• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.76-82
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• 2006

Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.59-67
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• 2014

Purpose : This study aims to evaluate 3D dosimetric impact for MIP image and each phase image in stereotactic body radiotherapy (SBRT) for lung cancer using volumetric modulated arc therapy (VMAT). Materials and Methods : For each of 5 patients with non-small-cell pulmonary tumors, a respiration-correlated four-dimensional computed tomography (4DCT) study was performed. We obtain ten 3D CT images corresponding to phases of a breathing cycle. Treatment plans were generated using MIP CT image and each phases 3D CT. We performed the dose verification of the TPS with use of the Ion chamber and COMPASS. The dose distribution that were 3D reconstructed using MIP CT image compared with dose distribution on the corresponding phase of the 4D CT data. Results : Gamma evaluation was performed to evaluate the accuracy of dose delivery for MIP CT data and 4D CT data of 5 patients. The average percentage of points passing the gamma criteria of 2 mm/2% about 99%. The average Homogeneity Index difference between MIP and each 3D data of patient dose was 0.03~0.04. The average difference between PTV maximum dose was 3.30 cGy, The average different Spinal Coad dose was 3.30 cGy, The average of difference with $V_{20}$, $V_{10}$, $V_5$ of Lung was -0.04%~2.32%. The average Homogeneity Index difference between MIP and each phase 3d data of all patient was -0.03~0.03. The average PTV maximum dose difference was minimum for 10% phase and maximum for 70% phase. The average Spain cord maximum dose difference was minimum for 0% phase and maximum for 50% phase. The average difference of $V_{20}$, $V_{10}$, $V_5$ of Lung show bo certain trend. Conclusion : There is no tendency of dose difference between MIP with 3D CT data of each phase. But there are appreciable difference for specific phase. It is need to study about patient group which has similar tumor location and breathing motion. Then we compare with dose distribution for each phase 3D image data or MIP image data. we will determine appropriate image data for treatment plan.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.395-403
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• 1993

Background: The cell cycle is composed of a series of steps which can be negatively or positively regulated by various factors. Alteration or inactivation of p53 by mutations, or by its interactions with oncogene products of DNA tumor viruses, can lead to cancer. Mutations of the p53 gene occur frequently in human primary lung cancers and the wild-type p 53 allele is often concomitantly deleted. These suggest that deprivation of suppressive role of the wild-type p53 may ensure tumor cell growth presumable by the mutant p53 gene. Methods: In an attempt to investigate this hypothesis, a mutant p53 gene was immunohistochemically demonstrated in the formalin-fixed paraffin-embedded tissue sections of lung cancers by using a monoclonal antibody p53 (Ab-3 and clone DO7). Results: The expression of p53 (DO7) was found in all four normal lung tissues, four small cell carcinomas, and four non small cell carcinomas in histologic types of lung cancer. In the six normal lung tissues the expressions of p53 (Ab-3) were not found. Contrarily, the expression of p53 (Ab-3) was found in the nuclei of lung cancers among fifteen (46.9%) of thirty-two cases studied. The expression of p53 (Ab-3) was disclosed in three case (37.5%) of eight small cell carcinomas and twelve cases (50.0%) of twenty-four non small cell carcinomas in histologic types of lung cancer. Conclusion: These findings suggest that expression of the mutant p53 is related to the one of events in the pathogenesis of human lung cancer and the role of the other oncogenes might be also related to the development of lung cancers.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.976-986
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• 1996

BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.

• Progress in Medical Physics
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• v.26 no.2
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• pp.87-92
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• 2015

The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.492-501
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• 1995

Background: Transforming growth factor- alpha(TGF-$\alpha$) may play important roles in carcinogenesis, tumor growth, and angiogenesis. Transforming growth factor-beta(TGF-$\beta$) are known to be involved in cell-cycle control and regeneration. TGF-$\alpha$ positively acts on growth control of many epithelial cells in contrast to the negative role of TGF-$\beta$. Method: To evaluate the possible role of TGF-$\alpha$ and TGF-$\beta$ in human primary lung cancers, the expression of TGF-$\alpha$ and TGF-$\beta$ were immmunohistochemically investigated in tissue sections from forty seven cases with lung cancers and ten cases with non-cancerous lung tissues. Recombinant cloned monoclonal antibody of TGF-$\alpha$ and neutralizing antibody of TGF-$\beta$ were employed as primary antibodies after dewaxing the formalin-fixed, paraffinized tissue sections. Results: TGF-$\alpha$ was expressed in the cytoplasms of tumor cells in thirty five cases of forty seven(74.5%) primary lung cancers, whereas the control expressed in two of ten brochial epithelial cells. The expression of TGF-$\alpha$ was disclosed in four cases of eleven(36.4 %) small cell carcinomas and thirty one cases of thirty six(86.1%) non-small cell carcinomas of the lung. Expressions of TGF-$\beta$ was discernible in bronchial epithelium in eight of ten non-cancerous lung tissues. The expression of TGF-$\beta$ was noted in the cytoplasms of tumor cells in eight cases of forty seven(17.0%) primary lung cancers. The expression of TGF-$\beta$ disclosed in two cases of eleven(18.2%) small cell carcinomas and six cases of thirty six(16.7%) non- small cell carcinomas of the lung. Conclusion: These findings suggest that up-regulation of TGF-$\alpha$ and down-regulation of TGF-$\beta$ are involved during development and growth of primary lung cancers.

• Pediatric Infection and Vaccine
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• v.30 no.2
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• pp.73-83
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• 2023

Purpose: This study aimed to investigate the viral load dynamics in children with underlying malignancies diagnosed with symptomatic coronavirus disease 2019 (COVID-19). Methods: This was a retrospective longitudinal cohort study of patients <19 years old with underlying hemato-oncologic malignancies that were diagnosed with their first symptomatic severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (PCR)-confirmed COVID-19 infection during March 1 to August 30, 2022. Review of electronic medical records and telephone surveys were undertaken to assess the clinical presentations and transmission route of the patients. Thresholds of negligible likelihood of infectious virus was defined as E gene reverse transcription (RT)-PCR cycle threshold (Ct) value ≥25. Results: During the 6-month study period, a total of 43 children with 44 episodes of COVID-19 were included. Of the 44 episodes, the median age of the patients included was 8 years old (interquartile range [IQR], 4.9-10.5), and the most common underlying disease was acute lymphoid leukemia (n=30, 68.2%), followed by patients post-hematopoietic stem cell transplantation (n=8, 18.2%). Majority of the patients had mild COVID-19 (n=32, 72.7%), and three patients (7.0%) had severe/critical COVID-19. Furthermore, 2.3% (n=1) died of COVID-19 associated acute respiratory distress syndrome. The largest percentage of the patients showed E gene RT-PCR Ct value ≥25 between 15-21 days (n=13, 39.4%), followed by 22-28 days (n=10, 30.3%). In 15.2% (n=5), E gene RT-PCR Ct value remained <25 beyond 28 days after initial positive PCR. Refractory malignancy status (β, 67.0; 95% confidence interval, 7.0-17.0; P=0.030) was significantly associated with prolonged duration of E gene RT-PCR <25. A patient with prolonged duration of E gene RT-PCR Ct value <25 was suspected to have infectivity shown by the transmission of the virus to his mother at day 86 after his initial positive test. Conclusions: Children that acquire symptomatic COVID-19 during refractory malignancy state are at a high risk for prolonged shedding warranting PCR-based transmission precautions in this cohort of patients.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.71-81
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• 2010

Purpose: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended the ratio of chest compression to ventilation ratio to 30:2 from 2005 CPR guideline to 2010 CPR guideline. However, current studies have shown that the hands-off time was > 10 seconds with that method. For this reason, we devised new CPR method that a ventilation to chest compression ratio of 2:30 to reduce pt assessment time and skipped the assessment step of carotid artery pulse would be a more effective way to reduce the hands-off time & the time to set the CPR. According to the more detailed purpose are listed below. 1) We would like to confirm efficiency of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 to reduce the hands-off time & the time to set the CPR. 2) We would like to evaluate possibility of increasing for chest compression accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 3) We would like to evaluate possibility of increasing for ventilation accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 Methods: According to 2005 American Heart Association Guidelines, 60 paramedic students(20 students X freshmen, sophomore, junior) performed 5 cycles of 3~ chest compressions : 2 ventilations after A, B, C evaluation with Laerdal Resusci R Anne SkillReporters. After 5 minutes rest, the 60 students performed 5 cycles of 2 ventilations : 30 chest compressions after A, B evaluation with the manikins between 13 and 17 September 2010. The short reports including speed & accuracy of chest compression, respiratory, CPR cycle were gained from the manikins. Hands-off times were measured by assistants. Results: Recently, the importance of high quality CPR was emphasized in order to perform the CPR faster and more accurate. To find out improving the conventional CPR method, we switch the procedure of the compression and the ventilation. By switching the procedure back and forth, we are able to compare the effectiveness of CPR between two type of CPR method which are 2:30 and 30:2 methods. 2:30 is that the breaths is delivered twice, first and perform 30 compressions while 30:2 perform 30 compressions first and give 2 breaths followed by the ABC method. Also, we verify the effectiveness of the hands off time, compression accuracy of the compression through the comparison of the two procedure as mentioned earlier. Consequently research verified that 2:30 is the efficient by providing faster set up delivering more accurate chest compression. Conclusion: 2:30 can minimize a time delay from cardiac standstill until starting the chest compression. In addition, hands-off time which is an interruption in chest compression can be shortened by 2:30 method, which result to effective oxygenation of coronary artery & maintenance of the bloodstream. Once again, performing the 2:30 method provide lessen hands off time and increase the accuracy of the chest compression.

• Journal of Life Science
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• v.30 no.8
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• pp.731-741
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• 2020

Coronavirus disease 19 (COVID-19) is caused by SARS-CoV-2 (Severe Acute Respiratory SyndromeCoronavirus 2). To date, seven coronaviruses that can infect humans were reported. Among them, infections with four coronavirus strains (HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1) resulted in mild symptoms such as common cold, whereas SARS-CoV and MERS-CoV caused severe symptoms and epidemics in 2002 and 2012, respectively. In the most recent, SARS-CoV-2 was first reported in Wuhan, China in December 2019 and became a notorious cause of the ongoing global pandemics. To diagnose, treat, and prevent COVID-19, the development of rapid and accurate diagnostic tools, specific therapeutic drugs, and safe vaccines essentially are required. In order to develop these powerful tools, it is prerequisite to understand a phenotype, a genotype, and life cycle of SARS-CoV-2. Diagnostic techniques have been developing rapidly around world and many countries take the fast track system to accelerate approval. Approved diagnostic devices are rapidly growing facing to urgent demand to identify carriers. Currently developed commercial diagnostic devices are divided into mainly two categories: molecular assay and serological & immunological assay. Molecular assays begins the reverse transcription step following polymerase chain reaction or isothermal amplification. Immunological assay targets SARS-CoV-2 antigen or anti-SARS-CoV-2 antibody of samples. In this review, we summarize the phenotype, genome structure and gene expression of SARS-CoV-2 and provide the knowledge on various diagnostic techniques for SARS-CoV-2.

• International Journal of Automotive Technology
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• v.4 no.2
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• pp.77-86
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• 2003

How to compare the environmental damage caused by vehicles with different foe]s and drive trains\ulcorner This paper describes a methodology to assess the environmental impact of vehicles, using different approaches, and evaluating their benefits and limitations. Rating systems are analysed as tools to compare the environmental impact of vehicles, allowing decision makers to dedicate their financial and non-financial policies and support measures in function of the ecological damage. The paper is based on the "Clean Vehicles" research project, commissioned by the Brussels Capital Region via the BIM-IBGE (Brussels Institute for the Conservation of the Environment) (Van Mierlo et at., 2001). The VriJe Universiteit Brussel (ETEC) and the universite Libre do Bruxelles (CEESE) have jointly carried out the workprogramme. The most important results of this project are illustrated in this paper. First an overview of environmental, economical and technical characteristics of the different alternative fuels and drive trains is given. Afterward the basic principles to identify the environmental impact of cars are described. An outline of the considered emissions and their environmental impact leads to the definition of the calculation method, named Ecoscore. A rather simple and pragmatic approach would be stating that all alternative fuelled vehicles (LPG, CNG, EV, HEV, etc.) can be considered as ′clean′. Another basic approach is considering as ′clean′ all vehicles satisfying a stringent omission regulation like EURO IV or EEV. Such approaches however don′t tell anything about the real environmental damage of the vehicles. In the paper we describe "how should the environmental impact of vehicles be defined\ulcorner", including parameters affecting the emissions of vehicles and their influence on human beings and on the environment and "how could it be defined \ulcorner", taking into account the availability of accurate and reliable data. We take into account different damages (acid rain, photochemical air pollution, global warming. noise, etc.) and their impacts on several receptors like human beings (e.g., cancer, respiratory diseases, etc), ecosystems, or buildings. The presented methodology is based on a kind of Life Cycle Assessment (LCA) in which the contribution of all emissions to a certain damage are considered (e.g. using Exposure-Response damage function). The emissions will include oil extraction, transportation refinery, electricity production, distribution, (Well-to-Wheel approach), as well as the emission due to the production, use and dismantling of the vehicle (Cradle-to-Grave approach). The different damages will be normalized to be able to make a comparison. Hence a reference value (determined by the reference vehicle chosen) will be defined as a target value (the normalized value will thus measure a kind of Distance to Target). The contribution of the different normalized damages to a single value "Ecoscore" will be based on a panel weighting method. Some examples of the calculation of the Ecoscore for different alternative fuels and drive trains will be calculated as an illustration of the methodology.