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Historical Studies on the Characteristics of Buyongjeong in the Rear Garden of Changdeok Palace (창덕궁 후원 부용정(芙蓉亭)의 조영사적 특성)

  • Song, Suk-ho;Sim, Woo-kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.40-52
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    • 2016
  • Buyongjeong, a pavilion in the Rear Garden of Changdeok Palace, was appointed as Treasure No. 1763 on March 2, 2012, by the South Korea government since it shows significant symmetry and proportion on its unique planar shape, spatial configuration, building decoration, and so forth. However, the designation of Treasure selection was mainly evaluated by concrete science, in that the selection has not clearly articulated how and why Buoungjeong was constructed as a present unique form. Therefore, this study aims to clarify the identity of Buyongjeong at the time of construction by considering its historical, ideological, philosophical background and building intention. Summary are as follows: First, Construction backgrounds and characters of Buyongjeong: Right after the enthronement, King Jeongjo had founded Kyujanggak(奎章閣), and sponsored civil ministers who were elected by the national examination, as a part of political reform. In addition, he established his own political system by respecting "Kaksin(閣臣)", Kyujanggak's officials as much as "Kain(家人)", internal family members. King Jeongjo's aggressive political reform finally enabled King's lieges to visit King's Rear Garden. In the reign of King Jeongjo's 16th year(1792), Naekaksangjohoe(內閣賞釣會) based on "Kaksin" was officially launched and the Rear Garden visitation became a regular meeting. The Rear Garden visitation consisted of "Sanghwajoeoyeon(賞花釣魚宴)" - enjoying flowers and fishing, and activities of "Nanjeongsugye". Afterward, it eventually became a huge national event since high rank government officials participated the event. King Jeongjo shared the cultural activities with government officials together to Buyongjeong as a place to fulfill his royal politics. Second, The geographical location and spatial characteristics of Buyongjeong: On the enthronement of King Jeongjo(1776), he renovated Taeksujae. Above all, aligning and linking Gaeyuwa - Taeksujae - a cicular island - Eosumun - Kyujangkak along with the construction axis is an evidence for King Jeongjo to determine how the current Kyujangkak zone was prepared and designed to fulfill King Jeonjo's political ideals. In 17th year(1793) of the reign of King Jeongjo, Taeksujae, originally a square shaped pavilion, was modified and expanded with ranks to provide a place to get along with the King and officials. The northern part of Buyongjeong, placed on pond, was designed for the King's place and constructed one rank higher than others. Discernment on windows and doors were made with "Ajasal" - a special pattern for the King. The western and eastern parts were for government officials. The center part was prepared for a place where government officials were granted an audience with the King, who was located in the nortern part of Buyongjeong. Government officials from the western and eastern parts of Buyongjeong, could enter the central part of the Buyongjeong from the southern part by detouring the corner of Buyongjeong. After all, Buyongjeong is a specially designed garden building, which was constructed to be a royal palace utilizing its minimal space. Third, Cultural Values of Buyongjeong: The Buyongjeong area exhibits a trait that it had been continuously developed and it had reflected complex King's private garden cultures from King Sejo, Injo, Hyunjong, Sukjong, Jeongjo and so forth. In particular, King Jeongjo had succeded physical, social and imaginary environments established by former kings and invited their government officials for his royal politics. As a central place for his royal politics, King Jeongjo completed Buyongjeong. Therefore, the value of Buyongjeong, as a garden building reflecting permanency of the Joseon Dynasty, can be highly evaluated. In addition, as it reflects Confucianism in the pavilion - represented by distinguishing hierarchical ranks, it is a unique example to exhibit its distinctiveness in a royal garden.

Image Watermarking for Copyright Protection of Images on Shopping Mall (쇼핑몰 이미지 저작권보호를 위한 영상 워터마킹)

  • Bae, Kyoung-Yul
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.147-157
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    • 2013
  • With the advent of the digital environment that can be accessed anytime, anywhere with the introduction of high-speed network, the free distribution and use of digital content were made possible. Ironically this environment is raising a variety of copyright infringement, and product images used in the online shopping mall are pirated frequently. There are many controversial issues whether shopping mall images are creative works or not. According to Supreme Court's decision in 2001, to ad pictures taken with ham products is simply a clone of the appearance of objects to deliver nothing but the decision was not only creative expression. But for the photographer's losses recognized in the advertising photo shoot takes the typical cost was estimated damages. According to Seoul District Court precedents in 2003, if there are the photographer's personality and creativity in the selection of the subject, the composition of the set, the direction and amount of light control, set the angle of the camera, shutter speed, shutter chance, other shooting methods for capturing, developing and printing process, the works should be protected by copyright law by the Court's sentence. In order to receive copyright protection of the shopping mall images by the law, it is simply not to convey the status of the product, the photographer's personality and creativity can be recognized that it requires effort. Accordingly, the cost of making the mall image increases, and the necessity for copyright protection becomes higher. The product images of the online shopping mall have a very unique configuration unlike the general pictures such as portraits and landscape photos and, therefore, the general image watermarking technique can not satisfy the requirements of the image watermarking. Because background of product images commonly used in shopping malls is white or black, or gray scale (gradient) color, it is difficult to utilize the space to embed a watermark and the area is very sensitive even a slight change. In this paper, the characteristics of images used in shopping malls are analyzed and a watermarking technology which is suitable to the shopping mall images is proposed. The proposed image watermarking technology divide a product image into smaller blocks, and the corresponding blocks are transformed by DCT (Discrete Cosine Transform), and then the watermark information was inserted into images using quantization of DCT coefficients. Because uniform treatment of the DCT coefficients for quantization cause visual blocking artifacts, the proposed algorithm used weighted mask which quantizes finely the coefficients located block boundaries and coarsely the coefficients located center area of the block. This mask improves subjective visual quality as well as the objective quality of the images. In addition, in order to improve the safety of the algorithm, the blocks which is embedded the watermark are randomly selected and the turbo code is used to reduce the BER when extracting the watermark. The PSNR(Peak Signal to Noise Ratio) of the shopping mall image watermarked by the proposed algorithm is 40.7~48.5[dB] and BER(Bit Error Rate) after JPEG with QF = 70 is 0. This means the watermarked image is high quality and the algorithm is robust to JPEG compression that is used generally at the online shopping malls. Also, for 40% change in size and 40 degrees of rotation, the BER is 0. In general, the shopping malls are used compressed images with QF which is higher than 90. Because the pirated image is used to replicate from original image, the proposed algorithm can identify the copyright infringement in the most cases. As shown the experimental results, the proposed algorithm is suitable to the shopping mall images with simple background. However, the future study should be carried out to enhance the robustness of the proposed algorithm because the robustness loss is occurred after mask process.

Analysis of Stromal Cells Developed from Cord Blood CD34+ Cells (제대혈 CD34+ 세포에서 유래된 지지세포의 분석)

  • Ryu, Kyung-Ha;Park, Se-Jin;Kim, Kyung Hyo;Seoh, Ju-Young;Khan, Mohammad;Shin, Hee-Young;Ahn, Hyo-Seop
    • IMMUNE NETWORK
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    • v.1 no.1
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    • pp.87-94
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    • 2001
  • Background: Cytokine-mediated ex vivo expansion has been proposed as a means of increasing the number of cord blood (CB) hematopoietic stem cells for transplantation. As well as stem cell number, stromal cells are necessary for functional maturation of hematopoiesis. The purpose of this study was to analyze the development of stromal cells during ex vivo expansion of CB $CD34^+$ cells. Methods : $CD34^+$ cells were purified from CB by magnetic bead selection. The levels of of interleukin-3, interleukin-$1{\beta}$, interleukin-6, granulocyte macrophagecolony stimulating factor and tumor necrosis factor-${\alpha}$ were measured in culture supernatants on 0, 1, 2, and 3 weeks, using ELISA techniques. CB $CD34^+$ cells were expanded in Iscoves modified Dulbeccos medium in the presence of several cytokines. The expression of E-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, platelet/endothelial cell adhesion molecule-1, von Willebrand factor, vimentin, and CD14 in newly developed stromal cells was examined by immunocytochemical method. Relevant extracellular matrix (ECM) proteins and proper cytokines were also assayed for the most suitable condition for expansion of stromal cells. Results: Several cytokines were found to have been produced by CB $CD34^+$ cells as well as bone marrow-derived $CD34^+$ cells. During ex vivo expansion of CB $CD34^+$ cells, stromal cells appeared in the culture by day 4 and expanded over the following 7-10 days before being confluent by day 2 1. These cells expressed surface markers characteristic of cells of endothelial lineage. Furthermore, these stroaml cells also expanded effectively when treated with thrombopoietin+flt-3 ligand+stem cell factor+leukemia inhibitory factor or 0.1% poly-L-lysine-coated wells. Conclusion: Stromal cells were developed during ex vivo expansion of CB $CD34^+$ cells and that this development could be enhanced further by treating the stromal cells with cytokines or ECM.

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Five Most Common Prognostically Important Fusion Oncogenes are Detected in the Majority of Pakistani Pediatric Acute Lymphoblastic Leukemia Patients and are Strongly Associated with Disease Biology and Treatment Outcome

  • Awan, Tashfeen;Iqbal, Zafar;Aleem, Aamer;Sabir, Noreen;Absar, Muhammad;Rasool, Mahmood;Tahir, Ammara H.;Basit, Sulman;Khalid, Ahmad Mukhtar;Sabar, Muhammad Farooq;Asad, Sultan;Ali, Agha Shabbir;Mahmood, Amer;Akram, Muhammad;Saeed, Tariq;Saleem, Arsalan;Mohsin, Danish;Shah, Ijaz Hussain;Khalid, Muhammad;Asif, Muhammad;Haq, Riazul;Iqbal, Mudassar;Akhtar, Tanveer
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5469-5475
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    • 2012
  • Background and Objectives: Acute lymphoblastic leukemia (ALL) is a complex genetic disease involving many fusion oncogenes (FO) having prognostic significance. The frequency of various FO can vary in different ethnic groups, with important implications for prognosis, drug selection and treatment outcome. Method: We studied fusion oncogenes in 101 pediatric ALL patients using interphase FISH and RT-PCR, and their associations with clinical features and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL t (22; 9), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (del 1p32) were found in 89/101 (88.1%) patients. Frequency of BCR-ABL was 44.5% (45/101). BCR-ABL positive patients had a significantly lower survival ($43.7{\pm}4.24$ weeks) and higher white cell count as compared to others, except patients with MLL-AF4. The highest relapse-free survival was documented with ETV6-RUNX1 (14.2 months) followed closely by those cases in which no gene was detected (13.100). RFS with BCR-ABL, MLL-AF4, TCF3-PBX1 and SIL-TAL1 was less than 10 months (8.0, 3.6, 5.5 and 8.1 months, respectively). Conclusions: This is the first study from Pakistan correlating molecular markers with disease biology and treatment outcome in pediatric ALL. It revealed the highest reported frequency of BCR-ABL FO in pediatric ALL, associated with poor overall survival. Our data indicate an immediate need for incorporation of tyrosine kinase inhibitors in the treatment of BCR-ABL+ pediatric ALL in this population and the development of facilities for stem cell transplantation.

The Selection of Proper Resource and Change of Salinity in Helianthus tuberosus L. Cultivated in Saemangeum Reclaimed Tidal Land (새만금간척지에서 뚱딴지(Helianthus tuberosus L.) 재배시 염류 특성 변화 및 적정 자원 선발)

  • Oh, Yang-Yeol;Lee, Jung-Tae;Hong, Ha-Cheol;Kim, Jae-Hyun;Seo, Woo-Duck;Kim, Sun;Ryu, Jin-Hee;Lee, Su-Hwan;Kim, Young-Joo
    • Korean Journal of Environmental Agriculture
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    • v.37 no.2
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    • pp.73-78
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    • 2018
  • BACKGROUND: Soil salinity of reclaimed tidal land in Korea is highly important factor. High salinity is harmful to crop productivity. Jerusalem artichoke (Helianthus tuberosus L.) is known to be salt-tolerant and has high adaptability to diverse pedo-climatic conditions. The objective of this study was to assess the changes of soil properties and crop productivity according to salt concentration in the reclaimed tidal lands. METHODS AND RESULTS: Experimental sites were selected at Saemangeum ($35^{\circ}46^{\prime}N$, $126^{\circ}37^{\prime}E$) reclaimed tidal land, and their dominant soil series were Munpo (coarse loamy, mixed, non-acid, mesic, typic Fluvaquents). H. tuberosus L were collected from 12 locations across Korea. Tubers were planted at $75{\times}25cm$ with EC 2 to $7dS\;m^{-1}$. Soil samples were periodically collected from both 0~20 cm and 20~40 cm depths of each site. Soil salinity and soil moisture contents were varied depending on weather conditions. Soil electrical conductivity varied from 1.0 to $5.9dS\;m^{-1}$, and soil moisture contents varied from 9.2 to 28.7%. The white-colored tubers of H. tuberosus L. collected from 'Yeongwol-gun' exhibited the highest height (207 cm), followed by the white-colored tubers of H. tuberosus L. collected from 'Iksan-si'(202 cm). The white-colored tubers of H. tuberosus L. collected from 'GyeongJu-si' showed the highest yield (549 kg/10a). The purple-colored tubers of H. tuberosus L. collected from 'Yeongwol-gun' showed the highest yield (615 kg/10a). CONCLUSION: Our results indicate that the plant height and tuber yield did not appear to be correlated. Considering yield and inulin content, the GyeongJu-si seemed to be suitable as the white-colored tubers of H. tuberosus L. and the Yeongwol-gun seemed to be suitable as the purple-colored tubers of H. tuberosus L. in the reclaimed tidal lands. However, it is necessary to consider the relationship between the inulin content and the yield.

Selection of Reference Equations for Lung Volumes and Diffusing Capacity in Korea (우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정)

  • Song, Eun Hee;Oh, Yeon Mok;Hong, Sang Bum;Shim, Tae Sun;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Kim, Tae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.218-226
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    • 2006
  • Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject's age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC's equation in males (sum of residual: 0.04 L) and Crapo/Morris's equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake's equation in males (sum of residual: -2.35) and the ECSC's equation -4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca's equation in males (sum of residual: -13.66 ml/min/mmHg) and Park's in women (25.08) in Hanyang University Guri hospital and Park's equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC's equation can be used for estimating the lung volume and Park's can be used for estimating the diffusing capacity.

The Persuit of Rationality and the Mathematics Education (합리성의 추구와 수학교육)

  • Kang Wan
    • The Mathematical Education
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    • v.24 no.2
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    • pp.105-116
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    • 1986
  • For any thought and knowledge, its growth and development has close relation with the society where it is developed and grow. As Feuerbach says, the birth of spirit needs an existence of two human beings, i. e. the social background, as well as the birth of body does. But, at the educational viewpoint, the spread and the growth of such a thought or knowledge that influence favorably the development of a society must be also considered. We would discuss the goal and the function of mathematics education in relation with the prosperity of a technological civilization. But, the goal and the function are not unrelated with the spiritual culture which is basis of the technological civilization. Most societies of today can be called open democratic societies or societies which are at least standing such. The concept of rationality in such societies is a methodological principle which completes the democratic society. At the same time, it is asserted as an educational value concept which explains comprehensively the standpoint and the attitude of one who is educated in such a society. Especially, we can considered the cultivation of a mathematical thinking or a logical thinking in the goal of mathematics education as a concept which is included in such an educational value concept. The use of the concept of rationality depends on various viewpoints and criterions. We can analyze the concept of rationality at two aspects, one is the aspect of human behavior and the other is that of human belief or knowledge. Generally speaking, the rationality in human behavior means a problem solving power or a reasoning power as an instrument, i. e. the human economical cast of mind. But, the conceptual condition like this cannot include value concept. On the other hand, the rationality in human knowledge is related with the problem of rationality in human belief. For any statement which represents a certain sort of knowledge, its universal validity cannot be assured. The statements of value judgment which represent the philosophical knowledge cannot but relate to the argument on the rationality in human belief, because their finality do not easily turn out to be true or false. The positive statements in science also relate to the argument on the rationality in human belief, because there are no necessary relations between the proposition which states the all-pervasive rule and the proposition which is induced from the results of observation. Especially, the logical statement in logic or mathematics resolves itself into a question of the rationality in human belief after all, because all the logical proposition have their logical propriety in a certain deductive system which must start from some axioms, and the selection and construction of an axiomatic system cannot but depend on the belief of a man himself. Thus, we can conclude that a question of the rationality in knowledge or belief is a question of the rationality both in the content of belief or knowledge and in the process where one holds his own belief. And the rationality of both the content and the process is namely an deal form of a human ability and attitude in one's rational behavior. Considering the advancement of mathematical knowledge, we can say that mathematics is a good example which reflects such a human rationality, i. e. the human ability and attitude. By this property of mathematics itself, mathematics is deeply rooted as a good. subject which as needed in moulding the ability and attitude of a rational person who contributes to the development of the open democratic society he belongs to. But, it is needed to analyze the practicing and pursuing the rationality especially in mathematics education. Mathematics teacher must aim the rationality of process where the mathematical belief is maintained. In fact, there is no problem in the rationality of content as long the mathematics teacher does not draw mathematical conclusions without bases. But, in the mathematical activities he presents in his class, mathematics teacher must be able to show hem together with what even his own belief on the efficiency and propriety of mathematical activites can be altered and advanced by a new thinking or new experiences.

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A Clinical Effect of Ofloxacin, Prothionamide, Cycloserine Streptomycin(Kanamycin or Tuberactinomycin) in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 Ofloxacin, Prothionamide, Cycloserine, Streptomycin(Kanamycin or Tuberactinomycin) 4제요법의 임상 효과)

  • Song, Ju-Young;Yoo, Min-Kyu;Hong, Jae-Rack;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.295-301
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    • 1995
  • Background: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. Results: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. Conclusion: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.

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The Influence of Perception and Attitudes of Inpatients Towards the Activation of Private Health Insurance (민간의료보험 활성화에 대한 입원환자의 인식 및 태도에 미치는 영향 - 서울시내 일개 종합병원을 대상으로 -)

  • Yoon, Soo-Jin;Kim, Seong-Ju;Yu, Seung-Hum;Oh, Hyohn-Joo
    • Korea Journal of Hospital Management
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    • v.13 no.1
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    • pp.24-41
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    • 2008
  • This research is aimed at analyzing and understanding the perception and attitudes of inpatients in a general hospital in Seoul towards the activation of private health insurance. Survey was conducted against 231 inpatients, results of which were analyzed in the methods of frequency analysis, chi square test, and logistic regression. The results are summarized as follows; First, better-educated population who finished college education at least, higher-income population, and people who had more knowledge about private health insurance showed more perception about activation of private health insurance. Second, better-educated population who finished college education at least, higher-income population, those who are insured in existing private insurance, oncological patients, and people who had more knowledge about private health insurance showed more positive attitude towards private health insurance paying for actual damages, long-term care insurance, and income security insurance. Third, age and education were the factors affecting perception about activation of private health insurance. The older the age is, perception was 1.035 times positive towards activation of private health insurance, and those who finished college education or above showed 3.148 times positive perception towards the same. Forth, surgical patients showed 1.087 times more positive attitude towards private health insurance paying for actual damages than internal medicine patients, while oncological patients showed 2.314 times more positive attitude than internal medicine patients. Further, understanding on the activation of private health insurance was 6.014 times higher in the higher understanding group than in the lower understanding group. Intention to use long-term care insurance was 2.692 times stronger in the male group than in the female group, and 3.616 times stronger in the oncological patients group than in internal medicine patients group. Further, understanding on the activation of private health insurance was 3.881 times deeper in the higher understanding group than in the lower understanding group. Intention to use income security insurance was 3.185 times stronger in those who have academic background of under the high school than those over the college, and 4.175 times higher in the group those whose monthly average income is over 4 million won than those under 4 million won. Also, intention to use income security insurance was 4.323 times higher in the group those who are insured by existing private insurances than those who are not insured by those insurances and it was 5.234 times higher in the group of oncological patients than in the group of internal medicine patients. Further, intention to use income security insurance was 3.559 times higher in the group those who thought that out-of-pocket money of the National Health Insurance is too much to bear than those it is quite endurable. Understanding on the activation of private health insurance was 4.875 times deeper in the higher understanding group than in the lower understanding group. There were some suggestions could be made based on the results of this research. First, reinforced publicity and education is needed for the low-educated or low-income group, as there are gaps in the understanding on the activation of private health insurance depending on the degree of education and income. Second, government should prepare administrative complementary measures to solve the problem of adverse selection by the consumer which is foreseen when private health insurances are activated. Third, government should suggest the desirable course of development of private health insurance items to ensure efficient use of enormous fund of private insurance market for health security of the people. Further, institutional complementary measures are needed to convert existing cancer insurances or specific disease insurances to private health insurances paying for actual damages guaranteeing against every kind of disease. Forth, it judged that, not only private health insurances paying for actual damages, but also long-term care insurances and income security insurances are prospective as fields to create fresh demand for insurance industry.

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Risk factors of Pneumonectomy in Non-Small Cell Lung Cancer (비소세포폐암에시 전폐절제술의 위험 인자)

  • Hwang Eun-Gu;Baek Heejong;Lee Hae-Won;Park Jong-Ho;Zo Jae-Ill
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.616-621
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    • 2005
  • Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.