• Journal of Chest Surgery
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• v.29 no.11
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• pp.1173-1181
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• 1996

The causes of degenerative changes in allograft cardiac valves are not well known to this day. Today's preserved allografts possess highly viable endothelial cells and degeneration of allografts can be facilitated by immune reaction which may be mediated by these viable cells. To test the antigenicity of endothelial cells, pieces from aortic wall were obtained from fresh and cryo-preserved rat allograft. Timings of sampling were prior to sterilization, after sterilization, after 1, 2, 7, 14 days of fresh preservation and cryopreservation. Endothelial cells were tested by immunohistochemical methods using monoclonal antibodies to MHC class I(MRC OX-18), class II(MRC OX-6) and ICAM-1 antigens. After transplantation of each group of aortic allograft at the subcutaneous layers of rats, population of CD4$^{+}$ T cell and CD8$^{+}$ T cell were analyzed with monoclonal antibodies after 1, 2, 3, 4, 6 and 8 weeks. MHC class I expression was 23.95% before preservation and increased to 35.53~48.08% after preservation(p=0.0183). MHC Class II expression was 9.72% before preservation and 10.13~13.39% after preservation(P=0.1599). ICAM-1 expression was 15.02% before preservation and increased to 19.85~35.33% after preservation(P=0.001). The proportion of CD4$^{+}$ T-cell was 42.13% before transplantation. And this was 49.23~36.8% after transplantation in No treat group (p=0.955), decreased to 29.56~32.80% in other group(p=0.0001~0.008). In all the groups, the proportion of CD8$^{+}$ T-cell increased from 25.57% before transplantation to 42.32~58.92% after transplantation(p=0.000l~0.0002). The CD4$^{+}$/CD8$^{+}$ ratio decreased from 1.22~2.28 at first week to 0.47~0.95 at eighth week(p=0.0001). The results revealed that the expression of MHC class I and ICAM-1 in aortic allograft endothelium were increased but that of MHC class II were not changed, despite the different method of preservation. During 8 weeks after transplantation of aortic allograft, the subpopulations of CD4$^{+}$ T cell were not changed or only slightly decreased but those of CD8$^{+}$ T cell were progressively increased.ely increased.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.141-146
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• 2002

Objectives : This study was peformed in order to assess the incidence of hypertension based on two-years follow-up of a rural hypertension-free cohort in Korea. Methods : The study cohen comprised 2,580 subjects aged above 20 (1,107 men and 1,473 women) of Chung-Song County in Kyungpook Province judged to be hypertensive-free at the baseline examination in 1996. For each of two examinations in the two-year follow-up, those subjects free of hypertension were followed for the development of hypertension to the next examination one year (1997) and two years later (1998). The drop-out rate was 24.7% in men and 19.6% in women. Hypertension was defined as follows 1) above mild hypertension as a SBP above 140 mmHg or a DBP above 90 mmMg,2) above moderate hypertension as a SBP above 160 mmHg or a DBP above 100 mmHg or when the participant reported having used antihypertensive medication after beginning this survey. Results : The age-standardized incidence of above mild hypertension was 6 per 100 person years (PYS) in men and that of above moderate hypertension was 1.2. In women, the age-standardized rate for above mild hypertension was 5.7 and 1.5 for above mild and moderate hypertension, respectively. However, the rates of incidence as calculated by the risk method were 4.8% and 1.0% in men and 4.6%, 1.2% in women, respectively. In both genders, incidence was significantly associated with advancing age(p<0.01), In men, the incidences of above moderate hypertension by age group were 0.5 per 100 PYS aged 20-39, 0.7 aged 40-49, 1.7 aged 50-59, 3.6 aged 60-69, and 5.8 aged above 70(p<0.01). In women, those the incidence measured 0.6 per 100 PYS aged 20-39, 1.8 aged 40-49, 1.3 aged 50-59, 3.3 aged 60-69, and 5.6 aged above 70(p<0.01). After age 60, the incidence of hypertension increased rapidly. Conclusions : The incidence data of hypertension reported in this study may serve as a reference data for evaluating the impact of future public efforts in the primary prevention of hypertension in Korea.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.142-149
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• 2003

Purpose : The urinary mass screening program for the detection of urinary abnormalities in school aged population has been performed in Seoul since 1981. Nation-wide urinary mass screening program was also performed since 1998. The aim of this study was to analyze the cause and nature of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province Methods : The medical records of 44 cases of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province, and evaluated for urinary abnormalities at the pediatrics outpatients renal clinics of Busan Paik Hospital from April 2002 to August 2003 were reviewed prospectively. Results : The cause and incidence of isolated proteinuria were as follows; transient proteinuria 4 cases(9.1%), orthostatic proteinuria 36 cases(81.8%) and persistent proteinuria 4 cases (9.1%). The total protein amount of the 24 hour urine were $121.0{\pm}136.4\;mg$ in transient proteinuria, $179.1{\pm}130.0\;mg$ in orthostatic proteinuria and $1532.8{\pm}982.5\;mg$ in persistent proteinuria. In the orthostatic proteinuria group, the total protein amount of the 24 hour urine was in the range of 40-616 mg. Spot urine protein/creatinine ratio(PCR) were $0.10{\pm}0.01$ in transient proteinuria, $0.61{\pm}0.61$ in orthostatic proteinuria and $4.35{\pm}4.04$ in persistent proteinuria. In the orthostatic proteinuria group, spot me PCR was in the range of 0.09-2.32. Renal biopsy was peformed in 4 children of the persisitent proteinuria group. They showed minimal change in 1 case, membranoproliferatiye glomerulonephritis in 2 cases and secondary renal amyloidosis in 1 case. Conclusion : The majority of isolated proteinuria which was detected by chance on school urinary mass screening were transient or orthostatic proteinuria. Even though the incidence of persistent proteinuria was much lower, it is necessary to take care of these children regularly and continuously, because persistent proteinuria itself is a useful marker of the progressive renal problems.

• Asia Marketing Journal
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• v.12 no.4
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• pp.27-54
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• 2011

This research attempted to present the efficiency of culture marketing to the organizations producing culture-art products and to the companies utilizing art and suggest the practical viewpoints to the culture and art policy agencies. The methodology used was to take an in-depth look at the consumer value cognition and benefits of culture-art products in contemporary consumption culture from a social context by conducting a total of 12 Focus Group Interviews, consisting of 58 males and females in their 10s~50s who can represent culture-art product consumers. The culture-art products refer to the artist's spiritual, actual act of creating or to the end products with economic exchange value. They are also sense goods and merit goods that affect the mental state of consumers. By looking at culture-art products as consumer merit goods, this research examined consumer value cognition of culture-art products based on the characteristics culture-art products. As a result, this research determined that consumers view culture-art products largely as 'aesthetic and sensuous merit goods', 'actual and individual merit goods', and 'social public property'. As 'aesthetic and sensuous merit goods', culture-art products are considered as the products of an artist's creative activities; as 'social public property', culture-art products have a public value in terms of ownership; and as 'actual and individual merit goods', culture-art products act on the spirit and reality of a consumer in terms of consumption. As a result of analyzing the benefits of culture-art products based on the above-mentioned consumer value cognition, it was observed that the benefits of culture-art-product consumption are chiefly divided into 'aesthetic character-oriented', 'social relationships-oriented', and 'individual benefits-oriented' depending on how consumers see culture-art products. A 3-conceptional structures model was constructed according to the relationship between consumer value cognition of culture-art products and the benefits. This research revealed that consumers who pursue the aesthetic value or sense of beauty as the central reason experience culture-art products themselves, enjoy intellectual quests, and pursue their satisfaction by expressing affection for and interests in culture-art products. On the other hand, consumers who pursue social value as the central reason as a means of communication by perceiving culture-art products as a public property of society, pursue sympathy with people close to them through the symbolic power of culture-art product consumption or the joy of self-display. Consumers who perceive art products as spiritual and actual merit goods and pursue consumer value as a central reason want to express their own personality, develop themselves, and differentiate themselves or identify themselves with others in the context of social relations for the ultimate goal of living a happy and satisfied life while pursuing to satisfy imminent and actual necessities as emotional stability and rest. The fact that culture-art product benefits could vary according to how a consumer perceives them implies that consumer value cognition of culture-art products and their benefits significant affect consumers' decision in choosing and consuming various culture-art products. It turned out that such benefits from the consumption of culture-art products reflect the complex contemporary consumption culture of rational consumption, symbolic consumption, experiential consumption, and social reflective consumption. This research identified conceptional structures of consumer value cognition on culture-art products and benefits that can be used for studying and understanding culture-art products consumers who pursue a variety of consumption values. They can also be used by private companies in utilizing art, as well as by national agencies in enhancing the population's quality of life. However, since this research could only conceptually grasp consumer perception of culture-art products and reveal the dimension of classification due to its own limitations arising from characteristic investigation, quantitative data on the benefits of culture-art product consumers should be measured in future studies through a quantitative investigation, while using the value cognition of culture-art products and the individual characteristics of consumers as variables based on this research.

• Journal of Preventive Medicine and Public Health
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• v.30 no.1 s.56
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• pp.45-59
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• 1997

It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.

• Journal of Korean Home Economics Education Association
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• v.28 no.3
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• pp.47-63
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• 2016

The purpose of this study is to suggest the basic information for diverse and balanced research and development in this field with understanding research trends related to safety education in home economics. In order to so, this study makes population and sampling by targeting cases which refer to 'safety' on 15 papers of academic journals related to home economics registered in the National Research Foundation from 2001 to 2015, 244 papers related to safety education area and 179 master doctorate thesis by searching keyword as 'safety'. Analysis contents are research trends of papers related to safety education by year and by subject and research trends of safety education by area and by research method. As a result of the study, first, the number of research papers related to safety education by year on home economics curriculum repeated increase and decrease and there have been consistent studies conducted on safety education with 14-52 papers per every year and yearly average 28.2 papers. On the other hand, the most number of studies conducted in 2015 with 52 papers which are twice as much of 26 papers in 2014. This seems to be affected by the announcement of safety comprehensive countermeasures from government and the emphasis of safety subject on 2015 curriculum revision of the Ministry of Education. Second, with regards to research trends by topic, 137 papers are related to safety education (29%), 336 papers are related to safety actual condition (71%). Accidents and recognition had a greater percentage in a paper before 2009 (74.4%) and studies are increased after 2009 (from 21 papers to 53 papers) in terms of development or evaluation of safety education program, development of education materials, development of education method etc. Subject area dealt with the most on the research of safety actual condition is regarding safety accidents or effective variables (23.2%). Subject regarding the variables are researches related to factors influencing family violence, internet addiction, spouse violence, willingness to purchase unsafe food, age harassment, or suicidal attempt etc. Next, researches related to safety recognition (13.9%), safety knowledge and attitude (7.4%), safety behaviors (6.3%), safety consciousness (2.3%) show in sequence. Subject area dealt with the most on the researches regarding safety education is development and evaluation of safety education program (11%) and this appears the most in 2015 by year (21.5%). Third, with regards to eight areas of safety education, there are 143 papers regarding public safety (33.8%), 106 papers regarding violence and personal safety (25.1%), 93 papers regarding general subject on safety or whole safety area (22%) and 58 papers regarding drug and internet addiction (13.7%) in sequence. And there is no paper related to first aid and 1 paper is related to occupational safety (0.2%). Occupational safety area is less researched nevertheless its included in home economic curriculum as relative chapter. First aid does not directly correlate with home economics curriculum but should be studied in preparation for accident which could happen in practical class. Forth, with regards to research trends by research method, quantitative research (89.1%) is mostly used and both research study (70.4%) and experimental research (18.7%) are used the most frequently. In particular, researches on the actual condition of safety education and experimental studies for effectiveness verification take most of research method. As qualitative studies, there are phenomenological study (3.1%) and case study (3.1%) related to actual conditions of safety accidents. 10 papers (2.4%) are mixture of quantitative and qualitative research and some research conducted research study and experimental research at the same time (0.9%). With regards to subject of study, human environments (87.5%) are more than physical environments (12.5) and students (48.4%) are more than teachers and school parents (20.6%). As the subject of physical environments, school (6.5%) is the most but home environment is none. As a result of the study, research for the development of evaluation tool for evaluating safety education, occupational safety and lifelong education should be conducted from this time forward. In addition, the object of study shall be expanded to both human environments in terms of entire life and physical environments for home. An in-depth qualitative research should be needed by observing and meeting with each student.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.56-78
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• 1998

Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.

• Journal of Sericultural and Entomological Science
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• v.16 no.2
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• pp.1-34
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• 1974

These experiments pertain to various factors influencing the quantitative characters of cocoon crops in summer and early autumn seasons. Initially, in order to establish the possible ways of the silkworm rearing more than three times a year in Korea, the author attempted to get further information about the various factors affecting the cocoon crop in every silkworm rearing season. The trials were conducted eleven times a year at four places for three years. The field trial was conducted with 19 typical sericultural farmers who had been surveyed. At the same time the author statistically analyzed the various factors in close relation to tile cocoon crop in autumn season. The effect of guidance on 40 sericultural farmers was analyzed, comparing higher level farmers with lower level farmers ; and the author surveyed 758 non-guided farmers near the guided farmers during both spring and autumn seasons. In addition, another trial on the seasonal change of leaf quality was attempted with artificial diets prepared with leaves grown in each season. It was found that related factors to cocoon crops in summer and early autumn seasons appeared to be leaf quality, and temperature for young and grown larvae. A 2$^4$ factorial experiment was designed in summer season, and another design with one more level of varied temperature or hard leaf added to a 24 factorial experiment was conducted in early autumn. The experimental results can be summarized： 1. Study on the cocoon crops in the different rearing seasons 1) It was shown that earlier brushing of silkworm generally produced the most abundant cocoon crop in spring season, and earlier or later than the conventional brushing season, especially earlier brushing was unfavorable for the abundant cocoon crop in autumn season. 2) The cocoon crop was affected by the rearing season, and decreases in order of sire with spring, autumn, late autumn, summer and early autumn seasons. 3) It was Proved that ordinary rearing and branch rearing were possibles 4 times a year ; in the 1st, 3rd, 8th, and 10th brushing season. But the 11th brushing season was more favorable for the most abundant cocoon crop of branch rearing, instead of the 10th brushing season with ordinary rearing. 2. Study on the main factors affecting the cocoon crop in autumn season 1) Accumulated pathogens were a lethal factor leading to a bad cocoon crop through neglect of disinfection of rearing room and instruments. 2) Additional factors leading to a poor cocoon crop were unfavorable for rearing temperature and humidity, dense population, poor choice of moderately ripened leaf, and poor feeding techniques. However, it seemed that there was no relationship between the cocoon crop and management of farm. 3) The percentage of cocoon shell seemed to be mostly affected by leaf quality, and secondarily affected by the accumulation of pathogens. 3. Study on the effect of guidance on rearing techniques 1) The guided farms produced an average yearly yield of 29.0kg of cocoons, which varied from 32.3kg to 25.817g of cocoon yield per box in spring versus autumn, respectively. Those figures indicated an annual average increase of 26% of cocoon yield over yields of non-guided farmers. An increase of 20% of cocoon yield in spring and 35% of cocoon yield in autumn were responsible. 2) On guided farms 77.1 and 83.7% of total cocoon yields in the spring and autumn seasons, respectively, exceeded 3rd grade. This amounted to increases of 14.1 and 11.3% in cocoon yield and quality over those of non-guided farms. 3) The average annual cocoon yield on guided farms was 28.9kg per box, based on a range of 31.2kg to 26.9kg per box in spring and autumn seasons, respectively. This represented an 8% increase in cocoon yield on farms one year after guidance, as opposed to non-guided farms. This yield increase was due to 3 and 16% cocoon yield increases in spring and autumn crops. 4) Guidance had no effect on higher level farms, but was responsible for 19% of the increases in production on lower level farms. 4. Study on the seasonal change of leaf quality 1) In tests with grown larvae, leaves of tile spring crop incorporated in artificial diets produced the best cocoon crop; followed by leaves of the late autumn, summer, autumn, and early autumn crops. 2) The cocoon crop for young larvae as well as for grown larvae varied with the season of leaf used. 5. Study on factors affecting the cocoon crops in summer and early autumn A. Early autumn season 1) Survival rate and cocoon yield were significantly decreased at high rearing temperatures for young larvae 2) Survival rate, cocoon yield, and cocoon quality were adversely affected by high rearing temperatures for grown larvae. Therefore increases of cocoon quantity and improvement of cocoon quality are dependent on maintaining optimum temperatures. 3) Decreases in individual cocoon weight and longer larval periods resulted with feeding of soft leaf and hard leaf to young larvae, but the survival rate, cocoon yield and weight of cocoon shell were not influenced. 4) Cocoon yield and cocoon quality were influenced by feeding of hard leaf to grown larvae, but survival rate was not influenced by the feeding of soft leaf and hard leaf. 5) When grown larvae were inevitably raised at varied temperatures, application of varied temperature in the raising of both young and grown larvae was desirable. Further research concerning this matter must be considered. B. Summer season 1) Cocoon yield and single cocoon weight were decreased at high temperatures for young larvae and survival rate was also affected. 2) Cocoon yield, survival rate. and cocoon quality were considerably decreased at high rearing temperatures for grown larval stages.

• 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.

• 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.