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The Clinical Study of Lung Cancer in Patients Younger than 40 Years of Age (약년자 폐암의 임상적 연구)

  • Kim, Geun-Hwa;Park, Hee-Sun;Kim, Myeng-Hoon;Kang, Dong-Won;Lee, Gyu-Seung;Ko, Dong-Seok;Suh, Jae-Chul;Jeong, Seong-Su;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.748-756
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    • 2000
  • Background : Bronchogenic carcinoma is generally considered as a disease that predominantly affects middleaged and elderly men. A small percentage of patients with lung cancer are diagnosed in the third or fourth decade of life or earlier. The current study was performed to review the clinical characteristics of bronchogenic carcinoma in patients younger than 40 years of age at Chungnam National University Hospital. Method : To determine the clinicopathologic characteristics including survival rates of lung cancer patients younger than 40 years of age and to compare them with those of patients 이der than 40 years of age at diagnosis, data of 905 patients diagnosed as lung cancer from January. 1990 to Marm 1997 were analyzed. Result : Twenty-three of 905 patients(2.5%) belonged to the young age group (less than 40 years). Male to female ratios of young age group and control group were 2.8 : 1 and 5.3 : 1, respectively. The mean duration of symptoms from onset to the definite diagnosis was 3.2 months in the young age group. The most common initial symptoms in the young age group were cough(52.2%) and dyspnea(43.5%). Adenocarcinoma (43.5%) was more frequent in the young age group than in the control group(20.1%). Stage III and IV(70%) tumors were more frequent in the young age group than in the control group(52.3%). Distant metastasis rate of the young age group(56.5%) was higher than that of the control group(22.3%). Conclusion : The predominance of adenocarcinoma, the lower male-female ratio, and the high incidence of advanced stage tumor at diagnosis are the characteristics of lung cancer in patients younger than 40 years of age.

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Clinical Features of Patients with Measles during 2000-2001 (2000-2001년 동안 발생한 홍역 환아의 임상적 고찰)

  • Ahn, Sung Ryon;Park, Su En
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.980-986
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    • 2002
  • Purpose : Although the number of patients with measles have dramatically decreased since the introduction of measles vaccines in 1965, measles outbreaks have occurred periodically every 4-6 years during the 1990s(1989-1990 and 1993-1994). During 2000-2001, measles prevailed all over the country again. A characteristic of current epidemics is that the majority of affected population was infants and school-aged children. This study was designed to analyze the epidemic and clinical features of measles prevalence during 2000-2001 and to find ways to overcome vaccination failure. Methods : We reviewed the records of 59 patients with mealses admitted in the Pediatric Department of Pusan National University Hospital from January 2000 to October 2001 for patient's age, month of admission, history of vaccination, clinical features and complications. Antibody titers of measles-specific IgM and IgG were measured by enzyme immunoassay. Results : The epidemic show two peaks in the age distribution. Forty three patients(72.9%) were under 2-years of age and 14 patients(23.7%) were over 5-years of age. Outbreaks had high incidence in July to August, 2000 and March to April, 2001, then faded away after July, 2001. Vaccinated group comprised 30.5% and unvaccinated group comprised 69.5% and their mean age was $9.25{\pm}4.27$ years old and $0.95{\pm}0.30$ years old respectively. Positive rate of IgM was 86.7% in vaccinated group and 90.3% in unvaccinated group. This means there was primary vaccine failure; 13 cases of 15 vaccinated patients were positive in IgM antibody. During the prevalence, two patients died with mealses complication. One of them was immunocompromised. Conclusion : To prevent another prevalence of measles in the future, we must enhance revaccination at ages 4-6 and check vaccination status when children enter elementary school. These will produce over 95% of herd immunity, with catch-up MMR vaccination which has been completed already.

A Study on the Improvement for Medical Service Using Video Promotion Materials for PET/CT Scans (PET/CT 검사에서 동영상 홍보물을 통한 의료서비스 향상에 관한 연구)

  • Kim, Woo Hyun;Kim, Jung Seon;Ko, Hyun Soo;Sung, Ji Hye;Lee, Jeoung Eun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.30-35
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    • 2013
  • Purpose: One of the current services, providing information to the patients and their guardians by using promotion materials induces positive responses and contributes to the improvement of the hospital reliability. Therefore, the objective of this study is to evaluate the effectiveness of audio visual materials, one of the means of promotion, as a way to give accurate medical information to resolve patient's curiosity about purpose and procedure of their examination and deplete complains about waiting which attributes negative effect to service quality assessment. Materials and Methods: 60 patients(mean age $53.97{\pm}12.24$, male : female = 26 : 34) who had $^{18}F-FDG PET/CT$ scan from July 2012 to August 2012 in Seoul Asan Medical Center were referred to the study. All of the patients having PET/CT scan were asked to watch an informative video material before the injection of radiopharmaceutical ($^{18}F-FDG$) and to fill in a questionnaire. Results: As a result of analyzing the contents of questionnaire, 52% of 60 patients had PET/CT scan for the first time and 72.4% of the patients read the PET/CT guidebook offered from their outpatient department or inpatient wards before their scan. After we searched the level of previous knowledge of the purpose and method of PET/CT scan, the patients answered 25.1% "know well", 34% "not sure", 40.9% "don't know" respectively. And 84.7% of the patients answered that watching the PET/CT guide video before the injection helps understanding what exam they were having and 15.3% of the patients did not. For the question asking ever the patients have experienced using our homepage or smart phone QR code to see the guide video before they visit out PET center, only 3.3% of them answered "yes". Lastly, the patients answered 60.1% "yes", 31.4% "so so" and 8.5% "no" respectively for the question asking whether watching the video makes the patients to fill the waiting time short. Conclusion: It is found that understanding of objective and method of the PET/CT scan and level of satisfaction was improved after the patients watched the guide video whether they had PET/CT scan before and read the PET/CT guidebook or not. Also, watching the video was effective for the reduction of perceptible waiting time. But while displaying the PET/CT guide video is useful for providing information about the scan and shortening the waiting time as one of the medical service, utilization of service was actually very poor because of the passive promotion and indifference of the patients about their examination. Therefore, from now on, it is necessary to construct the healthcare system which can be offered to more patients through the active promotion.

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Fish Distribution, Compositions and Community Structure Characteristics during Juksan-Weir Construction in Yeongsan River Watershed (영산강 수계에서 죽산보 건설 중의 어류 분포.종 조성 및 군집구조 특성)

  • Ko, Dae-Geun;Choi, Ji-Woong;Lim, Byung Jin;Park, Jong Hwan;An, Kwang-Guk
    • Korean Journal of Environment and Ecology
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    • v.26 no.6
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    • pp.892-901
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    • 2012
  • The purpose of this research was to analyze fish fauna, distribution patterns, and fish community structures in the Juksan-Weir regions of upper weir(R-UW) and lower weir(R-LW), which was constructed in 2011 on Yeongsan River watershed. Our outcomes will provide valuable information in the impact analysis of weir constructions next decades, even if the current research is limited to distributions and fauna studies of fishes. The fishes observed were 8 family and 30 species in all the sites, and the number of the species in the regions of R-UW and R-LW was 23(938 individuals) and 27(1,680 individuals), respectively, indicating greater abundance in the lower region of Juksan-Weir. Most dominant species was Opsarichthys uncirostris amurensis with relative abundance of 42%, and this species had greater abundance in the R-LW(49%) than in the R-UW(30%). Coilia nasus, was the migratory fish sampled in this region and had no differences of abundance between the two regions. The extic species observed were Carassius cuvieri, Lepomis macrochirus, and Micropterus salmoides. The two formers of Carassius cuvieri(1.2%) and Lepomis macrochirus(3.7%) dominated in the R-UW, whereas Micropterus salmoides had greater dominance in the region of R-LW. According to tolerance guild analysis, the proportion of sensitive species ranged from 0.4 to 0.5%, and that of tolerant species ranged from 65% to 70%, implying a severe pollution of nutrients and organic matters in the water body. In the mean time, according to trophic guild analysis, the proportion of carnivores(57 - 77%) was evidently higher than that of insectivores(10 - 20%), indicating a dominance of the carnivores. Especially, high abundance of the bass, exotic species, may disturb the fish overall food chain, so the efficient ecosystem management may be required for the conservation of endemic species. When we examined fish data files of last 60 years, the species of Culter brevicauda, designated as endangered species, was observed firstly in our research area and the total number was 5 individuals(0.2% of the total). So, this region observed should be conserved as a protection zone and further monitoring studies should be done in the future.

Predictability of Impending Events for Death within 48 Hours in Terminal Cancer Patients (말기암환자에서 임박사건 간 48시간 임종예측도 비교)

  • Hwang, In-Cheol;Choi, Chung-Hyun;Kim, Kyoung-Kon;Lee, Kyoung-Shik;Suh, Heuy-Sun;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.28-33
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    • 2011
  • Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

Analysis of Dose Reduction Rate with Dose Modulation Technic Depending on BMI (PET/CT검사에서 Dose Modulation Technic 적용시 BMI에 따른 선량 감소율 분석)

  • Kim, Jung Wook;Park, Se Yun;Jo, Young Jun;Park, Jong Yeop
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.25-28
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    • 2012
  • Purpose : It is important to reduce radiation dose associated with computed tomography (CT) scanning to as low as reasonably achievable (ALARA). With Dose Modulation Technic, user select a desired image quality and the system adapts tube current to obtain the desired image quality with greater radiation dose efficiency. In this paper, we presents a comprehensive description of fundamentals, clinical applications and radiation dose benefits of Dose Modulation Technic depending on Body Mass Index(BMI). Materials and Methods : In this study, 149 patients were examined(The mean age : $58{\pm}12.4$ years old). Biograph True Point 40 (Siemens, USA) and Gemini TF 64 (Philips. Cleveland) were used for equipment. When we used Care Dose 4D (Siemens, USA) and D-dom (Philips, Cleveland), we measured dose reduction and Computed Tomography Dose Index (CTDI) depending on BMI. Then we analyze data using SPSS Ver.18. Results : When we used Care Dose 4D, p-value is considered statistically significant by groups with the result that we compared Care Dose 4D with D-dom. On the other hand, p-value isn't considered statistically significant by groups using D-dom. Conclusion : Dose modulation based on the projection angle didn't affect degree of obesity. And When using Care Dose 4D, dose reduction rate in the normal patients were higher than the obese. In this study, there are errors on somato type. So I think more research have to be done. Then application of Dose Modulation technic can help in maintaining acceptable image quality while reducing radiation dose by 20-60% in most instances.

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Compositional Variations of the Beach Sediments in Cheju Island (제주도 해빈퇴적물의 구성성분)

  • 지옥미;우경식
    • 한국해양학회지
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    • v.30 no.5
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    • pp.480-492
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    • 1995
  • Petrographic investigation has been carried out to determine the composition of the beach sediments and the affecting factors which have controlled their compositional variations from Hyupjae, Aeweol, Iho, Samyang, Hamdeok, Sehwa, Pyoseon, Jungmun, and Hwasun areas along the coast of the Cheju Island. Average mean sizes of the beach sediments are Hyupjae 2.2ø, Aeweol 0.8ø, Iho 1.4ø, Samyang 2.4ø, Hamdeok 1.6ø, Sehwa 1.5ø, Pyoseon 2.1ø, Jungmun 0.4ø, and Hwasun 0.9ø, thus, aries from 0.4 to 2.4ø. The beach sediments from Pyoseon and Hwasun areas are poorly sorted, those from Aeweol and Jungmun areas are moderately sorted and those from the rest of the areas are moderately well sorted. While-colored beach sediments in Hyupjae, Aeweol, Hamdeok, Sehwa, and Pyoseon areas are mostly composed of calcareous shells (more than 85%) such as mollusk, red algae, benthic foraminiferas, etc., whereas volcanic rock fragment is the dominant component of the black-colored beach sediments in Iho, Samyang, and Hwasun areas. Especially, the relatively white-colored beach sediment in Jungmun area, which is on e of the carbonate-dominant areas, shows a higher content of rock fragments than the other carbonate-dominant areas. The beach sediments in Pyoseon area show a high content of carbonate intercalates. Considering the contributions by organisms according to grain size, grains with the size range of 1∼2ø are mostly composed of calcareous red algae fragments, and grains with the size range of 2∼3ø consist of mollusk fragments. It is also notable that bryozoan fragments comprise about 48% of the sediment in Samyang area with the size range of 0∼1ø. The composition of the beach sediments in Cheju Island appears o be controlled by the riverine supply rate of volcanic rock fragments, the lithology of the rocks distributed ear the beaches, the direction of alongshore currents, and the direction of storms, etc.. It is suggested that the beach sediments in Iho and Samyang areas show black color because of the higher supply rate of the volcanic rock fragments from the nearby rivers, whereas those in the rest of the areas show white color due to the relatively lower content of volcanic rock fragments and higher content of carbonate components transported from shallow marine environment. In Hwasun area, the content of volcanic rock fragments is high, and they are directly from the tuffaceous rocks distributed nearby. Also, the volcanic rock fragments in Jungmun area are transported not only from the rivers nearby but also from the nearby tuffs by storm activities. The beach sediment in Pyoseon area contains a high content of carbonate intercalates, which formed in the nearby shallow marine environment through marine cementation. This indicates that active marine cementation occurs in shallow marine environment near Pyoseon area.

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Related factors on musculoskeletal symptoms in selected Korean female office and blue-collar workers (우리나라 일부 사무직과 생산직 여성근로자에서 근골격계 자각증상과 관련요인)

  • Lee, Kyung-Jae;Han, Sung-Hyun;Ahn, Yeon-Soon;Hwang, Jung-Ho;Kim, Joo-Ja
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.17 no.4
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    • pp.289-299
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    • 2007
  • Objectives : To investigate the related factors on musculoskeletal symptoms among Korean female workers. Methods : A total of 1,875 female workers (1,002 office workers and 873 blue-collar workers) was analyzed. They were randomly selected among female workers by cluster sampling and interviewed by well trained interviewer, who filled out a structured questionnaire on the musculoskeletal symptoms. Other factors such as general and occupational characteristics including workplace location, employment condition, work duration, and working condition were also investigated. Results : Current smokers and drinkers were significantly more common in blue-collar workers than in office workers. Those working full time were significantly more common in blue-collar workers than in office workers. Those working over 8 hours per day were also popular in office workers than in blue-collar workers. Subjective musculoskeletal symptoms were significantly higher in the type of work including excessive repetitive work, work using awkward stretching hand upwards, work using repetitive wrist movements, static work using awkward hand posture, and heavy manual lifting and handling works. The mean score of the symptoms were significantly higher in blue-collar than in office workers. The significantly different working factors between two groups were work duration, employment condition and daily work hours. Conclusion : We suggest that the type of work including awkward and repetitive works as well as job type may be one of the most important factors related to musculoskeletal symptoms of female workers in the workplace. Preventive strategy will be needed to prevent the negative impact on health status of working women in the workplace.

Relation between Helicobacter pylori Infection and Socioeconomic Status in Korean Adolescents (Helicobacter pylori 감염과 사회경제적 요인에 대한 연구)

  • Jung, Min-Kyong;Kwon, Young-Se;Choe, Hyon;Choe, Yon-Ho;Hong, Yun-Chul
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.17-22
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    • 2000
  • Purpose: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. Methods: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents' education and occupation using a modified Hollingshead index. Results: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower calss). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). Conclusion: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.

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Thoracic Nodal Staging in Non-small Cell Lung Cancer by FDG-PET (비소세포폐암의 병기 판정에 있어서 N staging에서의 PET의 역할)

  • Yoo, Ji-Hoon;Kwon, Sung-Youn;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.290-297
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    • 2000
  • Background : Current non-invasive methods for evaluating the mediastinum by computed tomographic (CT) scan have limited sensitivity and specificity. The recently introduced PET was reported to be a more sensitive and specific method for the mediastinal staging of NSCLC (sensitivity : 76-100 %, specificity : 81-100%) than CT or MRI. We assessed the usefulness of PET in the mediastinal staging of NSCLC. Methods : We reviewed the medical records of NSCLC patients that had undertaken staging work-up by both CT and PET before thoracotomy between January 1997 and December 1998. A total of 23 patients were enrolled in the study (14 males and 7 females) with a mean age of 61$\pm$9 years. By comparing the clinical(CT and PET) and pathologic stagings, we evaluated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET in thoracic nodal staging. Results : Sensitivity, specificity, positive predicted value and negative predicted value were 38%, 40%, 25% and 50% respectively for computed tomography, and 50%, 60%, 30% and 69% for PET. The accuracy of FDG-PET in our study was lower than that reported by previous other studies. Conclusion : The addition of FDG-PET to CT scanning has limited benefit for the thoracic nodal staging of NSCLC, but its value in our study was lower than that observed by others.

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