100ppm$ within family history groups of food impaction by dental caries, diabetes mellitus and halitosis. As for values of $NH_3$, there showed a significant difference in respiratory system disease groups. 5 Value range of OG per ordinary halitosis self-awareness degree: values ranging less than 50 ppm were recorded at 55.9 % from the group realizing not aware of smell. 57.5 % from groups only realizing sometimes, while values range of $50{\sim}100ppm$ were recorded at 52.0 % from groups always aware of smell. 63.6 % from groups always strongly aware of smell. Meanwhile as for the values ranges of $NH_3$, $20{\sim}60ppm$. they occupied high portions for all groups of exams. 6. Values of OG per oral examination: the more pulp-exposed teeth and food impaction and the higher the tongue plaque index, values of OG increased within the range of $50{\sim}100ppm$. As for values of $NH_3$, the more prosthetic teeth and the higher the tongue plaque index, this value increased significantly, and the values increased up to no less than 60 ppm for groups of mandibular partial denture. 7. Within the realm of caries activity test: as for the Snyder test, high activity was highest by 43.0 % wherewith the higher the activity of acidogenic bacteria the higher the OG values. As for the salivary flow rate test, the number of cases below 8.0 ml showed the highest tendency by 62.5 %. The larger the salivary flow rate the more decreased OG values distribution. As for the salivary buffering capacity test, $6{\sim}10$ drops of 0.1N lactic acid showed the overwhelming trend by 58.7 % whereby the higher the salivary buffering capacity the greater distribution occupancy ratio of OG values below 50 ppm which is scentless to on ordinary person. 8. As for the correlation between oral environment and halitosis, OG showed the positive correlation with pulp exposed teeth, filled teeth, present teeth, tongue plaque index, and food impaction, while the negative correlation with salivary flow rate and prosthetic teeth. $NH_3$ showed a positive correlation with prosthetic teeth and frequency of tooth brushing, while decayed teeth was negative correlation. 9. As for the multiple regression analysis result, there have been selected female, pulp exposed teeth, prosthetic teeth, food impaction, salivary flow rate, tongue plaque index and severe activities in the Snyder test as factors affecting OG wherein explanatory power on it was 45.1 %. There have been selected females, pulp exposed teeth, tongue plaque index, and prosthetic teeth as factors affecting on $NH_3$ wherein explanatory power on it was 6.6 %. With the aforementioned results in mind, the status of halitosis among rural residents is considered to bare a close relation with oral environments and other factors related to halitosis such as the Snyder test from caries activity test, and salivary flow rate test. For the prevention of halitosis of residents in rural areas, we have to focus on correct tooth brushing methods and tongue brushing, with using auxiliary oral hygiene devices to remove fur of tongue plaque and food impaction. Also, when the cause and ingredients of halitosis are diverse and complex, in order to analyze exactly the factors of individual halitosis development, we need continuous and systematic study in order to provide rural residents with programs of oral hygiene education and encourage the use of dental hygienists in public health centers.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.36-42
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• 2006

Purpose: The $p21^{Waf1/Cip1}$ protein Inhibits the cell cycle by Inhibiting the phosphorylation at the $G1{\rightarrow}S$ check point, and the $p27^{kip1}$ protein similarly performs the suppressor function by controlling the p27-mediated G1 arrest. In this study, we analysed the clinical status and survival rates in correlations with p21 and p27 expression patterns in gastric cancer. Materials and Methods: Between 1993 and 1997, 192 patients who underwent surgeries in Catholic Medical Center were analysed retrospectively in this study. Immunohistochemical staining was performed and if the nuclei of the tumor cells were stained, we assumed those as positive results. Statistical analysis was based on clinicopathological findings and differences in survival rates. Results: The expression rate of p27 was 28.1% and 15.6% in p21 each. The ratio of T1-2(80.0%) was significantly high in p21 (+), but the ratio of T3-4 (50.6%) was slightly high in p21 (-). There was no statistical significance regarding other factors. The results in p27 was not much different from expression rate of p21 in T-stage. In addition, p27 expression in diffuse type (91.3%) was higher than in intestinal type (62.7%) by Lauren's classification (P<0.05). Also, there was no statistical significance in other factors. In the correlation of p21 and p27, p27 was positive when p21 was positive (53.5%). Conversely, p27 was negative when p21 was negative (76.5%, p<0.05). In the p21 and p27 combination test, there was higher rate of T1-2 (87.5%) in p21 (+)/p27 (+), and higher rate of T3-4 (58.1%) in p21 (-)/p27 (-) (P<0.05). Results showed higher rate of intestinal type (100%) in p21 (+)/p27 (+), and diffuse type (87.0%) was dominant in p21 (-)/p27 (-) (P<0.05) by Lauren's classification. Moreover, there was no statistical significance in the 5-year survival rate in the expression of p21 and p27, and the 5-year survival rate was highest in the case of p21 (+)/p27 (+) without statistical significance. Conclusion: In our study, $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ expressed similar patterns. The expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ affected the degree of invasiveness of the tumor, and. Combined examination result revealed the correlation of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ with Lauren's classification and depth of invasion of the tumor. However, we assumed that little difference between the survival rates depending on expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ has limited their value as predictable prognostic indicators.

• The Journal of Dong Guk Oriental Medicine
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• v.2 no.1
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• pp.73-105
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• 1993

To say nothing of the orient and the west, the human beings discover the method of Jin Mac(診脈) by the way that observe disease. But oriental medicine devise special method of Jin Mac(診脈) in the study of Kyoung Mac(經脈). Although sip-ei Kyoung Mac Jin(十二經脈診), Sam Bu Gu Who Jin(三部九候診), In Young Mac Gu Jin(人迎脈口診), Chon Kwan Chuck Jin(寸關尺診) namely Yuk Bu Jung Wee Jin Mac (六部定位診脈) that is used today are devised, it has changed naturally by the changing treatment and the introduction of Yuin Yang(陰陽) and five element(五行). Many methods dg Jin Mac(診脈), it had not developped successing alternative, it had developped of declined by it's own way. 1. Results for the birth of Mac(脈) 1) Mac(脈), it means Kyoung Mac(經脈), at first entirelly Mac(脈), is seized a blood vessel that flows in the body. As presumed today, after finding many acupunture point, a general idea of Mac(脈) is not maked by the line that connect point and point, it connect between acupunture point and acupunture point. 2) Like blood flows in Hyul Mac(血脈), Gie(氣) flows in Kyoung Mac(經脈). The two things relate deeply each other. In a general idea or actrally Kyoung Rak(經洛), the two things sometimes accord, sometimes seperate, sometimes mix alternative. 3) Hyul Mac(血脈) and Kyoung Mac(經脈), we call it Mac(脈) entirely Kyoung Mac(經脈), is a way that manifest disease through Kyoung Mac(經脈) or a boundary that disease belongs to it method of Mac Jin(脈診) individual that disease of Kyoung Mac(經脈) is diagnosed by the jumping situation of Hyul Mac(血脈). 4) In method of Moxa, athough the pathology and the diagnostic of Mac(脈) are created by finding Mac(脈). Finding acupunture have opportunitty fot Mac Jin(脈診) and treatment. 2. Results of Kyoung Mac Mac Jin(經脈脈診) 1) In theory of kyoung Rak(經洛), disease are resumed for malfunction of Young Wee(榮衛) that flows in Kyung Rak(經洛). So to speak, in treatment of Kyoung Rak area, the purpose of diagnosis observe the situation of disease and cause. For fitting the purpose of diagnosis, the dead had esatablised four-diagnosis method mangMunMnnJeul(望聞問切), in four-diagnosis(四診法), the core is Mac Jin(脈診). 2) sip-ei Kyoung Mac Mac Jin(十二經脈診) had existed as Kyoung Mac Mac Jin(經脈脈診), it precedes Sam Bu Gu Who Jin(三部九候診). In Young Ki Gu Mac(人迎脈口診). 3) Although Bu Yang Mac(趺陽脈), So Um Mac(少陰脈) is a part of Sip-ei Kyoung Mac(十二經脈診), they developped especially because they located in the point of Won Hyul(原穴) and they are convenient for diagnose. 4) Sip-ei Kyoung Mac Mac Jin(十二經脈診), which belongs to Bu Yang Mac(趺陽脈) and So Urn Mac(少陰脈), is not important for the comming age medical books compared with Mac Kyoung(脈經). 3. Results gor Sam Bu Gu Who Jin(三部九候診) 1) Mac Jin(脈診) of Sam Bu Gu Who(三部九候), which is noted in the theory of Sam Bu Gu Who(三部九候診) of So Mun(素問), belongs to Kyoung Mac Mac Jin's(經脈脈診) geneology, Sip-ei Kyoung Mac Mac Jin(十二經脈診) is arranged, simplicated by the idealogy three talents(三才思想) in the heaven and the earth. 2) What Sam Bu Gu Jin(三部九候診) is regardded as very important in So Mun(素問), the editor of So Mun(素問) recognize the meaning that one discover disease early in this method of diagnosis. 3) After Young chu(靈樞), Nan Kyoung(難經) it is lacked the method of Sam Bu Gu Who Jin(三部九候診) in the books that treatment has changed. Sam Bu Gu Who Jin(三部九候診) based on actually clinic appropriate. 4. results for In Young Mac Gu Jin(人迎脈口診) 1) In Young Mac Gu Jin(人迎脈口診) is the method of comparative Mac Jin(脈診) according to the theory of Yin Yang(陰陽), it is presumed after Sam Bu Gu Who Jin(三部九候診), it had perished in parallel with the development of the theory of five elelment(五行). The development of the acupunture, the perishment of the treatment of negative(刺絡). 2) In Young Mac Gu Jin(人迎脈口診), Wang Suk Wha(王叔和) recreated that the left is In Young(人迎), the right is Kie Gu(氣口). In future generations by Jin Mu Taek(陳無擇) who is the writer of Sam In Bang(三因方). In Young Mac Gu Jin(人迎脈口診) is a measure for disease which classify it's inside and outside cause. 5. Results for Chon Gu Mac Jin(寸口脈診) 1) What we say Mac Jin(脈診) of Chon Gu(寸口) two means are used in commn. First case, we simply say the area of Chon Gu(寸口), second case, we say Chon Kwan Chuk Jin(寸口尺診) reducingly. Chon Gu(寸口) is the area which is the radial artery of wrist joint. What we attemp diagnose by only Chon Gu Mac(寸口脈), it is clearly shoued in the method of Nan Kyoung, five Nan(難經五難). 2) Because Jin Mac(診脈) is made in only Chon Gu(寸口), that is the area in which is concentated Kyoung Kee(經氣). That is the birth of Jin Kee(眞氣) and Jin Kee(眞氣) is related with disease. We can diagnose disease by taking Chon Gu(寸口). 3) Chuk Jin(尺診) in Nae Kyoung(難經) have two things. One is Il Chuk(一尺), the other is Chon Kwan Chu(寸關尺). 4) Chuk Chon Jin(尺寸診) is the method which diagnose the difference of point and the condition of Mac(脈) by dividing a part of Chuk(尺) in the area of Chon Gu(寸口). In Chon Gu Jin(寸口診), by introducing the theory of Yin Yang(陰陽), the method of Chon Gu Jin(寸口診) is developed by chon Gu Jin(寸口診). 5) What Chuk Kwan Chon Jin(寸關尺診) is that area of the Chon Gu(寸口) are divided fot three point, we can diagnose. By consulting Sam Bu Gu Who Jin(三部九候診), developping of the method of acupunture, utilzing the theory of five element(五行) it is devised by concentrating way of thinking of the method mac Jin(脈診) exiting. 6) Chon Kwan Chuk Jin MaC(寸關尺診脈) begin from Nae Kyoung(內徑) exiting. After Nan Kyoung(內徑), spread out widely from Mac Kyoung(脈診) of Wang Suk wha(王叔和), the future medicins followed it. Yang Hyun Jo(楊玄操) and established Chon Kwan Chuk Jin(寸關尺診) which is used widely today. This right and left Chon Kwan Chuk Jin(寸關尺診), we call it method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 7) We can think the base which presume the arrangement of the viscera for Chon Kwan Chuk(寸關尺) of the right and the left. 8) The origin, which seperate the right and the left of Mac(脈), is showed at the treory of Ji Jin Yo Dae(至眞要大論) in So Mun(素問) which Chon Chuk(寸尺) seperate the right and the left. But the method of diagnosis in Nan Kyoung(難經) have no seperation the fight and the left. Otherwise this. there is clearly writtened the seperation for the right origin of the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈) seek for Cang Gong(倉公). 9) Yang Hyun Jo(楊玄操) notice that the Chuk(尺) is mentioned for Sam Cho(三焦) in the method of Mac Kyuong(脈經), Sim Po Kyung(心包經) which put together with Sam Cho(三焦) allot on this, he had established the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 10) On the method of Paen Jak Yin Yang Mac(扁鵲陰陽脈) in Mac Kyoung(脈經), equal article exist with the theory of Pyung In Kee Sang(平人氣象論) in So Mun(素問). When Wang Suk Wha(王叔和) write Mac Kyung(脈經), we can presume that the book of Mac(脈) which Paen Jak(扁鵲) had experienced the origin have exited besides So Mun(素問), Young Chu(靈樞). If so he must be make Chon Kwan Chuk Jin(寸關尺診) very fairly standard. So Nae Kyoung(內經), which must be fllowed the method of Paen Jak Mac(扁鵲脈), do the method diagnosis of Chon Kwan Chuk(寸關尺), diagnise of disease and treat.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.119-150
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• 1999

In spite of recent remarkable recent development in both western and oriental medical sciences, there is still only a shallow understanding of individual differences for various prognoses of incurable diseases and immunopathy diseases. Nevertheless, the care, cure and prevention methods of Sasang Constitutional Medicine are broadly used as an effective treatment of incurable diseases like immunopathy diseases and stress-related diseases and diseases due to aging. In this sense, the establishment of classification norms is urgent and essential for the worldwide application of Sasang Constitutional Medicine(SCM). This study began with the confirmation process of whether Sasang Constitutional types exist in Americans. To accomodate for cultural differences, the distinguishing tool was readjusted so that Sasang Constitutional Types in Americans could be determined. Hence, the selected tool is the new QSCCII+, which is a newly revised English version of the QSCCII. QSCCII was made and standardized by Dept. of SCM in Kyung Hee Medical Center and Dr. Kim7). The evaluation methods of the old version were improved in the new QSCCII+ through necessary statistical manipulation. The original QSCCII was officially authorized by the Korean Society of Sasang Constitutional Medicine as the only computerized version of Sasang diagnostics. This study is the first attempt to design a new diagnostic tool for the classification of Sasang Constitutional types in North Americans with the revision of QSCCII. The subjects of this study were selected from the cooperative people among the students and staffs of the University of Bridgeport and the patients who visited the Clinic in the Health Science Center. This study takes for about 1 year from 1998. 8 to 1999. 8 The conclusions of the study can be summarized as follows: 1. Sasang constitutional types also exist in Americans. It can also naturally be inferred that Sasang Constitutional types exist in all human beings, for there are many different human races in America. 2. There are more So-Yang In's than any other types in American white people. This result confirms the hypothesis that there also exist Sasang Constitutional types in westerners. 3. The result of repetitive tests suggests that the new QSCCII+ is an effective diagnostic tool for westerners when we consider the constant diagnostic results of the QSCCII+. 4. Sasang Constitutional types exit in the sample group regardless of racial difference. 5. The question items that were not often checked by Americans need to be modified into more understandable expressions. 6. The standardization of diagnosis for Americans should be established by use of the QSCCII+ 7. It can be guessed that there are many Tae-yang In's among the 71 persons who could not be clearly classified by the QSCCII+. Due to the scarcity of Tae-yang-In in general, it is important to improve upon the discernability of the QSCC II+. 8. The results of the Sasang Constitutional distribution in North Americans are as follows: The percentage of So-yang In distribution in the sample group is 36.25%(87persons), that of Tae-eum In is 13.75%(33persons), and that of So-eum In is 20.41%(49persons).

• Journal of Global Scholars of Marketing Science
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• v.17 no.2
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• pp.1-29
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• 2007

The flow theory becomes one of the most important frameworks in the internet research arena. Hoffman and Novak proposed a hierarchical flow model showing the antecedents and outcomes of flow and the relationship among these variables in the hyper-media computer circumstances (Hoffman and Novak 1996). This model was further tested after their initial research (Novak, Hoffman, and Yung 2000). At their paper, Hoffman and Novak explained that the balance of challenge and skill leads to flow which means the positive optimal state of mind (Hoffman and Novak 1996). An imbalance between challenge and skill, leads to negative states of mind like anxiety, boredom, apathy (Csikszentmihalyi and Csikszentmihalyi 1988). Almost all research on the flow 4-channel model have been focusingon flow, the positive state of mind (Ellis, Voelkl, and Morris 1994 Mathwick and Rigdon 2004). However, it also needs to examine the formation of the negative states of minds and their outcomes. Flow researchers explain play or playfulness as antecedents or the early state of flow. However, play has been regarded as a distinct concept from flow in the flow literatures (Hoffman and Novak 1996; Novak, Hoffman, and Yung 2000). Mathwick and Rigdon discovered the influences of challenge and skill on play; they also observed the influence of play on web-loyalty and brand loyalty (Mathwick and Rigdon 2004). Unfortunately, they did not go so far as to test the influences of play on state of mind. This study focuses on the relationships between state of mind in the flow 4-channel model and play. Early research has attempted to hypothetically explain state of mind in flow theory, but has not been tested except flow until now. Also the importance of play has been emphasized in the flow theory, but has not been tested in the flow 4-channel model context. This researcher attempts to analyze the relationships among state of mind, skill of play, challenge, state of mind and web loyalty. For this objective, I developed a measure for state of mind and defined the concept of play as a trait. Then, the influences of challenge and skill on the state of mind and play under on-line shopping conditions were tested. Also the influences of play on state of mind were tested and those of flow and play on web loyalty were highlighted. 294 undergraduate students participated in this research survey. They were asked to respond about their perceptions of challenge, skill, state of mind, play, and web-loyalty to on-line shopping mall. Respondents were restricted to students who bought products on-line in a month. In case of buying products at two or more on-line shopping malls, they asked to respond about the shopping mall where they bought the most important one. Construct validity, discriminant validity, and convergent validity were used to check the measurement validations. Also, Cronbach's alpha was used to check scale reliability. A series of exploratory factor analyses was conducted. This researcher conducted confirmatory factor analyses to assess the validity of measurements. All items loaded significantly on their respective constructs. Also, all reliabilities were greater than.70. Chi-square difference tests and goodness of fit tests supported discriminant and convergent validity. The results of clustering and ANOVA showed that high challenge and high skill leaded to flow, low challenge and high skill leaded to boredom, and low challenge and low skill leaded to apathy. But, it was different from my expectation that high challenge and low skill didnot lead to anxiety but leaded to apathy. The results also showed that high challenge and high skill, and high challenge and low skill leaded to the highest play. Low challenge leaded to low play. 4 Structural Equation Models were built by flow, anxiety, boredom, apathy for analyzing not only the impact of play on state of mind and web-loyalty, but also that of state of mind on web-loyalty. According the analyses results of these models, play impacted flow and web-loyalty positively, but impacted anxiety, boredom, and apathy negatively. Results also showed that flow impacted web-loyalty positively, but anxiety, boredom, and apathy impacted web-loyalty negatively. The interpretations and implications of the test results of the hypotheses are as follows. First, respondents belonging to different clusters based on challenge and skill level experienced different states of mind such as flow, anxiety, boredom, apathy. The low challenge and low skill group felt the highest anxiety and apathy. It could be interpreted that this group feeling high anxiety or fear, then avoided attempts to shop on-line. Second, it was found that higher challenge leads to higher levels of play. Test results show that the play level of the high challenge and low skill group (anxiety group) was higher than that of the high challenge and high skill group (flow group). However, this was not significant. Third, play positively impacted flow and negatively impacted boredom. The negative impacts on anxiety and apathy were not significant. This means that the combination of challenge and skill creates different results. Forth, play and flow positively impacted web-loyalty, but anxiety, boredom, apathy had negative impacts. The effect of play on web-loyalty was stronger in case of anxiety, boredom, apathy group than fl ow group. These results show that challenge and skill influences state of mind and play. Results also demonstrate how play and flow influence web-loyalty. It implies that state of mind and play should be the core marketing variables in internet marketing. The flow theory has been focusing on flow and on the positive outcomes of flow experiences. But, this research shows that lots of consumers experience the negative state of mind rather than flow state in the internet shopping circumstance. Results show that the negative state of mind leads to low or negative web-loyalty. Play can have an important role with the web-loyalty when consumers have the negative state of mind. Results of structural equation model analyses show that play influences web-loyalty positively, even though consumers may be in the negative state of mind. This research found the impacts of challenge and skill on state of mind in the flow 4-channel model, not only flow but also anxiety, boredom, apathy. Also, it highlighted the role of play in the flow 4-channel model context and impacts on web-loyalty. However, tests show a few different results from hypothetical expectations such as the highest anxiety level of apathy group and insignificant impacts of play on anxiety and apathy. Further research needs to replicate this research and/or to compare 3-channel model with 4-channel model.

• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.453-473
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• 1992

Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.535-547
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• 1995

Background: Intensive care units(ICUs) probably represent the single largest identifiable source of infection within the hospital. Although there are several studies on ICU infections in respect to their bacteriology or mortality rate for individual types of ICU, few studies have compared ICU infections between different types of ICU. The aim of this study was to identify clinical differences in bacteremia between medical ICU(MICU) and surgical ICU(SICU) patients. Methods: 256 patients with bacteremia were retrospectively evaluated. Medical records were reviewed to obtain the clinical and bacteriologic informations. Results: 1) The mean age of the patients with bacteremia of MICU($58.6{\pm}17.2\;yr$) was greater than that of all MICU patients($54.3{\pm}17.1\;yr$)(p<0.01), but there was no significant difference in SICU patients(patients with bacteremia of SICU: $56.3{\pm}18.6\;yr$, all SICU patients: $62.0{\pm}16.8$)(p>0.05). ICU stay was longer(MICU patients: $23.4{\pm}40.8$ day, SICU patients: $30.3{\pm}26.8$ day) than the mean stay of all patients($6.8{\pm}15.5$ day)(p<0.05, respectively). Bacteremia of both ICU patients developed past the average day of ICU stay(all MICU patients: 7.9 day, all SICU patients: 6.0 day, MICU bacteremia: 19th day, SICU bacteremia: 17th day of ICU stay)(p<0.05, respectively). 2) There were no significant differences in mean age, sex, and length of stay of both ICU patients with bacteremia. 3) Use of antibiotics or steroid, use of percutaneous devices and invasive procedures before development of bacteremia were more frequent in SICU patients than in MICU patients(prior antibiotics use: MICU 45%, SICU 63%, p<0.05; steroid use: MICU 14%, SICU 36%, p<0.01; use of percutaneous devices: MICU 19%, SICU 39%, p<0.01; invasive procedures: MICU 19%, SICU 61 %, p<0.01). 4) The prevalence of community acquired infections was significantly higher in MICU patients than in SICU patients(MICU 42%, SICU 9%)(p<0.01), whereas SICU patients showed higher prevalence of ICU-acquired infection than MICU patients(MICU 48%, SICU 78%)(p<0.01). 5) There were no differences in causative organisms, primary sites of infection and time interval to bacteremia between both ICUs. 6) There were no significant differences in outcome according to pathogenic organisms or primary sites of infection. 7) The mortality rate was higher in patients with bacteremia than without bacteremia(MICU mortality rate: patients with bacteremia 72.5%, patients without bacteremia 36.0%, p<0.01; SICU mortality rate: patients with bacteremia 40.3%, patients without bacteremia 8.5%, p<0.05), and the mortality rate of MICU bacteremia was significantly higher compared with that of SICU bacteremia(MICU 72.5%, SICU 40.3%)(p<0.01). Conclusion: ICU patients with bacteremia stayed longer before the development of bacteremia, and showed higher mortality than the overall ICU population. The incidence of bacteremia was higher in MICU patients than SICU patients. MICU patients with bacteremia showed higher prevalence of liver diseases and acute respiratory failure, community-acquired bacteremia and greater mortality rate than SICU patients with bacteremia. SICU patients with bacteremia, on the other hand, showed higher prevalence of trauma, prior use of immunosuppressive agents, invasive procedures, and ICU-acquired bacteremia, and lower mortality rate than MICU patients with bacteremia.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.38.1-38
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• 1981

Currently in the otologic field, there are various methods of special audiometric examinations, such as, tone decay, SISI, and impedance audiometry and only a few studies has been done in these fields sporadically in Korea. The purpose of this paper is to establish norms of various special audiometric tests, so we have performed the special audiometric tests on 100 male medical students in good physical condition and the follow results were obtained. 1. All cases showed over 90% of PB scores. The mean and its 2 S.D. were 98$\pm$4.9% in the right ear and 97$\pm$5.6% in the left ear. 2. The mean and its 2 S.D. of MCL(most comfortable level) were 45$\pm$15.4 dB in the right ear and 46$\pm$17.9 dB in the left ear, and its range was 12$\pm$12.2 dB in the right ear and 13$\pm$12.6 dB in the left ear. 3. The mean and its 2 S.D. of UCL (uncomfortable level) were 102$\pm$7.9 dB in the right ear and 102$\pm$7.9 dB in the left ear and about an half in cases showed over 106 dB of UCL. 4. In 95% of cases, SISIs(short increment sensitivity index) at 1, 000 Hz and 4000 Hz was below 45% in the right ear in both frequencies and below 55% and 75% in the left ear, respectively. 5. In 95% of cases, tone decays at 2, 000 Hz and 4, 000 Hz was below 10 dB in both ears. 6. The difference between SRT and PTA (speech reception threshold minus pure tone average) was 4$\pm$9.2 dB in the right ear and 4$\pm$10.0 dB in the left ear. 7. The dynamic range(uncomfortable level minus speech reception threshold) was 98$\pm$13.5 dB in the right ear and 99$\pm$13.5 dB in the left ear. We had trouble in estimating the dynamic range in about an half in cases, in which we couldn't estimate the UCL with our conventional audiometry. 8. The results of impedance audiometric tests were as follow: A. In the tympanogram, all cases were of A type with one exception of B type in the left ear. The mean and its 2 S.D. of its peak level were 22.8$\pm$32.94mm $H_2O$ in the right ear and 23.9$\pm$29. 81mm $H_2O$ in the left ear. B. The mean and its 2 S.D. of the compliance were 0.6$\pm$0.54cc in the right ear and 0.6$\pm$0.53cc in the left ear. C. The results of stapedial reflex: a. The mean and its 2 S.D. of the controlateral stapedial reflex at 500Hz, 1, 000Hz, 2, 000Hz, 4, 000Hz were 99$\pm$17.7 dB, 87$\pm$14.4 dB, 79$\pm$13.7 dB, 77$\pm$20.0 dB in the right ear and 99$\pm$15.9 dB, 88$\pm$13.9 dB, 79$\pm$13.7 dB, 77$\pm$21.3 dB in the left ear. Depending on the tested frequencies, the stapedial reflex wasn't generated in 6 cases in the right ear and 11 cases in the left ear. b. The mean and its 2 S.D. of the ipsilateral stapedial reflex at 1, 000Hz, and 2, 000Hz were 89$\pm$16.3 dB, 82$\pm$15.9 dB in the right ear and 89$\pm$18.0 dB, 83$\pm$18.9 dB in the left ear. Depending on the tested frequencies, the stapedial reflex wans't generated in 1 case in the right ear and 2 cases in the left ear. 9. Eustachian tube function using with impedance audiometry was malfunctioned in21 cases depending on the tested pressure and the range of peak level of tympanogram was 14$\pm$26.9mm $H_2O$(tested pressure:+250mm $H_2O$), 8$\pm$21.9mm $H_2O$ (tested pressure:-250mm $H_2O$) in the right ear and 11 cases depending on the tested pressure and the range of the peak level of tympanogram was 12$\pm$22.5mm $H_2O$ (tested pressure: +250 mm $H_2O$, 9$\pm$17.3mm $H_2O$(tested pressure: -250mm $H_2O$) in the left ear.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.51-66
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• 2004

Objectives : The matrix metalloproteinases (MMPs) that participate in the extracellular matrix metabolism play a important role in the progression of pulmonary fibrosis. The effects of the MMPs are regulated by several factors including Th-1 cytokines, $interferon-{\gamma}$ ($IFN-{\gamma}$). Up to now, $IFN-{\gamma}$ is known to inhibit pulmonary fibrosis, but little is known regarding the exact effect of $IFN-{\gamma}$ on the regulation of the MMPs. This study investigated the effects of $interferon-{\gamma}$ on the pulmonary fibrosis and the expression of the lung MMP-2,-9, TIMP-1,-2, and Th-2 cytokines in aa rat model of bleomycin induced pulmonary fibrosis. Materials and methods : Male, specific pathogen-free Sprague-Dawley rats were subjected to an intratracheal bleomycin instillation. The rats were randomized to a saline control, a bleomycin treated, and a bleomycin+$IFN-{\gamma}$ treated group. The bleomycin+$IFN-{\gamma}$ treated group was subjected to an intramuscular injection of $IFN-{\gamma}$ for 14 days. At 3, 7, 14, and 28 days after the bleomycin instillation, the rats were sacrificed and the lungs were harvested. In order to evaluate the effects of the $IFN-{\gamma}$ on lung fibrosis and inflammation, the lung hydroxyproline content, inflammation and fibrosis score were measured. Western blotting, zymography and reverse zymography were performed at 3, 7, 14, 28 days after bleomycin instillation in order to evaluate the MMP-2,-9, and TIMP-1,-2 expression level. ELISA was performed to determine the IL-4 and IL-13 level in a lung homogenate. Results : 1. 7 days after bleomycin instillation, inflammatory changes were more severe in the bleomycin+$IFN-{\gamma}$ group than the bleomycin group (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$2.08{\pm}0.15:2.74{\pm}0.29$, P<0.05), but 28 days after bleomycin instillation, lung fibrosis was significantly reduced as a result of the $IFN-{\gamma}$ treatment (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$3.94{\pm}0.43:2.64{\pm}0.13$, P<0.05). 2. 28 days after bleomycin instillation, the lung hydroxyproline content was significantly reduced as a result of $IFN-{\gamma}$ treatment (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$294.04{\pm}31.73{\mu}g/g:194.92{\pm}15.51{\mu}g/g$, P<0.05). 3. Western blotting showed that the MMP-2 level was increased as a result of the bleomycin instillation and highest in the 14 days after bleomycin instillation. 4. In zymography, the active forms of MMP-2 were significantly increased as a result of the $IFN-{\gamma}$ treatment 3 days after the bleomycin instillation, bleomycin+$IFN-{\gamma}$ group (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$209.63{\pm}7.60%:407.66{\pm}85.34%$, P<0.05), but 14 days after the bleomycin instillation, the active forms of MMP-2 were significantly reduced as a result of the $IFN-{\gamma}$ treatment (bleomycin group : bleomycin+$IFN-{\gamma}$ group=$159.36{\pm}20.93%:97.23{\pm}12.50%$, P<0.05). 5. The IL-4 levels were lower in the bleomycin and bleomycin+$IFN-{\gamma}$ groups but this was not significant, and the IL-13 levels showed no difference between the experiment groups. Conclusion : The author found that lung inflammation was increased in the early period but the pulmonary fibrosis was inhibited in the late stage as a result of $IFN-{\gamma}$. The inhibition of pulmonary fibrosis by $IFN-{\gamma}$ appeared to be associated with the inhibition of MMP-2 activation by $IFN-{\gamma}$. Further studies on the mechanism of the regulation of MMP-2 activation and the effects of MMP-2 activation on pulmonary fibrosis is warranted in the future.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.420-429
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• 2002

Moderate hypothermic cardiopulmonary bypass (CPB) has commonly been used in cardiac surgery. Several cardiac centers recently practice normothermic CPB in cardiac surgery, However, the clinical effect and safety of normothermic CPB on cerebral metabolism are not established and not fully understood. This study was prospectively designed to evaluate the clinical influence of normothermic CPB on brain metabolism and to compare it with that of moderate hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to receive normothermic (nasopharyngeal temperature ＞34.5 $^{\circ}C$, n=18) or hypothermic (nasopharyngeal temperature 29~3$0^{\circ}C$, n=18) CPB with nonpulsatile pump. Middle cerebral artery blood flow velocity (VMCA), cerebral arteriovenous oxygen content difference (CAVO$_{2}$), cerebral oxygen extraction (COE), modified cerebral metabolic rate for oxygen (MCMRO$_{2}$), cerebral oxygen transport (TEO$_{2}$), cerebral venous desaturation (oxygen saturation in internal jugular bulb blood$\leq$50 %), and arterial and internal jugular bulb blood gas analysis were measured during six phases of the operation： Pre-CPB (control), CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ in the hypothermic group), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ in the both groups), CPB-off and Post-CPB (skin closure after CPB-off). Postoperaitve neuropsychologic complications were observed in all patients. All variables were compared between the two groups. Result： VMCA at Rewarm-2 was higher in the hypothermic group (153.11$\pm$8.98%) than in the normothermic group (131.18$\pm$6.94%) (p＜0.05). CAVO$_{2}$ (3.47$\pm$0.21 vs 4.28$\pm$0.29 mL/dL, p＜0.05), COE (0.30$\pm$0.02 vs 0.39$\pm$0.02, p＜0.05) and MCMRO$_{2}$ (4.71 $\pm$0.42 vs 5.36$\pm$0.45, p<0.05) at CPB-10 min were lower in the hypothermic group than in the normothermic group. The hypothermic group had higher TEO$_{2}$ than the normothermic group at CPB-10 (1,527.60$\pm$25.84 vs 1,368.74$\pm$20.03, p＜0.05), Rewarm-2 (1,757.50$\pm$32.30 vs 1,478.60$\pm$27.41, p＜0.05) and Post-CPB (1,734.37$\pm$41.45 vs 1,597.68$\pm$27.50, p＜0.05). Internal jugular bulb oxygen tension (40.96$\pm$1.16 vs 34.79$\pm$2.18 mmHg, p＜0.05), saturation (72.63$\pm$2.68 vs 64.76$\pm$2.49 %, p＜0.05) and content (8.08$\pm$0.34 vs 6.78$\pm$0.43 mL/dL, p<0.05) at CPB-10 were higher in the hypothermic group than in the normothermic group. The hypothermic group had less incidence of postoperative neurologic complication (delirium) than the normothermic group (2 vs 4 patients, p＜0.05). Lasting periods of postoperative delirium were shorter in the hypothermic group than in the normothermic group (60 vs 160 hrs, p<0.01). Conclusion: These results indicate that normothermic CPB should not be routinely applied in all cardiac surgery, especially advanced age or the clinical situations that require prolonged operative time. Moderate hypothermic CPB may have beneficial influences relatively on brain metabolism and postoperative neuropsychologic outcomes when compared with normothermic CPB.