• Journal of Chest Surgery
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• v.32 no.5
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• pp.413-421
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• 1999

Background: Ischemia reperfusion injury is known to contribute to the major causes of the early graft failure in lung transplantation. Triiodothyronine (T3) has been suggested to ameliorate ischemia reperfusion injury from both in vivo and in vitro experiments of various organs. Prospecting its beneficial effect for pulmonary allograft preservation, we made a new solution by adding T3 into the extracellular type dextran solution. Material and Method: Twelve adult mongrel dogs underwent left lung allotransplantation. Six donor dogs were flushed with the new solution(Group 1, n=6), and the remaining six were flushed with Euro-Collins solution to serve as controls(Group 2, n=6). Allografts were stored in each preservation solution for 20 hours at 4$^{\circ}C$. Left single lung transplantations were performed. The right pulmonary artery and the right main bronchus were clamped at 15 minutes after the reperfusion and maintained throughout the experiment to evaluate the transplanted left lung function. Result: Arterial carbon dioxide tension was better in group 1 than in group 2 throughout the experiment period and the difference was statistically significant at 2 hours after reperfusion(28.0${\pm}$3.0 mmHg and 53.1${\pm}$17.4 mmHg, p<0.05). The differences of arterial oxygen partial pressure, peak airway pressure and pulmonary vascular resistance showed no statistical significance. The malondialdehyde(MDA) level, measured from tissue obtained at 120 minutes after reperfusion showed no statistically significant difference. The tissue wet/dry ratio of group 1(649${\pm}$27 %) was significantly lower than that of group 2(686${\pm}$71 %, p<0.05). The microscopic examination revealed varying degrees of injury represented mainly by findings such as perivascular neutrophil infiltration, capillary hemorrhage and interstitial congestion. These findings were less severe in group 1 than those in group 2. Conclusion: The new solution demonstrated superior allograft preservation after 20 hour ischemia compared to Euro-Collins solution in canine single left lung transplantation model, these results suggest that T3 might be a promising agent for pulmonary allograft preservation.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.1-14
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• 2004

Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.11 no.4
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• pp.37-48
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• 2016

This study explored how university entrepreneurial education service quality affects education satisfaction, entrepreneurial capability, and entrepreneurial intention. Although the various university entrepreneurial educations have been provided, current state of education support for entrepreneurial achievement is quite insufficient. In order to analyze factors for the entrepreneurial achievement enhancement, this study examines how university entrepreneurial education service quality affects education satisfaction, entrepreneurial capability, and entrepreneurial intention, as follows. First, in order to measure the entrepreneurial education service quality on the basis of theoretical background of the service quality, we set twenty one (21) questions for five (5) factors as follows: materiality, reliability, reactivity, certainty, consensuality. And then, impact of the entrepreneurial education service quality on education satisfaction and entrepreneurial capability was evaluated based on the survey results. Second, on the basis of previous studies of customer satisfaction, we gave the definition of education satisfaction for students in entrepreneurial education, and analyzed the causation that affects some elements of entrepreneurial capability (i.e. fulfillment capability, capacity of creativity, conceptualization capability, and social competence) by the aforementioned definition. Third, we analyzed the causation that affects entrepreneurial intention by education satisfaction and entrepreneurial capability. As a result, unlike the previous studies, there are only four (4) factors were confirmed for the entrepreneurial education service quality because the materiality and the reliability were founded as single element under the analysis. And it was identified that the entrepreneurial education service quality which is comprised of four (4) factors affects the education satisfaction and the entrepreneurial capability. In addition, as a result of the analysis under defining four (4) factors of entrepreneurial capability, the fulfillment capability and the capacity of creativity were founded as single element, and it was confirmed there is only three (3) factors, including the conceptualization capability and the social competence. With this result, it was confirmed that the entrepreneurial education service quality is influenced by the education satisfaction. Therefore, although the entrepreneurial intention is influenced by the entrepreneurial capability, it is not directly affected by the education satisfaction. These results showed that the education satisfaction affects indirectly to the entrepreneurial intention through the entrepreneurial capability that affected by the education satisfaction.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.524-529
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• 2004

Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

• Tuberculosis and Respiratory Diseases
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• v.54 no.2
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• pp.210-218
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• 2003

Background : Sex specific cross sectional reference values for the lung function indices usually employ a linear model with a term for age and height. The purpose of this study was to determine the effects of the body mass index (BMI), the fat percentage of the body mass and the fat-free mass index (FFMI) on the forced expiratory volume curve. Methods : Between January 2000 and December 2001, a total of 300 subjects, 150 men and 150 women (mean age : $45{\pm}13$ years), with a normal lung function were enrolled in the study sample. This study measured the $FEV_1$, FVC and $FEF_{25-75%}$ from the forced expiratory volume curve by a spirometer and the body composition by a bioelectrical impedance method in all subjects. Multiple regression analysis was used in order to examine the effects of the body composition on the parameters derived from the forced expiratory volume curve. Results : After adjusting for age, the BMI and Fat percentage improved the descriptions of the FVC (p<0.05, $r^2=0.491$) and $FEV_1$ (p<0.05, $r^2=0.654$) in women. In contrast, the FFMI contributed significantly to the FVC (p<0.05, $r^2=0.432$) and $FEV_1$ (p<0.05, $r^2=0.567$) in men. The $FEF_{25-75%}$ correlated with the fat percentage in women (p<0.05, $r^2=0.337$). Conclusion : These results suggest that the BMI, the fat percentage and the FFMI are significant determinants of the forced expiratory volume curve. The plmonary function test, when considering the BMI, the fat percentage and the FFMI, might be useful in clinical applications.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.60-71
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• 2000

Backgrounds : Cathepsin D, an aspartic lysosomal proteinase, is believed to be involved in local invasion and metastasis of tumor cells by its proteolytic activity and has been described to be associated with tumor progression and prognosis in some human malignancies including breast cancer. But, its prognostic value for human lung cancer remains to be determined. The purpose of this study is to determine clinicopathological and prognostic significance of cathepsin D expression in non-small cell lung cancer. Method : Using a polyclonal antibody, immunohistochemical analysis of cathepsin D was performed on paraffin embedded sections of tumors obtained surgically from 54 patients with non-small cell lung cancer (37 squamous cell carcinoma, 14 adenocarcinoma, 2 large cell carcinoma, and 1 undifferentiated carcinoma). Results : Eighteen patients (33.3%) showed positive immunoreactivities of cathepsin D in tumor cells. No significant correlation of cathepsin D expression in tumor cells was found in p-stage (surgical-pathologic stage), tumor size, tumor factor, nodal involvement, and differentiation. Of 54 patients, 29 (53.7%) patients showed moderate to massive cathepsin D-positive stromal cells within the tumor tissues, while the rest (46.3%) showed few cathepsin D-positive stromal cells within the tumor tissues. Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung canær (p=0.031). No significant correlation of the degree of cathepsin D-positive stromal cells was found in tumor size, T -factor, nodal involvement, differentiation Cathepsin D expression status in tumor cells and stromal cells was not significantly associated with prognosis expressed by survival rate. The results of multivariate analyses of variables possibly associated with prognosis showed that nodal involvement was the only independent prognostic factor in all patients. Conclusion : Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung cancer. However, it was not related to other clinicopathologic features and prognosis, and Cathepsin D expression in tumor was not related to p-stage and prognosis.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.325-333
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• 2001

Background : This study aimed to estimate the clinical outcome and identify the characteristics of a group of patients with pulmonary tuberculosis who completed anti-tuberculosis therapy with the First-line drugs in spite of having positive smear results with negative sputum culture results over the previous six months. Method : A retrospective chart review of 21 patients who fulfilled the above criteria between 1995 and 1999 was performed. The laboratory data as well as the clinical data of the patients with positive smear results and negative culture results over a six months period were reviewed. Results : The negative conversion of sputum culture results was achieved within $1.3{\pm}1.2$ months and the negative conversion of the sputum smear results was accomplished during $9.5{\pm}3.3$ months. Chest X-rays at 5 months following the institution of anti-tuberculosis therapy from all patients revealed improvements. Four out of 21 patients(19%) relapsed during the follow up, $15.2{\pm}13.4$ months after administering anti-tuberculosis therapy for $13.3{\pm}3.1$ months. Relapses were confirmed from between 3 months and 4 months after the treatment completion. Only one of the four relapses had no past history of anti-tuberculosis therapy and the others had prior treatment twice (p<0.01). The period of anti-tuberculosis treatment was extended to a mean of $4.6{\pm}2.6$ months in 12 patients. However, prolongation of anti-tuberculosis therapy had no affect on the relapse rate (odds ratio, 95% CI 0.18, 2.15). Conclusion : Prolongation of therapy with the First-line drugs is not necessary for patients with persistently positive smear results over 6 months and negative culture results. A patient who has had prior anti-tuberculosis therapy more than twice should be paid the closest attention.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.277-284
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• 2006

Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

• 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

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.421-431
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• 2000

Background : The length of postoperative drug therapy remains controversial in pulmonary tuberculosis. We analyzed our experiences to determine the postoperative duration of chemotherapy after resection. Method : A retrospective review was performed in 66 of 95 patients that underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1998. We compared the relapse rates according to the length of postoperative chemotherapy in each group, classified by the results of sputum AFB culture before the surgery, the number of resistant drugs, the number of prior treatment and the division of anti-TB drugs used postoperatively. Results : Fifty three of 66(80.3%) were men and 13(19.7%) were women with a median age of 33.5 years(range, 16 to 63). The mean lengths of the pre- and post-operative chemotherapies were 4.9 months, and 12.9 months respectively. Five of 66 patients (7.6%) relapsed during the mean period of follow up (39.7 months). In the group less than three times of the prior treatment, there were two relapses (20%) in Ed-the highlight above-rephrase 10 patients that were medicated for 6 months or less, and one relapse in 43 patients (2.3%) that took medicine for more than 6 months (p=0.03). In the group using second-line drugs postoperatively, there was one relapse (25%) in four patients that were medicated for 12 months or less. No patient in a total of 17 that received medicine for more than 12 months relapsed (p=0.03). Conclusion : We recommend that patients with the prior treatment less than three times should be treated for more than 6 months after resection and patients using the second-line drugs postoperatively should be medicated for more than 12 months.