Background : Steroid therapy has been shown to improve the clinical outcome in acute respiratory distress syndrome (ARDS) patients with histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. Because the histopathological features of acute interstitial pneumonia(AIP) are identical with that of ARDS, early steroid therapy was used in AIP patients who had histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. We analyzed seven years of our experience to evaluate the efficacy of early steroid therapy in AIP. Materials and Methods : A retrospective review was performed on AIP patients who received steroid therapy within 7 days of mechanical ventilatory support in Dankook university Hospital between May 1995 and May 2002. AIP was diagnosed clinically by ARDS without a known cause of the etiology and pathologically by a lung biopsy showing a fibroproliferative stage of diffuse alveolar damage. The clinical response and physiologic parameters were evaluated during steroid therapy. Results : Five AIP patients received intravenous methylprednisolone (1-2 mg/kg every 6 hours) after $0.6{\pm}1.7$ days of mechanical ventilatory support. Lung biopsies were performed after $1.8{\pm}1.4$ days of mechanical ventilatory support. Four patients(80%) survived and were extubated after $2.8{\pm}0.4$ days of steroid therapy with improvement in the $PaO_2/FiO_2$ ratio ($127.4{\pm}10.0$ at day 0 to $223.8{\pm}37.6$ at day 7) by steroid therapy. However, one patient(20%) died of respiratory failure after 15 days of steroid therapy. Conclusion : Early steroid therapy sppears to be beneficial in AIP patients without evidence of infection. However, as our study group was too small, further large scale studies to define the effectiveness of steroids are required.
Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.
Journal of the Korean Institute of Landscape Architecture
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v.37
no.3
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pp.82-90
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2009
The aim of this study is to identify the spatial foundation units required to execute a rural village landscape plan. Though there have been various previous studies on spatial foundation units for rural space and landscape elements, they are limited in clarifying the landscape identity of a rural village unit in creating a feasible a rural village landscape plan. Therefore, it is necessary to identify the natural spatial features of a rural village and then establish a landscape identity for each space by exploring the landscape elements for each rural village unit set as the basic unit. Accordingly, the basic spatial unit was analyzed through a 1:5000 scale mapping by applying geomancy theory to the spatial landscape unit in a naturally generated rural village. The spatial limitations for a rural village landscape were set based on the analysis. Afterwards, a field study on the feasibility of whether or not setting a space as the basic unit for landscape could have a sense of identity as a single landscape unit for verification was processed, and the spatial limitations for the landscape were adjusted. Moreover, landscape elements were investigated by classifying landscape resources based on rural amenity resources which have been diversely researched in terms of the set spatial boundaries, and the sense of identity for each landscape foundation unit was looked into. While the numerous preceding studies focused on exploring the rural landscape value and findingout the sense of identity on landscape elements, it is high time for feasible and applicable studies in conducting region-specific landscape plans. In particular, similar outcomes from all landscape plans, even those with the same purpose established in various regions, is not a desirable outcome. Therefore, a basic framework is needed to discover the landscape identity generated by each plan in a rural area space. In this sense, this study is significant in that itcan be utilized to establish spatial identity of each region and landscape features of each rural village, and come up with realistic alternatives in landscape plans for each region by exploring the landscape identity in each specific space divided per watershed in a single zone.
The compulsory beef labelling system has launched from January 1st 2007 by the amended Food Hygiene Law, we were checked the actual conditions of beef origin with a nationwide scale by the Hanwoo differentiation specific test method which was developed by Korea FDA using 90 SNP biomarkers. The test method is useful tool to differentiate the beef origin carrying out the mission of KFDA's annual food safety management guidance. Also we have technically transferred the Hanwoo differentiation specific test method to other institutes as well regional KFDA and established the training program as a regular course in Korea Human Resource Development Institute for Health and Welfare. The beef used in this study were collected according to the 2009 Food safety guidance in roast beef restaurants where business site area greater than 100 $m^2$. Total 216 samples were consisted of 48 samples of the Seoul area and 168 of the region. The monitoring result from restaurants in all the region of Korea showed that 3 of 216 Hanwoo-labelled beefs were found out as a non-Hanwoo (1.3%). This results are gradually deceasing trend compared with 34.0% in 2005, 30.1% in 2006, 3.2% in 2007 and 5.14% in 2008. From these data, the Hanwoo differentiation specific test method on the settlement of the compulsory beef labelling system has an important role. As a outcome of this project, we might be considered the early settlement of the compulsory beef labelling system, technically transferred to other institutes and the establishment of regular training program of the test method.
Journal of the korean academy of Pediatric Dentistry
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v.27
no.4
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pp.505-516
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2000
Chloral hydrate is one of the most widely used sedative agents to control the difficult-to-treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time of Chloral hydrate. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This study was designed to test the efficacy of one sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with mixed gas of Enflurane(2vol%) and $N_2O(50%)-O_2(50%)$ for $60\sim120$ seconds to 35 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The Result of this regimen was compare to those of two oral regimen of Chloral hydrate/Hydroxyzine and Chloral hydrate only Analyses of result on vital signs and behavior pattern were performed. The outcome of the study suggest that sleep induction by a short inhalation of low dose of $Enflurane/N_2O-O_2$ provide dentist with suitable condition for the completion of scheduled treatment in the patient who failed to oral Chloral hydrate. Evidence of adverse effect was not detected or reported during and/or after the procedures.
Journal of the Korean Institute of Landscape Architecture
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v.39
no.2
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pp.52-64
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2011
In this study, the effects of street improvement projects in particular regions are carefully scrutinized, classified, and compared based on the types of citizen participation in those projects which are offered as one of several urban regeneration methods. The Wonju and Siheung Street Improvement Projects were selected for case studies, and in-depth interviews and a survey are conducted in both regions. As a result of in-depth interviews, the Wonju project is the community initiative type in which the community has responsibilities and decision-making abilities. On the other hand, Siheung is the community participative type in which the opinions of the community have been limited The survey targeted more than 100 local merchants, and they were asked to answer to the questions which were categorized into 21 items with a 5-point Likert scale. The analysis method was carried out through a reliability test, regression. average analysis on each group, and a T-test by SPSS 18.0. Factor analysis results show four factors: physical, partnership, community, and economical revitalization. These results reveal that the social factor can be sub-divided into a community factor and partnership factor. As a result of revitalization factors by citizen participation type, the resident initiative type is more revitalized than the resident participative type in all four factors, and shows positive responses in physical and economical revitalization factors. In particular, the physical revitalization factor has a big impact on resident satisfaction regardless of type. The community revitalization factor also has an impact on two types. It reveals that the communication is as important as physical improvement. However, it shows that no type of project affects partnership revitalization. As a result of this study, if we considered only physical improvement as project achievement, you can achieve the desired outcome without consideration of residents' participation types. Furthermore, if regional revitalization is the goal of a street improvement project, we must consider other factors such as a partnership and community revitalization.
Research on technical efficiency, an important dimension of market performance, had received little attention until recently by most industrial organization empiricists, the reason being that traditional microeconomic theory simply assumed away any form of inefficiency in production. Recently, however, an increasing number of research efforts have been conducted to answer questions such as: To what extent do technical ineffciencies exist in the production activities of firms and plants? What are the factors accounting for the level of inefficiency found and those explaining the interindustry difference in technical inefficiency? Are there any significant international differences in the levels of technical efficiency and, if so, how can we reconcile these results with the observed pattern of international trade, etc? As the first in a series of studies on the technical efficiency of Korea's manufacturing industries, this paper attempts to answer some of these questions. Since the estimation of technical efficiency requires the use of plant-level data for each of the five-digit KSIC industries available from the Census of Manufactures, one may consture the findings of this paper as empirical evidence of technical efficiency in Korea's manufacturing industries at the most disaggregated level. We start by clarifying the relationship among the various concepts of efficiency-allocative effciency, factor-price efficiency, technical efficiency, Leibenstein's X-efficiency, and scale efficiency. It then becomes clear that unless certain ceteris paribus assumptions are satisfied, our estimates of technical inefficiency are in fact related to factor price inefficiency as well. The empirical model employed is, what is called, a stochastic frontier production function which divides the stochastic term into two different components-one with a symmetric distribution for pure white noise and the other for technical inefficiency with an asymmetric distribution. A translog production function is assumed for the functional relationship between inputs and output, and was estimated by the corrected ordinary least squares method. The second and third sample moments of the regression residuals are then used to yield estimates of four different types of measures for technical (in) efficiency. The entire range of manufacturing industries can be divided into two groups, depending on whether or not the distribution of estimated regression residuals allows a successful estimation of technical efficiency. The regression equation employing value added as the dependent variable gives a greater number of "successful" industries than the one using gross output. The correlation among estimates of the different measures of efficiency appears to be high, while the estimates of efficiency based on different regression equations seem almost uncorrelated. Thus, in the subsequent analysis of the determinants of interindustry variations in technical efficiency, the choice of the regression equation in the previous stage will affect the outcome significantly.
Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.
Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
Clinics in Shoulder and Elbow
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v.12
no.2
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pp.199-206
/
2009
Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.
Hong, Jin Ho;Park, Yong Bok;Ryu, Ho Young;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
The Journal of Korean Orthopaedic Ultrasound Society
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v.7
no.1
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pp.7-12
/
2014
Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.
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