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A Clinical and Pathological Analysis of Children with Membranoproliferative Glomerulonephritis According to the Clinical Manifestations at Presentation (발견 양상에 따른 소아 막증식성 사구체신염의 임상적 및 병리조직학적분석)

  • Jeon Chang-Ho;Kang Mi-Seon;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.186-194
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    • 2004
  • Purpose: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. Methods: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. Results: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and $C_3$ levels in the S group were significantly lower than those levels of the A group, respectively($4.9{\pm}1.2\;g/dL,\;vs\;7.0{\pm}0.5\;g/dL\;P=0.002,\;2.8{\pm}0.9\;g/dL\;vs.\;4.1{\pm}0.3\;g/dL\;P=0.002,\;63.9{\pm}36.4\;mg/dL\;vs.\;100.8{\pm}39.5\;g/dL\;P=0.041$). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group($3684.0{\pm}2601.3\;mg/m^2\;vs.\;559.4{\pm}4.6.9\;mg/m^2$, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy. as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. Conclusion: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum $C_3$ level when urinary abnormalities are found by school urinary screening test.

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Measuring Intracellular Mycobacterial Killing Using a Human Whole Blood Assay (인체 전혈 모델을 이용한 세포내 결핵균 살균력에 관한 연구)

  • Cheon, Seon-Hee;Song, Ho-Yeon;Lee, Eun-Hee;Oh, Hee-Jung;Kang, In-Sook;Cho, Ji-Yoon;Hong, Young-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.497-509
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    • 2002
  • Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.

Metabolic risk and nutritional state according to breakfast energy level of Korean adults: Using the 2007~2009 Korea National Health and Nutrition Examination Survey (한국 성인의 아침식사 에너지 수준에 따른 대사적 위험과 영양상태: 2007~2009년 국민건강영양조사 자료 이용)

  • Jang, So-Hyoun;Suh, Yoon Suk;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.46-57
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    • 2015
  • Purpose: The aim of this study was to determine an appropriate energy level of breakfast with less risk of chronic disease for Korean adults. Methods: Using data from the 2007~2009 Korean National Health & Nutrition Examination Survey, from a total of 12,238 adults aged 19~64, the final 7,769 subjects were analyzed except subjects who were undergoing treatment for cancer or metabolic disorder. According to the percent of breakfast energy intake versus their estimated energy requirement (EER), the subjects were divided into four groups: < 10% (very low, VL), 10~20% (low, L), 20~30% (moderate, M), ${\geq}30%$ (sufficient, S). All data were analyzed on the metabolic risk and nutritional state after application of weighted value and adjustment of sex, age, residential area, income, education, job or jobless, and energy intake using a general linear model or logistic regression. Results: The subjects of group S were 16.9% of total subjects, group M 39.2%, group L 37.6%, and group VL 6.3%. The VL group included more male subjects, younger-aged (19 to 40 years), urban residents, higher income, higher education, and fewer breakfasts eaters together with family members. Among the 4 groups, the VL group showed the highest waist circumference, while the S group showed the lowest waist circumference, body mass index, and serum total cholesterol. The groups of VL and L with lower intake of breakfast energy showed high percent of energy from protein and fat, and low percent of energy from carbohydrate. With the increase of breakfast energy level, intake of energy, most nutrients and food groups increased, and the percentage of subjects consuming nutrients below EAR decreased. The VL group showed relatively higher intake of snacks, sugar, meat and eggs, oil, and seasonings, and the lowest intake of vegetable. Risk of obesity by waist circumference was highest in the VL group by 1.90 times of the S group and the same trend was shown in obesity by BMI. Risk of dyslipidemia by serum total cholesterol was 1.84 times higher in the VL group compared to the S group. Risk of diabetes by Glu-FBS (fasting blood sugar) was 1.57 times higher in the VL group compared to the S group. Conclusion: The results indicate that higher breakfast energy level is positively related to lower metabolic risk and more desirable nutritional state in Korean adults. Therefore, breakfast energy intake more than 30% of their own EER would be highly recommended for Korean adults.

Econometric Analysis on Factors of Food Demand in the Household : Comparative Study between Korea and Japan (가계 식품수요 요인의 계량분석 - 한국과 일본의 비교 -)

  • Jho, Kwang-Hyun
    • Journal of the Korean Society of Food Culture
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    • v.14 no.4
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    • pp.371-383
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    • 1999
  • This report gave analysis of food demand both in Korea and Japan through introducing the concept of cohort analysis to the conventional demand model. This research was done to clarify the factors which determine food demand of the household. The traits of the new model for demand analysis are to consider and quantify those effects on food demand not only of economic factors such as expenditure and price but also of non-economic factors such as the age and birth cohort of the householder. The results of the analysis can be summarized as follows: 1) The comparison of the item-wise elasticities of food demand demonstrates that the expenditure elasticity is higher in Korea than in Japan and that the expenditure elasticity is -0.1 for cereal and more than 1 for eating-out in both countries. In respect to price elasticity, the absolute values of all the items except alcohol and cooked food are higher in the Korea than in Japan, and especially the price elasticities of beverages, dairy products and fruit are predominantly higher in Japan. In this way, both expenditure and price elasticities of a large number of items are higher in Korea than in Japan, which may be explained from the fact that the level of expenditure is higher in Japan than in Korea. 2) In both of Korea and Japan, as the householder grows older, the expenditure for each item increases and the composition of expenditure changes in such a way that these moves may be regarded as due to the age effect. However, there are both similarities and differences in the details of such moves between Korea and Japan. Those two countries have this trait in common that the young age groups of the householder spend more on dairy products and middle age groups spend more on cake than other age groups. In the Korea, however, there can be seen a certain trend that higher age groups spend more on a large number of items, reflecting the fact that there are more two-generation families in higher age groups. Japan differs from Korea in that expenditure in Japan is diversified, depending upon the age group. For example, in Japan, middle age groups spend more on cake, cereal, high-caloric food like meat and eating-out while older age groups spend more for Japanese-style food like fish/shellfish and vegetable/seaweed, and cooked food. 3) The effect of the birth cohort effect was also demonstrated. The birth cohort effect was introduced under the supposition that the food circumstances under which the householder was born and brought up would determine the current expenditure. Thus, the following was made clear: older generations in both countries placed more emphasis upon stable food in their composition of food consumption; the share of livestock products, oil/fats and externalized food was higher in the food composition of younger generation; differences in food composition among generations were extremely large in Korea while they were relatively small in Japan; and Westernization and externalization of diet made rapid increases simultaneously with generation changes in Korea while they made any gradual increases in Japan during the same time period. 4) The four major factors which impact the long-term change of food demand of the household are expenditure, price, the age of the householder, and the birth cohort of the householder. Investigations were made as to which factor had the largest impact. As a result, it was found that the price effect was the smallest in both countries, and that the relative importance of the factor-by-factor effects differed among the two countries: in Korea the expenditure effect was greater than the effects of age and birth cohort while in Japan the effects of non-economic factors such as the age and birth cohort of householder were greater than those of economic factors such as expenditures.

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Evaluation of Multiple System Atrophy and Early Parkinson's Disease Using $^{123)I$-FP-CIT SPECT ($^{123)I$-FP-CIT SPECT를 이용한 다중계위축증 및 조기 파킨슨병에서의 평가)

  • Oh, So-Won;Kim, Yu-Kyeong;Lee, Byung-Chul;Kim, Bom-Sahn;Kim, Ji-Sun;Kim, Jong-Min;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.10-18
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    • 2009
  • Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.

Studies on the Nutritional Effects of Locally Produced Dried Formula Milk and Fermented Milk -2. Effect of Feeding Dried Formula Milk and Fermented Milk on the Growing Performance, Protein Utilizability and Intestinal Microbial Changes of Albino Rats (국산(國産) 조제분유(調製粉乳)와 발효유(醱酵乳)의 영양효과(營養效果)에 관한 연구(硏究) - 2. 유제품(乳製品)이 성장기(成長期) 흰쥐에 미치는 영양효과(營養效果) 및 장내미생물(腸內微生物)의 변화(變化)에 관한 연구(硏究) -)

  • Paik, Jeong-J.;Han, In-K.
    • Journal of Nutrition and Health
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    • v.9 no.1
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    • pp.92-98
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    • 1976
  • The present studies were carried out to observe the nutritional effects of three kinds of locally produced dried infantile formula milk (DFM) and one fermented milk (FM). A feeding trial with 60 male growing albino rats weighing $60{\sim}70$ grams was conducted during 6 weeks to compare the nutritive values and protein qualities of three DFM and a FM. The diet treatments consisted of 100% control diet, 70% control diet plus 30% DFM-A, 70% control diet plus 30% DFM-B, 70% control diet plus 30% DFM-C, 100% control diet with FM and 70% control diet plus 30% DFM-B with FM. The items investigated were body weight gain, feed intake, feed efficiency ratio (FER), various organ weights, protein efficiency ratio (PER), digestibility of nutrients, biological value, utilizability of protein and intestinal microbial changes of albino rats. The results obtained are summarized as follows; 1. Although there was no statistical significance, rats fed diets containing DFMs and FM gained faster than the rats fed control diet. The best growth rate was obtained with the DFM-A and DFM-C groups. In spite of the lower protein contents of the three DFM diets than the control diet, the growth rate of albino rats fed the DFM diets was somewhat improved than rats fed control diet. 2. No statistical significance was found in feed consumption but the trend was that the feed intake of control group was higher than those of the DFM diet group. 3. Feed efficiency was inproved significantly (p<0.01) by feeding DFMs as compared with control diet. DFM-A group showed the best FER, although no statistical significance was found. 4. Rats fed the DFM diets showed significantly (p<0.01) higher PER as compared with those of the control group. But no difference was found anions DFM groups. The significant improvement (p<0.01) of PER due also to the feeding of FM was seemed to be brought about by the beneficial effect of FM. 5. The present data revealed that feeding DFM and FM didn't affect the weights of various organs of rats. 6. The protein digestibility of experimental diets was similar to each other. Although no statistical significance was found among treatments, the DFMs and FM surely tended to improve the biological value and utilizability of protein. 7. Microbial study indicated that among intestinal flora FM fed group, there were more Lactic acid bacteria than E. coli. From the experimental results described above, it may be concluded that the nutritive effects of three kinds of locally produced DFMs are much alike and the growth rate of growing albino rats can be improved by feeding either DFM or FM due to their beneficial effects on the feed efficiency and protein utilization.

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Studies on Lipids in Fresh-Water Fishes 7. Comparison of Lipid Components among Wild and Cultured Eel (Anguilla japonica), and Conger Eel (Astroconger myriaster) (담수어의 지질에 관한 연구 7. 천연 및 양식 뱀장어와 붕장어의 지질성분 비교)

  • CHOI Jin-Ho;RHIM Chae-Hwan;BAE Tae-Jin;BYUN Dae-Seok;YOON Tai-Heon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.5
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    • pp.439-446
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    • 1985
  • This study was designed to compare the lipid components among wild and cultured eel, Anguilla japonica, and conger eel, Astroconger myriaster. The lipid components of cultured eel were analyzed and compared with those of wild and conger eel. In the content of total lipid, the lipid content in cultured eel was slightly higher than that in wild one, but 2 times higher than that in conger eel. The lipid contents in edible portion of wild and cultured eel were 5 times higher than those in viscera, but the lipid content in edible portion of conger eel showed a similar trend to that in viscera. In the fatty acid composition of neutral lipid in edible portion, percentages of $C_{14:0},\;C_{16:0}\;and\;C_{18:1}$ in cultured eel were higher than those in wild one, while percentages of $C_{16:1},\;C_{18:2},\;C_{18:3},\;C_{20:4},\;C_{20:5},\;C_{22:5}\;and\;C_{22:6}$ lower, and percentages of $C_{18:0},\;C_{20:4}\;and\;C_{22:6}$ in conger eel were noticeably higher than those in wild and cultured eels. In the case of phospholipid in edible portion, percentages of $C_{18:0}\;and\;C_{18:2}$ in cultured eel were higher than those in wild one, while percentages of $C_{16:0},\;C_{16:1},\;C_{18:1},\;C_{18:3},\;C_{20:4},\;C_{20:5},\;C_{22:5}\;and\;C_{22:6}$ lower. The unsaturation (TUFA/TSFA) of neutral lipid was no significant difference among wild and cultured eel, and conger eel, but that of phospholipid in wild eel was higher than that in cultured eel and conger eel. The essential fatty acid content(TEFA) of neutral lipid in edible portion of wild eel was 3 times higher than that of cultured one. but the TEFA of phospholipid in edible portion was no significant difference among wild and cultured eels, and conger eel. The w3 highly unsaturated fatty acid content (w3 HUFA) of neutral lipid in edible portion of wild eel was 2.0 to 2.5 times higher than that of cultured eel and conger eel, but the w3 HUFA of phospholipid in edible portion of wild eel was noticeably higher than that of cultured eel and conger eel. In the ratio (A/B) of fatty acid content (A) in cultured eel to that (B) in diet, the A/B ratios of $C_{18:2}\;w6,\;C_{18:3}\;w3,\;C_{20:5}\;w3\;and\;C_{22:6}\;w3$ were 0.23 to 0.48 much lower than the other fatty acid. Consequently, it is considered that the ratios of w3 HUFA is related to the biosynthesis of polyenoic acid and growth rate of cultured eel.

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Potential Study for the Sedimentary Exhalative Pb-Zn Mineralization in Dyusembay Area, Kazakhstan (카자흐스탄 듀셈바이지역의 퇴적분기형 연-아연 광화작용에 대한 잠재력 연구)

  • No, Sang-gun;Lee, Seung-han;Park, Ki-woong;Jeong, Hyeon-guk;Yun, Ji-seong;Kim, Sun-ok;Park, Maeng-eon
    • Economic and Environmental Geology
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    • v.51 no.3
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    • pp.213-222
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    • 2018
  • Metasediment-hosted Pb-Zn mineralized zone has been found in Dyusembay of Kazakhstan. Its petrological properties, metal index, alteration index and redox-sensitivity are compared with those of SEDEX type deposit. Mineralization is developed along foliation of host rock (graphitic phyllite) and controlled by folds and faults; major ore minerals including pyrite, pyrrhotite, sphalerite, and galena are disseminated or interlayered with fine-grained quartz. The margin of the mineralized zone is metamorphosed accompanying sericite and chlorite. Hydrothermal brecciation and Pb-Zn mineralization formed in quartz-calcite stockworks are confirmed at the around of Maytyubin granitoid intrusions. The mineralization is classified into three types according to those of occurrence, paragenesis, chemical composition and isotopic characteristics. Type 1 whose fine-grained pyrite, pyrrhotite and sphalerite are formed in parallel yet discontinuous to well-developed foliations of the host rock; its geochemistry is similar to those of the earlier stage in SEDEX-type mineralization. In case of type 2, the ore minerals of which are concentrated being parallel to a foliation by regional metamorphism, and most of them associated with quartz and muscovite (${\pm}$ biotite) paragenetically. Type 3 is formed in the hydrothermal breccia zone whose ore minerals are controlled by foliation and breccia and developed in quartz ${\pm}$ calcite veins having a form such as stratification, stockwork or veinlets. Host rocks in the mineralized zone indicate homogeneous metamorphic grade and there is no specific alteration zonation. Also, all types (type 1, type 2, and type 3) represent similar REEs patterns, it can be interpreted that these are originated from a same source. Sulphides occurred in mineralized zone indicate a limited range of sulphur isotope values (type 2, ${\delta}^{34}S=-13.3{\sim}-11.7$‰; type 3, ${\delta}^{34}S=-13.9{\sim}-8.2$‰), and a result of geothermometry presents different temperature ranges: type 2($251{\pm}38^{\circ}C{\sim}277{\pm}40^{\circ}C$); type 3($360{\pm}2^{\circ}C$ to $537{\pm}29^{\circ}C$). It is estimated to be due to the effect of metamorphism and Maytyubin granitoid intrusions, respectively. In addition, ternary chart of thorium, scandium, and zircon for discrimination of tectonic setting and redox sensitivity using V/Mo values indicate that hydrothermal sediments put on reduction environment after precipitation, before being affected by metamorphism and intrusion activity. Geochemical data are plotted on a distal trend of SEDEX-type with discrimination plot using SEDEX index. As a result, petrological-geochemical properties demonstrate that Dyusembay Pb-Zn mineralized zone is comparable to distal-type of SEDEX deposit.

A Study on Air Operator Certification and Safety Oversight Audit Program in light of the Convention on International Civil Aviation (시카고협약체계에서의 항공안전평가제도에 관한 연구)

  • Lee, Koo-Hee;Park, Won-Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.1
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    • pp.115-157
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    • 2013
  • Some contracting States of the Convention on International Civil Aviation (commonly known as the Chicago Convention) issue FAOC(Foreign AOC and/or Operations Specifications) and conduct various safety audits for the foreign operators. These FAOC and safety audits on the foreign operators are being expanded to other parts of the world. While this trend is the strengthening measure of aviation safety resulting in the reduction of aircraft accident, it is the source of concern from the legal as well as economic perspectives. FAOC of the USA doubly burdens the other contracting States to the Chicago Convention because it is the requirement other than that prescribed by the Chicago Convention of which provisions are faithfully observed by almost all the contracting States. The Chicago Convention in its Article 33 stipulates that each contracting State recognize the validity of the certificates of airworthiness and licenses issued by other contracting States as long as they meet the minimum standards of the ICAO. Consequently, it is submitted that the unilateral action of the USA, China, Mongolia, Australia, and the Philippines issuing the FOAC to the aircraft of other States is against the Convention. It is worry some that this breach of international law is likely to be followed by the European Union which is believed to be in preparation for its own unilateral application. The ICAO established by the Chicago Convention to be in charge of safe and orderly development of the international civil aviation has been in hard work to both upgrade and emphasize the safe operation of aircraft. As the result of these endeavors, it prepared a new Annex 19 to the Chicago Convention with the title of "Safety Management" and with the applicable date 14 November 2013. It is this Annex and other ICAO documents relevant to the safety that the contracting States to the Chicago Convention have to observe. Otherwise, it is the economical burden due to probable delay in issuing the FOAC and bureaucracies combined with many different paperworks and regulations depending on where the aircraft is flown. It is exactly to avoid this type of confusion and waste that the Chicago Convention aimed at when it was adopted in 1944. The State of the operator shall establish a system for both the certification and the continued surveillance of the operator in accordance with ICAO SARPs to ensure that the required standards of operations are maintained. Certainly the operator shall meet and maintain the requirements established by the States in which it operate. The authority of a State stops where the authority of another State intervenes or where the former has yielded its power by an international agreement for the sake of international cooperation. Hence, it is not within the realm of the State to issue FAOC towards foreign operators for the reason that these foreign operators are flying in and out of the State. Furthermore, there are other safety audits such as ICAO USOAP, IATA IOSA, FAA IASA, and EU SAFA that assure the safe operation of the aircraft, but within the limit of their power and in compliance with the ICAO SARPs. If the safety level of any operator is not satisfactory, the operator could be banned to operate in the contracting States with watchful eyes until the ICAO SARPs are met. This time-honoured practice has been applied without any serious problems. Besides, we have the new Annex 19 to strengthen and upgrade with easy reference for contracting States. We don't have no reason to introduce additional burden to the States by unilateral actions of some States. These actions have to be corrected. On the other hand, when it comes to the carriage of the Personal or Pilot Log Book, the Korean regulation requiring it is in contrast with other relevant provisions of USA, USOAP, IOSA, and SAFA. The Chicago Convention requires in its Articles 29 and 34 only the carriage of the Journey Log Book and some other certificates, but do not mention the Personal Log Book at all. Paragraph 5.1.1.1 of Annex 1 to the Chicago Convention even makes it clear that the carriage in the aircraft of the Personal Log Book is not required on international flights. The unique Korean regulation in this regards giving the unnecessary burden to the national flag air carriers has to be lifted at once.

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The Impact of Bladder Volume on Acute Urinary Toxicity during Radiation Therapy for Prostate Cancer (전립선암의 방사선치료시 방광 부피가 비뇨기계 부작용에 미치는 영향)

  • Lee, Ji-Hae;Suh, Hyun-Suk;Lee, Kyung-Ja;Lee, Re-Na;Kim, Myung-Soo
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.237-246
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    • 2008
  • Purpose: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. Materials and Methods: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. Results: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was $299{\pm}155\;mL$ in the experimental group, as opposed to $187{\pm}155\;mL$ in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. Conclusion: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.