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Clinical Study of Topotecan as Second-Line Treatment in Small Cell Lung Cancer (소세포폐암의 2차요법으로서의 Topotecan의 치료효과)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.230-240
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    • 2002
  • Background : The majority of chemotherapy-treated small cell lung cancers(SCLC) patients eventually recur. Although many patients are in excellent physical condition at the time of recurrence, few drugs or drug combinations are capable of effecting a tumor regression in this setting. Topotecan, a topoisomerase I inhibitor, is one of the more widely studied single afents in SCLC. The aim of this study was to determine the response rate, survival and toxicity of topotecan as a second line traeatment SCLC. Materials and Methods : 19 patients with measurable SCLC, progressive during the first line chemotherapy (9 cases) or recurrent after the first line chemotherpy(10 cases), were enrolled in this study. Topotecan was administered as a 30-minute daily infusion at a dose of 1.5mg/$m^2$ for 5 consecutive days, every 3 weeks. Results : The overall response rate was 26.3%(5/19, CR 2, PR 3, SD 3, PD 11). The median survival was 24 weeks. The response rate and survival were poor in the nonresponders during first chemotherapy, those who were refractory to the first chemotherapy(recurrent within 3 months after completion of first chemotherapy) and extensive disease, but the results were not statistically significant. The toxicities were mainly hematologic and anemia grade III 1/90, leukopenia grade III 6/90 IV 4/90, thrombocytopenia grade III 1/90 IV 1/90, vomiting grade III 1/90 of cycles were occurred. There was no treatment-related deaths due to severe myelosuppression. Conclusion : Topotecan can be an active second line chemotherapeutic agent for treating SCLC.

Morphologic Response of Gravel Beach to Typhoon Invasion - A Case Study of Gamji Beach Taejongdae in Busan (태풍 내습 시 자갈 해빈의 지형반응 - 부산 태종대 감지 해빈의 사례)

  • Lee, Young Yun;Chang, Tae Soo
    • Journal of the Korean earth science society
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    • v.41 no.1
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    • pp.19-30
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    • 2020
  • To understand the impact of typhoons on Gamji gravel beach Taejongdae in Busan, we carried out beach profiling using a VRS-GPS system and a Drone photogrammetry for the typhoons 'Kong-rey' invaded in October 2018 and 'Danas' in July 2019. In addition, grain sizes are analyzed to investigate the overall distribution pattern of gravels on the beach, and the beach topography is surveyed periodically to confirm the recovery rate of the beach. Grain-size analysis reveals that mean gravel sizes, in general, become finer from -6.2Φ to -5.4Φ towards the east in the seashore line direction. Variation in mean sizes is obviously observed in the cross-shore direction. Gravels in the swash zone are relatively fine about -4.5Φ in size and equant in shape, whereas the coarse and oblate gravels ranged from -5Φ to -6Φ are found in the berm. Gamji gravel beach particularly has two lines of berms: a lower berm situated facing beach and an upper berm about 10 m landward. After the typhoon Kong-rey passed by, about 1.4 m of severe erosion in upper berm occurred, and the berm eventually disappeared. On the backshore of the upper berm about 50 cm of erosion took place so that the elevation became lower. However, tangible erosion was not observed in the lower berm. When typhoon Danas hit, rated as mild storm, both upper and lower berm were eroded out. However, about 50 cm of deposition occurred only in the backshore. Only three days later, the new lower berm was formed, meaning that sedimentation rate must be high. This result indicates that Gamji gravel beach is recovered very fast from erosion caused by the typhoons when it is under the fair-weather condition even though beach morphology changes dramatically in a short period of time. Gravel beach is estimated to be or evaluated very resilient to typhoon erosion.

A Research on Perception of Leadership Affects Long-term Working Intention in the Beauty Service Employees (미용서비스종사자의 리더십 지각이 장기근속의도에 미치는 영향에 관한 연구)

  • Oh, Jin Sook;Youn, Chun Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.4
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    • pp.21-32
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    • 2012
  • The current beauty service of Korea is upgrading its outside appearance from traditional small-shop image and its speed of change and competition are more severe than ever before. The top priority trait of beauty management is based on man-power resource, and personnel-management is the most important thing that more than anything else. Compared with other arenas of business, personnel management plays a key role in beauty industry. As a result, this research begins with the issue of personnel management. In addition, I will show that the management leadership of beauty service affects organization civil actions and changing jobs in the beauty industry employees, and the leadership can lower changing job rate to some extent. The role and duty of business manager is very significant because the dependence of man-power resource is magnificent in beauty service. In spite of rapid changing of economic surroundings, the management of beauty service is still working without any detail plans. It is no exaggeration to say that the most of beauty service managers are lack of leadership conception. Although the demands of customers are changing everyday, the frequent changing of jobs among talented employees drops customers credibility and high-quality service. From a management viewpoint, re-training cost of employees leads to economic loss and the company suffers from financial problems. As a result, it creates vicious circle in the beauty industry. Today, the management atmosphere in the beauty service is hard to get its right track because of the cutthroat competitions of beauty industry and difficulties of hiring promising employees. It has been said that "Nothing ventured, Nothing gained" Above all, the beauty service requires job speciality and it produces economic profits. Therefore, the managers desperately need to change the way they regard those with job changers. In this research shows the principal index of the leadership type of beauty business managers how much affects its employees' long-term working condition. The new concept of leadership, such as alternative suggestions, setting goals, and organization civil action will reorganize the stereo-type frame. I will also investigate the factors of job changing and intention of the beauty service employees for the development option of the beauty industry.

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Screening Methods for Resistant Cucumber Cultivars against Cucumber Scab Caused by Cladosporium cucumerinum Using Cucumber Fruits and Seedlings (오이 유묘와 과실을 활용한 검은별무늬병에 대한 저항성 품종 검정 방법)

  • Park, So-Hyang;Hong, Sung-Jun;Shim, Chang-Ki;Kim, Min-Jeong;Park, Jong-Ho;Han, Eun-Jung;Park, Jong-Won;Jee, Hyeong-Jin;Kim, Seok-Cheol;Kim, Yong-Ki
    • Research in Plant Disease
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    • v.22 no.1
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    • pp.18-24
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    • 2016
  • This study was conducted to elucidate the cultural and pathogenic characteristics of Cladosporium cucumerinum PT1 and resistance of 81 commercial cucumbers (Cucumis sativus). Cucumber leaves and fruits appeared as scab were collected from a plastic film house located in Pyeongtaek, Gyeonggi-province, Korea in late March, 2015. A casual fungus was isolated from the diseased fruits on potato dextrose agar and it was identified as C. cucumerinum PT1 based on the morphological characteristics. To find out the effect of wounding and fruit size on the development of cucumber scab, small (<10 cm long), medium (10 to 20 cm long), and large (>20 cm long, commercially mature fruit) size cucumber fruits were harvested, C. cucumerinum PT1 pathogens were inoculated with a single droplet of suspension ($1{\times}10^5$ spores/ml) on wounded or unwounded cucumber fruits. Small fruits were completely damaged with showing severe water-soaking symptoms and fast pathogen growth regardless of wounded or unwounded. Meanwhile slight water-soaking symptoms on medium and large size fruits occurred and disease development into plant tissues was observed only on wounded fruits. Disease resistance of 81 commercial cucumber cultivars was evaluated on third-stage seedlings and small fruits by inoculating suspension ($1{\times}10^5$ spores/ml) of C. cucumerinum PT1. As a result, mini and pickling cultivar groups were resistant, 'Cheoeumcheoreom' cultivar was symptomless and the other cultivars were resistant to medium resistant. On the other hand, most of cucumber cultivars belonging to the other groups were susceptible. Disease resistance of cucumber against cucumber scab was significantly different among cultivars and a few cucumber cultivars showed different disease resistant responses to two bioassay methods using seedlings and small fruits. Therefore, to screen scab resistance in cucumber, a test using both fruits and seedlings is advisable. We think that the selected resistant cultivars can be used to control cucumber scab effectively under the farmhouse condition.

Comparison of Inflammatory Response and Myocardial injury Between Normoxic and Hyperoxic Condition during Cardiopulmonary Bypass (체외순환 시 정상 산소분압과 고 산소분압의 염증반응 및 심근손상에 관한 비교연구)

  • 김기봉;최석철;최국렬;정석목;최강주;김양원;김병훈;이양행;조광현
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.524-533
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    • 2001
  • Background: Hyperoxemic cardiopulmonary bypass (CPB) has been recognized as a safe technique and is widely used in cardiac surgery. However, hyperoxemic CPB may produce higher toxic oxygen species and cause more severe oxidative stress and ischemia/reperfusion injury than normoxemic CPB. This study was undertaken to compare inflammatory responses and myocardial injury between normoxemic and hyperoxemic CPB and to examine the beneficial effect of normoxemic CPB. Material and method: Thirty adult patients scheduled for elective cardiac surgery were randomly divided into normoxic group (n=15), who received normoxemic CPB (about Pa $O_{2}$ 120 mmHg), and hyperoxic group (n=15), who received hyperoxemic CPB (about Pa $O_{2}$ 400 mmHg). Myeloperoxidase (MPO), malondialdehyde (MDA), adenosine monophosphate (AMP), and troponin-T (TnT) concentrations in coronary sinus blood were determined at pre- and post-CPB. Total leukocyte and neutrophil counts in arterial blood were measured at the before, during, and after CPB. Lactate concentration in mixed venous blood was analyzed during CPB, and cardiac index (Cl) and pulmonary vascular

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A Survey on the Workplace Environment and Personal Protective Equipment of Poultry Farmers (양계 농업인의 작업장 환경 및 개인보호구 착용 실태조사)

  • Kim, Insoo;Kim, Kyung-Ran;Lee, Kyung-Suk;Chae, Hye-Seon;Kim, Sungwoo
    • Journal of Environmental Health Sciences
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    • v.40 no.6
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    • pp.454-468
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    • 2014
  • Objectives: This study was conducted to investigate the actual condition of the farm work environment and personal protective equipment as part of the effort to improve livestock work for the safety and health of poultry farmers and provide basic data for establishing plans to improve and develop personal protective equipment. Methods: For this purpose, a questionnaire survey on general information about stables, the poultry work environment, accidents, the wearing of work clothes and personal protective equipment, and the level of awareness related to personal protective equipment was conducted among 148 poultry farmers. Results: As a result, it was found that poultry workplace environment was exposed to such risks as fine dusts; organic dusts; poisonous gases; odorous substances; chicken excrement; contact with chickens, bacteria or viruses; and accidents related to machine operation. Thirteen percent of respondents suffered severe respiratory diseases, and the most frequently injured sites due to accidents were the hands (25.7%), knees (23.8%), arms (17.3%), and head (10.9%). The most frequent type of accident was collisions between the body and obstacles or machinery during movement (36.4%), followed by erroneous machine operation such as feeders and electric shocks (8.5%). Regarding the wearing of work clothes and personal protective equipment, 51.7% of the respondents wore worn-out clothing or everyday clothes, whereas only 32.0% wore work clothes. The percentage of farmers who wore proper protective equipment for the work environment during poultry work was 48.4%. The most frequently used type of protective equipment was boots (38.9%), followed by mask (36.7%), gloves (36.3%), appropriate work clothes (22.6%), quarantine clothes (17.6%), helmets (13.4%), and goggles (12.6%). The rate of wearing goggles was low because they were considered inconvenient and lowered work efficiency. Furthermore, they purchased everyday products available on the market for their personal protective equipment which were not appropriate for maintaining safety in an actual harmful environment and its consequent risks. As a result of the survey of the awareness level related to personal protective equipment, their levels of awareness of accidents and attitude proved to be average or higher, but the practice of wearing protective equipment and the level of knowledge and management of personal protective equipment were lower. Conclusion: This survey found that the wearing status of personal protective equipment among poultry farmers was insufficient even though they were exposed to risks. Most respondents were aware of the necessity of wearing personal protective equipment and of the potential for accidents, but they did not wear proper protective equipment. Their wearing rate was low due to a lack of knowledge about protective equipment, as well as the inconvenience of wearing it. Therefore there is a need to improve and develop specialized personal protective equipment for respiration, hands, and eyes, as well as work clothes that can protect farmers from major harmful matter that is generated in the poultry workplace. Based on the results of this investigation, we will conduct further studies on the required performance and design directions of personal protective equipment while collecting more objective data through field-oriented assessments.

Clinical Features of Acute Pancreatitis in Children (소아 급성 췌장염의 임상적 고찰)

  • Seo, Jung-Ho;Kim, Seong-Heon;Jeong, Sang-Geon;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.58-65
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    • 2010
  • Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7${\pm}$4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3${\pm}$553.2 and 766.2${\pm}$723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.

The Usefulness of a Percutaneous Cardiopulmonary Support Device for the Treatment of Fulminant Myocarditis (전격성 심근염의 치료에 있어 경피적 순환 보조 장치의 유용성)

  • Lim, Juyoug;Jung, Sung Ho;Je, Hyoung-Gon;Lee, Taek Yeon;Choo, Suk Jung;Lee, Jae Won;Chung, Cheol Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.20-24
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    • 2010
  • Background: Fulminant myocarditis is a rare, but life threatening condition. Its prognosis is related with proper management in the acute phase. A cardiopulmonary support device can be very useful in this phase. We report on our experiences with managing acute fulminant myocarditis with a cardiopulmonary support (CPS) device. Material and Method: We reviewed retrospectively 9 patients who had a CPS device used for their fulminant myocarditis between September, 2006 and October, 2008. A Capiox emergency bypass system (Terumo Inc, Tokyo, Japan) was percutaneously inserted in all the patients. Upon implantation, all the patients were in cardiogenic shock because of ventricular arrhythmia or severe left ventricular dysfunction. The mean left ventricular ejection fraction (EF) was $20{\pm}6%$ according to transthoracic echocardiography. Result: 3 patients died despite CPS. The CPS was bridged to a transplanted heart in one patient. The rest were successfully explanted after a mean time of $107{\pm}70$ hours of running. The mean EF after discharge was $56{\pm}7%$ without dilated cardiomyopathy. Conclusion: Fulminant myocarditis can be fatal, but its prognosis is excellent if these patients receive proper, timely treatment. A cardiopulmonary support device can be very useful in this acute period. However, the implantation and management protocol of cardiopulmonary support are not yet settled. Further study is necessary to lower the complications of cardiopulmonary support for patients with fulminant myocarditis.

Regulation of Professional Advertising: Focusing on Physician Advertising (전문직 표시·광고규제의 몇 가지 쟁점: 의료광고를 중심으로)

  • Lee, Dongjin
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.177-219
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    • 2016
  • A commercial advertisement is not only a way of competition but also a medium of communication. Thus, it is under the constitutional protection of the freedom of business (article 15 of the Constitution) as well as the freedom of press [article 21 (1) of the Constitution]. In terms of the freedom of business or competition, it should be noted that an unfair advertising (false or misleading advertisement) can be regulated as an unfair competition, while any restraint on advertising other than unfair one might be doubted as an unjustifiable restraint of trade. In terms of the freedom of press or communication, it is important that article 21 (2) of the Constitution forbids any kind of (prior) censorship, and the Constitutional Court applies this restriction even to commercial advertising. In this article, the applicability of these schemes to advertising of the so-called learned professions, especially physician, are to be examined, and some proposals for the reformation of the current regulatory regime are to be made. Main arguments of this article can be summarized as follows: First, the current regime which requires advance review of physician advertising as prescribed in article 56 (2) no. 9 of Medical Act should be reformed. It does not mean that the current interpretation of article 21 of the Constitution is agreeable. Though a commercial advertising is a way of communication and can be protected by article 21 (1) of the Constitution, it should not be under the prohibition of censorship prescribed by article 21 (2) of the Constitution. The Constitutional Court adopts the opposite view, however. It is doubtful that physician advertising needs some prior restraint, also. Of course, there exists severe informational asymmetry between physicians and patients and medical treatment might harm the life and health of patients irrevocably, so that medical treatment can be discerned from other services. It is civil and criminal liability for medical malpractice and duty to inform and not regulation on physician advertising, to address these differences or problems. Advance review should be abandoned and repelled, or substituted by more unproblematic way of regulation such as an accreditation of reviewed advertising or a self-regulation preformed by physician association independently from the Ministry of Health and Welfare or any other governmental agencies. Second, the substantive criteria for unfair physician advertising also should correspond that of unfair advertising in general. Some might argue that a learned profession, especially medical practice, is totally different from other businesses. It is performed under the professional ethics and should not persue commercial interest; medical practice in Korea is governed by the National Health Insurance system, the stability of which might be endangered when commercial competition in medical practice be allowed. Medical Act as well as the condition of medical practice market do not exclude competition between physicians. The fact is quite the opposite. Physicians are competing even though under the professional ethics and obligations and all the restrictions provided by the National Health Insurance system. In this situation, regulation on physician advertising might constitute unjustifiable restraint of competition, especially a kind of entry barrier for 'new physicians.'

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Field Bioassays On Shellfish To Assess Environmental Pollution Levels Of The Masan Bay (마산만(馬山灣)의 환경오염(環境汚染) 평가(評價)를 위한 야외(野外) 생물(生物) 오염(汚染) 시험(試驗) 연구(硏究))

  • Park, Joo-Surk
    • 한국해양학회지
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    • v.14 no.1
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    • pp.15-25
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    • 1979
  • A study on field bioassay test using four species of commercially important shellfish was carried out to assess the effect of pollutants and determine the extent of marine environmental pollution of the Masan Bay from 9 to 15 August 1978. Water quality analysis and planktological examination of sea water were made during the experiment and the examination gave the following results. The water temperature was so high at 31.7$^{\circ}C$ in maximum and rather subject to change on weather condition of the land than on the effect of the water mass from outer bay. The range of DO,COD and SS at the stations were 0.3-7.08cc/l, 0.07-3.31ppm and 5.5-117ppm, respectively with the high values of COD and SS at the stations 7 and 1. The concentrations of the dissolved inorganic nitrogen in sea water, NH$\sub$4/-N, NO$\sub$2/-N, NO$\sub$3/-N, and PO$\sub$4/-P were 18.90-99.80, 2.48- 19.60, 13.00-39.00 and 1.04-14.0$\mu\textrm{g}$ at/l, respectively with decrease of their values in the outer part of the Bay. The high values mentioned above were caused by the sewage and industrial activities. The effects of organic waste are increased oxygen demand, nutrient concentration, turbidity and a higher input of pathogens, leading to structural changes in the marine ecosystems and to a considerable hazard to public health. The percentage composition of phytoplankton standing crop between diatom and dinoflagellate was characterized by making a difference between the two groups in respect of location: a decrease of diatom and a increase of dinoflagellate in numerical abundance toward inner part from outer part of the bay. Namely phytoplankton organisms were composed of 80% of diatom and 20% of dinoflagellate in outer bay, on the contrary, only 4% of diatom and 96% of dinoflagellate occupied by 94% of prorocentrum micans known as tolerant species to polluted reaas in the inner bay. On the occurrence and composition of zooplankton, there are two significant communities in the bay:one is characterized by the predominance of Oithona nana and the other by Favella sp They were composed of a range from 84% to 90% of the total organisms and monotonously constituted of themselves only at most inner station 3 even small numbers. From the results mentioned above, Oithona nana, Favella and prorocentrum micans recommed themselves as valuable indicators for judging the extent of the marine pollution.During the period of the biossays Mytilus edulis showed the highest mortality and Tapes japonica the lowest one between the four test species. The highest death rate by stations was found at most inner stations 3'and 4near Masan Free Export Zone with the most sensitive response and the lowest one occured at outer station 13 where no death specimen of oyster and arkshell was found during the whole test period.As for mussel,85 percent death rate appeared after 72 hours and 100percent rate after 120hours at station 4. It was found that the significant high mortality of the test shellfish mentioned above was caused by severe pollution with mainly organic pollutants from domestic sewage and industrial wastes from the results of too much higher concentrations of dissolved inorganic nitrogen especially ammonia-N,COD,SS and lack of dissolved oxygen,and furthermore occurrence and abundance composition of Prorcentrum,Favella and Oithona nana by stations, valuable indicator species of coastal pollution by orgnic and boilogical pollutants.

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