• The Journal of Korean Academy of Prosthodontics
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• v.46 no.1
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• pp.42-52
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• 2008

Purpose: Resonance Frequency Analysis(RFA) technique can be used as an effective method in measuring the implant stability and documenting the clinical results. This technique also determines how stable the implant is before performing a prosthetic practice. Having become one the guidelines of the implant therapy whose final objective is the immediate loading, the $Osstell^{TM}$ mentor is giving a lot of information to the clinicians recently. In this communication, experiments were performed to investigate how reliable the measured ISQ values by $Osstell^{TM}$ mentor are, and to see if those are also stable even after sterilization. As five objectives: 1) How stable measured ISQ values after fixation $Smartpeg^{TM}s$ for 400 times. 2) How stable measured ISQ values after 'attach-detach'$Smartpeg^{TM}'s$ for 400 times. 3) How stable measured ISQ values after clinical sterilization methods. 4) How stable measured ISQ values after repeatedly sterilization in autoclave for 10 times. 5) What is the critical temperature which is lost the magnetism of $Smartpeg^{TM}$. Materials and Methods: Clinical sterilization methods(Autoclave sterilization, Dentistar sterilization, Ultra violet sterilization, Vacuum dry unit sterilization, Boiling water sterilization, combined $H_{2}O_{2}$ and Alcohol sterilization).$Smartpeg^{TM}s$. D3 Block bone($3{\times}9{\times}2cm$). Osstem implant(${\emptyset}4.1$-10mm).$Osstell^{TM}$ mentor. Individual experiment was used 8 number of $Smartpeg^{TM}s$ and they had measured to ISQ values of before experiment and after experiment. Results: 1. The measured ISQ values did not change after fixation $Smartpeg^{TM}s$ for 400 times. 2. There was no significant changes in the measured ISQ values of 'attach-detach $Smartpeg^{TM}s'$ for 400 times. 3. The measured ISQ values did not change after the usual clinical sterilization methods. 4. The measured ISQ values did not change after sterilization in autoclave for 10 times. 5. It was impossible to exactly measure the critical temperature which is lost the magnetism of $Smartpeg^{TM}s$. But, the results was resulted to lost its magnetism in higher temperature than $150^{\circ}C$/10 minute. Conclusion: The measured ISQ values showed insignificant differences in case of no changes in the magnetism of the $Smartpeg^{TM}s$. It seems that the $Smartpeg^{TM}s$ can be used repeatedly in every measurement if the original magnetisms of the $Smartpeg^{TM}s$ can be recognized. There seems to be no significant changes in the measured ISQ values of 'attach-detach $Smartpeg^{TM}s'$ only if the screw pitches were unimpaired. The clinical sterilization methods seems acceptable because the result was resulted to lost its magnetism in higher temperature than $150^{\circ}C$/10minute.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.427-445
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• 2007

To improve osseointegration at the boneto-implant interface, several studies have been carried out to modify titanium surface. Variations in surface texture or microtopography may affect the cellular response to an implant. Osteoblast-like cells attach more readily to a rougher titanium surface, and synthesis of extracellular matrix and subsequent mineralization were found to be enhanced on rough or porous coated titanium. However, regarding the effect of roughened surface by physical and mechanical methods, most studies carried out on the reactions of cells to micrometric topography, little work has been performed on the reaction of cells to nanotopography. The purpose of this study was to examme the response of osteoblast-like cell cultured on blasted surfaces and alkali treated surfaces, and to evaluate the influence of surface texture or submicro-scaled surface topography on the cell attachment, cell proliferation and the gene expression of osteoblastic phenotype using ROS 17/2.8 cell lines. In scanning electron micrographs, the blasted, alkali treated and machined surfaces demonstrated microscopic differences in the surface topography. The specimens of alkali treatment had a submicro-scaled porous sur-face with pore size about 200 nm. The blasted surfaces showed irregularities in morphology with small(<10 ${\mu}m$) depression and indentation among flatter-appearing areas of various sizes. Based on profilometry, the blasted surfaces was significantly rougher than the machined and the alkali treated surfaces (p$TiO_2$) were observed on alkali treated surfaces, whereas not observed on machined and blasted surfaces. The attachment morphology of cells according to time was observed by the scanning electron microscope. After 1 hour incubation, the cells were in the process of adhesion and spreading on the prepared surfaces. After 3 hours, the cells on all prepared surfaces were further spreaded and flattened, however on the blasted and alkali treated surfaces, the cells exhibited slightly irregular shapes and some gaps or spaces were seen. After 24 hours incubation, most cells of the all groups had a flattened and polygonal shape, but the cells were more spreaded on the machined surfaces than the blasted and alkali treated surfaces. The MTT assay indicated the increase on machined, alkali treated and blasted surfaces according to time, and the alkali treated and blasted surfaces showed significantly increased in optical density comparing with machined surfaces at 1 day (p<0.01). Gene expression study showed that mRNA expression level of ${\alpha}\;1(I)$ collagen, alkaline phosphatase and osteopontin of the osteoblast-like cells showed a tendency to be higher on blasted and alkali treated surfaces than on the machined surfaces, although no siginificant difference in the mRNA expression level of ${\alpha}\;1(I)$ collagen, alkaline phosphatase and osteopontin was observed among all groups. In conclusion, we suggest that submicroscaled surfaces on osteoblast-like cell response do not over-ride the one of the surface with micro-scaled topography produced by blasting method, although the microscaled and submicro-scaled surfaces can accelerate osteogenic cell attachment and function compared with the machined surfaces.

• Journal of Nutrition and Health
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• v.41 no.1
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• pp.65-76
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• 2008

This study was performed to identify association between nutritional status and health risks of the elderly. This was a cross-sectional study involving low income elderly women in Gwangju, Korea (${\geq}$65y, n = 92). Socio-demographics, life style characteristics, health conditions, dietary intakes based on 24h-recall method, anthropometric measures, and clinical biochemistry parameters were examined. Anthropometric and clinical parameters included wt, ht, waist, hip, body protein, body fat, abdominal fat, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, hemoglobin, hematocrit, fasting blood glucose, ferritin, IL-2, IL-6, TNF-${\alpha}$, CRP, TAS, TBARS, systolic blood pressure, and diastolic blood pressure. The subjects were divided into three groups based on age (65-74y, 75-84y, 85y${\leq}$) and were divided into two groups according to the sum of the Nutrition Screening Initiative (NSI) checklist score (adequate nutritional status, NSI score ${\leq}$3; at risk of malnutrition, NSI score >3). Mean and frequency of variables were estimated. Analysis of Variance, Tukey test, Chi-square test, and Multiple linear regression analyses were performed. Mean BMI and body fat were 25.1 $kg/m^2$ and 40.0%, respectively. However, for over 80% of subjects, the intakes of energy, fiber, thiamin, riboflavin, niacin, folate, Ca, K, and Zn were less than the Korean DRI (EAR or AI). The subjects who had lower NSI score tended to have better health status, eat meals frequently, have less depression, and exercise regularly. The subjects who had higher NSI score tended to have tooth problems, to eat alone most of time, and to be physically unable to cook or feed. Serum IL-6 and TNF-${\alpha}$ were significantly related with nutritional status which suggested higher tendency of inflammatory response. Serum IL-2, TAS, and glucose were significantly correlated with body fat (%) or abdominal fat (%). These results suggest that improving the nutritional status, increasing regular exercise, maintaining normal weight are beneficial to health care of low income elderly women.

• Journal of Korean Society of Forest Science
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• v.88 no.4
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• pp.510-522
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• 1999

The air pollutants ; $SO_2$, $SO{_4}^{-2}$, $NO{_3}^-$, $Cl^-$ are absorbed into soils through falling with dusts and rain from the atmosphere. The sources of heavy metal contaminants in the environments are agricultural and horticultural materials, sewage sludges, fossil fuel combustion, metallurgical industries, electronics and waste disposal etc.. The soils and hydrosphere can be polluted on the way of the circulation of these heavy metals. Studied pollutant anions are $SO{_4}^{-2}$, $NO{_3}^-$ and $Cl^-$ and heavy metals are Se, Mo, Zn, Cd, Pb, Mn, Cr, Co, V, As, Cu and Ni which are the elements to be concerned with the essentials for plants, with animal and human health. This study is with the aim of selecting the species of roadside trees and green space trees which have excellent absorption of air pollutants and heavy metals from the atmosphere and the soils in the urban area. Two areas are designated to carry out this study : urban area ; Kwangju city and rural area ; the yard of Forest Environment Institute of Chollanam-do, at Sanje-ri, Sampo-myum, Naju city, Chollanam-do (23km away from Kwangju). This study is carried out to understand the movement of anions and heavy metals from the soils to the trees in both areas, the absorption of anions and heavy metals from atmosphere into leaves and the amounts of anions and heavy metals in leaves and fine roots(< 1mm dia.) of roadside trees and green space trees in Kwangju and trees in the yard of Forest Environment Institute of Chollanam-do. The tree species selected for this study in both areas are Ginkgo biloba, Quercus acutissima, Cedrus deodara, Platanus occidentalis, Robinia pseudoacacia, Alnus japonica. Metasequoia glyptostroboides. Zekova serrata. Prunus serrulata var. spontanea, and Pinus densiflora. The results of the study are as follows : 1. $SO{_4}^{-2}$, $NO{_3}^-$ and $Cl^-$ concentrations are higher in the soils of the urban area than in those of the rural area, and $NO{_3}^-$ and $SO{_4}^{-2}$ are higher in the leaves than in the roots due to the absorption of the these pollutants through the stomata. 2. Ginkgo biloba, Robinia pseudoacacia. Zekova serrata, Quercus acutissima, and Platanus occidentalis can be adequated to the roadside trees and the environmental trees due to their good absorption of $NO{_3}^-$ and $SO{_4}^{-2}$. 3. Heavy metals in the soils of both areas are in the order of Mn > Zn > V > Cr > Pb > Ni > Cu > Mo> Cd, and in the leaves and roots of the trees in the both areas are in the order of Mn>Zn>Cr>Cu>V>Ni. Both orders are similar ones except V. There are more in the urban soils than in the rural soils in amount of Mn, Zn, Pb, V, Cu. 4. It is supposed that there is no antagonism between Mn and Zn in this study. 5. Se, Co and As are not detected in the soils, the leaves and the roots in both areas. Sn, Mo, Cd and Pb are also not detected in the leaves and roots in spite of considerable amount in the soils of both areas.

• Korean Journal of Organic Agriculture
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• v.18 no.4
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• pp.613-626
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• 2010

Coming with the well-being era, consumer's demand for safe agricultural products is increasing. It is urgent to develop an environment-friendly pear production system. Accordingly, this study was conducted to develop an environment-friendly pear production system by using several environment-friendly agricultural materials which is known to be effective in agricultural production. In the effects of environment-friendly agricultural materials on the soil chemical characteristics in pear orchard, the content of total carbon, organic matter, Ca and Mg increased a little respectively compared with those of 2008, and 2nd treatment showed the highest EC and Mg content in the soil among treatments. The content of leaf N, P and Ca in 2009 decreased compared with those of 2008, while Mg content showed no difference between 2008 and 2009 years. Average pear weight in 2009 was 31g higher than that of 2008 (682g) and 2nd treatment showed the highest pear weight (738g) among treatments. The average sugar content was higher in 2009 (12.6$^{\circ}Bx$) compared with that of 2008 (12.2$^{\circ}Bx$) and the plot of 2nd treatment highest sugar content (12.6$^{\circ}Bx$) among treatments. There were no difference in hunter value of L among treatments, but hunter value of a showed higher 1.62 in 2009 than that of 2008 (3.73). The highest of gumminess and cohesiveness of fruits were obtained from 1st treatment and adhesiveness and chewiness of fruits were obtained from 3rd and 1st treatment respectively. Firmness of fruit increased a little in 2009 compared with that of 2008, while the highest firmness was obtained from 3rd treatment with 1.63kg/5mm$\oint$ among treatments. Phosphate content in the peel of 'Niitaka' pear of fruit skin in 2009 (0.97g/kg) showed 0.06g/kg more content than that of 2008 (0.91g/kg), while the highest content was obtained from 3rd treatment (1.15g/kg). Potassium content in the peel of 'Niitaka' pear in 2009 was 8.20g/kg, which is 0.06g/kg more content than that of 2008 (7.82g/kg) and the highest content was obtained from 1st treatment (8.34g/kg) among treatments. The highest nitrogen content in the flesh of 'Niitaka' pear was obtained from 3rd treatment (4.32mg/g), while it was the lowest in control plot (3.10mg/g). Phosphate content in the flesh of 'Niitaka' pear in 2009 (8.20g/kg) showed 0.06g/kg more content than that of 2008 (7.82g/kg), while the highest content was obtained from 1st treatment (8.34g/kg). There were no difference of the potassium content in the fruit peel of 'Niitaka' pear between years, but 1st treatment showed the highest content (11.81g/kg) among treatments, while the lowest was obtained from the control plot (10.83g/kg).

• Water for future
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• v.9 no.1
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• pp.38-42
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• 1976

Because of differences in thoughts and ideology, our country, Korea has been deprived of national unity for some thirty years of time and tide. To achieve peaceful unification, the cultivation of national strength is of paramount importance. This national strength is also essential if Korea is to take rightful place in the international societies and to have the confidence of these societies. However, national strength can never be achieved in a short time. The fundamental elements in economic development that are directly conducive to the cultivation of national strength can be said to lie in -a stable political system, -exertion of powerful leadership, -cultivation of a spirit of diligence, self-help and cooperation, -modernization of human brain power, and -establishment of a scientific and well planned economic policy and strong enforcement of this policy. Our country, Korea, has attained brilliant economic development in the past 15 years under the strong leadership of president Park Chung Hee. However, there are still many problems to be solved. A few of them are: -housing and home problems, -increasing demand for employment, -increasing demand for staple food and -the need to improve international balance of payment. Solution of the above mentioned problems requires step by step scientific development of each sector and region of our contry. As a spearhead project in regional development, the Saemaul Campaign or new village movement can be cited. The campaign is now spreading throughout the country like a grass fire. However, such campaigns need considerable encouragement and support and the means for the desired development must be provided if the regional and sectoral development program is to sucdceed. The construction of large multipurpose dams in major river basin plays significant role in all aspects of national, regional and sectoral development. It ensures that the water resource, for which there is no substitute, is retained and utilized for irrigation of agricultural areas, production of power for industry, provision of water for domestic and industrial uses and control of river water. Water is the very essence of life and we must conserve and utilize what we have for the betterment of our peoples and their heir. The regional and social impact of construction of a large dam is enormous. It is intended to, and does, dras tically improve the "without-project" socio-economic conditions. A good example of this is the Soyanggang multipurpose dam. This project will significantly contribute to our national strength by utilizing the stored water for the benefit of human life and relief of flood and drought damages. Annual average precipitation in Korea is 1160mm, a comparatively abundant amount. The catchment areas of the Han River, Keum River, and Youngsan River are $62,755\textrm{km}^2$, accounting for 64% of the national total. Approximately 62% of the national population inhabits in this area, and 67% of the national gross product comes from the area. The annual population growth rate of the country is currently estimated at 1.7%, and every year the population growth in urban area increases at a rising rate. The population of Seoul, Pusan, and Taegu, the three major cities in Korea, is equal to one third of our national total. According to the census conducted on October 1, 1975, the population in the urban areas has increased by 384,000, whereas that in rural areas has decreased by 59,000,000 in the past five years. The composition of population between urban and rural areas varied from 41%~59% in 1959 to 48%~52% in 1975. To mitigate this treand towards concentration of population in urban areas, employment opportunities must be provided in regional and rural areas. However, heavy and chemical industries, which mitigate production and employment problems at the same time, must have abundant water and energy. Also increase in staple food production cannot be attained without water. At this point in time, when water demand is rapidly growing, it is essential for the country to provide as much a reservoir capacity as possible to capture the monsoon rainfall, which concentarated in the rainy seaon from June to Septesmber, and conserve the water for year round use. The floods, which at one time we called "the devil" have now become a source of immense benefit to Korea. Let me explain the topographic condition in Korea. In northern and eastern areas we have high mountains and rugged country. Our rivers originate in these mountains and flow in a general southerly or westerly direction throught ancient plains. These plains were formed by progressive deposition of sediments from the mountains and provide our country with large areas of fertile land, emminently suited to settlement and irrigated agricultural development. It is, therefore, quite natural that these areas should become the polar point for our regional development program. Hower, we are fortunate in that we have an additional area or areas, which can be used for agricultural production and settlement of our peoples, particularly those peoples who may be displaced by the formation of our reservoirs. I am speaking of the tidelands along the western and southern coasts. The other day the Ministry of Agriculture and Fishery informed the public of a tideland reclamation of which 400,000 hectares will be used for growing rice as part of our national food self-sufficiency programme. Now, again, we arrive at the need for water, as without it we cannot realize this ambitious programme. And again we need those dams to provide it. As I mentioned before, dams not only provide us with essential water for agriculture, domestic and industrial use, but provide us with electrical energy, as it is generally extremely economical to use the water being release for the former purposes to drive turbines and generators. At the present time we have 13 hydro-electric power plants with an installed capacity of 711,000 kilowatts equal to 16% of our national total. There are about 110 potential dams ites in the country, which could yield about 2,300,000 kilowatts of hydro-electric power. There are about 54 sites suitable for pumped storage which could produce a further 38,600,000 kilowatts of power. All available if we carefully develop our water resources. To summarize, water resource development is essential to the regional development program and the welfare of our people, it must proceed hand-in-hand with other aspects of regional development such as land impovement, high way extension, development of our forests, erosion control, and develop ment of heavy and chemical industries. Through the successful implementation of such an integrated regional development program, we can look forward to a period of national strength, and due recognition of our country by the worlds societies.

• Magazine of the Korean Society of Agricultural Engineers
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• v.19 no.1
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• pp.4296-4311
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• 1977

This study was conducted to derive an Instantaneous Unit Hydrograph for the accurate and reliable unitgraph which can be used to the estimation and control of flood for the development of agricultural water resources and rational design of hydraulic structures. Eight small watersheds were selected as studying basins from Han, Geum, Nakdong, Yeongsan and Inchon River systems which may be considered as a main river systems in Korea. The area of small watersheds are within the range of 85 to 470$\textrm{km}^2$. It is to derive an accurate Instantaneous Unit Hydrograph under the condition of having a short duration of heavy rain and uniform rainfall intensity with the basic and reliable data of rainfall records, pluviographs, records of river stages and of the main river systems mentioned above. Investigation was carried out for the relations between measurable unitgraph and watershed characteristics such as watershed area, A, river length L, and centroid distance of the watershed area, Lca. Especially, this study laid emphasis on the derivation and application of Instantaneous Unit Hydrograph (IUH) by applying Nash's conceptual model and by using an electronic computer. I U H by Nash's conceptual model and I U H by flood routing which can be applied to the ungaged small watersheds were derived and compared with each other to the observed unitgraph. 1 U H for each small watersheds can be solved by using an electronic computer. The results summarized for these studies are as follows; 1. Distribution of uniform rainfall intensity appears in the analysis for the temporal rainfall pattern of selected heavy rainfall event. 2. Mean value of recession constants, Kl, is 0.931 in all watersheds observed. 3. Time to peak discharge, Tp, occurs at the position of 0.02 Tb, base length of hlrdrograph with an indication of lower value than that in larger watersheds. 4. Peak discharge, Qp, in relation to the watershed area, A, and effective rainfall, R, is found to be {{{{ { Q}_{ p} = { 0.895} over { { A}^{0.145 } } }}}} AR having high significance of correlation coefficient, 0.927, between peak discharge, Qp, and effective rainfall, R. Design chart for the peak discharge (refer to Fig. 15) with watershed area and effective rainfall was established by the author. 5. The mean slopes of main streams within the range of 1.46 meters per kilometer to 13.6 meter per kilometer. These indicate higher slopes in the small watersheds than those in larger watersheds. Lengths of main streams are within the range of 9.4 kilometer to 41.75 kilometer, which can be regarded as a short distance. It is remarkable thing that the time of flood concentration was more rapid in the small watersheds than that in the other larger watersheds. 6. Length of main stream, L, in relation to the watershed area, A, is found to be L=2.044A0.48 having a high significance of correlation coefficient, 0.968. 7. Watershed lag, Lg, in hrs in relation to the watershed area, A, and length of main stream, L, was derived as Lg=3.228 A0.904 L-1.293 with a high significance. On the other hand, It was found that watershed lag, Lg, could also be expressed as {{{{Lg=0.247 { ( { LLca} over { SQRT { S} } )}^{ 0.604} }}}} in connection with the product of main stream length and the centroid length of the basin of the watershed area, LLca which could be expressed as a measure of the shape and the size of the watershed with the slopes except watershed area, A. But the latter showed a lower correlation than that of the former in the significance test. Therefore, it can be concluded that watershed lag, Lg, is more closely related with the such watersheds characteristics as watershed area and length of main stream in the small watersheds. Empirical formula for the peak discharge per unit area, qp, ㎥/sec/$\textrm{km}^2$, was derived as qp=10-0.389-0.0424Lg with a high significance, r=0.91. This indicates that the peak discharge per unit area of the unitgraph is in inverse proportion to the watershed lag time. 8. The base length of the unitgraph, Tb, in connection with the watershed lag, Lg, was extra.essed as {{{{ { T}_{ b} =1.14+0.564( { Lg} over {24 } )}}}} which has defined with a high significance. 9. For the derivation of IUH by applying linear conceptual model, the storage constant, K, with the length of main stream, L, and slopes, S, was adopted as {{{{K=0.1197( {L } over { SQRT {S } } )}}}} with a highly significant correlation coefficient, 0.90. Gamma function argument, N, derived with such watershed characteristics as watershed area, A, river length, L, centroid distance of the basin of the watershed area, Lca, and slopes, S, was found to be N=49.2 A1.481L-2.202 Lca-1.297 S-0.112 with a high significance having the F value, 4.83, through analysis of variance. 10. According to the linear conceptual model, Formular established in relation to the time distribution, Peak discharge and time to peak discharge for instantaneous Unit Hydrograph when unit effective rainfall of unitgraph and dimension of watershed area are applied as 10mm, and $\textrm{km}^2$ respectively are as follows; Time distribution of IUH {{{{u(0, t)= { 2.78A} over {K GAMMA (N) } { e}^{-t/k } { (t.K)}^{N-1 } }}}} (㎥/sec) Peak discharge of IUH {{{{ {u(0, t) }_{max } = { 2.78A} over {K GAMMA (N) } { e}^{-(N-1) } { (N-1)}^{N-1 } }}}} (㎥/sec) Time to peak discharge of IUH tp=(N-1)K (hrs) 11. Through mathematical analysis in the recession curve of Hydrograph, It was confirmed that empirical formula of Gamma function argument, N, had connection with recession constant, Kl, peak discharge, QP, and time to peak discharge, tp, as {{{{{ K'} over { { t}_{ p} } = { 1} over {N-1 } - { ln { t} over { { t}_{p } } } over {ln { Q} over { { Q}_{p } } } }}}} where {{{{K'= { 1} over { { lnK}_{1 } } }}}} 12. Linking the two, empirical formulars for storage constant, K, and Gamma function argument, N, into closer relations with each other, derivation of unit hydrograph for the ungaged small watersheds can be established by having formulars for the time distribution and peak discharge of IUH as follows. Time distribution of IUH u(0, t)=23.2 A L-1S1/2 F(N, K, t) (㎥/sec) where {{{{F(N, K, t)= { { e}^{-t/k } { (t/K)}^{N-1 } } over { GAMMA (N) } }}}} Peak discharge of IUH) u(0, t)max=23.2 A L-1S1/2 F(N) (㎥/sec) where {{{{F(N)= { { e}^{-(N-1) } { (N-1)}^{N-1 } } over { GAMMA (N) } }}}} 13. The base length of the Time-Area Diagram for the IUH was given by {{{{C=0.778 { ( { LLca} over { SQRT { S} } )}^{0.423 } }}}} with correlation coefficient, 0.85, which has an indication of the relations to the length of main stream, L, centroid distance of the basin of the watershed area, Lca, and slopes, S. 14. Relative errors in the peak discharge of the IUH by using linear conceptual model and IUH by routing showed to be 2.5 and 16.9 percent respectively to the peak of observed unitgraph. Therefore, it confirmed that the accuracy of IUH using linear conceptual model was approaching more closely to the observed unitgraph than that of the flood routing in the small watersheds.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.803-810
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• 1999

Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.57-70
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• 2003

Background : Small cell lung cancer represents approximately 20% of all carcinomas of the lung, and is recognized as having a poor long term outcome compared to non-small cell lung cancer. Therefore, this study investigated the prognostic factors in small cell lung cancer patients in order to improved the survival rate by using the proper therapeutic methods. Material and method : The clinical data from 394 patients who diagnosed with small cell lung cancer and treated from 1993 to 2001 at the Kosin University Gospel Hospital, were analyzed. Result : There were 314 male patients (79.7%), and 80 female patients (20.3%). The number of those with limited disease was 177 (44.9%), and the number of those with extensive disease was 217 (55.1%). Overall, 366 out of 394 enrolled patients had died. The median survival time was 215 days (95% CI : 192-237days). The disease stage, Karnofsky performance state, 5% body weight loss for the recent 3 months, chemotherapy regimens, and the additive chest radiotherapy were identified as being statistically significant factors for the survival time. The median survival times of the supportive care group, one anticancer therapy, and two or more treatment groups were 17 days, 211 days, and 419 day, respectively (p<0.001). These data emphasize the importance of anticancer treatment to improve survival time for patients. The group of concurrent chemoradiotherapy (30 patients) showed significantly longer survival time than the group given sequential chemoradiotherapy (55 patients) (528 days versus 373 days, p=0.0237). The favorable prognostic factors of laboratory study were groups of leukocyte =8,000/mm3, ALP=200 U/L, LDH=450 IU/L, NSE=15 ng/mL, s-GOT=40 IU/L. In extensive disease, there was no difference according to the number of metastatic site. However, the median survival time of patients with ipsilateral pleural effusion had longer than patients having other metastatic sites. According to the survey periods, three groups were divided into 1993-1995, 1996-1998, and 1999-2001. The median survival time was significantly prolonged after 1999 in comparison to previous groups (177 days, 194 days, 289 days, p=0.001, 0.002, respectively). Conclusion: Disease stage and 5% body weight loss for recent 3 months at diagnostic state were significant prognostic factors. In addition, the performance status, serum ALP, LDH, NSE, CEA levels also appear to be prognostic factors. The survival time of those patients with small cell lung cancer has been prologned in recent years. It was suggested that the used of the EP (etoposied and cisplatin) chemotherapy method and concurrent chemoradiotherapy for patients with a limited stage contributed to the improved survival time.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.265-274
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• 1998

Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.