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The Clinical Characteristics of Lung Cancer in Patients with Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에 동반된 폐암 환자의 임상적 특정)

  • Park, Joo-Hun;Lee, Jin-Seong;Song, Koun-Sik;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.674-684
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    • 1999
  • Background : It has been generally known that the incidence of lung cancer is higher in the patients with idopathic pumonary fibrosis (IPF) than those in general population. The reported incidence was variable from 4.8 to 43.2%. There were controversies on the most frequent cell type (squamous cell carcinoma vs. adenocarcinoma) and no study was done about the real concordance of cancer and the fibrotic lesion. And the pulmonary fibrosis may influence not only the development of cancer but also the treatment and prognosis of the cancer, but there was no report on that point. Method : Total 63 patients ($66.8{\pm}7.8$ year, M : F=61 : 2) were diagnosed as IPF combined with lung cancer (IFF-CA) at Asan Medical Center. A retrospective analysis was done about the risk factors of the lung cancer, pulmonary function test, the site of cancer(especially the relationship of the cancer with the fibrotic lesion), the histologic types, and the stage of cancer. The histologic types were compared with those of 2,660 patients with lung cancer who were diagnosed at the same institute for the same period. The effect of IPF on the treatment of the cancer was evaluated with the survival time after the detection of lung cancer. Results : The lung cancer was found in 63(22.9%) out of 281 patients with IPF. But in most of them(45 patients), lung cancer was detected at the same time with IPF and only in 18 patients, the cancer was diagnosed during the follow-up($25.2{\pm}17.7$ months) of IPF. So in our study, 6.7% of patients with IPF developed lung cancer during the course of the disease. The age ($66.8{\pm}7.84$ vs. $63.4{\pm}11.1$ years), percentage of smoker (88.9 vs. 67.2%), and the male gender (96.8 vs. 67.6%) were significantly higher in IPF-CA compared with lone IPF (p<0.05). The odds ratio of smoking was 4.7 compared with non smoking IPF controls. The lung cancer was located more frequently in the upper lobe and 55.5% was in the periphery of lung. The cancer was developed in the fibrotic lesion in 23 patients (35.9%), and in the majority of the patients, the cancer was separated from the fibrosis. The cell type of the lung cancer in IPF-CA was squamous cell carcinoma 34.9%, adenocarcinoma 30.2%, small cell carcinoma 19.0%, large cell undifferenciated carcinoma 6.3%, and others 9.5%. No significant difference in the distribution of histologic type of the lung cancer was found between IPF-CA and lone lung cancer. There was no significant difference in demographic features, cell types, location and the stage of the cancer between the group with concurrent IPF-CA and the group with cancer diagnosed during the follow up of IPF. There was a tendency (but statistically not significant : p=0.081) of higher incidence of adenocarcinoma among the cancers developed in the fibrotic area(43.5%) (F-CA) than in the cancers in non-fibrotic area (22.5%) (NF-CA). The prognosis of the patients with F-CA was poor (median survival : 4 months) compared with the patients with NF-CA (7 months, p=0.013), partly because the prevalence of severe IPF (the extent of fibrosis in HRCT 50%) was higher in F-CA group. Conclusion : These data suggest that the lung cancer in the patients with IPF has similar features to the ordinary lung cancer.

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An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation (사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구)

  • Jung, Mi Wha
    • Korean Journal of Occupational Health Nursing
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    • v.3
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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  • A Study on the Effective Independent Study of Nursing Student (간호학생의 효과적인 자율학습을 위한 조사연구)

    • 김광주;이향련
      • Journal of Korean Academy of Nursing
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      • v.8 no.1
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      • pp.16-42
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      • 1978
    • This survey was made for a month starting from November 15 to December 15, 1977 covering 711 students taking the junior. (3rd-yea.) and the senior. (4th-year) at nine college of nursing in Seoul concerning their perception and Attitude toward the profession of nursing, motive for the necessity of learning, environment of study, attitude of study and particulars relevant with study performance, particulars of library, references and reading, assignments and particulars of the degree of confidence for the learning achievement. Through the survey of the above Particulars, the following results were obtained by classifying all subject matters and by analysing motive of the selection of their course, awarding or not awarding of scholarships. 1. General characteristics: it was revealed that 406 students (57.1%) were attending at the junior. while 305 students (42.9%) were taking the senior. Thus, the total number was 711 and their average age was 21.4 years. Their dwelling category was; 73.9 percent of them resided at their parent's home, 214 students (30.1%) were awarded with scholarships. The reason to be attracted by nursing science was the possibility of continuing social life after graduation (43.5%). 2. Their perception and attitude toward the profession of nursing: According to the perception of profession by the students of each grade, students of the 4th grade showed comparatively strong conception. Also, students of the 4th grade showed more positive attitude in the purchase and reading of magazines relative with the science of nursing, in the reading of Code for Nurses and in their interest in the activity of nursing field. For the necessity of mission of nurse, 97.7 percent of the entire number of students covered responded to necessity. For the necessity of the particular humanity and particularity in the character of nurses, 95.8 percent of those students responded to necessity. By the each grade, students of the 4th grade showed more response. 3. As to professional field desired after completing the professional course: 57 percent of those students desired for clinician nurse while 55 percents desired for community health-nurse. 4. As to the environment of study: they were mostly satisfied with their present residential environment. However, they complained of inconvenience at their lecture-halls. Students of the 3rd grade showed more complain. As to their attitude toward the adjustment of environment of study, they showed a affirmative response. As to the opinion of factors which interfere with their study, comparatively strong response was showed in their scepticism in the science of nursing, insufficient comprehension in general learning, relation with professors n4 discrepancy in the method of study. According to opinions of students at each grade, students of the 4th grade showed more scepticism. 5. Particulars relative with their attitude and performance of study : As to their knowledge of the objectives of their study of subject, the majority was to study with a partial knowledge of the objectives of their study. As to the plan of study, a low percentage indicated management of routine life under regular scheduling. Students of the 4th grade responded to rather planned life. As to time spent in independent study, response to concentrated study when necessary was stronger than that to regular daily study. Students of the 4th grade showed stronger response to regular study than that of the 3rd grade. As to the contents of their note-taking, 67.4 percents of those students responded to such regulatory procedure performing in the lecture-hall as they listen to lectures. 17.3 percents of those students showed response to adding supplementary informations from references to what was entered in choir note-taking at their lecture-halls. 6. Particulars of library, references and reading books: As to receiving of instruction for the utilization of library and time of receiving such instruction 64.7 percents of those students had received such instruction. 66.7 percents of the those responded received such instruction at orientation conducted for freshmen. As to the convenience of the utilization of library, 49.9 percents of those students responded to convenience. However, students of the 3rd grade showed a much stronger response to inconvenience. As to the time of the utilization of library,92.5 percents of those students showed a response to occasional utilization for particular purpose than regular utilization. 53.2 percents of those students responded to ordinary in quantity that library have references. 34.2 percents of those students responded to insufficient. As to the particular relative with the method and field of reading: 53.5 percents of those students responded to intensive reading and was the majority. As to the reading field, fiction u as the majority. When read any books for their major, they usually rend Korean text-b, oks. 7. Particular relative with giving assignment: All respondents were well aware of the objectives of giving home tasks. As to the attitude toward assignments and performing home tasks, 54.8 percents of those students to making ostentatious study because of an excessive quantity of assignments imposed. For performing assignment, they showed comparatively positive response. Also, 52.2 percents of those students responded that they usually submitted complected assignment with references. 8. As to motive to realize the necessity of study : 55.6 percents of those students responded that they realized such necessity in communication with patients when they were engaged in clinical practice. Also, 8.6, the lowest percents of those students responded that they realized such necessity in the course of conversation with nurses when they were engaged in clinical practice. 9. As to the determination of their confidence in the performance of study relative with clinical experience: They showed a general inclination of having in nursing. The major response was that they came to well comprehend the patients families. the lowest response was that they could apply what was learned at lecture-hall to practice. This response incidentally showed the distance the lecture-hall and practical study. In general items, students of the 4th grade showed more favorable response than students of the 3rd grade and there was a significant difference. 10. As to the perception and attitude toward profession according to the motive of selecting the nursing science : Those who selected the nursing voluntarily showed stronger conception than those who selected the nursing through indirect influence. However, there was no significant difference on this point. Only there was a remarkable difference in the reading of Code for Nurses. 11. Those who showed a stronger conception in the profession of nursing according to the motives of attractive nursing science indicated a strong will and ability to manage stable life and comparatively strong response was shown in the management of good home life because of the good adaptability of the science to their character. This group showed a strong conception of the profession than those who responded that they prefer this profession out of a longing for the work of a hospital and for the easy obtaining of opportunity to immigrate to over seas and for economic cause and for high school grade. There was significant difference between these two groups, 12. As to the conception and attitude toward the profession of nursing according to benefits by scholarships, those who were benefitted by scholarship showed stronger conception of profession than those who did not receive scholarship and there was a remarkable difference between these two categories. However, there was no remarkable difference between these two categories in the extent of interest of the activities of nursing fields and in the reading of Code for Nurses. 13. As activation for study according to the benefits of scholarships, those who were benefitted by scholarships showed stronger response to the motive for study comparing with those who receive. 14. As to tile field of reading according to the benefits by scholarships, those who received scholarships tended to read autobiographies and essayers to a considerable extent. Those who did not receive scholarships tended to read novels. Those who received scholarships more read nursing boots than those who did not receive scholarships. 15. As to the attitude of study and doing of assignment according to benefits of scholarships, those who received scholarships managed a favorable life with schedules for study, More students of receiving scholarship showed a regular study for more than one hour per day. Also, in the method of doing home tasks, more students of receiving scholarship showed reference to relative books frequently for the submission of completed assignments.

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    An Empirical Study on the Influencing Factors for Big Data Intented Adoption: Focusing on the Strategic Value Recognition and TOE Framework (빅데이터 도입의도에 미치는 영향요인에 관한 연구: 전략적 가치인식과 TOE(Technology Organizational Environment) Framework을 중심으로)

    • Ka, Hoi-Kwang;Kim, Jin-soo
      • Asia pacific journal of information systems
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      • v.24 no.4
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      • pp.443-472
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      • 2014
    • To survive in the global competitive environment, enterprise should be able to solve various problems and find the optimal solution effectively. The big-data is being perceived as a tool for solving enterprise problems effectively and improve competitiveness with its' various problem solving and advanced predictive capabilities. Due to its remarkable performance, the implementation of big data systems has been increased through many enterprises around the world. Currently the big-data is called the 'crude oil' of the 21st century and is expected to provide competitive superiority. The reason why the big data is in the limelight is because while the conventional IT technology has been falling behind much in its possibility level, the big data has gone beyond the technological possibility and has the advantage of being utilized to create new values such as business optimization and new business creation through analysis of big data. Since the big data has been introduced too hastily without considering the strategic value deduction and achievement obtained through the big data, however, there are difficulties in the strategic value deduction and data utilization that can be gained through big data. According to the survey result of 1,800 IT professionals from 18 countries world wide, the percentage of the corporation where the big data is being utilized well was only 28%, and many of them responded that they are having difficulties in strategic value deduction and operation through big data. The strategic value should be deducted and environment phases like corporate internal and external related regulations and systems should be considered in order to introduce big data, but these factors were not well being reflected. The cause of the failure turned out to be that the big data was introduced by way of the IT trend and surrounding environment, but it was introduced hastily in the situation where the introduction condition was not well arranged. The strategic value which can be obtained through big data should be clearly comprehended and systematic environment analysis is very important about applicability in order to introduce successful big data, but since the corporations are considering only partial achievements and technological phases that can be obtained through big data, the successful introduction is not being made. Previous study shows that most of big data researches are focused on big data concept, cases, and practical suggestions without empirical study. The purpose of this study is provide the theoretically and practically useful implementation framework and strategies of big data systems with conducting comprehensive literature review, finding influencing factors for successful big data systems implementation, and analysing empirical models. To do this, the elements which can affect the introduction intention of big data were deducted by reviewing the information system's successful factors, strategic value perception factors, considering factors for the information system introduction environment and big data related literature in order to comprehend the effect factors when the corporations introduce big data and structured questionnaire was developed. After that, the questionnaire and the statistical analysis were performed with the people in charge of the big data inside the corporations as objects. According to the statistical analysis, it was shown that the strategic value perception factor and the inside-industry environmental factors affected positively the introduction intention of big data. The theoretical, practical and political implications deducted from the study result is as follows. The frist theoretical implication is that this study has proposed theoretically effect factors which affect the introduction intention of big data by reviewing the strategic value perception and environmental factors and big data related precedent studies and proposed the variables and measurement items which were analyzed empirically and verified. This study has meaning in that it has measured the influence of each variable on the introduction intention by verifying the relationship between the independent variables and the dependent variables through structural equation model. Second, this study has defined the independent variable(strategic value perception, environment), dependent variable(introduction intention) and regulatory variable(type of business and corporate size) about big data introduction intention and has arranged theoretical base in studying big data related field empirically afterwards by developing measurement items which has obtained credibility and validity. Third, by verifying the strategic value perception factors and the significance about environmental factors proposed in the conventional precedent studies, this study will be able to give aid to the afterwards empirical study about effect factors on big data introduction. The operational implications are as follows. First, this study has arranged the empirical study base about big data field by investigating the cause and effect relationship about the influence of the strategic value perception factor and environmental factor on the introduction intention and proposing the measurement items which has obtained the justice, credibility and validity etc. Second, this study has proposed the study result that the strategic value perception factor affects positively the big data introduction intention and it has meaning in that the importance of the strategic value perception has been presented. Third, the study has proposed that the corporation which introduces big data should consider the big data introduction through precise analysis about industry's internal environment. Fourth, this study has proposed the point that the size and type of business of the corresponding corporation should be considered in introducing the big data by presenting the difference of the effect factors of big data introduction depending on the size and type of business of the corporation. The political implications are as follows. First, variety of utilization of big data is needed. The strategic value that big data has can be accessed in various ways in the product, service field, productivity field, decision making field etc and can be utilized in all the business fields based on that, but the parts that main domestic corporations are considering are limited to some parts of the products and service fields. Accordingly, in introducing big data, reviewing the phase about utilization in detail and design the big data system in a form which can maximize the utilization rate will be necessary. Second, the study is proposing the burden of the cost of the system introduction, difficulty in utilization in the system and lack of credibility in the supply corporations etc in the big data introduction phase by corporations. Since the world IT corporations are predominating the big data market, the big data introduction of domestic corporations can not but to be dependent on the foreign corporations. When considering that fact, that our country does not have global IT corporations even though it is world powerful IT country, the big data can be thought to be the chance to rear world level corporations. Accordingly, the government shall need to rear star corporations through active political support. Third, the corporations' internal and external professional manpower for the big data introduction and operation lacks. Big data is a system where how valuable data can be deducted utilizing data is more important than the system construction itself. For this, talent who are equipped with academic knowledge and experience in various fields like IT, statistics, strategy and management etc and manpower training should be implemented through systematic education for these talents. This study has arranged theoretical base for empirical studies about big data related fields by comprehending the main variables which affect the big data introduction intention and verifying them and is expected to be able to propose useful guidelines for the corporations and policy developers who are considering big data implementationby analyzing empirically that theoretical base.


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