• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.500-518
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• 1996

Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.151-183
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• 1999

The object of this study was 200 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 9 months from Jan. 1999 to sept. 1999. We proceeded the judgment of Sasang Constitution according to 'Questionnaire of Sasang Constitution Classification (I)', and 'Questionnaire of Sasang Constitution Classification II(QSCCII)' and the diagnosis by a medical specialist. The following conclusion were made in comparison with Sasang Constitution and Questionnaire. 1. We selected the 84 subjects what had the statistical value out of the 196 subjects('Questionnaire of Sasang Constitution Classification (I)' had the 71 subjects and 'Questionnaire of Sasang Constitution Classification II(QSCCII)', had the 121 subjects). And we selected again the 73 subjects('Questionnaire of Sasang Constitution Classification (I)', had the 33 subjects and 'Questionnaire of Sasang Constitution Classification II (QSCC II)' had the 40 subjects) out of the 84 subjects, because it had a repeated subjects. 2. We made the Questionnaire what has the 85 subjects, including the subjects what was approved its statistical value by 'A CLINICAL STUDY OF THE JUDGMENT OF SASANG CONSTITUTION ACCORDING TO QUESTIONNAIRE' and 'A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION'. The subject what ask the physique and the body form was 7, the subject what ask the external appearance and the posture was 7, the subject what ask the habit and the character was 3, the subject what ask the physiology and the pathology was 3, the subject what ask the phenomenon that he has frequency was 4, the subject what ask the eating was 3, the subject what ask the symptom that he has frequency was 14, the subject what ask the work and the qualities-defects was 6, the subject what ask the friendly intercourse was 7, the subject what ask the usual mind was 5, the subject what ask the emotional inclination was I, the subject what ask the behavioral inclination was 10, the subject what ask the character was 15. 3. In the new Questionnaire, the subject what has relevance to Soyang was 84, the subject what has relevance to Soeum was 87, the subject what has relevance to Taeeum was 70. And we made the point of subject with the statistical ratio. The total point of Soyang was 7785.04, the total point of Soeum was 7742.80, the total point of Taeeum was 7746.60. 4. As a result of judgment of Sasang Constitution between the clinical diagnosis by a medical specialist and the new Questionnaire, the diagnostic accuracy of new Questionnaire was 73.33%. The diagnostic accuracy of Soyang was low, the others was high. And the Taeyang was excepted.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.44-51
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• 1997

Background : The changes of the composition in the T-lymphocyte are important as an immunological abnormality in the pathogenesis of tuberculosis. Previously, the second type of TCR dimer(${\gamma}{\delta}$ T lymphocyte) that did not express CD4 or CD8 molecules was found. In other reports the presence of this type of lymphocytes was increased in the initial stage of tuberculous infections. Method : To determine whether there are some differences in the T-lymphocyte subsets in the peripheral blood or pleural effusion between pleural tuberculosis and other pleurisy. Thirty patients with pleural effusion among the forty-nine patients were examined T-lymphocyte subset analysis(CD4+T-cell,CD8+ T-cell,${\gamma}{\delta}$ T-lymphocytes) with anti- Leu4, anti-Leu3a, anti-Lea2a, anti HLA-DR and anti-TCR-${\gamma}{\delta}$-1(Becton & Dickinson Co.). Results : The average age of the patients was 50 years old(17-81year). There were 33 males and 16 female patients. Patiensts with tuberculosis are 30cases(tuberculous pleurisy 15), lung cancer 12cases(malignant effusion 9) and pneumonia 7cases(parapneumonic effusion 6cases) In T lymphocyte subsets of pleural effusion, helper T lymphocyte(54.6 + 13.8 %) of tuberculous pleurisy was higher than that(36.2 + 25.3 %) of non-tuberculous pleurisy(p=0.04). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes in tuberculousis was insignificantly higher than non-tuberculous patients(p= 0.24). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes and pleural ${\gamma}{\delta}$ T-Iymphocytes in tuberculous pleurisy was insignificantly higher than in non-tuberculous pleurisy(p= 0.16, p= 0.12). Conclusion : The percentage of -${\gamma}{\delta}$ T lymphocytes among the total T-lymphocytes is not significantly increased in the peripheral blood or pleural effusion of the pleural tuberculosis. ${\gamma}{\delta}$ T lymphocytes is less useful as a diagnostic method of pleural tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.63-68
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• 1996

Background: Interferon-$\gamma$ has various biologic effects, including antiviral effect, antitumor proliferative effect, activation of macrophage and B lymphocyte, and increased expression of major histocompatibility complex. Especially, antitumor proliferative effect of interferon-$\gamma$ has already been proved to be important in vivo as well as in vitro. And, clinical studies of interferon-$\gamma$ have been tried in lung cancer patients. However, the mechanism of antitumor effect of interferon-$\gamma$ has not yet been established despite of many hypotheses. "Necrosis" is a type of cell death which is well known to occur in the circumstances of severe stresses. In contrast, "apoptosis" is another type of cell death which occurs in such biological circumstances as embryonic development, regression of organs, and self-tolerance of lymphocytes. And, apoptosis is an active process of cell death in which cells are dying with fragmentations of their cytoplasms and nuclei. And, in the process of apoptosis the DNAs of cells are cleaved between nucleosomes by unidentified endonuclease and therefore DNAs of apoptotic cells result in a typical electrophoresis pattern known as DNA ladder pattern. Recently it has been suggested that cytotoxic effect of interferon-$\gamma$ occurs via apoptosis. To elucidate the mechanism of antitumor cytotoxic effect of interferon-$\gamma$, we microscopically observed a lung cancer cell line, A549 which was treated with interferon-$\gamma$. We observed A545 treated with interferon-$\gamma$ was dying fragmented. And so, we performed this study to find out that the mechanism of antitumor cytotoxic effect of interferon-$\gamma$ be apoptosis. Method: We treated A549, human lung cancer cell line with various concentration of interferon-$\gamma$ and quantified its cytotoxic effect of various periods, 24 hours, 72 hours and, 120 hours by MTT(dimethylthiazolyl diphenyltetrazolium bromide) bioassay. Also, after we treated A549 with 100 units/mi of interferon-$\gamma$ for 120 hours, we observed the pattern of cell death with inverted microscope and we extracted DNAs from the dead A549 cells and observed the pattern of 1.5% agarose gel electrophoresis with ethidium bromide staining. Result: 1) Cytotoxic effect of interferon-$\gamma$ on A549: For the first 24 hours, threre was little cytotoxic effect and for between 24 hours and 72 hours, there was the beginning of cytotoxic effect and for 120 hours there was increased cytotoxic effect. 2) Pattern of A549 cell death by interferon-$\gamma$: We observed with inverted microscope that A549 cells were dying fragmented. 3) DNA ladder pattern of gel electrophoresis: We observed DNA ladder pattern of gel electrophoresis of extracted DNAs from dead A549 cells. Conclusion: We concluded that the mechanism of interferon-$\gamma$induced cytotoxicity on lung cancer cell line, A549 be via apoptosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.516-526
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• 2004

Polymerization shrinkage of photoinitiation type composite resin cause several clinical problems. The purpose of this study was to evaluate the shrinkage strain stress, linear polymerization shrinkage, compressive strength and microhardness of recently developed composite resins. The composite resins were divided into four groups according to the contents of matrix and filler type. Group I : $Denfil^{TM}$(Vericom, Korea) with conventional matrix, Group II : $Charmfil^{(R)}$(Dentkist, Korea) with microfiller and nanofller mixture, Group III : $Filtek^{TM}$ Z250(3M-ESPE, USA) TEGDMA replaced by UDMA and Bis-EMA(6) in the matrix, and Group IV : $Filtek^{TM}$ Supreme(3M-ESPE, USA) using pure nanofiller. Preparation of acrylic molds were followed by filling and curing with light gun. Strain gauges were attached to each sample and the leads were connected to a strainmeter. With strainmeter shrinkage strain stress and linear polymerization shrinkage was measured for 10 minutes. The data detected at 1 minute and 10 minutes were analysed statistically with ONE-way ANOVA test. To evaluate the mechanical properties of tested materials, compressive hardness test and microhardness test were also rendered. The results can be summarized as follows : 1. Filling materials in acrylic molds showed initial temporary expansion in the early phase of polymerization. This was followed by contraction with the rapid increase in strain stress during the first 1 minute and gradually decreased during post-gel shrinkage phase. After 1 minute, there's no statistical differences of strain stress between groups. The highest strain stress was found in group IV and followed by group III, I, II at 10 minutes-measurement(p>.05). In regression analysis of strain stress, group III showed minimal inclination and followed by group II, I, IV during 1 minute. 2. In linear polymerization shrinkage test, the composite resins in every group showed initial increase of shrinkage velocity during the first 1 minute, followed by gradually decrease of shrinkage velocity. After 1 minute, group IV and group III showed statistical difference(p<.05). After 10 minutes, there were statistical differences between group IV and group I, III(p<.05) and between group II and group III(p<.05). In regression analysis of linear polymerization shrinkage, group II showed minimal inclination and followed by group IV, III, I during 1 minute. 3. In compressive strength test, group III showed the highest strength and followed by group II, IV, I. There were statistical differences between group III and group IV, I(p<.05). 4. In microhardness test, upper surfaces showed higher value than lower surfaces in every group(p<.05).

• Radiation Oncology Journal
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• v.17 no.2
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• pp.91-99
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• 1999

Propose : This study was performed to find out the prognostic factors affecting local control, survival and disease free survival rate in nasopharyngeal carcinomas treated with chemotherapy and radiation therapy. Materials and Methods : We analysed 47 patients of nasopharyngeal carcinomas, histologically confirmed and treated at Chonnam University Hospital between July 1986 and June 1996, retrospectively. Range of patients' age were from 16 to 80 years (median; 52 years). Thirty three (70$\%$) patients was male. Histological types were composed of 3 (6$\%$) keratinizing, 30 (64$\%$) nonkeratinizing squamous cell carcinoma and 13 (28$\%$) undifferentiated carcinoma. Histoiogicai type was not known in 1 patient (2$\%$). We restaged according to the staging system of 1997 American Joint Committee on Cancer Forty seven patients were recorded as follows: 71: 11 (23$\%$), T2a; 6 (13$\%$), T2b; 9 (19$\%$), 73; 7 (15$\%$), 74: 14 (30$\%$), and NO; 7 (15$\%$), Nl: 14 (30$\%$), N2; 21 (45%), N3: 5 (10%). Clinical staging was grouped as follows: Stage 1; 2 (4$\%$), IIA: 2 (4$\%$), IIB; 10 (21$\%$), III; 14 (30$\%$), IVA; 14 (30$\%$) and IVB; 5 (11$\%$). Radiation therapy was done using 6 MV and 10 MV X- ray of linear accelerator. Electron beam was used for the Iymph nodes of posterior neck after 4500 cGy. The range of total radiation dose delivered to the primary tumor was from 6120 to 7920 cGy (median; 7020 cGy). Neoadjuvant chemotherapy was performed with cisplatin +5-fluorouracil (25 patients) or cisplatin+pepleomycin (17 patients) with one to three cycles. Five patients did not received chemotherapy. Local control rate, survival and disease free suwival rate were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of survival rates between groups. multivariate analysis using Cox proportional hazard model was done for finding prognostic factors. Results: Local control rate was 81$\%$ in 5 year. Five year survival rate was 60$\%$ (median survival; 100 months). We included age, sex, cranial nerve deflicit, histologic type, stage group, chemotherapy, elapsed days between chemotherapy and radiotherapy, total radiation dose, period of radiotherapy as potential prognostic factors in multivariate analysis. As a result, cranial none deficit (P=0.004) had statistical significance in local control rate. Stage group and total radiation dose were significant prognostic factors in survival (P=0.000, P=0.012), and in disease free survival rates (P=0.003, P=0.008), respectively. Common complications were xerostomia, tooth and ear problems. Hypothyroidism was developed in 2 patients. Conclusion : In our study, cranial none deficit was a significant prognostic factor in local control rate, and stage group and total radiation dose were significant factors in both survival and disease free survival of nasopharyngeal carcinoma. We have concluded that chemotherapy and radiotherapy used in our patients were effective without any serious complication.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.4
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• pp.287-297
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• 2014

Purpose: The purpose of this study is to examine the impacts of infection control education on dental hygienists' perceptions for hepatitis B and their behaviors. Materials and methods: Study participants were chosen by random selection among dental hygienists working in Seoul, Korea. A total of 150 questionnaires were sent out for the survey from April 2013 to May 2013, of which 140-excluding incomplete responses-were used for the study. Chi-square tests and t-tests were used (SPSS 19.0), and post-hoc analysis was performed as well. The maximum significance level was 0.05. Results: Average 1.53 times infection control education was taken, but dental hygienists' perceptions for hepatitis B and their behaviors did not show statistical differences whether the education was done or not. Practices to prevent infection showed differences depending on categories, especially disinfection and sterilization were well performed by educated group. The most common reasons for not taking the education and noncompliance with infection prevention guidelines are lack of time and opportunity due to busy schedule. Conclusion: 1. The more highly educated, the greater number of patients per day, and the greater size of hospitals, the better infection control education was conducted. 2. Although hepatitis B is one of the most common chronic liver diseases in Korea, no significant correlation between perceptions of hepatitis B and infection control education was found. 3. Dental hygienists who received infection control education performed more efficient practices for protection against infections than those who did not.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.387-394
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• 2005

Purpose : We performed this study to compare the TSH and free $T_4$ levels according to gestational age and birth weight, and to reevaluate the cut-off values in the neonatal screening test for congenital hypothyroidism. Methods : Total 2,133 neonates(1,749 healthy newborns and 384 sick neonates) were screened in Dankook University Hospital from May 2000 to January 2003. Neonates with abnormal TSH values (higher than $20{\mu}IU/mL$) or abnormal free $T_4$ levels(lower than 1 ng/dL) were recalled to recheck the thyroid function test. At that time, physical examinations and history-taking regarding perinatal problem, medication history, and mother's illness were undertaken. Results : Serum TSH and free $T_4$ values revealed no significant difference according to sex, delivery type, and Apgar score. The free $T_4$ levels showed statistically significant differences, with gestational age or birth weight(P<0.01). The recall rate of neonates due to abnormal screening test was 7.48 percent. Compared with original cut-off values, the recall rate of the new cut-off values setted to TSH higher than $20{\mu}IU/mL$ or free $T_4$ lower than 0.64 ng/dL decreased from 7.48 percent to 4.8 percent in the healthy group. But, it compromised sensitivity when applied to the sick group. Conclusion : In this study, neonatal free $T_4$ levels were significantly different according to birth weight, gestational age, and the presence of compromised condition. Although the recall rate by TSH > $20{\mu}IU/mL$ or free $T_4$ <1 ng/dL was relatively high, it was impossible to set up new cut-off values without compromising sensitivity. We think studies including a larger study population will be required to change the cut-off values.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1097-1103
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• 2007

Purpose : Acute symptomatic seizure is defined as a temporary seizure together with acute systemic, metabolic, or toxic insult in association with an acute central nervous system insult. And unprovoked seizure is defined as seizure without provocating factors. We studied the risk factors of unprovoked seizures after acute symptomatic seizure in children. Methods : We retrospectively reviewed the records of one hundred and ten children with acute symptomatic seizures who were admitted to the pediatric department of Chungbuk National University Hospital between January, 1998 and December, 2003. We analyzed overall risk factors of unprovoked seizures after acute symptomatic seizures involving etiology, incidence, type of seizure, duration and neuroimaging. Results : We analyzed records of 110 children with acute symptomatic seizures aged from 1 month to 17 years. 24 children had unprovoked seizures (21.8%) after acute symptomatic seizures. Causes in order of frequency were encephalopathy, central nervous system infection, brain tumor, cerebrovascular disease. The risk of unprovoked seizure was significantly greater for those with status epilepticus (68.4%) than without status epilepticus, with partial seizure (64.7%) than generalized seizure. And the risk of unprovoked seizure was strongly associated with abnormal finding of electroencephalogram (79.1%) and neuroimaging (41.6%). Conclusion : In conclusion, the leading cause of subsequent unprovoked seizure in children with acute symptomatic seizure was encephalopathy and age specific incidence was high in the group aged 24-72 months. The risk for subsequent unprovoked seizure was greater for those with partial seizure, status epilepticus, abnormal finding of neuroimaging and electroencephalography.

• Korean Journal of Social Welfare
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• v.60 no.2
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• pp.99-129
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• 2008

This study analyzed the resilience process of persons with disabilities using the grounded theory approach. To conduct this study, the researcher conducted in-depth interviews with 8 persons with disabilities. In data analysis, this study identified 393 concepts on the resilience process of persons with disabilities and the concepts were categorized into 45 sub-categories and 18 primary categories. In the paradigm model on the resilience process of persons with disabilities, it was identified that casual conditions included 'unawareness of disability before being disability', 'extreme pain', 'repressing psychological pain', and the contingent conditions were 'dis-empowerment by staying in home', 'isolation by himself with difficulty in accepting the disability', 'experience of frustration from social barriers with prejudice against persons with disabilities'. Also, it was identified that the resilience process could be dependent on the type and the degree of the disability, the gender, and the length of time being disability. In spite of the casual and contingent conditions, the central way in which persons with disabilities could acquire resilience was identified as 'enhancement of the power of positive thinking'. The control conditions which accelerate or retard central phenomenon were 'the awareness of not being alone through family, friends, neighborhood and the social system' externally and 'finding purpose in life through religion and help from other persons with disabilities', internally. The action/interactional sequences enhanced the efforts, self searching and active acting, and as a result, persons with disabilities could find comfort in life, participate in society and change the perspective of disability in society. The core categories of resilience process in persons with disabilities were a belief in affirmation and choice of life by initiative. In the process analysis, stages developed in the following: 'pain', 'strangeness', 'reflection', 'daily life'. This stage was more continuous and causal than discrete and complete. In this process, the types of resilience of persons with disabilities are divided into 'existence reflection', 'course development', 'implicit endeavor', and 'active execution'. This study showed the details of the paradigm models, the process and types with an in-depth understanding of the resilience process of persons with disabilities using grounded theory as well as theory construction and policy and clinical involvement on the study of persons with disabilities.