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Usefulness and Limitations of Fine Needle Aspiration Cytology in Adult Cervical Lymph Node Enlargement Patients: An analysis of 342 cases (성인 경부 림프절 비대 환자들에서 미세침 흡인 세포검사법의 유용성과 문제점: 342 증례의 분석)

  • Lee, Jaeho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.18-28
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    • 2004
  • Background : Many diseases like lung cancer and tuberculosis can involve cervical lymph node. Fine needle aspiration cytology(FNAC) was known as a useful screening test for the evaluation of enlarged lymph node. But the usefulness and limitations of FNAC according to disease category or physical characteristics of lymph node were not yet fully established. Methods : Retrospective analysis of three hundred forty two adult patients who performed FNAC due to enlarged cervical lymph nodes at the Seoul Municipal Boramae Hospital during the period from January 1999 to December 2002 and final diagnosis could be made by surgical biopsy, microbiology or clinical observation. Results : Among the 342 cases, 176(51.5 %) were finally diagnosed as benign nature ncluding reactive hyperplasia, Kikuchi's disease and acute suppuration. Eighty eight(25.7 %) were diagnosed as tuberculous lymphadenitis, 66(19.3 %) as metastasis, and 12(3.5 %) as lymphoma. Tuberculosis, metastasis, and lymphoma all showed significantly larger diameter, longer duration of lymph node enlargement. There were higher frequency of supraclavicular involvement in the cases of tuberculosis and metastasis. The overall diagnostic sensitivity of FNAC was 88.0 %, and 88.6 % in benign nature lesion, 77.3 % in tuberculosis, 90.1% in metastasis and 58.3 % in lymphoma. The diagnosis of tuberculosis was made by FNAC in 68 cases (77.3 %) among 88 cases. Lung cancer(43.9 percent) was most frequent cause of cervical lymph node metastasis. Diagnostic sensitivity of FNAC was significantly lower in the supraclavicular than other cervical lymph node(80 % vs. 91.3 %) and not correlated with disease nature, node size or number. Conclusion : Though FNAC was a reliable screening test for enlarged cervical lymph node enlargement, the diagnostic sensitivity was low in the case of lymphoma or when the enlarged lymph node was located at the supraclavicular area.

Social Welfare Policy Expansion and Generational Equity: Generational Accounting Approach (복지지출 확대가 세대 간 형평성에 미치는 효과 분석: 세대 간 회계를 이용한 접근)

  • Chun, Young Jun
    • KDI Journal of Economic Policy
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    • v.34 no.3
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    • pp.31-65
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    • 2012
  • We study the sustainability of the current fiscal policy of Korea, and the effects of the social welfare policy expansion, which has been recently discussed among the political circles, on the government budget and the generational equity, using generational accounting. We follow the generational accounting approach, considering the fact that most of the social welfare policies are the entitlement programs, which imposes the limitation of the policy maker's discretion to control the cost of their provision. The social welfare expenditure will change due to the change in the policy environments of the future, such as population aging. Therefore, we need to take into account the government cash flow of the future as well as of the present to investigate its effects on the fiscal sustainability, which implies that the national debt or the budget balance is not a proper index for the investigation. Our findings are as follows. The current fiscal policies are not sustainable, and the long-term budgetary imbalance is shown very serious. The required tax adjustment, which is defined as the percentage change of tax burden required to attain the long-term budgetary balance, is very large. Unless the level of the government expenditure is properly controlled, the tax burden and the social contribution level will rise to the untolerable level. Moreover, the expansion of the social welfare policies, which has been discussed among the political circles, will substantially increase the fiscal burden of the future generations. Even though the provision of the free lunch to the primary and the secondary school students, the free child care, and the discounted college tuition do not increase the fiscal burden much, because their magnitude at present is not large and will decrease due to the decrease in the number of the newborns and the students resulting from the fall in the fertility rate, that of the free health care service will increase tax burden of the future generations very much, because the magnitude of the government expenditure needed at present is very large and the population aging will further increase the magnitude of the health care expenditure. The findings indicate that the structural reforms, to prevent the explosive increase in the social welfare expenditure in the future, are necessary before the implementation of the welfare policy expansion. In particular, the cost control of the social transfers to the elderly needs to be made, because the speed of the population aging of Korea is among the highest in the world. The findings also indicate that the budget balance or the national debt can cause the fiscal illusion, which makes the Korean government budget look sound, even though the fiscal policy will rapidly increase the social welfare expenditure in the future, as the population ages. The generational accounting, which takes into account the cash flow of the future as well as of the present, unlike the budgetary balance and the national debt, which shows the results of the government financial activities of the past and the present, is a useful method to overcome the fiscal illusion.

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Evaluation of Thermal Catalytic Decomposition of Chlorinated Hydrocarbons and Catalyst-Poison Effect by Sulfur Compound (염소계 탄화수소의 열촉매 분해와 황화합물에 의한 촉매독 영향 평가)

  • Jo, Wan-Kuen;Shin, Seung-Ho;Yang, Chang-Hee;Kim, Mo-Geun
    • Journal of Korean Society of Environmental Engineers
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    • v.29 no.5
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    • pp.577-583
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    • 2007
  • To overcome certain disadvantages of past typical control techniques for toxic contaminants emitted from various industrial processes, the current study was conducted to establish a thermal catalytic system using mesh-type transition-metal platinum(Pt)/stainless steel(SS) catalyst and to evaluate catalytic thermal destruction of five chlorinated hydrocarbons[chlorobenzene(CHB), chloroform(CHF), perchloroethylene (PCE), 1,1,1-trichloroethane(TCEthane), trichloroethylene(TCE)]. In addition, this study evaluated the catalyst poison effect on the catalytic thermal destruction. Three operating parameters tested for the thermal catalyst system included the inlet concentrations, the incineration temperature, and the residence time in the catalyst system. The thermal decomposition efficiency decreased from the highest value of 100% to the lowest value of almost 0%(CHB) as the input concentration increased, depending upon the type of chlorinated compounds. The destruction efficiencies of the four target compounds, except for TCEthane, increased upto almost 100% as the reaction temperature increased, whereas the destruction efficiency for TCEthane did not significantly vary. For the target compounds except for TCEthane, the catalytic destruction efficiencies increased up to 30% to 97% as the residence time increased from 10 sec to 60 sec, but the increase of destruction efficiency for TCEthane stopped at the residence time of 30 sec, suggesting that long residence times are not always proper for thermal destruction of VOCs, when considering the destruction efficiency and operation costs of thermal catalytic system together. Conclusively, the current findings suggest that when applying the transition-metal catalyst for the better destruction of chlorinated hydrocarbons, VOC type should be considered, along with their inlet concentrations, and reaction temperature and residence time in catalytic system. Meanwhile, the addition of high methyl sulfide(1.8 ppm) caused a drop of 0 to 50% in the removal efficiencies of the target compounds, whereas the addition of low methyl sulfide (0.1 ppm), which is lower than the concentrations of sulfur compounds measured in typical industrial emissions, did not cause.

An Analysis of the Hail Damages to Korean Forests in 2017 by Meteorology, Species and Topography (2017년 우박에 의한 산림피해의 기상, 수종 및 지형 특성 분석)

  • Lim, Jong-Hwan;Kim, Eunsook;Lee, Bora;Kim, Sunhee;Jang, Keunchang
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.4
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    • pp.280-292
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    • 2017
  • Hail is not a frequently occurring weather event, and there are even fewer reports of hail damages to forest stands. Since the 2000s, an increase in hail incidence has been documented in Europe and the United States. In Korea, severe hails occurred in Jeollanam-do province on May 31 and in Gyeongsangbuk-do province on June 1, 2017. Hail size was ranged from 0.5 to 5.0 cm in diameter in Jeollanam-do, and from 1.5 to 3.0 cm in Gyeongsangbuk-do. This study was aimed to analyze the hail damages to forests by species and topography based on damage-categorized maps created by using drones and aerial photographs, and to analyze relationships of the damages with meteorological factors. The total damaged forest area was 1,163.1ha in Jeollanam-do, and 2,942.3ha in Gyeongsangbuk-do. Among the 'severe' damaged area 326.7ha, 91% was distributed in Jeollanam-do, and concentrated in the city of Hwasun which covers 57.2% of the total 'severe' damaged area. The most heavily damaged species was Korean red pine(Pinus densiflora S. & Z.) followed by P. rigida. Most broad-leaved trees species including oaks were recovered without any dead trees found. Liliodendron tulipifera was the most severely damaged in terms of the rate of 'severe' degree individuals which are needed to be checked whether they will die or be recovered. Cause of the death of pines was considered as the combination of physical damage caused by the hail and long-lasting drought with high air temperature that occurred before and after the hail event. No pathogens and insects were found which might have affected to tree deaths. We suggested a dieback mechanism of the pine trees damaged by hail and drought.

Analysis of Influential Factors of Roadkill Occurrence - A Case Study of Seorak National Park - (로드킬 발생 영향요인 분석 - 설악산 국립공원 44번 국도를 대상으로 -)

  • Son, Seung-Woo;Kil, Sung-Ho;Yun, Young-Jo;Yoon, Jeong-Ho;Jeon, Hyung-Jin;Son, Young-Hoon;Kim, Min-Sun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.3
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    • pp.1-12
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    • 2016
  • This study aimed to interpret the fundamental cause of road-kill occurrences and analyzed spatial characteristics of the road-kill locations from Route 44 in Seorak National Park, Korea. Logistic regression analysis was utilized for backward elimination on variables. Seorak National Park Service has constructed GIS-data of 81 road-kill occurrences from 2008 to 2013 and these data were assigned as dependent variables in this study. Considered as independent variables from previous studies and field surveys, vegetation age-class, distance to streams, coverage of fences and retaining walls, and distance to building sites were assigned as road-kill impact factors. The coverage of fences and retaining walls(-1.0135) was shown as the most influential factor whereas vegetation age-class(0.0001) was the least influential among all of the significant factor estimates. Accordingly, the rate of road-kill occurrence can increase as the distance to building sites and stream becomes closer and vegetation age-class becomes higher. The predictive accuracy of road-kill occurrence was shown to be 72.2% as a result of analysis, assuming as partial causes of road-kill occurrences reflecting spatial characteristics. This study can be regarded as beneficial to provide objective basis for spatial decision making including road-kill occurrence mitigation policies and plans in the future.

A Study of Cause of Employee Turnover and Countermeasures against Turnover in Shipping and Port Logistics Firms (중소항만물류기업의 이직원인 분석과 대책에 관한 연구)

  • Kim, Jae-Hun;Shin, Yong-John
    • Journal of Navigation and Port Research
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    • v.39 no.6
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    • pp.545-552
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    • 2015
  • This study One of the key elements of corporate competitiveness in the modern world of unlimited competition is human resource management. The reason that the world's leading companies are devoting a lot of investment and effort for good human resource development and management is that human resource can impact firm survival. In particular, there is little research on the internal and external environmental stimuli and job stress in the employee of small business which are often led to turnover, while they have suffered from chronic shortage of manpower. The purpose of this study is to determine the turnover factors in the small logistics companies and contribute to stable maintenance of workforce, facilitating human resource management and minimizing turnover. This study empirically analyzed the factors of the turnover in the organization of logistics companies from Busan Port, South Korea, which became one of the national infrastructure and the fifth world largest harbor. The conclusion proposed the development and direction of the human resource management which could promote the job environment improving the turnover factors and creating sustainable work condition through conducting preventive measures. The results indicated that the highest turnover rates was found in the category of field work, and the highest turnover group was from the 'less than one year', which implies that high turnover rates after and during job training might be greater cost to the companies than early turnover. The most common reasons for the high employee turnover were 'excessive workload' and 'dissatisfaction with wages'. Followed reasons including 'troubles with managers' and 'failure in organizational adaptation' can be understood in line with worse working conditions of the small logistic companies. It turned out that the preventive programs of the logistic enterprises had little effect through 'incentives system' and 'improving wage system' which are mainly conducted. The human resource managers appreciated the importance of 'wage raise' and 'benefits improvement'. This study is aimed at contributing to efficient human resource management through understanding of the turnover causes and human resource managers applying preventive measures. In particular, this can benefit small port logistics companies securing competitiveness and promoting persistent growth and development.

Deterioration Characteristic Analysis for Stone Properties in the Taereung Royal Tomb of the Joseon Dynasty using Nondestructive Analysis (비파괴 분석을 활용한 조선왕릉 태릉 석조물의 손상특성 분석)

  • Lee, Myeonseong;Choie, Myoungju;Lee, Taejong;Chun, Yungun
    • Korean Journal of Heritage: History & Science
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    • v.53 no.2
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    • pp.222-241
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    • 2020
  • The Taereung Royal Tomb from the Joseon Dynasty is the tomb of Empress Munjeong, the second queen of King Jungjong, and it contains various types of stone artifacts. All of these stone artifacts were constructed using coarse- to medium-grained biotite granite. The major types of deterioration of the stone artifacts are identified as surface weathering and biological contaminants. Exfoliation (145 sculptures), granular decomposition (138 sculptures), and repair materials (156 sculptures), along with biological contaminant algae (154 sculptures), lichen (165 sculptures) and moss (97 sculptures), have a high occurrence frequency. In particular, it is deemed that immediate conservation treatment is required, as biological deterioration (algae) represents the most serious condition (grade 3 or higher in 94% of all stones), and it is thought that exfoliation and granulation decomposition are required for long-term conservation management. As a result of equo -tip hardness and ultrasonic measurement, more than 70% of stones were found to have very weak physical properties. Through hyperspectral analysis, organisms were shown to inhabit more than 80% of the surface of burial mound stone artifacts, and P (phosphorus), S (sulfur), Cl (chlorine), and Ca (calcium) were detected in this area. This is because Taereung Royal Tomb has been exposed to the outdoors for hundreds of years and has been weathered by physical, chemical, and biological factors. Therefore, among the stone artifacts in the Taereung Royal Tomb, those with high physical weathering grades are considered to require consolidation to reinforce them physically. Since organisms are highly likely to cause stone damage, they must be removed via dry and wet cleaning. In addition, in order to delay the reoccurrence of organisms following conservation treatment, it is necessary to regularly clean up the soil that has flowed into the burial mound, and to monitor conservation conditions over the long term.

A Clinical Study on the Surgical Treatment of the Rheumatic Cardiac Valve Disease (류마티스성 심장판막질환의 외과적 치료에 대한 임상적 연구)

  • 김종원;정황규;이성광;김병준;신영우
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.346-352
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    • 1998
  • Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7+/-2.9% in 1 year, 88.0+/-4.5% in 5 year, 82.3+/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

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Comparison of the Reconstruction Routes after Esophagectomy for Esophageal Cancer (식도암 절제후 식도 재건경로의 비교)

  • Lee, Seung-Yeoll;Kim, Kwang-Taik;Choi, Young-Ho;Kim, Il-Hyun;Baik, Man-Jong;Sun, Kyung;Lee, In-Sung;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.806-812
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    • 1999
  • Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

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Results of Extracardiac Pericardial-flap Lateral Tunnel Fontan Operation (자가심낭막절편을 이용한 심외외측통로 Fontan 수술의 결과)

  • Park Han-Ki;Youn Young-Nam;Yang Hong-Seok;Yoo Byoung-Won;Choi Jae-Young;Park Young-Hwan
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.281-288
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    • 2006
  • Background: Extracardiac pericardial-flap lateral tunnel Fontan operation has theoretical advantage of growth potentiality of the extracardiac tunnels. The mid-term results of this technique and morphologic change of the lateral tunnel were studied. Material and Method: Clinical data was reviewed in 42 patients who underwent extracardiac pericardial-flap lateral tunnel Fontan operation between November 1993 and December 2004. The age was $2.8{\pm}1.5$ years and the body weight was $12.3{\pm}3.2$ kg. Extracardiac tunnel was constructed using the pedicled pericardium with the base undetached. By reviewing the follow-up cardiac angiograms, the diameter and the cross-sectional area of the lateral tunnel was compared to those of inferior vena cava. Result: There were four operative mortality cases (9.8%) and the causes of death were low cardiac output for all four cases. Postoperatively, five patients had prolonged pleural effusion longer than two weeks and one patient required a permanent pacemaker due to complete heart block. Follow-up was possible in 37 patients and the follow up duration was $3.8{\pm}2.2$ years. During that period, one patient died, of upper gastrointestional bleeding combined with heart failure and one patient died a sudden death of unknown cause. Two patients required reoperation due to subaortic stenosis and anastomosis site stenosis between inferior vena cava and lateral tunnel. In one patient, bradyarrhythmia was anew but there was no thromboembolic complication. The lateral tunnel showed growth in proportion to the size of the inferior vena cava. Conclusion: Extracardiac pericardial-flap lateral tunnel Fontan operation is relatively simple and safe. The mid-term result was favorable and the extracardiac tunnel showed potential for growth.