• Title/Summary/Keyword: Systemic analysis

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Comparison of Single vs Combined Modality Treatment in Locally Advanced Non-Small Cell Lung Cancer (국소 진행된 비소세포 폐암에서 복합요법과 단일요법의 비교)

  • Kim, Ae-Kyoung;Jeong, Seong-Su;Shin, Kyoung-Sang;Park, Sang-Gee;Jo, Hai-Jeong;Lee, Jong-Jin;Seo, Jee-Won;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.502-512
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    • 1995
  • Background: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. Method: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. Result: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. Conclusion: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.

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Etiology and Analysis of Severity in Childhood Pancreatitis (소아 췌장염의 원인과 중증도 분석)

  • Park, Jun-Eun;Kim, Kyong-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.194-203
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    • 1999
  • Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

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An Analysis of Epidemiological Investigation Reports Regarding to Pathogenic E. coli Outbreaks in Korea from 2009 to 2010 (최근 2년간(2009-2010) 우리나라 병원성 대장균 식중독 역학조사 보고서 분석)

  • Lee, Jong-Kyung;Park, In-Hee;Yoon, Kisun;Kim, Hyun Jung;Cho, Joon-Il;Lee, Soon-Ho;Hwang, In-Gyun
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.366-374
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    • 2012
  • Recently pathogenic E. coli is one of the main foodborne pathogens resulting in many patients in Korea. To understand the characteristics of pathogenic E. coli outbreaks in Korea, the epidemiological investigation reports of pathogenic E. coli outbreak in 2009 (41 reports) and in 2010 (27 reports) were collected in the web site of the Korea Centers for Disease Control and Prevention, reviewed and analysed in this study. The main places of the pathogenic E. coli outbreaks were food catering service area (64.8%) and restaurants (25.0%). The main type of the pathogens were EPEC (44.7%) and ETEC (34.2%). EAEC and EHEC was responsible for 10.5 and 9.2%, respectively. Eight of 68 outbreak cases were caused by more than 2 types of pathogenic E. coli which implicates the complicated contamination pathways of pathogenic E. coli. The incidence rate of pathogenic E. coli was $33.6{\pm}30.5%$ and the main symptoms were diarrhea, stomach ache, nausea, vomiting, and fever etc. The two identified food sources were identified as frozen hamburger pattie and squid-vegetable mixture. To improve the food source identification by epidemiological investigation, food poisoning notification to the agency should not be delayed, whole food items attributed the outbreak should be collected and detection method of the various pathogenic E. coli in food has to be improved. In conclusion, the characteristics between the EHEC outbreaks in the western countries and the EPEC or ETEC outbreaks in Korea needs to be distinguished to prepare food safety management plan. In addition, the development of the trace back system to find the contamination pathway with the improved detection method in food and systemic and cooperative support by the related agencies are necessary.

A Basic Study on the Performance Improvement of Safety Certification Standards (안전인증기준 성능화에 대한 기반 연구)

  • Byeon, Jung-Hwan;Kim, Jung-Gon
    • Journal of the Society of Disaster Information
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    • v.17 no.3
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    • pp.487-499
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    • 2021
  • Purpose:The purpose of the paper is to review the problems of performance enhancement of safety certification standards and to suggest directions for improvement in order to rationalize safety certification standards for future industrial development and environmental changes. Method: The problems and limitations of the safety certification system are summarized through literature review and interview with manager, and the status of safety certification standards is classified into design standards, performance standards, and detailed standards, and the status analysis is performed. In addition, by synthesizing the results of the investigation and analysis, improvements are suggested to improve the performance of the safety certification standards. Result: Through the survey, the problems and limitations of safety certification could be grouped into six categories: government-led certification system operation, standardized certification standards, long time required to improve certification, poor certification standards preparation system, and lack of reflection of industry opinions. And, as a result of analyzing the certification standards by dividing them into performance and design standards, in the case of machinery, equipment, and protection devices, the design standards were high at 69.7% and 64.9%, whereas in the case of protective equipment, the performance standards were high at 61.1%. In order to improve the performance of safety certification standards centered on design standards, it is necessary to determine the possibility of performance enhancement of the certification standards and determine the feasibility of the inspection test method. In order to improve performance, it was reviewed that it was necessary to establish a systemic foundation and infrastructure, such as strengthening the Product Liability Act, systematizing market monitoring, etc., distributing certification test tasks, and participating in the preparation of certification standards by the private sector. Conclusion: Through this study, the problems and limitations of Korea's safety certification system were summarized and the necessity for performance improvement was reviewed. Performance improvement of safety certification standards is a matter that requires preparatory work, such as legislative revision and infrastructure construction, and requires mid-to-long-term promotion. In addition, rather than improving the overall safety certification standards, the performance requirements for each item subject to certification should be reviewed and promoted, and details should be specified through additional research.

The social representation and trust of Korean society and people: Indigenous psychological analysis of the perception of Korean adolescents and adults (한국 사회와 사람에 대한 사회적 표상과 신뢰: 청소년과 성인의 지각을 통해 본 토착심리 분석)

  • Uichol Kim ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.10 no.3
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    • pp.103-129
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    • 2004
  • This article examines the Korean adolescents and adults' social representation and trust of Korean society and people using indigenous psychological analysis. Respondents were asked to write in an open-ended questionnaire their perception of the following five aspects: Korean politics, economy, society, culture and people. They were then asked to report why they trust or distrust Korean society. A total of 1,064 respondents (218 middle school students, 200 university students, 218 fathers of the middle school students, 218 mothers of the middle school students, and 210 teachers) completed a questionnaire developed by the present researchers. The data were collected during April to June, 2003. The results indicate that 94.5% of Koreans view the existing political system and politicians as being corrupt, inept, factional, and lacking in integrity. A vast majority (84.9%) recognize the existence of systemic problems in the Korean economy. A total of 78.2% see problems in Korean society being dominated by selfishness, factionalism, conservatism, and social uncertainty. For Korean culture, a majority of respondents report being proud of its cultural tradition, accomplishment, and creativity. At the same time, 45.7% report loss of cultural identity and pride due to external influences. More than half of the respondents report negative aspects of Korean people (i.e., selfish, lack of morality, rushed, and overly focused on their social image), while nearly half of the respondents report positive aspects of Korean people as being compassionate, cooperative, good-natured and hard-working. As for reason for trusting Korean society, around a third report "because it is our country," followed by its future potential, and the good-nature and willingness of Korean people to work hard. The reasons for distrusting Korean society is the dishonesty politicians, corruption, institutional ineptness, and economic uncertainty. These results indicate a low level of collective efficacy in influencing and affecting change in Korean society.

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Immunohistochemical Detection of Lymph Nodes Micrometastases in Patients of Pathologic Stage I Non-small-cell Lung Cancer (병리적 병기 1기의 비소세포폐암 환자에서 면역조직화학염색에 의한 림프절 미세전이 관찰)

  • Ryu, Jeong-Seon;Han, Hye-Seung;Kim, Min-Ji;Kwak, Seung-Min;Cho, Jae-Hwa;Yoon, Yong-Han;Lee, Hong-Lyeol;Chu, Young-Chae;Kim, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.345-350
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    • 2004
  • Background : To evaluate the frequency and clinical significance of lymph node micrometastasis in patients of non-small-cell lung cancer pathologically staged to be T1-2,N0. Method : From consecutive 29 patients of non-small-cell lung cancer who received curative operation and routine systemic nodal dissection, we immunohistochemically examined 806 lymph nodes from mediastinal, hilar and peribronchial lesion. All slides were stained with hematoxylin and eosin staining for one section and with cytokeratin AE1/AE3 antibody for another consecutive section of same lymph node to find out micrometastasis. Results : In 806 lymph nodes examined, no tumor cell was seen on hematoxylin and eosin staining and micrometastic foci were shown to be on 0.37%(3) of 806 lymph nodes, in which were upper paratracheal, interlobar and peribronchial lymph node. These three positive stains constitute 10.3%(3) of the 29 patients with non-small-cell lung cancer. Nine patients died from disease progression(4), postoperative complication(3) and concomitant diseases(2). The four patients with disease progression did not show evidence of micrometastasis on their lymph node examination. Conclusion : The frequency of lymph node micrometastasis was in 0.37% of 806 lymph nodes examined. The study results might suggested that routine analysis of micrometastasis on the lymph node didn't give any clinical implication on patients with non-small-cell lung cancer.

The Relationship between Dementia and Oral Health in Some Elderly in Daejeon (대전 일부 노인의 치매와 구강건강의 관계)

  • Go, Hye-Bin;Kim, Min-Gyeong;Kim, Jin-Young;Kim, Hyun-Soo;Park, Young-Seo;Seo, Seung-Hyeon;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.481-487
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    • 2016
  • The elderly population with dementia is rapidly growing in South Korea. The aim of this study was to investigate the relationship between dementia and oral health in 197 subjects aged ${\geq}65$ years. The questionnaire included questions on subjective health status, subjective health concern, subjective oral health status and behavior, mastication ability, Oral Health Impact Profile-14 (OHIP-14), and Korean Dementia Screening Questionnaires (KDSQ). Oral examination was conducted by a single dentist to evaluate upper or lower denture use, and determine the numbers of remaining and functioning teeth, including implant and fixed prosthesis. The subjects who required a dementia test (KDSQ-C [cognition] of ${\geq}6$) had significant differences in systemic disease prevalence rate, subjective health status, subjective health concern, KDSQ-V (vascular disease) score, KDSQ-D (depression) score, subjective oral treatment need, key food mastication ability and OHIP-14 score compared to the healthy subjects. The proportion of denture wearers, total remaining teeth, total functioning teeth, toothbrushing frequency, oral pain severity, symptoms of periodontal disease, subjective oral health status, and subjective oral health concern showed no significant differences between the two groups. KDSQ-C and OHIP-14 scores showed a strong positive relationship, while KDSQ-C score and total remaining teeth or key food mastication ability showed a weak negative relationship. In the multiple regression analysis, the KDSQ-D, KDSQ-V, and OHIP-14 scores influenced the KDSQ-C scores. We suggest a relationship between oral health and cognitive impairment.

Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.