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Causes of Unresectability in Non-Small Cell Lung Cancer Patients Thought to Be Resectable Preoperatively (수술시 절제가 불가능하였던 비소세포폐암 환자에 대한 분석)

  • Oh, Yeon-Mok;Mo, Eun-Kyung;Jung, Man-Pyo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Sim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.97-102
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    • 1994
  • Objectives : Since Mountain proposed the new staging system of non-small cell lung cancer in 1986, the indications for operation of NSCLC have been extended. However, operative mortality is from 3 to 6%. Therefore it is important to reduce unnecessary operation and to evaluate unresectability of tumor correctly, preoperatively. The purpose of this study is to find out the causes of unresectability in patients who were initially thought to be resectable preoperatively. Methods : By retrospective analysis, 64 patients out of 291 NSCLC patients who were undergone operation for curative resection in Seoul National University Hospital from Jan. of 1987 to Dec. of 1991, were found to be unresectable at operating room, were selected for this study. Out of 64 patients, 42 were evaluable. The analysis was focused on the change of pre- & post-operative staging and the causes of unresectability of tumors. Results : Among 42 patients with unresectable tumor who could be evaluated, preoperative CT finding showed resectable tumors in 55%(23 patients) and suspicious for unresectable tumors in 45%(19 patients). The causes of unresectability were technically unresectable T3 lesions in 7%(3 patients), T4 lesions in 62%(26 patients), N2 lesions in 17%(7 patients) and N3 lesions in 14%(6 patients). Conclusion : The major causes of unresectability of NSCLC were pulmonary artery invasions. It is suggested that careful evaluation of mediastinal structure, especially great vessels by additional imaging technique other than CT(like MRI) is indicated in selected NSCLC cases.

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CHEMICAL DEGRADATION OF LIGHT-CURED DENTAL COMPOSITE RESINS (수종 치과용 광중합형 복합레진의 화학적 분해)

  • Yang, Kuy-Ho;Choi, Nam-Ki;Park, Mi-Ran;Park, Eun-Hae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.403-411
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    • 2001
  • The aim of this study was to evaluate the resistance to degradation of four commercial composite resins in an alkaline solution. The brands studied were Unifil(GC, Japan), Palfique(Tokuyama Japan). Definite$Degussa-H\ddot{u}ls$ AG, Germany). Revolution(Kerr, U.S.A.). Preweighed discs of each brand were exposed 0.1N NaOH solution at $60^{\circ}C$. After 14 days they were removed, neutralized with HCl, washed with water and dried. Resistance to degradation was evaluated on the basis of following parameters: (a) mass loss(%) - determined from pre-and post-exposed specimen weights; (b) Si loss(ppm) - obtained from ICP-AE analysis of solution exposed to specimens; and (c) degradation depth$({\mu}m)$ - measured microscopically (SEM) from polished circular sections of exposed specimens. The results were follows: 1. The mass loss of Unifil was 3.21%, it was the highest of materials. But, there was no significant difference among the materials. 2. The degree of degradation layer depth was $107.69\sim47.40{\mu}m$, the sequence of the degree pf degradation layer depth was in descending order by Unifil, Palfique, Revolution, Definite. There was significant difference among the materials except Palfique and Definite. 3. The Si loss of Paltique was 8940.0ppm, it was the highest. There was significant difference among the materials, except Revolution and Definite(p<0.05). 4. The correlation coefficient between mass loss and degradation depth was relatively high(r = 0.06, p<0.05). 5. There was no significant coefficient correlation between Si loss and mass loss, and/or the degree of degradation layer depth and Si loss. 6. When observed with SEM, destruction of bonding is observed between resin matrix and filler. Above results suggested that the hydrolytic degradation is considered as evaluation factor of composite resins.

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Auxiliary Reinforcement Method for the Safety of Tunnelling Face (터널 막장안정성에 따른 보강공법 적용)

  • Kim, Chang-Yong;Park, Chi-Hyun;Bae, Gyu-Jin;Hong, Sung-Wan;Oh, Myung-Ryul
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.2 no.2
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    • pp.11-21
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    • 2000
  • Tunnelling has been created as a great extent in view of less land space available because the growth of population in metropolitan has been accelerated at a faster pace than the development of the cities. In tunnelling, it is often faced that measures are obliged to be taken without confirmation for such abnormality as diverged movement of surrounding rock mass, growing crack of shotcrete and yielding of rockbolts. In this case, it is usually said that the judgments of experienced engineers for the selection of measure are importance and allowed us to get over the situations in many construction sites. But decrease of such experienced engineers need us to develop the new system to assist the selection of measures for the abnormality without any experiences of similar tunnelling sites. In this study, After a lot of tunnelling reinforcement methods were surveyed and the detail application were studied, an expert system was developed to predict the safety of tunnel and choose proper tunnel reinforcement system using fuzzy quantification theory and fuzzy inference rule based on tunnel information database. The expert system developed in this study have two main parts named pre-module and post-module. Pre-module decides tunnel information imput items based on the tunnel face mapping information which can be easily obtained in-situ site. Then, using fuzzy quantification theory II, fuzzy membership function is composed and tunnel safety level is inferred through this membership function. The comparison result between the predicted reinforcement system level and measured ones was very similar. In-situ data were obtained in three tunnel sites including subway tunnel under Han river. This system will be very helpful to make the most of in-situ data and suggest proper applicability of tunnel reinforcement system developing more resonable tunnel support method from dependance of some experienced experts for the absent of guide.

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From Trauma To growth: Posttraumatic Growth Clock (외상 후 병리에서 성장으로: 외상 후 성장 시계)

  • Lee, Hong-Seock
    • Korean Journal of Cognitive Science
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    • v.27 no.4
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    • pp.501-539
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    • 2016
  • The human mind is a self-evolving system that develops along a multidimensional hierarchical pathway in response to traumatic stimulus. In absence of trauma, a mind integrated in conflict-free state is called monistic. When the monistic mind responses to a traumatic stimulus, a response polarity forms toward stimulus polarity within the mind, turning it into a bipartite structure. Dialectical interaction between the two opposites, originating from their incompatibility, creates a new third polarity in the upper dimension. Thereby, the mind turns into a trinity structure. When the interaction among the three polarities becomes optimized, the plasticity of the mind gets maximized into the "far-from-equilibrium state," and the function of three polarities is synchronized. Through this recalibration, the mind returns back to its monistic structure. If the mind with the recurred monistic structure responds to another traumatic stimulus, this cycle of hierarchical transformation repeats itself in this cyclical and fractal growth process through synchronization of basic trinity system. Applying this concept to the process of post-traumatic growth (PTG), this paper explores how the mind transforms traumatic experiences into PTG and proposes a 'PTG Clock' that shows a fundamental sequence in the development of the human mind. The PTG Clock consists of seven hierarchical phases, and each of the first six phases has two opposite sub-phases: shocked/numbed, feared/intrusive, paranoid/avoidant, obsessional/explosive, dependent/depressive, and meaningless/searching for meaning. The seventh, the synchronization phase, completes one cycle of the mind's transformation, realizing a grand trinity system, where the mind synchronizes its biological, social, and existential dimensions. At that point, the mind becomes more susceptible to not only the stimulus of its own traumatic experience but also the pain of others. Thereby, the PTG Clock sets out on a journey to another cycle of transformation in higher dimensions. The validity of this transformational process for the PTG Clock will be examined by comparing it to Horowitz's theory of stress response syndrome.

COMPARISON OF SCREW-IN EFFECT FOR SEVERAL NICKEL-TITANIUM ROTARY INSTRUMENTS IN SIMULATED RESIN ROOT CANAL (모형 레진 근관에서 수종의 전동 니켈-티타늄 파일에 대한 screw-in effect 비교)

  • Ha, Jung-Hong;Jin, Myoung-Uk;Kim, Young-Kyung;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.35 no.4
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    • pp.267-272
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    • 2010
  • Screw-in effect is one of the unintended phenomena that occurs during the root canal preparation with nickel-titanium rotary files. The aim of this study was to compare the screw-in effect among various nickel-titanium rotary file systems. Six different nickel-titanium rotary instruments (ISO 20/.06 taper) were used: $K3^{TM}$ (SybronEndo, Glendora, CA, USA), $M_{two}$ (VDW GmbH, Munchen, Germany), NRT with safe-tip and with active tip (Mani Inc., Shioya-gun, Japan), ProFile$^{(R)}$ (Dentsply-Maillefer, Ballaigues, Switzerland) and ProTaper$^{(R)}$ (Dentsply-Maillefer, Ballaigues, Switzerland). For ProTaper$^{(R)}$, S2 was selected because it has size 20. Root canal instrumentations were done in sixty simulated single-curved resin root canals with a rotational speed of 300 rpm and single pecking motion. A special device was designed to measure the force of screw-in effect. A dynamometer of the device recorded the screw-in force during simulated canal preparation and the recorded data was stored in a computer with designed software (LCV-USE-VS, Lorenz Messtechnik GmbH, Alfdorf, Germany). The data were subjected to one-way ANOVA and Tukey's multiple range test for post-hoc test. P value of less than 0.05 was regarded significant. ProTaper$^{(R)}$ produced significantly more screw-in effects than any other instruments in the study (p < 0.001). $K3^{TM}$ produced significantly more screw-in effects than $M_{two}$, and ProFile$^{(R)}$ (p < 0.001). There was no significant difference among $M_{two}$, NRT, and ProFile$^{(R)}$ (p > 0.05), and between NRT with active tip and NRT with safe one neither (p > 0.05). From the result of the present study, it was concluded, therefore, that there seems significant differences of screw-in effect among the tested nickel-titanium rotary instruments. The radial lands and rake angle of nickel-titanium rotary instrument might be the cause of the difference.

Effects of Foot Baths on Stress and exhaustion for high school senior students -A comparative study on the aroma oil and fermentation extract- (족욕이 수험생의 스트레스 및 피로에 미치는 효과 -아로마 오일과 발효추출물의 비교연구-)

  • Oh, Hee-Sun;Gang, Gyeong-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.1
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    • pp.402-408
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    • 2010
  • In the twenty first century, people experience a lot of stresses by psychological, social and environmental impetus. If the stress is excessive, it can become a problem and finally lead to diseases. Foot bath makes the body warm starting with the feet, controls the blood circulations and autonomic nervous systems. This study aims at examining the effects of stress and fatigue of senior students preparing for college entrance examination by foot bath with the aroma essential oil and the fermentation extracts. The experimental period was from March 30 to April 18, 2009. The study objects were 21 senior students of C Girls' High School in Cheonan. They were divided into 3 groups and treated 20 times. The first group was a foot bath group with Artemisia Herbal fermentation extracts. The second group was a foot bath group with the blending aroma essential oil of grapefruit, cypress and cedarwood. The third group was not treated. In the case of difference of physical and psychological stress, there was a reduction of 18.43 and 16.71 for the fermented extract group and 10.71 and 9.43 for the aroma group, while a reduction of 0.43 and 0.29 for the control group, respectively. This shows that foot baths using fermented extracts and aroma had lower physical stress compared to the control group (p<.01). For the difference of fatigue, there was a reduction of 19.14 for the fermented extract group, 11.57 for the aroma group and 0.07 for the control group, showing that foot baths accompanied by fermented extracts and aroma used in this study having lower fatigue compared to the control group (p<.01). The fermented extract group (M=55.71) had the highest level of satisfaction after foot baths, followed by the aroma group (M=49.14) and the control group (M=33.29). Duncan's post hoc test showed that there was a statistically considerable difference between the tests groups and control groups (p<.01). Through the results of this study, it was found that foot baths using bathing supplements were very effective for reducing stress and fatigue.

Music Recall Technique for Affect Modification using Stimulative-Sedative Music : Case Study of Anorexia Nervosa (자극성-진정성 음악을 이용한 부적 정서 조절의 음악회상기법 (Music Recall Technique) : 신경성 식욕부진증 환자의 사례 연구)

  • Gill, Su Yeon
    • Journal of Music and Human Behavior
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    • v.2 no.1
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    • pp.1-15
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    • 2005
  • The purpose of this study is to develop Music Recall Technique for affect modification using programmed series of classical music, and further to apply the technique as therapeutic intervention for clients with anorexia nervosa. Music Recall Technique is composed of two sub-technique: first one is 'Music Recall(MR)' which is the way to reproduce of existing music on one's head and mind after listening to the music, and second intervention is 'Creative Music Recall(CMR)' which is the way to modify the exposed musical pieces or newly learned musical pieces. A client with anorexia nervosa with severe anxiety, anger and depression participated in this case study. The MRT is implemented in different stages pertaining to client's level of utilizing the music recall skill for the period of 10 sessions. Situations eliciting negative emotions were identified and music recalling was reinforced for the pertaining situation in order for the negative emotion to be coped and reduced by the end of session time. The client participated for 10 sessions, and was asked to fill out self-report on the affect change using MRT. Visual Analogue Scale was used for pre and post test for each session to measure the self perceived level of negative affect. State-trait anxiety inventory was also used to measure the anxiety level following the implementation of MRT. As results, negative emotions, such as anxiety, anger and depression were modified during stimulative-sedative music recall process. These negative emotions were decreased mostly during stimulative MR, especially, in the beginning process. Each negative affect on negative situation measured by VAS during each and entire session have been decreased. Negative emotion measured by state-trait anxiety inventory, state-trait anger expression inventory, and hopelessness-depression inventory were decreased as well. The results suggest that stimulative music using contemporary classic music was effective in reduction and modification of negative affect such as anxiety, anger and depression. It shows that Music Recall Technique can be a meaningful intervention for affect modification, and further it can be utilized as self-help in the outside of music therapy setting.

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The Comparison of Noise-induced Hearing Loss Evaluation Criteria for Management (소음성난청 관리를 위한 판정기준간의 비교)

  • 남궁원자;원정일
    • Journal of environmental and Sanitary engineering
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    • v.13 no.1
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    • pp.123-134
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    • 1998
  • The study was performed to investigate the differences among various evaluation criteria for noise-induced hearing loss(NIHL). The subjects were 100 workers who had received detailed audiometric examinations after the periodic annual examination for hearing loss. The evaluation criteria included were as follows: The criterion I was NIHL of 50dB or greater at 4,000Hz in either ear which is one of the legal requirements for determining occupational hearing loss in Korea. The criterion II was NIHL of 40dB or greater by 4-divided classification(a+b+c+d/4 at 500Hz(a), 1,000Hz(b), 2,000Hz(c), 4,000Hz(d)) which is also one of the legal requirements for determining occupational hearing loss in Korea. The criterion III was NIHL of 31dB of greater by 6-divided classification(a+2b+2c+d/6) which is the workers' compensation standard. The criterion IV was NIHL of 40dB or greater by 6-divided classification(a+2b+2c+d/6), the criterion used to prohibite workers to be employed in the noisy workplace. The criterion V was NIHL of 40dB or greater by 3-divided classification(a+b+c/3) which is the guideline of the Japanes Labour Department. The results were as follows; 1. The percentage of workers with NIHL by the criterion I was the highest(96%) and covered all workers with NIHL diagnosed by other criteria. Therefore, this criterion was the most sensitive one for early detection of NIHL among various evaluation criteria. 2. The percentage of workers with NIHL by the criterion II was 29% of the subjects, but all of them could be diagnosed as having NIHL by the criterion I and 33.1% of the NIHL by the criterion III could not be covered by the criterion II. Thus, this criterion was not considered suitable as an initial step for determining occupational hearing loss. 3. The percentage of workers with NIHL by the criterion III was 45% of the subjects. This percentage was 46.9% of the NIHL by the criterion I and was estimated to cover 3.6% of all noise exposed workers. 4. The percentage of workers with NIHL by the criterion IV was 28% of the subjects, but 37.8% of the NIHL by the criterion III and 70.8% of the NIHL by the criterion I were not covered by the criterion. Therefore, these workers could have been employed in the noisy workplaces. 5. Employed relocation which was one of the post management methods was an option in the criterion I in Korea and in the criterion V in Japan. The number of NIHL by the criterion I was 6.7times greater than that by the criterion V. Thus, although employee relocation was not used exclusively, many more workers with NIHL could have been relocated. In conclusion, this study revealed that the criteria being used for managing occupational hearing loss showed a lack uniformity among them. In addition, since these criteria are all relied on the total threshold shifts caused by the noise exposure at the time of hearing test with no consideration given to the past noise exposure history nor age, it can be said that they are not an effective tool for occupational hearing loss management. Since legal requirements are usually followed after being diagnosed as having NIHL, it is recommended that a uniform diagnostic criterion should be used to minimize confusion. Pre-employment hearing tests should also be utilized so as to managing occupational hearing loss after employment rather than being used as a legal roadblock of prohibiting workers with mild hearing loss from being employed. Thus, what is needed is an establishment of a rational criterion for occupational hearing loss management rather than for legal requirements.

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Evaluation of Antibodies Against Haemophilus influenzae Type b in Korean Adults (우리나라 성인에서 Haemophilus influenzae type b에 대한 항체 평가)

  • Lee, Ji Hyen;Kim, Han Wool;Lee, Soyoung;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.125-133
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    • 2017
  • Purpose: After the introduction of Haemophilus influenzae type b (Hib) vaccine in 1995 in Korea, it was included in the national immunization program in 2013. In the post-Hib vaccine era, some studies in other countries reported that invasive Hib disease affects adults, especially the elderly and immunocompromised persons, more often than it affects children. To evaluate disease susceptibility, quantitative and qualitative analysis of anti-polyribosylribitol phosphate (PRP) antibodies were carried out in Korean adults aged 20 to 85 years. Methods: Sera were collected from 39 healthy adults (20 to 50 years of age) and from 30 elderly adults (75 to 85 years of age) who did not have immune-compromising conditions. The concentration of anti-PRP immunoglobulin G (IgG) and serum bactericidal indices (SBIs) were measured by enzyme-linked immunosorbent assay and serum bactericidal assay. Results: Geometric mean concentrations of anti-PRP IgG and geometric mean SBIs were $0.88{\mu}g/mL$ (95% confidence interval [CI], 0.17 to 3.85) and 354 (95% CI, 50 to 2,499) in young adults and $1.67{\mu}g/mL$ (95% CI, 0.53 to 5.24) and 449 (95% CI, 146 to 1,376) in elderly adults, respectively. When the threshold of seropositivity for anti-PRP IgG was applied as 0.15 or $1.0{\mu}g/mL$, which is the protective antibody level in children, seropositive rates were 87.2% or 53.8% in young adults and 100% or 60% in elderly adults. The seropositivity rates of the SBI ($SBI{\geq}4$) were 82.1% and 100% in the groups, respectively. Conclusions: Most subjects in the adult and elderly adult groups display immunity to Hib based on quantitative and qualitative antibody levels, but not all. Because high immunization and low Hib circulation rates may reduce the natural Hib immunity in the population, monitoring Hib immunity as well as disease are needed continuously.

The Knowledge, Attitude and Behavior on the Radiation Safety Management for Dental Hygiene Major Students (치위생(학)과 학생의 방사선안전관리에 대한 지식, 태도 및 행위)

  • Jeon, Yeo Ryeong;Cho, Pyong Kon;Han, Eun Ok;Jang, Hyon Chul;Ko, Jong Kyung;Kim, Yong Min
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.411-420
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    • 2015
  • Objectives : This study tries to find the educational basis based on the radiation safety knowledge, attitudes and behaviors to check the level of radiation safety behavior in domestic students who study dental hygiene. Methods : The students of 3rd and 4th grades in 83 universities which have registered on the Korean University Education Council were involved, and they were given a questionnaire for this study. The questionnaire was provided via visit with 20 copies to each university (total 1660 copies), mail by post and e-mail. Among them, we analyzed only 723 copies that we can trust. The data were analyzed with frequency, percentage, mean, standard deviation and Pearson's correlation using the SPSS/WIN 15.0. Results : As a result, there are correlations in the students' knowledge, attitudes and behaviors regarding the radiation safety management. It means that the education which can improve the knowledge and attitudes should be applied to increase the action level of the radiation safety. In addition, the physical environment is the most closely correlated with the individual behavior, so it will be limited to improve the behavioral levels of the radiation safety if the physical environment is not prepared. Therefore, the physical environment should be supported to enhance the level of the radiation safety activity, and to increase the individual attitude level of radiation safety. Conclusions : The knowledge level of the radiation safety management is relatively lower than the attitudes level, and the behavior level is the lowest. Therefore, the education policy of the safety behavior must be enhanced. For domestic students, the educational intervention is necessary to improve their behavioral level of radiation safety management because they will be able to reduce the amount of radiation exposure of their patients in dental care after getting a job.