• Radiation Oncology Journal
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• 제26권4호
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• pp.247-256
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• 2008

Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.

• Journal of the Korean Applied Science and Technology
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• 제18권3호
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• pp.214-232
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• 2001

CTA ester bonds in TG molecules were not attacked by pancreatic lipase and lipases produced by microbes such as Candida cylindracea, Chromobacterium viscosum, Geotricum candidium, Pseudomonas fluorescens, Rhizophus delemar, R. arrhizus and Mucor miehei. An aliquot of total TG of all the seed oils and each TG fraction of the oils collected from HPLC runs were deuterated prior to partial hydrolysis with Grignard reagent, because CTA molecule was destroyed with treatment of Grignard reagent. Deuterated TG (dTG) was hydrolyzed partially to a mixture of deuterated diacylglycerols (dDG), which were subsequently reacted with (S)-(+)-1-(1-naphthyl)ethyl isocyanate to derivatize into dDG-NEUs. Purified dDG-NEUs were resolved into 1, 3-, 1, 2- and 2, 3-dDG-NEU on silica columns in tandem of HPLC using a solvent of 0.4% propan-1-o1 (containing 2% water)-hexane. An aliquot of each dDG-NEU fraction was hydrolyzed and (fatty acid-PFB ester). These derivatives showed a diagnostic carboxylate ion, $(M-1)^{-}$, as parent peak and a minor peak at m/z 196 $(PFB-CH_{3})^{-}$ on NICI mass spectra. In the mass spectra of the fatty acid-PFB esters of dTGs derived from the seed oils of T. kilirowii and M. charantia, peaks at m/z 285, 287, 289 and 317 were observed, which corresponded to $(M-1)^{-}$ of deuterized oleic acid ($d_{2}-C_{18:0}$), linoleic acid ($d_{4}-C_{18:0}$), punicic acid ($d_{6}-C_{18:0}$) and eicosamonoenoic acid ($d_{2}-C_{20:0}$), respectively. Fatty acid compositions of deuterized total TG of each oil measured by relative intensities of $(M-1)^-$ ion peaks were similar with those of intact TG of the oils by GLC. The composition of fatty acid-PFB esters of total dTG derived from the seed oils of T. kilirowii are as follows; $C_{16:0}$, 4.6 mole % (4.8 mole %, intact TG by GLC), $C_{18:0}$, 3.0 mole % (3.1 mole %), $d_{2}C_{18:0}$, 11.9 mole % (12.5 mole %, sum of $C_{18:1{\omega}9}$ and $C_{18:1{\omega}7}$), $d_{4}-C_{18:0}$, 39.3 mole % (38.9 mole %, sum of $C_{18:2{\omega}6}$ and its isomer), $d_{6}-C_{18:0}$, 41.1 mole % (40.5 mole %, sum of $C_{18:3\;9c,11t,13c}$, $C_{18:3\;9c,11t,13r}$ and $C_{18:3\;9t,11t,13c}$), $d_{2}-C_{20:0}$, 0.1 mole % (0.2 mole % of $C_{20:1{\omega}9}$). In total dTG derived from the seed oils of M. charantia, the fatty acid components are $C_{16:0}$, 1.5 mole % (1.8 mole %, intact TG by GLC), $C_{18:0}$, 12.0 mole % (12.3 mole %), $d_{2}-C_{18:0}$, 16.9 mole % (17.4 mole %, sum of $C_{18:1{\omega}9}$), $d_{4}-C_{18:0}$, 11.0 mole % (10.6 mole %, sum of $C_{18:2{\omega}6}$), $d_{6}-C_{18:0}$, 58.6 mole % (57.5 mole %, sum of $C_{18:3\;9c,11t,13t}$ and $C_{18:3\;9c,11t,13c}$). In the case of Aleurites fordii, $C_{16:0}$; 2.2 mole % (2.4 mole %, intact TG by GLC), $C_{18:0}$; 1.7 mole % (1.7 mole %), $d_{2}-C_{18:0}$; 5.5 mole % (5.4 mole %, sum of $C_{18:1{\omega}9}$), $d_{4}-C_{18:0}$ ; 8.3 mole % (8.5 mole %, sum of $C_{18:2{\omega}6}$), $d_{6}-C_{18:0}$; 82.0 mole % (81.2 mole %, sum of $C_{18:3\;9c,11t,13t}$ and $C_{18:3 9c,11t,13c})$. In the stereospecific analysis of fatty acid distribution in the TG species of the seed oils of T. kilirowii, $C_{18:3\;9c,11t,13r}$ and $C_{18:2{\omega}6}$ were mainly located at sn-2 and sn-3 position, while saturated acids were usually present at sn-1 position. And the major molecular species of $(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13c})_{2}$ and $(C_{18:1{\omega}9})(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13c})$ were predominantly composed of the stereoisomer of $sn-1-C_{18:2{\omega}6}$, $sn-2-C_{18:3\;9c,11t,13c}$, $sn-3-C_{18:3\;9c,11t,13c}$, and $sn-1-C_{18:1{\omega}9}$, $sn-2-C_{18:2{\omega}6}$, $sn-3-C_{18:3\;9c,11t,13c}$, respectively, and the minor TG species of $(C_{18:2{\omega}6})_{2}(C_{18:3\;9c,11t,13c})$ and $ (C_{16:0})(C_{18:3\;9c,11t,13c})_{2}$ mainly comprised the stereoisomer of $sn-1-C_{18:2{\omega}6}$, $sn-2-C_{18:2{\omega}6}$, $sn-3-C_{18:3\;9c,11t,13c}$ and $sn-1-C_{16:0}$, $sn-2-C_{18:3\;9c,11t,13c}$, $sn-3-C_{18:3\;9c,11t,13c}$. The TG of the seed oils of Momordica charantia showed that most of CTA, $C_{18:3\;9c,11t,13r}$, occurred at sn-3 position, and $C_{18:2{\omega}6}$ was concentrated at sn-1 and sn-2 compared to sn-3. Main TG species of $(C_{18:1{\omega}9})(C_{18:3\;9c,11t,13t})_{2}$ and $(C_{18:0})(C_{18:3\;9c,11t,13t})_{2}$ were consisted of the stereoisomer of $sn-1-C_{18:1{\omega}9}$, $sn-2-C_{18:3\;9c,11t,13t}$, $sn-3-C_{18:3\;9c,11t,13t}$ and $sn-1-C_{18:0}$, $sn-2-C_{18:3\;9c,11t,13t}$, $sn-3-C_{18:3\;9c,11t,13t}$, respectively, and minor TG species of $(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13c})_{2}$ and $(C_{18:1{\omega}9})(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13c})$ contained mostly $sn-1-C_{18:2{\omega6}$, $sn-2-C_{18:3\;9c,11t,13t}$, $sn-3-C_{18:3\;9c,11t,13t}$ and $sn-1-C_{18:1{\omega}9}$, $sn-2-C_{18:2{\omega}6}$, $sn-3-C_{18:3\;9c,11t,13t}$. The TG fraction of the seed oils of Aleurites fordii was mostly occupied with simple TG species of $(C_{18:3\;9c,11t,13t})_{3}$, along with minor species of $(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13t})_{2}$, $(C_{18:1{\omega}9})(C_{18:3\;9c,11t,13t})_{2}$ and $(C_{16:0})(C_{18:3\;9c,11t,13t})$. The sterospecific species of $sn-1-C_{18:2{\omega}6}$, $sn-2-C_{18:3\;9c,11t,13t}$, sn-3-C_{18:3\;9c,11t,13t}$, $sn-1-C_{18:1{\omega}9}$, $sn-2-C_{18:3\;9c,11t,13t}$, $sn-3-C_{18:3\;9c,11t,13t}$ and $sn-1-C_{16;0}$, $sn-2-C_{18:3\;9c,11t,13t}$, $sn-3-C_{18:3\;9c,11t,13t}$ are the main stereoisomers for the species of $(C_{18:2{\omega}6})(C_{18:3\;9c,11t,13t})_2$, $(C_{18:1{\omega}9})(C_{18:3\;9c,11t,13t})_{2}$ and $(C_{16:0})(C_{18:3\;9c,11t,13t})$, respectively.

• Tuberculosis and Respiratory Diseases
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• 제44권2호
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• pp.360-378
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• 1997

Background : Severe acute lung injury(ALI), also known as the adult respiratory distress syndrome(ARDS), is a heterogenous nature of dynamic and explosive clinical synrome that exacts a mortality of approximately 50%. Endotoxin(ETX) is an abundant component of the outer membrane of gram-negative bacteria capable of inducing severe lung injury in gram-negative sepsis and gram-negative bacterial pneumonia, which are among the most common predisposing causes of ARDS. The influx of PMNs into airway tissue is a pathological hallmark of LPS-induced lung injury. And there is a substantial evidence suggesting that cytokines are important mediators of lung injury in gram-negative sepsis. However, the kinetics of phagocytes and cytokines by an exact time sequence and their respective pathogenic importance remain to be elucidated. This study was performed to investigate the role of phagocytes and proinflammatory cytokines in ETX-induced ALI through a time course of changes in the concentration of protein, $TNF{\alpha}$ and IL-6, and counts of total and its differential cells in BALF. The consecutive histologic findings were also evaluated. Method : The experimental animals, healthy male Sprague-Dawley, weighted $200{\pm}50g$, were divided into control- and ALI- group. ALI was induced by an intravenous administration of ETX, 5mg/kg. Above mentioned all parameters were examined at 0(control), 3, 6, 24, 72 h after administration of ETX. $TNF{\alpha}$ and IL-6 cone. in BALF were measured by a bioassay. Results : The protein concentration and total leukocyte count(TC) in BALF was significantly increased at 3h compared to controls(p < 0.05). The protein conc. was significantly elavated during observation period, but TC was significantly decreased at 72h(p < 0.05 vs. 24h). There was a close relationship between TC and protein cone. in BALF(r = 0.65, p < 0.001). The PMN and monocyte count was well correlated with TC in BALF, and the correlation of PMN(r = 0.97, p < 0.001) appeared to be more meaningful than that of monocyte(r = 0.61, p < 0.001). There was also a significant correlation between protein cone. and PMN or monocyte count in BALF(PMN vs. monocyte : r = 0.55, p < 0.005 vs. r = 0.64, p < 0.001). The count of monocyte was significantly elavated during observation period though a meaningful reduction of PMN count in BALF at 72h, this observation suggested that monocyte may, at least, partipate in the process of lung injury steadly. In this study, there was no relationship between IL-6 and $TNF{\alpha}$ cone., and $TNF{\alpha}$ but not IL-6 was correlated with TC(r = 0.61, p < 0.05) and monocyte(r = 0.67, p < 0.05) in BALF only at 3, 6h after ETX introduced. In particular, the IL-6 cone. increased earlier and rapidly peaked than $TNF{\alpha}$ cone. in BALF. In histologic findings, the cell counts of lung slices were increased from 3 to 72h(p < 0.001 vs. NC). Alveolar wall-thickness was increased from 6 to 24h(p < 0.001 vs. NC). There was a significant correlation between the cell counts of lung slices and alveolar wall-thickness(r= 0.61, p < 0.001). This result suggested that the cellular infiltrations might be followed by the alterations of interstitium, and the edematous change of alveolar wall might be most rapidly recovered to its normal condition in the process of repair. Conclusion : We concluded that although the role of PMN is partly certain in ETX-induced ALI, it is somewhat inadequate to its known major impact on ALL Alveolar macrophage and/or non-immune cells such as pulmonary endothelial or epithelial cells, may be more importantly contributed to the initiation and perpetual progression of ETX-induced ALI. The IL-6 in ETX-induced ALI was independent to $TNF{\alpha}$, measured by a bioassay in BALF. The early rise in IL-6 in BALF implies multiple origins of the IL-6.

• Tuberculosis and Respiratory Diseases
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• 제45권6호
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• pp.1265-1276
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• 1998

Background : Nitric oxide(NO) is an endogenously produced free radical that plays an important role in regulating vascular tone, inhibition of platelet aggregation and white blood cell adhesion to endothelial cells, and host defense against infection. The highly reactive nature of NO with oxygen radicals suggests that it may either promote or reduce oxidant-induced cell injury in several biological pathways. Oxidant injury and interactions between pulmonary vascular endothelium and leukocytes are important in the pathogenesis of acute lung injury, including acute respiratory distress syndrome(ARDS). In ARDS, therapeutic administration of NO is a clinical condition providing exogenous NO in oxidant-induced endothelial injury. The role of exogenous NO from NO donor or the suppression of endogenous NO production was evaluated in oxidant-induced endothelial injury. Method : The oxidant injury in cultured rat lung microvascular endothelial cells(RLMVC) was induced by hydrogen peroxide generated from glucose oxidase(GO). Cell injury was evaluated by $^{51}$chromium($^{51}Cr$) release technique. NO donor, such as S-nitroso-N-acetylpenicillamine(SNAP) or sodium nitroprusside(SNP), was added to the endothelial cells as a source of exogenous NO. Endogenous production of NO was suppressed with N-monomethyl-L-arginine(L-NMMA) which is an NO synthase inhibitor. L-NMMA was also used in increased endogenous NO production induced by combined stimulation with interferon-$\gamma$(INF-$\gamma$), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and lipopolysaccharide(LPS). NO generation from NO donor or from the endothelial cells was evaluated by measuring nitrite concentration. Result : $^{51}Cr$ release was $8.7{\pm}0.5%$ in GO 5 mU/ml, $14.4{\pm}2.9%$ in GO 10 mU/ml, $32.3{\pm}2.9%$ in GO 15 mU/ml, $55.5{\pm}0.3%$ in GO 20 mU/ml and $67.8{\pm}0.9%$ in GO 30 mU/ml ; it was significantly increased in GO 15 mU/ml or higher concentrations when compared with $9.6{\pm}0.7%$ in control(p < 0.05; n=6). L-NMMA(0.5 mM) did not affect the $^{51}Cr$ release by GO. Nitrite concentration was increased to $3.9{\pm}0.3\;{\mu}M$ in culture media of RLMVC treated with INF-$\gamma$ (500 U/ml), TNF-$\alpha$(150 U/ml) and LPS($1\;{\mu}g/ml$) for 24 hours ; it was significantly suppressed by the addition of L-NMMA. The presence of L-NMMA did not affect $^{51}Cr$ release induced by GO in RLMVC pretreated with INF-$\gamma$, TNF-$\alpha$ and LPS. The increase of $^{51}Cr$ release with GO(20 mU/ml) was prevented completely by adding 100 ${\mu}M$ SNAP. But the add of SNP, potassium ferrocyanate or potassium ferricyanate did not protect the oxidant injury. Nitrite accumulation was $23{\pm}1.0\;{\mu}M$ from 100 ${\mu}M$ SNAP at 4 hours in phenol red free Hanks' balanced salt solution. But nitrite was not detectable from SNP upto 1 mM The presence of SNAP did not affect the time dependent generation of hydrogen peroxide by GO in phenol red free Hanks' balanced salt solution. Conclusion : Hydrogen peroxide generated by GO causes oxidant injury in RLMVC. Exogenous NO from NO donor prevents oxidant injury, and the protective effect may be related to the ability to release NO. These results suggest that the exogenous NO may be protective on oxidant injury to the endothelium.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.987-996
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• 1996

Background : We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods : Twenty-six out of 106 patients with either acute ventilatory failure (VF: $PaCO_2$ > 43 mm Hg with pH < 7.35) or oxygenation failure (OF: $PaO_2/AO_2$ < 300 mm Hg with $pH{\geq}7.35$) requiring mechanical ventilation were managed by NIV (CPAP + pressure suppon, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M : F=7 : $55.4{\pm}14.6$ yrs) and 15 out of 87 cases with OF (17.2%) (M : F=12 : 3, $50.6{\pm}15.6$ yrs) were s uilable for NIY. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of YF and 40% (6/15) of OF were successfully managed on NIV and were weruled from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV ($34{\pm}9$ /min pre-NIV, $26{\pm}6$ /min at 12 hour of NIV, p=0.045), while $PaCO_2$ ($87.3{\pm}20.6$ mm Hg pre-NIV, $81.2{\pm}9.1$ mm Hg at 24 hour of NIV) and pH ($7.26{\pm}0.04$, $7.32{\pm}0.02$, respectively, p <0.05) were both significantly decreased at 24 hour of NIV In NIV for oxygenation failure, $PaCO_2$ were not different between the successful and the failed cases at pre-NIV and till 12 hours after NIV. The $PaO_2/FIO_2$ ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6 : at baseline, 0.5h, 6h, 12h : $120.0{\pm}19.6$, $218.9{\pm}98.3$, $191.3{\pm}55.2$, $232.8{\pm}17.6$ mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9 : $127.9{\pm}63.0$, $116.8{\pm}24.4$, $100.6{\pm}34.6$, $129.8{\pm}50.3$ mm Hg, respectively, p=0.5319). Conclusion : From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rale before the reduction in $PaCO_2$ level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of $PaO_2/FIO_2$ ratio at 0.5h after application is thought to be a predictor of successful NIV.

• Journal of the Korean Institute of Landscape Architecture
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• 제44권6호
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• pp.84-97
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• 2016

This study was to investigate the user's thermal environments of the children's parks according to pavements and sunscreen types during periods of heat waves. The measurements were conducted at the sand pits, rubber chip pavement, shelters, and green shade ground of the two children's parks located in Jinju, Korea(Chilam: $N\;35^{\circ}11^{\prime}1.4{^{\prime}^{\prim}}$, $E\;128^{\circ}5^{\prime}31.7{^{\prime}^{\prime}}$, elevation 38m, Gaho: $N\;35^{\circ}09^{\prime}56.8{^{\prime}^{\prime}}$, $E\;128^{\circ}6^{\prime}41.1{^{\prime}^{\prime}}$, elevation 24m) over three days during 11-13, August, 2016. The highest ambient air temperatures at the Jinju Meteorological Office during the three measurement days were $35.9{\sim}36.8^{\circ}C$, which corresponded with the extremely hot weather. A series of experiments measured air temperature, relative humidity, wind velocity, black globe temperature, and long-wave and short-wave radiation of the six directions 0.6 m above ground level. The wet bulb globe temperature(WBGT) and the universal thermal climatic index(UTCI) were used to evaluate thermal stress. Surface temperature images of the play equipment were also taken using infrared thermography. Surface temperatures of the play equipment and grounds were used to evaluate burn risk through contact with playground materials. The results showed the following. The maximum air temperatures averaged over 1-hour period for three days were $36.6{\sim}39.4^{\circ}C$. The sun shades reduced those temperatures by up to $2.8^{\circ}C$(green shade) and $1.0^{\circ}C/2.3^{\circ}C$(shelters). The minimum relative humidity values averaged over 1-hour period for three days were 44~50%. The sun shades increased those humidity values by up to 6%(green shade) and 4%/6%(shelters). The risk of heat related illness at the measurement sites of the children's parks were extreme and high in the daytime hours. The maximum WBGT values averaged over a 30-minute period for three days were $31.2{\sim}33.6^{\circ}C$. The sun shades reduced those WBGT values by up to $2.4^{\circ}C$(green shade) and $0.5^{\circ}C/2.1^{\circ}C$(shelters) compared to sandpits, but would not block the risk of heat related illness in the daytime hours. The category of heat stress at the measurement sites of the children's parks were extreme and very strong in the daytime hours. The maximum UTCI values averaged over a 30-minute period for three days were $39.9{\sim}48.1^{\circ}C$. The sun shades reduced those UTCI values by up to $7.8^{\circ}C$(green shade) and $4.1^{\circ}C/8.2^{\circ}C$(shelters) compared to sandpits, but could not lower heat stress category from extreme and very strong to strong and moderate in the daytime hours. According to the burn threshold criteria when skin was in contact with playground materials, the maximum surface temperature of the stainless steels($70.8^{\circ}C$) surpassed three seconds $60^{\circ}C$ threshold for uncoated steel, that of the rubber chip($76.5^{\circ}C$) surpassed five seconds $74^{\circ}C$ threshold for the plastic, that of the plastic slide($68.5^{\circ}C$) and seats($71.0^{\circ}C$) surpassed the one min $60^{\circ}C$ threshold for plastic, respectively. The surface temperatures of shaded play equipment were lower approximately $20^{\circ}C$ than those of play equipment exposed to the sun. Therefore, sun shades can block the risk of burns in daytime hours. Because of the extreme and high risk of heat related illness and extreme and high heat stress at the children's parks during periods of heat waves, parents and administrators must protect children from the use of playgrounds. The risk of burn when contact with play equipments and grounds at the children's parks during periods of heat waves, was very high. The sun shades are essential to block the risk of burn from play equipments and grounds at the children's parks during heat waves.

• Tuberculosis and Respiratory Diseases
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• 제42권4호
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• pp.555-568
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• 1995

Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

• Tuberculosis and Respiratory Diseases
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• 제44권3호
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• pp.516-524
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• 1997

Background : Cancer invasion and metastasis require the dissolution of the extracellular matrix in which several proteolytic enzymes are involved. One of these enzymes is the urokinase-type plasminogen activator(u-PA), and plasminogen activator inhibitors(PAI-1, PAI-2) also have a possible role in cancer invasion and metastasis by protection of cancer itself from proteolysis by u-PA. It has been reported that the levels of u-PA and plasminogen activator inhibitors in various cancer tissues are significantly higher than those in normal tissues and have significant correlations with tumor size and lymph node involvement. Here, we measured the concentration of plasma u-PA and PAI-1 antigens in the patients with lung cancer and compared the concentration of them with histologic types and staging parameters. Methods : We measured the concentration of plasma u-PA and PAI-1 antigens using commercial ELISA kit in 37 lung cancer patients, 21 benign lung disease patients and 24 age-matched healthy controls, and we compared the concentration of them with histologic types and staging parameters in lung cancer patients. Results : The concentration of u-PA was $1.0{\pm}0.3ng/mL$ in controls, $1.0{\pm}0.3ng/mL$ in benign lung disease patients and $0.9{\pm}0.3ng/mL$ in lung cancer patients. The concentration of PAI-1 was $14.2{\pm}6.7ng/mL$ in controls, $14.9{\pm}6.3ng/mL$ in benign lung disease patients, and $22.1{\pm}9.8ng/mL$ in lung cancer patients. The concentration of PAI-1 in lung cancer patients was higher than those of benign lung disease patients and controls. The concentration of u-PA was $0.7{\pm}0.4ng/mL$ in squamous cell carcinoma, $0.8{\pm}0.3ng/mL$ in adenocarcinoma, 0.9ng/mL in large cell carcinoma, and $1.1{\pm}0.7ng/mL$ in small cell carcinoma. The concentration of PAI-1 was $22.3{\pm}7.2ng/mL$ in squamous cell carcinoma, $22.6{\pm}9.9ng/mL$ in adenocarcinoma, 42 ng/mL in large cell carcinoma, and $16.0{\pm}14.2ng/mL$ in small cell carcinoma. The concentration of u-PA was 0.74ng/mL in stage I, $1.2{\pm}0.6ng/mL$ in stage II, $0.7{\pm}0.4ng/mL$ in stage IIIA, $0.7{\pm}0.4ng/mL$ in stage IIIB, and $0.7{\pm}0.3ng/mL$ in stage IV. The concentration of PAI-1 was 21.8ng/mL in stage I, $22.7{\pm}8.7ng/mL$ in stage II, $18.4{\pm}4.9ng/mL$ in stage IIIA, $25.3{\pm}9.0ng/mL$ in stage IIIB, and $21.5{\pm}10.8ng/mL$ in stage IV. When we divided T stage into T1-3 and T4, the concentration of u-PA was $0.8{\pm}0.4ng/mL$ in T1-3 and $0.7{\pm}0.4ng/mL$ in T4, and the concentration of PAI-1 was $17.9{\pm}5.6ng/mL$ in T1-3 and $26.1{\pm}9.1ng/mL$ in T4. The concentration of PAI-1 in T4 was significantly higher than that in T1-3. The concentration of u-PA was $0.8{\pm}0.4ng/mL$ in M0 and $0.7{\pm}0.3ng/mL$ in M1, and the concentration of PAI-1 was $23.6{\pm}8.3ng/mL$ in M0 and $21.5{\pm}10.8ng/mL$ in M1. Conclusions : The plasma levels of PAI-1 in lung cancer were higher than benign lung disease and controls, and the plasma levels of PAI-1 in T4 were significantly higher than T1-3. These findings suggest involvement of PAI-1 with local invasion of lung cancer, but it should be confirmed by the data on comparison with pathological staging and tissue level in lung cancer.

• Journal of Intelligence and Information Systems
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• 제23권3호
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• pp.155-175
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• 2017

As social data become into the spotlight, mainstream web search engines provide data indicate how many people searched specific keyword: Web Search Traffic data. Web search traffic information is collection of each crowd that search for specific keyword. In a various area, web search traffic can be used as one of useful variables that represent the attention of common users on specific interests. A lot of studies uses web search traffic data to nowcast or forecast social phenomenon such as epidemic prediction, consumer pattern analysis, product life cycle, financial invest modeling and so on. Also web search traffic data have begun to be applied to predict tourist inbound. Proper demand prediction is needed because tourism is high value-added industry as increasing employment and foreign exchange. Among those tourists, especially Chinese tourists: Youke is continuously growing nowadays, Youke has been largest tourist inbound of Korea tourism for many years and tourism profits per one Youke as well. It is important that research into proper demand prediction approaches of Youke in both public and private sector. Accurate tourism demands prediction is important to efficient decision making in a limited resource. This study suggests improved model that reflects latest issue of society by presented the attention from group of individual. Trip abroad is generally high-involvement activity so that potential tourists likely deep into searching for information about their own trip. Web search traffic data presents tourists' attention in the process of preparation their journey instantaneous and dynamic way. So that this study attempted select key words that potential Chinese tourists likely searched out internet. Baidu-Chinese biggest web search engine that share over 80%- provides users with accessing to web search traffic data. Qualitative interview with potential tourists helps us to understand the information search behavior before a trip and identify the keywords for this study. Selected key words of web search traffic are categorized by how much directly related to "Korean Tourism" in a three levels. Classifying categories helps to find out which keyword can explain Youke inbound demands from close one to far one as distance of category. Web search traffic data of each key words gathered by web crawler developed to crawling web search data onto Baidu Index. Using automatically gathered variable data, linear model is designed by multiple regression analysis for suitable for operational application of decision and policy making because of easiness to explanation about variables' effective relationship. After regression linear models have composed, comparing with model composed traditional variables and model additional input web search traffic data variables to traditional model has conducted by significance and R squared. after comparing performance of models, final model is composed. Final regression model has improved explanation and advantage of real-time immediacy and convenience than traditional model. Furthermore, this study demonstrates system intuitively visualized to general use -Youke Mining solution has several functions of tourist decision making including embed final regression model. Youke Mining solution has algorithm based on data science and well-designed simple interface. In the end this research suggests three significant meanings on theoretical, practical and political aspects. Theoretically, Youke Mining system and the model in this research are the first step on the Youke inbound prediction using interactive and instant variable: web search traffic information represents tourists' attention while prepare their trip. Baidu web search traffic data has more than 80% of web search engine market. Practically, Baidu data could represent attention of the potential tourists who prepare their own tour as real-time. Finally, in political way, designed Chinese tourist demands prediction model based on web search traffic can be used to tourism decision making for efficient managing of resource and optimizing opportunity for successful policy.

• Journal of the Korean Society of School Health
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• 제5권2호
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• pp.42-65
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• 1992

A survey was made of 976 students who were selected among students of 5 middle schools at Taegu so that it could furnish basic knowledge about sex education of adolescents by analyzing students recognition of sex, acquaintance with the opposite-sex, sex-education, The survery took a month from Nov. 1, to Nov 30, 1991. The results of this study are summarized as follows. 1. The general characteristics of the surveyed students. The survey consisted of 332 boys middle school student & 325 girls middle school students, 157 male & 162 female students of coeducational middle schools. 32.9% of them were from the first grade, 33.2% from the second grade & 33.9% from the third grade. 35.7% of them believed in Buddhism, 19% Christianism and the mode of their living standard, 86.7%, fell on 34.7% of their parents engaged in commerce and they were followed by salary man and public officals, 93.1 % of the students, parents were alive. 44.9% of their fathers were graduates of high school and 42.2% of their mothers middle school. 2. Sexual maturity 89.1 % of the surveyed girls had experienced menstruation. The mode of first menstruation, 48.2%, was at the age of 13 and the mean of it was 12.9, 3.7% the surveyed boys had exprienced a wet drem before. The mode of the first wet dream, 40.0%, was at the age of 14 and the mean was 13.4. 21.3% of surveyed students had the experience of masturbation but the number of girls fell far short of that boys. The mode of the first masturbation, 37.0%, was at the age of 14 and the mean was 13.4. 3. The acquaintance and sexual relations with the opposite sex 1) Analyzing the students actual conditions with the opposite, I found out that 52.3% of them wanted to have any kind of relations with the opposite and that 30.25 had already had some kind of relations. 73.2% of the students having relations with the opposite thought the other sex merely as a friend and the number of students who were thinking that way was distributed evenly among schools. 28.8% of the students had got acquainted with the other sex through their frieds and there were not much difference between boys and girls in the method of getting acquainated with the opposite. About 35.2% of the students having relations with the opposite came from the third grade. 47.8% of them answered that the meeting place was not fixed and 26.4% answered that they were meeting their parthers outdoors. 60.7% replyed that they were not disturbed in their studies by the relations with the other sex. 2) Most of the students 79.4%, answered that they had never had sexual relations and 16.3% of the rest said that thery were expressing their feelings by grasping each other's hand. 3) 16.6% of the surveyed students asid that they had the exprience of smoking, 1.1 % of an illusion caused by inhaling chemical addhesives, 44.0% of drinking and 41.4% of warching pornographic films. 4. The knowledge and attitude about the sex 1) The distribution and analysis according to schools and grades : 64.8% of the surveyed students answered correctly to the questions about mensturation, 49.3 % did so about wet dreams, 94.3 % did so about conception, 60.6% did so about child birth, 73.9% did so about AIDS and 50.1 % did so about sexual diseases. Roughly speaking, they had not much knowledge of sexual diseases. 2) The recognition of sex according to schools and grades : 39.0% of the students said that they had worries about sex. 33.1 % of what they worried was concerned with their bodies and 26.8% was about the acqaintance and relationship with the opposite sex. The girls were much more concerned about the former and the boys the latter. 51.1 % of the students asid that they had no specific opinion of masturbation but 19.2% said that's alright if self-restrained. About the sexual intercourse before marriage, 75.7% said negatively. 5. The need for sex education most of the students, 99.4% said they needed sex education and there was not much difference in that thought among schools. And 49.7% answered that schools, families, and societies were equlally important in sex education. About half of the students, exactly 50.2%. considered it as the main reason of sex education to prevent accidents cauesd by ignorance of sex. 81.4% said that they had had some kind of sex education. Most of the educations, 87.0%, had taken place at schools but 5.2% said they were getting most of the knowledge about sex from therir friednds, juniors and seniors. 59.5% of the students who had ever had a sex education said "Just so, so" when asked of the level of their contentment but the number of students who said "satisfied" was only a few, 16.1 %. 20.7% of the survered answered that thery wanted sex education to be made in the course of home life, and 26.6 % of the students most wanted to know about the acquaintance and relationship with the oppostie sex, 29.0% preferred nurse teachers as proper councellors of sex education. The mode of their present councellors, 42.0%, was friends but only 7.6% answered they dicussed with teachers. 6. The correlation analysis between general characteristcs and sexual behaviors of the surveyed students revealed that sex had a signigicant(P<0.001) positive correlation with parents' love toward students(P<0.01), the experience of masturbation, smoking, an illusion caused by inhaling chemical adhesives and the experience of watching pornographic films. And the standard of living had a significant(P<0.01) positive correlation(P<0.01) with grade point average, parents' existence(P<0.01) and parents' love, but a significant(P<0.01) negative correlation with sexual worries. grade point average had a significant(P<0.01)negative correlation with the experience of an illusion caused by chemical adhesives(P<0.01) and smoking. Parents' existence had significant(P<0.01) positive correlations with parents' love and smoking but a significant(P<0.01) negative correlation with the experience of an illusion by chemical adhesives. There was a significant(P<0.01) negative correlations between parents' love and the experience of an illusion by chemical adhesives, and a significant(P<0.001) positive correlation among masturbation and sexual worries, smoking, an illusion by chemical adhesives and the experience of watching pornographic films. There was a significant(P<0.001) positive correlation among acquaintance with the opposite sex, smoking, the experience of an illusion by chemical adhesives and watching pornographic films. Sexual worries had significant(P<0.01) positive correlations with smoking, the experience of an illusion by chemical adhesives and watching pornographic films. smoking had a significant positive correlation with drinking the experirence of, an illusion by chemical adhesives and watching pornographic films. Finally, there was a significant(P<0.01) positive correlation between the drinking experience and the illusion experience by chemical adhesives. According to the results mentioned above, the fact is certain that there is a great need for sex education of adolescents. Therefore, it is desirable that the schools teach sexual physiology and normal positively and that sex education including hygien education be an independant course in the curriculums. Furthermore, it is essential that the schools should have enough nurse teachers to take up sex education, expand training opportunities for them and that they develop educational materials. Considering the unbalance of the level of sex educations between boys and girls, I want to suggest that all boys and girls have sex education evenly and lead happy lives by correction irrational thought about sex, that is to say, sex discrimination, Sex education programs, especially of middle school students, should be reexamined if it is to give the students effective and profitable knowledge about sex. In addition, the government should establish a policy of adolescents' sex education to have healthy opinions of sex settled nationwide.