• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.99-104
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• 2008

Background: Acute respiratory distress syndrome (ARDS) is ultimately an inflammatory state. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are inflammatory markers. The aim of this study was to evaluate the value of the ESR, CRP and APACHE II score as prognostic factors for patient with ARDS. Methods: We retrospectively analyzed the medical records of 87 ARDS patients. The predictors (APACHE II score, ESR and CRP) and outcomes (mortality and length of the total hospital stay, the ICU stay and mechanical ventilator care) were obtained from the patients' records. The patients were grouped according to survival as the Survivor and Non survivor groups. We compared the APACHE II score, the ESR and the CRP level between the survivor group and the nonsurvivor group. We evaluated the correlation between the predictors and the outcomes. The initial ESR, CRP level and APACHE II score were checked at the time of ICU admission and the second ESR and CRP level were checked $3.3{\pm}1.2$ days after ICU admission. Results: Thirty-eight (43.7%) patients remained alive and 49 (56.3%) patients died. The APACHE II score was significantly lower for the survivor group than that for the non survivor group ($14.7{\pm}7.6$ vs $19.6{\pm}9.1$, respectively, p=0.006). The initial ESR and CRP level were not different between the survivor and non-survivor groups (ESR $64.0{\pm}37.8mm/hr$ vs $63.3{\pm}36.7mm/hr$, respectively, p=0.93, CRP $15.5{\pm}9.6mg/dl$ vs $16.3{\pm}8.5mg/dl$, respectively, p=0.68). The decrement of the CRP level for the survivor group was greater than that for the non survivor group ($-8.23{\pm}10.0mg/dl$ vs $-1.46{\pm}10.1mg/dl$, respectively, p=0.003). Correlation analysis revealed the initial ESR was positively correlated with the length of the total hospital stay and the ICU stay (correlation coefficient of the total hospital days: R=0.43, p=0.001, correlation coefficient of the ICU stay: R=0.39, p=0.014). Conclusion: The initial APACHE II score can predict the mortality of ARDS patients, and the degree of the early CRP change can be a predictor of mortality for ARDS patients. The initial ESR has positive correlation with the ARDS patients' duration of the total hospital stay and the ICU stay.

• Journal of Gastric Cancer
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• v.9 no.4
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• pp.231-237
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• 2009

Purpose: The aim of this study was to evaluate the significance of palliative gastrojejunostomy for treating patients with unresectable stage IV gastric cancer, and as compared with laparotomy for treating patients with incurable gastric cancer. Materials and Methods: We retrospectively studied 167 patients who could not undergo resection without obstruction at Korea University Hospital from 1984 to 2007. They were classified into two groups, one that underwent palliative gastrojejnostomy (the bypass group, n=62) and one that underwent explo-laparotomy (the O&C group, n=105), and the clinical data and operative outcomes were compared according to the groups. Results: For the clinical characteristics, there were no differences of age, gender and liver metastasis between the bypass group and the explo-laparotomy group, but there was a significant different for the presence of peritoneal metastasis (P=0.001). There was no difference between two groups for the postoperative mortality and morbidity. For the postoperative outcomes, the duration of the hospital stay (29.25 vs 16.67) and the frequency of re-admission were not different, but the median overall survival (4.3 months vs. 3.4 months, respectively) was significantly different. By multivariate analysis, the presence of peritoneal metastasis was identified as the independent prognostic factor for incurable gastric cancer. Conclusion: A prophylactic bypass procedure is not effective for improving the quality of life and prolonging the life expectancy of unresectable stage IV gastric cancer patients without obstruction.

• Journal of Korean Society of Forest Science
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• v.79 no.1
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• pp.56-70
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• 1990

Eighteen Korean white pine (P. koraiensis S. et Z.) families were tested in 3 different regions from age 5 to 9. Family and site were significant sources of variation for seedling survival and field growth, whereas the effects of family x site interaction ware relatively small as compared with the former sources of variation. Variance components estimated from the separate and combined sites indicated that the most variabilities were associated with individual trees within plot. Family ${\times}$ site interaction components as a percentage of family variance decreased sharply with age. Heritability estimates varied with testing site and tree age. Combined analyses, however, showed a moderate change in heritability with increasing tree ages, and demonstrated high and stable trends of estimates, particularly in family heritabilities of tree height ($h_F{^2}=0.789-0.798$). The gains estimated from combined analysis have expected maximum or near-maximum efficiencies at age 6 or 7. Given equal intensity of selection, mass selection showed the most efficient gains within and across the sites. However, for the differences between mass and combined selections are small, selection made on the combination of family and within-family would be more effective in improving genetic gains. Indirect selection method indicated that 5-and 6-years height were all good predictors of 9-year-old height with little loss of relative efficiency (less than 10%) as compared with direct family selection at age 9. Phenotypic and genetic correlations computed on the basis of family mean values of height and diameter have shown predominantly high, positive, and statistically significant (1% level) relationships between all tested pairs of traits, which indicates that family growth maintained statistically consistent trends with age. The best families are those that maintained a stable superiority overall sites and ages in growth performance, therefore, it can be suggested that early identification of superior families at age 9 is feasible at age 5 or 6 in Pinus koraiensis S. et Z.

• Strategy21
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• s.38
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• pp.112-162
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• 2015

This study began to confirm or review the balance of power theory by applying scientific methods through experiential cases. Though there are several kinds of national power, this study supposes military power as a crucial power when it comes to war and peace. This research covered balance and imbalance through comparing relative military power between nations or nations' group. Comparison of relative military power can be achieved by statistically processing the values of which has been converted into the standard variables in same domain, then calculating the values of nation's power which has been synthesized different experiential factors. In addition, the criteria of experiential experiment is highly dedicated to European countries, USA, Japan prior to 1st and 2nd World War, as well as USA, Soviet Union and North East Asia during Cold War era. In addition, the balance of power theory has been redefined to review the action of the state upon the changes of power as mentioned in the theory. To begin with, the redefined theory states that relative level of military power between nations defines the consistency of peace and balance of power. If military power is enough to be on the range of level required to keep the power in equilibrium, peace and balance can be achieved. The opposite would unbalance the military power, causing conflicts. While the relative military level between nations change, nations seek to establish 'nations group' via military cooperation such as alliance, which also shift relative military power between nations group as well. Thus, in order to achieve balance of power, a nation seeks to strengthen its military power(self-help), while pursuing military cooperation(or alliance). This changes relative military power between nations group also. In other words, if there exists balance of power between nations, there is balance of power between nations group as well. In this theory, WWI and II broke out due to the imbalance of military force between nations and nations group, and reviewed that due to the balance of military force during the Cold War, peace was maintained. WWI was resulted from imbalance of military cooperation between two powerful states group and WWII was occurred because of the imbalance among the states. Peace was maintained from cooperation of military power and balance among the states during the Cold War. Imbalance among continental states is more threatening than maritime states and balance of power made by army force and naval force also is feasible. Also the outcomes of two variables are found military power balanced ratio of military power for balance is 67% when variable ratio of balance is 100% and standard value for balance is 0.86. Military power exists in a form of range. The range is what unstabilized the international system causing nations to supplement their military powers. These results made possible the calculation and comparison between state's military power. How balance of power inflicted war and peace has been studied through scientific reviews. Military conflict is highly possible upon already unbalanced military powers of North East Asian countries, if the US draws its power back to America. China and Japan are constantly building up their military force. On the other hand, Korean military force is inferior so in accordance to change of international situation state's survival could be threatened and it is difficult to achieve drastic increase in military force like Germany did. Especially constructing naval force demands lots of time; however but has benefit that naval force can overcome imbalance between continental states and maritime states.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.145-159
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• 1999

To find the association, between vinyl house work and the prevalence of low back pain, a questionnaire survey was made toward 215 vinyl house farmers and 228 general farmers without vinyl house who are cared by Jungjung Community health Practioners at Soobuk Myun, Damyang-gun, Chollanamdo. 1. Vinyl house farmers were significantly younger in age, higher in educational status higher survival rate of spouse, higher economic state and less cared by medical aid than general farmers. 2. Vinyl house farmers showed shorter career for agricultural work, used modern farming instrument more frequently and worked with sitting position. 3. During unbusy season in general agriculture, vinyl house farmers consumed significantly more time in agricultural work and general activity, but no significant difference of time of the above activity among busy season. 4. During the last spring season when most vinyl house work was performed, vinyl house farmers showed significantly higher prevalence of low back pain than general farmers, but no significant difference of prevalence among the two groups for the last one week. 5. By the simple analysis statistical significant related variables with low back pain was found to be sex(p<0.001), educational status(p<0.05), work posture(p<0.001) and use of modern agricultural machine(p<0.05). 6. By the multiple logistic regression the odds ratio for low back pain among vinyl house farmers were 2.08(95% confidence interval 1.31-3.00) compared to general farmers, the odds ratio among female was 2.35(95% confidence interval 1.24-4.47) to male, the odds ratio among illiterate persons were 2.60(95% confidence interval 1.24-4.47) to high school graduate, and the odds ration among primary school graduate was 2.19(95% confidence interval 1.04-4.47) to high school graduate. In conclusion because vinyl house farmers showed significantly higher rates of low back pain compared to farmers without vinyl house, continuous study to find the true cause of low back pain among vinyl-house farmers and active effort to prevent low back pain are necessary.

• The Korean Journal of Financial Management
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• v.24 no.2
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• pp.147-181
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• 2007

Our article investigates the risk implication of ownership structure in life insurance companies. We set up a model to identify the priority structure of policyholder's and shareholder's cashflow claims, and to derive its implications. Current literature on this issue has focused on the agency paradigm or the risk-sharing efficiency. Fama and Jensen(1983a, 1983b) and Mayers and Smith(1981, 1986, 1988, 1990, 1994) argue that the survival of both the corporate and the mutual form of organization is due in part to the relative efficiencies in controlling agency problems. With regard to insurance business, agency problems arise because of the three functions inherent in the organizations:manager, risk-bearer(owner), and policyholder. Stock insurers are characterized by the potentially complete separation of all three functions while mutual insurers merger the policyholder with the ownership function. Doherty and Dionne(1993) and Doherty(1991) concentrate their analysis on differences in the efficiency of risk sharing between participating and non-participating policies. They argue that when the undiversifiable risk has higher portion in business risk, combining policy and equity claims into a single package is a more efficient risk-sharing contract than a simple prepaid risk-transfer. Among various methods for assembling the policy/equity package, Doherty and Dionne(1993) and Doherty(1991) suggest that policy/equity package offered by the mutual is the most efficient risk-sharing arrangement. There has been a controversy on the property of participating policies sold by life insurance corporations in Korea. Some scholars argue that participating policyholders of Korean life insurance companies have shared the cashflow risk with shareholders. They emphasize that insurance firms have used dividend reserves to supplement for equity deficits. Thus, they argue that the economic entities of Korean life insurance companies are mutual companies though their legal entities are corporations. Our article explicitly sets up each stakeholder's cashflow claim in stock and mutual insurers, and thus identify risk differences in shareholder and policyholder. Using our model, we could derive direct implications on the controversy. Our model shows that life insurance companies would sell participating policies since policyholders would have the incentive to share the risk inherent in their primary claims with equityholders. And there exists a fundamental difference in shareholder's risk and equityholder's.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.60-71
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• 2000

Backgrounds : Cathepsin D, an aspartic lysosomal proteinase, is believed to be involved in local invasion and metastasis of tumor cells by its proteolytic activity and has been described to be associated with tumor progression and prognosis in some human malignancies including breast cancer. But, its prognostic value for human lung cancer remains to be determined. The purpose of this study is to determine clinicopathological and prognostic significance of cathepsin D expression in non-small cell lung cancer. Method : Using a polyclonal antibody, immunohistochemical analysis of cathepsin D was performed on paraffin embedded sections of tumors obtained surgically from 54 patients with non-small cell lung cancer (37 squamous cell carcinoma, 14 adenocarcinoma, 2 large cell carcinoma, and 1 undifferentiated carcinoma). Results : Eighteen patients (33.3%) showed positive immunoreactivities of cathepsin D in tumor cells. No significant correlation of cathepsin D expression in tumor cells was found in p-stage (surgical-pathologic stage), tumor size, tumor factor, nodal involvement, and differentiation. Of 54 patients, 29 (53.7%) patients showed moderate to massive cathepsin D-positive stromal cells within the tumor tissues, while the rest (46.3%) showed few cathepsin D-positive stromal cells within the tumor tissues. Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung canær (p=0.031). No significant correlation of the degree of cathepsin D-positive stromal cells was found in tumor size, T -factor, nodal involvement, differentiation Cathepsin D expression status in tumor cells and stromal cells was not significantly associated with prognosis expressed by survival rate. The results of multivariate analyses of variables possibly associated with prognosis showed that nodal involvement was the only independent prognostic factor in all patients. Conclusion : Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung cancer. However, it was not related to other clinicopathologic features and prognosis, and Cathepsin D expression in tumor was not related to p-stage and prognosis.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.265-272
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• 2004

Background : RASSF1A, which is one of tumor suppressor genes, is frequently inactivated by hypermethylation of the promoter region in a variety of human cancers, including lung cancer. This study was performed to investigate the association between RASSF1A methylation and the clinicopathological factors in patients with squamous cell carcinoma of the lung. Methods : Eighty-one samples from the patients with squamous cell carcinoma of lung were examined. The promoter methyation of RASSF1A was analyzed by methylation specific PCR and sequencing. Statistical analysis was made to examine the association between RASSF1A methylation and the clinicopathological parameters. Results : RASSF1A methylation was observed in 37.0 % (30 of 81) of the patients with squamous cell carcinoma of the lung. RASSF1A methylation was found to be associated with cellular differentiation(p=0.0097) and the overall survival(p=0.0635). However, there was no association between RASSF1A methylation and the other clinicopathological parameters, such as the pathological TNM stage, the recurrence rate, lymph node invasion and the amount of cigarettes smoked. Conclusion : RASSF1A methylation might be associated with a poor prognosis in patients with squamous carcinoma of the lung. A larger scale study is needed.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.52-58
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• 2016

Purpose Recent retrospective studies are being actively conducted to analyze the survival of patients with SUVmax, MTV, TLG, such as information from a variety of PET originating. However, there is no clear way is difficult to accurately measure the volume of the tumor may be the difference between the caster is raised. In this study, to evaluate compare the volume measuring methods according to the characteristics of the tumor. Materials and Methods 18F-saline to fill the NEMA IEC Body Phantom insert the volume of balance and imbalance in phantom were acquired to the Biograph truepoint 40 (Siemens medical system, Germany) PET/CT scanner. The ratio of the volume and Background was acquired as 3.0, 5.0, 8.0, 18, 40. Clinical patients were randomly selected 120 people in staging patients with cancer of the digestive system from the year 2010 until the year 2014. Measurement methods were used a 40% threshold, 50% threshold and gradient segmentation technique, i.e. PET EDGE. Five years of experience of the two radio-technologist and one doctor was measured by repeated three times. Analysis methods were Intraclass correlation coefficient and Pearson correlation. Results In Phantoms, the 40% threshold method gave the best concordance between measured and actual volumes (r = 0.992, 0.997). In clinical patient outcome agreement between observers EDGE it is as high as 0.999 (CI: 0.998-0.999). And there were no statistical significance of the difference between the measurements (P = 0.620). 40% threshold method showed the best correlation between the measurements (r = 0.953). Increasing the ratio of tumor to background decreased the influence of a measuring method. Conclusion How to measure volume of the tumor in the patient was clinically most useful is 50% and the lowest impact on the characteristics of the tumor. Therefore, to reduce the background of the patients in PET/CT scan, it should be required research and effort.

• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.28-33
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• 2011

Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.