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Preoperative Staging in Non-Small Cell Lung Cancer without Lymphadenopathy on Computed Tomogram (흉부 전산화 단층촬영상 임파절종대가 없는 비소세포암 환자에 있어서 술전 병기판정)

  • Cha, Seung-Ick;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Chang, Bong-Hyun;Kang, Duk-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.616-623
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    • 1994
  • Objectives: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. Methods & Results: 1) Records of a total of 41 patients with preoperative $T_{1-3}N_0M_0$ non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative $T_2$, 2 cases were identified postoperatively as $T_3$ with invasion of chest wall and among 6 cases with preoperative $T_3$, 1 case was identified postoperatively as $T_4$ with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with $T_{1-2}$, 5 cases were $N_1$ and 3 cases were $N_2$ postoperatively. After the operation of 6 cases with $T_3$, 2 cases were $N_1$ and 3 cases were $N_2$ postoperatively. Preoperative $T_3$ showed more intrathoracic lymph node metastases and higher $N_2/N_1$ involvement ratio than preoperative $T_{1-2}$. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative $N_2$ tumors. Conclusion: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative $T_3$ non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.

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A Comparative Study of Effect of Secondary Anti-tuberculosis Drugs in the Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 이차항결핵제 복합처방의 효과에 관한 비교 연구)

  • Ha, Hyun-Cheol;Kwon, Eun-Soo;Choi, In-Hwan;Hwang, Su-Hee;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1154-1166
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    • 1998
  • Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

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An Evaluation of the Accuracy of Mini-Wright Peak Flow Meter (mini-Wright Peak Flow Meter에 의한 PEFR 측정의 정확도)

  • Koh, Young-Il;Choi, In-Seon;Na, Hyun-Ju;Park, Seok-Chae;Jang, An-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.298-308
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    • 1997
  • Background : Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. Methods : The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. Results : The PEFR measured with MPFM was significantly related to the PEFR and $FEV_1$ measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r = 0.92 ; p < 0.001 ; for $FEV_1$, r = 0.78 ; p < 0.001). The accuracy of MPFM was within 100(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being 16.5L/min(percentage of difference being 2.90%) or 10.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or 20.49~+9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p > 0.05) and the coefficient of variation($2.4{\pm}1.2%$) of PEFR measured with MPFM was significantly lower than that($5.2{\pm}3.5%$) with standard pneumotachygraph in normal (p < 0.05). Conclusion : This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.

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Time Series Analysis on Outcomes of Tuberculosis Control and Prevention Program between Small Areas in Korea - with Patient Registry Data of 234 City.County.District Public Health Centers - (소규모 지역간 결핵관리사업 성과에 대한 시계열분석 - 전국 234개 시.군.구 보건소의 환자등록자료를 중심으로 -)

  • Kim, Chun-Bae;Choe, Heon;Shin, Kye-Chul;Park, Jong-Ku;Ham, Soo-Keun;Kim, Eun-Mi
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.837-852
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    • 2000
  • Backgrounds : Today, tuberculosis cannot only be cured medically, but also controlled by public health. Despite the overall worldwide decline in tuberculosis, the disease continues to be a significant problem among developing countries and in the slums of large cities in some industrialized countries. Particularly, this communicable disease has come into the public health spotlight because of its resurgence in the 1990's. our country has been operating the Korean National Tuberculosis Control Program since 1962, focusing around public health centers. Therefore, this study aims to compare the effectiveness of tuberculosis control activities, one of the major public health activities in Korea, by producing indexes, such as the yearly registration rate per 100,000 population and treatment compliance of tuberculosis on in small areas (communities). Methods : This work was accomplished by constructing a time-series analytic model using data from "1980~2000: the Yearly Statistical Report" with patient registry data of 234 City. County. District public health centers and by identifying the factors influencing the tuberculosis indexes. Results : The trends of pulmonary tuberculosis positive point prevalence and pulmonary tuberculosis negative point prevalence on X-ray screening have declined steadily, beginning in 1981 and continuing to 1998 by region (city, county, district). Although the tuberculosis mortality rate steadily shows a declining trend by year and region, but Korea still ranks first among 29 OECD countries in 1998, with a tuberculosis mortality rate of 7.1 per 100,000 persons, according to the time-series analysis for fatal diseases. Conclusion : The results of the study will form the fundamental basis of future regional health care planning and the Korean Tuberculosis Surveillance System on 2000. Since the implementation of local autonomy through the Local Health Act of 1995, it has now become vita1 for each city, county, district public health centers to determine its own priorities for relevant health care management, including budget allocation and program goals.

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Estimating the Likelihood of Malignancy in Solitary Pulmonary Nodules by Bayesian Approach (Bayes식 접근법에 의한 고립성 폐결절의 악성도 예측)

  • Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Han, Sung-Beom;Jeon, Young-Jun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.498-506
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    • 1999
  • Background : The causes of solitary pulmonary nodule are many, but the main concern is whether the nodule is benign or malignant. Because a solitary pulmonary nodule is the initial manifestation of the majority of lung cancer, accurate clinical and radiologic interpretation is important. Bayes' theorem is a simple method of combining clinical and radiologic findings to estimate the probability that a nodule in an individual patients is malignant. We estimated the probability of malignancy of solitary pulmonary nodules with a specific combination of features by Bayesian approach. Method : One hundred and eighty patients with solitary pulmonary nodules were identified from multi-center analysis. The hospital records of these patients were reviewed and patient age, smoking history, original radiologic findings, and diagnosis of the solitary pulmonary nodules were recorded. The diagnosis of solitary pulmonary nodule was established pathologically in all patients. We used to Bayes' theorem to devise a simple scheme for estimating the likelihood that a solitary pulmonary nodule is malignant based on radiological and clinical characteristics. Results : In patients characteristics, the probability of malignancy increases with advancing age, peaking in patients older than 66 year of age(LR : 3.64), and higher in patients with smoking history more than 46 pack years(LR : 8.38). In radiological features, the likelihood ratios were increased with increasing size of the nodule and nodule with lobulated or spiculated margin. Conclusion : In conclusion, the likelihood ratios of malignancy may improve the accuracy of the probability of malignancy, and can be a guide of management of solitary pulmonary nodule.

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Participation Level in Online Knowledge Sharing: Behavioral Approach on Wikipedia (온라인 지식공유의 참여정도: 위키피디아에 대한 행태적 접근)

  • Park, Hyun Jung;Lee, Hong Joo;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.97-121
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    • 2013
  • With the growing importance of knowledge for sustainable competitive advantages and innovation in a volatile environment, many researches on knowledge sharing have been conducted. However, previous researches have mostly relied on the questionnaire survey which has inherent perceptive errors of respondents. The current research has drawn the relationship among primary participant behaviors towards the participation level in knowledge sharing, basically from online user behaviors on Wikipedia, a representative community for online knowledge collaboration. Without users' participation in knowledge sharing, knowledge collaboration for creating knowledge cannot be successful. By the way, the editing patterns of Wikipedia users are diverse, resulting in different revisiting periods for the same number of edits, and thus varying results of shared knowledge. Therefore, we illuminated the participation level of knowledge sharing from two different angles of number of edits and revisiting period. The behavioral dimensions affecting the level of participation in knowledge sharing includes the article talk for public discussion and user talk for private messaging, and community registration, which are observable on Wiki platform. Public discussion is being progressed on article talk pages arranged for exchanging ideas about each article topic. An article talk page is often divided into several sections which mainly address specific type of issues raised during the article development procedure. From the diverse opinions about the relatively trivial things such as what text, link, or images should be added or removed and how they should be restructured to the profound professional insights are shared, negotiated, and improved over the course of discussion. Wikipedia also provides personal user talk pages as a private messaging tool. On these pages, diverse personal messages such as casual greetings, stories about activities on Wikipedia, and ordinary affairs of life are exchanged. If anyone wants to communicate with another person, he or she visits the person's user talk page and leaves a message. Wikipedia articles are assessed according to seven quality grades, of which the featured article level is the highest. The dataset includes participants' behavioral data related with 2,978 articles, which have reached the featured article level, with editing histories of articles, their article talk histories, and user talk histories extracted from user talk pages for each article. The time period for analysis is from the initiation of articles until their promotion to the featured article level. The number of edits represents the total number of participation in the editing of an article, and the revisiting period is the time difference between the first and last edits. At first, the participation levels of each user category classified according to behavioral dimensions have been analyzed and compared. And then, robust regressions have been conducted on the relationships among independent variables reflecting the degree of behavioral characteristics and the dependent variable representing the participation level. Especially, through adopting a motivational theory adequate for online environment in setting up research hypotheses, this work suggests a theoretical framework for the participation level of online knowledge sharing. Consequently, this work reached the following practical behavioral results besides some theoretical implications. First, both public discussion and private messaging positively affect the participation level in knowledge sharing. Second, public discussion exerts greater influence than private messaging on the participation level. Third, a synergy effect of public discussion and private messaging on the number of edits was found, whereas a pretty weak negative interaction effect of them on the revisiting period was observed. Fourth, community registration has a significant impact on the revisiting period, whereas being insignificant on the number of edits. Fifth, when it comes to the relation generated from private messaging, the frequency or depth of relation is shown to be more critical than the scope of relation for the participation level.

Biological Identity of Hwangchung and History on the Control of Hwangchung Outbreaks in Joseon Dynasty Analyzed through the Database Program on the Annals of the Joseon Dynasty and the Enrollment of Haegoeje (조선왕조실록과 해괴제등록 분석을 통한 황충(蝗蟲)의 실체와 방제 역사)

  • Park, Hae-Chul;Han, Man-Jong;Lee, Young-Bo;Lee, Gwan-Seok;Kang, Tae-Hwa;Han, Tae-Man;Hwang, Seok-Jo;Kim, Tae-Woo
    • Korean journal of applied entomology
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    • v.49 no.4
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    • pp.375-384
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    • 2010
  • We tried to establish the history of outbreaks and control methods of 'hwangchung' in Joseon Dynasty, uncovering the biological reality of the 'hwangchung' (called hwang or bihwang) analyzed through the Database program on 'the Annals of the Joseon Dynasty' and 'the Emollment of Haegoeje', two of the finest examples of classical historical records. The total number of articles on the outbreak of the hwangchung is 261 in the Annals of the Joseon Dynasty and 65 in the Emollment of Haegoeje. There were four peaks by hwangchung throughout the Joseon Era. Among them, the periods of King Taejo to King Sejong had the highest incidence. By comparing the number of records of the hwangchung from the Annals of the Joseon Dynasty with that in the Emollment of Haegoeje during the same period, results show the former was less than the latter, 35 vs 65. However, both records were relatively inconsistent with each other. Insect pests in forests as well as in agriculture were included in the biological identities of the hwangchung in the Joseon Dynasty periods, which is in accordance with those of Saigo's. The taxonomic identity could be confirmed in only 25 cases (9.5%) among the articles on hwangchung. It largely coincided with Paik's opinion: II in armyworm, nine in moth larva, one in rice stem borer, two in migratory locust, one in planthopper and one in rice-plant weevil. Therefore, it is not reasonable to regard hwangchung as a migratory locust or grasshopper only. The number of reports on the occurrence of hwangchung in the Annals of the Joseon Dynasty was 173 (66% of the total) and 47% of them were just simple reports, which means the report itself on the appearance of hwangchung was very significant. The reports on controlling insect pests were of low frequency, in 20% (34 cases) of the total reports, capturing insect pests or holding traditional ceremony called 'Poje'. Among them, only one case related to the treatment of seeds to prevent the damage by hwangchung was published in the King Sejong period. There were 37 discussions about changes and management of government policies due to disasters by hwangchung. They were mostly about relief or tax cut to the people who suffered damage and about cancellation of recruiting people to military training, constructing castles, and so on. It seems that not only the people but also the king was influenced by the hwangchung. In the case of King Seongjong, he referred to the stress of the prevention measure of locusts in 10 articles. The damage also had an effect on abdication in the reign of King Jeongjong.

Toxicological Effects of Some Insecticides against Welsh Onion Beet Armyworm (Spodoptera exigua) (Metaflumizone을 포함한 몇 가지 약제의 파밤나방(Spodoptera exigua)에 대한 독성검정)

  • Kang, E.J.;Kang, M.G.;Seo, M.J.;Park, S.N.;Kim, C.U.;Yu, Y.M.;Youn, Y.N.
    • Korean journal of applied entomology
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    • v.47 no.2
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    • pp.155-162
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    • 2008
  • The Welsh onion beet armyworm, Spodoptera exigua (Hubner), has attacked Welsh onion and is now the most important pest of Welsh onion in southwestern Korea. The beet armyworm has a wide host range, occurring as a serious pest of vegetable and fields. The relatively high abundance of beet armyworm has stimulated frequent application of insecticides to foliage. Insecticide resistance is a major problem in management of this insect. Accordingly, pesticide application for the control of beet armyworm was tried in both the open field and in laboratory, using 4 synthetic compounds such as metaflumizone and chlorfenapyr, indoxacarb, flufenoxuron, emamectin benzoate. In the laboratory, each developmental stages from eggs, larva to pupa was tested against 4 insecticides. Against the eggs of welsh onion beet armyworm, there was no significantly different with each other. These tested chemicals no killing effect to eggs. However, the population of 1st larva hatched from eggs were reduced because they eaten the egg shell with residual insecticides. The tested insecticides were taken very high mortalities to 1st to 3rd larva of Welsh onion beet armyworm. Otherwise, there were decreased the death rate from 4th to 6th larva. On the other hand, their value of control effects were relatively good against Welsh onion beet armyworms in the field between 87.2 and 90.5% on 10 days after insecticide application.

The Key Success Factors of University Entrepreneurship Education: Implication from USA University Cases (대학 창업교육 핵심 성공요인: 미국 대학 사례의 시사점)

  • Choi, Jong-In;Park, Chygwan
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.85-96
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    • 2013
  • Entrepreneurship courses and programs in Korean universities tend to increase steadily but seem to have some limitations. They are usually recognized as another domain of Business Administration. Entrepreneurship program is practical like Business Administration but should be much more interdisciplinary than that. Because Korean Entrepreneurship programs are in the early stage, they must be reinforced with factors such as education culture, faculties, curriculum and relationships with communities. This study aims to get some implications from Entrepreneurship programs have been run by universities in America in order to facilitate Entrepreneurship program in Korean universities. Based on 11 success factors found by our case universities' Entrepreneurship programs and Kauffman Campus, this study has drawn implications of critical success factors of Entrepreneurship programs as follow. First of all, because Entrepreneurship programs should focus on Entrepreneurship mind sets such as innovative idea generation and courage to overcome risk, it is more desirable that Entrepreneurship programs are introduced in all departments of universities such as Arts, Science and Engineering. These programs also need to take interdisciplinary approach and required to be opened from liberal arts course. In order to be sustained during all their academic careers, vision, mission and strategy for Entrepreneurship programs should be based on strong leadership and support of top leaders. Entrepreneurship culture of each university is also one of the most important success factors. Entrepreneurship programs not only as major programs but also as specific Entrepreneurship minors designed for departments such as Arts, Science and Engineering could be considered according to each university's situation. This study also suggest to make a motivation system for Entrepreneurship faculties, Ph d. programs for Entrepreneurship, communication network for Entrepreneurship programs and mentor system in community. To begin Entrepreneurship programs, it also needs to develop good education contents as many as possible. When it concerned with teaching method, project based 4 year program can be suggested to be effective and efficient. To introduce project based program that should be consistent till participants' graduation, university must prepare regulations to support team teaching, mentor and interdisciplinary cooperation. To dissipate the concept that Entrepreneurship is another version of management, this study support the idea that Entrepreneurship programs should be designed and run by independent and central-focused governance system, Entrepreneurship education center.

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H-T-P reaction Study on differences between the juvenile delinquents groups classified by the family system type for Creative happy Education management (창의적 행복학교 교육경영을 위한 HTP 검사 반응 연구)

  • Park, Soon Marn;Choi, Chong Myoung;Kim, Jin Nyo;Byun, Sang Hae
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.157-163
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    • 2013
  • This study is to notify differences of H-T-P reactions between Juvenile delinquents groups classified by family system type. This study aims to know reaction of 'House' on each juvenile delinquents and apply to creative school education administration. The research was performed as below: First, Measuring and descriptive statistical analysis were performed. One hundred and twenty subjects who were youths disposed of Seoul nambu youth alternative education center. Data were collected from July to October in 2012. Then There were classified Two groups following subjects; 'parents family' and 'single parent family'. Second, Questionaries assessing demographic and H-T-P by Buck, N. Third, statistical analysis was done by SPSS for Window 18.0. To Verify the reliability of the measures and correlations between two groups, and to find out the difference of the reaction of 'House', were used frequency analysis and Pearson Chi-Square. The results of this is significant personality types of juvenile delinquents are followings; The Juvenile delinquents living 'Single parent family' have frustrations for their past and current family. Also they have mental conflicts for their family better than another group.

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