• Pediatric Infection and Vaccine
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• v.20 no.1
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• pp.17-27
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• 2013

Purpose: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-${\gamma}$ release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON$^{(R)}$-TB Gold In-Tube (QFT-GIT) and compared their results. Methods: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. Results: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the nonintrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFTGIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. Conclusion: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.233-241
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• 1997

Purpose : This study was done to evaluate the survival rate and Prognostic factors of patients with inoperable non-small cell lung cancer(NSCLC) treated with radiation therapy. Materials and Methods A retrospective analysis was undertaken of 62 Patients who had inoperable NSCLC treated with radiation therapy from January 1991 through December 1993. According to AJCC slaging, stage IIIA was 14 patients and stage IIIB was 48 patients. Forty Gy to 70.2Gy to the primary tumor site was delivered with daily fractions of 1.8Gy or 2Gy, 5days per week. Thirty-seven patients received neoadjuvant chemotherapy. Results : Complete, partial and no response to radiation therapy were 3 patients, 34 Patients and 25 patients, respectively The median survival period of all patients was 11 month. One rear survival rate, 2 year survival rateand 5 rear survival rate for all patients were 45.0%, 14.3%, and 6.0% respectively The median survival period was 6.5 months in stage IIIA and 13 months in stage IIIB. One year survival rates were 28.6% in stage IIIA and 50.3% in stage IIIB In univariaite analysis, prognostic factors affecting survival were T-s1aging, AJCC staging, and response after radiation therapy (P<0.05) . Pretreatment peformance status affected survival but was not statistically significant (0.050.1). In multivariate analysis, Pathology and response to radiation therapy are independently significant prognostic factor. T stage was marginally significant (P=0.0809). During follow-up duration, distant metastasis developed in 20 patients-bone metastasis in 10 patients, brain metastasis in 3 patients, liver mentastasis in 3 patients, contralateral lung metastasis in 1 patients and multiple metastases in 3 patients. Conclusion :　Conventional radiotherapy alone or combined chemoradiotherapy are unlikely to achieve long term survival in patients with NSCLC.　Surgery after concurrent chemoradiotherapy is Ivied to improve the local　control in our hospital

• Radiation Oncology Journal
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• v.15 no.3
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• pp.225-231
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• 1997

Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.133-140
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• 2010

Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

• Korean Security Journal
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• no.14
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• pp.413-429
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• 2007

The Guard over the royal household in the "Goryeo" era was the same as if was over the President or Ruler of a nation today. In those days, a king represented a nation and any threat to the safety of a king could bring the destruction of a nation and the dispersion of the people. by reviewing the change of the 2-Gun 6-Wi system of the era, it can be, summed up as follow, Ther will be suggestions. The Guard might focus on a king's personal safety in the wake of the system of the Silla and Taebong dynasties until the establishment of the Goryeo Dynasty's unique political system. "Goryeo" rebuilt the royal palace in Gyeonyeong-gun to take the shape of unified country after its accomplishment of unification of the late three countries, Then it was afraid of the rebellion and uprising of local powerful clans, The country put them under control and organized the local army with them in the era of Kings, Seongjong, through the kings, Seongjong and Gwangjong. The army system of "Goryeo" consisted of 2-Gun and 6-Wi, and 2-Gun placed above the 6-Wi played the role of the Royal guards, and among the organizations a certain army under the specific name of "Gyeonyong-gun" guarded the kings in the nearest position. An aristocratic culture enjoyed its golden age in the period of stability of the aristocracy of "Goryeo", but afterward in the confusion of the aristocratic disruption and incompatible confrontation the country lost its control, and faced military rebellions by treating civil officials well and ill-treating military officials The safety of kings become unstable with the grasping political power by the military officials, and "Dobang" was established in the era of Choi's family to grasp political power. In the era of Choi Woo, he gathered his men and organized his familys army with them and managed the personnel administration with the civil officials of "Jeongbang and Seobang under his command. Such a fact shows the similarity to today's task of guarding. Considering the facts that "Sambyeolcho, the military ground of the military-men-rule, was at the center of the struggling against Mongolia and that even after the fall of the military regime, they rebelled and fought against Mongolia to the end, we came to know that the nationalism in the era of the military era was great. In the transition of external situations from "Myeong" to "Won"(Chinese dynasties), the conflict between the old "Won"-friendly power and the new "Myeong"-friendly power caused the weakness of the power to guard the royal household, and "Goryeo" at last gave way to the newly rising "Joseon" led by Lee, Seong Gye who won the people's confidence.

• Journal of the Korean Society of School Health
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• v.4 no.2
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• pp.193-215
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• 1991

This study is aimed at providing basic information applicable to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and influencing factors. The samples consisted of 814 students, 557 parents and 362 teachers selected randomly from 8 high schools, one from each school district in Seoul. Date Analyses were made through Chi-Square test, Factor Analysis, One Way ANOVA, Multiple Regression, Correlation. SPSS/$PC^+$program was utilized. Smoking behavior (continuous smoking, re-smoking, ex-smoking, never smoking, daily smoking, occasional smoking) were used as dependent variables. Influencing factors (male students, habits, attitudes and knowledge toward smoking, home life, school life, juvenile delinquency, friendship, demographic parent's and teacher's recognition toward male students smoking) were used as in dependent variables. The major findings of the study are as follows : 1. The total smoking rate occupies 41.1% whereas the continuous smoking rate stands at 19.2%, re-smoking rate 9.5%, ex-smoking rate 12.4% and never smoking rate 58.9%. 2. The total smoking rate among high school students is significantly correlated with their monthly expenditures and type of school (p<0.001). The continuous smoking rate also shows the same tendency. As the length of butt get shorter, the current smoking rate increase. The duration of smoking is in proportion to its continuity. The major motive of smoking is curiousity whereas that re-smoking is to follow friend's behavior. The study shows that peer pressure is the most powerful factor influencing smoking behavior of students. Friends and fellow students encourage to pick up smoking and resume smoking even alter one stops smoking. 3. The correlationship between favorable attitudes toward smoking and the current smoking rate and its continuity is statistically significant(p<0.05, p<0.01, p<0.001). 4. The stability and harmony of family life and the current smoking rate show negative correlationship. The daily smoking amount of father is in proportion to the continuity of students' smoking. When parents are in favor of smoking, it is more likely that the experimental smoking rate increase the smoking rate increases, and vice versa. The more acceptable attitudes toward smoking among siblings is also one of the factors to increase the smoking rate and continuity (p<0.001). The more lenient the attitudes of parents toward their children's association with smoking friends, the higher the smoking rate. When students have difficulties in adjusting to school life, it is more likely that the current smoking rate and continuity increase. 5. The continuity of smoking and friendship are significantly correlated (p<0.05, p<0.01, p<0.001). 6. The continuity of smoking and juvenile delinquency are significantly correlated (p<0.001). 7. The difference in attitudes and smoking reasons of parents and students is significantly correlated to different smoking behavior (p<0.01, p<0.001). While smoking knowledge does not significantly influence their smoking behavior, it is noted that in the case of teachers, smoking reason (p<0.05), attitudes (p<0.001) and knowledge (p<0.05) strongly influence their smoking behavior. 8. There is a significantly correlation among the smoking reasons, attitudes and knowledge between students and parents(p<0.001). As for the correlationship between regularity and smoking amount and other influencing factors, the daily smoking amount is in proportion to depth of inhalation and duration of smoking, negative attitudes of parents unstability of family, dissatisfaction of family members, juvenile delinquency, strong smoking reasons and positive attitudes towards smoking. 9. In the case of daily smokers depth of inhalation is significantly correlated to the duration of smoking, juvenile delinquency, acceptability of parents, dissatisfaction of family members and smoking reasons. The duration of smoking motives is significantly correlated to juvenile delinquency, high acceptability of parents, strong smoking motive and positive attitudes toward smoking. 10. It is noted that 40% of parents and 30% of teachers do not recognize the significant correlationship between and the relative influencing factors mentioned above.

• Journal of Sericultural and Entomological Science
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• v.23 no.2
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• pp.11-36
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• 1982

Forty-nine plant species as additives to silkworm artificial diet and 5 species as cellulose sources for artificial diet were screened for their economic values as feed-resources for the silkworm. Feeding response to artificial diet was tested on 82 silkworm strains. The effect of rearing conditions on feeding response and enzyme activities in the silkworm was investigated. The results were summarized as follows. 1. Seven species out of 49, Vigna sinensis ENDL, Ipomoea vatatas Lamarck, Cyperus anuricus Var. Laxus, Alnus japonica Stendel, Trifolium repens L, Prunus serrulata Lindley. Var, Glycine max L increased feeding response, compared with the basic formula of artificial diet. 2. The economic values of Vigna sinensis ENDL, Ipomoea vatatas Lamarck, Cyperus anuricus Var. Laxus, Ainus japonica Stendel, Cassia tera L, Erigeron canedensis L as feed-resources for artificiale diet were recognized, through feeding experiment during the entire larval stage. 3. Mulberry cellulose showed the best results in rearing and cocoon characteristics. 4. The extent of feeding response varied according to strains and varieties. Varieties in japanese strains showed higher feeding response than those in chinese and european varieties, with considerable variations among a varieties in strains. 5. The begining of 4th instar seems to be a proper time to convert from mulberry to artificial diet, or artificial diet to mulberry, however the middle of 3rd instar seems acceptable. 6. The optimum temperature for artificial diet rearing is 30$^{\circ}C$ during the period of 1st-3rd instar and 28$^{\circ}C$ for 4th-5th instar. 7. Electrophoretic isozyme patterns of esterase and acid phosphatase on agarose gel, as affected by strain. rearing temperature and feed-resources, were observed as follow. (1) Isozyme patterns of mid-gut esterase varied, depending on instar. One or two more isozyme bands were observed in the larvae than feed on the mulberry fed for the artificial diet. (2) A strain, chinese-15 with a higher feeding response, had 1∼2 more bands than chinese-60 with a lower feeding response. (3) Five bands of mid-gut esterase in 3rd and 4th instar larvae reared at 28$^{\circ}C$. and 4 for 3rd instar and 6∼7 for 4th instar larvae at 35$^{\circ}C$ were observed. (4) No similar esterase bands could be found among mid-gut, blood and silkgland. There are five esterase bands in the midgut, one in blood and three in silkgland. (5) There was rather small digerence in acid phosphatase types of mid-gut and blood according to varieties and rearing temperature. No active band was shown in silkgland. In midgut, there was one acid phosphatase band at 3rd instar, two at 4th instar and three at 5th instar. In blood, one active band at 3rd or 4th instar and three bands at 5th inster wire detected.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.366-370
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• 2005

Background: In general, cardiac surgery has been performed via median sternotomy. During the past decade, improvements in endoscopic equipment and operative techniques have resulted in development of minimally invasive cardiac operation using small incisions. With the advent of a voice controlled camera-holding robotic arm (AESOP 3000, Automated Endoscope System for Optimal Positioning), cardiac surgery entered the robotic age. Material and Method: Between April 2004 and December 2004, a total of seventy eight patients underwent robotic cardiac surgery, of whom sixty four patients underwent robot-assisted minimally invasive cardiac surgery via 5cm right lateral minithoracotomy using voice controlled robotic arm, femoral vessels cannulation, percutaneous internal jugular cannulation, transthoracic aortic cross clamp. Other fourteen patients underwent MIDCAB via internal mammary artery harvesting using AESOP. Result: Robotic cardiac surgery were mitral valve repair in 37 cases, mitral valve replacement in 10 cases, aortic valve replacement in 1 case, MIDCAB in 14 cases, ASD operation in 9 cases, and isolated Maze procedure in 1 case. In mitral operation, mean CPB time was $165.3\pm43.1$ minutes and mean ACC time was $110.4\pm48.2$ minutes. Median length of hospital stay was 6 days (range 3 to 30) in mitral operation, 4 days (range 2 to 7) in MIDCAB, and 4 days (range 2 to 6) in ASD operation. For complications, 3 patients were required by reoperation for bleeding. There was no hospital mortality. Conclusion: Our experience of robot cardiac surgery suggests that many cardiovascular surgeons will be able to perform minimally invasive cardiac operations through small incisions with robot-assisted video-direction. Well-designed studies and close long-term follow-up will be required to analyze the benefits of robot-assisted operation.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.827-832
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• 2004

Background: The significance of MIDCAB is emerging topics recently as OPCAB is going to be universalized, and long-term outcome of bypass graft surgery was proved to be more excellent than balloon dilation or stent insertion. We report our MIDCAB results in 73 patients in the last three years. Material and Method: Retrospective analysis of medical records was done from November 1, 2000 through November 31, 2003. There were 47 males and 26 females ranging in age from 31 years to 79 years (average $61.3\pm9.8$ years). Observation periods after operative procedures were 10 to 1238 days (average $763\pm319.8$ days). Left longitudinal parasternal incision as a standard procedure was done to approach the heart after dissection of the left internal thoracic artery by partial or total resection of 3rd to 5th ribs. Result: Of those patients, 46 patients were transferred to ICU after extubation at operation room and 58 patients were extubated within 3 hours after operation. Average ICU staying periods was $26.8\pm11.5$ hours. Follow-up angiography during admission was done in 36 patients and showed 100% patency. Only one patient died on the 10$^{th}$ post operative day because of sudden CVA. Complications included wound problems in 4 patients, and constructing pericardial window using thoracoscopy due to continuous pericardial effusion in 1. Permanent pacemaker was inserted in one patient owing to sick sinus syndrome. In one patient with recurrence of angina 8 months after operation, stenosis at anastomic site was found and improved with balloon dilatation. Conclusion: We were satisfied with our results of MIDCAB in single and multi-vessel coronary artery disease. These results have made the cardiologists tried to operate positively and we expect widening operative indications including hybrid revascularization.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.513-517
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• 2010

Background: Diaphragmatic plication through a thoracoscopic approach has been an effective modality to treat diaphragmatic enventration. However, the conventional technique for thoracoscopic plication has some disadvantages. We have developed an improved and simplified technique with utilizing the head up position, $CO_2$ insufflation and figure-of-eight sutures. Material and Method: Between October 2005 and September 2009, 9 patients with diaphragmatic paralysis underwent repair using our modified technique. The mean patient age was $38.5{\pm}53.0$ years (range: 2~76 years). Result: The mean operation time was $46.7{\pm}15.9$ min (range: 30~85 min). None of the patients died due to this procedure, but there was one case of prolonged air leakage, and a case of re-expansion pulmonary edema, which required 3 days of ventilator support after the procedure. The mean hospital stay was $6.22{\pm}2.04$ days (range: 4~11 days). The mean follow-up duration was $27.2{\pm}11.6$ months (range: 2~43 months). All the patients had their symptoms relieved and there was no recurrence of eventration except for one patient who developed more than 2 cm elevation of the diaphragm compared to the immediate post-operation status. Conclusion: With our technique, thoracoscopic diaphragmatic plication was feasible via using only three 5 mm ports and without a working window and the midterm results were favorable. Therefore, we advocate thoracoscopic diaphragmatic plication as a preferred technique to the conventional open plication technique.