• Journal of Radiation Protection and Research
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• v.38 no.4
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• pp.214-227
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• 2013

Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.43-58
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• 2000

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

• Applied Biological Chemistry
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• v.38 no.5
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• pp.468-472
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• 1995

Substantial amount of caryophyllene oxide (CPO) is present in the essential oils of traditionally-used folk medicinal plants and herbal spices. The CPO, produced via chemical and/or enzymatic reaction of caryophyllene (CP), has largely being used as a flavoring component and exhibited a variety of biological activities. Now, we report the antimutagenic activity of CPO determined by Ames's preincubation test. S-9 fraction was prepared from the liver of rats treated with Arochor 1254. Anatoxin $B_1\;(AFB_1)$ and 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) were used as mutagens. Reduction of mutagenicity of $AFB_1$ or IQ for S. typhimurium TA98 and TA100 by CPO was found to be a dose-dependant manner. CPO (500 ${\mu}g/plate$) reduced mutagenicity of AEB1 for S. typhimurium TA98 and TA100 to 89% and 71%, respectively. For IQ, similar results were observed against S. typhimurium TA98 and TA100, resulting in the inhibition percentage of 77% and 51%, respectively. CP also reduced mutagenicity of AEB1 and IQ for S. typhimurium TA98 and TA100, but the reduction rate was somewhat lowered relative to that of CPO. These results indicate that CPO could be developed as a potent antimutagenic flavoring agent.

• Journal of Korean Academy of Nursing
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• v.29 no.1
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• pp.161-173
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• 1999

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support, sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnare from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. ［$\chi$$^2$＝6.93(df＝5, P＝.23), GFI＝.99, AGFI＝.94, RMSR＝.019, NNFI＝.97, NFI＝.98, CN＝440, standardized residuals(-2.14-2.10)］ 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. The modified model also showed a good fit with the data. ［$\chi$$^2$＝5.26(df＝7, P＝.63), GFI＝.99, AGFI＝.97, RMSR＝.014, NNFI＝1.02, NFI＝.99, CN＝710, standardized residuals(-1.46-1.70)］ Results of the testing of the hypothesis were as follows : 1. Marital intimacy(${\gamma}$11＝.78, t＝14.37) and professional support(${\gamma}$13＝.12, t＝2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(${\gamma}$25＝.32, t＝3.12), importance of uterus(${\gamma}$22＝.20, t＝2.61) and spouse's support($\beta$2l＝-.19, t＝-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss($\beta$32＝-.66, t＝-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(${\gamma}$31＝.19, t＝3.33), indirect(${\gamma}$31＝.14, t＝2.52) and total effect(${\gamma}$31＝.25, t＝4.41) on the quality of life. Professional support had a direct effect(${\gamma}$33＝.11, t＝2.07) and total effect(${\gamma}$33＝.13, t＝2.31) on the quality of life. The direct effect of pre-operative symptoms(${\gamma}$35＝-.36, t＝4.02) and positive coping behavior(${\gamma}$34＝.15, t＝2.06) had the insignificant effect on the quality of life while, due to the idirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre -operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1154-1166
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• 1998

Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.311-316
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• 1999

Background: The drug-resistant tuberculosis has recently decreased in Korea, but it is still one of the major obstacles in the treatment of pulmonary tuberculosis. Unfortunately there are no reliable ways to figure out the drug sensitivity pattern of the M. tuberculosis in the starting point of treatment. At least several months which is critical for the success of treatment have to be passed away before getting the report of drug-sensitivity test. The aim of this study was to find out the clinical and radiological parameters that make it possible to predict the drug-resistant pulmonary tuberculosis and to make a correct decision on the antituberculosis drug regimens. Method: We studied 253 pulmonary TB patients with sputum and/or bronchial washing fluid culture-positive diagnosed at the Chung-Ang University Young-San Hospital in the period of 1989-1994. The differences in the clinical and raiological variables between the drug-sensitive and the drug-resistant tuberculosis patients were evaluated. Results: In 66 out of 253 patients(26.1%), drug resistant tuberculosis to at least one antituberculosis drug were found. Patients with retreatment showed higher resistance rate than those with initial treatment(30/69, 43.5% vs 36/184, 19.5%, p<0.01). Patients with cavitary TB showed higher resistance rate than those with non-cavitary TB(24/54, 44.4% vs 42/199, 21.1%, p<0.05). Among patients with initial treatment, those with far-advanced TB showed a higher drug resistance rate than those with minimal lesion(9/23, 36.9% vs 10/82, 12.5%, p<0.05). Patients with culture positive only in the bronchial washing fluid showed lower resistance rate than those with sputum culture positive(7/63, 11.1 % vs 59/190, 31.1%, p<0.05). Conclusion: Prior treatment history for pulmonary tuberculosis, the presence of cavity & far advanced tuberculosis in the radiologic exam, sputum rather than solely bronchial washing culture positivity would be the related factors to the drug resistance. So in the patients with such characteristics, it is needed to try to find out the drug sensitivity pattern of the infecting tuberculosis organism as soon as possible.

• Journal of Korean Society of Environmental Engineers
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• v.31 no.1
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• pp.51-57
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• 2009

Biofouling in seawater reverse osmosis (SWRO) desalination process causes many problems such as flux decline, biodegradation of membrane, increased cleaning time, and increased energy consumption and operational cost. Therefore biofouling is considered as the most critical problem in system operation. To control biofouling in early stage, detection of the most problematic bacteria causing biofouling is required. In this study, six model bacteria were chosen; Bacillus sp., Flavobacterium sp., Mycobacterium sp., Pseudomonas aeruginosa, Pseudomonas fluorescens, and Rhodobacter sp. based on report in the literature and phylogenetic analysis of seawater intake and fouled RO membrane. The adhesion to RO membrane, the high pressure resistance, and the hydrophobicity of the six model bacteria were examined to find out their fouling potential. Rhodobacter sp. and Mycobacterium sp. were found to attach very well to RO membrane surface compared to others used in this study. The test of hydrophobicity revealed that the bacteria which have high hydrophobicity or similar contact angle with RO membrane ($63^{\circ}$ of contact angle) easily attached to RO membrane surface. P. aeruginosa which is highly hydrophilic ($23.07^{\circ}$ of contact angle) showed the least adhesion characteristic among six model bacteria. After applying a pressure of 800 psi to the sample, Rhodobacter sp. was found to show the highest reduction rate; with 59-73% of the cells removed from the membrane under pressure. P. fluorescens on the other hand analyzed as the most pressure resistant bacteria among six model bacteria. The difference between reduction rates using direct counting and plate counting indicates that the viability of each model bacteria was affected significantly from the high pressure. Most cells subjected to high pressure were unable to form colonies even thought they maintained their structural integrity.

• Research in Plant Disease
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• v.14 no.1
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• pp.15-20
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• 2008

Three isolates of Cucumber mosaic virus (CMV) were isolated from weed hosts showing typical mosaic symptoms, and some properties of the viruses were investigated. CMV isolates, designated as Is-CMV, Jd-CMV and Pla-CMV from Isodon inflexus, Jeffersonia dubia and Phryma leptostachya var. asiatica, respectively, were identified and characterized by biological reaction in several host plants, serological property, dsRNA analysis, reverse transcription-polymerase chain reaction (RT-PCR), restriction fragment-length polymorphism (RFLP). All isolates systemically infected in Nicotiana benthamiana, Cucurbita pepo cv. Black beauty and Cucumis sativus, and did not reveal any differences in these host plants between the isolates. However, remarkable difference in the symptoms was found between the CMVs in Capsicum annuum. Is-CMV induced an asymptomatic symptoms, while Jd-CMV and Pla-CMV produced severe mosaic symptoms in C. annuum plants. In dsRNA analysis, all isolates revealed four major bands with estimated molecular size of 3.4, 3.2, 2.1 and 1.0 kbp. The cDNAs of coat protein gene of the isolates were amplified by RT-PCR using a genus-specific single pair primers that designed to amplify a DNA fragment of approximately ranging from 938 to 966 bp. By restriction mapping analysis using RFLP of the RT-PCR products as well as by serological properties of gel diffusion test, the CMV isolates belong to a typical members of CMV subgroup IA. This is the first report on the occurrence of CMV in the three weed hosts.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.425-431
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• 1998

Purpose : We retrospectively analyzed the impact of subpleural lesions of early stage non-small cell lung cancer on the patterns of failure to support selection of postoperative adjuvant therapy. Methods and Materials : The study included 91 patients who underwent surgery for early stage non-small cell lung cancer at Dong-A University Hospital from Dec 1990 to Sep 1996. Twenty five patients were excluded due to postoperative mortality (four patients, 4.4$\%$) and stage III (21 patients). Of 66 patients, 22 patients were subpleural lesions (15 patients in stage I, and seven patients in stage II). Postoperative adjuvant radiation therapy was given to seven patients with T2Nl disease. The median follow-up duration was 29.5 months (range; 8-84 months). Results : The overall survival rate was 69.5$\%$ at 3 years. For all patients who presented with (22 patients) and without (44 patients) subpleural lesions, 3-year overall survival rates were 35.5$\%$ and 84.6$\%$, respectively (p=0.0017). For stage I patients who presented with (15 patients) and without (29 patients) subpleural lesions, 3-year overall survival rates were 33.1$\%$ and 92.3$\%$, respectively (p=0.001). For stage II patients who presented with (7 patients) and without (15 patients) subpleural lesions, 3-year overall survival rates were 53.3$\%$ and 45.7$\%$, respectively (p=0.911). For patients with T2N0 disease (34 patients) who presented with (11 patients) and without (23 patients) subpleural lesions, 3-year overall survival rates were 27.3$\%$ and 90.3$\%$, respectively (p=0.009). Conclusion : These observations suggest that the subpleural lesion play an important role as a prognostic factor for early stage non-small cell lung cancer. Especially for T2N0 disease, patients with subpleural lesions showed significantly lower survival rate than those without that.