• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.601-608
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• 1999

Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

• Journal of Dairy Science and Biotechnology
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• v.34 no.2
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• pp.99-116
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• 2016

We herein performed animal safety assessment in accordance with Good Laboratory Practice (GLP) regulations with the aim of developing sialic acid from glycomacropeptide (hereafter referred to as "GMP") as an index ingredient and functional component in functional foods. GMP is a type of whey protein derived from milk and a safe food, with multiple functions, such as antiviral activity. A test substance was produced containing 7% (w/w) sialic acid and mostly-hydrolyzed whey protein (hereafter referred to as "7%-GNANA") by enzymatic treatment of substrate GMP. The maximum intake test dose level was selected based on 5,000 mg/kg/day dose set for male NOEL (no-observed-effect-level) and female NOAEL (no-observed-adverse-effect-level) determined by a dose-range finding (DRF) test (GLP Center of Catholic University of Daegu, Report No. 15-NREO-001) that was previously conducted with the same test substance. To evaluate the toxicity of a repeated oral dose of the test substance in connection with the previous DRF study, 1,250, 2,500, and 5,000 mg/kg of the substance were administered by a probe into the stomachs of 6-week-old SPF Sprague-Dawley male and female rats for 90 d. Each test group consisted of 10 male and 10 female rats. To determine the toxicity index, all parameters, such as observation of common signs; measurements of body weight and food consumption; ophthalmic examination; urinalysis, electrolyte, hematological, and serum biochemical examination; measurement of organ weights during autopsy; and visual and histopathological examinations were conducted according to GLP standards. After evaluating the results based on the test toxicity assessment criteria, it was determined that NOAEL of the test substance, 7%-GNANA, was 5,000 mg/kg/day, for both male and female rats. No animal death was noted in any of the test groups, including the control group, during the study period, and there was no significant difference associated with test substance, as compared with the control group, with respect to general symptoms, body weight changes, food consumption, ophthalmic examination, urinalysis, hematological and serum biochemical examination, and electrolyte and blood coagulation tests during the administration period (P<0.05). As assessed by the effects of the test substance on organ weights, food consumption, autopsy, and histopathological safety, change in kidney weight as an indicator of male NOAEL revealed up to 20% kidney weight increase in the high-dose group (5,000 mg/kg/day) compared with the change in the control group. However, it was concluded that this effect of the test substance was minor. In the case of female rats, reduction of food consumption, increase of kidney weight, and decrease of thymus weight were observed in the high-dose group. The kidney weight increased by 10.2% (left) and 8.9% (right) in the high-dose group, with a slight dose-dependency compared with that of the control group. It was observed that the thymus weight decreased by 25.3% in the high-dose group, but it was a minor test substance-associated effect. During the autopsy, botryoid tumor was detected on the ribs of one subject in the high-dose group, but we concluded that the tumor has been caused by a naturally occurring (non-test) substance. Histopathological examination revealed lesions on the kidney, liver, spleen, and other organs in the low-dose test group. Since these lesions were considered a separate phenomenon, or naturally occurring and associated with aging, it was checked whether any target organ showed clear symptoms caused by the test substance. In conclusion, different concentrations of the test substance were fed to rats and, consequently, it was verified that only a minor effect was associated with the test substance in the high-dose (5,000 mg/kg/day) group of both male and female rats, without any other significant effects associated with the test substance. Therefore, it was concluded that NOAEL of 7%-GNANA (product name: Helicobactrol) with male and female rats as test animals was 5,000 mg/kg/day, and it thus was determined that the substance is safe for the ultimate use as an ingredient of health functional foods.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.78-85
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• 1999

Purpose : Mycoplasma pneumoniae pneumonia has been to be developed frequently in school age children and adolescence and hard to see under 3 year-old children. But it seems to be increased in number of patients with Mycoplasma pneumoniae pneumonia under 3-year old in clinical practice in these days. We have aimed to examine the characteristics of clinical findings of Mycoplasma pneumonia under 3 year-old children. Methods : We had performed retrospective review of medical records of 30 patients with Mycoplasmal pneumonia under 3-year old children who admitted to Department of Pediatrics, Kyunghee University Hospital from Jan. 1994 to Dec. 1997. The diagnostic criteriae was Cold agglutinin titer>1:64 or Mycoplasma antibody titer>1:80. Results : Mycoplasmal pneumonia was 30 out of 235 cases(12.7%) of total pneumonia under 3 year old children. Male female ratio was 1.3 : 1 and age distributions were 0~1y : 0, 1~2y : 8, 2~3y : 22 cases. Clinical symptoms and signs were cough(100.0%), sputum(83.3%), fever(80.0%) rhinorrhea(33.3%), vomiting(33.3%), moist rale(86.7%), decreased breathing sound(26.7%), wheezing(20.0%), and pharyngeal injection(30.0%). Thirteen out of 30 cases(43.3%) had unilateral infiltration, 10 cases(33.4%) had bilateral infiltration, 1 case(3.3%) had pleural effusion, and 6 cases(20.0%) had negative findings on chest radiography and there was no cases of atelectasis. On laboratory findings, 6 out of 30 cases(20.0%) had leukocytosis, 1 case(3.3%) had neutrophilia, 10 cases(30.0%) had eosinophilia, 17 cases(56.7%) had increased ESR, and 18 cases(60.6%) had positive CRP. Positive cold agglutinin titers(>1 : 64) were 19 cases(63.3%), and positive mycoplasma antibody(M-ab) titers(>1 : 80) were 27 cases(93.3%). Mycoplasma antibody test was more valuable than cold agglutinin test for the diagnosis of Mycoplasmal pneumonia and there was no correlation between cold agglutinin titer and mycoplasma antibody titer. Mycoplasma-polymerase chain reaction(M-PCR) was done with 13 cases, 12 out of 13 cases(92.3%) were positive. M-PCR test was valuable to the diagnosis of Mycoplasmal pneumonia but it will be needed to further study for their clinical application. Among 30 cases, 5 cases(16.7%) had complications, 3 cases(10.0%) had skin rash, 1 case(3.3%) had pleural effusion, 1 case(3.3%) had arthralgia, but all complications were mild and recovered without residual sequelae. Conclusion : The occurrence of Mycoplasmal pneumonia under 3 year-old children was not rare from this study. Clinical characteristics of Mycoplasmal pneumonia under 3-year old were normal radiologic findings in many cases, low complication rate, mild clinical course, and tend to rapid recovery compared with general manifestations of Mycoplasmal infectionsin children and adolescence. There were likely to be missed patients with Mycoplasmal pneumonia which did not diagnose by conventional serologic tests that had low sensitivity and specificity. We have to pay attention to the Mycoplasmal infection of the young children with pneumonia during epidemic periods of Mycoplasmal infection.

• Journal of the Korean Society of Costume
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• v.1
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• pp.119-129
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• 1977

It is significant for developing the future for us to know our present age. In order to preserve our Korean costume as a fola clothes retaining our distinguished independent characterisitics and to help design the tomorrow of our Korean costume playing a role as a racial to develop the world clothing culture, a survey was conducted to investigate modern people's conscious-ness and wearing practumes of Korean costume by questionaire and interviewing methods. The results of the survey were analyzed as follows: (1) At present, Korean costumes were purchased as customtailored(64.0%) and as ready-made(17.8%) and most of them were not made at individual homes. The laundry and ironing of them were carried out at laundry shops(68.8%). Considering our present economic, social and cultural aspects, sowing, laundryand ironing will not be carried out at homes again in the future and ready made costumes seen to be produced in a large scale in the future. Garment makers and laundry shop operators should be trained how to make our Korean costumes retain our traditional beauty in the course of their production and laundry and the makers of ready-made costumes must make research how to efficiently produce ideal ready-made costumes by adopting the synchro system in their wrk odisivion. (2) The age group wearing Korean costumes most frequently was the aged people over 60 (their wearing rate; 45%-50%) and the group wearing them most frequently next io the aged people over 60, was housewives(their wearing rate; 15%-20%). Excludign aged people and housewives, other respondentsdid not wear Korean costumes very frequently. Men's wearing rate was lower their wearing rate was the younger their ages were and the less their monthly incomes were. Korean costumes were used for holiday and festival(60%), wedding and funeral ceremonies (52%), visiting and working(22%), casual wear(12.8%) and home wear(9.2%). The use of Korean costumes as casual and home wears, was lower than the use for holday, festival, visiting and working, Under our present circumstances in which our Korean people use both Western style clothes and Korean costumer, our Korean costume has lostits position as a basic and necessary requiement in Korean people's daily life and become a ceremonical and fancy costume. It is natural that the times and life change everything in our daily life. Our costume has to be made as good ceremonial and fancy clothes satisfying modern sensibility according to its new role. In order for us to get close with our clothes, a keen study must be carried out to cleat the color, material, style, function and harmony of the Korean costume matching the of the times. (3) The 47.8% of the respondents answered that they were proud of our Korean costume as our folk clothes, 47.6% replied that thought them just common and 1.1% responded that they were ashamed of it. Most of them were affirmative in feeling pride with our Korean costume. (4) Considering the functional aspect of Korean costumes, their strong points were symetric beauty, rhythmical beauty, unity feeling, harmonical beauty and detailed decorations. Their common shortcomings were lack of individuality and inadequateness for active life. The shortcomings of woman costumes were suppressing breast, making resperation difficult and in adequnteness in summer time. The main reason not to wear our Korean costumes, was due to the fact that they are incomvenient for active life. As a measure to eliminate such shortcomings, 1) the suspension system of skirt to remove the suppression of breast should be generally adopted. 2) they should be simplified in their structure to make them convenient for active life and adepuate in wearing them in hot weather in an extent to which the traditional beauty of the costume may not be lostand 3) a new technique must be explored for showing individuality by wearing method and new arrangment of colors and decorations. (5) The reasons desiring to wear Korean costumes were classifide as follows: A. Korean costumes are our traditional clothes(43.4%). B. Korean costumes are noble and beautiful(26.8%). C. They are accustomed to wear Korean costumes by habit(19.5%). D. Korean costumes are necessary for attending ceremoneis(9.5%). E. Miscellaneous reasons(0.8%). Classifying these reasons into age groups, the high age group over 40 wore them because they were easy to wear by habit and the low age group of 10-30 never thought that they were east to wear by habit. Considering that even those who were accustomed to wear Korean costumes showed a low wearing rate and that the young generation were accustomed to wear Western style clothes rather than Korean costumes, the wearing rate of Korean costumes will be reduced in the future if such trend continues. It is urgent for us to make our best efforts in order to enhance the interest of young generation in Korean costumes and not to make them lose the strong points of Korean costume in the future. (6) Conicering the plan of the respondents on what kind of clothes they were going to wear in the future, among the age group over 50, those who wanted to wear only Korean costumes were 24.8%(men) and 35.1%(women), those who wanted to wear 49.7%(men) and 47.4(women), those who wanted to wear chiefly Western style clothes were 20.7% (men) and 14.4%(women) and those who wanted to wear only Western style clothes, were 2.4% (men) and 2.1%(women). This shows that the general tendency to wear only or chiefly Korean costumes is more prevalent than that to wear only Western style. Among the age group under 50, the tendency to wear Western style clothes was conspicuous and most of the respondent answered that they would wear chiefly Western style clothes and Korean costumes occasionally. Only 5.4% of the respondent answered that they would wear only Western style clothes and this shows that meny respondents still wonted to wear Korean costumes. Those who wanted their descendants to wear what they desire, were 50.1%(men) and 68.8% (women) and those who wanted their descendants to wear Koran costumes occasionally, were 85.8%(men) and 86.3%(women). This shows that most of respondents wanted their descendants to wear Korean costumes. In order to realize, it is necessory for us to make ourdescendants recognize the preciousness of our traditional culture and modify our Korean costumes according to their taste so that they may like wearing them.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.660-668
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• 1995

Background: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. Methods: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age, sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. Results: 1) Group 1 patients had lower glucose level{$63.3{\pm}30.8$(mg/dl)} than that of the group 2{$98.5{\pm}34.2$(mg/dl), p<0.05}, and higher LDH level{$776.3{\pm}266.0$(IU/L)} than the group 2 patients{$376.3{\pm}123.1$(IU/L), p<0.05}, and also longer duration of symptom before treatment{$2.0{\pm}1.7$(month)} than the group 2{$1.1{\pm}1.2$(month), p<0.05}, respectively. 2) In group 1, FVC changed from preoperative $2.55{\pm}0.80$(L) to postoperative $2.99{\pm}0.78$(L)(p<0.05), and FEV1 changed from preoperative $2.19{\pm}0.70$(L/sec) to postoperative $2.50{\pm}0.69$(L/sec)(p<0.05). 3) There was no difference in pleural fluid protein level($5.05{\pm}1.01$(gm/dL) and $5.15{\pm}0.77$(gm/dl), p>0.05) and WBC differential count between group 1 and group 2. Conclusion: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.

• Journal of the Korean Geotechnical Society
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• v.35 no.5
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• pp.5-19
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• 2019

Considering the natural phenomenon in which steep slopes ($65^{\circ}{\sim}85^{\circ}$) consisting of rock mass remain stable for decades, slopes steeper than 1:0.5 (the standard of slope angle for blast rock) may be applied in geotechnical conditions which are similar to those above at the design and initial construction stages. In the process of analysing the stability of a good to fair continuum rock slope that can be designed as a steep slope, a general method of estimating rock mass strength properties from design practice perspective was required. Practical and genealized engineering methods of determining the properties of a rock mass are important for a good continuum rock slope that can be designed as a steep slope. The Genealized Hoek-Brown (H-B) failure criterion and GSI (Geological Strength Index), which were revised and supplemented by Hoek et al. (2002), were assessed as rock mass characterization systems fully taking into account the effects of discontinuities, and were widely utilized as a method for calculating equivalent Mohr-Coulomb shear strength (balancing the areas) according to stress changes. The concept of calculating equivalent M-C shear strength according to the change of confining stress range was proposed, and on a slope, the equivalent shear strength changes sensitively with changes in the maximum confining stress (${{\sigma}^{\prime}}_{3max}$ or normal stress), making it difficult to use it in practical design. In this study, the method of estimating the strength properties (an iso-angle division method) that can be applied universally within the maximum confining stress range for a good to fair continuum rock mass slope is proposed by applying the H-B failure criterion. In order to assess the validity and applicability of the proposed method of estimating the shear strength (A), the rock slope, which is a study object, was selected as the type of rock (igneous, metamorphic, sedimentary) on the steep slope near the existing working design site. It is compared and analyzed with the equivalent M-C shear strength (balancing the areas) proposed by Hoek. The equivalent M-C shear strength of the balancing the areas method and iso-angle division method was estimated using the RocLab program (geotechnical properties calculation software based on the H-B failure criterion (2002)) by using the basic data of the laboratory rock triaxial compression test at the existing working design site and the face mapping of discontinuities on the rock slope of study area. The calculated equivalent M-C shear strength of the balancing the areas method was interlinked to show very large or small cohesion and internal friction angles (generally, greater than $45^{\circ}$). The equivalent M-C shear strength of the iso-angle division is in-between the equivalent M-C shear properties of the balancing the areas, and the internal friction angles show a range of $30^{\circ}$ to $42^{\circ}$. We compared and analyzed the shear strength (A) of the iso-angle division method at the study area with the shear strength (B) of the existing working design site with similar or the same grade RMR each other. The application of the proposed iso-angle division method was indirectly evaluated through the results of the stability analysis (limit equilibrium analysis and finite element analysis) applied with these the strength properties. The difference between A and B of the shear strength is about 10%. LEM results (in wet condition) showed that Fs (A) = 14.08~58.22 (average 32.9) and Fs (B) = 18.39~60.04 (average 32.2), which were similar in accordance with the same rock types. As a result of FEM, displacement (A) = 0.13~0.65 mm (average 0.27 mm) and displacement (B) = 0.14~1.07 mm (average 0.37 mm). Using the GSI and Hoek-Brown failure criterion, the significant result could be identified in the application evaluation. Therefore, the strength properties of rock mass estimated by the iso-angle division method could be applied with practical shear strength.

• Asia Marketing Journal
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• v.12 no.2
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• pp.27-52
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• 2010

It is not new that today's business organizations are expected to exhibit ethical and moral management and to carry out social responsibility as a good corporate citizen. Since South Korea emerged as a newly industrialized country during the 1980s, Korean corporations have become active in carrying out their social responsibility as a good corporate citizen to society. In spite of the short history of corporate social responsibility, Korean companies have actively participated in corporate philanthropy. Corporations' significant donations to various social causes, no-lay-off policies, corporate volunteerism and green marketing are evidences of their commitment to corporate citizenship. Corporate social responsibility is now an essential management practice whereby corporation can strengthen its sustainable value creation processes by enhancing the trust assets underlying the relationships between the business and the stakeholders. Much of the conceptual work in the area of corporate social responsibility(CSR) has originated from researches conducted in the management field. Carroll(1979) proposed that corporations have four types of social responsibilities: economic, legal, ethical and philanthropic responsibility. Most past research has investigated CSR and its impact on consumers' attitudes toward the corporations and corporate performances. Although there exists a large body of literature on how consumers perceive and respond to CSR, the majority of past studies were conducted in the United States. The stability and applicability of past findings need to be tested across different national/cultural settings, especially since corporate social responsibility is a reflection of implicit conformation with the expectations and criticism that society may have toward a corporation(Matten and Moon, 2004). In this study, we explored whether people in Korea perceive CSR of Korean corporations in the same four dimensions as done in the United States and what were the measurement items tapping each of these four dimensions. In order to investigate the dimensions of CSR and the measurement items for CSR perceived by Korean people, nine focus group interviews were conducted with several stakeholder groups(two with undergraduate students, two with graduate students, three with general consumers, and two with NGO groups). Scripts from the interviews revealed that the Korean stakeholders perceived four types of CSR which are the same as those proposed by Carroll(1979). However we found CSR issues unique to Korean corporations. For example for the economic responsibility, Korean people mentioned that the corporation needed to contribute to the economic development of the country by generating corporate profits. For the legal responsibility, Koreans included the "corporation need to follow the consumer protection law." For the ethical responsibility, they considered that the corporation needed to not promote false advertisement. In addition, Koreans thought that an ethical company should do transparent management. For the philanthropic responsibility, people in Korea thought that a corporation needed to return parts of its profits to the society for the betterment of society. The 28 items were developed based on the results of the nine focus group interviews, while considering the scale developed by Maignan and Ferrell(2001). Following the procedure proposed by Churchill(1979), we started by developing an item poll consisting of 28 items and purified the initial pool of items through exploratory, confirmatory factor analyses. 176 samples were sued for this analysis. Confirmatory factor analysis was performed on the 28 items in order to verify the underlying four factor structure. Study 1 provided new measurement items for tapping the Korean CSR dimensions, which can be useful for the future studies exploring the effects of CSR on Korean consumers' attitudes toward the corporations and corporate performances. And we found the CSR scale(17 items) has good reliability, discriminant validity and nomological validity. Economic Responsibility: "XYZ company continuously improves the quality of our products", "XYZ company has a procedure in place to respond to customer complaint", "XYZ company contributes to the economic development of our country by generating profits", "XYZ company is eager to hire people". Legal Responsibility: "XYZ company's products meet legal standards", "XYZ company seeks to comply with all laws regulating hiring and employee benefits", "XYZ company honors contractual obligations to its suppliers", "XYZ company's managers try to comply with the law related to the business operation". Ethical Responsibility: "XYZ company has a comprehensive code of conduct", "XYZ company does not promote a false or misleading advertisement", "XYZ company seems to conduct a transparent business", "XYZ company does a fair business with its suppliers or sub-contractors". Philanthropic Responsibility: "XYZ company encourages partnerships with local businesses and schools", "XYZ company supports sports and cultural activities", "XYZ company gives adequate contributions to charities considering its business size", "XYZ company encourages employees to support our community". Study 2 was condusted for comprehensive validity. 655 samples were used for this anlysis. Collected samples were tested by factor analysis and Crnbach's Alpha coefficiednts and were found to be satisfactory in terms of validity and reliability. Furthermore, fitness of the measurement model was tested by using conformatory factor analysis. χ²=880.73(df=160), GFI=0.891, AGFI=0.854, NFI=0.908, NNFI=0.913, RMR=0.059, RMESA=0.070. We hope that CSR scale could greatly facilitate research on Corporate social resposibility, it is by no means the final answer.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

• Journal of dental hygiene science
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• v.5 no.4
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• pp.211-220
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• 2005

The purpose of this study was to examine the job performance of dental coordinators and their perception of their job to lay the groundwork for utilizing dental personnels more efficiently. The subjects in this study were dental coordinators who worked at selected dental hospitals and clinics in Seoul, Gyeonggi province and Incheon. A survey was conducted to gather data from May 1 to August 8, 2005 and answer sheets from 108 respondents were analyzed. The findings of the study were as follows: 1. As for the length of service, 43.5 percent of the dental coordinators investigated had worked at dental institutes for five years or more, which was followed by less than two years(19.5%) and three years to less than five years(19.4%). Concerning the length of service as dental coordinators, 39.8 percent had served for less than two years, and 19.4 percent had worked for two years to less than three years and for five years or more respectively. Regarding the name of position, 38 percent were called team leaders, and 30.6 percent were called coordinators. As to duties, the largest group of them that stood at 30.6 percent were in charge of receiving, and in regard to department, the largest group, 57.4 percent, belonged to the treatment backup department. 2. Concerning education, the greatest number of them, 45.4 percent, had received education at private institutes, and 73.1 percent found it necessary for dental coordinators to take an authorized qualification test. 43.5 percent, the largest group, looked upon the central government as the best organization to authorize their qualifications and 70.8 percent believed that what they learned enabled them to perform their job successfully. As to the necessity of follow-up education as a means to improve job performance, 96.3 percent consented to it. As for the reason, 63.9 percent considered that necessary to enhance their own ability and 22.2 percent were in want of systematic education. Regarding educational expenses, 29.6 percent were subsidized by the dental institutes where they had worked and 25.9 percent had totally been responsible for that. Regarding a required course, medical service and marketing was most widely pointed out(66.7%), followed by theory and practice(65.7%) and introduction to dentistry(57.4%). As to what sort of education they wanted to receive more, dental service and marketing was selected the most, followed by practical health insurance(35.2%). 3. In regard to what type of job they performed as dental coordinators, 88.9 percent were in charge of appointment in the field of customer service, and 87.9 percent paid attention to having good manners as service providers in the area of self-management. In the field of hospital affairs, 81.3 percent were in charge of receiving. 4. As to their awareness of dental coordinator job, the largest group took pride in the job they performed ($3.99{\pm}0.76$), and the second largest group believed that dental coordinators made a great contribution to hospital management ($3.92{\pm}0.70$). The third largest group gave a great weight to their own job ($3.91{\pm}0.84$) in light of overall dental duties and the fourth largest group found themselves to get along with other employees regardless of position ($3.86{\pm}0.74$). The fifth largest group believed their job was of great use for promoting the oral health of patients ($3.76{\pm}0.75$), and the sixth largest group thought the future of dental coordinators was promising($3.74{\pm}0.86$). 5. In regard to their perception by age group, those who were older had a better opinion on every item of their job in general. Their age made a statistically significant difference to their view of the weight of dental coordinator job(P < 0.001) in light of overall dental duties, of being approved and trusted by managers(P < 0.01), of social awareness of dental coordinator, and of being understood and approved by other employees and dentists. Their pride in current job and their satisfaction with the name of their position were statistically significantly different according to their age as well. Besides, their age made a statistically significant difference to their opinion about whether or not there was an age limit to their occupation and about their contribution to hospital management (P < 0.05). 6. As for their perception by type of job, the dental hygienists were generally most satisfied with their job, followed by nursing aids and others. There was a statistically significant gap among their opinions about whether to make a job-related decision on their own(P < 0.001). the weight of their job in terms of overall dental duties, whether their job improved their ability, whether their job made a great contribution to enhancing the oral health of patients, whether their job was understood and approved by other employees(P < 0.01), social awareness of their job, whether they conflicted with other employees during job performance, and whether dental hospitals or clinics offered a self-development opportunity for them to take their ability to another level(P < 0.05). And their satisfaction with current pay was statistically significantly different as well.

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

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