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Clinical review of acute seizures among children who visited the emergency room in Masan Samsung hospital from 2004 to 2006 (최근 3년간(2004-2006년) 응급실로 내원한 소아환자 중 급성 발작으로 인한 환자들에 대한 임상적 고찰)

  • Lee, Won Deok;Yoo, Jae Wook;Lee, Ju Suk;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.420-425
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    • 2008
  • Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

Analysis of Health Functional Foods Advertisements Effects according to the Delivery Tool for Efficacy Information and Consumers' Attitudes (기능성 정보 전달 방법 및 소비자 태도에 따른 건강기능식품 광고 효과 분석)

  • Lee, Yeonkyung;Kim, Ji Yeon;Kwon, Oran;Hwang, In-Kyeong
    • The Korean Journal of Food And Nutrition
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    • v.29 no.6
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    • pp.835-848
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    • 2016
  • The purpose of this study was to find efficient and customized tools for delivering the benefit of health functional foods (HFFs). Delivery tools which could influence the impact of advertising were images, explanations of ingredients, diagrams of health benefit, patents, and comments from authority. Six advertisements were developed using these tools: "A": relevant image + explanation of ingredients + scientific diagram of efficacy; "B": relevant image + explanation of ingredients; "C": relevant image; "D": irrelevant image; "E": irrelevant image + explanation of ingredient + patent; "F": irrelevant image + explanation of ingredient + comments from authority. To analyze the consumer perceptions on HFFs and advertisement effects, 300 respondents were requested to answer a questionnaire comprising of the following questions: 5 questions of attitudes (necessity of HFFs, trust in HFFs, gathering information, watching advertisements and trust in advertisement claims) and 6 questions on the 6 developed advertisements (attention, understanding, sufficiency of information, sympathy, trust, and purchase). Scoring was done as per the 5 Likert scale. There was a higher proportion of females and the elderly, as compared to males and youngsters. The overall consumer attitudes were positive. Explanation of ingredients, scientific diagram of health benefit, patents and expert comments were helpful factors in increasing the advertisement evaluation by consumer, but the images were not. Advertisement evaluation of consumer did not differ with gender and age. However, differences were observed between some of the consumer attitudes (necessity of HFFs, trust in HFFs, gathering information and trust in advertisements claim) and advertisement evaluations (attention, understanding, sympathy and purchase). Our results indicate that for consumers utilizing the HFFs, advertisements with concrete tools such as diagrams, patent, and expert comments are more helpful. However, for consumers who do not have interest in HFFs, the scientific information was irrelevant. We believe that to maximize the effect of health information in advertisements, consumers should be segmented, and customized tools for each segment needs to be developed.

Changes of Housing in the FCS Curricular from the 1st to 2009 Revised of Secondary School (중등학교 가정과 교육과정의 주생활 영역 내용 변화 - 1차 교육과정부터 2009 개정 교육과정을 대상으로 -)

  • Heo, YoungSun;Kim, NamEun;Choi, MinJi;Baek, MinKyung;Gwak, SeonJeong;Cho, JaeSoon
    • Journal of Korean Home Economics Education Association
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    • v.25 no.1
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    • pp.95-118
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    • 2013
  • The purpose of this study was to analyze the contents of housing related to characters, objectives, and contents of FCS curricular from the 1st to 2009 revised curriculum of secondary school. The data were downloaded from the NCIC homepage(http://www.ncic.re.kr/2012. 04. 08) from the 1st(1955. 08) to 2009 revised curriculum(2012. 03) of secondary school. After examining the characters and objectives of each curriculum, contents of housing was analyzed by units and context elements of middle and high school separately. The titles of the subject, the objectives, the instructions, the leaning spheres, weekly hours, grade and gender of candidates, the emphasis of the instruction, etc. have been changed through the curriculum revision. The 6th curriculum was the main period to open to both genders, the $7^{th}$ was the period to combine with technology, the 2007 version was to change the structure of contents of home economics, and the 2009 version switched technology home economics from mandatory to optional in high school. The character of the courses was presented at the 1st curriculum, but it was left out from the $2^{nd}$ to $5^{th}$ curriculum. From the $6^{th}$ curriculum, the characters were separately given to middle and high school. The character of housing area started to appear only in high school home economics from the $7^{th}$ curriculum. The course objectives were described in all curriculum of both middle and high school. This applies to housing area as well. The course objectives have been modified in order to reflect value changes due to social issues. During each curriculum, contents of housing continued to change in context, course load, and candidates. Reflection of housing trends and social needs were the main causes of the change. 2009 version emphasizes on eco-life and sense of community.

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Prehospital Status of the Patients with Ischemic Chest Pain before Admitting in the Emergency Department (허혈성 흉통 환자의 응급의료센터 방문 전 상황)

  • Jin, Hye-Hwa;Lee, Sam-Beom;Do, Byung-Soo;Chun, Byung-Yeol
    • Journal of Yeungnam Medical Science
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    • v.24 no.1
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    • pp.41-54
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    • 2007
  • Background : The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). Materials and Methods : We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. Results : Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. Conclusion : Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.

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

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

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Distributors' Preference for the Flextime System (유통업체 종사자의 유동근무제에 대한 선호성향에 대한 연구)

  • Lee, Won-Haeng
    • Journal of Distribution Science
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    • v.10 no.4
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    • pp.13-20
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    • 2012
  • The "flextime" system, which was initially designed to maintain a balance between work and personal life, has recently received much attention as an alternative form of work, enabling employees to fully exert their creativity. Most studies show that the effects of flextime on performance, productivity, attitude toward the organization, absenteeism, and turnover differ between managerial and non-managerial workers. This suggests that workers' personal characteristics affect their preference for flextime by directly or indirectly influencing its result variables. As most Korean companies have not adopted the flextime system, little research has been conducted on it in Korea. Recently, Korean companies have been discussing flextime as one of several measures for enhancing international competitiveness. Therefore, this study aims to offer a theoretical framework for the introduction of the system by analyzing the effects of the precedent factors on the preference for flextime. Though not statistically significant, a higher preference for flextime is noted among workers over the age of 36. Older workers usually are more conservative and less adaptable to change but here the older Korean workers may be anxious and resistant. Additional research on workers in different types of businesses using improved research methods will lead to more meaningful results. Married workers display a lower preference to flextime than single workers. In Korea, the current atmosphere focused on a happy home encourages married workers to prefer regular work hours, enabling them to go to and from work on a regular schedule. This means that normal working hours, from morning to evening, are preferred as it is the most suitable system for families. However, this is not so in the case of single workers. Unmarried singles tend to prefer flextime for investing in self-development toward future prosperity, over the benefits of regular working-hours. Flextime is designed to meet their needs to some extent as it is helpful in maintaining a balance between work life and self-development. If flextime is selected, workers can spend mornings on self-development and work in the afternoons. Therefore, when flextime is introduced in Korea, it would be desirable to start with unmarried workers, to increase corporate creativity and productivity and develop individual potential. In particular, when the five-day workweek, the main concern for companies and labor unions, is adopted, synergy with flextime could be expected and a gradual implementation of flextime will be effective. Gender difference shows similar results to marital status with male workers displaying a higher preference for flextime. It is inferred that male workers' attitudes toward flextime are more favorable than female workers' because flextime enables self-development and work life to coexist. A relatively weak, though statistically significant, correlation exists between control position and flextime preference with inner-control-oriented workers displaying favorable attitudes toward flextime. Generally, inner-control-oriented workers tend to attribute the consequences caused by any person or partner relationship to themselves. Thus, when a new system is introduced they are likely to have less reluctance and fear than outer-control-oriented workers, because they think it is important to deal with the new system. A weak but slight correlation exists between the desire for achievement and flextime preference. People who have a higher desire for achievement are willing to consider the new system, especially if significant success is reasonably expected. This result is derived from a reasonable judgment that flextime offers an individual the time for self-development while the organization benefits from the resulting creativity and performance enhancements. Although not the primary analysis, a high correlation is found between control position and the desire for achievement, which is consistent with the results of previous research. The regression analysis not only supports the preceding ANOVA and correlation analysis but also shows the existence of a causal relationship. Married workers have a weak preference for flextime, which is consistent with the results of the preceding ANOVA. Relative to men, women have a weak preference for flextime. No statistically significant correlation was noticed for age. Inner-control-oriented workers prefer flextime more than outer-control-oriented workers as the former view the consequences of change to be their own responsibility. However, the preference for flextime seems to be weak. As expected, people with a higher desire for achievement have a stronger preference for flextime, presumably because the greater the desire for achievement, the stronger the spirit of challenging an uncertain future. No significant correlation exists between job satisfaction and flextime preference.

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Dietary Habits and Foodservice Attitudes of Students Attending American International Schools in Seoul and Gyeonggi Area (서울.경기지역 외국인 학교 학생들의 식습관 및 급식만족도 -미국계 외국인 학교를 중심으로-)

  • Kim, Ok-Sun;Lee, Young-Eun
    • Journal of the East Asian Society of Dietary Life
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    • v.22 no.6
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    • pp.744-757
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    • 2012
  • This study was designed to obtain basic data for the globalization of Korean food and the expansion of food exports through contract foodservices. A survey of dietary habits and attitudes toward school foodservices was given to students in three American international schools served by a domestic contract foodservice management company located in Seoul and Gyeonggi area. The results showed an average of three meals taken daily 3.39 times for male students and 2.95 times for female students and the time required for a meal was about 24~26 minutes. The average breakfast frequency was 5.10 times(4.59 times for male students and 5.35 times for female students) and many students reported skipping breakfast due to a lack of time. The average weekly frequency of dining out was 1.78 times(2.15 times for male students and 1.60 times for female students). In all schools, irrespective of gender and grade, students responded that a desire for snacking was 'why they want to have cookies', and snacking hours were frequently listed as 'between noon and evening'. Many also responded that an unbalanced diet is the reason some snacks are 'not to their taste'. Overall, students were highly satisfied with the foodservice menu, although there was a significant difference in what was considered proper food temperature, proper food seasoning, suitable amounts of food, and freshness of food. Male and female students were specifically highly satisfied with the 'freshness of food materials' and 'variety of menu' respectively. Overall, all students were highly satisfied with the foodservice, including the 'cleanliness of tables and trays'.

Typology of Korean Eco-sumers: Based on Clothing Disposal Behaviors (관우한국생태학적일개예설(关于韩国生态学的一个预设): 기우복장탑배적행위(基于服装搭配的行为))

  • Sung, Hee-Won;Kincade, Doris H.
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.59-69
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    • 2010
  • Green or an environmental consciousness has been a major issue for businesses and government offices, as well as consumers, worldwide. In response to this movement, the Korean government announced, in the early 2000s, the era of "Green Growth" as a way to encourage green-related business activities. The Korean fashion industry, in various levels of involvement, presents diverse eco-friendly products as a part of the green movement. These apparel products include organic products and recycled clothing. For these companies to be successful, they need information about who are the consumers who consider green issues (e.g., environmental sustainability) as part of their personal values when making a decision for product purchase, use, and disposal. These consumers can be considered as eco-sumers. Previous studies have examined consumers' purchase intention for or with eco-friendly products. In addition, studies have examined influential factors used to identify the eco-sumers or green consumers. However, limited attention was paid to eco-sumers' disposal or recycling behavior of clothes in comparison with their green product purchases. Clothing disposal behaviors are ways that consumer can get rid of unused clothing and in clue temporarily lending the item or permanently eliminating the item by "handing down" (e.g., giving it to a younger sibling), donating, exchanging, selling, or simply throwing it away. Accordingly, examining purchasing behaviors of eco-friendly fashion items in conjunction with clothing disposal behaviors should improve understanding of a consumer's clothing consumption behavior from the environmental perspective. The purpose of this exploratory study is to provide descriptive information about Korean eco-sumers who have ecologically-favorable lifestyles and behaviors when buying and disposing of clothes. The objectives of this study are to (a) categorize Koreans on the basis of clothing disposal behaviors; (b) investigate the differences in demographics, lifestyles, and clothing consumption values among segments; and (c) compare the purchase intention of eco-friendly fashion items and influential factors among segments. A self-administered questionnaire was developed based on previous studies. The questionnaire included 10 items of clothing disposal behavior, 22 items of LOHAS (Lifestyles of Health and Sustainability) characteristics, and 19 items of consumption values, measured by five-point Likert-type scales. In addition, the purchase intention of two eco-friendly fashion items and 11 attributes of each item were measured by seven-point Likert type scales. Two polyester fleece pullovers, made from fabric created from recycled bottles with the PET identification code, were selected from one Korean brand and one US imported brand among outdoor sportswear brands. A brief description of each product with a color picture was provided in the survey. Demographic variables (i.e., gender, age, marital status, education level, income, occupation) were also included. The data were collected through a professional web survey agency during May 2009. A total of 600 final usable questionnaires were analyzed. The age of respondents ranged from 20 to 49 years old with a mean age of 34 years. Fifty percent of the respondents were males and about 58% were married, and 62% reported having earned university degrees. Principal components factor analysis with varimax rotation was used to identify the underlying dimensions of the clothing disposal behavior scale, and three factors were generated (i.e., reselling behavior, donating behavior, non-recycling behavior). To categorize the respondents on the basis of clothing disposal behaviors, k-mean cluster analysis was used, and three segments were obtained. These consumer segments were labeled as 'Resale Group', 'Donation Group', and 'Non-Recycling Group.' The classification results indicated approximately 98 percent of the original cases were correctly classified. With respect to demographic characteristics among the three segments, significant differences were found in gender, marital status, occupation, and age. LOHAS characteristics were reduced into the following five factors: self-satisfaction, family orientation, health concern, environmental concern, and voluntary service. Significant differences were found in the LOHAS factors among the three clusters. Resale Group and Donation Group showed a similar predisposition to LOHAS issues while the Non-Recycling Group presented the lowest mean scores on the LOHAS factors compared to the other segments. The Resale and Donation Groups described themselves as enjoying or being satisfied with their lives and spending spare-time with family. In addition, these two groups cared about health and organic foods, and tried to conserve energy and resources. Principal components factor analysis generated clothing consumption values into the following three factors: personal values, social value, and practical value. The ANOVA test with the factors showed differences primarily between the Resale Group and the other two groups. The Resale Group was more concerned about personal value and social value than the other segments. In contrast, the Non-Recycling Group presented the higher level of social value than did Donation Group. In a comparison of the intention to purchase eco-friendly products, the Resale Group showed the highest mean score on intent to purchase Product A. On the other hand, the Donation Group presented the highest intention to purchase for Product B among segments. In addition, the mean scores indicated that the Korean product (Product B) was more preferable for purchase than the U.S. product (Product A). Stepwise regression analysis was used to identify the influence of product attributes on the purchase intention of eco product. With respect to Product A, design, price and contribution to environmental preservation were significant to predict purchase intention for the Resale Group, while price and compatibility with my image factors were significant for the Donation Group. For the Non-Recycling Group, design, price compatibility with the factors of my image, participation to eco campaign, and contribution to environmental preservation were significant. Price appropriateness was significant for each of the three clusters. With respect to Product B, design, price and compatibility with my image factors were important, but different attributes were associated significantly with purchase intention for each of the three groups. The influence of LOHAS characteristics and clothing consumption values on intention to purchase Products A and B were also examined. The LOHAS factor of health concern and the personal value factor were significant in the relationships with the purchase intention; however, the explanatory powers were low in the three segments. Findings showed that each group as classified by clothing disposal behaviors showed differences in the attributes of a product, personal values, and the LOHAS characteristics that influenced their purchase intention of eco-friendly products. Findings would enable organizations to understand eco-friendly behavior and to design appropriate strategic decisions to appeal eco-sumers.

Efficacy of Pigtail Catheter Drainage in Patients with Thoracic Empyema or Complicated Parapneumonic Effusion (농흉 및 합병된 부폐렴성 흉막 삼출 환자에서 Pigtail 도관 배액의 유용성)

  • Park, Jeong Woo;You, Seung Min;Seol, Won Jong;Paik, Eun Ki;Lee, Kyu Hoon;Seo, Joon Beom;Jeong, Seong Hwan;An, Chang Hyeok;Lim, Youg Hee;Park, Jeong Woong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.219-229
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    • 2003
  • Background : The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. Materials and Methods : 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. Results : Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated, were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion($9.4{\pm}5.25days$ vs. $19.2{\pm}9.42days$, p<0.05) and the duration of hospital admission after catheter insertion($15.9{\pm}10.45days$ vs. $38.6{\pm}11.46days$, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD($11.1{\pm}7.35days$ vs. $19.2{\pm}9.42days$, p<0.05, $17.5{\pm}9.17days$ vs. $38.6{\pm}11.46days$, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. Conclusion : In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.

The Clinical Characteristics of Lung Cancer in Patients with Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에 동반된 폐암 환자의 임상적 특정)

  • Park, Joo-Hun;Lee, Jin-Seong;Song, Koun-Sik;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.674-684
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    • 1999
  • Background : It has been generally known that the incidence of lung cancer is higher in the patients with idopathic pumonary fibrosis (IPF) than those in general population. The reported incidence was variable from 4.8 to 43.2%. There were controversies on the most frequent cell type (squamous cell carcinoma vs. adenocarcinoma) and no study was done about the real concordance of cancer and the fibrotic lesion. And the pulmonary fibrosis may influence not only the development of cancer but also the treatment and prognosis of the cancer, but there was no report on that point. Method : Total 63 patients ($66.8{\pm}7.8$ year, M : F=61 : 2) were diagnosed as IPF combined with lung cancer (IFF-CA) at Asan Medical Center. A retrospective analysis was done about the risk factors of the lung cancer, pulmonary function test, the site of cancer(especially the relationship of the cancer with the fibrotic lesion), the histologic types, and the stage of cancer. The histologic types were compared with those of 2,660 patients with lung cancer who were diagnosed at the same institute for the same period. The effect of IPF on the treatment of the cancer was evaluated with the survival time after the detection of lung cancer. Results : The lung cancer was found in 63(22.9%) out of 281 patients with IPF. But in most of them(45 patients), lung cancer was detected at the same time with IPF and only in 18 patients, the cancer was diagnosed during the follow-up($25.2{\pm}17.7$ months) of IPF. So in our study, 6.7% of patients with IPF developed lung cancer during the course of the disease. The age ($66.8{\pm}7.84$ vs. $63.4{\pm}11.1$ years), percentage of smoker (88.9 vs. 67.2%), and the male gender (96.8 vs. 67.6%) were significantly higher in IPF-CA compared with lone IPF (p<0.05). The odds ratio of smoking was 4.7 compared with non smoking IPF controls. The lung cancer was located more frequently in the upper lobe and 55.5% was in the periphery of lung. The cancer was developed in the fibrotic lesion in 23 patients (35.9%), and in the majority of the patients, the cancer was separated from the fibrosis. The cell type of the lung cancer in IPF-CA was squamous cell carcinoma 34.9%, adenocarcinoma 30.2%, small cell carcinoma 19.0%, large cell undifferenciated carcinoma 6.3%, and others 9.5%. No significant difference in the distribution of histologic type of the lung cancer was found between IPF-CA and lone lung cancer. There was no significant difference in demographic features, cell types, location and the stage of the cancer between the group with concurrent IPF-CA and the group with cancer diagnosed during the follow up of IPF. There was a tendency (but statistically not significant : p=0.081) of higher incidence of adenocarcinoma among the cancers developed in the fibrotic area(43.5%) (F-CA) than in the cancers in non-fibrotic area (22.5%) (NF-CA). The prognosis of the patients with F-CA was poor (median survival : 4 months) compared with the patients with NF-CA (7 months, p=0.013), partly because the prevalence of severe IPF (the extent of fibrosis in HRCT 50%) was higher in F-CA group. Conclusion : These data suggest that the lung cancer in the patients with IPF has similar features to the ordinary lung cancer.

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