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Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

Studies on the Inheritance of Heading Date in Wheat(Triticum aestivum L. em Thell) (소맥(Triticum aestivum L. em Thell)의 출수기 유전에 관한 연구)

  • Chang-Hwan Cho
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.15
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    • pp.1-31
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    • 1974
  • Introducing genes for earliness of wheat varieties is important to develop early varieties in winter wheat. In oder to obtain basic informations on the response of heading to the different day length and temperature treatments and on the inheritance of heading dates, experiments were conducted at the field and greenhouse of the Crop Experiment Station, Suwon. Varieties used in this experiments were, early variety Yecora F70, medium varieties Suke #169, Parker and Yukseung #3, and late varieties Changkwang, Bezostaia, Sturdy and Blueboy. The parents and F$_1$s of partial diallel crosses of above eight varieties were subjected the following four different treatments; 1. high temperature and long day, 2. high temperature and short day, 3. low temperature and long day, and 4. low temperature and short day. The same materials were grown also in field condition. Parents, F$_1$ and F$_2$ generation were grown also in both greenhouse under high temperature and short day and in field. The results obtained were summarized as follow: 1. No effects of temperature and daylength on the number of leaves on the main stem were found when -varieties were vernalized. The number of main stem leaves were fewer for spring type of varieties than for winter type of varieties. 2. The effects of temperature and daylength on the days to flag leaf opening were dependent on the speed of leaf emergence. The speed of leaf emergence were faster for lower leaves than for upper leaves. 3. The response to short day and long day (earliness of narrow sense) of varieties were found to be direct factor responsible to physiology of heading dates in vernalized varieties. Great difference of varieties to heading date was found in high temperature and short day treatment, but less differences were found in high temperature and long day, low temperature and long day and low temperature and short day treatments respectively. The least varietal difference for heading dates was found in the field condition. 4. Changkwang and Parker were found to be the most sensitive to short day treatment (photosensitive) and the heading of these varieties were delayed by short day treatment. No great varietal differences were found among other varieties. 5. Varietal differences of heading dates due to daylength were greater in high temperature than in low temperature. 6. Varietal differences of heading dates due to temperature were not great. but in general the heading dates of varieties were faster under high temperature than under low temperature. 7. Earliness of heading dates was due to partial dominance effect of genes involved in any condition. The degree of dominance was greater under short day than under long day treatment. 8. The varietal differences of heading date under high temperature and long day were due to earliness or narrow sense (response to long day) of varieties. The degree of dominance was greater for Yecora F70, spring type than for other winter type of varieties. No differences or less differences of degree of dominance was found among winter type of varieties. The estimated number of effective factor concerned in the earliness of narrow sense was one pair of allele with minor genes. 9. The insensitivity of varieties to short day treatment in heading dates was due to single dominant gene effect. Under the low temperature the sensitivity of varieties to short day treatment was less apparent. 10. The earliness of short day and long day (earliness of narrow sense) sensitivities of varieties appearea to be due to partial dominance of earliness over lateness. In strict sense, the degree of the dominance should be distinguished. 11. Dominant gene effects were found for the thermo-sensitivity of varieties, and the effect was less, significant than the earliness in narrow sense. 12. One pair of allele, ee and EE, for photosensitivity was responsible for the difference in the heading dates between Changkwang and Suke #169. Two pairs of alleles, ee, enen and EE, EnEn. appeared to be responsible for the difference between Changkwang and Yecora F70. The effects of EE and EnEn were, additive to the earliness and the effects of EE were greater than EnEn under short day. However, the effects of EE were not evident in long day but the effects of EnEn were observed in long day. 13. Two pairs of dominant alleles for the earliness were estimated from the analysis of F$_1$ diallels in the field but the effects of these alleles in F$_2$ were not apparent due to low temperature and short day treatment in early part of growth and high temperature and long day treatment in later part of growth. The F$_2$ population shows continuous variation due to environmental effects and due to other minor gene effects. 14. The heritabilities for heading dates were ranged from 0.51 to 0.72, indicating that the selection in early generation might be effective. The extent of heritability for heading dates varied with environments; higher magnitude of heritability was obtained in short day treatment and high temperature compared with long day and low temperature treatments. The heritabilities of heading date due to response to short day were 0.86 in high temperature and 0.76 in low temperature. The heritabilities of heading date due to temperature were not significantly high. 15. The correlation coefficients of heading dates to the number of grains per spike, weight of 1, 000 grains. and grain yield were positive and high, indicating the difficulties of selections of high yielding lines from early population. But no significant correlation coefficient was obtained between the earliness and the number of spikes, indicating the effective selection for high tillering from early varieties for high yielding.

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Recognition Level of Organization, Motivation and Job Satisfaction Factors of the Staff of Health Centers (보건소직원의 조직에 대한 인식과 동기부여요인 및 직무만족요인)

  • 남철현;위광복
    • Health Policy and Management
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    • v.10 no.3
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    • pp.19-49
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    • 2000
  • This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

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Studies on the Utilization of Woodland for Livestock Farming II. Problem and Its Improvement Followed by the Join Cattle Grazing in king Won Do (임지의 축산적 이용에 관한 연구 제2보. 강원도의 새마을 "소" 임간공동방목사업의 문제점과 개선책)

  • 맹원재;윤익석;유제창;정승헌
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.3 no.2
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    • pp.100-111
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    • 1983
  • The research results reported herein had the objectives to understand and analyze the present problems of saemaeul woodland joint cattle grazing system in Kang Won Do and to take steps of improvement. The study results on actual management conditions, problems analyzed and improvement plan of total 208 joint cattle grazing area which was established 105 area in 1981 and 103 area in 1982 were summarized as follows: 1. the effectiveness of joint cattle grazing projects 1) Average daily weight gain of cattle during joint cattle grazing period was 0.4kg, showing higher daily than the conventional feeding of 0.33kg. 2) Increase of total farm income over the conventional feeding system were \1,031,357,320 during the grazing period from May to October in 1982 by adapting the 208 joint cattle grazing system, of which effectiveness of weight gain was \293,075,300 and labor saving was \543,838,750. 3) According to the results of questionaire investigation from 208 joint cattle grazing area, effectiveness of joint cattle grazing system over the conventional system were (1) labor saving, (2) feed cost saving, (3) reduced diseases, (4) increase of number of feeding, (5) inspiration of joint endeavor, (6) effect of more gain, (7) easiness of feeding and feed cost savings. 2. Problems of joint cattle grazing system. 1) Shortages of grass were a problem at second year of joint cattle grazing period due to the low regrowth rate of wild grass. 2) Proper land for woodland joint cattle grazing is belonging to land of Government ownership and it is very hard to get the permission from office of forestry for cattle grazing purpose. 3) It is also difficult to find a proper time of breeding in grazing area by the difficulty of estrus detection. 4) There are a difficulty to give a proper vaccination and medical examination for the grazing cattle. 3. Improvement plans for woodland joint cattle grazing projects. 1) Obtain sufficient roughages by hoof cultivation and oversowing pasture from the second year of joint cattle grazing period. 2) In order to increase the beef production and to use for a calf production area, Government should arrange that all proper grazing land of Government owned in Kang Won Do convert into woodland joint cattle grazing area. 3) Make a good reproductive record by mixed grazing with a excellent breeding cow in a remote area. And carry out the collective artificial insemination with synchronous puberty induced by injection of puberty stimulation hormone. 4) Make a preventive injection for blackleg, twice medication of fasciola hepatica in a year, and spray and medication of tick insecticide. 4. A policy towards upbringing of woodland joint cattle grazing area. 1) Government should thoroughly investigate about a proper land for woodland joint cattle grazing from all forests. 2) When the area is suitable for the woodland joint cattle grazing, though it is national forest or restricted area, government should make it possible to establish a grazing area. 3) On the proper land foe joint cattle grazing in the remote place, Government should support for the road construction and electric fence equipments by using of national funds. 4) There should be an administrative consideration for well promotion of the project that make woodland joint cattle grazing suitable to the characteristics of Kang Won Do. 5) In order to improve the reproduction record, Government should reform the insufficiency of artificial insemination in the joint cattle grazing area. 6) In order to maintain a proper price of cow, Government should carry out the price plan. 7) When there is any request for grassland formation in the woodland joint cattle grazing area, Government should permit it with preference.

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Effects of Taeumin, Soeumin and Soyangin Prescriptions on the Adipocyte Induced by Gold Thioglucose in the Rat (태(太)·소음인(少陰人), 소양인(少陽人)의 처방(處方)이 Gold thioglucose로 유발(誘發)된 백서(白鼠)의 비만병(肥滿病)에 미치는 효과(效果))

  • Kim, Kyung-Yo
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.295-317
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    • 1996
  • It is researched to elucidate the effects of Taeumjowuitang(TE,太陰調胃湯), Sibimikwanjungtang(SE, 十二味寬中湯) and Yangkeogsanwhatang(SY,凉膈散火湯) on the obesity induced by gold thioglucose and the differentiation and growth of preadipocyte 3T3-L1 in the mouse. The result were as follows: 1. TE,SE and SY extracts improved the blood level of transaminase in the obese mouse induced by gold thioglucose. 2. TE,SE and SY extracts inhibited the increase of liver fat and body fat in the obese mouse induced by gold thioglucose. 3. TE,SE and SY extracts inhibited the increase of body weight in the obese mouse induced by gold thioglucose. 4. TE,SE and SY extracts inhibited the growth of undifferentiate preadipocyte 3T3-L1. 5. TE,SE and SY extracts showed inhibitory effect on the differentiation of preadipocyte 3T3-L1. The above results suggest that the TE,SE and SY extracts may be used on the obesity induced by the overgrowth and differentiation of adipocyte, and the accumulation of fat in liver and body.

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Study on the Radial Variation of Structural Element in the Diffuse-Porous Woods (주요산공재(主要散孔材) 구성요소(構成要素)의 방사방향(放射方向) 변동(變動)에 관한 연구(硏究))

  • Han, Cheol-Soo
    • Journal of the Korean Wood Science and Technology
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    • v.15 no.2
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    • pp.26-52
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    • 1987
  • Among the diffuse-porous woods which arc dominant in Korea and used as construction materials due to their wood quality, ten species of six genus involving seven species of three genus in Betulaceae were studied on the radial variation of structural demenb. The species studied were Betula platyphylla var. japonica, B. ermanii, B. davurica, B. scstata, B. schmidtii, Carpinus laxifora, Alnus japonica, Prunus sargentii. Acer mono and Diospyros kaki. Wood fiber, vessel elements and ray increased rapidly in size from pith to a certain annual ring. After then the radial variation in size of the main structural elements seemed to be divided into three types; levelled off curve pattern indicating constant size(type I), continuously increasing curve pattern showing ever increase in size (type II) and parabolic curve pattern showing the gradual decrease after the maximum (type III), but the variation types by structural dements were different even in the same species. Based on the results from this study, it appears to be reasonable to consider the stabilized age of wood fiber, vessel elements and ray rather than considering wood fiber length in distinguishing mature woods from juvenile woods.

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Analysis of Management Status and Optimum Production Scale of Quarrying Firms in Korea -Comparative Analysis of Aggregate and Building-Stone Quarrying Firms- (산지채석업체(山地採石業體)의 경영실태(經營實態) 및 적정규모설정(適正規模設定) -골재용(骨材用) 채석업체(採石業體)와 건축용(建築用) 채석업체(採石業體)의 비교(比較) 분석(分析)-)

  • Joung, Ha Hyeon;Cho, Eung Hyouk
    • Journal of Korean Society of Forest Science
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    • v.80 no.1
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    • pp.72-81
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    • 1991
  • This study was carried out to provide necessary information for improving quarrying industry management in Korea. The results of the study are summarized as follows : 1. In aggregate and building-stone quarrying firms the managers over 40 years of age are 97% and 89.1%, the ones above education level of high school are 90% and 85% and the ones not more than 10 years of quarrying experience are 70% and 52%, respectively. Accordingly it can be pointed out that most of the managers of two types of firms are relatively old, have high educational background, while quarrying experiences of building-stone firm managers are longer than that of aggregate firm managers. 2. Most of the management forms are social corporation(60%) for aggregate quarry firms and private management(76%) for building-stone firms. Average areas of permitted stone-pits of aggregate and building-stone quarries are about 2.86ha and 1.66ha respectively. That is, aggregate quarrying firms are carried on a larger scale than building-stone quarrying firms. 3. The yearly average product of aggregate quarrying firms has increased steadily from $88.961m^3$ in 1985 to $144.028m^3$ in 1988, while, in case of building-stone quarry firms, it has significantly increased from $4.155m^3$ to $19.462m^3$ from 1985 to 1987, but reduced to $13.400m^3$ in 1988. Unstable production activities of building-stone quarrying firms may require continuous government support. 4. Major cost items are equipment rental, depreciation, salaries, repair, maintenance for aggregate quarrying firms, and salaries, depreciation, fuel, tax for building-stone quarrying firms. The yearly average rate of return is about 9.7% for aggregate quarry firms and 2.6% for building-stone quarry firms. It can be pointed out that aggregate quarrying firms is better managed than building-stone quarrying firms. 5. The production elasticity of salary for aggregate quarrying firms is 0.495, that of employees is 0.559, and that of capital service is 0.513. The sum of the elasticities is 1.257>1. Fur building-stone quarrying firms, that of employees is 0.492, that of variable costs is 0.192, and that of capital service is 0.498. The sum of elasticities is 1.172>1, thus denotes the increasing returns to scale for both types quarrying firms. 6. The ratio of marginal value product to opportunity cost of empolyees is 2.54, that of variable costs is 3.62, and that of capital service is 1.45, in aggregate quarrying firms. That of employees is 2.47, that is variable costs was 2.34, and that of capital service is 19.67 in building-stone quarrying firms. Therefore the critical factors for more expansion of management scale in aggregate quarrying firms are variable cost and employees, and are capital service in building-stone quarry ing firms. 7. The break-even points of stone sales are about 0.587 billion won and 0.22 billion won in aggregate and building-stone quarrying firms respectively. The optimum sales Level for profit maximization are about 2.0 billion and 0.5 billion in aggregate and building-stone quarry firms respectively.

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Internet Addiction in Adolescents and its Relation to Sleep and Depression (청소년의 인터넷 중독 : 수면, 우울과의 관련성)

  • Song, Ho-Kwang;Jeong, Mi-Hyang;Sung, Da-Jung;Jung, Jung-Kyung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Jin-Seong
    • Sleep Medicine and Psychophysiology
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    • v.17 no.2
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    • pp.100-108
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    • 2010
  • Objectives: "Internet-addiction" came into common use not only in clinical setting but also in everyday life. But, pathophysiology and diagnostic criteria of the internet addiction remain unknown. Because adolescents are in developing period, they might be vulnerable to the internet addiction, depression and sleep-related problem. The objectives of this study were to investigate the characteristics of internet addiction and its association with sleep pattern and depression in Korean adolescence. Methods: Subjects were 799 middle and high school students in Seoul, Korea. We administered a self-reported questionnaire including socio-demographic data, Korean versions of Young's Internet Addiction Scale (YIAS), Pittsburgh Sleep Quality Index (PS-QI), the Center for Epidemiologic Studies for Depression Scale (CES-D) and questions about internet using patterns. Data of 696 subjects were included in analysis. Chi-square tests were used to analyze proportional differences, and ANOVA with post-hoc tests were used to analyze differences among groups. Partial correlation analyses were performed to analyze the correlation of internet addiction with other variables (two-tailed, p<0.05). Results: Of the 696 participants (grade 2 of middle school; M2 135 vs. grade 1 of high school; H1 238 vs. grade 2 of high school; H2 323), 2.0% (n=14) were internet-addicted (IA), 27.7% (n=193) were over-using (OU) and 70.3% (n=489) were not-addicted (NA). The mean scores of YIAS, PSQI and CES-D scores were 35.24${\pm}$12.78, 5.53${\pm}$3.04 and 16.72${\pm}$8.69, respectively. In higher grade students, average total sleep time was shorter (M2 426.20${\pm}$67.68 min. vs. H1 380.47${\pm}$62.57 min. vs. H2 354.67${\pm}$73.37 min., F=51.909, p<0.001), and PSQI (4.69${\pm}$3.14 vs. 5.42${\pm}$3.15 vs. 5.97${\pm}$2.83, F=8.871, p<0.001) CES-D (13.53${\pm}$8.37 vs. 16.96${\pm}$8.24 vs. 17.87${\pm}$8.84, F=12.373, p<0.001) scores were higher than those of lower grade students. Comparing variables among IA, OU and NA groups, computer using time not for study (96.36${\pm}$63.31 min. vs. 134.92${\pm}$86.79 min. vs. 213.57${\pm}$136.87 min., F=34.287, p<0.001) and portable device using time not for study (84.22${\pm}$79.11 min. vs. 96.97${\pm}$91.89 min. vs. 152.31${\pm}$93.64 min., F= 5.400, p=0.005) were different among groups. PSQI (5.26${\pm}$2.97 vs. 6.08${\pm}$2.97 vs. 7.50${\pm}$4.41, F=8.218, p<0.001) and CES-D scores (15.40${\pm}$8.08 vs. 19.05${\pm}$8.42 vs. 30.43${\pm}$13.69, F=32.692, p<0.001) were also different among groups. YIAS score were correlated with computer using time not for study (r=0.356, p<0.001) and portable device using time not for study (r= 0.136, p<0.001). PSQI score (r=0.237, p<0.001) and CES-D score (r=0.332, p<0.001). YIAS score and PSQI score (r=0.131, p= 0.001), YIAS and CES-D score (r=0.265, p<0.001), PSQI score and CES-D score (r=0.357, p<0.001) were correlated each other. Conclusion: These results suggested that adolescents' internet-addiction was correlated with not only computer and portable device using time not for study but also depression and sleep-related problems. We should pay attention to depression and sleep-related problems, when evaluating internet-addiction in adolescents.

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The Predictable Factors for the Mortality of Fatal Asthma with Acute Respiratory Failure (호흡부전을 동반한 중증천식환자의 사망 예측 인자)

  • Park, Joo-Hun;Moon, Hee-Bom;Na, Joo-Ock;Song, Hun-Ho;Lim, Chae-Man;Lee, Moo-Song;Shim, Tae-Sun;Lee,, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.356-364
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    • 1999
  • Backgrounds: Previous reports have revealed a high morbidity and mortality in fatal asthma patients, especially those treated in the medical intensive care unit(MICU). But it has not been well known about the predictable factors for the mortality of fatal asthma(F A) with acute respiratory failure. In order to define the predictable factors for the mortality of FA at the admission to MICU, we analyzed the relationship between the clinical parameters and the prognosis of FA patients. Methods: A retrospective analysis of all medical records of 59 patients who had admitted for FA to MICU at a tertiary care MICU from January 1992 to March 1997 was performed. Results: Over all mortality rate was 32.2% and 43 patients were mechanically ventilated. In uni-variate analysis, the death group had significantly older age ($66.2{\pm}10.5$ vs. $51.0{\pm}18.8$ year), lower FVC($59.2{\pm}21.1$ vs. $77.6{\pm}23.3%$) and lower $FEV_1$($41.4{\pm}18.8$ vs. $61.l{\pm}23.30%$), and longer total ventilation time ($255.0{\pm}236.3$ vs. $98.1{\pm}120.4$ hour) (p<0.05) compared with the survival group (PFT: best value of recent 1 year). At MICU admission, there were no significant differences in vital signs, $PaCO_2$, $PaO_2/FiO_2$, and $AaDO_2$, in both groups. However, on the second day of MICU, the death group had significantly more rapid pulse rate ($121.6{\pm}22.3$ vs. $105.2{\pm}19.4$ rate/min), elevated $PaCO_2$ ($50.1{\pm}16.5$ vs. $41.8{\pm}12.2 mm Hg$), lower $PaO_2/FiO_2$, ($160.8{\pm}59.8$ vs. $256.6{\pm}78.3 mm Hg$), higher $AaDO_2$ ($181.5{\pm}79.7$ vs. $98.6{\pm}47.9 mm Hg$), and higher APACHE III score ($57.6{\pm}21.1$ vs. $20.3{\pm}13.2$) than survival group (p<0.05). The death group had more frequently associated with pneumonia and anoxic brain damage at admission, and had more frequently developed sepsis during disease progression than the survival group (p<0.05). Multi-variate analysis using APACHE III score and $PaO_2/FiO_2$, ratio on first and second day, age, sex, and pneumonia combined at admission revealed that APACHE III score (40) and $PaO_2/FiO_2$ ratio (<200) on second day were regarded as predictive factors for the mortality of fatal asthma (p<0.05). Conclusions: APACHE III score ($\geq$40) and $PaO_2/FiO_2$ ratio (<200) on the second day of MICU, which might reflect the response of treatment, rather than initially presented clinical parameters would be more important predictable factors of mortality in patients with FA.

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The Study in Objectification of the diagnosis of Sasang Constitution(According to Analysis of the Past Questionnaires) (사상체질진단(四象體質診斷)의 객관화(客觀化)에 관한 연구(硏究)(기존(旣存) 설문지(說問紙)의 분석(分析)을 중심(中心)으로))

  • Kim, Young-woo;Kim, Jong-won
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.151-183
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    • 1999
  • The object of this study was 200 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 9 months from Jan. 1999 to sept. 1999. We proceeded the judgment of Sasang Constitution according to 'Questionnaire of Sasang Constitution Classification (I)', and 'Questionnaire of Sasang Constitution Classification II(QSCCII)' and the diagnosis by a medical specialist. The following conclusion were made in comparison with Sasang Constitution and Questionnaire. 1. We selected the 84 subjects what had the statistical value out of the 196 subjects('Questionnaire of Sasang Constitution Classification (I)' had the 71 subjects and 'Questionnaire of Sasang Constitution Classification II(QSCCII)', had the 121 subjects). And we selected again the 73 subjects('Questionnaire of Sasang Constitution Classification (I)', had the 33 subjects and 'Questionnaire of Sasang Constitution Classification II (QSCC II)' had the 40 subjects) out of the 84 subjects, because it had a repeated subjects. 2. We made the Questionnaire what has the 85 subjects, including the subjects what was approved its statistical value by 'A CLINICAL STUDY OF THE JUDGMENT OF SASANG CONSTITUTION ACCORDING TO QUESTIONNAIRE' and 'A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION'. The subject what ask the physique and the body form was 7, the subject what ask the external appearance and the posture was 7, the subject what ask the habit and the character was 3, the subject what ask the physiology and the pathology was 3, the subject what ask the phenomenon that he has frequency was 4, the subject what ask the eating was 3, the subject what ask the symptom that he has frequency was 14, the subject what ask the work and the qualities-defects was 6, the subject what ask the friendly intercourse was 7, the subject what ask the usual mind was 5, the subject what ask the emotional inclination was I, the subject what ask the behavioral inclination was 10, the subject what ask the character was 15. 3. In the new Questionnaire, the subject what has relevance to Soyang was 84, the subject what has relevance to Soeum was 87, the subject what has relevance to Taeeum was 70. And we made the point of subject with the statistical ratio. The total point of Soyang was 7785.04, the total point of Soeum was 7742.80, the total point of Taeeum was 7746.60. 4. As a result of judgment of Sasang Constitution between the clinical diagnosis by a medical specialist and the new Questionnaire, the diagnostic accuracy of new Questionnaire was 73.33%. The diagnostic accuracy of Soyang was low, the others was high. And the Taeyang was excepted.

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