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Short-term Clinical Experience on Interferon gamma-1b Therapy for Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에서 Interferon gamma-1b 치료의 단기 임상경험)

  • Hwang, Jung Hye;Chung, Man Pyo;Kang, Eun Hae;Kim, Kyung Chan;Lee, Byoung-Hoon;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Lee, Kyung Soo;Han, Joungho;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.619-627
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    • 2004
  • Background : Corticosteroids in combination with cytotoxic drugs are the mainstays of therapy for idiopathic pulmonary fibrosis (IPF). However, there has been no regimen showing any survival benefit. The aim of this study was to describe a short-term clinical experience on interferon gamma-1b (IFN-${\gamma}1b$) therapy for IPF, as an antifibrotic agent. Methods : Medical records of 27 patients who were treated with IFN-${\gamma}1b$ (2 million IU, 3 times a week, subcutaneous injection) were retrospectively reviewed. Treatment response was assessed using ATS/ERS criteria in 17 patients who received IFN-${\gamma}1b$ for more than 6 months. In addition, we compared the efficacy of IFN-${\gamma}1b$ therapy with that of cyclophosphamide${\pm}$prednisolone therapy (n=26). Results : The median age of IFN-${\gamma}$ treated group (M:F=19:8) was 59 years (44-74 years). Compared to the patients who showed a stable response at 6 months (n=12), the deteriorated group (n=5) had worse baseline lung function (FVC, $55.4{\pm}11.3%$ vs. $70.7{\pm}10.9%$, p=0.019; DLco, $50.3{\pm}7.3%$ vs. $76.9{\pm}19.6%$, p=0.014). Lower baseline $PaO_2$ on room air breathing was observed in the deteriorated group ($68.6{\pm}7.8mmHg$ vs. $91.4{\pm}6.6mmHg$ p=0.001). Subcutaneous IFN-${\gamma}1b$ did not show better efficacy than prednisolone. Five patients discontinued IFN-${\gamma}$ because of severe side effects. ARDS developed in one patient, who eventually died. Conclusion : The administration of IFN-${\gamma}1b$ is not desirable for patients diagnosed with IPF with poor lung function. Long-term and large-scaled clinical studies are needed for its efficacy in IPF.

Preliminary Study on the Ultramafic Rocks from the Chungnam Province, Korea (충남지역에 분포하는 초염기성암의 기원규명을 위한 기초연구)

  • Wee, Soo-Meen;Choi, Seon-Gyu;So, Chil-Sup
    • Economic and Environmental Geology
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    • v.27 no.2
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    • pp.171-180
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    • 1994
  • Several ultramafic bodies and ultramafic origin talc deposits are distributed in Chungnam province near the contact zone with Ogchun fold belt They occur as discontinued belt form with northeast trending, and most of them are more or less sepentinized. Major, trace, and rare earth elements analyses were made of the ultramafics from the study area to constrain their origin and genetic relationships. Compared to the primitive mantle estimates of privious workers, the correlations defined by the studied rock samples indicate similar Ni but very lower $Al_{2}O_{3}$, CaO and $TiO_{2}$ contents. It is inferred that source material of the studied rocks might be residual mantle which had undergone a large degree of partial melting event. The REE patterns show relatively flat to enriched in LREE (chondrite normalized La/Yb and Sm/Yb ratios are 1.1-5.2 and 1.2-1.6). Several alternative explaination are possible for LREE enrichment patterns in the studied ultramafic rocks such as 1) enrichment due to late stage alteration, 2) enriched pre-melting composition, and 3) mixing of two components. Based on the result, the LREE enrichment characteristic of the studied rocks might be result from the mixture of two geochemically distinct components; one is depleted residual mantle and the other component which determine the abundances of incompatible elements and responsible for the LREE enrichment.

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Evaluation of compensator to reduce thermal sensation in oncological hyperthermia (고주파 온열암 치료 시 열감감소를 위해 자체 제작한 보상체의 유효성 평가)

  • Lee, Yeong Cheol;Kim, Sun Myung;Jeong, Deok Yang;Kim, Young Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.27-32
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    • 2017
  • Objectives: Oncological hyperthermia is a treatment to selectively kill cancer cells by directly applying heat to cancer cells or indirectly demage cancer cells. One of the most side effects of treatment is burn that can appear on the skin. In areas with irregularities such as the umbilicus, the patient feels a sense of hot and treatment may be discontinued. Therefore, in order to eliminate the irregularities of these areas, compensators are manufactured and measured to decrease in temperature. Materials and Methods: The temperature of the four sites (umbilicus, near the umbilicus, 5 cm below the umbilicus, back) was measured five times around the umbilicus in patients who were treated at oncological hyperthermia treatment device(EHY-2000, Oncotherm Kft, Hungary). The temperature sensor (TM-100, Oncotherm Kft, Hungary) was attached to four sites and the changes were observed at 5, 15, 25, 35, and 50 minutes after treatment. Compensators of three materials were used(Vaseline, Bolus, Dental resin). The data measured five times were compared for each compensator. Results: The temperature change when the compensator was not used increase from 34.65 degrees to 42.9 degrees on average. The near umbilicus was changed from 32.20 degrees to 37.00 degrees, and the 5 cm below the umbilicus was changed from 31.90 to 34.41 degrees. When the compensator material was inserted into the umbilicus, the temperature change was measured as 5.42 degrees for bolus, 6.55 degrees for vaseline, and 6.83 degrees for resin. Conclusion: Using the compensator in the region where the irregularities such as the umbilicus, the heat sensation could be reduced. the use of a resin that can be customized not only lowers the temperature but also significantly reduces the feeling of the patient. It will be possible to reduce the heat sensation in the treatment and to treat it in a more comfortable condition.

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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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The effect of Percutaneous pig-tail catheter drainage in the management of lung abscess and empyema (폐 농양및 농흉 치료에서 Pig-tail 도관 배액술의 효과)

  • Kim, Yeon Sao;Kim, Seong Min;Kim, Jin Ho;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee;Choi, Yo Won;Jean, Seok Chol;Kim, Young Tae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.571-578
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    • 1996
  • Background : Long abscess is an accumulation of pus within a destroyed portion of the lung. Antibiotic therapy and postural drainge has proven to be an effective method of treatment for the majority of patients with pyogenic lung abscess. When medical therapy fails, thoracotomy and pulmonary resection are the current therapies. empyema is pus in the pleural space, and this term is deserved for effusions on which the Gram stain of the pleural fluid is positive. Initially, such collection may be drained via chest tribe. Recently, in patients who are judged to be unsuitable for surgery are in poor condition, percutaneous drainage using pig-tail catheter has been performed. We report out experience with 10 cases of lung abscess and 23 cases of empyema who were treated by percutaneous pit-tail catheter drainage. Subjects and Methods : Our study included 10 patients with lung abscess and 23 patients with empyema who were treated by percutaneous pig-tail catheter drainage, from January, 1990, to May, 1996, at Hanyang University then a pig-tail catheter was inserted into the abscess or the site of empyema under fluoroscopic and ultrasonograpic guidance. Following aspiration, the catheter was sutured into the skin, and connected to the suction tip. Catheter drainage was discontinued when the abscess of empyema was resolved in radiologically and clinically. Results : There were 2 cases of lung abscess caused by Staphylococcus aureus and Klebsiella pneumoniae and 14 cases of empyema caused by M. tuberculosis. The others were unknown. The duration of drainage was 1-2 weeks in 7 cases of lung abscess and 14 cases of empyema. In the 29 of 33 patients, percutaneous drainage were carried out successfully 20 of the 29 Gases rapidly improved. Conclusion : Percutaneous drainge is effective and relatively saute for management of lung abscess or empyema refractory to medical therapy or poor candidates for surgical treatment.

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Nonvital Pulp Therapy of Elongation of Roots of Mandibular Cheek Teeth in Pet Rabbits (애완토끼에서 과잉성장된 하악치아의치신경치료 연구)

  • Park, Cheon-Sik;Cha, Se-Yeoun;Kang, Min;Kim, Jury;Jeong, Soon-Wuk;Jang, Hyung-Kwan
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.474-482
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    • 2012
  • Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.

Empty Time, Empty Space, and Non(非)-Place in World of Warcraft: The Accumulated Experience and the Recovery in Reality (<월드 오브 워크레프트>(World of Warcraft)의 빈 시간, 빈 공간, 비(非) 장소: 축적된 체험과 실감의 회복)

  • Song, Kyong-Won
    • Cartoon and Animation Studies
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    • s.19
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    • pp.127-143
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    • 2010
  • The purpose of this study is to aesthetically approach a game, which was popular at home, through microscopic analysis on World of Warcraft. World of Warcraft(hereunder called WOW), which improved a game method of MMORPG that had been popular conventionally at home, from several angles, is suggesting new paradigm of MMORPG game. This study aims to propose new vision on game analysis by approaching this new method from the perspective of player. For this, it divided WOW into shift method, instruction implementation method, and communication configuration method, and analyzed this, respectively, by introducing a concept of empty time, empty space, and non-place, which was borrowed from Zygmunt Bauman's "Liquid Modernity". WOW's shifting method rather extends empty time, that is, the waiting time, contrary to the conventional MMORPG, which used a method of removing. Instead of maximally reducing boring, which becomes disturbance of a game, it is what overwhelmingly enlarges time that needs to be waited, thereby being what induces a sense of time, which a player experiences daily life, to the inside of a game. WOW's instruction implementation method offers one of hugely single map instead of zone-system necessary for map loading in the discontinued form. This minutely implements even a greatly insignificant place in playing a game, thereby stirring up a sense of travel, which explores there in reality. Finally, WOW's community configuration method makes a hunting-targeted group clear, which added a concept of hunting called the raid to the existing gild system. The raid, which is a large party of being bound to the inside of Instant Dungeon, clearly gives a performance role to each of party members, thereby allowing the identity in character to be connected directly to the identity of player. Through this, the player filled the suggested 'space' with experience, thereby being able to change it into 'place' that is significant to an individual.

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Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

  • Berk, Veli;Kaplan, Mehmet Ali;Tonyali, Onder;Buyukberber, Suleyman;Balakan, Ozan;Ozkan, Metin;Demirci, Umut;Ozturk, Turkan;Bilici, Ahmet;Tastekin, Didem;Ozdemir, Nuriye;Unal, Olcun Umit;Oflazoglu, Utku;Turkmen, Esma;Erdogan, Bulent;Uyeturk, Ummugul;Oksuzoglu, Berna;Cinkir, Havva Yesil;Yasar, Nurgul;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7367-7369
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    • 2013
  • Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.

A Comparative Study of Internet Addiction among Middle and High School Students in Seoul, Cheonan, and Rural Area (서울, 천안, 농촌지역 중 고교 학생들의 인터넷 중독에 대한 비교 연구)

  • Lee, Seok-Bum;Lee, Kyung-Kyu;Paik, Ki-Chung;Kim, Hyun-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.145-156
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    • 2004
  • Objectives : Internet addiction is a newly appeared addictive phenomenon that is defined as 'difficulty in real life due to internet over-use', 'excessive time spent on the internet or replacement of genuine real relationships with superficial virtual ones' or 'weakness in self-control about internet use and if discontinued, fallen in psychological confusion and anergic state'. This study was aimed to compare the internet addiction rate, demographic factors, computer using patterns, anxiety, depression, and internet self-efficacy and outcome expectancy between Korean middle and high school students in three areas - Seoul, Cheonan, and Rural areas - that were different in economic, cultural, and geographic state. Methods : Subjects are consisted of middle and high school students in Seoul, Chunan, and Rural areas(N=1718). Self-rating questionnaire included demographic data, Korean Spielberger State-Trait Anxiety Inventory, Korean Self-Rating Depression Scale(SDS), questions for internet-using pattern, Korean version of Internet Addiction Scale invented by K. S. Young, Internet Self-efficacy and Out-come Expectancy Scale. Results: In this study, prevalence of internet addiction was 2.9%. There was no significant difference found in prevalence of internet addiction among three areas. In all subjects, there were significant differences in anxiety, depression, internet self-efficacy and outcome expectancy, leisure style, places of internet use, internet connecting method, and insight on internee addiction. But, in addicted group, there was no significant difference among three areas. Conclusion: This study suggested that the difference in economic, cultural, and geographic state was not related to prevalence of internet addiction. Although there were significant differences in anxiety, depression, self-efficacy associated with internee use, leisure style, places of internet use, internet connecting method, insight on internet addiction among three areas, there were no significant difference in addicted group among three areas. So, we concluded that the difference in economic, cultural, and geographic state did not influence the prevalence of internet addiction, and despite the difference in economic, cultural, and geographic state, people in three areas were equally influenced by internet addiction.

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Development of a Detection Model for the Companies Designated as Administrative Issue in KOSDAQ Market (KOSDAQ 시장의 관리종목 지정 탐지 모형 개발)

  • Shin, Dong-In;Kwahk, Kee-Young
    • Journal of Intelligence and Information Systems
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    • v.24 no.3
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    • pp.157-176
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    • 2018
  • The purpose of this research is to develop a detection model for companies designated as administrative issue in KOSDAQ market using financial data. Administration issue designates the companies with high potential for delisting, which gives them time to overcome the reasons for the delisting under certain restrictions of the Korean stock market. It acts as an alarm to inform investors and market participants of which companies are likely to be delisted and warns them to make safe investments. Despite this importance, there are relatively few studies on administration issues prediction model in comparison with the lots of studies on bankruptcy prediction model. Therefore, this study develops and verifies the detection model of the companies designated as administrative issue using financial data of KOSDAQ companies. In this study, logistic regression and decision tree are proposed as the data mining models for detecting administrative issues. According to the results of the analysis, the logistic regression model predicted the companies designated as administrative issue using three variables - ROE(Earnings before tax), Cash flows/Shareholder's equity, and Asset turnover ratio, and its overall accuracy was 86% for the validation dataset. The decision tree (Classification and Regression Trees, CART) model applied the classification rules using Cash flows/Total assets and ROA(Net income), and the overall accuracy reached 87%. Implications of the financial indictors selected in our logistic regression and decision tree models are as follows. First, ROE(Earnings before tax) in the logistic detection model shows the profit and loss of the business segment that will continue without including the revenue and expenses of the discontinued business. Therefore, the weakening of the variable means that the competitiveness of the core business is weakened. If a large part of the profits is generated from one-off profit, it is very likely that the deterioration of business management is further intensified. As the ROE of a KOSDAQ company decreases significantly, it is highly likely that the company can be delisted. Second, cash flows to shareholder's equity represents that the firm's ability to generate cash flow under the condition that the financial condition of the subsidiary company is excluded. In other words, the weakening of the management capacity of the parent company, excluding the subsidiary's competence, can be a main reason for the increase of the possibility of administrative issue designation. Third, low asset turnover ratio means that current assets and non-current assets are ineffectively used by corporation, or that asset investment by corporation is excessive. If the asset turnover ratio of a KOSDAQ-listed company decreases, it is necessary to examine in detail corporate activities from various perspectives such as weakening sales or increasing or decreasing inventories of company. Cash flow / total assets, a variable selected by the decision tree detection model, is a key indicator of the company's cash condition and its ability to generate cash from operating activities. Cash flow indicates whether a firm can perform its main activities(maintaining its operating ability, repaying debts, paying dividends and making new investments) without relying on external financial resources. Therefore, if the index of the variable is negative(-), it indicates the possibility that a company has serious problems in business activities. If the cash flow from operating activities of a specific company is smaller than the net profit, it means that the net profit has not been cashed, indicating that there is a serious problem in managing the trade receivables and inventory assets of the company. Therefore, it can be understood that as the cash flows / total assets decrease, the probability of administrative issue designation and the probability of delisting are increased. In summary, the logistic regression-based detection model in this study was found to be affected by the company's financial activities including ROE(Earnings before tax). However, decision tree-based detection model predicts the designation based on the cash flows of the company.