Kim, Mi-Jeong;Han, Seung-Beom;Kwak, Jin-Ho;Kwon, Doo-Young;Kim, Min-Su;Choi, Won-Il;Jeon, Young-June;Park, Jae-Yong;Jung, Tae-Hoon
Tuberculosis and Respiratory Diseases
/
v.50
no.1
/
pp.84-93
/
2001
Backgrounds : In the absence of distant metastasis, small cell lung cancer (SCLC) patients presenting with supraclavicular lymph node (SCLN) involvement and pleural effusion can benefit from thoracic radiotherapy. But there are some debate as to the prognostic significance of both SCLN involvement and pleural effusion. The purpose of this study was to determine the prognostic significance of SCLN involvement and pleural effusion in SCLC. Methods : Two Hundred and fifteen patients with histologically confirmed small cell lung cancer, who were treated either at the Keimyung university Dongsan hospital and Kyungpook national university hospital from January 1994 to June 1998, were evaluated retrospectively. The patients were classified as having either limited or extensive stage using the Veterans Administration staging system. Results : SCLN was presented in 10.5% of patients(n=21). The median survival was 247 days for patients with SCLN(n=21) and 264 days for patients without(n=194) (p=0.52). After treatment, the median survival was 298 days for patients with SCLN(n=13) and 348 days for patients without(n=115) (p=0.52). SCLN involvement was not correlated with the presence of distant metastases. Median survival was 459 days for patients with a limited stage without SCLN(n=66), 650 days for those with a limited stage with SCLN (n=7) (p=0.96). Pleural effusion was presented in 24.7% of patients(n=52). The median survival was 198 days for patients with pleural effusion(n=52) and 275 days for patients without(n=163) (p<0.05). After treatment, the median survival was 294 days for patients with a pleural effusion(n=25) and 286 days for patients without(n=103) (p=0.39). The presence of pleural effusion was not correlated with that of distant metastases. The median survival was 395 days for patients with a limited stage without a pleural effusion(n=63), 451 days for those with a limited stage with pleural effusion(n=10) (p=0.92). Conclusionsa : In this study, SCLN involvement does not explain the poor survival rate and the relevance to extensive staged disease. Furthermore, the existence of a pleural effusion did not correlated with the presence of distant metastases. However, the presence of a pleural effusion appears to be a minor prognostic factor in our study. Therefore supraclavicular lymph node involvement and the presence of a pleural effusion in SCLC are not poor prognostic factors, which does not justify any amendment to the staging system currently used.
Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
Tuberculosis and Respiratory Diseases
/
v.61
no.1
/
pp.34-40
/
2006
Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.
Park, Un-Je;Nam, Hae-Seong;Kim, Kwang-Hwan;Park, Chang-Soo;Kwon, In-Sun;Kim, Jeong-A;Lee, Tae-Yong
Journal of the Korea Academia-Industrial cooperation Society
/
v.14
no.3
/
pp.1234-1244
/
2013
This study aimed to analyze the ten years cancer incidence based on diagnosis years 2000-2009, and to evaluate the quality of cancer registry in Daejeon City and Chungcheongnam-Do, Korea. Crude incidence rate and age-standardized incidence rate (ASR) in these two regions were compared, and validity of incidence data was assessed by three indicators; age unknown (Age UNK%), histological verification (HV%), and death certificate only (DCO%). Mortality/incidence ratio (M/I ratio) was used to evaluate completeness of incidence data. Incidence rate differences were assessed using Poission distribution and calculated their 95% confidence interval of ASR, and those by sex, age, and region were compared by incidence rate curve. As a result, the highest cancer site during 2000-2009 was stomach in both regions, and incidence prpportion were 18.8% in Daejeon, 21.5% in Chungnam. The overall cancer incidence was higher in males than in females, and ASR of total cancer in Daejeon increased 0.6% (from 322.1 to 323.9 per 100,000) for men and 60.3% (from 203.9 to 326.8) for women, that in Chungnam increased 14.3% (from 294.7 to 336.9) for men and 70.7% (from 156.5 to 267.1) for women. The Age UNK% during 2000-2009 were 0.0% in both regions. MV% for men was increased from 71.8% to 88.5% and that for women was increased from 78.1% to 93.2%. DCO% for men was decreased from 6.4% to 0.7% and that for women was decreased from 5.4% to 0.8%. M/I ratio was ranged from 15.3% to 62.1% and can be evaluated fairy good registration.
Park, Hyung-Bae;Kim, Jin-Sung;Jang, Sang-Ruyl;Rho, Tae-Yong;Suh, Hye-Soo;Kim, Chang-Su;Lee, Kwang-Hun;Kim, Young-Uck
Journal of Yeungnam Medical Science
/
v.12
no.1
/
pp.113-123
/
1995
This study was intended to identify the neurotic traits related to sexual abuse in female high school students. The Neurosis Scale of Middlesex Hospital Questionnaire was conducted to 320 female high school students in Taegu, Korea from July 10 to July 17, 1994. The results were as follows: 1) The sexual abuse victim group showed significantly higher neurotic traits of Free floating anxiety (p<0.05), Phobic(p<0.01), Obsession(p<0.01), Somatic(p<0.05), Depression(p<0.01) than the control group. 2) The Neurotic traits of Somatic(p<0.01), Depression(p<0.01), Hysteric(p<0.01) were higher in the multiple-abused than the single-abused. 3) When the duration of being abused was concerned, subjects with more than 1 year duration had significantly higher neurotic traits of Obsession(p<0.05), Somatic(p<0.05), Depression(p<0.05) than subjects with less than 1 year duration. 4) The neurotic traits of Phobic, Somatic, Depression were significantly higher in the subjects with higher intensity of sexual abuse than with lower intensity. S) Among 68 victims, 31 girls(45%) were assaulted by strangers, 10(14%) were by relatives, 7(10.3%) were by siblings, 6(8.8%) were by neihbors. Among them, 34 girls(50%) bad counselling or psychotherapy and the people to whom they had sought for help were friends(23 girls; 68%), parents (7 girls; 11.7%) and mental health professonals (2 girls; 5.9%).
Park, Hyung-Bae;Kim, Jin-Sung;Jang, Sang-Ruyl;Park, Sung-Chan;Suh, Hye-Sao;Lee, Kwang-Hun;Kim, Young-Uck;Kim, Chang-Su
Journal of Yeungnam Medical Science
/
v.12
no.1
/
pp.56-74
/
1995
The authors applied ADDES-HV parent evaluation scale for the purpose of screening test to 538 2nd grade elementary school students from March 1994 to May. The results were as follows: There was no differences in scores of ADHD between schools. In comparing the male and female between three school students, male students showed signifieant high scores (p<0.05) than female students in the score of ADDES-HV subscale and total. There was no significant differences in ADDES-HV scale between male students and female students in both ADHD patients and normal controls. In reliability test for test and retest, the reliability coefficient was higher satisfatorily and that of inattention was 0.80, inpulsivity was 0.69, hyperactivity was 0.63 and the total score was 0.82. In reliability test by internal consistancy, the Cronbach ${\alpha}$ coefficient of patient group was 0.85(p<0.05) and that of normal control was 0.84(p<0.05). The Concurrent validity between ADDES-HV scale and DSM-III-R scale was 0.57(p<0.05) in ADHD patient group and 0.84(p<0.05) in normal control group. In discriminant validity test between ADHD patient group and normal control, the ADHD patient group showed higher score(p<0.05). The total disciminant capacity of the patient group in ADDES-HV scale was 94.44%. When we regard the cut off point as standard deviation 1.5, the male student was 80 score and the female student was 69 score. In this point of view, ADDES-HV scale was proved to be the useful screening test tool for ADHD research and showed higher reliability and validity in applying to Korean subjects.
Metropolitan rapid transit system plays an essential role in the public transportation system of any large city, and its managing agency is usually charged with the responsibility of storing and managing the design drawings of the system. The drawings are important and historically valuable documents that must be kept permanently because they contain comprehensive data that is used to manage and maintain the system. However, no study has been performed in Korea on how well agencies are preserving and managing these records. Seoul Metropolitan Rapid Transit Corporation(SMRT) is the managing agency established by the city of Seoul to operate subway lines 5, 6, 7, and 8 more efficiently to serve its citizens. By the Act on Records Management in Public Institutions(ARMPI), SMRT should establish a records center to manage its records. Furthermore, all drawings produced by SMRT and other third party entities should be in compliance with the Act. However, SMRT, as a form of local public corporation, can establish a records center by its own way. Accordingly, the National Archives & Records Service(NARS) has very little control over SMRT. Therefore, the purpose of this study is to research and analyze the present state of storage and management of the drawings of metropolitan rapid transit in SMRT and is to find a desirable method of preservation and management for drawings of metropolitan rapid transit. In the process of the study, it was found that a records center is being considered to manage only general official documents and not to manage the drawings as required by ARMPI. SMRT does not have a records center, and the environment of management on the drawings is very poor. Although there is a plan to develop a new management system for the drawings, it will be non-compliant of ARMPI. What's happening at SMRT does not reflect the state of all other cities' metropolitan rapid transit records management systems, but the state of creation of records center of local public corporation is the almost same state as SMRT. There should be continuous education and many studies conducted in order to manage the drawings of metropolitan rapid transit efficiently by records management system. This study proposes a records center based on both professional records centers and union records centers. Although metropolitan rapid transit is constructed and managed by each local public corporation, the overall characteristics and processes of metropolitan rapid transit projects are similar in nature. In consideration of huge quantity, complexity and specialty of drawings produced and used during construction and operation of metropolitan rapid transit, and overlap of each local public corporation's effort and cost of the storage and management of the drawings, they need to be managed in a professional and united way. As an example of professional records center, there is the National Personnel Records Center(NPRC) in St. Louis, Missouri. NPRC is one of the National Archives and Records Administration's largest operations and a central repository of personnel-related records on former and present federal employees and the military. It provides extensive information to government agencies, military veterans, former federal employees, family members, as well as researchers and historians. As an example of union records center, there is the Chinese Union Dangansil. It was established by several institutions and organizations, so united management of records can be performed and human efforts and facilities can be saved. We should establish a professional and united records center which manages drawings of metropolitan rapid transit and provides service to researchers and the public as well as members of the related institutions. This study can be an impetus to improve interest on management of not only drawings of metropolitan rapid transit but also drawings of various public facilities.
Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
Journal of the Korean Orthopaedic Association
/
v.54
no.3
/
pp.244-253
/
2019
Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.
Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.
Chang, Joon;Michael, John R.;Kim, Se-Kyu;Kim, Sung-Kyu;Lee, Won-Young;Kang, Kyung-Ho;Yoo, Se-Hwa;Chae, Yang-Seok
Tuberculosis and Respiratory Diseases
/
v.45
no.6
/
pp.1265-1276
/
1998
Background : Nitric oxide(NO) is an endogenously produced free radical that plays an important role in regulating vascular tone, inhibition of platelet aggregation and white blood cell adhesion to endothelial cells, and host defense against infection. The highly reactive nature of NO with oxygen radicals suggests that it may either promote or reduce oxidant-induced cell injury in several biological pathways. Oxidant injury and interactions between pulmonary vascular endothelium and leukocytes are important in the pathogenesis of acute lung injury, including acute respiratory distress syndrome(ARDS). In ARDS, therapeutic administration of NO is a clinical condition providing exogenous NO in oxidant-induced endothelial injury. The role of exogenous NO from NO donor or the suppression of endogenous NO production was evaluated in oxidant-induced endothelial injury. Method : The oxidant injury in cultured rat lung microvascular endothelial cells(RLMVC) was induced by hydrogen peroxide generated from glucose oxidase(GO). Cell injury was evaluated by $^{51}$chromium($^{51}Cr$) release technique. NO donor, such as S-nitroso-N-acetylpenicillamine(SNAP) or sodium nitroprusside(SNP), was added to the endothelial cells as a source of exogenous NO. Endogenous production of NO was suppressed with N-monomethyl-L-arginine(L-NMMA) which is an NO synthase inhibitor. L-NMMA was also used in increased endogenous NO production induced by combined stimulation with interferon-$\gamma$(INF-$\gamma$), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and lipopolysaccharide(LPS). NO generation from NO donor or from the endothelial cells was evaluated by measuring nitrite concentration. Result : $^{51}Cr$ release was $8.7{\pm}0.5%$ in GO 5 mU/ml, $14.4{\pm}2.9%$ in GO 10 mU/ml, $32.3{\pm}2.9%$ in GO 15 mU/ml, $55.5{\pm}0.3%$ in GO 20 mU/ml and $67.8{\pm}0.9%$ in GO 30 mU/ml ; it was significantly increased in GO 15 mU/ml or higher concentrations when compared with $9.6{\pm}0.7%$ in control(p < 0.05; n=6). L-NMMA(0.5 mM) did not affect the $^{51}Cr$ release by GO. Nitrite concentration was increased to $3.9{\pm}0.3\;{\mu}M$ in culture media of RLMVC treated with INF-$\gamma$ (500 U/ml), TNF-$\alpha$(150 U/ml) and LPS($1\;{\mu}g/ml$) for 24 hours ; it was significantly suppressed by the addition of L-NMMA. The presence of L-NMMA did not affect $^{51}Cr$ release induced by GO in RLMVC pretreated with INF-$\gamma$, TNF-$\alpha$ and LPS. The increase of $^{51}Cr$ release with GO(20 mU/ml) was prevented completely by adding 100 ${\mu}M$ SNAP. But the add of SNP, potassium ferrocyanate or potassium ferricyanate did not protect the oxidant injury. Nitrite accumulation was $23{\pm}1.0\;{\mu}M$ from 100 ${\mu}M$ SNAP at 4 hours in phenol red free Hanks' balanced salt solution. But nitrite was not detectable from SNP upto 1 mM The presence of SNAP did not affect the time dependent generation of hydrogen peroxide by GO in phenol red free Hanks' balanced salt solution. Conclusion : Hydrogen peroxide generated by GO causes oxidant injury in RLMVC. Exogenous NO from NO donor prevents oxidant injury, and the protective effect may be related to the ability to release NO. These results suggest that the exogenous NO may be protective on oxidant injury to the endothelium.
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