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Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.

A Clinical Study on Transpulmonary Leukostasis and Prophylactic Effects of Steroid in Cardiac Surgery (심장수술시 백혈구의 폐내정체와 스테로이드의 예방적 효과에 관한 연구)

  • 최석철
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.133-151
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    • 1996
  • After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.

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Les problèmes et les solutions de thèâtre musical corèen (한국 라이선스 뮤지컬의 현실과 개선에 대한 연구)

  • Kim, Gyunhyeong
    • (The) Research of the performance art and culture
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    • no.18
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    • pp.257-282
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    • 2009
  • Le $th{\acute{e}}{\hat{t}}re$ musical en $Cor{\acute{e}}e$ est devenu aujourd'hui une mode. Beaucoup parlent de musical, mais beaucoup de musicals sont $mont{\acute{e}}s$ sur la $sc{\grave{e}}ne$ sans des recherches $n{\acute{e}}cessaires$ suffisantes. C'est pour cette raison que la plupart des spectacles musicaux qui sont $cr{\acute{e}}es$ en $Cor{\acute{e}}e$ sont $destin{\acute{e}}s$ en faillite $d{\grave{e}}s$ la naissance. D'ailleurs les musicals $liscenci{\acute{e}}s$ par $l^{\prime}Am{\acute{e}}rique$, la France qui sont $mont{\acute{e}}s$ sur la $sc{\grave{e}}ne$ de $Cor{\acute{e}}e$ aujourd'hui sont assez pour nuire le $march{\acute{e}}$ $cor{\acute{e}}en$ $constitu{\acute{e}}$ autour de musical. Quels sont donc les $probl{\grave{e}}mes$ que posent les musicals $liscenci{\acute{e}}s$? $Premi{\grave{e}}rement$ ils encouragent la mime, pas la $cr{\acute{e}}ation$. En d'autre terme, les musicals $liscenci{\acute{e}}s$ que les $Cor{\acute{e}}ens$ montent sur la $sc{\grave{e}}ne$ ne sont pas les $cr{\acute{e}}ations$ propres chez les $Cor{\acute{e}}ens$, par contre, ces derniers sont $demand{\acute{e}}s$ de suivre ${\grave{a}}$ la mot les indications $dict{\acute{e}}es$ par le droit d'auteur. Les $cr{\acute{e}}ateurs$ $cor{\acute{e}}ens$ ne sont pas libres de $cr{\acute{e}}ation$. $Deuxi{\grave{e}}mement$ les musicals ${\grave{a}}$ la mode ont pouvoir de $d{\acute{e}}truire$ la $diversit{\acute{e}}$ de l'homme. L'homme se $caract{\grave{e}}rise$ par la $diversit{\acute{e}}$ et se $diff{\grave{e}}re$ l'un par rapport ${\grave{a}}$ l'autre. C'est l'essence de l'homme. Tous sont $diff{\acute{e}}rents$. Pourtant le musical qui $r{\grave{e}}gne$ sur tous genres de spectacles d'aujourd'hui de $Cor{\acute{e}}e$ ne laisse pas vivre d'autres genres de spectacles, la danse, le $th{\acute{e}}{\hat{a}}tre$, etc. Seul le musical est $compt{\acute{e}}$. $Troisi{\grave{e}}mement$ le musical ne peut pas nier $compl{\grave{e}}tement$ son origine commerciale. En fait le musical est devenu une chose important depuis des investigations immenses par le gouvernement $d^{\prime}Am{\acute{e}}rique$ pour donner des travails aux gens. Donc, $d{\grave{e}}s$ le $d{\acute{e}}but$, il n'y avait pas de $consid{\acute{e}}rations$ artistiques dans et sur le musical. Comme c'est par le commerce que le musical est $r{\acute{e}}pandu$, s'il y aura un $probl{\grave{e}}me$ quelconque, il est $tr{\grave{e}}s$ possible qu'on cherche ${\grave{a}}$ $r{\acute{e}}soudre$ le $probl{\grave{e}}me$ par la vue de commerce. En comprenant les $probl{\grave{e}}mes$ $mentionn{\acute{e}}s$ $l{\grave{a}}$-dessus, il faut $pr{\acute{e}}parer$ le changement de $march{\acute{e}}$ $cor{\acute{e}}enne$ de musical. Le moyen le plus $su{\hat{r}}$ de se $pr{\acute{e}}parer$ est de trouver la $r{\acute{e}}solution$ dans la culture. Pourtant cette $derni{\grave{e}}re$ ne signifie pas la tradition comme $c^{\prime}{\acute{e}}tait$ le cas $jusqu^{\prime}{\grave{a}}$ aujourd'hui, car les $Cor{\acute{e}}ens$ ne sont pas ${\acute{e}}duqu{\acute{e}}s$ par cette $derni{\grave{e}}re$. La $modernit{\acute{e}}$, disons occidentale, traverse la $Cor{\acute{e}}e$. Donc, la signification du mot 'culture' doit ${\hat{e}}tre$ $bas{\acute{e}}e$ sur la tradition et la $modernit{\acute{e}}$ en $m{\hat{e}}me$ temps.

Breeding and Development of the Tscherskia triton in Jeju Island (제주도 서식 비단털쥐(Tscherskia triton)의 번식과 발달)

  • Park, Jun-Ho;Oh, Hong-Shik
    • Korean Journal of Environment and Ecology
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    • v.31 no.2
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    • pp.152-165
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    • 2017
  • The greater long-tail hamster, Tscherskia triton, is widely distributed in Northern China, Korea and adjacent areas of Russia. Except for its distribution, biological characteristics related to life history, behavior, and ecological influences for this species are rarely studied in Korea. This study was conducted to obtain biological information on breeding, growth and development that are basic to species-specific studies. The study adopted laboratory management of a breeding programme for T. triton collected in Jeju Island from March, 2015 to December, 2016. According to the study results, the conception rate was 31.67% and the mice in the large cages had a higher rate of conception than those in the small cages (56.7 vs. 6.7%). The gestation period was $22{\pm}1.6days$ (ranges from 21 to27 days), and litter size ranged from 2 to 7, with a mean of $4.26{\pm}1.37$ in the species. The minimum age for weaning was between $19.2{\pm}1.4days$ (range of 18-21 days). There were no significant differences by sex between mean body weight and external body measurements at birth. However, a significant sexual difference was found from the period of weaning (21 days old) in head and body length, as well as tail length (HBL-weaning, $106.50{\pm}6.02$ vs. $113.34{\pm}4.72mm$, p<0.05; HBL-4 months, $163.93{\pm}5.42$ vs. $182.83{\pm}4.32mm$, p<0.05; TL-4 months, $107.23{\pm}3.25$ vs. $93.95{\pm}2.15mm$, p<0.05). Gompertz and Logistic growth curves were fitted to data for body weight and lengths of head and body, tail, ear, and hind foot. In two types of growth curves, males exhibited greater asymptotic values ($164.840{\pm}7.453$ vs. $182.830{\pm}4.319mm$, p<0.0001; $163.936{\pm}5.415$ vs. $182.840{\pm}4.333mm$, p<0.0001), faster maximum growth rates ($1.351{\pm}0.065$ vs. $1.435{\pm}0.085$, p<0.05; $2.870{\pm}0.253$ vs. $3.211{\pm}0.635$, p<0.05), and a later age of maximum growth than females in head and body length ($5.121{\pm}0.318$ vs. $5.520{\pm}0.333$, p<0.05; $6.884{\pm}0.336$ vs. $7.503{\pm}0.453$, p<0.05). However, females exhibited greater asymptotic values ($105.695{\pm}5.938$ vs. $94.150{\pm}2.507mm$, p<0.001; $111.609{\pm}14.881$ vs. $93.960{\pm}2.150mm$, p<0.05) and longer length of inflection ($60.306{\pm}1.992$ vs. $67.859{\pm}1.330mm$, p<0.0001; $55.714{\pm}7.458$ vs. $46.975{\pm}1.074mm$, p<0.05) than males in tail length. These growth rate constants, viz. the morphological characters and weights of the males and females, were similar to each other in two types of growth curves. These results will be used as necessary data to study species specificity of T. triton with biological foundations.

Analysis of 5-aza-2'-deoxycytidine-induced Gene Expression in Lung Cancer Cell Lines (폐암 세포주에서 5-aza-2'-deoxycytidine 처치에 의해 발현되는 암항원 유전자 분석)

  • 김창수;이해영;김종인;장희경;박종욱;조성래
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.967-977
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    • 2004
  • Background: DNA methylation is one of the important gene expression mechanisms of the cell. When cytosine of CpG dinucleotide in promotor is hypomethylated, expression of some genes that is controlled by this promoter is altered. In this study, the author investigated the effect of DNA demethylating agent, 5-aza-2'-deoxycytidine (ADC), on the expressions of cancer antigen genes, MHC and B7 in 4 lung cancer cell lines, NCIH1703, NCIH522, MRC-5, and A549. Material and Method: After treatment of cell lines, NCIH1703, NCIH522, MRC-5 and A549 with ADC (1 uM) for 48 hours, RT-PCR was performed by using the primers of MAGE, GAGE, NY-ESO-1, PSMA, CEA, and SCC antigen gene. In order to find the optimal ADC treatment condition for induction of cancer antigen, we studied the effect of ADC treatment time and dose on the cancer antigen gene expression. To know the effect of ADC on the expression of MHC or B7 and cell growth, cells were treated with 1 uM of ADC for 72 hours for FACS analysis or cells were treated with 0.2, 1 or 5 uM of ADC for 96 hours for cell counting. Result: After treatment of ADC (1 uM) for 48 hours, the expressions of MAGE, GAGE, NY-ESO-1, and PSMA genes increased in some cell lines. Among 6 MAGE isotypes tested, and gene expression of MAGE-1, -2, -3, -4 and -6 could be induced by ADC treatment. However, CEA gene expression did not change and SCC gene expression was decreased by ADC treatment. Gene expression was generally induced 24 - 28 hours after ADC treatment and expression of MAGE, GAGE, and NY-ESO-1 was maintained at least 14 days after ADC ADC teatment, and expression of MAGE, GAGE, and NY-ESO-1 was maintained at least 14 days after ADC teatment in ADC-Free medium. Most gene expression could be induced at 0.2 uM of ADC, but gene expression increased dependently on ADC treatment dose. The expression of MHC and B7 was not increased by ADC treatment in all four cell lines, and the growth rate of 4 cell lines decreased significantly with the increase of ADC concentrations. Conclusion: Treatment of lung cancer cell lines with ADC increases the gene expression MAGE, GAGE and NY-ESO-1 that are capable of induction of cytotoxic T lymphocyte response. We suggest that treatment with 1 uM of ADC for 48 hours and then culturing in ADC-free medium is optimal condition for induction of cancer antigen. However, ADC has no effect on MHC and B7 induction, additional modification for increase of expression of MHC, B7 and cytokine will be needed for production of efficient cancer cell vaccine.

Early Results of Heart Transplantaion: A Review of 20 Patients (심장이식술 20례의 조기성적)

  • Park, Chong-Bin;Song, Hyun;Song, Meong-Gun;Kim, Jae-Joong;Lee, Jay-Won;Seo, Dong-Man;Sohn, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.164-171
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    • 1997
  • Heart transplantation is now accepted as a definitive therapeutic modality in patients with terminal hear failure. The first successful heart transplantation in humans was done in 1967 and the first case in Korea was performed in november, 1992. Since the first case in 1992, more than 50 cases have been performed in Korea. A total of 20 patients underwent orthotopic heart transplantation since November, 1992 in Asan Medicla Center. The purpose of this study is to evaluate the early results and the follow-up course of 20 cases of heart transplantation done in Asan Medical Center. The average age of 20 patients was 39.9$\pm$11.8 years old(20~58). The mean follow-up duration was 14.4$\pm$11.2 months(1~41). All patients are alive till now. The blood type was identical in 14 and compatible in 6 patients. ihe original heart disease was dilated cardiomyopathy in 16, valvular heart disease in 2, ischemic cardiomyopathy in 1, and giant cell myocarditis in 1 patient. HLA cross matching for recipient and donor was done in 18 cases and the results were negative for T-cell and B-cell in 16 patients, pos tive for warm B-cell in 2 patients. Among 6 loci of A, B, and DR, one locus was matched in 8 cases, 2 loci in 5 cases, and 3 loci matched in 1 case. The number of acute allograft rejection averaged 2.8$\pm$0.5 (0~6) per case and the number of acute allograft rejection requiring treatment averaged 1.0$\pm$0.9 (1~3) per case. The time interval from operation to the first acute rejection requiring treatment was 35.5$\pm$20.4 days (5~60). Acute humoral rejection was suspected strongly in 1 case and was successfully treated. The left ventricular ejection fraction measured by echocardiography and/or MUGA scan was dramatically increased from 17.5$\pm$6.8 (9~32)% to 58.9$\pm$2.0 (55~62)% after heart transplantation. Temporary pacing was needed in 5 patients over 24 hours but normal sinus rhythm appeared within 7 days in all cases. One patient has been taken permanent pacemaker implantation due to complete AV block appearing 140 days after heart transplantaion. One patient had cyclosporine-associated n urotoxicity during the immediate postoperative period and was recovered after 27 hours. The heart transplantation of Asan Medical Center is on a developing stage but the early result is comparable to that of well established centers in other countries, even though the long-term follow-up result must be reevaluated. We can conclude that the heart transplantion is a promising therapeutic option in patients with terminal heart failure.

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Physico-Chemical Properties of Aggregate By-Products as Artificial Soil Materials (골재 부산물의 용토재 활용을 위한 특성 분석)

  • Yang, Su-Chan;Jung, Yeong-Sang;Kim, Dong-Wook;Shim, Gyu-Seop
    • Korean Journal of Soil Science and Fertilizer
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    • v.40 no.5
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    • pp.418-428
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    • 2007
  • Physical and chemical properties of the aggregate by-products including sludge and crushed dust samples collected from the 21 private companies throughout the country were analyzed to evaluate possible usage of the by-products as artificial soil materials for plantation. The pH of the materials ranged from 8.0 to 11.0. The organic matter content was $2.85g\;kg^{-1}$, and the total nitrogen content and available phosphate content were low as 0.7 percents and $12.98mg\;kg^{-1}$, respectively. Exchangeable $Ca^{2+}$, $Mg^{2+}$, $K^+$, and $Na^+$ were 2.29, 0.47, 0.02 and $0.05cmol\;kg^{-1}$, respectively. Heavy metal contents were lower than the limits regulated by environmental law of Korea. Textural analysis showed that most of the materials were silt loam with low water holding capacity ranged from 0.67 to 7.41 percents, and with low hydraulic conductivity ranged from 0.4 to $2.8m\;s^{-1}$. Mineralogical analysis showed that the aggregate by product materials were mostly composed of silicate, alumina and ferric oxides except calcium oxide dominant materials derived from limestones. The primary minerals were quartz, feldspars and dolomites derived from granite and granitic gneiss materials. Some samples derived from limestone material showed calcite and graphite together with the above minerals. According to the result, it can be concluded that the materials could be used as the artificial soil material for plantation after proper improvement of the physico-chemical properties and fertility.

The Purpose and background of this study (노인질환에 대한 한양방동시종합검진 결과에 대한 보고)

  • Gwon, Gyeong-Suk;Lee, Tae-Hwan;Song, Jeong-Mo;Kim, In-Seop;Yun, Ho-Yeong;Im, Jun-Gyu
    • The Journal of Korean Medicine
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    • v.15 no.2
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    • pp.9-27
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    • 1994
  • This study is to analyze of senile disease status and the social problem according to increased old ages, and then to find distributions of old man's diseases and health status efficiency of oriental-occidental contemporary health examination. And it is the first oriental-occidental contemporary health examination of old man performed by JeonJu Woosuk University Oriental Medicine Hospital and Woosuk-Clinic in nation. Methods The objects in this research are 641's old man of KimJe Gun's over 60's years performed medical examination at JeonJu Woosuk University Oriental- Mmedicine-Hospital and Woosuk-Clinic by oriental-occidental medical contemporary exam., from 1994, 24th June till 1994. 13th July. The 1st occident medical examination methods were consisted of chest x-ray check. blood and urine exam., measurement of blood pressure, visual power and audiometry. The Oriental medical examination methods were consisted of four diagnostics (望,聞,問,切), present illness. chief complaint, past history, families history, social history by question and SA Sang constitution test index. The results and conclusions The results and conclusions are the next: 1. In order of distribution. the athletic disease (75.8%),the digestive disease(43.4%), the circulatory disease(41.5%), the respiratory disease(22.3%), EENT disease(8.1%), the endocrinopathy(5.6%), and the genito-urinary disease(5.3%) are the results of the object about 641's old man, by the oriental-occidental medicine's contemporay exam. 2. Distribution of disease distiction are lumbago. gastritis and peptic ulcer. knee joint pain. heart disease. hypertension. chronic bronchitis. asthma. anemia. DM. Tbc. visual disturbance. CVA. etc in order. 3. Disease distribution according to age is almost high incident in 60-75years. Disease incidence is decreased except E.E.N.T disease in over 76years. 4. The relationships of disease and family history are: the 25.0% of CVA pts. has family history and the 11.6% of hypertension pts has family history. so they showed high relative family history. In addition the 5.6% of TBC pts. and the 2.6% of DM pts. have family history. 5. The relationships of disease and drinking are: Drinking proportion is the 36.4% in respiratory disease pts. the 34.7% in hypertension pts. the 33.3% in heart disease pts.. the 28.4% in digestive disease pts.. but because of no surveying drinking amount we can't know the absolut relationships of disease and drinking. 6. The relationships of Disease and smoking are: Smoking proportion is the 44.1% in respiratory disease pts.. the 38.0% in Heart disease pts.. the 29.8% in Hypertension pts.. but because of no surveying of smoking amount. we can't know the absolut relationships of disease and smoking. 7. Distribution of Sasang constitution is : Tae-eum-in 44.8%. So-yang-in 30.7%. So-eum-in 24.6%. Tae-yang-in 0.0%. And disease distribution of Sasang constitution distinction is ; Tae-eum-in has high incidence of circulation disease(50.0%) and respiratory disease(23.1%).So-yang-in has high incidence of athletics disease(77.7%) and EENT disease(12.2%), So-eum-in has high incidence of digestive disease(65.8%). 8. Distribution of abnormal result in occidental medical examination and oriental-occidental contemporal exam result is considerably different. This is the reason of needing oriental medicine exam, for characteristics of Senile. I think that the oriental-occidental contemporary examination in old man is much more effecient than only occident medical examination. This oriental-occidental contemporary examination has many defects because it is the first practice. To participate in the public health program efficiently. I think that we must improve lots of problems and present the model of the oriental-occidental contemporary examination and the project of oriental medicine's for public health.

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Intestinal Atresia - The Second National Survey (선천성 장폐쇄증 2차 조사 - 대한소아외과학회 회원을 주 대상으로 한 전국조사 -)

  • Kim, Seong-Chul;Kim, D.Y.;Kim, S.Y.;Kim, I.K.;Kim, I.S.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Park, K.W.;Park, W.H.;Park, J.Y.;Seo, J.M.;Seol, J.Y.;Oh, S.M.;Oh, J.T.;Lee, N.H.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chung, S.Y.;Jung, S.E.;Jeong, Y.J.;Jung, P.M.;Choi, K.J.
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.1-10
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    • 2010
  • The members of the Korean Association of Pediatric Surgeons conducted a retrospective study of two hundred and twenty-two cases of intestinal atresia for the period from January 1, 2007 to December 31, 2009. Seventeen hospitals were involved. There were 76 duodenal, 65 jejunal, and 81 ileal atresias (3 colonic). The male to female ratio was 0.85:1 in DA and 1.34:1 in JIA. Ninety-four patients(43.3 %) were premature babies (DA 40.3 %, JA 64.6 %, IA 28.8 %), and 70 babies (32.0 %) had low birth weight (DA 38.7 %, JA 44.4 %, IA 16.0 %). Antenatal diagnosis was made in 153 cases (68.9 %). However, 27 infants (17.6 %) with antenatal diagnosis were transferred to the pediatric surgeon's hospitals after delivery. Maternal polyhydramnios was observed in 81 cases (36.59 %) and most frequent with proximal obstruction. In forty-four cases (19.8 %), only simple abdominal film was taken for diagnostic study. The associated malformations were more frequently observed in DA - 61.8 % in DA and 22.6 % in JIA. Meconium peritonitis, small bowel volvulus and intussusception were more frequently associated with ileal atresia. The overall mortality rate was 3.6 %. (Abbreviations: DA;duodenal atersia, JA;jejunal atresia, JIA;jejunoileal atresia, IA;ileal atrsia).

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Effects of Electronic Security Service Quality Satisfaction and Customer Satisfaction on Switching Barrier and Customer Loyalty (기계경비 서비스품질만족과 고객만족이 전환장벽 및 고객충성도에 미치는 영향)

  • Kim, Chang-Ho;Yoon, Jong-Dae;Jung, Chul-Kyu;Lee, Bong-Keun
    • Korean Security Journal
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    • no.36
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    • pp.111-137
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    • 2013
  • The purpose of this study is to examine the effects of electronic security service quality satisfaction and customer satisfaction on switching barrier and customer loyalty. Survey questionnaires were distributed to business owners in Seoul that are using electronic security system and the total of 500 copies were used as research data except 60 copies with insufficient responses. The results are as follow. First, as for the effects of electronic security service quality satisfaction on electronic security customer satisfaction, it indicates that the higher electronic security service quality satisfaction achieves, the more it has positive effects on electronic security customer satisfaction. Second, as for the effects of electronic security service quality satisfaction on switching cost, it indicates that the higher electronic security service quality satisfaction achieves, the more it has positive effects on switching cost. As for the effects of electronic security service quality satisfaction on human relations, it indicates that the higher electronic security service quality satisfaction achieves, the more it has positive effects on human relations. It indicates that the effects of electronic security service quality satisfaction on alternative attraction was not meaningful. Third, as for the effects of electronic security customer satisfaction on switching cost, it indicates that the higher electronic security customer satisfaction achieves, the more it has positive effects on switching cost. As for the effects of electronic security customer satisfaction on human relations, it indicates that the higher electronic security customer satisfaction achieves, the more it has positive effects on human relations. But, it indicates that the effects of electronic security customer satisfaction on alternative attraction was not meaningful. Fourth, As for the effects of electronic security service quality satisfaction and electronic security customer satisfaction on customer loyalty, it indicates that the higher electronic security service quality satisfaction achieves, the more it has positive effects on customer loyalty. As for the effects of switching cost on customer loyalty, it indicates that the higher switching cost achieves, the more it has positive effects on customer loyalty. As for the effects of alternative attraction on customer loyalty, it indicates that there is no meaningful relation between alternative attraction and customer loyalty. But, effects of human relations on customer loyalty, it indicates that there is no meaningful relation between human relations and customer loyalty. Based on the above results, it is noticeable that in the effects of electronic security service quality satisfaction and electronic security customer satisfaction on switching barrier, all of them had meaningful effects except for alternative attractiveness. This signifies that switching barrier factor can increase when the service quality of electronic security and customer satisfaction increase. In other words, it can be said that increased awareness of electronic security service quality satisfaction and electronic security customer satisfaction by electronic security users can lead to high customer loyalty by establishing switching barrier through such increased awareness.

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