• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.315-329
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• 1999

Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

• Journal of the Institute of Electronics Engineers of Korea SD
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• v.43 no.11 s.353
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• pp.58-68
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• 2006

This work proposes a 10b 250MS/s $1.8mm^2$ 85mW 0.13um CMOS A/D Converter (ADC) for high-performance integrated systems such as next-generation DTV and WLAN simultaneously requiring low voltage, low power, and small area at high speed. The proposed 3-stage pipeline ADC minimizes chip area and power dissipation at the target resolution and sampling rate. The input SHA maintains 10b resolution with either gate-bootstrapped sampling switches or nominal CMOS sampling switches. The SHA and two MDACs based on a conventional 2-stage amplifier employ optimized trans-conductance ratios of two amplifier stages to achieve the required DC gain, bandwidth, and phase margin. The proposed signal insensitive 3-D fully symmetric capacitor layout reduces the device mismatch of two MDACs. The low-noise on-chip current and voltage references can choose optional off-chip voltage references. The prototype ADC is implemented in a 0.13um 1P8M CMOS process. The measured DNL and INL are within 0.24LSB and 0.35LSB while the ADC shows a maximum SNDR of 54dB and 48dB and a maximum SFDR of 67dB and 61dB at 200MS/s and 250MS/s, respectively. The ADC with an active die area of $1.8mm^2$ consumes 85mW at 250MS/s at a 1.2V supply.

• Journal of the Institute of Electronics Engineers of Korea SD
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• v.43 no.11 s.353
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• pp.37-47
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• 2006

This work proposes a 10b 25MS/s $0.8mm^2$ 4.8mW 0.13um CMOS A/D Converter (ADC) for high-performance wireless communication systems such as DVB, DAB and DMB simultaneously requiring low voltage, low power, and small area. A two-stage pipeline architecture minimizes the overall chip area and power dissipation of the proposed ADC at the target resolution and sampling rate while switched-bias power reduction techniques reduce the power consumption of analog amplifiers. A low-power sample-and-hold amplifier maintains 10b resolution for input frequencies up to 60MHz based on a single-stage amplifier and nominal CMOS sampling switches using low threshold-voltage transistors. A signal insensitive 3-D fully symmetric layout reduces the capacitor and device mismatch of a multiplying D/A converter while low-noise reference currents and voltages are implemented on chip with optional off-chip voltage references. The employed down-sampling clock signal selects the sampling rate of 25MS/s or 10MS/s with a reduced power depending on applications. The prototype ADC in a 0.13um 1P8M CMOS technology demonstrates the measured DNL and INL within 0.42LSB and 0.91LSB and shows a maximum SNDR and SFDR of 56dB and 65dB at all sampling frequencies up to 2SMS/s, respectively. The ADC with an active die area if $0.8mm^2$ consumes 4.8mW at 25MS/s and 2.4mW at 10MS/s at a 1.2V supply.

• Journal of the Institute of Electronics Engineers of Korea SD
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• v.43 no.11 s.353
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• pp.48-57
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• 2006

This work describes a 12b 200KHz 0.52mA $0.47mm^2$ algorithmic ADC for sensor applications such as motor controls, 3-phase power controls, and CMOS image sensors simultaneously requiring ultra-low power and small size. The proposed ADC is based on the conventional algorithmic architecture with recycling techniques to optimize sampling rate, resolution, chip area, and power consumption. The input SHA with eight input channels for high integration employs a folded-cascode architecture to achieve a required DC gain and a sufficient phase margin. A signal insensitive 3-D fully symmetrical layout with critical signal lines shielded reduces the capacitor and device mismatch of the MDAC. The improved switched bias power-reduction techniques reduce the power consumption of analog amplifiers. Current and voltage references are integrated on the chip with optional off-chip voltage references for low glitch noise. The employed down-sampling clock signal selects the sampling rate of 200KS/s or 10KS/s with a reduced power depending on applications. The prototype ADC in a 0.18um n-well 1P6M CMOS technology demonstrates the measured DNL and INL within 0.76LSB and 2.47LSB. The ADC shows a maximum SNDR and SFDR of 55dB and 70dB at all sampling frequencies up to 200KS/s, respectively. The active die area is $0.47mm^2$ and the chip consumes 0.94mW at 200KS/s and 0.63mW at 10KS/s at a 1.8V supply.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.9
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• pp.1243-1252
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• 2009

We investigated a method to improve anticancer activities of Acer mono by ultra high pressure extraction process. The extract yields by ultra high pressure were 9.49% and 9.87% for 5 min and 15 min processing time, respectively, which were relatively higher than 3$\sim$4% of conventional extraction processes due to their resid bark structure. The extract for 15 minutes extraction (HPE15) showed higher potent scavenging effect as 94.56% than the control, BHA as 93.24%. On SOD-like test, HPE15 also showed the highest activity as 38.6% at 1.0 mg/mL concentration. The cytotoxicity of HPE15 on normal human lung and kidney cell were below 23.54% in adding 1.0 mg/mL. Generally, human cancer cell growth stomach adenocarcinoma (AGS), lung adenocarcinoma (A549), breast adenocarcinoma (MCF-7), colon adenocarcinoma (Caco-2) and liver adenocarcinoma (Hep3B) were inhibited up to 75% with higher selectivity of above 4.0. High antioxidant activity of HPE15 resulted in high anticancer activity, and its activity was also due to higher yields of Acer mono by ultra high pressure extraction process. It was also proved by HPLC comparison analysis.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.76-83
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• 2006

Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.130-141
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• 1995

Background: Endobronchial tuberculosis is one of the serious complications of pulmonary tuberculosis. Without early diagnosis and proper treatment of endobronchial tuberculosis, bronchostenosis can leave and lead to the collapse of distal lung parenchyme, bronchiectasis, and secondary pneumonia accompanied with moderate to severe dyspnea, cough, hemoptysis, and localized wheezing. Therefore steroid therapy has been tried to prevent bronchostenosis. But the effect of steroid therapy on the endobronchial tuberculosis is not definite at present. We tried to elucidate the effect of steroid on the treatment of endobronchial tuberculosis for prevention of bronchostenosis. Methods: We observed the initial and sequential bronchoscopic findings, pulmonary function tests and simple chest roentgenograms in 58 patients diagnosed as endobronchial tuberculosis and admitted to Chung-Ang university hospital from 1988 to 1992. The patients in nonsteroid group (n=39) were treated with anti-tuberculosis chemotherapy only and steroid group(n=17) with combined steroid therapy. Sequential bronchoscopic findings, pulmonary function tests, and chest roentgenograms were comparatively analyzed between the two groups. Results: 1) The endobronchial tuberculosis was highly prevalent in young females especially in third decade. 2) Both actively caseating type and the stenotic type without fibrosis was the most common in the bronchoscopic classification. 3) The sequential bronchoscopic findings in steroid group 2 months after treatment showed no significant improvements compared with nonsteroid group. 4) There was no significant difference between the two groups in the sequential bronchoscopic improvements according to bronchoscopic types. 5) We did not find any significant difference in improvements on follow-up pulmonary function tests and simple chest roentgenograms between the two groups 2 month after treatment. 6) There was no significant adverse effect of steroid during the treatment. Conclusion: Combined steroid therapy provably would not influence outcome of the treatment of endobronchial tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.730-739
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• 2000

Background : The aim of this study was to analyze the clinical manifestations and efficacy of treatment regimens in order to determine the adequate combination of anti-tuberculotic agents and duration of treatment for tuberculous lymphadenitis. Methods : We made a review of 373 patients with tuberculous lymphadenitis, who were admitted to four medical college hospitals in Taegu Korea from 1989 to 1998, and their diagnoses were confirmed histologically and bacteriologically. Results : The incidence of tuberculous lymphadenitis was 71.3% in women and 57.7% were between the ages of 20 and 39 years. The most common symptom was painless swelling. The most commonly involved lymph nodes were unilateral superficial cervical lymph node groups. Tuberculous lymphadenitis was accompanied with active pulmonary tuberculosis, commonly. The sensitivity of fine needle aspiration(FNA) in tuberculous lymphadenitis was 79.6%, and 92.2% of the patients had a strong positive reaction to the tuberculin skin test. The most commonly prescribed anti-tuberculotic regimen was the combination of INH, RMP, EMB, and PZA(62.6 %). Eighty percent of patient were treated for 9-12 months. There was no significantly difference in the recurrence rate of tuberculous lymphadenitis between the combinations of anti-tuberculotic agent, including INH and RMP, and between the durations of treatment, for a period of 6 months of more. Conclusion : The combination of FNA cytologic examination and tuberculin skin test may be helpful in the diagnosis of tuberculous lymphadenitis. We propose that the combination of anti-tuberculotic agents, INH, RMP, EMB, and PZA, be prescribed to patients for 6 to 9 months.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.274-282
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• 2003

Background : Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. It was recently reported that the treatment for tuberculous lymphadenitis could be shortened to 6 months without increasing the risk of a relapse. However, there is no report of a prospective randomized study on the use of 6-month chemotherapy with HERZ for cervical lymphadenitis, which is regimen recommended in the areas concerned with the initial drug resistance. The aim of this study is to evaluate the efficacy of the 6-month regimen with HERZ for cervical lymphadenitis in areas where there is a high prevalence of drug resistance in Korea. Method : From January 1997 to February 2002, 92 patients with cervical tuberculous lymphadenitis were recruited from Kyungpook national university hospital. Forty-six patients were given the 6-month regimen(2HERZ/4HER) and the other forty-six patients were given the 9-month regimen(2HERZ/7HER). Result : Of the 46 patients given the 6-month regimen, 5 had residual lymph nodes greater than 5 mm after the completion of treatment and 3 had new lymph nodes or an increased lymph node size during the follow-up period. Of the 46 patients in the 9-month regimen, 9 had residual lymph nodes and 8 had new events during the follow-up period. There were no significant differences between the two groups. Conclusion : These results suggest that the 6-month HERZ regimen can be used safely as the initial treatment for tuberculous lymphadenitis in areas with a similar prevalence of drug resistance.

• Tuberculosis and Respiratory Diseases
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• v.60 no.4
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• pp.426-436
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• 2006

Background : Particulate matters (PM) when inhaled is known to induce pulmonary diseases including asthma and chronic bronchitis when inhaled. Despite the epidemiological proofevidence, the pathogenesis of PM-related pulmonary diseases is unclearremain poorly understood. Methods : Primary alveolar macrophages were harvested from the SPF and inflammatory rats by bronchioalveolar lavage (BAL). The cultured primary alveolar macrophages were treated with the medium only, PM only ($5{\sim}40{\mu}g/cm^2$), LPS (5ng/ml) only, and PM with LPS for 24 and 48 hours. The level of secreted nitric oxide (NO) was assayed from the cultured medium by using the Griess reaction. The cultured cells were utilized for the western blotting against the inducible nitric oxide synthase (iNOS) proteins. Immunocyto- chemical staining against the iNOS and NT-proteins were performed in cells that cultured in the $Lab-Tek^{(R)}$ chamber slide after treatments. Results : The PM that utilizein this experiments induced NO formation with iNOS expression in the cultured SPF and inflammatory rats alveolar macrophages, by itself. When the cells were co-treated with PM and LPS, there was a statistically significant synergistic effect on NO formation and iNOS expression over the LPS effect. The cells from the sham control showed minimal immunoreactivity for the NT-proteins. Significantly higher quantities of NT-proteins were detected in the PM and PM with LPS co-treated cells than from the sham control. Conclusion : Increased iNOS expression and NO formation with increased NT-proteins formation might be involved in the pathogenesis of PM-induced lung injury.