• Journal of Chest Surgery
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• v.36 no.6
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• pp.397-403
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• 2003

Background: The research sought to identify the clinical features of pleomorphic carcinoma of the lung generally known as a rare subtype in accordance with the lung cancer classification done in 1999 by WHO. Material and Method: 250 cases of surgically resected lung cancers were collected in this hospital from January 1992 to December 2001. This study included 42 cases of pleomorphic carcinoma diagnosed through light microscope and immunohistochemistry. Result: Out of 42 cases, males represented 31, and females 11, the age ranged from 26 to 77. Main clinical symptoms included coughing, hemoptysis, sputum. Diagnoses disclosed the stage as stage la in 3 cases (7%), Ib in 16 (38%), IIa in 1 (2%), IIb in 8 (19%), IIIa in 15 (35%), and IIIb in 1 (2%). Out of these, no lymph node metastasis was represented in 23 cases (54%), while N1 and N2 involving lymph node metastasis was shown 19 cases (46%). A total of 19 patients developed metastasis, comprising the brain in 5 cases (26%), bone in 4 (21%), muscle in 4 (21%), Lymph node in 2 (10%), and 1 liver, ovary, contralateral lung, and adrenal gland, respectively. The size of the tumor ranged from 1 cm to 11 cm, averaging 5.85 cm. Out of the 42 patients, the total two-year and five-year survival rates in accordance with the Kaplan-Meier method represented 26% and 13%, respectively, These figures compared to the corresponding 44% and 34% in cases other than pleomorphic carcinoma from the survey target of 256 cases, proved to be significantly low (p<0.002). No significant difference was found in the survival rates compared between age and tumor size, between stage I and above stage II, and between N0 and above N1. Patients who developed postoperative metastasis all died, and showed significantly low survival rates (p<0.002) compared to those patients without metastasis. Conclusion: With the new diagnosis method of f999 WHO's lung cancer classification applied, pleomorphic carcinoma showed a higher prevalence rate than under previous classifications, their postoperative survival rate was significantly low compared to histologic type of non small cell lung carcinomas.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.1
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• pp.58-71
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• 2015

Objectives: The aims of this study were to investigate the classification system of chemical substances in the Occupational Safety and Health Act(OSHA) and Chemical Substances Control Act(CSCA) and to compare several health indices (i.e., Time Weighted Average (TWA), Lethal Dose ($LD_{50}$), and Lethal Concentration ($LC_{50}$) of chemical substances by categories in each law. Methods: The chemicals regulated by each law were classified by the specific categories provided in the respective law; seven categories for OSHA (chemicals with OELs, chemicals prohibited from manufacturing, etc., chemicals requiring approval, chemicals kept below permissible limits, chemicals requiring workplace monitoring, chemicals requiring special management, and chemicals requiring special heath diagnosis) and five categories from the CSCA(poisonous substances, permitted substances, restricted substances, prohibited substances, and substances requiring preparation for accidents). Information on physicochemical properties, health indices including CMR characteristics, $LD_{50}$ and $LD_{50}$ were searched from the homepages of the Korean Occupational and Safety Agency and the National Institute of Environmental Research, etc. Statistical analysis was conducted for comparison between TWA and health index for each category. Results: The number of chemicals based on CAS numbers was different from the numbers of series of chemicals listed in each law because of repeat listings due to different names (e.g., glycol monoethylether vs. 2-ethoxy ethanol) and grouping of different chemicals under the same serial number(i.e., five different benzidine-related chemicals were categorized under one serial number(06-4-13) as prohibited substances under the CSCA). A total of 722 chemicals and 995 chemicals were listed at the OSHA and its sub-regulations and CSCA and its sub-regulations, respectively. Among these, 36.8% based on OSHA chemicals and 26.7% based on CSCA chemicals were regulated simultaneously through both laws. The correlation coefficients between TWA and $LC_{50}$ and between TWA and $LD_{50}$, were 0.641 and 0.506, respectively. The geometric mean values of TWA calculated by each category in both laws have no tendency according to category. The patterns of cumulative graph for TWA, $LD_{50}$, $LC_{50}$ were similar to the chemicals regulated by OHSA and CCSA, but their median values were lower for CCSA regulated chemicals than OSHA regulated chemicals. The GM of carcinogenic chemicals under the OSHA was significantly lower than non-CMR chemicals($2.21mg/m^3$ vs $5.69mg/m^3$, p=0.006), while there was no significant difference in CSCA chemicals($0.85mg/m^3$ vs $1.04mg/m^3$, p=0.448). $LC_{50}$ showed no significant difference between carcinogens, mutagens, reproductive toxic chemicals and non-CMR chemicals in both laws' regulated chemicals, while there was a difference between carcinogens and non-CMR chemicals in $LD_{50}$ of the CSCA. Conclusions: This study found that there was no specific tendency or significant difference in health indicessuch TWA, $LD_{50}$ and $LC_{50}$ in subcategories of chemicals as classified by the Ministry of Labor and Employment and the Ministry of Environment. Considering the background and the purpose of each law, collaboration for harmonization in chemical categorizing and regulation is necessary.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

• The Journal of Korean Physical Therapy
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• v.17 no.4
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• pp.505-517
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• 2005

The Purposes of this study were to find complementary connectible new factors that analyzed correlation relate of Sasang Constitution and GCM Body Type in Static Posture and Dynamic Hyper/Hypo-mobility Pattern. Method of this study was asymtomatic volunteers 232(unmarried man and women), conducted from September 1 to December 31. In this main study progressing step diagnosised first, Constitution of Sasang medicine after being classified into four groups of Soyangin, Taeumin, Soeumin, Taeyangin diagnosis of GCM Body Type and progressed that related Static Posture and Dynamic Hyper/Hypo mobility Pattern. The results are as follows. Distribution of Sasang Medicine Constitution proved to be Taeyangin 13, Soyangin 66, Taeumin 67, Soeumin 86 respectively. Distribution of GCM Body Type proved I Body Type 72(31.0%), II Body Type 54(23.3%), III Body Type 89(38.4%), IV Body Type 17(7.3%). The distribution of Sasang Constitution according to GCM Body Type was that; I Body Type was distributed in the order Soeumin 34.7%(25), Taeumin 31.9%(23), Soyangin 30.6%(22), Soeumin 34.7%(25) is the most people. II Body Type was distribution of in the order Soeumin 42.6%(23), Soyangin 5.9%(14), Taeumin 24.1%(13), Soeumin 42.6%(23) is the most people. III Body Type was distribution of in the order Soeumin 37.1%(33), Taeumin 30.3%(27), Soyangin 28.1%(25), Soeumin 37.1% is the most people. IV Body Type proved high distribution each of Soeumin 29.4%(5) and Soyangin 29.4%(5). In case of main left side posture character of spine and limbs about I Body Type 72 persons with left scapular and ilium forward tilted pattern proved in the order high distribution iliac crest thigh and scapular high 70(97.2%), gluteal fold high and scapular abduction 69(95.8%), lumbar scoliosis 65(90.3%). Also, in case of right side posture character proved in the order high distribution deep gluteal fold 69(95.8%), umbilical deviation 68(94.4%). Incase of main left side posture character of spine and limbs about n Body Type 54 persons proved in the: order high distribution knee hyperextension 50(92.6%), shoulder deviation 49(90.7%) etc. Also, in case of right side posture character proved in the order high distribution pelvic deviation 53(98.1%), iliac crest thigh 52(96.3%), hip flexion and ankle inversion 51(94.4%) etc. In case of main left side posture character of spine and limbs about III Body Type 89 persons proved in the order high distribution shoulder deviation 87(97.8%), scapular abduction 86(96.6%), scapular high 85(95.5%) etc. And in case of right side posture character proved in the order high distribution pelvic deviation and iliac crest thigh 86(96.6%) etc. In case of main left side posture character of spine and limbs about IV Body Type 17 persons proved in the order high distribution pelvic deviation, lumbar sciliosis and lumbar lordosis increase 15(88.2%) etc. Also, in case of right side posture character proved in the order high distribution wrist dorsiflexion 16(94.1%), thickened achilles tendon etc.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.143-151
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• 2009

Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.103-111
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• 1985

Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epileptic children have associated problems such as physical and mental handicaps, psychologicaldisorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized ionic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), a typical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%), DPT vaccination (1.0%), cerebrovascular accident (1.0%) and neonatal jaundice (1.0%) were found, 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.

• Journal of Sasang Constitutional Medicine
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• v.10 no.2
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• pp.1-14
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• 1998

1. Purpose : The correct constitutional diagnosis and the accurate prescription are very important in clinical application of Sasang Constitutional Medicine. Lee Je-ma emphasized that symptom is the best clue to diagnose constitution in "DongYi Suse Bowon". After research the characteristics of each constitution's symptoms and the backgrounds of constitutional prescriptions, this paper is to know the correct clinical application of Sasang Constitutional Medicine. 2. Method : Through the clinical applications of "DongYi Soose Bowon" and "Dongyi Sasang Sinpeun", the characteristics of constitutional symptoms and the application of prescription were researched 3. Results & Conclusions 1) The symptoms of Sasang Constitutional Medicine were came from the Hyung-Sang Medicine(形象醫學) which were important to mind-body equally and from the summarizing spirit of four Qi such as Warm-Hot-Cool-Cold(溫熱凉寒) 2) The symptoms of Soeumin and Soyangin are the Cold-Hot symptoms of ingestive food(水穀) and the treatment of symptoms is to control the ascent-descent of up and down. The symptoms of Taeumin and Taeyangin are the Warm-Cool symptoms of Qi-Yack(氣液) and the treatment of symptom is to control the unfasten-fasten of interior and exterior. 3) The symptoms of Taeyangin are 'Weak Lower part and Firm Upper part symptom'(下虛上實病證) and 'Blood and Yack Exhasted Symptom'(血液俱耗病證), the symptoms of Soeumin are 'Fall Down Symptom'(下陷病證) and Stomach Cold Symptom(胃寒病證), the symptoms of taeumin is 'Dryness Fever Symptom'(燥熱病證) and 'Interior Fever Symptom'(燥熱病證), the symptoms of Soyangin is 'Fire Fever Symptom'(火熱病證) and 'Interior Fever Symptom'(燥熱病證). 4) The characteristics of sasang constitutional symptoms are the exterior-interior symptoms classified with nature-emotion and cool-hot, the inclusive control of exterior-interior symptoms with healthy energy, and the classification of ingestive food symptoms and Qi-Yack symptoms. 5) The characteristics to treat symptoms are the classification of seriousness and obedience, the use herbs according to each constitutions, and inclusive symptoms control.

• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.570-575
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• 2005

Introduction : Diffuse interstitial lung diseases (DILD) comprise of a large group of lung diseases with diverse etiologies. They are classified into four categories based on the etiology and pathological findings. In Korea, epidemiological data on DILD has never been reported in a prospective manner. Method : From May 2002 to April 2004, total 487 patients with DILD were prospectively registered at Samsung Medical Center. The prospective observational analysis of the etiologies, its classification based on 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) guidelines, as well as diagnostic tests and the retrospective analysis of the treatment modalities were carried out. Any infectious and malignant causes were excluded. Results : 1) The patients were classified into idiopathic interstitial pneumonia (IIP) in 269 patients (55.2%), known causes of DILD in 168 patients (34.5%), sarcoidosis in 27 patients (5.5%), other forms of DILD in 14 patients (2.9%), and undetermined DILD in 9 patients (1.9%). 2) The diagnostic test showed that most patients had undergone chest high resolution computed tomography (HRCT) and pulmonary function test (PFT) (97%, 89%). Transbronchial lung biopsy (TBLB) and surgical lung biopsy (SLB) were performed in limited patients (38%, 29%). 3) Among 269 patients with IIP, 220 (82%) had idiopathic pulmonary fibrosis (IPF) while 23 (9%) had nonspecific interstitial pneumonia. SLB was carried out in 36% of patients with IIP. 4) Symptomatic supportive care was given to 67% of IPF, but specific medical treatment including corticosteroids was administered to 89% of non-IPF patients. Conclusion : A nationwide registry of DILD patients is required to determine the annual incidence, etiology, and practice pattern of diagnosis and treatment in Korea.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.388-397
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• 1999

Purpose: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Perrectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. Materials and Methods: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Perrectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 40 patients with cirrhosis ($59.8{\pm}27.2%$) was significantly higher than that of normal control ($5.0{\pm}1.2%$. p<0.01) and chronic hepatitis ($11.4{\pm}3.5%$, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from $59.9{\pm}27.3%$ to $51.3{\pm}15.3%$ (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. Conclusion : The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.2
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• pp.221-228
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• 2021

The aim of this study was to evaluate the use of easily accessible machine learning application to identify mesiodens, and to compare the ability to identify mesiodens between trained model and human. A total of 1604 panoramic images (805 images with mesiodens, 799 images without mesiodens) of patients aged 5 - 7 years were used for this study. The model used for machine learning was Google's teachable machine. Data set 1 was used to train model and to verify the model. Data set 2 was used to compare the ability between the learning model and human group. As a result of data set 1, the average accuracy of the model was 0.82. After testing data set 2, the accuracy of the model was 0.78. From the resident group and the student group, the accuracy was 0.82, 0.69. This study developed a model for identifying mesiodens using panoramic radiographs of children in primary and early mixed dentition. The classification accuracy of the model was lower than that of the resident group. However, the classification accuracy (0.78) was higher than that of dental students (0.69), so it could be used to assist the diagnosis of mesiodens for non-expert students or general dentists.