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Comparative Analysis of Patterns of Care Study of Radiotherapy for Esophageal Cancer among Three Countries: South Korea, Japan and the United States (한국, 미국, 일본의 식도암 방사선 치료에 대한 PCS($1998{\sim}1999$) 결과의 비교 분석)

  • Hur, Won-Joo;Choi, Young-Min;Kim, Jeung-Kee;Lee, Hyung-Sik;Choi, Seok-Reyol;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.83-90
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    • 2008
  • Purpose: For the first time, a nationwide survey of the Patterns of Care Study(PCS) for the various radiotherapy treatments of esophageal cancer was carried out in South Korea. In order to observe the different parameters, as well as offer a solid cooperative system, we compared the Korean results with those observed in the United States(US) and Japan. Materials and Methods: Two hundreds forty-six esophageal cancer patients from 21 institutions were enrolled in the South Korean study. The patients received radiation theraphy(RT) from 1998 to 1999. In order to compare these results with those from the United States, a published study by Suntharalingam, which included 414 patients[treated by Radiotherapy(RT)] from 59 institutions between 1996 and 1999 was chosen. In order to compare the South Korean with the Japanese data, we choose two different studies. The results published by Gomi were selected as the surgery group, in which 220 esophageal cancer patients were analyzed from 76 facilities. The patients underwent surgery and received RT with or without chemotherapy between 1998 and 2001. The non-surgery group originated from a study by Murakami, in which 385 patients were treated either by RT alone or RT with chemotherapy, but no surgery, between 1999 and 2001. Results: The median age of enrolled patients was highest in the Japanese non-surgery group(71 years old). The gender ratio was approximately 9:1(male:female) in both the Korean and Japanese studies, whereas females made up 23.1% of the study population in the US study. Adenocarcinoma outnumbered squamous cell carcinoma in the US study, whereas squamous cell carcinoma was more prevalent both the Korean and Japanese studies(Korea 96.3%, Japan 98%). An esophagogram, endoscopy, and chest CT scan were the main modalities of diagnostic evaluation used in all three countries. The US and Japan used the abdominal CT scan more frequently than the abdominal ultrasonography. Radiotherapy alone treatment was most rarely used in the US study(9.5%), compared to the Korean(23.2%) and Japanese(39%) studies. The combination of the three modalities(Surgery+RT+Chemotherapy) was performed least often in Korea(11.8%) compared to the Japanese(49.5%) and US(32.8%) studies. Chemotherapy(89%) and chemotherapy with concurrent chemoradiotherapy(97%) was most frequently used in the US study. Fluorouracil(5-FU) and Cisplatin were the most preferred drug treatments used in all three countries. The median radiation dose was 50.4 Gy in the US study, as compared to 55.8 Gy in the Korean study regardless of whether an operation was performed. However, in Japan, different median doses were delivered for the surgery(48 Gy) and non-surgery groups(60 Gy). Conclusion: Although some aspects of the evaluation of esophageal cancer and its various treatment modalities were heterogeneous among the three countries surveyed, we found no remarkable differences in the RT dose or technique, which includes the number of portals and energy beams.

Experimental Studies on the Antitumor Effects of Jinryungtang Gagambang Extract (진령탕가감방의 항종양효과(抗腫瘍效果)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Jeong, Jun-Tak;Moon, Goo;Moon, Suk-Jae
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.4 no.1
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    • pp.37-53
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    • 1998
  • The sprig of Jinryungtang Gagambang has been used for curing as a traditional medicine without any experimental evidence to support the rational basis for their clinical use. This experiment was carried out to evaluate the possible therapeutic or antitumoral effects of Jinryungtang Gagambang extract against cancer, and to study some mechanisms responsible for its effect. The cytotoxic and antitumor effects were evaluated on human cell liens (A549, hep3B, Caki-1, Sarcoma 180) after exposure to Jinryungtang Gagambang extract using in ILS, colony forming efficency and SRB assay which were regarded as a valuable method for cytotoxic and antitumor effects of unknown compound on tumor cell lines. The results obtained in this studies were as follows. 1. As a result of exposure to Jinryungtang Gagambang extract, the proliferation of A549, hep3B, Caki-1, good correlations were shown from the results of SRB assay and those of clogenetic assay. 2. The oral administration of Jinryungtang Gagambang extract showed significant effects of increase of MST(mean survival time) and ILS(increased life span) depending on the increasing concentration. 3. Against squamous cell carcinoma induced by MCA, Jinryungtang Gagambang decreased not only the frequency of tumor production but also the number and weight of tumors per tumor bearing mice(TBM). Jinryungtang Gagambang also significantly suppressed the development of 3LL cell-implanted tumors by frequency and their size, and some developed tumors were regressed by the continuous treatment of Jinryungtang Gagambang extract into TBM. 4. Jinryungtang Gagambang extract also increased NK cell activities. According to the above results, it could be suggested that Jinryungtang Gagambang extract has prominent antiutmor effect.

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A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan (일본 '고증파(考證派)' 의학에 관한 연구)

  • Park, Hyun-Kuk;Kim, Ki-Wook
    • Journal of Korean Medical classics
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    • v.20 no.4
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    • pp.211-250
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    • 2007
  • 1. The 'Kao Zheng Pai(考證派) comes from the 'Zhe Zhong Pai' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金娥), Yoshida Koton(吉田篁墩) became central members, and the rise of the methodology of historical research(考證學) influenced the members of the 'Zhe Zhong Pai', and the trend of historical research changed from confucianism to medicine, making a school of medicine based on the study of texts and proving that the classics were right. 2. Based on the function of 'Nei Qu Li '(內驅力) the 'Kao Zheng Pai', in the spirit of 'use confucianism as the base', researched letters, meanings and historical origins. Because they were influenced by the methodology of historical research(考證學) of the Qing era, they valued the evidential research of classic texts, and there was even one branch that did only historical research, the 'Rue Xue Kao Zheng Pai'(儒學考證派). Also, the 'Yi Xue Kao Zheng Pai'(醫學考證派) appeared by the influence of Yoshida Kouton and Kariya Ekisai(狩谷掖齋). 3. In the 'Kao Zheng Pai(考證派)'s theories and views the 'Yi Xue Kao Zheng Pai' did not look at medical scriptures like the "Huang Di Nei Jing"("黃帝內經") and did not do research on 'medical' related areas like acupuncture, the meridian and medicinal herbs. Since they were doctors that used medicine, they naturally were based on 'formulas'(方劑) and since their thoughts were based on the historical ideologies, they valued the "Shang Han Ja Bing Lun" which was revered as the 'ancestor of all formulas'(衆方之祖). 4. The lives of the important doctors of the 'Kao Zheng Pai' Meguro Dotaku(目黑道琢) Yamada Seichin(山田正珍), Yamada Kyoko(山田業廣), Mori Ritsi(森立之) Kitamura Naohara(喜多村直寬) are as follows. 1) Meguro Dotaku(目黑道琢 1739${\sim}$1798) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai, Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 1749${\sim}$1787) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論) and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯) 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai 's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋司"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue", "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Rits(森立之 1807${\sim}$ 1885) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken and later became a pupil of Shou Gu Yi Zhai, a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("神農本草經"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"(神農本草經) and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"("枳園隨筆") that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"("說文解字") to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據). Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬 1804${\sim}$1876) learned scriptures and ancient texts from confucian scholar Asaka Gonsai, and learned medicine from his father Huai Yaun(槐園). He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi" and "Lao Yi Zhi Yan" but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 912-955) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 1755-1810) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi" and "Jin Qui Yao Lue Ji Yi" are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng" is a collection of essays on research. Also there are the "Su Wen Shi"("素問識"), "Ling Shu Shi"("靈樞識"), and the "Guan lu Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 1789-1827), and his works include works of research such as "Nan Jing Shu Jeng"("難經疏證"), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"("疾雅"), "Ming Yi Gong An"("名醫公案"), and "Yi Ji Kao"("醫籍考"). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 1789-1827), Yuan Jian(元堅 1795-1857) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(樂匙). He left about 15 texts, including "Su Wen Shao Shi"("素間紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"(傷寒廣要), and "Zhen Fu Yao Jue"("該腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(失數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', 'the founding of Ji Shou Guan and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai ' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.

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The Morphological Study on Inflammation of Murine Knee Joint by Lipopolysaccharide - Based on the Morphological Changes of Synovial Membrane and Fibrous Membrane - (Lipopolysaccharide로 유발된 생쥐 무릎관절낭 염증에 관한 형태학적 연구 - 윤활관절막과 섬유관절막의 변화를 중심으로 -)

  • Kim, Jin-Tack;Ahn, Sang-Hyun;Choi, Nan-Hee;Chung, Jae-Man;Park, In-Sick;Gang, Yun-Ho;Kim, Ho-Hyun;Lee, Hai-Poong
    • The Journal of Dong Guk Oriental Medicine
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    • v.7 no.2
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    • pp.107-120
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    • 1999
  • Synovial joint of BALB/C mice were injeced with Lipopolysaccharide(LPS) were observed to investigate the morphological changes of synovial capsule caused by rheumatoid arthritis(RA). The RA on female Balb/c mice were induced by LPS injection, as dose of $300{\mu}{\ell}/kg$, into synovial cavity of knee joint. And then these specimen were fixed in 10% neutral buffered formalin and were decalcificated in EDTA solution for 4 weeks. The hyperplasia of synovium were appeared in synovial membrane. The filopodia of phagocytic like synoviocyte(type I synoviocyte) projected into synovial cavity and the number of fibroblast like synoviocyte(type II synoviocyte) with well-developed endoplasmic reticulum were increased in synovium. In fibrous membrane, the fibrosis induced by synthesis of collagen fiber were enlarged to all fibrous membrane, and the number of fibroblast were increased. A great number of inflammation component cell as lymphocyte and neutrophil leukocyte were infiltrated around capillary and the degranulate typed mast cell were increased. As results indicated that the hyperplasia of synovium induced by LPS, subsequently to cause the fibrosis, infiltration of imflammation component cell, and increase of degranulated type mast cell as same as symptoms of RA.

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Identification of Chloride Channels in Hamster Eggs (햄스터 난자에서 존재하는 Chloride 통로)

  • Kim, Y.-M.;Kim, J.-S.;Hong, S.-G.
    • Journal of Embryo Transfer
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    • v.19 no.2
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    • pp.101-112
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    • 2004
  • Chloride($Cl^-$) channels play critical roles in cell homeostasis and its specific functions such as volume regulation, differentiation, secretion, and membrane stabilization. The presence of these channels have been reported in all kinds of cells and even in frog oocytes. These essential role of $Cl^-$­ channels in cell homeostasis possibly play any role in egg homeostasis and in the early stage of development, however, there has been no report about the presence of $Cl^-$­ channel in the mammalian oocyte. This study was performed to elucidate the presence of $Cl^-$­ channels in hamster eggs. When allowing only $Cl^-$­ to pass through the channel of the egg membrane by using impermeant cation such as N-methyl-D-glucamine(NMDG), single channel currents were recorded. These channel currents showed typical long-lasted openings interrupted by rapid flickering. Mean open $time({\tau}o)$ was 43${\pm}$10.14 ms(n=9, at 50 mV). The open probability(Po) was decrease with depolarization. The current-voltage relation showed outward rectification. Outward slop conductance(32${\pm}$5.4 pS, n=22) was steeper than the inward slop conductance(10${\pm}$1.3 pS). Under the condition of symmetrical 140 mM NaCl, single channel currents were reversed at 0 mV(n=4). This reversal potential(Erev) was shifted from 0 mV at 140 mM concentration of internal NaCl(140 mM [Na+]i) to ­9.8${\pm}$0.5 mV(n=4) at 70 mM [Na+]i and 11.5${\pm}$1.9 mV at 280 mM [Na+]i(n=4) respectively, strongly suggesting that these are single $Cl^-$­ channel currents. To examine further whether this channel has pharmacological property of the $Cl^-$­ channel, specific Cl­ channel blockers, IAA-94(Indanyloxyacetic acid-94) and DIDS(4, 4'-diisothiocyan ostillben- 2-2'disulfonic acid) were applied. IAA-94 inhibited the channel current in a dose-dependent manner and revealed a rapid and flickering block. From these electrophysiological and pharmacological resluts, we found the novel $Cl^-$­ channel present in the hamster oocyte membrane. The first identification of $Cl^-$­ channel in the hamster oocyte may give a clue for the further study on the function of $Cl^-$­ channel in the fertilization and cell differentiation.

Displayed Subjects of Practice and Case-Mix of Private Practitioners in Taegu City (개원의의 진료과목표방 및 진료환자 구성)

  • Park, Jae-Yong;Oh, Kang-Jin;Kam, Sin
    • Health Policy and Management
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    • v.2 no.1
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    • pp.42-65
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    • 1992
  • To survey the specialties or sujects of practice displayed by the private practitioners the authors visited 691 clinics in Taegu from April 1 to May 18, 1991, At the same time, a mail questionnaire was administered to ask the number of displayed subjects of practice, and the reasons for displaying the subjects, reasons for not displaying in case of no specialty was displayed, composition of patients, and role as a specialist. The questionnaire was returned by 308(44.6%) practitioners. The distributions of private practitioners by specialty were 13.9% for internal medicine (IM), 11.7% for pediatrics(Ped), 13.0% for obstetrics '||'&'||' gynecology(OBGY), 11.1% for general surgery(GS), 10.0% for family practice(FP), and 5.3% for general practitioner(GP). Ninety percent of the specialists have displayed their specialty in their offices. Among all the private practitioners, 61.9% of them have displayed their subjects of practice and 23.7% have shown telephone number. Among private practitioners who displayed the subjects of practice, 80.6% have signs of 'subjects of practice'. Mean number of the displayed subjects of practice for the all private practitioners is 1.20, and 1.93 for the private practitioners who displayed subjects of practice. FP and GS have displayed their subjects of practice in 91.2% and 87.0% respectively and OBGY have displayed in 32.2%, the lowest percentage among all the soecuaktues. IM specialists displays pediatrics as a major subject of practice in 72.1% the pediatricians display IM in 88.9% the OBGYs display pediatrics in 77.8%, and the GSs display IM in 51.9%. Most commonly displayed subjects of practice are Ped and IM. Sixty-five percent of the private practitioners answered that they don't display their specialties because their clinics are "primary health care facility". The reasons for displaying the subjects of practice and its relevance with their own specialty(45.6%), and the difficulty in clinic management only with the patients for their own specialty(36.9%). The proportion of clinics whose patients of other specialty are than their own specialty accounted less than 10% was 52.8% and that accounted more than 51% was 16.0%. Specially, 51.4% of GS specialists cared more than 51% of patients of other specialty area than their own specialty. Most of the patients of IM, Ped, and OBGY specialists are the patients of their own specialty. However, 56.8% of GS care more of IM patients and only 24.3% of them care mostly GS patients, The respondents to the mail questionnaire who stated that they can not play the role of specialist well are 30.5% and especially 72.9% of the GS specialists state so. The proportion of respondents who do not suffort the private practice of specialists is 71.1%. Among the surgical specialists, 82.7% of them rarely perform operation. The reasons for not performing operation are insufficient insurance fee (76.9%), and risk of operation(58.0%), so as the OBGY specialists. Above finidngs suggest that most of the specialists, especially surgeons, in the private practice can not play their role as a specialist. It is necessary to develop a policy that facilitates the production of practice and the retention of the specialists in the hospitals.s.

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Long-term Survival after CABG in Patients with Abnormal LV Wall Motion after MI (심근경색으로 좌심실 벽 운동장애를 가진 환자들에서 관상동맥 우회술 후 장기생존율)

  • Lee, Mi-Kyung;Choi, Soon-Ho;Choi, Jong-Bum
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.685-692
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    • 2005
  • Background: Wall motion abnormalities may be a significant predictor for long-term survival after coronary bypass surgery (CABG). The aim of this study is to see whether post-infarction wall motion abnormality of left ventricle affect on the long-term survival after CABG. Material and Method: One-hundred and thirty-three patients (male/female, 92/41) undergoing CABG more than 9 years ago were included in this study. Fifty-six patients (M/F, 42/14; mean age, $59.2\pm9.2$ years) with LV wall motion abnormalities were compared to 77 patients (M/F, 50/27; mean age, $58.0\pm7.6$ years) without the wall motion abnormalities. Most patients (112/133, $84.2\%$) had undergone on-pump CABG with the in-situ left internal thoracic artery and free grafts of saphenous vein, in which the proximal and distal anastomoses were done for the single aortic cross-clamping period. Result: Ejection fraction of left ventricle was lower in the group with LV wall motion abnormalities (mean ejection fraction, $48.7\pm13.2\%$) compared to the group without wall motion abnormalities (mean ejection fraction, $57.1\pm10.1\%$)(p=0.0001). Risk­unadjusted survivals after CABG in the group without wall motion abnormalities were $85.7\pm4.0\%,\;76.2\pm4.9\%,\;and\;57.2\pm10.3\%$ at 5, 10, and 13 years, respectively, and in the group with wall motion abnormalities were $80.4\pm5.3\%,\;58.7\pm7.3\%,\;and\;51.9\pm7.9\%$ at 5, 10, and 13 years, respectively (p=0.1). In univariate analysis, predictable factors of long-term survival in the patients with LV wall motion abnormalities were LV ejection fraction and post operative outpatient treatment. In multivariate analysis, predictable factor of long-term survival in the patients with the wall motion abnormalities was postoperative outpatient treatment, and that in those without the wall motion abnormalities was female. Conclusion: Although there was no significant survival difference after CABG between the group with LV wall motion abnormalities and that without wall motion abnormalities, the survival in the group with wall motion abnormalities seems to be more decreased. For the patients with LV wall motion abnormalities after myocardial infarction, the post-CABG outpatient treatment is suggested to be an important factor for the long-term survival.

Outcomes of Treatment for Pathologic Fractures Secondary to Simple Bone Cyst (장관골 단순성 골낭종에 동반된 병적 골절의 치료결과)

  • Jeon, Si-Hyun;Song, Kwang-Soon;Kim, Chul-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.38-44
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    • 2003
  • Purpose: To suggest an appropriate treatment modality regarding analyze outcomes of treatment for pathologic fracture to simple bone cyst of the long bone. Materials and Methods: We selected 12 cases with pathologic fracture of the long bone among the 31 cases treated for simple bone cyst from December. 1993 to May. 2001. The mean age was 9 years ranged from 2 years to 19 years, male was 11 cases and female was 1 cases, and the mean follow up interval was 32.9 month ranged from 12 month to 69 month. The principle of treatment for pathologic fracture of the long bone was conservative treatment except operative treatment for fracture with displacement of the femur. After fracture was united, the residual lesion was treated by local steroid injection, cortical drilling, curettage & bone graft. But we observed without specific treatment in cases that had healing process of simple bone cyst followed by bony union. The clinical results were evaluated as exellent if simple bone cyst was completely healed, as good if that had process of healing, as poor if that was no change or more increased in size. Results: The pathologic fracture was united in all cases treated with conservative treatment in 9cases and by open reduction with internal fixation in 3 cases. After fracture was united, the 6 cases were observed without specific treatment, because they had healing process of cyst, and had outcomes as good and excellent. Conclusion: We suggest to need observation when simple bone cyst has healing process after pathologic fracture was united, otherwise secondary treatment will be needed when residual lesion is persisted.

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Development of the Korean Form of Zung's Self-Rating Anxiety Scale (한국형 자가평가 불안척도의 개발)

  • Lee, Jung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.279-294
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    • 1996
  • This study was carried out to develop a Korean language version of Zung's self-rating anxiety scale(SAS) from august, 1994 to September, 1996. The subjects consisted of 205 normal control subjects from the general population group, and 97 subjects with anxiety disorders. These 97 subjects were chosen from a group by the structured clinical interview for DSM-IV of in patients and out patients. Both normal control subjects and anxiety disorder subjects were drawn utilizing a cluster of sampling methods. In order to analyze the data on anxiety scores, Pearson's product moment correlation coefficient method was carried out, as well as reliability, factor analysis and discriminant function analysis, utilizing the SPSS/PC+ program. The results obtained were as follows: The mean average of the total anxiety scores were 32.36 + 6.35 for the normal control subjects and 50.53 + 7.67 for anxiety disorder subjects. Test-retest reliability(coefficient r=0.98, p < 0.001), and internal consistency(coefficient r=0.96, p < 0.001) were satisfactory. Factor analysis using oblique technique rotation yielded four factors. The normal control subjects scored higher concerning the symptoms such as sweating, restlessness, apprehension, insomnia and dyspnea, and lower for faintness, mental disintegration, paresthesia, dizziness and tremor. On the other hand, for the anxiety disorders, apprehension, restlessness, sweating, dyspnea and insomnia scored higher, and lower for faintness, paresthesia, nightmare, dizziness and tremor.

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A study of conception of pyo(標).bon(本).joong(中) in the part of woongihak(運氣學) in negeong(內徑) (내경(內徑) 운기편(運氣篇)의 표(標).본(本).중(中) 개념에 대한 연구(硏究))

  • Baik, You Sang;Park, Chan-Guk
    • Journal of Korean Medical classics
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    • v.11 no.2
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    • pp.114-134
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    • 1998
  • The conception of pyo(標) bon(本) joong(中) in the part of woongihak(運氣學) of negeong(內徑) one of the important thing that decides the relation between six gi(六氣) and samyum and samyang(三陰三陽) or between each other's of samyum and samyang itself, it says that the relation of Pyo-rce(表裏). So this conception from the ancient times have been used to explain the theory of meridian(經絡) and organs(五臟六腑) and in other important field of oriental medicine - Sanghannon(傷寒論), it became basis of explanation of pcthoiogical principles in the system of six kyung(六徑). At first, the subject or this study is limited to the rament of $\ll$Somun(素問)$\gg$ in order to find the accurate and original meanings of pyo(標) bon(本) joong(中). And the meanings are studied by the way of expanding it's meaning with basic conceptions of woongihak(運氣學) and astronomy included in negeong(內徑). In this study, the results are summarized as the followings. 1. The contents of - the 68th chapter of negeong(內徑), concerning pyo(標) and joong(中) come under chogi(初氣) and joonggi(中氣) of the same chapter, after consideration of astronomical knowledge. And they become active during the period that last about 30days, a haft of one step(一步) of kaekgi(客氣). 2. Bon(本) as a kind of six gi(六氣) that is revealed from internal principle of something, that is to say Ohhaeng(五行), comes mainly under the kaekgi(客氣) of woongihak(運氣學) with the meaning of 'sign' is thai the specific properties of six gi(六氣) are revealed to our sight, so we can feel that through the change of nature, Joong(中) is the other property hidden in the inside of six gi(六氣), that is a portion of original nature(本性) like the bon(本). 3. The relation of pyo(標) and bon(本) is like that bctween the principle hidden inside in all things(理) and it's expression into the real world(氣) also similar to thai of yumyang(陰陽) and ohhaeng(五行). Therefore bon(本), though it means one of the six gi(六氣), hale the property of ohhaeng(五行) and pyo(標) is revealed, with an appearance of samyum-samyang(三陰三陰). 4. pyo(標) and joong(中) are also the both sides of yum(陰) and yang(陰) that revealed under the change of yumyang-ohhaengl(陰陽五行) in the nature. For example, if the one is yang(陰), the other is yum(陰). In the process that the change of all things is revealed out, first the property of pyo(標) appears strongly and then that of joong(中) appears comparatively weakly. But, in spite of the inhibitive relation of yumyang(陰陽), pyo(標) and joong(中) promote each other. 5. Under the course of change. It happens according to the bon(本), the property of ohhaeng(五行) in the case of soyang(少陽) and taeyum(太陰), because the effect of moisture(濕) and fire(火) that makes hyung(形) and gi(氣) is very strong in the universe. In the case of taeyang(太陽) and soyum(少陰), it happens according to the bon(本) and pyo(標) because they hare the polarity of water and fire(火水), at the same time, are not separated each other. In the case of yangmeong(陽明) and gualyum(厥陰), the change appears only according to the joong(中), but not strongly because the phase of yangmeong(陽明) and gualyum(厥陰) is a lull phase processing to the next one.

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