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Clinical Differential Diagnosis of Usual Interstitial Pneumonia from Nonspecific Interstitial Pneumonia (통상성 간질성 폐렴과 비특이성 간질성 폐렴의 임상적 감별 진단)

  • An, Chang-Hyeok;Koh, Young-Min;Chung, Man-Pyo;Suh, Gee-Young;Kang, Soo-Jung;Kang, Kyeong-Woo;Ahn, Jong-Woon;Lim, Si-Young;Kim, Ho-Joong;Han, Jeung-Ho;Lee, Kyung-Soo;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.932-943
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    • 2000
  • Background : Nonspecific interstitial pneumonitis (NSIP) is most likely to be confused with usual interstitial pneumonitis (UIP). Unlike patients witþ UIP, the majority of patients with NSIP have a good prognosis, with most patients improving after treatment with corticosteroids. Therefore it is clinically important to differentiate NSIP from UIP. Up to now, the only means of differentiating these two diseases was by means of surgical lung biopsy. American Thoracic Society (ATS) proposed a clinical diagnostic criteria for UIP to provide assistance to clinicians in its diagnosis without surgical lung biopsy. This study is aimed to investigate whether there were clinical and radiological differences between NSIP and UIP, and the usefulness of ATS clinical diagnostic criteria for UIP in Korea. Methods : We studied 60 patients with UIP and NSIP confirmed by surgical lung biopsy. Clinical manifestations, pulmonary function test, arterial blood gas analysis, bronchoalveolar lavage (BAL), and high resolution computed tomography (HRCT) were evaluated and analyzed by Chi-square test or t-test. The clinical criteria for UIP proposed by ATS were applied to all patients with idiopathic interstitial pneumonia. Results : Forty-two patients with UIP and 18 with NSIP were pathologically identified. Among the 18 patients with NSIP (M : F=1 : 17), the mean age was 55.2$\pm$8.4 (44~73) yr. Among the 42 patients with UIP (M : F=33 : 9), the mean age was 59.5$\pm$7.1 (45~74) yr (p=0.046). Fever was more frequent in NSIP (39%) (p=0.034), but clubbing was frequently observed in UIP (33%) (p=0.023). BAL lymphocytosis was more frequent (23%) (p=0.0001) and CD4/CD8 ratio was lower in NSIP (p=0.045). On HRCT, UIP frequently showed honeycomb appearance (36 of 42 patients) though not in NSIP (p=0.0001). Six of 42 UIP patients (14.3%) met the ATS clinical criteria for IPF, and 3 of 16 NSIP patients (18.8%) met the diagnostic criteria. Conclusion : Being a relatively young female and having short duration of illness, fever, BAL lymphocytosis, low CD4/CD8 ratio with the absence of clubbing and honeycomb appearance in HRCT increase the likelihood of the illness being NSIP. The usefulness of ATS clinical diagnostic criteria for UIP may be low in Korea.

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The Influence of Obstructive Sleep Apnea on Systemic Blood Pressure, Cardiac Rhythm and the Changes of Urinary (폐쇄성 수면 무호흡이 전신성 혈압, 심조율 및 요 Catecholamines 농도 변화에 미치는 영향)

  • Lo, Dae-Keun;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.153-168
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    • 1998
  • Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

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The Effect of Glucocorticoid on the Change of Nitric Oxide and Cytokine Levels in Induced Sputum from Patients with Bronchial Asthma (기관지 천식 환자에서 부신피질 스테로이드 투여 전후 유도객담내 Nitric Oxide 및 Cytokine의 변화)

  • Kim, Tae-Yon;Yoon, Hyeong-Kyu;Choi, Young-Mee;Lee, Sook-Young;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.922-931
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    • 2000
  • Background : It has been well known that bronchia1 asthma is a chronic airway inflammatory disorder. Recently, sputum induced with hypertonic saline was introduced as a simple and useful nonivasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, eosinophil cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating facta (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchia1 asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation or changes in pulmonary function tests and symptoms. Methods : A total 30 patients with bronchia1 asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second ($FEV_1$), total blood eosinophil count and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. Results : Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in $FEV_1$ (% of predicted value) from 78.1$\pm$20.6 % to 90.3$\pm$ 18.3 % (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1$\pm$27.2 % versus 29.6$\pm$21.3 % (P<0.001), and ECP were $134.5\pm68.1\;{\mu}g/L$ versus $41.5\pm42.4\;{\mu}g/L$ (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7$\pm$12.8 pg/ml to 21.7$\pm$8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count (425.7$\pm$265.9 vs 287.7$\pm$294.7) and in the concentration of NO derivatives ($70.4\pm44.6{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) after the prednisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments or after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-D.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05) Conclusion : The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchia1 asthma. In addition, the measurement of sputum eosinophil percent ages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the prednisolone treatment in bronchia1 asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.

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If This Brand Were a Person, or Anthropomorphism of Brands Through Packaging Stories (가설품패시인(假设品牌是人), 혹통과고사포장장품패의인화(或通过故事包装将品牌拟人化))

  • Kniazeva, Maria;Belk, Russell W.
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.231-238
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    • 2010
  • The anthropomorphism of brands, defined as seeing human beings in brands (Puzakova, Kwak, and Rosereto, 2008) is the focus of this study. Specifically, the research objective is to understand the ways in which brands are rendered humanlike. By analyzing consumer readings of stories found on food product packages we intend to show how marketers and consumers humanize a spectrum of brands and create meanings. Our research question considers the possibility that a single brand may host multiple or single meanings, associations, and personalities for different consumers. We start by highlighting the theoretical and practical significance of our research, explain why we turn our attention to packages as vehicles of brand meaning transfer, then describe our qualitative methodology, discuss findings, and conclude with a discussion of managerial implications and directions for future studies. The study was designed to directly expose consumers to potential vehicles of brand meaning transfer and then engage these consumers in free verbal reflections on their perceived meanings. Specifically, we asked participants to read non-nutritional stories on selected branded food packages, in order to elicit data about received meanings. Packaging has yet to receive due attention in consumer research (Hine, 1995). Until now, attention has focused solely on its utilitarian function and has generated a body of research that has explored the impact of nutritional information and claims on consumer perceptions of products (e.g., Loureiro, McCluskey and Mittelhammer, 2002; Mazis and Raymond, 1997; Nayga, Lipinski and Savur, 1998; Wansik, 2003). An exception is a recent study that turns its attention to non-nutritional packaging narratives and treats them as cultural productions and vehicles for mythologizing the brand (Kniazeva and Belk, 2007). The next step in this stream of research is to explore how such mythologizing activity affects brand personality perception and how these perceptions relate to consumers. These are the questions that our study aimed to address. We used in-depth interviews to help overcome the limitations of quantitative studies. Our convenience sample was formed with the objective of providing demographic and psychographic diversity in order to elicit variations in consumer reflections to food packaging stories. Our informants represent middle-class residents of the US and do not exhibit extreme alternative lifestyles described by Thompson as "cultural creatives" (2004). Nine people were individually interviewed on their food consumption preferences and behavior. Participants were asked to have a look at the twelve displayed food product packages and read all the textual information on the package, after which we continued with questions that focused on the consumer interpretations of the reading material (Scott and Batra, 2003). On average, each participant reflected on 4-5 packages. Our in-depth interviews lasted one to one and a half hours each. The interviews were tape recorded and transcribed, providing 140 pages of text. The products came from local grocery stores on the West Coast of the US and represented a basic range of food product categories, including snacks, canned foods, cereals, baby foods, and tea. The data were analyzed using procedures for developing grounded theory delineated by Strauss and Corbin (1998). As a result, our study does not support the notion of one brand/one personality as assumed by prior work. Thus, we reveal multiple brand personalities peacefully cohabiting in the same brand as seen by different consumers, despite marketer attempts to create more singular brand personalities. We extend Fournier's (1998) proposition, that one's life projects shape the intensity and nature of brand relationships. We find that these life projects also affect perceived brand personifications and meanings. While Fournier provides a conceptual framework that links together consumers’ life themes (Mick and Buhl, 1992) and relational roles assigned to anthropomorphized brands, we find that consumer life projects mold both the ways in which brands are rendered humanlike and the ways in which brands connect to consumers' existential concerns. We find two modes through which brands are anthropomorphized by our participants. First, brand personalities are created by seeing them through perceived demographic, psychographic, and social characteristics that are to some degree shared by consumers. Second, brands in our study further relate to consumers' existential concerns by either being blended with consumer personalities in order to connect to them (the brand as a friend, a family member, a next door neighbor) or by distancing themselves from the brand personalities and estranging them (the brand as a used car salesman, a "bunch of executives.") By focusing on food product packages, we illuminate a very specific, widely-used, but little-researched vehicle of marketing communication: brand storytelling. Recent work that has approached packages as mythmakers, finds it increasingly challenging for marketers to produce textual stories that link the personalities of products to the personalities of those consuming them, and suggests that "a multiplicity of building material for creating desired consumer myths is what a postmodern consumer arguably needs" (Kniazeva and Belk, 2007). Used as vehicles for storytelling, food packages can exploit both rational and emotional approaches, offering consumers either a "lecture" or "drama" (Randazzo, 2006), myths (Kniazeva and Belk, 2007; Holt, 2004; Thompson, 2004), or meanings (McCracken, 2005) as necessary building blocks for anthropomorphizing their brands. The craft of giving birth to brand personalities is in the hands of writers/marketers and in the minds of readers/consumers who individually and sometimes idiosyncratically put a meaningful human face on a brand.

Evaluating Reverse Logistics Networks with Centralized Centers : Hybrid Genetic Algorithm Approach (집중형센터를 가진 역물류네트워크 평가 : 혼합형 유전알고리즘 접근법)

  • Yun, YoungSu
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.55-79
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    • 2013
  • In this paper, we propose a hybrid genetic algorithm (HGA) approach to effectively solve the reverse logistics network with centralized centers (RLNCC). For the proposed HGA approach, genetic algorithm (GA) is used as a main algorithm. For implementing GA, a new bit-string representation scheme using 0 and 1 values is suggested, which can easily make initial population of GA. As genetic operators, the elitist strategy in enlarged sampling space developed by Gen and Chang (1997), a new two-point crossover operator, and a new random mutation operator are used for selection, crossover and mutation, respectively. For hybrid concept of GA, an iterative hill climbing method (IHCM) developed by Michalewicz (1994) is inserted into HGA search loop. The IHCM is one of local search techniques and precisely explores the space converged by GA search. The RLNCC is composed of collection centers, remanufacturing centers, redistribution centers, and secondary markets in reverse logistics networks. Of the centers and secondary markets, only one collection center, remanufacturing center, redistribution center, and secondary market should be opened in reverse logistics networks. Some assumptions are considered for effectively implementing the RLNCC The RLNCC is represented by a mixed integer programming (MIP) model using indexes, parameters and decision variables. The objective function of the MIP model is to minimize the total cost which is consisted of transportation cost, fixed cost, and handling cost. The transportation cost is obtained by transporting the returned products between each centers and secondary markets. The fixed cost is calculated by opening or closing decision at each center and secondary markets. That is, if there are three collection centers (the opening costs of collection center 1 2, and 3 are 10.5, 12.1, 8.9, respectively), and the collection center 1 is opened and the remainders are all closed, then the fixed cost is 10.5. The handling cost means the cost of treating the products returned from customers at each center and secondary markets which are opened at each RLNCC stage. The RLNCC is solved by the proposed HGA approach. In numerical experiment, the proposed HGA and a conventional competing approach is compared with each other using various measures of performance. For the conventional competing approach, the GA approach by Yun (2013) is used. The GA approach has not any local search technique such as the IHCM proposed the HGA approach. As measures of performance, CPU time, optimal solution, and optimal setting are used. Two types of the RLNCC with different numbers of customers, collection centers, remanufacturing centers, redistribution centers and secondary markets are presented for comparing the performances of the HGA and GA approaches. The MIP models using the two types of the RLNCC are programmed by Visual Basic Version 6.0, and the computer implementing environment is the IBM compatible PC with 3.06Ghz CPU speed and 1GB RAM on Windows XP. The parameters used in the HGA and GA approaches are that the total number of generations is 10,000, population size 20, crossover rate 0.5, mutation rate 0.1, and the search range for the IHCM is 2.0. Total 20 iterations are made for eliminating the randomness of the searches of the HGA and GA approaches. With performance comparisons, network representations by opening/closing decision, and convergence processes using two types of the RLNCCs, the experimental result shows that the HGA has significantly better performance in terms of the optimal solution than the GA, though the GA is slightly quicker than the HGA in terms of the CPU time. Finally, it has been proved that the proposed HGA approach is more efficient than conventional GA approach in two types of the RLNCC since the former has a GA search process as well as a local search process for additional search scheme, while the latter has a GA search process alone. For a future study, much more large-sized RLNCCs will be tested for robustness of our approach.

A Study on the Liturgical Vestments of Catholic-With reference to the Liturgical Vestments Firm of Paderborn and kevelaer in Germany (카톨릭교 전례복에 관한 연구-독일 Paderborn 과 kevelaer의 전례복 회사를 중심으로)

  • Yang, Ri-Na
    • The Journal of Natural Sciences
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    • v.7
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    • pp.133-162
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    • 1995
  • Paderborn's companies, Wameling and Cassau, produce the liturgical vestments, which have much traditional artistic merit. And Kevelaerer Fahnen + Paramenten GmbH, located in Kevelater which is a place of pilgrimage of the Virgin Mary, was known to Europe, Africa, America and the Scandinavia Peninsula as the "Hidden Company" of liturgical vesments maker up to now. Paderborn and Kevelaer were the place of the center of the religious world and the Catholic ceremony during a good few centries. The Catholic liturgical vestiments of these 3 companies use versatile design, color, shape and techniques. These have not only the symbolism of religion, but also can meet our's expectations of utilization of modern textile art, art clothing and wide-all division of design. These give the understanding of symbolic meanings and harmony according to liturgical vestments to the believers. And these have an influence on mental thinking and induction of religious belief to the non-believers as the recognition and concerns about the religious art. The liturgical vestments are clothes which churchmen put on at the all ceremonial function of a mass, a sacrament, performance and a parade according to rules of church. These show the represen-tation of "Holy God" in silence and distinguish between common people and churchmen. And these represent a status and dignity of churchmen and induce majesty and respect to churchmen. Common clothes of the beginning of the Greece and Rome was developed to Christian clothes with the tendency of religion. There were no special uniforms distinguished from commen people until the Christianity was recognized officially by the Roman Emperor Constantinus at A.D.313. The color of liturgical vestments was originally white and changed to special colors according to liturgical day and each time by the Pope Innocentius at 12th century. The color and symbolic meaning of the liturgical vestments of present day was originated by the Pope St. Pius(1566-1572). Wool and Linen was used as decorations and materials in the beginnings and the special materials like silk was used after 4th century and beautiful materials made of gold thread was used at 12th century. It is expected that there is no critical changes to the liturgical vestments of future. But the development of liturgical vestments will continues slowly by the command of conservative church and will change to simple and convenient formes according to the culture, the trend of the times and the fashion of clothes. The companies of liturgical vestments develop versatile design, embroidery technique and realization of creative design for distinction of the liturgical vestments of each company and artistic progress. The cooperation of companies, artists and church will make the bright future of these 3 companies. We expect that our country will be a famous producing center of the liturgical vestments through the research and development of companies, participation of artists in religeous arts and concerts of church.

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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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The Effects of Autologous Blood Pleurodesis in the Pneumothorax with Persistent Air Leak (지속성 기흉에서 자가혈액을 이용한 흉막유착술의 효과)

  • Yoon, Su-Mi;Shin, Sung-Joon;Kim, Young-Chan;Shon, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Chung, Won-Sang;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.724-732
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    • 2000
  • Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

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Structural and Functional Changes of The Brain in The Patient with Schizophrenia, Paranoid type : Correlation among Brain MRI Findings, Neurocognitive Function and Psychiatric Symptoms (편집형 정신분열병 환자에서 뇌의 구조적 변화와 기능적 변화 : 뇌자기공명영상소견, 신경인지기능 및 정신증상간의 상관관계)

  • Kang, Cheol-Min;Lee, Young-Ho;Jung, Young-Jo;Lee, Jung-Heum;Kim, Su-Ji;Park, Hyun-Jin
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.54-70
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    • 1998
  • Objectives : The purpose of this study is to evaluate the role of structural and functional changes of the brain in the pathophysiology of schizophrenia. Methods : The authors measured the regions of interest on the magnetic resonance imaging of the brain in 20 patients with paranoid schizophrenia(15 men and 5 women) and 23 control subjects(15 men and 8 women). We also assessed the neurocognitive functions with the Wisconsin Card Sorting Test, the Benton Neuropsychological Assessment, and the Weschler IQ test-Korean version, soft neurologic signs, and psychiatric symptoms in the patient group. Results : In the patient group, all ventricles and basal ganglia including caudate nucleus and globus pallidus were significantly enlarged. Although there were no significant differences between the two groups in the values of right frontal lobe and left temporal lobe, there was a tendency of decrease in the values of right frontal lobe and left temporal lobe. There were significant positive correlations between the values of ventricles and the frequency of previous hospitalization. However, there were no significant correlations between other values of regions of interest and clinical data. The value of the right frontal lobe was significantly correlated with the score of soft neurologic signs, which is suggestive of the neurodevelopmental abnormalities. There were significant correlations between the value of frontal lobe and the scores of the various subscales of Benton Neuropsychiatric Inventory. In contrast, the value of left amygdala and putamen showed significant correlation with the score of verbal IQ on the Weschler IQ test. Structural changes of the temporal lobe areas were related with the positive and general symptom scores on PANSS, while those of the basal ganglia were related with the negative symptom scores. Conclusions : These results suggest that the structural changes of the brain in the patients with schizophrenia show the dual process, which is suggestive that the enlarged ventricle show the neurodegenerative process, while enlarged basal ganglia, and shrinked right frontal and left temporal lobe show the neurodevelopmental abnormalities. Among these changes, structural changes of the frontal lobe related with various neuropsychological deficits, while those of left temporal lobe related with language abnormality. Relative to the relation between structural changes and psychiatric symptoms, structural changes of the temporal lobe areas were related with the positive and general symptoms, while those of the basal ganglia were related with the negative symptoms.

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A Study on Aviation Safety and Third Country Operator of EU Regulation in light of the Convention on international Civil Aviation (시카고협약체계에서의 EU의 항공법규체계 연구 - TCO 규정을 중심으로 -)

  • Lee, Koo-Hee
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.1
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    • pp.67-95
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    • 2014
  • Some Contracting States of the Chicago Convention issue FAOC(Foreign Air Operator Certificate) and conduct various safety assessments for the safety of the foreign operators which operate to their state. These FAOC and safety audits on the foreign operators are being expanded to other parts of the world. While this trend is the strengthening measure of aviation safety resulting in the reduction of aircraft accident. FAOC also burdens the other contracting States to the Chicago Convention due to additional requirements and late permission. EASA(European Aviation Safety Agency) is a body governed by European Basic Regulation. EASA was set up in 2003 and conduct specific regulatory and executive tasks in the field of civil aviation safety and environmental protection. EASA's mission is to promote the highest common standards of safety and environmental protection in civil aviation. The task of the EASA has been expanded from airworthiness to air operations and currently includes the rulemaking and standardization of airworthiness, air crew, air operations, TCO, ATM/ANS safety oversight, aerodromes, etc. According to Implementing Rule, Commission Regulation(EU) No 452/2014, EASA has the mandate to issue safety authorizations to commercial air carriers from outside the EU as from 26 May 2014. Third country operators (TCO) flying to any of the 28 EU Member States and/or to 4 EFTA States (Iceland, Norway, Liechtenstein, Switzerland) must apply to EASA for a so called TCO authorization. EASA will only take over the safety-related part of foreign operator assessment. Operating permits will continue to be issued by the national authorities. A 30-month transition period ensures smooth implementation without interrupting international air operations of foreign air carriers to the EU/EASA. Operators who are currently flying to Europe can continue to do so, but must submit an application for a TCO authorization before 26 November 2014. After the transition period, which lasts until 26 November 2016, a valid TCO authorization will be a mandatory prerequisite, in the absence of which an operating permit cannot be issued by a Member State. The European TCO authorization regime does not differentiate between scheduled and non-scheduled commercial air transport operations in principle. All TCO with commercial air transport need to apply for a TCO authorization. Operators with a potential need of operating to the EU at some time in the near future are advised to apply for a TCO authorization in due course, even when the date of operations is unknown. For all the issue mentioned above, I have studied the function of EASA and EU Regulation including TCO Implementing Rule newly introduced, and suggested some proposals. I hope that this paper is 1) to help preparation of TCO authorization, 2) to help understanding about the international issue, 3) to help the improvement of korean aviation regulations and government organizations, 4) to help compliance with international standards and to contribute to the promotion of aviation safety, in addition.