• 제목/요약/키워드: Prospective approach

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The review on the identification of the gifted child in the sports (스포츠영재의 판별에 관한 고찰)

  • 신승윤
    • Journal of Gifted/Talented Education
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    • v.11 no.1
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    • pp.81-98
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    • 2001
  • The purpose of this study was to indicate the ways to identify the gifted child in the sports, and the research direction in this area in the future. The most of researches related to the early development of the children who showed the gifted talents in the certain sports skills were published from the European area such as the old East Germany or Soviet Union. Those research papers or articles were main focus of this study to be analyzed. The analysis in this study will be assistant to provide the direction of the research in the future about the method to identify appropriately on the children with the gifted sports skills. -Related to the period of selection of the children with sports skill gifted, the divided selection procedure will be good such as the 1st selection and 2nd selection. In the 1st selection, the goal will be to test the potentials of the children with the sports talents in the public school with creating the special group, and the 2nd selection will be to examine the qualification of the admission to the special schools for the children with the sports talents. -Related to the method of selection of the children with sports talents, the special item on the developmental procedure should be considered on the each field as well as the potentials focused. And, the physical factors, the condition of growth and development, psychological factor, and environmental factor should be comprehensively considered. -The system of promotion in the period of the primary school will be appropriate in the special group for the children with the sports talents, and the special school will be good from the middle school. The system outlooks will be adequate if shaped as the hierarchical structure. -The curriculum for the children with the sports talents will be proper that the basic fitness for the earlier ages and the professional skills will be recommended if getting older. -The continuous research is strongly required for the judgement and promotion of the children with sports talents, therefore, the multiple intelligences approach will be helpful for the development of the bodily-kinesthetic intelligence, and in other words, the new era of the genetic method will be another prospective area such as the DNA analysis in the identification of the talented children for the sports filed.

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Characteristics of Middle Aged Depressed Women with Hot Flushes (안면 홍조 증상을 수반한 중년 우울증 여성의 특성)

  • Song, Minjae;Joe, Sook-Haeng;Jung, Hyun-Gang
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.176-184
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    • 2017
  • Objectives : Middle aged women with depression often experience hot flush symptoms. It is still unclear about the association between depression and hot flush symptoms. Therefore, we investigated hormonal profile, functional somatic symptoms, coping styles and attitude for menopause between depressed women with hot flush and those without hot flush. Methods : This study included 33 depressed patients with hot flush symptoms and 33 depressed patients without hot flush symptoms. Hot flush was confirmed through prospective daily symptom ratings for a week. Subjects' coping styles were assessed by the stress coping checklist. Somatic symptoms were assessed by the Patient Health Questionnaire-15(PHQ-15). Sex hormonal levels were assayed by a radioimmunoassay. The Brief World Health Organization Quality of Life Assessment Instrument(WHOQOL-BREF) was used to evaluate quality of life. Results : In coping style, depressed women with hot flush symptoms used less 'problem-centered coping'($13.15{\pm}3.17$) and 'search for social support'($11.83{\pm}2.84$) than those without hot flush symptoms($15.17{\pm}3.1$, p=0.028 ; $14.25{\pm}3.22$, p=0.009 ; respectively). Depressed women with hot flush symptoms showed more negative attitude toward post-menopause, but its statistical significance was marginally insufficient(p=0.059). We did not find any group differences in sex hormonal levels and somatic complaints assessed by the PHQ-15. The score of social relationship domain of WHOQOL-BREF was significantly lower in subjects with hot flush symptoms($8.62{\pm}2.04$) than subjects without hot flush symptoms($9.71{\pm}1.65$ ; p=0.044). Conclusions : Among middle aged women with depression, the manifestation of hot flush symptoms was associated with coping styles and attitude for menopausal transition. Hot flush symptoms in depressed women negatively influence quality of life, so clinicians actively perform therapeutic approach in case of depressed patients with hot flush symptoms. In case of depressed patients who present hot flushes, cognitive behavior therapy or stress management might be an effective treatment option in company with antidepressants or hormonal treatment. Later, longitudinal study will be needed to evaluate risk factor, cause and effect associated with hot flush and depression.

LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA (국내에서 제작된 고정성 보철물의 수명과 실패 요인 및 양상)

  • Shin Woo-Jin;Jeon Young-Sik;Lee Keun-Woo;Lee Ho-Yong;Han Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.158-175
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    • 2005
  • Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.

Enhancement of Inter-Image Statistical Correlation for Accurate Multi-Sensor Image Registration (정밀한 다중센서 영상정합을 위한 통계적 상관성의 증대기법)

  • Kim, Kyoung-Soo;Lee, Jin-Hak;Ra, Jong-Beom
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.42 no.4 s.304
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    • pp.1-12
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    • 2005
  • Image registration is a process to establish the spatial correspondence between images of the same scene, which are acquired at different view points, at different times, or by different sensors. This paper presents a new algorithm for robust registration of the images acquired by multiple sensors having different modalities; the EO (electro-optic) and IR(infrared) ones in the paper. The two feature-based and intensity-based approaches are usually possible for image registration. In the former selection of accurate common features is crucial for high performance, but features in the EO image are often not the same as those in the R image. Hence, this approach is inadequate to register the E0/IR images. In the latter normalized mutual Information (nHr) has been widely used as a similarity measure due to its high accuracy and robustness, and NMI-based image registration methods assume that statistical correlation between two images should be global. Unfortunately, since we find out that EO and IR images don't often satisfy this assumption, registration accuracy is not high enough to apply to some applications. In this paper, we propose a two-stage NMI-based registration method based on the analysis of statistical correlation between E0/1R images. In the first stage, for robust registration, we propose two preprocessing schemes: extraction of statistically correlated regions (ESCR) and enhancement of statistical correlation by filtering (ESCF). For each image, ESCR automatically extracts the regions that are highly correlated to the corresponding regions in the other image. And ESCF adaptively filters out each image to enhance statistical correlation between them. In the second stage, two output images are registered by using NMI-based algorithm. The proposed method provides prospective results for various E0/1R sensor image pairs in terms of accuracy, robustness, and speed.

Distribution and Interrelationship of Smoking, Drinking, and Physical Exercising among Some Rural Adult, an Application of the Transtheoretical Model (행동수정의 단계적 변화론 모형(Transtheoretical Model)에 의한 일부 농촌성인의 흡연, 음주 및 운동행태 분포와 상호 관련성)

  • Lee, Moo-Sik;Lee, Young-Sung;Shin, Hyun-Hwa;Lee, Kun-Sei;Yoon, Seok-Jun;Jung, Ki-Hweon;Kim, Eun-Young;Chun, Byung-Chul
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.113-131
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    • 2000
  • Transtheoretical model of change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. The objectives of this study were to describe the distribution of smokers by stage of change of smoking, alcoholic drinking, and exercising in rural residents and to develope health promotion strategies. This study was done in Okchun County of Chungbuk Province. The representative sample were 892 residents over 30 years old. The questionnaires of interview included socio-demographic, the six stage distribution of smoking, alcoholic drinking, and exercising. In male, 50.6% of smokers were in the precontemplation stage, 32.5% in the contemplation. In female, corresponding figures were 60.6% and 28.8%. Precontemplation and contemplation stage of drinker were 72.8%, 19.3% in male and 80.3%, 15.5%. Distribution of exercise were 80.6%, 1.8% in male, 87.6%, 1.2% in female, respectively. The stage distribution of smoker, alcoholic drinker, and exerciser was shift to left of the distribution. And the stage distribution was slightly differ with each health behavior. The stage of change with smoking, drinking and exercising was correlated with each other but not concordant. So interventions in rural residents need to take into account the large proportion of precontemplators repeatedly observed among smoker, drinker, and non-exerciser. And intervention strategies of each risk behavior should be different approach. Result of concordance analysis suggest reconstruct validity of the transtheoretical model in our country due to ethnic and sociocultural difference. This results and theory should be tested in prospective intervention studies for seeking the possible gateway of health behavior.

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

A Study on the Meaning and Strategy of Keyword Advertising Marketing

  • Park, Nam Goo
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.49-56
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    • 2010
  • At the initial stage of Internet advertising, banner advertising came into fashion. As the Internet developed into a central part of daily lives and the competition in the on-line advertising market was getting fierce, there was not enough space for banner advertising, which rushed to portal sites only. All these factors was responsible for an upsurge in advertising prices. Consequently, the high-cost and low-efficiency problems with banner advertising were raised, which led to an emergence of keyword advertising as a new type of Internet advertising to replace its predecessor. In the beginning of 2000s, when Internet advertising came to be activated, display advertisement including banner advertising dominated the Net. However, display advertising showed signs of gradual decline, and registered minus growth in the year 2009, whereas keyword advertising showed rapid growth and started to outdo display advertising as of the year 2005. Keyword advertising refers to the advertising technique that exposes relevant advertisements on the top of research sites when one searches for a keyword. Instead of exposing advertisements to unspecified individuals like banner advertising, keyword advertising, or targeted advertising technique, shows advertisements only when customers search for a desired keyword so that only highly prospective customers are given a chance to see them. In this context, it is also referred to as search advertising. It is regarded as more aggressive advertising with a high hit rate than previous advertising in that, instead of the seller discovering customers and running an advertisement for them like TV, radios or banner advertising, it exposes advertisements to visiting customers. Keyword advertising makes it possible for a company to seek publicity on line simply by making use of a single word and to achieve a maximum of efficiency at a minimum cost. The strong point of keyword advertising is that customers are allowed to directly contact the products in question through its more efficient advertising when compared to the advertisements of mass media such as TV and radio, etc. The weak point of keyword advertising is that a company should have its advertisement registered on each and every portal site and finds it hard to exercise substantial supervision over its advertisement, there being a possibility of its advertising expenses exceeding its profits. Keyword advertising severs as the most appropriate methods of advertising for the sales and publicity of small and medium enterprises which are in need of a maximum of advertising effect at a low advertising cost. At present, keyword advertising is divided into CPC advertising and CPM advertising. The former is known as the most efficient technique, which is also referred to as advertising based on the meter rate system; A company is supposed to pay for the number of clicks on a searched keyword which users have searched. This is representatively adopted by Overture, Google's Adwords, Naver's Clickchoice, and Daum's Clicks, etc. CPM advertising is dependent upon the flat rate payment system, making a company pay for its advertisement on the basis of the number of exposure, not on the basis of the number of clicks. This method fixes a price for advertisement on the basis of 1,000-time exposure, and is mainly adopted by Naver's Timechoice, Daum's Speciallink, and Nate's Speedup, etc, At present, the CPC method is most frequently adopted. The weak point of the CPC method is that advertising cost can rise through constant clicks from the same IP. If a company makes good use of strategies for maximizing the strong points of keyword advertising and complementing its weak points, it is highly likely to turn its visitors into prospective customers. Accordingly, an advertiser should make an analysis of customers' behavior and approach them in a variety of ways, trying hard to find out what they want. With this in mind, her or she has to put multiple keywords into use when running for ads. When he or she first runs an ad, he or she should first give priority to which keyword to select. The advertiser should consider how many individuals using a search engine will click the keyword in question and how much money he or she has to pay for the advertisement. As the popular keywords that the users of search engines are frequently using are expensive in terms of a unit cost per click, the advertisers without much money for advertising at the initial phrase should pay attention to detailed keywords suitable to their budget. Detailed keywords are also referred to as peripheral keywords or extension keywords, which can be called a combination of major keywords. Most keywords are in the form of texts. The biggest strong point of text-based advertising is that it looks like search results, causing little antipathy to it. But it fails to attract much attention because of the fact that most keyword advertising is in the form of texts. Image-embedded advertising is easy to notice due to images, but it is exposed on the lower part of a web page and regarded as an advertisement, which leads to a low click through rate. However, its strong point is that its prices are lower than those of text-based advertising. If a company owns a logo or a product that is easy enough for people to recognize, the company is well advised to make good use of image-embedded advertising so as to attract Internet users' attention. Advertisers should make an analysis of their logos and examine customers' responses based on the events of sites in question and the composition of products as a vehicle for monitoring their behavior in detail. Besides, keyword advertising allows them to analyze the advertising effects of exposed keywords through the analysis of logos. The logo analysis refers to a close analysis of the current situation of a site by making an analysis of information about visitors on the basis of the analysis of the number of visitors and page view, and that of cookie values. It is in the log files generated through each Web server that a user's IP, used pages, the time when he or she uses it, and cookie values are stored. The log files contain a huge amount of data. As it is almost impossible to make a direct analysis of these log files, one is supposed to make an analysis of them by using solutions for a log analysis. The generic information that can be extracted from tools for each logo analysis includes the number of viewing the total pages, the number of average page view per day, the number of basic page view, the number of page view per visit, the total number of hits, the number of average hits per day, the number of hits per visit, the number of visits, the number of average visits per day, the net number of visitors, average visitors per day, one-time visitors, visitors who have come more than twice, and average using hours, etc. These sites are deemed to be useful for utilizing data for the analysis of the situation and current status of rival companies as well as benchmarking. As keyword advertising exposes advertisements exclusively on search-result pages, competition among advertisers attempting to preoccupy popular keywords is very fierce. Some portal sites keep on giving priority to the existing advertisers, whereas others provide chances to purchase keywords in question to all the advertisers after the advertising contract is over. If an advertiser tries to rely on keywords sensitive to seasons and timeliness in case of sites providing priority to the established advertisers, he or she may as well make a purchase of a vacant place for advertising lest he or she should miss appropriate timing for advertising. However, Naver doesn't provide priority to the existing advertisers as far as all the keyword advertisements are concerned. In this case, one can preoccupy keywords if he or she enters into a contract after confirming the contract period for advertising. This study is designed to take a look at marketing for keyword advertising and to present effective strategies for keyword advertising marketing. At present, the Korean CPC advertising market is virtually monopolized by Overture. Its strong points are that Overture is based on the CPC charging model and that advertisements are registered on the top of the most representative portal sites in Korea. These advantages serve as the most appropriate medium for small and medium enterprises to use. However, the CPC method of Overture has its weak points, too. That is, the CPC method is not the only perfect advertising model among the search advertisements in the on-line market. So it is absolutely necessary that small and medium enterprises including independent shopping malls should complement the weaknesses of the CPC method and make good use of strategies for maximizing its strengths so as to increase their sales and to create a point of contact with customers.

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The Long-term Follow-up Study of Therapeutic Effects of 8 French Catheter for Spontaneous Pneumothorax (자연 기흉의 치료에서 8 French 도관삽입의 치료 효과에 대한 장기적 관찰)

  • Shin, Jong-Wook;Lee, Byoung-Hoon;An, Chang-Hyeok;Choi, Jae-Sun;Yoo, Jee-Hoon;Lim, Seong-Yong;Kang, Yoon-Jung;Koh, Hyung-Ki;Kim, Jae-Yeol;Na, Moon-Jun;Park, In-Won;Sobn, Dong-Suep;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1094-1104
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    • 1997
  • Background : Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces (PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. Method : From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. Results : The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Ther was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was $6.2{\pm}3.8$ days, which was significantly shorter than that of chest tube group in SP, $9.1{\pm}7.5$ days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p=0.041 ; one-tailed, p=0.053; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. Conclusion : Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.

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The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

  • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.671-682
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    • 1996
  • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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Clinical Experience of Three Dimensional Conformal Radiation Therapy for Non-Small Cell Lung Cancer (비소세포성 폐암에서 3차원 입체조형 방사선 치료 성적)

  • Choi Eun Kyung;Lee Byong Yong;Kang One Chul;Nho Young Ju;Chung Weon Kuu;Ahn Seung Do;Kim Jong Hoon;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.265-274
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    • 1998
  • Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

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