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A Patterns of Care Study of the Various Radiation Therapies for Prostate Cancer among Korean Radiation Oncologists in 2006 (Patterns of Care Study를 위한 2006년 한국 방사선종양학과 전문의들의 전립선암 방사선치료원칙 조사연구)

  • Kim, Jin-Hee;Kim, Jae-Sung;Ha, Sung-Whan;Shin, Seong-Soo;Park, Won;Cho, Jae-Ho;Suh, Chang-Ok;Oh, Young-Taek;Shin, Sei-Won;Kim, Jae-Chul;Jang, Ji-Young;Nam, Taek-Keun;Choi, Young-Min;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.96-103
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    • 2008
  • Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

Causative Organisms of Neonatal Sepsis (신생아 패혈증의 원인 병원체에 대한 조사)

  • Kim, Kyung-Ah;Shin, Son-Moon;Moon, Han-Ku;Park, Young-Hoon
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.60-68
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    • 1999
  • A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

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Sanitary Characteristics of Seawater and Sediments in Tongyeong Harbor (통영항의 해수 및 저질의 위생학적 특성)

  • Park, Jun-Yong;Kim, hhhYeong-In;Bae, Ki-Sung;Oh, Kwang-Soo;Choi, Jong-Duck
    • Journal of Food Hygiene and Safety
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    • v.25 no.4
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    • pp.367-375
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    • 2010
  • The bacteriological and physiochemical analysis of sea water and sediments in Tongyeong harbor was conducted to evaluate sanitary conditions. The samples were collected at 8 stations established once a month from June, 2008 to May, 2009. During the study period, the range of temperature was from 6.7 to $25.2^{\circ}C$, transparency ranged from 1.2 to 2.6 m, chemical oxygen demand ranged from 1.90 to 2.92 mg/L, dissolved oxygen ranged from 6.2 to 10.5 mg/L, dissolved nitrogen ranged from 0.052 to 0.098 mg/L, phosphate ranged from 0.044 to 0.065 mg/L, respectively. Seafood, if eaten raw, carries the risk of food poisoning. Seafood poisoning is often cause by pathogenic microorganism originating from fecal contamination, such as Salmonella sp., Shigella sp. and norovirus. Fecal coliforms are an important indicator of fecal contamination. Therefore, data on fecal coliform are very important for evaluating the safety of fisheries in coastal areas. So, we investigated the sanitary indicate bacteria. The coliform group and fecal coliform MPN's of sea water in Tongyeong harbor were ranged from < 1.8~22,000/100 mL (GM 164.9 MPN/100 mL) and < 1.8~7,900 MPN/100 mL (GM 33.7 MPN/100 mL), respectively. Total coliform were detected 97.0% in 96 of samples and 68.9% of total coliforms were fecal coliforms. These results similar to another seawater detection ratio of total coloforms and fecal coliforms. The Vibrios was isolated and identified with VITEK system. Four hundred eighty strains that were obtained from sea water samples in Tongyeong harbor Detection ratio Vibrio alginolyticus, 34.2%, Vibrio parahaemolyticus, 13.8%, Vibrio vulnificus 10.0%, and V. mimicus 12.5% respectively. Vibrio cholerae O1, was not detected. During the study period, the ranges of water content, ignition loss, COD, and acid volatile sulfates in sediments in Tongyeoung harbor were 41.0~57.4%, 7.8~10.5%, 6.51~9.30 mg/g, 0.04~0.09 mg/g, respectively. Heavy metals in sediment of Tongyeoung harbor were Cd, $0.10{\pm}0.05$; Cu, $4.79{\pm}8.20$; As, $1.95{\pm}0.17$; Hg, $0.10{\pm}0.07$; $Cr^{6+}$, $0.34{\pm}0.12$; Zn, $125.33{\pm}16.40$; Ni, $16.43{\pm}1.93$ mg/kg.

DENTAL TREATMENT IN A PATIENT WITH FUKUYAMA TYPE MUSCULAR DYSTROPHY UNDER TOTAL INTRAVENOUS ANESTHESIA USING PROPOFOL (후쿠야마 선천성 근이영양증 환자의 프로포폴을 이용한 전정맥마취 하 치과치료)

  • Jin, Dallae;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.1
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    • pp.66-71
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    • 2013
  • Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol $3{\sim}3.5{\mu}g/mL$. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.

A Study on the Australian Law Regarding RPAS (Remotely Piloted Aircraft System): Need for an International Approach

  • Wheeler, Joseph;Lee, Jae-Woon
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.311-336
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    • 2015
  • This article surveys the current international law with respect to RPAS from both the public air law and private air law perspectives. It then reviews current and proposed Australian domestic RPAS regulation while emphasizing the peculiar risks in operation of RPAS; and how they affect concepts of liability, safety and privacy. While RPAS operations still constitute only a small portion of total operations within commercial aviation, international pilotless flight for commercial air transport remains a future reality. As the industry is developing so quickly the earlier the pursuit of the right policy solutions begins, the better the law will be able to cope with the technological realities when the inevitable risks manifest in accidents. The paper acknowledges that a domestic or regional approach to RPAS, typified by the legislative success of the Australian experience, is and continues to be the principal measure to deal with RPAS issues globally. Furthermore, safety remains the foremost factor in present and revised Australian RPAS regulation. This has an analogue to the international situation. Creating safety-related rules is imperative and must precede the creation or adoption of liability rules because the former mitigates the risk of accidents which trigger the application of the latter. The flipside of a lack of binding airworthiness standards for RPAS operators is potentially a strong argument that the liability regime (and particularly strict liability of operators) is unfair and unsuited to pilotless flight. The potential solutions the authors raise include the need for revised ICAO guidance and, in particular, SARPs with respect to RPAS air safety, airworthiness, and potentially liability issues for participants/passengers, and those on the ground. Such guidance could then be adapted swiftly for appropriate incorporation into domestic laws bypassing the need for or administrative burden and time it would take to activate the treaty process to deal with an arm of aviation that states know all too well is in need of safety regulation and monitoring.

The Role of Open Lung Biopsy in Diagnosis and Treatment of Diffuse Interstitial Lung Disease in High-resolution Computed Tomography Era (고해상도 전산화단층촬영 시대에 있어서 미만성 간질성 폐질환의 진단 및 치료에서의 개흉폐생검의 역할)

  • Kim, Gye Su;Lee, Jae Chul;Lee, Seung Joon;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Min, Kyung Up;Im, Jung-Gi;Kim, You Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.746-754
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    • 1996
  • Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share conUTIon clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCf) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide infonnation on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treannent plan in patients who have undergone high-resolution CT. Method : Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results : High-resolution cr suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confinned (0 be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution cr was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lWlg biopsy in only 2 cases. Conclusion: The aoove fmdings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.

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A Leg Analysis on the Discharge of Cargo Residue at Sea (화물잔류물의 해양 투입처분(배출) 사안에 대한 법률적 분석)

  • Hong, Gi-Hoon;Park, Chan-Ho
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.9 no.4
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    • pp.193-202
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    • 2006
  • The Consultative Meeting of the Convention on the Prevention of Marine Pollution by Dumping of Wastes and other matter, 1972 (London Convention 1972) has requested to International Maritime Organization (IMO) Marine Environmental Protection Committee to collaborate and help clarify a boundary issue between International Convention for the Prevention of Pollution from Shops, 1973 as modified by the Protocol of 1978 (MARPOL) and the London Convention concerning 'dumping' versus 'discharges' during normal operations of ships in 2004, and subsequently established a Joint London Convention/MEPC Correspondence Group. The Contracting Parties to London Convention expressed their environmental concerns on the broad interpretation of the "cargo-associated wastes" by the States, which could be discharged by ships under MARPOL. Regulatory regimes for the cargo residues appear to vary among states. Some countries require fur ships to discharge their cargo wastes into the port reception facility and IMO also recommends doing so. This paper examines the related current national and international legal texts for the regulation of disposal of wastes from ships in order to analyze the current global concern on the marine pollution associated with waste discharge during operations of ships. In particular, we attempt to evaluate the likely marine environmental consequences arising from the disposal of cargo residue using an hypothetical case for the coal cargo residue among bulk cargos in this paper, since location, magnitude and frequency of the discharge of coal cargo residues into the sea adjacent to Korean Peninsula are not readily available. The cargo residues may be discharged to the sea according to MARPOL 73/78; however, its marine environmental consequences can be significant depending upon the characteristics and amounts of wastes to be discharged. Also the public tolerance of the environmental consequences would be widely different among nations. Multilateral environmental agreements, in general, more strictly apply their rules if there are other options to disposal at sea, i.e. port reception facility in this case. Therefore, port reception facilities for the wastes generated by ships are recommended to be further constructed in major national ports in order to reduce the risk of environmental damages during the operations of ships.

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Strategies of Large Park Development and Management through Governance - Case Studies of The Presidio and Sydney Harbour National Park - (거버넌스를 통한 대형 도시공원의 조성 및 운영관리 전략 - 프레시디오 공원과 시드니 하버 국립공원 사례를 중심으로 -)

  • Sim, Joo-Young;Zoh, Kyung-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.60-72
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    • 2016
  • This study aims to suggest strategies of development and management for large parks by examining experimental cases of park governance models related to a shift away from public administration. The shifts towards governance as well as public-private partnership in city parks have involved the need for new public management. This study has analyzed two exemplary cases of Presidio Park and Sydney Harbour National Park in the aspects of planning process and management strategies, as the results derived the meaning and effect of park governance management and is also an essential prerequisite for the achievement of the model. There are six dimensions of research frames--namely policy, governance, partnership, finances and funds, design and maintenance-management, and evaluation-monitoring-taken as the basis for this study. Through the analysis, several key characteristics of these cases were elicited. First, the park planning process must be consistent in carrying a policy from planning to implementation, and furthermore, an independent operation body which can properly authorize an execution and uphold its responsibility from the public could serve in adaptable park services. Second, it has been suggested to build various partnerships with PAs and NGOs, private corporations, community groups, and academic institutes that allow it to expand the diversity of the park activities. Third, there has been experimental exploration to achieve a financially self-sufficient model by establishing internal revenue models and hence allow the reduction of reliance on public finances. The result of this type of park management would allow for improving park quality and make the park space a vital part of the local economy. Fourth, the strategies for a local community's participation are needed to allow the community to become a producer as well as a consumer. This study shows that the direction and significance of the park governance model regarding the fact that the plans sought by the two parks are extending the layout of public-centered discussion to the private sector and the third non-governmental sector including to the local community group. This shows both implications and limitations, such as the risk of privatization through non-governmental activities at the park or the violation of essential functions as a public good due to a profit-generating management policy for securing financial self-sufficiency. At the current point in which plans are under way for the development and management of large parks, a park governance model requires continuous study and expansion of discussion in the future.

The Measurements of Plasma Cytokines in Radiation-induced Pneumonitis in Lung Cancer Patients (폐암환자에서 방사선 폐렴 예측을 위한 혈장 Cytokine측정)

  • Hur Won Joo;Youn Seon Min;Lee Hyung Sik;Yang Kwang Mo;Sin Geun Ho;Son Choon Hee;Han Jin Yeong;Lee Ki Nam;Jeong Min Ho
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.314-320
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    • 2000
  • Purpose :To investigate whether changes in plasma concentrations of transforming growth factor-$\beta$1(TGF-$\beta$1), tumor necrosis factor-alpha (TNF-$\alpha$) and interleukin-6 (IL-6) could be used to identify the development of radiation-induced pneumonitis in the lung cancer patients. Methods and Materials :Seventeen patients with lung cancer (11 NSCLC, 6 SCLC) were enrolled in a prospective study designed to evaluate clinical and molecular biologic correlation of radiation-induced pneumonitis. The study began in May 1998 and completed in July 1999. All patients were treated with radiotherapy with curative intent : 1.8 Gy per day, 5 fractions per week. Serial measurements of plasma TGF-$\beta$1, TNF-$\alpha$ and IL-6 were obtained in all patients before, weekly during radiotherapy and at each follow-up visits after completion of treatment. These measurements were quantified using enzyme linked immunosorbent assay (ELISA). All patients were evaluated for signs and symptoms of pneumonitis at each follow-up visit after completion of radiotherapy. High resolution CT (HRCT) scans were obtained when signs and symptoms of pneumonitis were developed after completion of radiotherapy. Results : Thirteen patients eventually developed signs and symptoms of clinical pneumonitis 씬file four patients did not. TGF-$\beta$ 1 levels were elevated in all 13 patients with pneumonitis, which showed characteristic pattern of elevation (38.45 ng/ml at pretreatment, 13.66 ng/ml during radiotherapy, then 60.63 ng/ml at 2-4 weeks after completion of radiotherapy). The levels of TNF- $\alpha$ and IL-6 were also elevated In the group of patients who developed pneumonitis but the pattern was not characteristic. Conclusions : Changes in plasma TGF$\beta$-1 levels before, during and after radiotherapy appears to be a useful means by which to identify patients at risk for the development of symptomatic pneumonitis. Other cytokines like TNF- $\alpha$ and IL-6 shows no meaningful changes in association with radiation pneumonitis.

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Platelet count change by vincristine in maintenance phase of acute lymphoblastic leukemia chemotherapy (급성 림프구성 백혈병의 항암 유지요법 중 vincristine과 관련된 혈소판수의 변화)

  • Lee, Sung Moon;Ham, Soon Shik;Jeon, In-sang
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.181-186
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    • 2006
  • Purpose : The hematologic change during the treatment of acute lymphoblastic leukemia(ALL) is critical as a prognostic determinant and a variable to determine the dose of chemotherapeutic agents. It is known that the dose of vincristine used in the maintenance phase of ALL is small enough to increase the count of platelet. To investigate the change of platelet count according to the vincristine administration in maintenance phase of ALL chemotherapy, we performed this study. Methods : Eleven patients eligible under the criteria of Children's Cancer Study Group(CCG)-1882 and who had completed chemotherapy were enrolled in this study. The count of platelets before vincristine administration was compared with those of vincristine administration 1, 2 and 3 weeks after the early and last periods of maintenance phases. The platelet count before vincristine administration was defined as 100 percent and that after vincristine were compared. In addition, we tentatively defined an enhancing effect of vincristine as positive when the relative count was more than 120 percent. Results : Platelet count did not differ according to the early and last periods of maintenance phase. Platelet count at first week after vincristine administration increased more significantly than that before vincristine in early and last periods. There was an enhancing effect in 10(90.9 percent) of 11 patients after 1 week vincristine administration both in the early and last periods of the maintenance phase. Conclusion : Vincristine, used in ALL maintenance phases as a low dose, increased platelet count 1 week after administration. The increased platelet count resumed to the previous level 2-3 weeks later. However, the thrombocytosis observed in the maintenance phase by vincristine was not high enough to induce thrombosis. In addition, vincristine is known to reduce the activity of platelets. Therefore, the risk of thrombosis in the maintenance phase of ALL chemotherapy would be low.