Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.
This study investigated the effectiveness of the assessment of psychosocial treatment outcome in symptomatology and social functioning as rated by the depressed client's significant other in explaining the client's symptomatology and social adjustment at 6 and 12 month follow-up period after the 16-week psychosocial treatment was terminated. The data were drawn from the National Institute of Mental Health Treatment of Depression Collaborative Research Program of the U.S. Significant others of depressed clients have rarely participated in the assessment of treatment outcome, although they are major participants of the clients' daily life and have meaningful opportunities to observe the clients' functioning in different social situations. Thus, this study aimed to examine the explanatory power of the significant others' outcome assessment in depressive symptomatology and social functioning for the long-term outcome in symptomatology and social adjustment. The outcome measures used by the significant others were actual performance, expected performance, gap between actual and expected performance, and symptomatology drawn from the Katz Adjustment Scale-Relatives Form. Three major findings were: (1) in general, the posttreatment assessment by the significant other demonstrated stronger explanatory power of the follow-up status than the assessment rated at pretreatment in all of the four outcome domains; (2) the significant other's assessment of actual and expected performance at both pre- and posttreatment demonstrated significant explanatory power of the follow-up status in symptomatology and social/leisure and work adjustment; and (3) the significant other's assessment of social functioning at pretreatment improved the explanatory power over and above the explanation by symptomatology in the follow-up status of social/leisure and work adjustment; however, at posttreatment, symptomatology improved the explanation over and above social functioning more frequently in predicting both symptomatology and social/leisure and work adjustment. These findings suggest the effectiveness of the measures of symptomatology and actual and expected performance as assessed by significant others. The results imply that mental health professionals and researchers need to involve the depressed client's significant other in the treatment and make good use of their contribution in treatment planning and further intervention in the follow-up period to prevent relapse.
Background : A clinical study was carried out on 153 new cases with small cell lung cancer registered at Presbyterian Medical Center, Chonju during the 7 years from 1986 to 1992. They were analyzed by sex and age distribution, symptoms and signs, classification of stage and site and its treatments. Especially, an effort was made to compare the overall survival time between limited stage and extensive stage. Methods : Among 806 lung cancer patients diagnosed by biopsy or cytologic evaluation for the 7 years, 153 patients was shown small cell lung cancer. These 153 cases was analyzed retrospectivery through patient's records, letters or telephones. Results : The results of evaluation of small cell lung cancer are as follows. Over 85 percent of the small cell lung cancer patients were over 50 years of age and prominent clinical features were cough(86.3%), sputum(75.8%) and dyspnea(54.9%). One hundred and five patients(68.7%) was staged to have limited stage. Mean survival time of the chemotherapy and chemoradiotherapy in limited stage has significant difference and its survivals are 5.3 months and 15.0 months. Patients whose disease was staged as limited, regardless of whether or not chemotherapy was administered, had a median survival time of 10.9 months, compared with 4.8 months for those with extensive stage. Conclusion : Lung cancer is one of the malignant diseases tend to increase gradually in Korea and proven to be the most common cancer next to the gastric cancer among various cancers in males found at the Presbyterian Medical Center in the past seven years. This report is a retrospective view of the clinical therapeutic results of the small cell lung cancer patients. Especially at the limited stage, the combined therapy revealed higher survival rate than the chemotherapy alone. For a more accurate evaluation. a prospective view, without any bias, of patients selected at random is needed.
Objective : Appropriate antituberculosis chemotherapy may not prevent occurrence or progression of tracheobronchial stenosis and obstruction in the patients with endobronchial tuberculosis. The effect of corticosteroid treatment combined with antituberculosis chemotherapy was inconclusive. We evaluated prospectively the effect of corticosteroid treatment. Methods : We diagnosed endobronchial tuberculosis by bronchoscopic examination and bronchial biopsy in the patients of tuberculosis within one month of antituberculosis chemotherapy. After randomization, we prescribed isoniazid, rifampin, ethambutol, and pyrazinamide with or without prednisolone 40 mg for 4 weeks. We carried out bronchoscopy in second month and ninth month of treatment. Results : Edematous endobronchial tuberculosis showed significant improvement of bronchial stenosis after corticosteroid treatment(p < 0.05). Corticosteroid treatment did not have advantage of improvement of bronchial stenosis in the patients with infiltrative endobronchial tuberculosis. Conclusion : Corticosteroid is effective in the treatment of bronchial stenosis when endobronchial tuberculosis is edematous type, in the early period of antituberculosis chemotherapy.
Objective : Cavitary lesion in pulmonary tuberculosis sometimes makes problems in the course of treatment. Especially, retreatment cases tend to respond poorly to current antituberculosis agents. So, authors tried to render a guideline for clinical approach toward cavitary lesions in pulmonary tuberculosis. Methods : Retrospective analysis of 33 pulmonary tuberculosis patients with cavitary lesions was made. All the patients had got treatment at National Masan Tuberculosis Hospital from Jan. 1995 to Aug. 1995. Results: The ratio between male and female was 10:1. Age distribution was 69.7% in 3rd and 4th decades. The locations of cavitary lesion were 60.6% in right upper lung field and 36.4% in left upper lung field. In the extent of disease, there were 12 cases(36.4%) in moderate advanced and 21 cases in far advanced. Cavitary lesions were closed in 5 eases and remained in 28 eases. In the cases of closed cavity, it was happened within $10.6{\pm}4.72$ months after they took treatment, the size of cavity was $35.5{\pm}17.1$ in long diameter, $27.0{\pm}12.2$ in short diameter and $4.6{\pm}2.1\;mm$ in wall thickness. In the cases of remained cavity, the size of cavity was $31.9{\pm}12.3$ in long diameter, $21.0{\pm}9.8$ in short diameter and $5.04{\pm}2.0\;mm$ in wall thickness. In terms of negative conversion, it took $3.8{\pm}2.17$ months in the case of closed cavity but it was happened within 5 months for only 4 patients in the case of remained cavity. In the point of past medication history, there was none in closed cavities but there were none in 1 case, once in 3 cases, two times in 9 cases and more than three times in 13 cases among remained cavitary lesions. Conclusion : In the retreatment cases of pulmonary tuberculosis with cavitary lesions, they tend to respond poorly to current antituberculosis agents. So, if the lesions are localized, operative intervention may be a proper method as adjunctive treatment.
Journal of the Korean Society of Food Science and Nutrition
/
v.40
no.8
/
pp.1164-1171
/
2011
The purpose of this study was to compare service quality between local and global coffee brand shops and to investigate improvement. Of 350 questionnaires distributed to customers of six brand coffee shops (three local brands, three global brands) located in Daejeon, 330 complete questionnaires (94.3%) were analyzed. The questionnaire included a seven-point multiple-item scale for measuring service quality. The 21 items measuring service quality were grouped into four factors, and the mean scores for the levels of "representativeness", "coffee sensory and beverage features", "employee attitude" and "physical environment" were 5.42, 4.77, 4.74, and 4.13, respectively. The levels of "coffee sensory and beverage features" and "employee attitude" of the high income customers were significantly lower than those of the low income customers. The results showed that the levels of "employee attitude" of local coffee brand shops was significantly higher (p=0.050) than that of global coffee brand shops. Whereas, the levels of "representativeness" of global coffee brand shops was significantly higher (p=0.003) than that of local coffee brand shops. Based on the results, the global coffee brand shops should pay attention to internal marketing and the local coffee brand shops must strive to improve service quality through strategies such as improving brand awareness and developing representative beverages and foods.
In this study, we investigated the change of future land-surface and relationships of land-surface change with geo-spatial information, using a Bayesian prediction model based on a likelihood ratio function, for analysing the land-surface change of the Gongju area. We classified the land-surface satellite images, and then extracted the changing area using a way of post classification comparison. land-surface information related to the land-surface change is constructed in a GIS environment, and the map of land-surface change prediction is made using the likelihood ratio function. As the results of this study, the thematic maps which definitely influence land-surface change of rural or urban areas are elevation, water system, population density, roads, population moving, the number of establishments, land price, etc. Also, thematic maps which definitely influence the land-surface change of forests areas are elevation, slope, population density, population moving, land price, etc. As a result of land-surface change analysis, center proliferation of old and new downtown is composed near Gum-river, and the downtown area will spread around the local roads and interchange areas in the urban area. In case of agricultural areas, a small tributary of Gum-river or an area of local roads which are attached with adjacent areas showed the high probability of change. Most of the forest areas are located in southeast and from this result we can guess why the wide chestnut-tree cultivation complex is located in these areas and the capability of forest damage is very high. As a result of validation using a prediction rate curve, a capability of prediction of urban area is $80\%$, agriculture area is $55\%$, forest area is $40\%$ in higher $10\%$ of possibility which the land-surface change would occur. This integration model is unsatisfactory to Predict the forest area in the study area and thus as a future work, it is necessary to apply new thematic maps or prediction models In conclusion, we can expect that this way can be one of the most essential land-surface change studies in a few years.
Phomsouvanh, Virasith;Phetpaseuth, Vannaphone;Park, Soo Jin
Journal of the Korean Geographical Society
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v.51
no.6
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pp.779-797
/
2016
A calibrated hydrological model is a useful tool for quantifying the impacts of the climate variations and land use/land cover changes on sediment load, water quality and runoff. In the rainy season each year, the Xe Bang Fai river basin is provisionally flooded because of typhoons, the frequency and intensity of which are sensitive to ongoing climate change. Severe heavy rainfall has continuously occurred in this basin area, often causing severe floods at downstream of the Xe Bang Fai river basin. The main purpose of this study is to investigate the climate change impact on river discharge using a Soil and Water Assessment Tool (SWAT) model based on future climate change scenarios. In this study, the simulation of hydrological river discharge is used by SWAT model, covering a total area of $10,064km^2$ in the central part of country. The hydrological model (baseline) is calibrated and validated for two periods: 2001-2005 and 2006-2010, respectively. The monthly simulation outcomes during the calibration and validation model are good results with $R^2$ > 0.9 and ENS > 0.9. Because of ongoing climate change, three climate models (IPSL CM5A-MR 2030, GISS E2-R-CC 2030 and GFDL CM3 2030) indicate that the rainfall in this area is likely to increase up to 10% during the summer monsoon season in the near future, year 2030. As a result of these precipitation increases, the SWAT model predicts rainy season (Jul-Aug-Sep) river discharge at the Xebangfai@bridge station will be about $800m^3/s$ larger than the present. This calibrated model is expected to contribute for preventing flood disaster risk and sustainable development of Laos
Journal of Korean Home Economics Education Association
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v.20
no.2
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pp.75-94
/
2008
The purposes of this paper are to describe the newly established reference values of nutrient intakes: to apply the changed dietary reference intakes to the new text book based on the revised curriculum: and to contrive substantial contents in the domain of dietary life(foods & nutrition) of new text book. Dietary Reference Intakes for Koreans(KDRIs) is newly established reference values of nutrient intakes that are considered necessary to maintain the health of Koreans at the optimal state and to prevent chronic diseases and overnutrition. Unlike previously used Recommended Dietary Allowances for Koreas(KRDA), which presented a single reference value for intake of each nutrient, multiple values are set at levels for nutrients to reduce risk of chronic diseases and toxicity as well as prevention of nutrient deficiency. The new KDRIs include the Estimated Average Requirement(EAR), Recommended Intake(RI), Adequate Intake(AI), and Tolerable Upper Intake Level(UL). The EAR is the daily nutrient intake estimated to meet the requirement of the half of the apparently healthy individuals in a target group and thus is set at the median of the distribution of requirements. The RI is set at two standard deviations above the EAR. The AI is established for nutrients for which existing body of knowledge are inadequate to establish the EAR and RI. The UL is the highest level of daily nutrient intake which is not likely to cause adverse effects for the human health. Age and gender subgroups are established in consideration of physiological characteristics and developmental stages: infancy, toddler, childhood, adolescence, adulthood and old age. Pregnancy and lactation periods were considered separately and gender is divided after early childhood. Reference heights and weights are from the Korean Agency for Technology and Standards, Ministry of Commerce, Industry and Energy. The practical application of DRIs to the new books based on the revision in the 7th curriculum is to assess the dietary and nutrient intake as well as to plan a meal. It can be utilized to set an appropriate nutrient goal for the diet as usually eaten and to develop a plan that the individual will consume using a nutrient based food guidance system in the new books based on the revision in the 7th curriculum.
Proceedings of The Korean Society of Health Promotion Conference
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2004.10a
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pp.89-109
/
2004
The Korean Government has produced the Health Plan 2010 aimed at setting up healthy Korea objectives, policies on preventing chronic diseases, reshaping the country's health and medical infrastructure. The policy goal targets the people's healthy life expectancy at 75 by 2010, and includes healthy life practice measures including health education, health improvement services, and disease management measures, in achieving the objectives. Also, the plan provides life cycle-based health improvement and disease prevention services, as well as pushes ahead with projects with greater ripple effects in each area. To this end, the government is simultaneously pushing to operate an experts-centered health promotion committee and establishing the infrastructure including the augmentation of national health improvement funds. Through its Health Plan 20 I 0, the Korean Government will exert efforts to achieve its policy objectives as addressed in the measures by enhancing the national potential health and providing systematic disease prevention services.
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