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Risk Factor Analysis for Preventing Foodborne Illness in Restaurants and the Development of Food Safety Training Materials (레스토랑 식중독 예방을 위한 위해 요소 규명 및 위생교육 매체 개발)

  • Park, Sung-Hee;Noh, Jae-Min;Chang, Hye-Ja;Kang, Young-Jae;Kwak, Tong-Kyung
    • Korean journal of food and cookery science
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    • v.23 no.5
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    • pp.589-600
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    • 2007
  • Recently, with the rapid expansion of the franchise restaurants, ensuring food safety has become essential for restaurant growth. Consequently, the need for food safety training and related material is in increasing demand. In this study, we identified potentially hazardous risk factors for ensuring food safety in restaurants through a food safety monitoring tool, and developed training materials for restaurant employees based on the results. The surveyed restaurants, consisting of 6 Korean restaurants and 1 Japanese restaurant were located in Seoul. Their average check was 15,500 won, ranging from 9,000 to 23,000 won. The range of their total space was 297.5 to $1322.4m^2$, and the amount of kitchen space per total area ranged from 4.4 to 30 percent. The mean score for food safety management performance was 57 out of 100 points, with a range of 51 to 73 points. For risk factor analysis, the most frequently cited sanitary violations involved the handwashing methods/handwashing facilities supplies (7.5%), receiving activities (7.5%), checking and recording of frozen/refrigerated foods temperature (0%), holding foods off the floor (0%), washing of fruits and vegetables (42%), planning and supervising facility cleaning and maintaining programs of facilities (50%), pest control (13%), and toilet equipped/cleaned (13%). Base on these results, the main points that were addressed in the hygiene training of restaurant employees included 4 principles and 8 concepts. The four principles consisted of personal hygiene, prevention of food contamination, time/temperature control, and refrigerator storage. The eight concepts included: (1) personal hygiene and cleanliness with proper handwashing, (2) approved food source and receiving management (3) refrigerator and freezer control, (4) storage management, (5) labeling, (6) prevention of food contamination, (7) cooking and reheating control, and (8) cleaning, sanitation, and plumbing control. Finally, a hygiene training manual and poster leaflets were developed as a food safety training materials for restaurants employees.

Effects of Hysteroscopic Septotomy on Pregnancy in Patients with History of Infertility or Recurrent Spontaneous Abortion (불임 또는 습관성 유산 환자에서 중격자궁의 치료가 임신에 미치는 영향)

  • Koo, Hwa-Seon;Cha, Sun-Hwa;Yang, Kwang-Moon;Bae, Ju-Youn;Ahn, Hyun-Suk;Han, Ae-Ra;Park, Chan-Woo;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.361-368
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    • 2010
  • Objective: The aim of this study was to evaluate the influences of uterine septum and their elimination on the reproductive outcomes in women who have history of recurrent spontaneous abortion (RSA) and/or infertility. Methods: The medical records of reproductive outcomes in patients who have had history of RSA and infertility who were diagnosed with uterine septum only by hysterosalpingogram (HSG) between January 2008 and December 2009 were retrospectively analyzed. The subjects who have had severe male factor, tubal factors, other uterine factors, endocrine abnormalities, peritoneal factors, and abnormal karyotyping among both partners were excluded. In 27 patients, confirmation of diagnosis by laparoscopy and elimination of uterine septum by trans-vaginal hysteroscopy was done. Seventeen patients were strongly suspected to uterine septum on HSG but tried to get pregnancy without any other procedure for evaluation and management of uterine anomaly. Age matched 42 patients who have history of RSA and/or infertility and diagnosed to normal HSG finding at same period were randomly selected as control. The medical records of reproductive outcomes were analyzed and compared between groups. Results: The mean time of observation after diagnosis was 21.8 months (10 to 32). 55.6% (15/27) of patients in patients who received trans-vaginal hysteroscopic uterine septotomy were success to get pregnancies and was significantly higher than that of 17 patients who did not receive proper management (23.5%, 4/17, p<0.05). In control population, 40.5% (17/42) were success to pregnancies and the differences were not statistically significant compared to both two study groups. The live birth rate which was excluded pregnancy loss by abnormal fetal karyotyping and congenital anomaly were 75% (9/12) in treated septated uterus group and 84.6% (11/13) in control group each which have no statistically significant different. In patients with septated uterus who did not receive proper management showed lower delivery rate (50%, 2/4) than that of other groups but was not statistically significant. Conclusion: According to present data, women with a uterine septum have an increased chance of successful pregnancy with improved obstetric outcome after proper management of the uterine cavity. And these results were showed in patients with no regard to their reproductive history. But, in case of failed to receive proper management, uterine septum can affect not only pregnancy ongoing but successful pregnancy too.

Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer (초기 유방암의 유방 보존수술 후 방사선 치료 결과)

  • Cho, Heung-Lae;Kim, Cheol-Jin;Park, Sung-Kwang;Oh, Min-Kyung;Lee, Jin-Yong;Ahn, Ki-Jung
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.204-212
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    • 2008
  • Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

The Results of Hyperfractionated Radiotherapy on Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포 폐암에 대한 과분할 방사선 치료의 성적)

  • Hur, Won-Joo;Lee, Hyung-Sik;Kim, Jeong-Ki;Choi, Young-Min;Lee, Ho-Jun;Youn-Seon-Min;Kim, Jae-seok;Kim, Hyo-Jin;Woo-Jong-Soo;Choi, Pill-Jo;Lee, Ki-Nam
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.275-282
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    • 1998
  • Purpose : The effect of hyperfractionated radiotherapy on locally advanced non-small lung cancer was studied by a retrospective analysis. Materials & Methods : We analyzed sixty one patients of biopsy-confirmed, IIIA and IIIB non-small cell lung cancer. Using the ECOG performance scale, all the patients were scored less than 2. They were treated by curative hyperfractionated radiotherapy alone from Oct. 1992 to Oct. 1995 at the Department of Radiation Oncology. All the patients received 120cGy b.i.d with more than 6 hours interval between each fraction. The total dose of radiation was reached up to 6400-7080 cGy with a mean dose of 6934 cGy. The results were analyzed retrospectively. Results : The overall survival rate was 53 1$\%$ in 1 year, 9.9$\%$ in 2 years with a median survival time (MST) of 13.9 months. The progression free survival (PFS) rate was 37.0$\%$ in 1 year, 8.9$\%$ in 2 years. Twenty two Patients were classified as complete responders to this treatment and their MST was 19.5 months When this was compared with that of partial responders (MST: 11 7months), it was statistically significant (p=0.0003). Twenty nine patients of stage IIIA showed a better overall survival rate (1yr 63.3$\%$, 2yr 16.8$\%$) than IIIB patients (1yr 43.3$\%$, 2yr 3.6$\%$), which was also statistically significant (p=0.003). Patients with adenocarcinoma showed a better survival rate (1yr 64.3$\%$, 2yr 21.4$\%$) than that of squamous cell counterpart (1yr 49.4$\%$, 2yr 7.4$\%$), although this was not significant statistically (p=0.61). Two patients developed fatal radiation-induced pneumonia right after the completion of the treatment which progressed rapidly and they all died within 2 months. One patient developed radiation-induced fibrosis after 13 months. He refused further treatment and died soon after the development of fibrosis. Conclusion : Among locally advanced NSCLC, hyperfractionated radiotherapy was effective on stage IIIA patients by increasing MST with acceptable toxicities. Acute radiation-induced pneumonia should be carefully monitored and must be avoided during or after this treatment.

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A study on the factors to affect the career success among workers with disabilities (지체장애근로자의 직업성공 요인에 관한 연구)

  • Lee, Dal-Yob
    • 한국사회복지학회:학술대회논문집
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    • 2003.10a
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    • pp.185-216
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    • 2003
  • This study was aimed at investigating important factors influencing career success among regular workers. The current researcher scrutinized the degree to which variables and factors affect the career success and occupational turnover rates of the research participants. At the same tune, two hypothetical path models established by the researcher were examined using linear multiple regression methods and the LISREL. After examining the differences among the factors of career success, a comparison was made between the disabled worker group and the non-disabled worker group. A questionnaire using the 5-point Likert scale was distributed to a group of 374 workers with disabilities and 463 workers without disabilities. For the data analysis purpose, the structural equation model, factor analysis, correlation analysis, and multiple regression analysis were carried out. The results of this study ran be summarized as follows. First, the results of factor analysis showed important categories of conceptual themes of career success. The initial conceptual factor model did not accord with the empirical one. A three-factorial model revealed categories of personal, family, and organizational factor respectively. The personal factor was composed of the self-esteem and self-efficiency. The family factor was consisted of the multi-roles stress and the number of children. Finally, the organizational factor was composed of the capacity for utilizing resources, networking, and the frequency of mentoring. In addition, the total 10 sub areas of career success were divided by two important aspects; the subjective career success and the objective career success. Second, both research participant groups seemed to be influenced by their occupational types. However, all predictive variables excluding the wage rate and the average length of work years had significant impact on job success for the disabled work group, while all the variables excluding the frequency of advice and length of working years had significant impact on job success for the non-disabled worker group. Third, the turnover rate was significantly influenced by the age and the experience of turnover of the research participants. However, the number of co-workers was the strongest predictive variable for the worker group with disabilities, but the occupation choice variable for the worker group without disabilities. For the disabled worker group, the turnover rate was differently influenced by the type of occupation, the length of working years, while multi-role stress and the average working years at the time of turnover for the worker group without disabilities. Fifth, as a result of verifying the hypothetical path model, it showed that the first model was somewhat proper and could predict the career success on both research participant groups. In the second model, the Chi-square, the degree of freedom (($x^2=64.950$, df=61, P=0.341), and the adjusted Goodness of Fit Index (AGFI) were .964, and the Comparative Fit Index (CFI) were .997, and the Root Mean Squared Residual (RMR) was respectively. .038. The model was best fitted and could predict the career success more highly because the goodness of fit index in the whole models was within the allowed range. In conclusion, the following research implications can be suggested. First, the occupational type of research participants was one of the most important variables to predict the career success for both research participant groups. It means that people with disabilities require human development services including education. They need to improve themselves in this knowledge-based society. Furthermore, for maintaining the career success, people with disabilities should be approached by considering the subjective career success aspects including wages and the promotion opportunities than the objective career success aspects.

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Study about the clinical features and Pulmonary function Tst of Endobronchial Tuberculosis (기관지결핵의 임상상 및 폐기능검사에 관한 연구)

  • Chung, Hee-Soon;Lee, Jae-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.147-158
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    • 1996
  • Background : Endobronchial tuberculosis(ET) is known to affect frequently young female and serious complication like bronchial stenosis would occur if early diagnosis and treatment for ET is not performed immediately. But ET shows normal chest roentgenogram in about 10% of patients, and is often confused with bronchial asthma because ET presents clinical features like cough, dyspnea, wheezing in history and physical examination. The pulmonary function test(PFT) feature of ET is not well known, but when we consider the fact that ET is pathophysiologically different from bronchial asthma, if there is any feature of PFT in ET, and we know it, PFT will be very helpful for diagnosis and follow up of ET. Methods : We performed both PFT and bronchoscopy in 68 ET patients who visited Boramae hospital, and were confirmed as ET by bronchoscopic biopsy and were followed prospectively from November 1991 to March 1995. After history taking and physical examination, we performed chest roentgenogram, complete blood count, sputum AFB stain and culture, and also performed PFT before anti-tuberculosis chemotherapy. PFT was classified as restrictive, if only PVC was reduced below 80%, and obstructive, if only FEV1 was reduced below 75%. In the case of both FVC and FEV1 were reduced, PFT was classified as restrictive if FEY1/FVC was greater than 75%, and mixed if FEV1/FVC was reduced below 75%. We repeated the PFT and bronchoscopy for 68 ET patients who were proven by biopsy in the first month and sixth month after starting anti-tuberculosis chemotherapy, and studied the feature and change of PFT of the ET and the relation between PFT and the bronchoscopic finding, and obtained following results. Results: 1) Number of male patients was 12, and that of female patient was 56, and mean age was $35.4{\pm}17yr$.(17-74yr). Clinical symptom was in the order of cough(86.8%), dyspnea(63.2%), fever(17.6%) and hemoptysis (10.3%), and the wheezing and stridor were audible among the 40 patients(58.4%) in the physical examination. 2) Hemoglobin level was below 12g/dl among 25 patients (36.8%), and WBC level was above $10,000/mm^3$ among 9 patients(13.2%) and ESR was above 20 among 46 patients (67.6%) and AFB stain and culture were positive among 50 patients(73.5%). 3) The dominant roentgenographic finding of ET was fibronodular feature in 35 patients(51.5%), pneumonic feature in 14 patients (20.6%), collapse in 11 patients(16.2%), mass-like lesion in 3 patients(4.4%), cavitary lesion in 2 patients(2.9%), and normal in 3 patients(4.4%). 4) PFT feature at the time of diagnosis of ET was normal in 16 patients(23.5%), restrictive pattern in 32 patients (47%), obstructive in 4 patients(5.8%), and mixed in 14 patients(23.5%). So restrictive pattern was the dominate feature of ET. 5) The PFT feature was little correlated with the gross finding of bronchoscopy, but the change of PFT during treatment of ET showed relatively good correlation with the change of bronchoscopic finding. 6) FVC(2.30L vs. 2.61L) and FEV1(1.74L vs. 2.06L) increased significantly (p < 0.01), but FEV1/FVC(82% vs. 83%) and PEF(3.45L/sec vs. 3.95L/sec) did not change significantly after 1 month of treatment (p > 0.01), and there was no significant change among all parameters during first and sixth month of treatment(p > 0.01). Conclusion : PFT may be useful in the diagnosis and treatment follow up of ET but further study would be needed to confirm it.

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The micro-tensile bond strength of two-step self-etch adhesive to ground enamel with and without prior acid-etching (산부식 전처리에 따른 2단계 자가부식 접착제의 연마 법랑질에 대한 미세인장결합강도)

  • Kim, You-Lee;Kim, Jee-Hwan;Shim, June-Sung;Kim, Kwang-Mahn;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.148-156
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    • 2008
  • Statement of problems: Self-etch adhesives exhibit some clinical benefits such as ease of manipulation and reduced technique-sensitivity. Nevertheless, some concern remains regarding the bonding effectiveness of self-etch adhesives to enamel, in particular when so-called 'mild' self-etch adhesives are employed. This study compared the microtensile bond strengths to ground enamel of the two-step self-etch adhesive Clearfil SE Bond (Kuraray) to the three-step etch-and- rinse adhesive Scotchbond Multi-Purpose (3M ESPE) and the one-step self-etch adhesive iBond (Heraeus Kulzer). Purpose: The purpose of this study was to determine the effect of a preceding phosphoric acid conditioning step on the bonding effectiveness of a two-step self-etch adhesive to ground enamel. Material and methods: The two-step self-etch adhesive Clearfil SE Bond non-etch group, Clearfil SE Bond etch group with prior 35% phosphoric acid etching, and the one-step self-etch adhesive iBond group were used as experimental groups. The three-step etch-and-rinse adhesive Scotchbond Multi-Purpose was used as a control group. The facial surfaces of bovine incisors were divided in four equal parts cruciformly, and randomly distributed into each group. The facial surface of each incisor was ground with 800-grit silicon carbide paper. Each adhesive group was applied according to the manufacturer's instructions to ground enamel, after which the surface was built up using Light-Core (Bisco). After storage in distilled water at $37^{\circ}C$ for 1 week, the restored teeth were sectioned into enamel beams approximately 0.8*0.8mm in cross section using a low speed precision diamond saw (TOPMET Metsaw-LS). After storage in distilled water at $37^{\circ}C$ for 1 month, 3 months, microtensile bond strength evaluations were performed using microspecimens. The microtensile bond strength (MPa) was derived by dividing the imposed force (N) at time of fracture by the bond area ($mm^2$). The mode of failure at the interface was determined with a microscope (Microscope-B nocular, Nikon). The data of microtensile bond strength were statistically analyzed using a one-way ANOVA, followed by Least Significant Difference Post Hoc Test at a significance level of 5%. Results: The mean microtensile bond strength after 1 month of storage showed no statistically significant difference between all adhesive groups (P>0.05). After 3 months of storage, adhesion to ground enamel of iBond was not significantly different from Clearfil SE Bond etch (P>>0.05), while Clearfil SE Bond non-etch and Scotchbond Multi-Purpose demonstrated significantly lower bond strengths (P<0.05), with no significant differences between the two adhesives. Conclusion: In this study the microtensile bond strength to ground enamel of two-step self-etch adhesive Clearfil SE Bond was not significantly different from three-step etch-and-rinse adhesive Scotchbond Multi-Purpose, and prior etching with 35% phosphoric acid significantly increased the bonding effectiveness of Clearfil SE Bond to enamel at 3 months.

Long Term Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암 환자에서의 기관지 소매 절제술의 장기 성적)

  • Cho, Suk-Ki;Sung, Ki-Ick;Lee, Cheul;Lee, Jae-Ik;Kim, Joo-Hyun;Kim, Young-Tae;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.917-923
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    • 2001
  • Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

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Epidemiology and Clinical Manifestations of $Henoch-Sch\"{o}nlein$ Purpura in Children (소아 $Henoch-Sch\"{o}nlein$ 자반증의 역학 및 임상양상)

  • Kim Se-Hun;Lee Chong-Guk
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.166-173
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    • 2003
  • Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.

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Evaluation of Radiation Exposure to Nurse on Nuclear Medicine Examination by Use Radioisotope (방사성 동위원소를 이용한 핵의학과 검사에서 병동 간호사의 방사선 피폭선량 평가)

  • Jeong, Jae Hoon;Lee, Chung Wun;You, Yeon Wook;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.44-49
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    • 2017
  • Purpose Radiation exposure management has been strictly regulated for the radiation workers, but there are only a few studies on potential risk of radiation exposure to non-radiation workers, especially nurses in a general ward. The present study aimed to estimate the exact total exposure of the nurse in a general ward by close contact with the patient undergoing nuclear medicine examinations. Materials and Methods Radiation exposure rate was determined by using thermoluminescent dosimeter (TLD) and optical simulated luminescence (OSL) in 14 nurses in a general ward from October 2015 to June 2016. External radiation rate was measured immediately after injection and examination at skin surface, and 50 cm and 1 m distance from 50 patients (PET/CT 20 pts; Bone scan 20 pts; Myocardial SPECT 10 pts). After measurement, effective half-life, and total radiation exposure expected in nurses were calculated. Then, expected total exposure was compared with total exposures actually measured in nurses by TLD and OSL. Results Mean and maximum amount of radiation exposure of 14 nurses in a general ward were 0.01 and 0.02 mSv, respectively in each measuring period. External radiation rate after injection at skin surface, 0.5 m and 1 m distance from patients was as following; $376.0{\pm}25.2$, $88.1{\pm}8.2$ and $29.0{\pm}5.8{\mu}Sv/hr$, respectively in PET/CT; $206.7{\pm}56.6$, $23.1{\pm}4.4$ and $10.1{\pm}1.4{\mu}Sv/hr$, respectively in bone scan; $22.5{\pm}2.6$, $2.4{\pm}0.7$ and $0.9{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. After examination, external radiation rate at skin surface, 0.5 m and 1 m distance from patients was decreased as following; $165.3{\pm}22.1$, $38.7{\pm}5.9$ and $12.4{\pm}2.5{\mu}Sv/hr$, respectively in PET/CT; $32.1{\pm}8.7$, $6.2{\pm}1.1$, $2.8{\pm}0.6$, respectively in bone scan; $14.0{\pm}1.2$, $2.1{\pm}0.3$, $0.8{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. Based upon the results, an effective half-life was calculated, and at 30 minutes after examination the time to reach normal dose limit in 'Nuclear Safety Act' was calculated conservatively without considering a half-life. In oder of distance (at skin surface, 0.5 m and 1 m distance from patients), it was 7.9, 34.1 and 106.8 hr, respectively in PET/CT; 40.4, 199.5 and 451.1 hr, respectively in bone scan, 62.5, 519.3 and 1313.6 hr, respectively in myocardial SPECT. Conclusion Radiation exposure rate may differ slightly depending on the work process and the environment in a general ward. Exposure rate was measured at step in the general examination procedure and it made our results more reliable. Our results clearly showed that total amount of radiation exposure caused by residual radioactive isotope in the patient body was neglectable, even comparing with the natural radiation exposure. In conclusion, nurses in a general ward were much less exposed than the normal dose limit, and the effects of exposure by contacting patients undergoing nuclear medicine examination was ignorable.

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