• 제목/요약/키워드: Function Analysis

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Diffuse Panbronchiolitis : Clinical Significance of High-resolution CT and Radioaerosol Scan Manifestations (미만성 범세기관지염에서 흉부 고해상도 전산화 단층촬영의 임상적의의 및 폐환기주사 소견)

  • Song, So Hyang;Kim, Hui Jung;Kim, Young Kyoon;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Kim, Hak Hee;Chung, Soo Kyo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.124-135
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    • 1997
  • Background : Diffuse panbronchiolitis(DPB) is a disease characterized clinically by chronic cough, expectoration and dyspnea; and histologically by chronic inflammation localized mainly in the region of the respiratory bronchiole. It is prevalent in Japanese, but is known to be rare in Americans and Europians. Only a few cases in Chinese, Italians, North Americans and Koreans have been reported. It is diagnosed by characteristic clinical, radiological and pathologic features. High-resolution CT(HRCT) is known to be valuable in the study of the disease process and response to therapy in DPB. To our knowledge, there has been no correlation of its appearance on HRCT with the severity of the disease process, and radioaerosol scan(RAS) of the lung has not previously been used for the diagnosis of DPB. Method : During recent two years we have found 12 cases of DPB in Kangnam St. Mary's Hospital, Catholic University Medical College. We analysed the clinical characteristics, compared HRCT classifications with clinical stages of DPB, and determined characteristic RAS manifestations of DPB. Results : 1. The ages ranged from 31 to 83 years old(mean 54.5 years old), and male female ratio was 4:8. 75%(9/12) of patients had paranasal sinusitis, and only one patient was a smoker. 2. The patients were assigned to one of three clinical stages of DPB on the basis of clinical findings, sputum bacterology and arterial blood gas analysis. of 12 cases, 5 were in the first stage, 4 were in the second stage, and 3 were in the third stage. In most of the patients, pulmonary function tests showed marked obstructive and slight restrictive impairments. Sputum culture yielded P.aeruginosa in 3 cases of our 12 cases, K.pneumoniae in 2 cases, H.influenzae in 2 cases, and S.aureus in 2 cases. 3. Of 12 patients, none had stage I characteristics as classified on HRCT scans, 4 had slage II findings, 5 had stage III findings, and 3 had stage IV characteristics. 4. We peformed RAS in 7 of 12 patients With DPB. In 71.4% (5/7) of the patients, RAS showed mottled aerosol deposits characteristically in the transitional and intermediary airways with peripheral airspace defects, which contrasted sharply with central aerosol deposition of COPD. 5. There were significant correlations between HRCT stages and clinical stages(r= 0.614, P < 0.05), between HRCT types and Pa02(r= -0.614, P < 0.05), and between HRCT types and ESR(r= 0.618, P < 0.01). Conclusion : The HRCT classifications correspond well to the clinical stage. Therfore in the examination of patients with DPB, HRCT is useful in the evaluation of both the location and severity of the lesions. Also, RAS apears to be a convenient, noninvasive and useful diagnostic method of DPB.

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Studies on the Roadside Revegetation and Landscape Reconstruction Measures (도로녹화(道路綠化) 및 도로조경기술개발(道路造景技術開発)에 관(関)한 연구(硏究))

  • Woo, Bo Myeong;Son, Doo Sik
    • Journal of Korean Society of Forest Science
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    • v.48 no.1
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    • pp.1-24
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    • 1980
  • One of the most important basic problems for developing the new techniques in the field of road landscape planting practices in Korea, is to clarify, analyse, and evaluate the existing technical level through actual field survey on the various kinds of planting techniques. This study is, therefore, aimed at the good grasp of detail essences of the existing level of road landscape planting techniques through field investigations of the executed sites. In this study, emphasized efforts are made to the detail analysis and systematic rearrangements of such main subjects as; 1) principles and functions of the road landscape planting techniques; 2) essential elements in planning of it; 3) advanced practices in execution of planting of it; 4) and improved methods in maintenance of plants and lands as an entire system of road landscape planting techniques. The road landscape planting techniques could be explained as the planting and landscaping practices to improve the road function through introduction of plants (green-environment) on and around the roads. The importances of these techniques have been recognized by the landscape architects and road engineers, and they also emphasize not on]y the establishment of road landscape features but also conservation of human's life environment by planting of suitable trees, shrubs, and other vegetations around the roads. It is essentially required to improve the present p]anting practices for establishment of the beautiful road landscape features, specially in planning, design, execution, establishment, and maintenance of plantings of the environmental conservation belts, roadside trees, footpathes, median strips, traffic islands, interchanges, rest areas, and including the adjoining route roads.

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The Effect of the Gap between College Students' Perception of the Importance of Coffee Shops and Their Satisfaction after Patronizing Coffee Shops on Their Purchasing Behavior (대전원교학생대가배점중요성적감지화타문광고가배점지후적만의도지간적차거대타문구매행위적영향(大专院校学生对咖啡店重要性的感知和他们光顾咖啡店之后的满意度之间的差距对他们购买行为的影响))

  • Lee, Won-Ok
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.4
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    • pp.1-10
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    • 2009
  • The purpose of this study was to categorize the gap between coffee shop 'importance' (as perceived by customers before patronizing the coffee shop) and 'satisfaction' (perception of customers after patronizing the coffee shop) as positive or negative and to analyze the effect of these gaps on purchasing behavior. To do this, I used the gap between importance and satisfaction regarding the choice of a coffee shop as the explanatory variable and performed an empirical analysis of the direction and size of the effect of the gap on purchasing behavior (overall satisfaction, willingness-to-revisit) by applying the Ordered Probit Model (OPM). A previous study that used IPA to evaluate the effects of gaps estimated the direction and size of a quadrant but failed to analyze the effect of gaps on customers. In this study, I evaluated the effects of positive and negative gaps on customer satisfaction and willingness-to-revisit. Using OPM, I quantified the effect of positive and negative gaps on overall customer satisfaction and willingness-to-revisit. Per-head expenditure, frequency of visits, and coffee-purchasing place had the most positive effects on overall customer satisfaction. Frequency of visits, followed by per-head expenditure and then coffee-purchasing place, had the most positive impact on willingness-to-visit. Thus per-head expenditure and frequency of visits had the greatest positive effects on overall satisfaction and willingness-to-revisit. This finding implies that the higher the actual satisfaction (gap) of customers who spend KRW5,000 or more once or more per week at coffee shops is, the higher their overall satisfaction and willingness-to-revisit are. Despite the fact that economical efficiency had a significant effect on overall satisfaction and willingness-to-revisit, college and university students still use coffee shops and are willing to spend KRW5,000 because they do not only purchase coffee as a product itself, but use the coffee shop for other activities, such as working, meeting friends, or relaxing. College and university students also access the Internet in coffee shops via personal laptops, watch movies, and study; thus, coffee shops should provide their customers with the appropriate facilities and services. The fact that a positive gap for coffee shop brand had a positive effect on willingness-to-revisit implies that the higher the level of customer satisfaction, the greater the willingness-to-revisit. A negative gap for this factor, on the other hand, implies that the lower the level of customer satisfaction, the lower the willingness-to-revisit. Thus, the brand factor has a comparatively greater effect on satisfaction than the other factors evaluated in this study. Given that the domestic coffee culture is becoming more upscale and college/university students are sensitive to this trend, students are attentive to brands. In most upscale coffee shops in Korea, the outer wall is built out of glass that can be opened, the interiors are exotic with an open kitchen. These upscale coffee shops function as landmarks and match the taste of college/university students. Coffee shops in Korea have become a cultural brand. To make customers feel that coffee shops are upscale, good quality establishments and measures to provide better services in terms of brand factor should be instituted. The intensified competition among coffee shop brands in Korea as a result of the booming industry indicates that provision of additional services is needed to differentiate competitors. These customers can also use a scanner free of charge. Another strategy that can be used to boost brands could be to provide and operate a seminar room for seminars and group study. If coffee shops adopt these types of strategies, college/university students would be more likely to consider the expenses they incur worthwhile and, subsequently, they would be more likely to be satisfied with the brands of these coffee shops, with an associated increase in their willingness-to-revisit. Gender and study year had the most negative effects on overall satisfaction and willingness-to-revisit. Female students were more likely to be satisfied and be willing to return than male students, and third and fourth-year students were more likely to be satisfied and willing-to-return than first or second-year students. Students who drink coffee, read books, and use laptops alone at coffee shops are easily noticeable. High-grade students tend to visit coffee shops alone in order to use their time efficiently for self-development and to find jobs. The economical efficiency factor had the greatest effect on overall satisfaction and willingness-to-revisit in terms of a positive gap. The higher the actual satisfaction (gap) of students with the price of the coffee, the greater their overall satisfaction and willingness-to-revisit. Economical efficiency with a negative gap had a negative effect on willingness-to-revisit, which implies that a less negative gap will result in a greater willingness-to-revisit. Amid worsening market conditions, coffee shops located around colleges/universities are using strategies, such as a point or membership card, strategic alliances with credit-card companies, development of a set menu or seasonal menu, and free coffee-shot services to increase their competitive edge. Product power also had a negative effect in terms of a negative gap, which indicates that a higher negative gap will result in a lower willingness-to-revisit. Because there are many more customers that enjoy coffee in this decade, as compared to previous decades, the new generation of customers, namely college/university students, want various menu items in addition to coffee, and coffee shops should, therefore, add side menu items, such as waffles, rice cakes, cakes, sandwiches, and salads. For example, Starbucks Korea is making efforts to enhance product power by selling rice cakes flavored in strawberry, wormwood, and pumpkin, and providing coffee or cream free of charge. In summary, coffee shops should focus on increasing their economical efficiency, brand, and product power to enhance the satisfaction of college/university students. Because shops adjacent to colleges or universities enjoy a locational advantage, providing differentiated services in terms of economical efficiency, brand, and product power, is likely to increase customer satisfaction and return visits. Coffee shop brands should, therefore, be innovative and embrace change to meet their customers' desires. Because this study only targeted college/university students in Seoul, comparative studies targeting diverse regions and age groups are required to generalize the findings and recommendations of this study.

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Estimation of Productivity for Quercus variabilis Stand by Forest Environmental Factors (삼림환경인자(森林環境因子)에 의한 굴참나무임분(林分)의 생산력추정(生産力推定))

  • Lee, Dong Sup;Chung, Young Gwan
    • Journal of Korean Society of Forest Science
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    • v.75 no.1
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    • pp.1-18
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    • 1986
  • This study was initiated to estimate productivity of Quercus variabilis stand. However the practical objective of this study was to provide some information to establish the basis of selecting the suitable site for Quercus variabilis. The productivity measured in terms of DBH, height, basal area and stem volume was hypothesized, respectively, to be a function of a group of factors. This study considered 32 factors, 20 of which were related to the forest environmental factors such as tree age, latitude, percent slope, etc. and the rest of which were related to soil factors such as soil moisture, total nitrogen, available $P_2O_5$, etc. The data on 4 productivity measurements of Quercus variabilis growth and related factors cited were collected from 99 sample plots in Kyeongbook and chungbook provinces. Some factors considered were, in nature, discrete variables and the others continuous variables. Each kind of factor was classified into 3 or 4 categories and total numbers of such categories were eventually amounted to 110. Then each category was treated as an independent variable. This is amounted to saying that individual variable was treated a dummy variable and assigned a value 1 or 0. However the first category of each factor was deleted from the normal equation for statistical consideration. First of all, each of 4 productivity measurements of Quercus variabilis growth was regressed and, at the same time, those 110 categories. Secondly, the partial correlation coefficients were measured between each pair of 4 productivity measurements and 32 individual foctors. Finally, the relative scores were estimated in order to derive the category ranges. The result of these statistical analyses could be summarized as follows: 1) Growth measurement in terms of height seems to be a more significant criterion for estimation of productivity of Quercus variabilis. 2) Productivity of forest on stocked land may better be estimated in terms of forest environmental factors, on the other hand, that of unstocked land may be estimated in terms of physio-chemical factors of soil. 3) The factors that a strongly positive relation to all growth factors of tree are age group, effective soil, soil moisture, etc. This implies that these factors might effectively be used for criteria for selecting the suitable site for Quercus variabilis. 4) Parent rock, latitude, total nitrogen, age group, effective soil depth, soil moisture, organic matter, etc., had more significant category range for tree growth. Therefore, the suitable site for Quercus variabilis may be selected, based on this information. In conclusion, the above results obtained by the multivariable analysis can be not only the important criteria for estimating the growth of Quercus variabilis but also the useful guidance for selecting the suitable sites and performing the rational of Quercus variabilis forest.

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The Effect of Physical Therapy on Functional Change and Related Factors in Stroke Patients (뇌졸중환자의 물리치료경과에 따른 기능변화와 관련요인)

  • Lee Seung-Ju;Yeh Min-Hae;Chun Byung-Yeol
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.7-21
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    • 1998
  • An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.

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The Comparison of Quantitative Indices by Changing an Angle of LAO View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 좌전사위상 각도의 변화에 따른 정량적 지표 비교)

  • Yoon, Soon-Sang;Nam, Ki-Pyo;Ryu, Jae-Kwang;Kim, Seong-Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.57-61
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    • 2012
  • Purpose: The multi-gated cardiac blood pool scan is to evaluate the function of left ventricle (LV) and usefully observe a value of ejection fraction (EF) for a patient who is receiving chemotherapy. To calculate LVEF, we should adjust an angle of left anterior oblique (LAO) view to separate both ventricles. And by overlapped ventricles, it is possible to affect LVEF. The purpose of this study is to investigate and compare quantitative indices by changing an angle of LAO view. Materials and methods: We analyzed the 49 patients who were examined by multi-gated cardiac blood pool scan in department of nuclear medicine at Asan Medical Center from June to September 2011. Firstly, we acquired "Best septal" view. And then, we got images by addition and subtraction of angle for LAO view to anterior and lateral. We compared three LAO views for 20 people by 5 degrees and 39 people by 10 degrees. And we analyzed quantitative indices, EF, end diastole and end systole counts, by automated and manual region of interest (ROI) modes. Results: Firstly, we analyzed quantitative indices by automated ROI mode. In case of 5 degrees, the averages of EF are $61.0{\pm}7.5$, $62.1{\pm}7.1$, $60.9{\pm}6.7%$ ($p$=0.841) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $62.4{\pm}9.5$, $62.3{\pm}10.8$, $61.6{\pm}.9.3%$ ($p$=0.938) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Secondly, we analyzed quantitative indices by manual ROI mode. In case of 5 degrees, the averages of EF are $62.8{\pm}7.1$, $63.6{\pm}7.5$, $62.7{\pm}7.3%$ ($p$=0.903) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $65.5{\pm}9.0$, $66.3{\pm}8.7$, $63.5{\pm}.9.3%$ (p=0.473) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Conclusion: When an image is nearly "Best septal" view, the difference of LAO angle would not affect to change LVEF. Although there was no difference in quantitative analysis, deviations could happen when to interpret wall motion qualitatively by reading physicians.

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Clinical Analysis of Repeated Heart Valve Replacement (심장판막치환술 후 재치환술에 관한 임상연구)

  • Kim, Hyuck;Nam, Seung-Hyuk;Kang, Jeong-Ho;Kim, Young-Hak;Lee, Chul-Burm;Chon, Soon-Ho;Shinn, Sung-Ho;Chung, Won-Sang
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.817-824
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    • 2007
  • Background: There are two choices for heart valve replacement-the use of a tissue valve and the use of a mechanical valve. Using a tissue valve, additional surgery will be problematic due to valve degeneration. If the risk of additional surgery could be reduced, the tissue valve could be more widely used. Therefore, we analyzed the risk factors and mortality of patients undergoing repeated heart valve replacement and primary replacement. Material and Method: We analyzed 25 consecutive patients who underwent repeated heart valve replacement and 158 patients who underwent primary heart valve replacement among 239 patients that underwent heart vale replacement in out hospital from January 1995 to December 2004. Result: There were no differences in age, sex, and preoperative ejection fraction between the repeated valve replacement group of patients and the primary valve replacement group of patients. In the repeated valve replacement group, the previously used artificial valves were 3 mechanical valves and 23 tissue valves. One of these cases had simultaneous replacement of the tricuspid and aortic valve with tissue valves. The mean duration after a previous operation was 92 months for the use of a mechanical valve and 160 months for the use of a tissue valve. The mean cardiopulmonary bypass time and aortic cross clamp time were 152 minutes and 108 minutes, respectively, for the repeated valve replacement group of patients and 130 minutes and 89 minutes, respectively, for the primary valve replacement group of patients. These results were statistically significant. The use of an intra aortic balloon pump (IABP) was required for 2 cases (8%) in the repeated valve replacement group of patients and 6 cases (3.8%) in the primary valve replacement group of patients. An operative death occurred in one case (4%) in the repeated valve replacement group of patients and occurred in nine cases (5.1%) in the primary valve replacement group of patients. Among postoperative complications, the need for mechanical ventilation over 48 hours was different between the two groups. The mean follow up period after surgery was $6.5{\pm}3.2$ years. The 5-year survival of patients in the repeated valve replacement group was 74% and the 5-year survival of patients in the primary valve replacement group was 95%. Conclusion: The risk was slightly increased, but there was little difference in mortality between the repeated and primary heart valve replacement group of patients. Therefore, it is necessary to reconsider the issue of avoiding the use of a tissue valve due to the risk of additional surgery, and it is encouraged to use the tissue valve selectively, which has several advantages over the use of a mechanical valve. In the case of a repeated replacement, however, the mortality rate was high for a patient whose preoperative status was not poor. A proper as sessment of cardiac function and patient status is required after the primary valve replacement. Subsequently, a secondary replacement could then be considered.

Clinical Characteristics of Arthrogryposis, Renal Tubular Dysfunction, Cholestasis(ARC) Syndrome in Korea (ARC(Arthrogryposis, Renal Tubular Dysfunction, Cholestasis) 증후군의 발병양상에 관한 연구)

  • Lee Soon Min;Kim Ji Hong;Lee Jae Seung;Han Suk Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.222-230
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    • 2005
  • Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

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Analysis of Childhood Rapidly Progressive Glomerulonephritis (소아 급속 진행성 사구체신염의 임상적 고찰)

  • Uhm Ji Hyun;Kim Mi Jin;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon Won;Jeung Hyeun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.78-86
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    • 2001
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

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Statistical Analysis of Operating Efficiency and Failures of a Medical Linear Accelerator for Ten Years (선형가속기의 10년간 가동률과 고장률에 관한 통계분석)

  • Ju Sang Gyu;Huh Seung Jae;Han Youngyih;Seo Jeong Min;Kim Won Kyou;Kim Tae Jong;Shin Eun Hyuk;Park Ju Young;Yeo Inhwan J.;Choi David R.;Ahn Yong Chan;Park Won;Lim Do Hoon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.186-193
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    • 2005
  • Purpose: To improve the management of a medical linear accelerator, the records of operational failures of a Varian CL2l00C over a ten year period were retrospectively analyzed. Materials and Methods: The failures were classified according to the involved functional subunits, with each class rated Into one of three levels depending on the operational conditions. The relationships between the failure rate and working ratio and between the failure rate and outside temperature were investigated. In addition, the average life time of the main part and the operating efficiency over the last 4 years were analyzed. Results: Among the recorded failures (total 587 failures), the most frequent failure was observed in the parts related with the collimation system, including the monitor chamber, which accounted for $20\%$ of all failures. With regard to the operational conditions, 2nd level of failures, which temporally interrupted treatments, were the most frequent. Third level of failures, which interrupted treatment for more than several hours, were mostly caused by the accelerating subunit. The number of failures was increased with number of treatments and operating time. The average life-times of the Klystron and Thyratron became shorter as the working ratio increased, and were 42 and $83\%$ of the expected values, respectively. The operating efficiency was maintained at $95\%$ or higher, but this value slightly decreased. There was no significant correlation between the number of failures and the outside temperature. Conclusion: The maintenance of detailed equipment problems and failures records over a long period of time can provide good knowledge of equipment function as well as the capability of predicting future failure. Wore rigorous equipment maintenance Is required for old medical linear accelerators for the advanced avoidance of serious failure and to improve the qualify of patient treatment.