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A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism (폐색전증에서 나선형 컴퓨터 전산화 단층촬영의 관찰자간의 일치도에 관한 연구)

  • Kim, Yang-Ki;Lee, Young Mok;Kim, Ki-up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Hwang, Jung-Hwa;Kim, Dong Hun;Goo, Dong-Erk;Choi, Deuk-Lin
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.473-479
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    • 2005
  • Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

The Effect of Inhibition of Heme Oxygenase-1 on Chemosensitivity of Cisplatin in Lung Cancer Cells (폐암세포주에서 Heme Oxygenase-1의 억제가 Cisplatin의 항암제 감수성에 미치는 영향)

  • Kim, So-Young;Kim, Eun-Jung;Jang, Hye-Yeon;Hwang, Ki-Eun;Park, Jung-Hyun;Kim, Hwi-Jung;Jo, Hyang-Jeong;Yang, Sei-Hoon;Jeong, Eun-Taik;Kim, Hak-Ryul
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.33-42
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    • 2007
  • Background: Heme oxygenase-1 (HO-1) is known to modulates the cellular functions, including cell proliferation and apoptosis. It is known that a high level of HO-1 expression is found in many tumors, and HO-1 plays an important role in rapid tumor growth on account of its antioxidant and antiapoptotic effects. Cisplatin is a widely used anti-cancer agent for the treatment of lung cancer. However, the development of resistance to cisplatin is a major obstacle to its use in clinical treatment. We previously demonstrated that inhibiting HO-1 expression through the transcriptional activation of Nrf2 induces apoptosis in A549 cells. The aim of this study was to determine of the inhibiting HO-1 enhance the chemosensitivity of A549 cells to cisplatin. Materials and Methods: The human lung cancer cell line, A549, was treated cisplatin, and the cell viability was measured by a MTT assay. The change in HO-1, Nrf2, and MAPK expression after the cisplatin treatment was examined by Western blotting. HO-1 inhibition was suppressed by ZnPP, which is a specific pharmacologic inhibitor of HO activity, and small interfering RNA (siRNA). Flow cytometry analysis and Western blot were performed in to determine the level of apoptosis. The level of hydrogen peroxide ($H_2O_2$) generation was monitored fluoimetrically using 2',7'-dichlorofluorescein diacetate. Results: The A549 cells showed more resistance to the cisplatin treatment than the other cell lines examined, whereas cisplatin increased the expression of HO-1 and Nrf2, as well as the phosphorylation of MAPK in a time-dependent fashion. Inhibitors of the MAPK pathway blocked the induction of HO-1 and Nrf2 by the cisplatin treatment in A549 cells. In addition, the cisplatin-treated A549 cells transfected with dither the HO-1 small interfering RNA (siRNA) or ZnPP, specific HO-1 inhibitor, showed in a more significantly decrease in viability than the cisplatin-only-treated group. The combination treatment of ZnPP and cisplatin caused in a marked increase in the ROS generation and a decrease in the HO-1 expression. Conclusion: Cisplatin increases the expression of HO-1, probably through the MAPK-Nrf2 pathway, and the inhibition of HO-1 enhances the chemosensitivity of A549 cells to cisplatin.

Tuberculin Survey to Estimate the Prevalence of Tuberculosis Infection of the Elementary Schoolchildren under High BCG Vaccination Coverage (고 비시지 접종률 상태에서 초등학생들의 투베르쿨린 조사를 통한 감염률 추정 조사)

  • Kim, Hee Jin;Oh, Soo Yeon;Lee, Jin Bum;Park, Yun Sung;Lew, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.269-276
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    • 2008
  • Background: Although the prevalence of tuberculosis infections (PTBI) is one of the basic epidemiologic indices, no survey has been carried out since 1995 because the nation-wide tuberculosis prevalence survey was changed to a surveillance system. Subjects without a BCG scar are examined in a tuberculin survey. However, it is very difficult to select these subjects under high vaccination coverage. It is important to evaluate the impact of BCG vaccinations on the tuberculin response and estimate the PTBI regardless of the BCG vaccination status. Methods: A nation-wide, school-based cross-sectional tuberculin survey was carried out among first graders in elementary school in 2006. A total of 5,148 children in 40 schools were selected by quota sampling. Tuberculin testing with 0.1 ml of two tuberculin units of PPD RT23 was carried out on 4,018 children. The maximum transverse diameter of induration was measured 48 to 72 hours later. The presence of a BCG scar was checked separately. Results: There were no BCG scars in 6.3% of the subjects. The mean induration size of tuberculin testing was $3.7{\pm}4.4mm$, which included 1,882 (46.8%) subjects with an induration size of 0 mm. The PTBI was 10.9% (439 subjects) using a cut-off point of ${\geq}10mm$ (conventional method). The annual risk of tuberculosis infections (ARTI) was 1.9% when the mean age of the subjects was assumed to be 6 years. There was no difference in the PTBI according to the presence or absence of a BCG scar [11.2% vs 7.6% (OR: 1.54, 95% CI: 0.98~2.43)]. Using a mirror image technique with 16 mm as the cut-off point, the PTBI and ARTI had decreased to 2.4% and 0.4% respectively. Conclusion: PTBI and ARTI, as estimated by conventional methods, appear to be high among BCG vaccinated children. A mirror image technique is more suitable for estimating the indices in a country with an intermediate burden of tuberculosis than the conventional method.

Determinants of Demand for Long-Term Care (장기요양서비스 수요의 결정요인)

  • Chung, Wankyo
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.139-167
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    • 2009
  • A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

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The Effect of Cold Shock on Function and Morphology of Dog Epididymal Spermatozoa (개에서 cold shock이 정소상체유래의 정자의 기능과 형태에 미치는 영향)

  • Yu Il-jeoung
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.329-335
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    • 2004
  • Dog spermatozoa were recovered from the caudae epididymides of 23 domestic dogs which were 11 pure breed and 12 mix-breed dogs ranging in age from 0.6 to 3 years. The experimental designs were as follows: 1) the effect of chilling to 0. 10 or 37$^{\circ}C$. 2) the kinetics of chilling injury at 0 or 4$^{\circ}C$, and 3) the effect of sugars at $0^{\circ}C$. Viable spermatozoa were recovered by percoll gradient separation and adjusted to 5${\times}$10$^{7}$ spermatozoa/ml. In experiment 1, spermatozoa were diluted with 0.33 M glucose supplemented with 3% BSA (G-BSA) at 1:2 dilution. Spermatozoa were loaded into straws and exposed at 0, 10 or 37$^{\circ}C$ for 30 min. In experiment 2, spermatozoa were prepared as the experiment 1 and exposed for 0.5, 5, 15, or 30 min at 0 or 4$^{\circ}C$. In experiment 3, spermatozoa were diluted with different sugars (0.33 M galactose, glucose, fructose, mannitol, lactose, sucrose, raffinose) and cooled to $0^{\circ}C$ for 30 min. Sperm membrane integrity, motility and acrosome integrity were assayed after rewarming at 37$^{\circ}C$ for 5 min. Sperm motility and membrane integrity abruptly decreased with decreasing temperature but acrosome integrity gradually decreased (P<0.05). Sperm motility was more sensitive to cold shock than membrane integrity and acrosome integrity. Spermatozoa cooled to $0^{\circ}C$ were more damaged than those at 4$^{\circ}C$. Sperm motility was not different among exposed times at both. 0 and 4$^{\circ}C$. However, membrane integrity of spermatozoa exposed for 30 min at both 0 and 4$^{\circ}C$ was significantly lower (P<0.05). Spermatozoa diluted in 0.33 M fructose or galactose showed lower motility and higher morphological abnormality with coiled tail at $0^{\circ}C$. These sperm characteristics were strongly related. These results indicate that dog epididymal spermatozoa are relatively sensitive to rapid cooling and higher morphological abnormality at $0^{\circ}C$ was shown in spermatozoa diluted in fructose and galactose.

Effect of Nonsolvent Additive in Casting Solutions on Polysulfone Membrane Preparation (Polysilfone 막의 제조에 있어 제막용액에 첨가된 비용매의 영향)

  • 한명진
    • Membrane Journal
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    • v.6 no.3
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    • pp.157-165
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    • 1996
  • Polysulfone(PS) membranes were prepared from homogeneous PS solutions by the phase inversion technique. When propionic acid(PA) was added into a casting solution of n-methylpyrrolidone(NMP) and PS, precipitation rate of the solution film was accelerated. This kind of acceleration was consistent, even though a precipitating nonsolvent was changed from water to isopropanol. These phenomena were caused by decrease of nonsolvent tolerance in the casting solution due to addition of PA. PS powder was prepared by precipitation of a 3wt% solution in dimethylformamide(DMF) using ethanol as nonsolvent. Gas adsorption analysis of the powder showed that the capillary condensation sites were found in the powder structure. Membranes prepared from PS solution(15wt%) in NMP had the following characteristics of gas adsorption and water permeation. In gas adsorption analysis, the membrane precipitated using isopropanol showed low uptake of nitrogen gas and the capillary condensation sites were not found. On the contrary, a significant amount of the capillary condensation sites was found in the membrane coagulated by water, which was related to increase of nitrogen uptake. tn the membrane prepared froin the solution including PA, an increase of the Henry's law sites and the Langmuir sites was not found clearly. However, the capillary condensation sites were significantly increased, and the water transport also increased.

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Influence of the Increase of Dissolved $CO_2$ Concentration on the Marine Organisms and Ecosystems (해수중 용존 $CO_2$ 농도 증가가 해양생물 및 해양생태계에 미치는 영향: 국내외 사례 연구)

  • Lee, Jung-Suk;Lee, Kyu-Tae;Kim, Chan-Kook;Park, Gun-Ho;Lee, Jong-Hyeon;Park, Young-Gyu;Gang, Seong-Gil
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.9 no.4
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    • pp.243-252
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    • 2006
  • Influence of the increasing carbon dioxide concentration in seawater on various marine organisms is assessed in this article with regard to the impacts of anthropogenic $CO_2$ introduced into surface or deep oceans. Recent proposals to sequester $CO_2$ in deep oceans arouse the concerns of adverse effects of increased $CO_2$ concentration on deep-sea organisms. Atmospheric introduction of $CO_2$ into the ocean can also acidify the surface water, thereby the population of some sensitive organisms including coral reefs, cocolithophorids and sea urchins will be reduced considerably in near future (e.g. in 2100 unless the increasing trend of $CO_2$ emission is actively regulated). We exposed bioluminescent bacteria and benthic amphipods to varying concentrations of $CO_2$ and also pH for a short period. The ${\sim}l.5$ unit decrease of pH adversely affected test organisms. However, amphipods were not influenced by decreasing pH when HCl was used for the seawater acidification. In this article, we reviewed the biological adverse effects of $CO_2$ on various marine organisms studied so for. Theses results will be useful to predict the potential risks of the increase of $CO_2$ concentrations in seawater due to the increase of atmospheric $CO_2$ emission and/or sequestration of $CO_2$ in deep oceans.

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Effect on Survival and Developmental Competence of Vitrified Mouse Embryos Using Various Cryoprotectants and Cooling Speeds (생쥐 배아의 유리화 동결에 동결액의 조성과 냉각속도의 영향)

  • Park, Jae-Kyun;Go, Young-Eun;Eum, Jin-Hee;Won, Hyung-Jae;Lee, Woo-Sik;Yoon, Tae-Ki;Lee, Dong-Ryul
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.307-319
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    • 2010
  • Objective: Vitrification requires a high concentration of cyroprotectant (CPA) and an elevated cooling speed to avoid ice crystal formation. We have evaluated the effect of different combinations of cooling rate and CPA on embryonic integrity (developmental competence) in order to increase the efficiency of vitrification without impairing embryo viabilit. We hypothesized that the combination of CPA or the increase of cooling rates can reduce the concentration of toxic CPA for vitrification. As consequently, we performed experiments to evaluate the effect of various composition of CPA or slush nitrogen ($SN_2$) on the mouse embryonic development following vitrification using low CPA concentration. Methods: Vitrification of mouse embryos was performed with EM grid using liquid nitrogen ($LN_2$) or $SN_2$ and different composition of CPAs, ethylene glycol (EG) and dimethylsulfoxide (DMSO). After vitrification-warming process, their survival and blastocyst formation rates were examined. For analyzing long-term effect, these blastocysts were transferred into the uterus of foster mothers. Results: Survival and blastocyst formation rates of vitrified embryos were higher in EG+DMSO group than those in EG only. Furthermor, the group using $SN_2$ with a lower CPA concentration showed a higher survival of embryos and developmental rates than group using $LN_2$. Conclusion: The combination of EG and DMSO as CPAs may enhance the survival of mouse embryos and further embryonic development after vitrification. $SN_2$ can generate high survival and developmental rate of vitrified/warmed mouse embryos when a lower concentration of CPA was applied. Therefore, these systems may contribute in the improvement of cryopreservation for fertility preservation.

Topographic Placement(Structure) and Macro Benthos Community in Winter for the Shellfish Farm of Namsung-ri, Goheung (고흥 남성리 패류양식장의 지형 구조와 저서생물 현장 조사)

  • Jo, Yeong-Hyun;Kim, Yun;Ryu, Cheong-Ro;Lee, Kyeong-Sig;Lee, In-Tae;Yoon, Han-Sam;Jun, Sue-Kyung
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.16 no.2
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    • pp.175-183
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    • 2010
  • To understand the variation of macro benthos community according to the installation of structure and topographic placement in the shellfish farm on tidal flat, the practical example of the tidal shellfish growing area at Namsung-ri Goheung was observed. The results of the research for the field observation were summarized as follows. (1) The ground gradient of the shellfish farm was very flat below about $1^{\circ}$. The shellfish farm ground took the shape of $\sqcup$ from the shoreline to the place of 150 m seawards, and the shape of $\sqcap$ from there to the low tide line. During ebb tide, the $\sqcup$ shape ground stored the sea water, and the $\sqcap$ shape ground was supposed to act as the effect factor to leak slowly or to prevent the outflow. (2) The oyster shell bag or the type of riprap wall as the boundary in the shellfish farm was classified into five types. The air exposure time and flooding time were 181 and 434 minutes, respectively. (3) In the numerical experiment, the deep-sea water wave coming in the study area had 0.5 m of maximum wave height to show the very stable conditions and the wave direction pattern of S-direction was dominant at Naro great ridge, and SE, SSW and S-direction were distributed strongly around the shellfish farm. (4) By the grain size analysis, the sediment around tidal flat consisted of gravel 0.00~5.81(average 1.70)%, sand 14.15~18.39(average 13.23)%, silt 27.59~47.15(average 30.84)% and clay 35.79~55.73(average 36.19)%, and the sediment type was divided into (g)M(lightly gravelly mud), sM(sandy mud) and gM(gravelly mud) by Folk's diagram. (5) The macro benthos community survey conducted in this site in January, 2010 showed that 1 species of Mollusca, 8 species of Polychaeta and 2 species of Crustacea appeared, and 11 species occupying over 1% of total abundance were dominant.

A Study on the Recovery of Radiation Hardening of PWR Pessure Vessel Steel Using Michrohardness and Positron Annihilation (미세경도와 양전자 소멸을 이용한 PWR 압력용기강의 조사 경화 회복에 관한 연구)

  • Garl, Seong-Je;Yoon, Young-Ku;Park, Soon-Pil;Park, Yong-Ki
    • Nuclear Engineering and Technology
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    • v.22 no.4
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    • pp.337-350
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    • 1990
  • A post-irradiation annealing study was conducted with use of reactor pressure vessel(RPV) steel A533B Cl.1 base metal irradiated to a dose of 4.84$\times$10$^{18}$ n/$\textrm{cm}^2$ at about 38$0^{\circ}C$. Microhardness and positron annihilation (PA) methods were used to obtain better understanding of the recovery of radiation hardening. Isochronal anneal experiments indicated that two recovery processes occur during annealing of irradiated specimens. The first recovery process occurs in the temperature range of 280-3O5$^{\circ}C$, Michrohardness and positron annihilation (PA) methods were used to obtain better understanding of the recovery of radiation hardening. Isochronal anneal experiments indicated that two recovery processes occur during annealing of irradiated specimens. The first recovery process occurrs in the temperature range of 280-305$^{\circ}C$. The variations of Ip, Iw and R parameters indicated that the formation of vacancy clusters by vacancy agglomeration and the annihilation of monovacancies are the first recovery process. The second recovery process occurs in the range of 405-49$0^{\circ}C$ and positron annihilation parameters measured indicated that the dissolution of carbon atoms decorated around vacancy-type defects and possible precipitates, and the annihilation of monovacancies give rise to the second recovery process. It was further indicated that radiation anneal hardening (RAH) in the range of 305-405$^{\circ}C$ between the temperature ranges for the two processes occurs due to the formation of carbon-decorated vacancy clusters and precipitates. The activation energies, orders of reaction and other characteristics of recovery processes were determined by the Meechan-Brinkman method. The activation energy for the first recovery process was determined as 1.76 eV and that for the second recovery process as 2.00eV. These values are lower than those obtained by other workers. This difference may be attributed to the lower copper content of the RPV steel used in the present study. The order of reaction for the first recovery process was determined as 1.78, while that for the second recovery process as 1.67 Non-integer orders of reaction for recovery processes seem to be attributed to the fact that several mechanisms for the first order and the second order of reaction are compounded in one process. This result also supports for the above conclusions from measurements of PA parameters.

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