Purpose: Gastrointestinal stromal tumorsm (GISTs) are the most common mesenchymal tumors that arise anywhere in the tubular GI tract. The prognosis for GSTIs is important because f GISTs may metastasiwx in the liver or the abdominal cavity in an early stage. For the reason we examined the tumor size, the mitotic number, ki 67, p53, and c-kit mutation as independent prognostic factor for GISTs. Materials and Methods: A retrospective study was conducted in 76 patients who had been re-evaluated for confirmation of diagnosis between Jan 1998 and Dec. 2001. at Catholic University of medicine. Results: There were significant difference between the turner size, mitotic indices, ki 67, c-kit mutations and the 5-years survival rates. Tumor size (${\geq}5\;cm$) and mitotic index (${\geq}5/50\;HPF$) were statistically related to a significantly poor prognosis (P=0.017 and P=0.042, respectively). c-kit mutations in exon 11 were found in 7 cases c-kit mutation was observed more frequently in high risk patients, and there was a significant difference between c-kit mutation and survival (P=0.037). Elevated ki 67 was noted in 34 out of the 76 cases. High risk patients showed elevated ki67 index more frequently and there was significant relation with the survival rate (P=0.0417). Conclusion: We think that tumor size, mitotic index, Ki 67 and c-kit mutation are as independent prognostic factors for GISTs, but more research is needed.
The purposes of this study were to (a) analyze school foodservice employees' knowledge and performance degree of HACCP system and (b) provide the basic data for planning the strategies which can be performed for systematic HACCP system in school foodservice. For these purposes, the subjects included 91 dieticians (a response rate 98.9%) and 270 foodservice employees (a response rate 98.2%) at school in Jeju city and they were surveyed from October 21 to November 4, 2006. The data were analyzed by descriptive analysis, reliability analysis, t-test, ANOVA (Duncan multiple range test) and Pearson's correlation coefficients using the SPSS Win Program (version 12.0). In terms of the number of training practice, the result of sanitary training indicated that the dieticians who trained the employees more than once per a week (48.6%) or everyday (36.3%) were 84.7%. And the dieticians who were higher age, full-time job, and working at middle school implemented significantly more training the employees. In the training methods, 40.7% of dieticians used the oral presentation and 37.4 % utilized the printed matters. Also, most of employees (98.1%) have experienced for the training, 39.6% of them did not have regular training experience and 40.7% of them responded that they were understanding the HACCP system well. The result of employees' knowledge level of HACCP system reported that the items of the personal hygiene scored the highest (92.3 points) whereas the items of CCP3 scored the lowest (58.3 points) as the average being 84.2 points (out of 100 scale). In terms of the performance degree of HACCP system, the average was 4.40 (out of 5 scale), the items of the personal hygiene scored the highest as 4.51 whereas the items of CCP2 scored the lowest as 4.31 points. The dieticians' perception degree of employees' performance degree in HACCP system showed that the average was 4.13 (out of 5 scale), so it was significantly lower than actual performance degree as average 4.40 (out of 5 scale). Additionally the employees' knowledge level was positively correlated to performance degree and employees' knowledge level of CCP3, CCP4, and the personal hygiene significantly influenced to the HACCP performance degree. Finally, the dieticians have to recognize correctly the employees' performance degree and on the basis of it must plan the sanitary training which has a proper contents and methods to enhance the employees' knowledge level and achieve more systematic HACCP system in school foodservice.
Background : Five year survival rate of postoperative stage I non-small cell lung cancer(NSCLC) reaches to 66%. In the remaining one third of patients, however, cancer recurs and the overall survival of NSCLC remains dismal. To evaluate clinical and pathologic characteristics of recurred NSCLC, the patterns and factors for postoperative recurrence in patients with staged I and II NSCLC were studied. Method : A retrospective analysis was performed in 234 patients who underwent radical resection for pathologic stage I and II NSCLC. All patients who were followed up for at least one year were included in this study. Results : 1) There were 177 men and 57 women The median age was 63. The median duration of the follow up period was 732 days (range 365~1,695 days). The overall recurrence rate was 26.5%, and the recurrence occurred $358.8{\pm}239.8$ days after operation. 2) The ages of recurred NSCLC patients were higher ($63.2{\pm}8.8$ years) than those of non-recurred patients ($60.3{\pm}9.8$ years)(p=0.043). The recurrence rate was higher in stage II (46.9%) than in stage I (18.8%) NSCLC p<0.001. The size of primary lung mass was larger in recurred ($5.45{\pm}3.22\;cm$) than that of non-recurred NSCLC ($3.74{\pm}1.75\;cm$, p<0.001). Interestingly, there were no recurrent cases when the resected primary tumor was less than 2cm. 3) Distant recurrence was more frequent than locoregional recurrence (66.1% vs. 33.9%). Distant recurrence rate was higher in females and in cases of adenocarcinoma. Brain metastasis was more frequent in patients with adenocarcinoma than in those with squamous cell carcinoma (p=0.024). Conclusion: The tumor size and stage were two important factors for determining the possibility of a recurrence. Because distant brain metastasis was more frequent in patients with adenocarinoma, a prospective study should be conducted to evaluate the effectiveness of preoperative brain imaging.
This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day : Group I, 60 workers, lesser than 4 hours a day and group II, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0.15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group II. 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05) . The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of seven subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker(2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P<0.01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the work place and control of excessive VDT work are recommended to prevent such eye symptoms.
Eighty one products from 36 kinds of vitamin and mineral feed supplement collected during August, 1984 to February, 1985 were examined for microbiological contamination. In addition, 83 strains of coliform isolated from the samples were tested for the resistance to 8 kinds of antimicrobial drugs and distribution of R plasmid. General bacteria were detected in all of samples tested. Bacterial population was varied from less than 10 per gram of the sample to 1,400,000 per gram and 34 (42%) of 81 samples were contaminated with 100 to 1,000 cells per gram. Coliform isolation, which was more frequent in samples with larger number of general bacteria, was possible in 14 (17.3%) out of 81 samples tested and 6 (33.3%) out of 18 companies were coliform positive in their products. Forty one (49.4%) out of 83 coliform isolates were fecal coliform. The frequency of resistant strains was the highest to sulfadimethoxine (Sa) with 92.8% and followed by streptomycin (Sm, 67.5%), tetracycline (Tc, 50.6%), kanamycin (Km, 26.5%), chloramphenicol (Cm, 18.1%) and ampicillin (Am, 15.7%). No strain was resistant to nalidixic acid (Na) and gentamicin (Gm). The resistance frequency of fecal coliform strains were higher compare to non-fecal coliform strains. There were minimum inhibitory concentration (MIC) of $3,200{\mu}g/m{\ell}$ or higher in 7 strains to Am, 3 to Sm and 3 to Km, and 70 strains had MIC of $1,600{\mu}g/m{\ell}$ of higher to Sa while Tc had MICs from $1.6{\mu}g/m{\ell}$ to $400{\mu}g/m{\ell}$. All strains had MICs of $6.3{\mu}g/m{\ell}$ of lower to Na and $3.1{\mu}g/m{\ell}$ of lower to Gm. Seventy nine (95.2%) of 83 strains were resistant to one or more drugs tested. The most frequent resistance patterns were SaSm (14.5%) and followed by SaSmTc(12%), SaSmTcKm(8.4%) SaTc (8.4%) and SaSmKm (7.2%) ; total 19 different patterns were noted. Thirty two (40.5%) of 79 resistant strains were transferred all of a part of their resistance to Escherichia coli ML 1410. The frequency of transferable resistance was high in Am (100%) and Cm (80%) while low in Tc (38.1%), Sa (18.2%), Sm (17.9%) and Km (4.5%).
Background: Acute interstitial pneumonia is a relatively rare form of interstitial pneumonia, since the vast majority of interstitial pneumonia have a more chronic course. It corresponds to the lesion described by Hamman and Rich, as Hamman-Rich disease in 1944. Another name in the clinical literature is accelerated interstitial pneumonia, idiopathic acute respiratory distress syndrome (idiopathic ARDS), and the organizing stage of diffuse alveolar damage. Acute interstitial pneumonia differs from chronic interstitial pneumonia by clinical and pathologic features. Clinically, this disease is characterized by a sudden onset and a rapid course, and reversible disease. Method and Purpose: Five cases of pathologically proven acute interstitial pneumonia were retrospectively studied to define the clinical, radiologic, and pathologic features. Results: 1) The five cases ranged in age from 31 to 77 years old. The onset of illness was acute in all patients, it began with viral-like prodrome 6~40 days prior to shortness of breath, and respiratory failure eventually developed in all patients. In 2 cases, generalized skin rash was accompanied with flu-like symptoms. Etiologic agent could not be identified in any case. 2) All patients had leukocytosis and severe hypoxemia. Pulmonary function test of 3 available cases shows restrictive ventilatory defect, and one survived patient(case 5) has a complete improvement of pulmonary function after dismissal. 3) Diffuse bilateral chest infiltrates were present radiologically. Theses were the ground-glass, consolidation, and reticular densities without honeycomb fibrosis in all patients. The pathologic abnormalities were the presence of increased numbers of macrophages and the formation of hyaline membranes within alveolar spaces. There was also interstitial thickening with edema, proliferation of immature fibroblast, and hyperplasia of type II pneumocyte. In the survived patient(case5), pathologic findings were relatively early stage of acute interstitial pneumonia, such as hyaline membrane with mild interstitial fibrosis. 4) Of the 5 patients, four patients died of respiratory failure 14~90 days after onset of first symptom, and one survived and recovered in symptoms, chest X ray, and pulmonary function test Conclusion: These results emphasize that acute interstitial pneumonia is clinically, radiologically, and pathologically distinct form of interstitial pneumonia and should be separated from the group of chronic interstitial pneumonia. Further studies will be needed to evaluate the pathogenesis and the treatment of acute interstitial pneumonia.
Journal of the Korean Institute of Landscape Architecture
/
v.41
no.6
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pp.107-116
/
2013
This study was undertaken to investigate the characteristics of retention and evapotranspiration in the extensive greening module of sloped and flat rooftops for stormwater management and urban heat island mitigation. A series of 100mm depth's weighing lysimeters planted with Sedum kamtschaticum. were constructed on a 50% slope facing four orientations(north, east, south and west) and a flat rooftop. Thereafter the retention and evapotranspiration from the greening module and the surface temperature of nongreening and greening rooftop were recorded beginning in September 2012 for a period of 1 year. The characteristics of retention and evapotranspiration in the greening module were as follows. The water storage of the sloped and flat greening modules increased to 8.7~28.4mm and 10.6~31.8mm after rainfall except in the winter season, in which it decreased to 3.3mm and 3.9mm in the longer dry period. The maximum stormwater retention of the sloped and flat greening modules was 22.2mm and 23.1mm except in the winter season. Fitted stormwater retention function was [Stormwater Retention Ratio(%)=-18.42 ln(Precipitation)+107.9, $R^2$=0.80] for sloped greening modules, and that was [Stormwater Retention Ratio(%)=-22.64 ln(X)+130.8, $R^2$=0.81] for flat greening modules. The daily evapotranspiration(mm/day) from the greening modules after rainfall decreased rapidly with a power function type in summer, and with a log function type in spring and autumn. The daily evapotranspiration(mm/day) from the greening modules after rainfall was greater in summer > spring > autumn > winter by season. This may be due to the differences in water storage, solar radiation and air temperature. The daily evapotranspiration from the greening modules decreased rapidly from 2~7mm/day to less than 1mm/day for 3~5 days after rainfall, and that decreased slowly after 3~5 days. This indicates that Sedum kamtschaticum used water rapidly when it was available and conserved water when it was not. The albedo of the concrete rooftop and greening rooftop was 0.151 and 0.137 in summer, and 0.165 and 0.165 in winter respectively. The albedo of the concrete rooftop and greening rooftop was similar. The effect of the daily mean and highest surface temperature decrease by greening during the summer season showed $1.6{\sim}13.8^{\circ}C$(mean $9.7^{\circ}C$) and $6.2{\sim}17.6^{\circ}C$(mean $11.2^{\circ}C$). The difference of the daily mean and highest surface temperature between the greening rooftop and concrete rooftop during the winter season were small, measuring $-2.4{\sim}1.3^{\circ}C$(mean $-0.4^{\circ}C$) and $-4.2{\sim}2.6^{\circ}C$(mean $0.0^{\circ}C$). The difference in the highest daily surface temperature between the greening rooftop and concrete rooftop during the summer season increased with an evapotranspiration rate increase by a linear function type. The fitted function of the highest daily surface temperature decrease was [Temperature Decrease($^{\circ}C$)=$1.4361{\times}$(Evapotranspiration rate(mm/day))+8.83, $R^2$=0.59]. The decrease of the surface temperature by greening in the longer dry period was due to sun protection by the sedum canopy. The results of this study indicate that the extensive rooftop greening will assist in managing stormwater runoff and urban heat island through retention and evapotranspiration. Sedum kamtschaticum would be the ideal plant for a non-irrigated extensive green roof. The shading effects of Sedum kamtschaticum would be important as well as the evapotranspiration effects of that for the long-term mitigation effects of an urban heat island.
Intestinal histopathological changes due to infection with Echinostcma hortense (Trematoda) were studied in rats after experimental infection with the metacercariae. The metacercariae were obtained from the tadpoles of Rana nigrcmaculata, a second intermediate host infected in the laboratory. Total 18 albino rats(Sprague-Dawley) were given 200 matacercariae each and sacrificed on the day 1, 3, 7, 11, 22 or 44 post-infection(PI) Segments of- the small intestine at 1, 3, 5, 8 and 30 cm posterior to the pylorus(PTP) were rejected and studied histopathologically. 1. The flukes were seen to have intruded into the intervillous space in the upper small intestine at early stages(1∼3 days PI), however, they were located mainly in the intestinal lumen at later stages(7∼44 days PI) . The flukes were sucking and destroying the epithelial layers of villi with their oral and ventral suckers. 2. Histopathological changes of the intestine were recognizable in as early as 1∼3 days after infection, and the changes became severer as the infection progressed. 3. The intestinal mucosa was histopathologically characterized by villous atrophy and crypt hyperplasia throughout the infection period. Major villous changes were blunting, fusion, severe destruction and loss of epithelial layers of villi. Villous/crypt(V/C) height ratio was remarkably reduced from 3 : 1 in controls to 1 : 1 in severely infected animals. In the stroma of villi, inaamma- tory cell infiltrations, vascular congestion, edema, and/or fibrosis were recognized. The goblet cells were increased in number after 11 days PI. It was revealed in the present study that the pathological changes in the intestine of rats infected with E. hortense were chieay confined to the mucosal layer of the upper small intestine, however, the changes were very severe accompanying remarkable destruction of villi and loss of mucosal integrity, and persistent until 44 days PI.
Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.
Kim, Byung-Il;Lee, Jong-Inn;Yang, Won-Il;Lee, Jae-Sung;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
The Korean Journal of Nuclear Medicine
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v.35
no.5
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pp.301-312
/
2001
Purpose: Stomach cancer is one of the most common malignancies in Korea, but there is no report on FDG PET in patients with stomach cancer. We observed findings of FDG PET in patients with stomach cancer. Materials and Methods: In 13 patients with pre-operative stomach cancer, PET and CT were performed. Primary lesion and regional lymph nodes detection were aualyzed. Correlation between FDG uptake ratio and each prognostic factor of primary lesion was analyzed. In 19 patients diagnosed as recurrence or displaying suspicious symptoms, conventional work up including tumor marker and PET were performed. Recurrence detection of anastomotic site, distant metastasis, and tumor marker elevation were analyzed. Results: Sensitivity for primary lesion detection was 83.3% (CT 71.4%) and two submucosal lesions were undetected. FDG uptake ratio was variable and had no correlation with invasion-depth, size, Borrmann type, staging and differentiation. Sensitivity for regional lymph node detection was 58.3% (CT 58.3%) and the lesions less than 1cm were undetected. Sensitivity for recurrence detection was 100% but there were three false positives. Sensitivity for distant metastasis detection was 64.3% and significantly higher than that of conventional work-up (21.4%). Average of tumor marker level in patients who were confirmed as recurrence was higher than false positive. Conclusion: PET is more useful than conventional work up in distant metastasis detection when recurrence is suspected. In pre-operative stomach cancer, PET is comparable to CT for detection of primary lesion and regional lymph node metastasis and detection of distant metastasis requires further study.
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