• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1493-1504
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• 2021

Purpose This study aimed to evaluate the utility of the 16-cm axial volume scan technique for calculating the coronary artery calcium score (CACS) using non-enhanced chest CT. Materials and Methods This study prospectively enrolled 20 participants who underwent both, non-enhanced chest CT (16-cm-coverage axial volume scan technique) and calcium-score CT, with the same parameters, differing only in slice thickness (in non-enhanced chest CT = 0.625, 1.25, 2.5 mm; in calcium score CT = 2.5 mm). The CACS was calculated using the conventional Agatston method. The difference between the CACS obtained from the two CT scans was compared, and the degree of agreement for the clinical significance of the CACS was confirmed through sectional analysis. Each calcified lesion was classified by location and size, and a one-to-one comparison of non-contrast-enhanced chest CT and calcium score CT was performed. Results The correlation coefficients of the CACS obtained from the two CT scans for slice thickness of 2.5, 1.25, and 0.625 mm were 0.9850, 0.9688, and 0.9834, respectively. The mean differences between the CACS were -21.4% at 0.625 mm, -39.4% at 1.25 mm, and -76.2% at 2.5 mm slice thicknesses. Sectional analysis revealed that 16 (80%), 16 (80%), and 13 (65%) patients showed agreement for the degree of coronary artery disease at each slice interval, respectively. Inter-reader agreement was high for each slice interval. The 0.625 mm CT showed the highest sensitivity for detecting calcified lesions. Conclusion The values in the non-contrast-enhanced chest CT, using the 16-cm axial volume scan technique, were similar to those obtained using the CACS in the calcium score CT, at 0.625 mm slice thickness without electrocardiogram gating. This can ultimately help predict cardiovascular risk without additional radiation exposure.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.124-135
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• 1997

Background : Diffuse panbronchiolitis(DPB) is a disease characterized clinically by chronic cough, expectoration and dyspnea; and histologically by chronic inflammation localized mainly in the region of the respiratory bronchiole. It is prevalent in Japanese, but is known to be rare in Americans and Europians. Only a few cases in Chinese, Italians, North Americans and Koreans have been reported. It is diagnosed by characteristic clinical, radiological and pathologic features. High-resolution CT(HRCT) is known to be valuable in the study of the disease process and response to therapy in DPB. To our knowledge, there has been no correlation of its appearance on HRCT with the severity of the disease process, and radioaerosol scan(RAS) of the lung has not previously been used for the diagnosis of DPB. Method : During recent two years we have found 12 cases of DPB in Kangnam St. Mary's Hospital, Catholic University Medical College. We analysed the clinical characteristics, compared HRCT classifications with clinical stages of DPB, and determined characteristic RAS manifestations of DPB. Results : 1. The ages ranged from 31 to 83 years old(mean 54.5 years old), and male female ratio was 4:8. 75%(9/12) of patients had paranasal sinusitis, and only one patient was a smoker. 2. The patients were assigned to one of three clinical stages of DPB on the basis of clinical findings, sputum bacterology and arterial blood gas analysis. of 12 cases, 5 were in the first stage, 4 were in the second stage, and 3 were in the third stage. In most of the patients, pulmonary function tests showed marked obstructive and slight restrictive impairments. Sputum culture yielded P.aeruginosa in 3 cases of our 12 cases, K.pneumoniae in 2 cases, H.influenzae in 2 cases, and S.aureus in 2 cases. 3. Of 12 patients, none had stage I characteristics as classified on HRCT scans, 4 had slage II findings, 5 had stage III findings, and 3 had stage IV characteristics. 4. We peformed RAS in 7 of 12 patients With DPB. In 71.4% (5/7) of the patients, RAS showed mottled aerosol deposits characteristically in the transitional and intermediary airways with peripheral airspace defects, which contrasted sharply with central aerosol deposition of COPD. 5. There were significant correlations between HRCT stages and clinical stages(r= 0.614, P < 0.05), between HRCT types and Pa02(r= -0.614, P < 0.05), and between HRCT types and ESR(r= 0.618, P < 0.01). Conclusion : The HRCT classifications correspond well to the clinical stage. Therfore in the examination of patients with DPB, HRCT is useful in the evaluation of both the location and severity of the lesions. Also, RAS apears to be a convenient, noninvasive and useful diagnostic method of DPB.

• Korean Journal of Heritage: History & Science
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• v.42 no.1
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• pp.88-99
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• 2009

This study was conducted to formulate management guidelines for Natural monumental old trees in Korea through survey of tree vigor and analysis of growing environments. A total of 20 old trees designated as natural monuments in Seoul, Incheon, and Gyeonggi Province were surveyed. The biological characteristics were surveyed with 4 items of species, ages and height of trees. The surrounding environments were surveyed with 2 items of location types and surroundings. The root conditions were surveyed with 2 items of denudation and molding depth. The health conditions were surveyed with 5 items of withering rate, cavity size, bark breakaway rate, damages by blight and insects, and growing tips. The soil conditions were surveyed with 6 items of PH, organic contents, valid phosphoric acid, transposal cations(K, Ca) and soil compaction. On the basis of outcomes of these research items, mutual relations among locations, growings and soil conditions of old trees were analyzed by carring out cross tabulation, correlation, and simple and multiple regression. Management guidelines were presented searching the factors effecting on the health of the monumental old trees. On the biological characteristics, the old trees designated as natural monuments were Pinus bungeana(4 trees), Juniperus chinensis(3 trees), Ginkgo biloba(3 trees), Poncirus trifoliata(2 trees). Actinidia arguta, Wisteria floribunda, Thuja orientalis, Quercus mongolica, Sophora japonica, Fraxinus rhynchophylla, Zelkova serrata, and Pinus densiflora. The tree height ranged from 4.2 to 39.2m, and root collar rounds ranged from 1.01 to 15.2m. On the surrounding environments, The location types ; Gardens(4), historical sites(5), residental sections(3) open agricultural fields(3), mountain hills(3), and near ocean beaches(1) and stream site(1). The surroundings ; 75% denudation of roots, molded more than 10cm except 4 trees(25%). On the health conditions, 1)Withering rate ; Ginkgo biloba(20%) in Yongmoon temple, (5%) in Saki-ri, kanwha-gun, and others had no withering rate. 2) Cavity size ; all subject had $5{\sim}100cm^3$ of cavity. 3) Bark breakaway rate ; Pinus bungeana in Soosong-dong, in the shrine of Confucius, in Samchung-dong, especially high rate of cavity(5~50%) in Seoul area and in Saki-ri, Kangwha-gun were high 45% brakeaway rate. 4) Damages by blight and insects was slight due to managements. 5Growing tips ; In cases of Juniperus chinensis in Changdeok palace and SunnogDang, seoul, growing tips were 1/2, presumably cause by air pollution, and in cases of Fraxinus rhynchophylla in Paju city and Pinus densiflora in BacksaDorip-ri, Icheon city, growing tips were fine, presumably because there were no moldings. On the Soil conditions, Soil pH ranged from 5.2 to 8.3, organic matter contents from 12% to 56%, phosphorus contents from 104 to 618ppm, soil compaction ranged from 7 to 28mm( among them, Denudation was severe with 21~28mm soil compactions in cases of Pinus bungeana in Soosong -dong, Thuja orientalis in Samchung -dong, Ginkgo biloba in the shrine of Confucius and in Yongmoon temple.) Results of cross tabulation, correlation, and regression analysis showed that molding depth was the most serious factor to deteriorate the tree vigor and cambium conductivity. In addition, soil acidity, organic matter contents, disease and insect damages and cambial detachment were also related to the tree vigor. Additional research of these relationships will be needed to conduct more detailed studies. Based on the relationships between the tree vigor and growing environments, it is considered that old trees should be managed to give them more growing spaces and less abuses. Also, molded soils should be removed and further soil-molding around the tree collar should be prohibited. For the construction of systematic management and removal of harmful factors, appropriative management according to spices, persistent monitering of damaged cases and construction of management system through the accumulation of data on the relationships of soil conditions are required.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.448-455
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• 1999

Background: Recent developments in techniques of video-assisted thoracic surgery(VATS) and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery. Especially, it will probably become the treatment of choice of spontaneous pneumothorax(SP). There is, however, a high recurrence rate, high cost, and paucity of long-term results. We report the results of postoperative follow-up and analyze perioperative parameters affected to recurrence, retrospectively. Material and Method: From march 1992 to march 1997, 276 patients with spontaneous pneumothorax underwent 292 VATS procedures. Conversion to open thoracotomy was necessitated in eight patients, and this patients excluded from the study. Result: The sex distribution was 249 males and 31 females. The mean age was 28.1 12.2 years(range, 15 to 69 years). Primary SP was 237cases(83.5%) and secondary SP was 47cases(16.5%). The major underlying lung diseases associated with secondary SP were tuberculosis 27cases(57.4%) and emphysema 8cases (38.3%). Operative indications included Ipsilateral recurrence 123(43.9%), persistent air-leak 53(18.9%), x-ray visible bleb 40(14.3%), tension 30(10.7%), contralateral recurrence 21(7.5%), uncomplicated first episode 8(2.9%), bilateral 3(1.1%), complicated episode 2(0.7%). Blebs were visualized in 247cases(87%) and 244cases(85.9%) performed stapled blebectomy. Early postoperative complications occurred in 33 cases(11.6%): 16 prolonged air-leak more than 5 days(four of them were required a second operation and found missed blebs); 5 bleeding; 5 empyema; 2 atelectasis; 1 wound infection. No deaths occured. The mean operative time was 52.8 23.1 minutes(range, 20 to 165 minutes). The mean d ration of chest tube drainage was 5.0 4.5 days(range, 2 to 37 days). The mean duration ofhospital stay was 8.2 5.5 days (range, 3 to 43days). At a mean follow-up 22.3 18.4 months(range, 1 to 65 months), 12 patients(4.2%) were lost to follow-up. There were 24 recurrences and seven patients underwent second operation and 6 patients(85.7%) were found the missed blebs. 12 perioperative parameters(age, sex, site, underlying disease, extent of collapse, operative indication, size of bleb, number of bleb, location of bleb, bleb management, pleural procedure, prolonged postoperative air-leak) were analyzed statistically to identify significant predictors of recurrence. The significant predictors of recurrence was the underlying disease[17.0%(8/47): 6.8%(16/237), p=0.038], prolonged postoperative air-leakage[37.5%(6/16): 6.7%(18/268), p=0.001], and pleural procedure [11.4%(19/167): 4.3%(5/117), p=0.034]. Blebectomy has less recurrence rate then non-blebectomy [8.2%(20/244) : 10.0%(4/40), p>0. 5]. However, this difference was not statistically significant(p=0.758). Conclusion: We conclude that it is important that we shoud careful finding of bleb during VATS due to reducing of recurrnece, and cases of no bleb identified and secondary spontaneous pneumothorax were indicated of pleurodectomy. VATS is a valid alternative to open procedure for the treatment of spontaneous pneumothorax with less pain, shorter hospital stay, more rapid return to work, high patient acceptance, less scar and exellent cosmetics. But, there is high recurrence rate and high cost, and than it is necessary to evaluate of long-term results for recurrence and to observate carefully during VATS.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.62-71
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• 2005

Background: This study examined the oral health condition of diabetic patients and evaluated the oral health behavior through a questionnaires survey. In addition, this study provide primary informations for developing a dental health program for diabetic patients. Materials and Methods: There were fifty patients with diabetes mellitus or glucose tolerance (controlled by a community health center at Dalsung-Gun in Daegu City and fifty nondiabetic age, gender and location matched control subjects. Data were collected by a direct oral examination and by questionnaires from 100 subjects in July, 2004. Results: The DMFT (Decay, Missing, Filling Teeth) mean values in diabetics were significantly higher than that in non-diabetics (p<0.05). The decay teeth index and Filling teeth index was similar in the two groups, but the mean Missing teeth index was significantly higher in the diabetics than in non-diabetics. The PI (Periodontal Index) mean values were significantly higher in the diabetics than in the non-diabetics (p<0.01). There was a significant difference between the diabetics and non diabetics aged in their 50s and 60s, but there was no difference with those aged in their 70s. The oral hygiene status was similar in the two groups. The average number of remaining teeth was significantly lower in the diabetics ($16.1{\pm}10.35$) than in the non-diabetics ($20.04{\pm}8.70$) (p<0.05). Conclusion: In the diabetic patients, the M component of the DMFT index was found to be higher than the controls. Diabetics lose their teeth mainly due to periodontal disease, which is supported by the increased PI mean values.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.139-148
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• 1987

The community health practitioners (CHP) play an important role in primary health care services to the underserved population in rural area. Time and motion study of 26 CHPs in Kyungpook Province was conducted through work diary method for 6 consecutive days from the time they arrived until they left the primary health post(PHP) during the past 3 weeks from November 16 to December 5, 1987. The allocation of activity time by working category, service category, location of activity and CHP's function was analyzed according to the characteristics of CHPs i. e., age, marital status and experience as CHP. The major findings are as follows : The mean activity time per CHP in a week was 2,918 minutes. The length of their working hours was longer for older, married and more experienced CHPs than others. About 80% of the CHP's activities took place within the PHP and only about 20% occured outside of the PHP. Working hours for the outdoor activities were longer for younger, single and less experienced CHPs than others. The allocation of activity time by working category showed 46.3% in the technical work and 18.7% in the administrative work. Working hours for the technical activities were longer for younger, single and less experienced CHPs than others. The percentage of activity time revealed greatest as much as 63.1% for direct patient care in technical work and 61.6% for record keeping in administrative work. Of the total working hours in a week, direct patient care and public health activities accounted for 29.2% and 16.2%, respectively. Of the indoor activities, working hours for direct patient care were longer than those for public health activities. However, of the outdoor activities, working hours for public health activities were longer than those for direct patient care. The allocation of activity time by CHP's function showed 49.7% in management of common disease, 31.8% in management of PHP and technical supervision of village health workers, 9.5% in MCH and family planning, 6.6% in community health management and 2.4% in community approach. Based on these findings, it was found that CHPs were mainly working in the PHP with a majority of their time being spent for direct patient care rather than preventive and promotive health cares. To enhance the preventive and promotive health services of the CHPs and to involve the activities for community development, refresher course for CHPs should be reinforced and supervision mechanism of the CHPs should be established and operated in Gun- and province-level.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.1
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• pp.207-244
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• 2015

Aviation safety is the stage in which the risk of harm to persons or of property damage is reduced to, and maintained at or below, an acceptable level through a continuing process of hazard identification and risk management. Many accidents and incidents have been taking place since 2014, while there had been relatively safer skies before 2014. International civil aviation community has been exerting great efforts to deal with these emerging issues, thus enhancing and ensuring safety throughout the world over the years. The Preamble of the Chicago Convention emphasizes safety and order of international air transport, and so many Articles in the Convention are related to the safety. Furthermore, most of the Annexes to the Convention are International Standards and Recommended Practices pertaining to the safety. In particular, Annex 19, which was promulgated in Nov. 2013, dealing with safety management system. ICAO, as law-making body, has Air Navigation Commission, Council, Assembly to deliberate and make decisions regarding safety issues. It is also implementing USOAP and USAP to supervise safety functions of member States. After MH 370 disappeared in 2014, ICAO is developing Global Tracking System whereby there should be no loophole in tracking the location of aircraft anywhere in world with the information provided by many stakeholders concerned. MH 17 accident drove ICAO to install web-based repository where information relating to the operation in conflict zones is provided and shared. In addition, ICAO has been initiating various solutions to emerging issues such as ebola outbreak and operation under extreme meteorological conditions. Considering the necessity of protection and sharing of safety data and information to enhance safety level, ICAO is now suggesting enhanced provisions to do so, and getting feedback from member States. It has been observed that ICAO has been approaching issues towards problem-solving from four different dimensions. First regarding time, it analyses past experiences and best practices, and make solutions in short, mid and long terms. Second, from space perspective, ICAO covers States, region and the world as a whole. Third, regarding stakeholders it consults with and hear from as many entities as it could, including airlines, airports, community, consumers, manufacturers, air traffic control centers, air navigation service providers, industry and insurers. Last not but least, in terms of regulatory changes, it identifies best practices, guidance materials and provisions which could become standards and recommended practices.

• Journal of Preventive Medicine and Public Health
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• v.2 no.1
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• pp.5-22
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• 1969

The urban population of our country is rapidly increasing due to many factors of social structure, and sociologists are predicting that the increase rate of the urban population will be over 50% in 1980's. Above all, the population of the capital city of Seoul, is at present more than four millions. Such centring of people in cities, together with the improvement of the standards of living, caused rapid increase in the amount of fuel consumption, and this consumption of fuels became one of the primary sources of the air pollution in cities. Moreover, the heavy traffic, construction of many tall buildings, and the increasing number of new factories due to the industrial development-all these are contributing to make the matter of air pollution worse and worse in the Metropolitan, whose geographical location is quite unfavorable considered from the view point of air pollution. Most homes in Seoul use briquet as fuel, while oils are used in tall buildings. The CO, $SO_2$, and smoke that come from burning of these fuels are a great threat to the health of the urban population. With the purpose of examining the influence of air pollution upon the public health, written inquiries were made upon respiratory diseases, and the carboxyhemoglobin saturation in the blood was measured to determine whether the air pollution may affect the health of the urban population. Method of Health Examination (1) Investigation of Respiratory Diseases Patients' records were examined to figure out the monthly ambulance rate of respiratory patients to the total number of patients treated. On the other hand, by using the questionnaire form approved by the Medical Research Council's Committee on Research into Chronic Bronchitis, investigators interviewed the examinees and inquired into the respiratory symptoms. (2) Measuring of Carboxyhemoglobin Saturation From the ear lobe of the examinees, with the use of the melangeur for the white blood cell counting, blood was taken, and after diluting it ten times with 0.1% $Na{2}CO_{3}$, again diulting it 20 times with 0.5% $Na_{2}\;CO_{3}$, its absorbancy was measured. The following results are obtained from the investigation. (1) It was found out that 7.7% of the total patients under treatment were suffering from upper respiratory infection, acute or chronic bronchitis, bronchial asthma, pulmonary emphysema and bronchiectasis. Of them all, patients with upper respiratory infection numbered the greatest with 4.8% and patients with acute or chronic bronchitis the next with 2.1%, and their monthly ambulance rate was high from December to February during the winter, and from April to May and from September to October during the changeable seasons. (2) The daily ambulance rate of respiratory patients, it was revealed, had a close connection with the concentration of $SO_2$ and CO in the air. (3) It was found out that men were more subject to respiratory disease than women, and both men and women were more liable to the diseases with the advancing of age. (4) People living at Choong-ku with the heavy traffic and in the industrial zones of Yeungdungpo had high frequency of respiratory symptoms. (5) Considered from the view point of occupations, high frequency was found among those without job, with jobs unknown, merchants and intdustrial workers, whose social status was rather low and traffic policemen who were always exposed to the exhaust gas of cars. As for women, the frequency was detected in the order of those from high to low, housewives who were exposed to briquet gas, women with jobs unknown, women without jobs, whose social status was low. (6) Ex-smokers rather than smokers, of both sexes, had higher frequency. As for men, heavy smokers had high frequency, while in women light smokers had rather high frequency which was presumed to be due to their average old age. (7) Men's average of carboxyhemoglobin saturation was 9.48%, while women's was 11.3%, higher than men's. (p<0.05). Age meant no difference in the case of men, but as for women, the saturation was remarkably high between the ages from 20 to 60. (8) No regional difference was detected in the carboxyhemoglobin saturation. (9) The carboxyhemoglobin saturation was found, in the case of men, in the order of office workers, traffic policemen, students, the unemployed, merchants and industrial workers, drivers; and as for women, the order was housewives, office workers, merchants and industrial workers. (10) No significant correlation was found between the carboxyhemoglobin saturation and the concentration of CO detected in kitchens, or between the carhoxyhemoglobin saturation and the passing of time after exposure to briquet gas. No difference of carboxyhemoglobin saturation was detected between smokers and non-smokers, and the degrees of smoking; only, significant negative correlation was found between the passing of time after smoking and the carboxyhemoglobin saturation. It is ture that air pollution causes or aggravates the respiratory diseases, increases the carboxyhemoglobin saturation in the blood, but what seems to be more hazardous to the health is the air polluted by the briquet gas in the kitchens and on-dol rooms rather than the atmospheric air pollution.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.766-775
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• 1997

Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.10-16
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• 2000

Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.