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

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

• Journal of Gastric Cancer
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• v.10 no.1
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• pp.1-4
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• 2010

Purpose: Gastric epithelial dysplasia (GED) was defined as "unequivocally neoplastic epithelium that may be associated with or give rise to invasive adenocarcinoma" and GED also represents a direct precursor of intestinal type adenocarcinoma of the stomach. The recommended treatment guidelines for GED in the medical literature are endoscopic mucosal resection (EMR) or surgery for high grade dysplasia (HGD) and annual endoscopic surveillance with biopsy for low grade dysplasia (LGD) The aim of this study was to determine the treatment plan for GED that is diagnosed by endoscopic biopsy. Materials and Methods: We enrolled 148 patients who were treated by endoscopic mucosal resection (EMR) or endoscopiccsubmucosal dissection (ESD) for GED: there were 63 patients with HGD and 85 patients with LGD and all of them were diagnosed by endoscopic biopsy from January 2006 to December 2008. The results of the final histopathologic reports after EMR or ESD were compared with the results of the endoscopic biopsies. Results: The final histopathologic results of the 148 patients with GED showed 49 (33.1%) patients with adenocarcinoma, 40 (27.0%) patients with HGD and 59 (39.9%) patients with LGD. Among the 63 patients with HGD, 34 (54.0%) patients had adenocarcinoma, 20 (31.7%) patients had HGD and 9 (14.3%) patients had LGD. For the 85 patients with LGD, 15 (17.6%) patients had adenocarcinoma, 20 (23.5%) patients had HGD and 50 (58.8%) patients had LGD Conclusion: Complete resection, including EMR or ESD, is needed for patients with GED diagnosed by endoscopic biopsy and they have HGD. For patients with LGD, EMR or ESD may be needed in addition to endoscopic surveillance with biopsy for making the correct diagnosis and proper treatment because of the possibility of adenocarcinoma.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.136-142
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• 2009

Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.

• KSBB Journal
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• v.21 no.6 s.101
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• pp.466-473
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• 2006

Impaired insulin secretion from pancreatic beta-cells in response to glucose is an important feature in the pathology of non-insulin-dependent diabetes mellitus (NIDDM). In the course of screening for useful insulin secretagogues, we have isolated and identified YHB-2017 (Genistein) as a insulin secretion potentiator from fermentation broths of our in-house microbial library. The insulinotropic activity of YHB-2017 in isolated rat pancreatic islets was exerted only at high concentration of glucose (8.3-16 mM) but not at low concentration of glucose (3.3-5.5 mM). Also, in perifusion study with isolated rat pancreatic islets, YHB-2017 stimulated insulin secretion in a time-dependent manner when YHB-2017 was added to KRB buffer containing 16 mM glucose. In the presence of $200\;{\mu}M$ diazoxide and 35 mM KCI, which stimulates maximum $Ca^{2+}$ influx independently of KATP channel, YHB-2017 enhanced KATP channel-independent insulin secretion at high concentration glucose (16 mM). To elucidate the mechanisms of the glucose-dependent potentiation effect of YHB-2017, pharmacologic inhibitors for protein kinase A, protein kinase C and calcium/calmodulin kinase II were pre-treated and then the potentiation effect of YHB-2017 on insulin secretion was investigated. Pre-treatment of H89 as a PKA inhibitor had a significant inhibitory effect on YHB-2017-induced potentiation effect. Furthermore, western immunoblotting analyses revealed that YHB-2017 increased phosphorylation of PKA substrates and cAMP response element-binding protein (CREB) under high concentration of glucose. These results demonstrated that the insulinotropic effect of YHB-2017 is mediated through PKA signal pathway and activated amplifying $K_{ATP}$ channel-independent insulin secretion pathway.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.194-201
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• 2010

Purpose: The purpose was to compare the marginal fidelity and the fracture resistance of the zirconia crowns according to the various coping designs with different thicknesses and cement types. Materials and methods: Zirconia copings were designed and fabricated with various thicknesses using the CAD/CAM system (Everest, KaVo Dental GmbH, Biberach., Germany). Eighty zirconia copings were divided into 4 groups (Group I: even 0.3 mm thickness, Group II: 0.3 mm thickness on the buccal surface and the buccal half of occlusal surface and the 0.6 mm thickness on the lingual surface and the lingual half of occlusal surface, Group III: even 0.6 mm thickness, Group IV: 0.6 mm thickness on the buccal surface and the buccal half of occlusal surface and the 1.0 mm thickness on the lingual surface and the lingual half of occlusal surface) of 20. By using a putty index, zirconia crowns with the same size and contour were fabricated. Each group was divided into two subgroups by type of cement: Cavitec$^{(R)}$ (Kerr Co, USA) and Panavia-$F^{(R)}$ (Kuraray Medical Inc, Japan). After the cementation of the crowns with a static load compressor, the marginal fidelity of the zirconia crowns were measured at margins on the buccal, lingual, mesial and distal surfaces, using a microscope of microhardness tester (Matsuzawa, MXT-70, Japan, ${\times}100$). The fracture resistance of each crown was measured using a universal testing machine (Z020, Zwick, Germany) at a crosshead speed of 1 mm/min. The results were analyzed statistically by the two-way ANOVA and oneway ANOVA and Duncan's multiple range test at $\alpha$=.05. Results: Group I and III showed the smallest marginal fidelity, while group II demonstrated the largest value in Cavitec$^{(R)}$ subgroup (P<.05). For fracture resistance, group III and IV were significantly higher than group I and II in Cavitec$^{(R)}$ subgroup (P<.05). The fracture resistances of Panavia-$F^{(R)}$ subgroup were not significantly different among the groups (P>.05). Panavia-$F^{(R)}$ subgroup showed significantly higher fracture resistance than Cavitec$^{(R)}$ subgroup in group I and II (P<.05). Conclusion: Within the limitation of this study, considering fracture resistance or marginal fidelity and esthetics, a functional ceramic substructure design of the coping with slim visible surface can be used for esthetic purposes, or a thick invisible surface to support the veneering ceramic can be used depending on the priority.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.623-634
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• 1994

Although the average menopausal age has not changed, women's life span has increased. Today's women live longer after their menopause than those in the past, and this calls for attention in both nursing and medical fields. Many studies have revealed how women reacted to menopause and suffered from it. But they did not discriminate the menopausal meaning and effects from the climacteric phenomena. So, this author tried to clarify what menopause itself meant to the climacteric women, by means of grounded theory methodology. The interviewees were 21 women, whose ages were between 46 and 60 years. They were selected by theoretical sampling technique, and the author tried to include all levels of important variables such as age, educational background, religion and job. Data were collected by the author through in -depth interviews and observations in July, 1994. The interviews were mostly done in the homes of the subjects, or in some cases at the author's office or in a hospital. Interviews took from 30 minutes to 2 hours. Interviews were tape recorded and transcribed later by a research assistant. Data were analyzed as gathered, by the constant comparative method proposed by Strauss and Corbin. Eleven concepts were discovered from the data, and they were grouped under six higher order categories. These six categories were "to give menopause a meaning", "to experience value change", "to have self-help strategies", "to have no strategies", "to live a life worth living", "to have a sense of powerlessness" Among these "to experionce value change" was . selected as the core category. Five major categories were systematically integrated around the core category. Women's adaptation to menopause was defined as proceeding as follows : Most women felt relief and sorrow at the same time when they faced menopause, and some only sorrow or agony. Then, they consulted with others about menopausal symptoms, or tried to think of them by themselves. Finally, they gave menopause a meaning, which was that menopause and its symptoms were natural phenomena. But menopause made women reflect on them-selves and their past lives. As they reflected on themselves, their value on life began to change. As their value changed, some women seeked self help strategies. Those self help strategies were what they had learned from collegues, professionals or mass media. The quality of their lives depended on whether they practiced self help strategies or not. Three types of lives were found. Twelve women enjoyed a life worth living, and practiced the self help strategies, because they accepted menopause a chance to change. They were characterized by a high educational level, having a professional job and a sincere faith in God. Seven women were living as usual, because they did not have the necessity to change. They were high school graduates and house wives. Two women recognized menopause a chance to change, but they did not try self help strategies. Their characteristic was low educational level. Those who did not try self help strategies complained of powerlessness to varying degrees. The educational background, full-time jobs and faith helped women adapt to menopause positively. But social support was not helpful to women's adaptation to menepause. Three hypotheses were derived from the analysis. (1) The higher the educational level, the more theneed to change. (2) Women with higher educational background will practice self help strategies more than those with lower edcational background. (3) The more women practice self help strategies, the worthier lives they will live. Suggestions for further studies are as follows. (1) Studies to test hypotheses are needed. (2) A study to find the relationship between the degree of practicing self help strategies and locus of control. (3) Spiritual approaches would better be applied to help menopausal women. (4) Education through mass media should be given mere frequently.

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

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

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.58-66
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• 2009

Objectives: Active participation of poultry breeder in surveillance system of Avian Influenza (AI) is very important. Therefore this study was conducted to present basis data for active report of AI that is affected by media's coverage in poultry breeder. Methods: Subjects were 88 persons, 28 who were poultry breeder at epidemic area of AI and 60 who were general person at non-epidemic area. Data were collected by the trained investigator from Jul. 1 to Aug. 31, 2008. Respondents were interviewed by means of a structured questionnaire. Results: The third-person effect among perceptions of influence in media's report on the AI was higher in breeder (32.1%) than in non-breeder (10.0%). However, Confidence to media report on the AI was lower in breeder than in non-breeder. Intention to report of the AI was 71.4% in breeder respectively, was 90.0% in non-breeder. There was statistically significant lower in breeder than non-breeder. The cause of avoidance of report was 'economic damage' for 87.5%, which acocounted for the majority of cases. Confidence to media report on the AI were positively correlated with concern on the AI and perception on seriousness of the AI, but negatively correlated with the third-person effect. Conclusions: These results showed that intention to report of the AI of breeder was susceptible to influenced by the third person effect and confidence in media's report on the AI. Therefore we should give a special attention to increase active report of poultry breeder during epidemic period of AI which is consideration of reasonable strategy of media's coverage, including mind and emotion state of poultry breeder.

• Korean Journal of Oriental Medicine
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• v.3 no.1
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• pp.41-65
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• 1997

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.213-230
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• 2008

The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.