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A Clinical Study on the Hypercalcemia in Primary Bronchogenic Carcinoma (고칼슘혈증을 동반한 원발성 폐암의 임상적 특징)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Moon, Young-Chul;Chung, Jin-Hong;Lee, Kwan-Ho;Sung, Cha-Kyung;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.208-218
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    • 1999
  • Background: Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic disorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advanced stage with obvious bulky tumor and carry a poor prognosis. Materials and Methods: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level ${\geq}$ 10.5 mg/dL, and symptoms which could possibly be attributed to hypercalcemia. In this retrospective study, we evaluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics. Results: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance status, and bone metastasis, it was not significant statistically. Altered consciousness was significantly more frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. Conclusion: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of death and should be treated aggressively to prevent sudden deterioration or death.

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Arthroscopic Retrieval Analysis for Intra-articular Foreign Body of the Knee Joint (슬관절내 이물질에 대한 관절경적 제거술식의 분석)

  • Lee, Byung-Ill;Choi, Hyung-Suk;Jo, Joo-Hyoung;Kwon, Sai-Won
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.211-216
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    • 2008
  • Purpose: The frequency of foreign body in the knee joint is not as high, but it sometimes required wide or multiple arthrotomy in order to remove, which can baffle the surgeon in some ways. Our study is to evaluate for effectiveness of arthroscopic retrieval for intra-articular foreign body in the knee joint. Materials and Methods: The 22 patients(16 males, 6 females) had received arthroscopic foreign body retrieval in the knee joint from March 1983 to September 2006. The causes of foreign bodies of the knee joint were 7 of trauma (31.9%) related cases, 13 of surgery related cases (59.0%), 2 found during follow up after operation (8.1%) in pathologies of foreign body. Results: There were 15 of metal showed the most percentage (68.1%), 7 of non-metal (31.9%) in types of foreign bodies, and others included bullet, suture material, pencil lead, broken wire etc. All cases were used by arthroscopic techniques. All foreign bodies were removed easily and were showed no complication such as postoperative joint stiffness. Conclusion: Arthroscopic foreign body retrieval in the knee joint is effective surgery in terms of easy access to foreign body and less postoperative complication.

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Safety of Various Types of Cheese manufactured from Unpasteurized Raw Milk: A Review (비살균 원유로 만든 다양한 치즈의 안전성에 관한 연구: 총설)

  • Kim, Hong-Seok;Chon, Jung-Whan;Lim, Jong-Soo;Kim, Hyun-Sook;Kim, Dong-Hyeon;Song, Kwang-Young;Kim, Soo-Ki;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.33 no.1
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    • pp.1-15
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    • 2015
  • Before the advent of pasteurization and other microbiological controls in the dairy industry, milk product-borne diseases such as scarlet fever, typhoid fever, septic sore throat, and tuberculosis were globally widespread. Pasteurization was invented by Louis Pasteur, and it has been considered as one of the most effective ways to control milk product-borne diseases since the 20th century. Nevertheless, till date, various types of cheese in the EU, the USA, and other countries are made from unpasteurized milk as artisan cheese, following the specific food regulations of each nation. Furthermore, after the effectiveness of the Free Trade Agreement (FTA) negotiations between Korea and many nations, the import of various types of cheese made in different conditions and influenced by acidity, preservatives, temperature, competing flora, water activity, and salt concentration increased yearly. Hence, the objective of this review was to describe (1) the 60-day aging rule of cheese, (2) characteristics of the outbreaks linked to cheese manufactured from unpasteurized milk since 1998 to 2011 in USA, and (3) serious health risks from unpasteurized milk, to ensure food protection and safety and to use this basic information for risk assessment.

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The Study of Reducing Radiation Exposure Dose and Comparing SUV According to Applied IRIS (Iterative Reconstruction in Image Space) for PET/CT (PET/CT 검사 시 IRIS (Iterative Reconstruction in Image Space) 적용에 따른 CT 피폭선량 감소와 PET SUV 비교 연구)

  • Do, Yong Ho;Song, Ho Jun;Lee, Hyung Jin;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.29-34
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    • 2012
  • Purpose : Presently, hardwares and softwares for reducing radiation exposure are continually developed for PET/CT examination. Purpose of this study is to evaluate effectiveness of reducing radiation exposure dose of CT and SUV changes of PET when applied each kernel to ACCT (Attenuation Correction Computed Tomography) according to adopted IRIS (Iterative Reconstruction in Image Space) software. Materials and Methods : Biograph mCT (Siemens, Germany) was used as a PET/CT scanner. Using AAPM CT performance phantom, from standard (120 kVp, 100 mAs), 7 scans were conducted by reducing 15 mAs each. After image reconstruction by FBP (Filtered Back Projection) and IRIS, noise and spatial resolution were evaluated. The same method was applied to anthropomorphic chest phantom and acquired images were compared. NEMA IEC body phantom was used for SUV evaluation. Injected dose rate for hot sphere (hot) and background cylinder (BKG) were 1:8. CT dose condition (120 kVp, 50 mAs) was the same for each scan and PET scan durations were 1, 2, 3 and 4min. After scanning, each kernel of IRIS was applied to ACCT. And PET images were reconstructed by ACCT adopted IRIS for comparing SUV changes. Results : AAPM phantom test for noise evaluation, SD for FBP 100 mAs, IRIS 55 mAs were 8.8 and 8.9. FBP 85 mAs, IRIS 40 mAs were 9.5 and 9.7. FBP 70 mAs, IRIS 25 mAs were 11.9 and 11.1. Above mAs condition for FBP and IRIS, SD showed similar values. And for spatial resolution test, there was no significant difference. For chest phantom test, when applied the same mAs and kernel to both of FBP and IRIS, every applied kernels showed reduced noise. Lower mAs and higher kernel value showed higher noise reduction. There was no considerable difference only except for I70 very sharp kernel for SUV comparison using NEMA IEC body phantom. Conclusion : In this study, low mAs (55 mAs) applied IRIS and standard mAs (100 mAs) applied FBP showed similar noise. And only except for I70 kernel, there was no significant SUV changes. It is possible to reduce needless radiation exposure and acquire better image quality than FBP's through applying appropriate kernel of IRIS to PET/CT.

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Evaluation of Usefulness for Anti-TPO Antibody Test in Item of the Medical Examination (건강검진 종목으로서 항갑상선 과산화효소 항체검사의 유용성에 대한 평가)

  • Kim, Yun-Hyun;Shin, Yong-Hwan;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.112-115
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    • 2009
  • Purpose: The test had been applied for outpatient by end of 2006, however, it has been included in the medical examination since January 2007, as demand and interests have been gradually increasing in the thyroid gland disease and cancer. thus, we would necessarily evaluate usefulness of the test by comparing the number of patients who are diagnosed as "benignancy" by the medical test with the number of outpatient who attend and are diagnosed as autoimmune thyroid disease among the benign patient, in samsung medical center for a certain period. Materials and Methods: Based on the result for Anti-TPO Antibody test by RIA for the 12,937 patients in samsung medical center from October 2007 to March 2008, for six months, benignancy rate classified by sex and age is measured statistically and number of the patients who are diagnosed as autoimmune thyroid disease are kept tracked on. Results: According to the analysis of the Anti-TPO antibody test 1,135 of 12,937, which is 8.77% are benign and 218 treated patient of them, which is 19.2%, were diagnosed as autoimmune thyroid disease. Conclusions: Based on the statistics, usefulness of the test seem to have co relationship with derivation of autoimmune thyroid disease. this is 19.2% of probability relatively high. this figure, however, does not have strong relationship with specialty of the disease. Thus screening test seems to have somewhat effectiveness, considering other experiments and their margin.

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Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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Estimation of Groundwater Recharge by Considering Runoff Process and Groundwater Level Variation in Watershed (유역 유출과정과 지하수위 변동을 고려한 분포형 지하수 함양량 산정방안)

  • Chung, Il-Moon;Kim, Nam-Won;Lee, Jeong-Woo
    • Journal of Soil and Groundwater Environment
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    • v.12 no.5
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    • pp.19-32
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    • 2007
  • In Korea, there have been various methods of estimating groundwater recharge which generally can be subdivided into three types: baseflow separation method by means of groundwater recession curve, water budget analysis based on lumped conceptual model in watershed, and water table fluctuation method (WTF) by using the data from groundwater monitoring wells. However, groundwater recharge rate shows the spatial-temporal variability due to climatic condition, land use and hydrogeological heterogeneity, so these methods have various limits to deal with these characteristics. To overcome these limitations, we present a new method of estimating recharge based on water balance components from the SWAT-MODFLOW which is an integrated surface-ground water model. Groundwater levels in the interest area close to the stream have dynamics similar to stream flow, whereas levels further upslope respond to precipitation with a delay. As these behaviours are related to the physical process of recharge, it is needed to account for the time delay in aquifer recharge once the water exits the soil profile to represent these features. In SWAT, a single linear reservoir storage module with an exponential decay weighting function is used to compute the recharge from soil to aquifer on a given day. However, this module has some limitations expressing recharge variation when the delay time is too long and transient recharge trend does not match to the groundwater table time series, the multi-reservoir storage routing module which represents more realistic time delay through vadose zone is newly suggested in this study. In this module, the parameter related to the delay time should be optimized by checking the correlation between simulated recharge and observed groundwater levels. The final step of this procedure is to compare simulated groundwater table with observed one as well as to compare simulated watershed runoff with observed one. This method is applied to Mihocheon watershed in Korea for the purpose of testing the procedure of proper estimation of spatio-temporal groundwater recharge distribution. As the newly suggested method of estimating recharge has the advantages of effectiveness of watershed model as well as the accuracy of WTF method, the estimated daily recharge rate would be an advanced quantity reflecting the heterogeneity of hydrogeology, climatic condition, land use as well as physical behaviour of water in soil layers and aquifers.

Determination of Practical Dosing of Warfarin in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 Warfarin 용량결정)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.761-772
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

Treatment of Pectus Carinatum with a Compressive Brace (압박 교정기를 이용한 새가슴의 치료)

  • Son, Jin-Sung;Jeon, Cheol-Woo;Lee, Seong-Jin;Lee, Chol-Sae;Lee, Kihl-Rho;Lee, Seock-Yeol
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.369-375
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    • 2007
  • Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

Effects of Green Tea Extracts on Quality Characteristics and Reduced Nitrite Content of Emulsion Type Sausage during Storage (녹차 추출물의 첨가가 저장 중 유화형 소시지의 품질 특성 및 아질산염 감소에 미치는 영향)

  • Yang, Han-Sul;Jeong, Jin-Yeon;Lee, Jeong-Ill;Yun, I-Ran;Joo, Seon-Tea;Park, Gu-Boo
    • Food Science of Animal Resources
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    • v.26 no.4
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    • pp.454-463
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    • 2006
  • This study was carried out to investigate the effects of addition of green tea extract material with or without nitrite (0.02 g) on the quality characteristics and reduced nitrite content of emulsion-type sausages during 4 weeks of storage at $4^{\circ}C$. The treatments were; non-added nitrite and green tea extract (0, added nitrite and non-added green tea extract (T1), added nitrite and 0.2% green tea extract (T2), added nitrite and 0.5% green tea extract (T3), and added nitrite and 1% green tea extract (T4). The lightness $(L^*)$ of sausage containing nitrite and green tea extract together were significantly lower than control and T1 (p<0.05). The redness $(a^*)$ of sausage containing only nitrite (T1) and, nitrite and green tea extract at 1% (T4) were significantly higher than control (p<0.05). The total expressible fluid (%) of sausage containing nitrite and green tea extract were significantly lower than control (p<0.05). Cohesiveness of sausage containing green tea extract were significantly lower than control (p<0.05) at 2 and 4 weeks storage period. Addition of nitrite and green tea extract decreased the TBARS values (p<0.05). It was also found that natural extract (green tea) treatments decreased TBARS formation more than only added nitrite (Tl) (p<0.05). The changes of total plate count and coliform plate count were increased during storage time. The total plate count of T1 was higher at 4 weeks of storage period, while the coliform plate count was higher in control at 2 and 4 weeks of storage period compare to other treatments. The residual nitrite content was decreased during storage time in all treatment except control and the effectiveness of decreasing ability was higher with increasing green tea extract.