• 제목/요약/키워드: Case finding

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A Clinical Review of Mucoepidermoid Carcinoma of The Lung in Korea (점액상피암의 임상적 고찰)

  • Kim, Yeon-Jae;Park, Jae-Yong;Shin, Moo-Chul;Bae, Moon-Sup;Kim, Jeong-Seok;Chae, Sang-Cheol;Park, Tae-In;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.311-321
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    • 1998
  • Background: Mucoepidermoid carcinoma of the lung arises from submucosal gland of tracheobronchial tree. Histologically, the tumor is composed of mucin-secreting cells, squamous cells, and intermediated cells, which show no particular differentiating characteristics, in varying proportions. The tumor is divided into low grade and high grade depending on the proportion of cells, and the degree of the mitotic activity, cellular necrosis and nuclear pleomorphism. While favorable prognosis of low grade tumor, high grade tumor, which is very difficult to differentiate from adenosquamous carcinoma, has an aggressive clinical course. The tumor is rare, comprising 0.1 to 0.2% of primary lung cancers and 1 to 5% of bronchial adenomas. Method: A retrospective clinical study was done on 17 cases of mucoepidermoid carcinoma. The study investigated the clinical features, radiologic findings, bronchoscopic findings, histology and clinical courses. Results: Age ranged between second to seventh decade with a mean age of 42 years. Twelve out of 17 cases were male. Five out of 17 cases were smokers with a mean 11 pack-years. Common symptoms included dyspnea, cough, hemoptysis, and wheezing. Two out of 17 cases was asymptomatic. Atelectasis or mass was common radiologic finding. Plain chest radiography was normal in one patient whom the tumor was located in upper trachea. Bonchoscopy revealed exophytic mass in 12 cases and nodular infiltrations in 4 cases. One case having solitary pulmonary nodule in the right lower lung was normal on bronchoscopy. Histologically, ten out of 17 cases were low grade, and seven out of 17 cases were high grade. Among 10 patients with low grade tumor,9 patients were performed operation and have been alive without recurrence during a mean follow-up of 30 months. Two out of 7 patients with high grade tumor were performed pneumonectomy and have been alive during a follow-up of 3 and 8 months, respectively. Conclusion: Most of mucoepidermoid carcinoma is located at central airway and is presented symptoms by mucosal irirtation. Although atelectasis or mass is common radiologic finding. chest X -ray can be normal. The histologic grading and the extent of tumor are two most important factors for prognosis.

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Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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Impact of Social Activities on Healthy Life Expectancy in Korean Older Adults: 13-Year Survival Analysis Focusing on Gender Comparison (한국 노인의 사회활동이 건강수명에 미치는 영향에 대한 생존분석: 성별 비교를 중심으로 한 13년간 분석)

  • Yang, Seungmin;Choi, Jae-Sung
    • 한국노년학
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    • v.41 no.4
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    • pp.547-566
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    • 2021
  • The purpose of this study is to analyze the effect of social activities on healthy life expectancy (HLE) by gender difference. HLE implies an estimate of how long an individual can expect to live in full health or without disease and/or disability. Morbidity, mortality, and functional health status usually have been known as key variables. Many researchers have tried to investigate factors affecting HLE in countries level by performing comparative analyses. In micro level, there have been some studies about social factors affecting HLE in individual level. However, few studies are found focusing on the relationship between HLE and social activities. This study anlayzes 4,029 over 65 years of age from the first wave (2006) to the seventh wave (2018) of the Korean Longitudinal Study of Ageing (KLoSA), which is a national panel data collected by Korea Employment Information Service. The data has been collected as a part of social and economic policies planning for Korean government. HLE was measured by life period without disease or disability. One of findings is that male older adults (76.9 yrs) show higher HLE in comparing to female group (75.3 yrs). Female group appeared to be more likely to have higher incidence rate and disorders. Another finding indicates that age, number of chronic diseases, and subjective health status affect HLE of both groups. Finally, regarding social activities, religion affiliated activities appear to significantly affect HLE of both groups. In case of male older adults, alumni or hometown gathering also appeared another activities affecting HLE. This study indicates that the effect of social activities types on HLE among older adults appears differently by gender. Further, unlikely of longer life expectancy among female older adults as known, HLE shows a reverse estimate, longer healthy life expectancy among male older adults. This finding may imply that later life of female older adults shows lower quality of life in comparing to that of male group, even if female life expectancy has been higher. This study encourages to develop more social activity programs for older adults in community level. Specifically, more attention is required to planning for programs targeting female older adults.

A Case of Glycogen Storage Disease Type Ia Confirmed by Biopsy and Enzyme Assay (제Ia형 당원병 1례 (Glycogen Storage Disease , Type Ia))

  • Meen Sang-Ae;Rho Kwang-Sik;Kim Pyung-Kil;Jeong Hyeon-Joo;Park Young-Nyeon;Kim Myung-Joon;Kim Ji-Hong
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.77-81
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    • 1998
  • The author exprienced a case of glycogen storage disease type Ia(GSD-I) in an 18-year-old male patient who was admitted to our hospital due to proteinuria and hypertension. he was suspected to have GSD when 12 years old because of his family history of short stature and hepatomegaly. On admission, physical examination revealed short stature, heparomegaly, and The diagnosis of GSD-I was confirmed by compatible liver biopsy finding and enzyme assay which erealeddeficiency of glcose-6-phosphatase if hepatocyte. Sympromatic treatment was done using antihypertensive drugs and allopurinol with diet control. The authors report a case of glycogen storage disease type Ia completely confirmed by typical clinical manifestation, pathologic findings of the liver and the kidney, and the result of enzyme assay which revealed deficiency of glucose-6-phosphatase in hepatocytes with brief review fo related literatures.

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Clinical Characteristics of Pulmonary Cryptococcosis (국내 폐효모균증의 임상적 특징)

  • Moon, Doo-Seop;Yoo, Jeong-Soo;Kim, Chung-Mi;Kim, Yeon-Soo;Kim, Seung-Min;Oh, Kwang-Taek;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Hahm, Shee-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1083-1093
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    • 1997
  • Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.

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A Comparative Case Study on the Adaptation Process of Advanced Information Technology: A Grounded Theory Approach for the Appropriation Process (신기술 사용 과정에 관한 비교 사례 연구: 기술 전유 과정의 근거이론적 접근)

  • Choi, Hee-Jae;Lee, Zoon-Ky
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.99-124
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    • 2009
  • Many firms in Korea have adopted and used advanced information technology in an effort to boost efficiency. The process of adapting to the new technology, at the same time, can vary from one firm to another. As such, this research focuses on several relevant factors, especially the roles of social interaction as a key variable that influences the technology adaptation process and the outcomes. Thus far, how a firm goes through the adaptation process to the new technology has not been yet fully explored. Previous studies on changes undergone by a firm or an organization due to information technology have been pursued from various theoretical points of views, evolved from technological and institutional views to an integrated social technology views. The technology adaptation process has been understood to be something that evolves over time and has been regarded as cycles between misalignments and alignments, gradually approaching the stable aligned state. The adaptation process of the new technology was defined as "appropriation" process according to Poole and DeSanctis (1994). They suggested that this process is not automatically determined by the technology design itself. Rather, people actively select how technology structures should be used; accordingly, adoption practices vary. But concepts of the appropriation process in these studies are not accurate while suggested propositions are not clear enough to apply in practice. Furthermore, these studies do not substantially suggest which factors are changed during the appropriation process and what should be done to bring about effective outcomes. Therefore, research objectives of this study lie in finding causes for the difference in ways in which advanced information technology has been used and adopted among organizations. The study also aims to explore how a firm's interaction with social as well as technological factors affects differently in resulting organizational changes. Detail objectives of this study are as follows. First, this paper primarily focuses on the appropriation process of advanced information technology in the long run, and we look into reasons for the diverse types of the usage. Second, this study is to categorize each phases in the appropriation process and make clear what changes occur and how they are evolved during each phase. Third, this study is to suggest the guidelines to determine which strategies are needed in an individual, group and organizational level. For this, a substantially grounded theory that can be applied to organizational practice has been developed from a longitudinal comparative case study. For these objectives, the technology appropriation process was explored based on Structuration Theory by Giddens (1984), Orlikoski and Robey (1991) and Adaptive Structuration Theory by Poole and DeSanctis (1994), which are examples of social technology views on organizational change by technology. Data have been obtained from interviews, observations of medical treatment task, and questionnaires administered to group members who use the technology. Data coding was executed in three steps following the grounded theory approach. First of all, concepts and categories were developed from interviews and observation data in open coding. Next, in axial coding, we related categories to subcategorize along the lines of their properties and dimensions through the paradigm model. Finally, the grounded theory about the appropriation process was developed through the conditional/consequential matrix in selective coding. In this study eight hypotheses about the adaptation process have been clearly articulated. Also, we found that the appropriation process involves through three phases, namely, "direct appropriation," "cooperate with related structures," and "interpret and make judgments." The higher phases of appropriation move, the more users represent various types of instrumental use and attitude. Moreover, the previous structures like "knowledge and experience," "belief that other members know and accept the use of technology," "horizontal communication," and "embodiment of opinion collection process" are evolved to higher degrees in their dimensions of property. Furthermore, users continuously create new spirits and structures, while removing some of the previous ones at the same time. Thus, from longitudinal view, faithful and unfaithful appropriation methods appear recursively, but gradually faithful appropriation takes over the other. In other words, the concept of spirits and structures has been changed in the adaptation process over time for the purpose of alignment between the task and other structures. These findings call for a revised or extended model of structural adaptation in IS (Information Systems) literature now that the vague adaptation process in previous studies has been clarified through the in-depth qualitative study, identifying each phrase with accuracy. In addition, based on these results some guidelines can be set up to help determine which strategies are needed in an individual, group, and organizational level for the purpose of effective technology appropriation. In practice, managers can focus on the changes of spirits and elevation of the structural dimension to achieve effective technology use.

The Significance of Sentinel Node Biopsy in Malignant Melanoma and Squamous Cell Carcinoma of Lower Extremities (하지에 발생한 악성흑색종 및 편평상피세포암에서 소속 림프절 생검의 의미)

  • Kim, Jae-Do;Lee, Gun-Woo;Kwon, Young-Ho;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.69-73
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    • 2010
  • Purpose: Sentinel lymph node (SLNB) is the first confronted lymph node from primary lesion of tumor through lymphatic drainage, which is important for determining early metastasis and setting guidelines for treatment. We reported significant of sentinel lymph node biopsy in malignant melanoma (MM) and squamous cell carcinoma (SCC) of lower extremities. Materials and Methods: Twenty-five cases of surgically treatment and being possible for follow up more than 1 year among the patients who were diagnosed as MM and SCC in this institution from Sep. 2005 to Jan. 2009, and 10 cases of them were performed SLNB. Average age was 64 years old, and 15 cases of male and 10 cases of female were in this group. Results: 3 years overall survival rate was 100% and 3 years disease-free survival rate was 76%. Metastasis occurred in total 6 patients, 4 cases of inguinal lymph nodes, 1 case of soft tissue around knee, 1 case of left achilles tendon. In 15 cases of not performing SLNB, overall survival rate was 93.3% and disease-free survival rate was 73.3%. In 10 cases of performing SLNB, overall survival rate was 100% and disease-free survival rate was 90%. And only 1 case showed positive finding in the biopsy, and none of the 10 cases showed metastasis in follow-up. Conclusion: SLNB leads simpler and less complications compared to prior elective lymph node dissection, and shows high degree of accuracy. Throughout the SLNB, setting guidelines for treatment by accurate staging is thought to be helpful for increasing the survival rate in the patient with MM and SCC.

Foreign Body in the Gastrointestinal Tract in Children (소아의 위장관 이물질에 대한 임상적 고찰)

  • Lee, Bo-Hyeong;Lee, Hyun-Kyung;Kim, Mi-Jung;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.75-84
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    • 2001
  • Background: The accidental swallowing of foreign body is a common problem in the children. Ingested foreign bodies may be managed by endoscopy, observation, or surgery. So we analyzed the methods of removal, type, location and complications of foreign bodies. Materials and Methods: This report reviewed 37 cases of ingested foreign body in the gastrointestinal tract at the Department of Pediatrics, Yeungnam University Hospital between January 1997 and April 2001. Results: The age ranged from 8 months to 8 years. The most prevalent age group was between 1 year and 2 years of age(19%). The male to female ratio was 2.1:1 with 25 male and 12 female patients. The type of foreign bodies were coins in 20 cases(54%), nail in 4 cases(11%), key in 4 cases(11%), pin in 2 cases(5.5%), necklace in 2 cases(5.5%) and others. The locations of foreign bodies were upper esophagus in 12 cases(32.5%), lower esophagus in 4 cases(10.8%), stomach in 16 cases(43.2%), small bowel in 5 cases(13.5%). 4. Presenting symptoms were variable with asymptomatic(59.4%), vomiting(19.0%), epigastric pain(8.1%), dysphagia(5.4%) and others. The methods for removal of foreign bodies included 20 cases of endoscopic removal(54.0%). 3 cases of spontaneous removal(8.1%) and there was no surgical removal. 14 cases(37.9%) did not confirmed removal of foreign body because of no revisit of our hospital. Endoscopic finding of patients were normal(15 cases), ulceration(2 cases), erosion(1 case), inflammation(1 case), mucosal scratch(1 case). Conclusion: It appears that the endoscopic approach is the preferable method for the removal of upper gastrointestinal foreign bodies in the children.

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New Government's Responsibility and Achievement in Records & Archives Management (공공기록물 관리에 있어 이명박정부의 책임과 '업적')

  • Lee, Seung-Hwi
    • The Korean Journal of Archival Studies
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    • no.18
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    • pp.257-280
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    • 2008
  • The purpose of this paper is reviewing the hot issue called 'draining away the presidential records' case occurred recently and finding the root cause why the state of affairs has been happened in Korea. Though the presidential records management law ensures the rights for the prior president to view his presidential records, the prior president has copied his presidential records produced while in office and moved to his private house at his retirement. He might have interpreted his right to his presidential records too broadly and done the 'draining away' them. There was a motive why the prior president did that at that time. The reason was because the National Archives didn't guarantee the services for right viewing the records to him who wanted to review his records from right after his retirement. The National Archives have judged the draining away the prior presidential records as illegal and accused a few public servants suspected to be responsible for the affairs. The formal accuser is the National Archives, but the actual accuser might be the current Presidential Secretariat. Whatever the results of juristic judgement are, the reason why the records management field should focus and treat this case importantly is that the collapse possibility of the protection wall needed essentially and critically to the Presidential records becomes very high. The root cause of this case might exist in the fact that the records and archives management organizations have not owned the political independence. But the National Archives has submitted the revised bill of the public records and archives management law which lower the position of the National Records Management Committee controlled under from the Prime Minister to the Ministry of Administration and Security. It might be hot concern that the records and archives management organizations have difficulty for keeping the political independence if the revision would be passed. Besides the political independence factor, the most important factor needed for the right records management is the establishing the professional specificity of records management. The specific action for the establishing professional specificity would be employing of specialists and introducing the open official appointment. But it was found from the reorganization after the governmental change that the professional specificity of the National Archives have been reduced. Although the policies introduced by the new government are worrying, it might be an inheritance from the prior government. If new government would build establish the institution for the political independence of the records and archives management organizations and expand the employment of the records management professions to the local government, these affairs can be not only the responsibilities but also the achievements of the new government.

Applying the Theory of Affordance to the Design of Water Purification Facilities : Focusing on the Case of Binh Dinh in Vietnam (정수시설 설계에 대한 어포던스 이론 적용 연구: 베트남 빈딘 사례를 중심으로)

  • Park, Hye-Rin;Hwang, Yeo-Kyeong;Kim, Seul-Gi;Lee, Jun-Min;Hwang, Jun-Seok
    • Journal of Appropriate Technology
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    • v.6 no.1
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    • pp.28-36
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    • 2020
  • Sustainable appropriate technology requires user-centered design with consideration of the political, cultural and environmental aspects of the area. However, in the preparation of appropriate technology, there is a limit to the prior grasp of the user's intention and experience leading to the actual behavior of the user after the dissemination. As a result, appropriate technologies are often inconvenient for practical use or used for other purposes, contrary to the designer's intention. This study analyzes the case of appropriate technology with an analysis framework that reflects Maier's affordance theory, and proposes a design solution that can overcome the limitations of existing design. Affordance theory is the theory of factors that cause the user to identify and use features through interpretation based on prior knowledge and experience about things. The analysis cases in this study are the interviews with the designers, management education materials, and manager interviews for water purification systems at three of six schools in Binh Dinh Province, Vietnam, from August 2015 to January 2018. The case was attempted to be improved by periodic installation, maintenance, and inspection, but similar problems continued to occur. First, the facility inspections and manager interviews are compared with manager training materials distributed at the time of installation to find inconsistencies. Next, we analyze the designer's intended affordance and the affordances that actually influenced the management behavior. And then, we propose design solutions based on commonly found problems and affordances. This study suggests that it is necessary to apply the design considering the user's behavior before distributing the appropriate technology, and this study will be precedent in the process of finding the improvement through the analysis framework based on the affordance.