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Evaluation of the influence of a visual design of an examination guide on patient comprehension and testing accuracy (검사 안내문의 시각적 디자인화가 환자의 검사 이해도 및 정확성에 미치는 영향 평가)

  • Kang, Young-Eun;Jung, Woo-Young;Hong, Bo-Ruem
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.29-34
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    • 2019
  • Purpose An examination guide is a useful medium to provide the patient with an overview, pre- and post-test preparation, and precautions of nuclear testing. The design and arrangement of existing written texts and announcements were evaluated to elucidate the comprehension of patients undergoing testing. Materials and Methods Informational material describing bone scanning and $^{201}thallium$ myocardium perfusion single-photon emission computed tomography (SPECT), as a secondary examination, which accounts for the largest portion of gamma imaging at Asan Hospital (Seoul, South Korea), was selected as an improvement target in consultation with a national innovation center. Existing informational material was dispensed to patients scheduled for bone scans from November 2016 to February 2017 and the revised material was issued from March 2017 to May 2017. A survey was conducted of 200 patients who underwent $^{201}thallium$ myocardium perfusion SPECT before and after the revisions (n = 100 each time period) to assess the patients' understanding of the informational material. Results When comparing the use of the conventional vs. revised material, the number of patients who received treatment before bone scanning had decreased from 130 to 60, while the number of those who required additional imaging decreased from 53 to 14. Prior to the revision, 43% of patients underwent testing before preparation and 18% underwent additional testing. The decreased need for additional image acquisition after revision of the informational material resulted in a decrease in acquisition time of about 2 min, from 16.5 to 14.2 min. In the case of $^{201}thallium$ myocardium perfusion SPECT, patient comprehension of all five items surveyed had increased, while the number of patients who had repeatedly asked about various facets of the procedure pre- and post-testing had decreased from 36% to 16% and 31% to 14%, respectively. Conclusion Lower patient comprehension is accompanied by a decrease in image quality due to non-compliance during pre-testing and may lead to repetitive questions from the patient, which may also negatively affect the fatigue and work efficiency of the examiner. Improved readability and visibility of informational material through visualization was correlated with greater patient comprehension as well as improved image quality and acquisition time.

Evolution of Aviation Safety Regulations to cope with the concept of data-driven rulemaking - Safety Management System & Fatigue Risk Management System

  • Lee, Gun-Young
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.345-366
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    • 2018
  • Article 37 of the International Convention on Civil Aviation requires that rules should be adopted to keep in compliance with international standards and recommended practices established by ICAO. As SARPs are revised annually, each ICAO Member State needs to reflect the new content in its national aviation Acts in a timely manner. In recent years, data-driven international standards have been developed because of the important roles of aviation safety data and information-based legislation in accident prevention based on human factors. The Safety Management System and crew Fatigue Risk Management Systems were reviewed as examples of the result of data-driven rulemaking. The safety management system was adopted in 2013 with the introduction of Annex 19 and Chapter 5 of the relevant manual describes safety data collection and analysis systems. Through analysis of safety data and information, decision makers can make informed data-driven decisions. The Republic of Korea introduced Safety Management System in accordance with Article 58 of the Aviation Safety Act for all airlines, maintenance companies, and airport corporations. To support the SMS, both mandatory reporting and voluntary safety reporting systems need to be in place. Up until now, the standard of administrative penal dispensation for violations of the safety management system has been very weak. Various regulations have been developed and implemented in the United States and Europe for the proper legislation of the safety management system. In the wake of the crash of the Colgan aircraft, the US Aviation Safety Committee recommended the US Federal Aviation Administration to establish a system that can identify and manage pilot fatigue hazards. In 2010, a notice of proposed rulemaking was issued by the Federal Aviation Administration and in 2011, the final rule was passed. The legislation was applied to help differentiate risk based on flight according to factors such as the pilot's duty starting time, the availability of the auxiliary crew, and the class of the rest facility. Numerous amounts data and information were analyzed during the rulemaking process, and reflected in the resultant regulations. A cost-benefit analysis, based on the data of the previous 10 year period, was conducted before the final legislation was reached and it was concluded that the cost benefits are positive. The Republic of Korea also currently has a clause on aviation safety legislation related to crew fatigue risk, where an airline can choose either to conform to the traditional flight time limitation standard or fatigue risk management system. In the United States, specifically for the purpose of data-driven rulemaking, the Airline Rulemaking Committee was formed, and operates in this capacity. Considering the advantageous results of the ARC in the US, and the D4S in Europe, this is a system that should definitely be introduced in Korea as well. A cost-benefit analysis is necessary, and can serve to strengthen the resulting legislation. In order to improve the effectiveness of data-based legislation, it is necessary to have reinforcement of experts and through them prepare a more detailed checklist of relevant variables.

A Plan to Activate the Archive of Maeul Communities (마을공동체 아카이브 활성화 방안)

  • Sohn, Dong-you;Lee, Kyoung-juhn
    • The Korean Journal of Archival Studies
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    • no.35
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    • pp.161-206
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    • 2013
  • 'Maeul' is a concept connoting a community. As a place where ordinary people's lives are planned and realized, Maeul is the foundation of their daily lives as well as a place where they work, rest and enjoy pastime activities. In Korea, however, most Maeul communities are dismantled while going though the modern period representing colonization and developmental dictatorship. Growth-oriented industrialization and urbanization turned into such adverse effects as individualization, a sense of loss and a sense of alienation. Recently, through innovations from below, Maeuls are restored, and through Maeul communities restored this way, every Maeul and many researchers carry out activities to build a healthy civil society. This study was conducted on such a background. For a healthy restoration of Maeul communities and a sustainable operation of those communities, it is necessary to establish archives where record the trace of Maeul members' daily lives and relations between those members. The archive of Maeul communities is a place that contains each Maeul's local characteristics as well as human relations as well. It is because this place can be space where Maeul members can record their history, communicate with each other and make a better future. The archive of Maeul communities can be made into various different models, which can be operated by reflecting the identity of a community such as main agents and characteristics, objectives and orientation of objects recorded. Rather than when Maeul communities exist as individuals, they can display more important functions and better effect when they form a network. Therefore, it is needed to provide various and creative methodologies different from the existing government-led record management. Not only on the form of archives, but also all over their functions, such as collection, arrangement, classification, evaluation, management and utilization, Maeul and Maeul residents' norms, orientation and realistic conditions should be thoroughly reflected. Starting from a chance to look back at individuals' lives, the archive of Maeul communities will be a new chapter to restore and build a healthy community in our society and overcome social contradictions from below. Moreover, the archive of Maeul communities has a great significance that it will broaden its prospect creatively with a new paradigm, not only mechanically turning the existing public sector-centered record management into a non-governmental sector.

A Study on the Problems of Eating Habits of Mordern People and Suggesting Alternatives to Overcome Diseases: A Review of the Five Blue Zones, Based on the Roma Linda Region in the USA (현대인의 식습관 문제점 인지와 발생 질병극복을 위한 대안 제시: 5대 블루존 중 미국 로마린다 지역을 중심으로)

  • Shin, Kyung-Ok;Je, Haejong
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.53-62
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    • 2018
  • The purpose of this study was to propose an alternative for the eating habits of modern people and coping with the diseases. The purpose of this study was to apply the principles of eating habits of people living in Roma Linda to modern dietary life and to help healthy life and prevent disease. The period of this study was from May 1, 2016 to February 28, 2018. Literature search was conducted using Pubmed and Korean academic web sites. Based on the recognition of wrong eating habits, we classify and classify diseases according to eating habits. A total of more than 100 papers were selected and 60 papers and a database were prepared. People living in Roma Linda have eight health principles. The Roma Linda practiced balanced nutritional intake, sufficient exercise, adequate water intake, sunlight, temperance (abstinence from alcohol etc.), fresh air, adequate rest, and trust in eating habits. People living in Roma Linda have a high intake of vegetables, fruits and nuts. People living in Roma Linda are educated about nutrition, and among them, there is a low prevalence of coronary heart disease and cancer, because they mostly do not smoke or drink alcohol. Unhealthy eating habits and dietary behavior are associated with many diseases. Many chronic, degenerative diseases are due to bad eating habits and stress. If you take good food habits of people living in the Roma Linda area and practice it steadily, it will have a great effect on disease prevention.

A Study on Calligraphy theory and the Calligraphy and Paintings aesthetic of GangAm, Song Sungyong (강암(剛菴) 송성용(宋成鏞)의 서예관과 서화미학 고찰)

  • Kim, Doyoung
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.4
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    • pp.273-280
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    • 2021
  • GangAm Song Sungyong (1913~1999) was from Gimje, Jeollabuk-do. And he is a calligrapher from the last Confucian scholar of the 20th century and a writer of poetry, calligraphy, and painting. While wearing a topcoat and hanbok for the rest of his life, he approached the study, thought, and calligraphy art of Yoo Jae Song Kimyeon and Kojae Lee Byungeun from the perspective of 'GucheSinyong'. And he kept the philosophical subjectivity that tries to maintain character and a right mind. It was based on 'Guche', which is a faithful succession to the reverence of the old. When I was young, I practiced Mibul and Dong Kichang with Gu Yangsun as the center, and Hwang Jeonggyeon, Hanye, Oh Heejae, and Sojeon typefaces were grafted together during the national exhibition. Then, in 1965 (age 53), he moved to Jeonju, and learned several typefaces such as Chusa typeface on his own, creating a Gangam typeface without any obstacles. And he created 'Sinyong' with Windy Bamboo painting, which embodied strange and unconventional meanings. In addition, he re-established his identity by reexamining the fundamental spirit and natural aesthetics of calligraphy, and based on this, he greatly contributed to expanding the aesthetics of modern calligraphy and painting art by pursuing an aesthetic that explores novelty. In particular, Windy Bamboo painting has strong abstraction based on the principle of 'drawing the will'. And, in terms of discipline, the ethical aesthetic of Express Tao with pictures (畵以載道), which expresses the high level of elegance of observing small things in a big way, based on deep research on the logic of things and fulfilling human nature. By implementing it, Tao and Art become one. The Jeonbuk calligraphy group achieved the greatest prosperity in the Gangam era, and at the end of the 20th century, it entered a period of revival as it established itself as the central calligraphy group of Korean calligraphy.

Aggregate of Korea in 2022 (2022년 한국의 골재)

  • Sei Sun Hong;Jin Young Lee
    • Economic and Environmental Geology
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    • v.56 no.6
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    • pp.871-885
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    • 2023
  • In 2022, the total of 129 million m3 of aggregate was produced in Korea, a slightly decrease from the total production of 2021. Of these, about 44 million m3 of sand and about 84 million m3 of gravel were produced. About 41% of total quantity of aggregates were produced by permission and the rest were produced after declaration. It estimated that of the 129 million m3 of aggregates in Korea in 2022, about 54.9% was produced by screening crushed aggregate, by 32.8% by forest aggregate, 2.2% by land aggregate, 6.2% by marine aggregate and 3.1% by washing aggregate, and 0.3% by river aggregate. This indicates that screening crushed and forest aggregate are the main producers of domestic aggregate in 2022. Leading producing metropolitan governments were Gyeonggi-do, Gyeongsangnam-do, Chungcheongnam-do, Incheon, Jeollanam-do, Chungcheongbuk-do, Gangwon-do, Gyeongsangbuk-do in order decreasing volume. In 2022, aggregates were produced in 147 local governments, and the 10 leading producing local governments were, in descending order of volume, Hwaseong, Pocheon, Paju, Ongjin, Youngin, Gwangju, west EEZ, Incheon Seo-gu, Namyangju, Asan. The combined production of the 10 leading local governments accounted for 31% of the national total. And 44 local governments have produced aggregates of more than 1 million m3 each other. In 148 local governments that produced aggregate, a total of 800 active operations produced aggregate with 350 operations by river, land and forest aggregate, 450 operations by selective crushed and washing aggregate.

Characteristics of Plant Community Structure for Vegetation Management Planning of Bonguisan Neighborhood Park, Chuncheon City (춘천시 봉의산근린공원의 식생관리방안을 위한 식물군집구조 특성 연구)

  • Lee, Eun-Seok;Han, Bong-Ho;Kim Jong Yup;Lee, Hak-Gi
    • Journal of the Korean Institute of Landscape Architecture
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    • v.52 no.1
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    • pp.17-33
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    • 2024
  • This study suggests management planning of Bonguisan Neighborhood Park located on the central of Chuncheon city and highly used for citizen's rest and leisure space utilizing its vegetation structure feature. Bonguisan has been the central of the chuncheon since the period of the Three states in Korean history and consistently damaged, especially in present era, an isolation and sererance of its ecosystem has deepen for indiscreet urban development. The percentage of actual vegetation of Boinguisan Neighborhood Park is as follows: Quercus mongolica is 28.5%, Quercus mongolica - Quercus serrata is 2.1%, Pinus densiflora is 15.6%, Pinus densiflora - Quercus mongolica is 15.9%, Betula schmidtii is 1.6%, Robinia pseudoacacia is 5.9%, Pinus koraiensis is 1.6%. Quercus mongolica is distributed on the southwest, northwest, southeast side of region, Pinus densiflora is distributed on the ridge of east and southeast side of region, Betula schmidtii is distributed on the valley of northeast side region and steep slope region which is on the north side of chungwonsa temple. Pinus densiflora community (Comm. I) and Quercus acutissima - Robinia pseudoacacia community (Comm. V) is expected to undergo succession since it's categorized as Quercus spp. and Quercus mongolica community (Comm. II) and Quercus serrata-Quercus mongolica community (Comm. III), Betula schmidtii community (Comm. IV), Pinus koraiensis community (Comm. VI) is expected to maintain. Also for target vegetation and management planning, Vegetation of Bonguisan Neighborhood Park is classified as 1st Natural landscape conservation and improvement type, 2nd Ecological succession type, 3rd Unusual community conservation type, and 4th Recreation and experience type. And we suggested ecological management measure about each management types. For efficient management of Bonguisan Neighborhood Park, it is need to unify management system of it and after designating Pinus densiflora community and Betula schmidtii community which has high ecological preservation value as an ecological landscape protected area and manage it.

A Study on Forest Insurance (산림보험(山林保險)에 관한 연구(硏究))

  • Park, Tai Sik
    • Journal of Korean Society of Forest Science
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    • v.15 no.1
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    • pp.1-38
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    • 1972
  • 1. Objective of the Study The objective of the study was to make fundamental suggestions for drawing a forest insurance system applicable in Korea by investigating forest insurance systems undertaken in foreign countries, analyzing the forest hazards occurred in entire forests of Korea in the past, and hearing the opinions of people engaged in forestry. 2. Methods of the Study First, reference studies on insurance at large as well as on forest insurance were intensively made to draw the characteristics of forest insurance practiced in main forestry countries, Second, the investigations of forest hazards in Korea for the past ten years were made with the help of the Office of Forestry. Third, the questionnaires concerning forest insurance were prepared and delivered at random to 533 personnel who are working at different administrative offices of forestry, forest stations, forest cooperatives, colleges and universities, research institutes, and fire insurance companies. Fourth, fifty three representative forest owners in the area of three forest types (coniferous, hardwood, and mixed forest), a representative region in Kyonggi Province out of fourteen collective forest development programs in Korea, were directly interviewed with the writer. 3. Results of the Study The rate of response to the questionnaire was 74.40% as shown in the table 3, and the results of the questionaire were as follows: (% in the parenthes shows the rates of response; shortages in amount to 100% were due to the facts of excluding the rates of response of minor respondents). 1) Necessity of forest insurance The respondents expressed their opinions that forest insurance must be undertaken to assure forest financing (5.65%); for receiving the reimbursement of replanting costs in case of damages done (35.87%); and to protect silvicultural investments (46.74%). 2) Law of forest insurance Few respondents showed their views in favor of applying the general insurance regulations to forest insurance practice (9.35%), but the majority of respondents were in favor of passing a special forest insurance law in the light of forest characteristics (88.26%). 3) Sorts of institutes to undertake forest insurance A few respondents believed that insurance companies at large could take care of forest insurance (17.42%); forest owner's mutual associations would manage the forest insurance more effectively (23.53%); but the more than half of the respondents were in favor of establishing public or national forest insurance institutes (56.18%). 4) Kinds of risks to be undertaken in forest insurance It would be desirable that the risks to be undertaken in forest insurance be limited: To forest fire hazards only (23.38%); to forest fire hazards plus damages made by weather (14.32%); to forest fire hazards, weather damages, and insect damages (60.68%). 5) Objectives to be insured It was responded that the objectives to be included in forest insurance should be limited: (1) To artificial coniferous forest only (13.47%); (2) to both coniferous and broad-leaved artificial forests (23.74%); (3) but the more than half of the respondents showed their desire that all the forests regardless of species and the methods of establishment should be insured (61.64%). 6) Range of risks in age of trees to be included in forest insurance The opinions of the respondents showed that it might be enough to insure the trees less than ten years of age (15.23%); but it would be more desirous of taking up forest trees under twenty years of age (32.95%); nevertheless, a large number of respondents were in favor of underwriting all the forest trees less than fourty years of age (46.37%). 7) Term of a forest insurance contract Quite a few respondents favored a contract made on one year basis (31.74%), but the more than half of the respondents favored the contract made on five year bases (58.68%). 8) Limitation in a forest insurance contract The respondents indicated that it would be desirable in a forest insurance contract to exclude forests less than five hectars (20.78%), but more than half of the respondents expressed their opinions that forests above a minimum volume or number of trees per unit area should be included in a forest insurance contract regardless of the area of forest lands (63.77%). 9) Methods of contract Some responded that it would be good to let the forest owners choose their forests in making a forest insurance contract (32.13%); others inclined to think that it would be desirable to include all the forests that owners hold whenerver they decide to make a forest insurance contract (33.48%); the rest responded in favor of forcing the owners to buy insurance policy if they own the forests that were established with subsidy or own highly vauable growing stock (31.92%) 10) Rate of premium The responses were divided into three categories: (1) The rate of primium is to be decided according to the regional degree of risks(27.72%); (2) to be decided by taking consideration both regional degree of risks and insurable values(31.59%); (3) and to be decided according to the rate of risks for the entire country and the insurable values (39.55%). 11) Payment of Premium Although a few respondents wished to make a payment of premium at once for a short term forest insurance contract, and an annual payment for a long term contract (13.80%); the majority of the respondents wished to pay the premium annually regardless of the term of contract, by employing a high rate of premium on a short term contract, but a low rate on a long term contract (83.71%). 12) Institutes in charge of forest insurance business A few respondents showed their desire that forest insurance be taken care of at the government forest administrative offices (18.75%); others at insurance companies (35.76%); but the rest, the largest number of the respondents, favored forest associations in the county. They also wanted to pay a certain rate of premium to the forest associations that issue the insurance (44.22%). 13) Limitation on indemnity for damages done In limitation on indemnity for damages done, the respondents showed a quite different views. Some desired compesation to cover replanting costs when young stands suffered damages and to be paid at the rate of eighty percent to the losses received when matured timber stands suffered damages(29.70%); others desired to receive compensation of the actual total loss valued at present market prices (31.07%); but the rest responded in favor of compensation at the present value figured out by applying a certain rate of prolongation factors to the establishment costs(36.99%). 14) Raising of funds for forest insurance A few respondents hoped to raise the fund for forest insurance by setting aside certain amount of money from the indemnity paid (15.65%); others wished to raise the fund by levying new forest land taxes(33.79%); but the rest expressed their hope to raise the fund by reserving certain amount of money from the surplus money that was saved due to the non-risks (44.81%). 15) Causes of fires The main causes of forest fires 6gured out by the respondents experience turned out to be (1) an accidental fire, (2) cigarettes, (3) shifting cultivation. The reponses were coincided with the forest fire analysis made by the Office of Forestry. 16) Fire prevention The respondents suggested that the most important and practical three kinds of forest fire prevention measures would be (1) providing a fire-break, (2) keeping passers-by out during the drought seasons, (3) enlightenment through mass communication systems. 4. Suggestions The writer wishes to present some suggestions that seemed helpful in drawing up a forest insurance system by reviewing the findings in the questionaire analysis and the results of investigations on forest insurance undertaken in foreign countries. 1) A forest insurance system designed to compensate the loss figured out on the basis of replanting cost when young forest stands suffered damages, and to strengthen credit rating by relieving of risks of damages, must be put in practice as soon as possible with the enactment of a specifically drawn forest insurance law. And the committee of forest insurance should be organized to make a full study of forest insurance system. 2) Two kinds of forest insurance organizations furnishing forest insurance, publicly-owned insurance organizations and privately-owned, are desirable in order to handle forest risks properly. The privately-owned forest insurance organizations should take up forest fire insurance only, and the publicly-owned ought to write insurance for forest fires and insect damages. 3) The privately-owned organizations furnishing forest insurance are desired to take up all the forest stands older than twenty years; whereas, the publicly-owned should sell forest insurance on artificially planted stands younger than twenty years with emphasis on compensating replanting costs of forest stands when they suffer damages. 4) Small forest stands, less than one hectare holding volume or stocked at smaller than standard per unit area are not to be included in a forest insurance writing, and the minimum term of insuring should not be longer than one year in the privately-owned forest insurance organizations although insuring period could be extended more than one year; whereas, consecutive five year term of insurance periods should be set as a mimimum period of insuring forest in the publicly-owned forest insurance organizations. 5) The forest owners should be free in selecting their forests in insuring; whereas, forest owners of the stands that were established with subsidy should be required to insure their forests at publicly-owned forest insurance organizations. 6) Annual insurance premiums for both publicly-owned and privately-owned forest insurance organizations ought to be figured out in proportion to the amount of insurance in accordance with the degree of risks which are grouped into three categories on the basis of the rate of risks throughout the country. 7) Annual premium should be paid at the beginning of forest insurance contract, but reduction must be made if the insuring periods extend longer than a minimum period of forest insurance set by the law. 8) The compensation for damages, the reimbursement, should be figured out on the basis of the ratio between the amount of insurance and insurable value. In the publicly-owned forest insurance system, the standard amount of insurance should be set on the basis of establishment costs in order to prevent over-compensation. 9) Forest insurance business is to be taken care of at the window of insurance com pnies when forest owners buy the privately-owned forest insurance, but the business of writing the publicly-owned forest insurance should be done through the forest cooperatives and certain portions of the premium be reimbursed to the forest cooperatives. 10) Forest insurance funds ought to be reserved by levying a property tax on forest lands. 11) In order to prevent forest damages, the forest owners should be required to report forest hazards immediately to the forest insurance organizations and the latter should bear the responsibility of taking preventive measures.

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Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.27-36
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    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

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Current Status and Transition of the Prevalence of Intestinal Parasitic Infections in Korea (한국(韓國)에 있어서의 장내기생충감염(腸內寄生虫感染)의 현황(現況)과 추이(推移))

  • Kim, Dong-Chan
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.83-108
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    • 1984
  • Out of a total of 58 species of helminthic and protozoan parasitic infections in Korea, so far 38 species were reported as intestinal parasites of man. Quite a few species of the intestinal parasitic infections have long been prevalent throughout the country and this has been a significant public health problem. In this paper, current status and transition of the intestinal parasitic infections in the past years were presented. Chronological reviewing of data show background and prospects of change in the prevalence of infections. In the national prevalence survey on parasitic infections conducted once every five years since 1971, stool examinations were done by both cellophane thick smear and brine flotation techniques. Every egg positive case of Ascaris lumbricoides and Clonorchis sinensis was further examined by Stoll's dilution egg counting technique. In 1981, perianal swab using adhesive cellulose tape was added for Enterobius infection. For protozoan cyst examination conducted by province and city in '81, fecal specimens were fixed in SAF solution and examined by the formalin-ether concentration technique. High prevalence of parasitic infection in ana before the 1960s can be easily understood from the data given by the Ministry of Health and Social Affairs in 1967. From a parasite control point of view, the 1960s was the preparatory period particularly for control of soil-transmitted helminthiasis. Several organizations which have contributed to parasite control were founded in this period and the prevention law of parasitic infections was passed in '66. In the '70s, overall prevalence rates of the common intestinal parasitic infections, which were highly prevalent in the past were turned into reduction phase for the first time. The '80s can be said to be an active control period of parasitic infections. Intestinal helminths According to the reports of the national prevalence survey on parasitic infections, the prevalence of helminthic infections was 84.3%(number of person examined:24,887) in '71, 63.2%(27,178) in '76, and 41.1%(35,018) in '81. By area, the prevalence rate in '81 was 35.1%(20,569) in urban areas and 49.6%(14,447) in rural areas. Intestinal nematodes Ascaris lumbricoides The prevalence of Ascaris infection has decreased significantly in recent years. Among students, the prevalence was 55.4%, in '69 and decreased to 4.7% in '83. In the national prevalence surveys, the prevalence decreased to 13.0% in '81 from 54.9% in '71. By area, the prevalence decreased to 8.5% in '81 from 46.4% in '71 in urban area and 19.4% in '81 from 59.6% in '71 in rural area. By age, the prevalence has become in recent years relatively even in all age groups, although higher prevalence used to be seen in young age groups of around 10 years old, particulary in the highly prevalent rural areas. By sex, the prevalence was higher in the female than in the male. Unfertilized egg positive rates among the ascariasis cases increased gradually up to 55.4% on the average in '81. The intensity of the infection was also significantly decreased. Trichuris trichiura Trichuris infection had also decreased to 23.4% in '81 from 65.4% in '71. By area, the decreasing tendency of the prevalence became faster in urban areas than in the rural areas. The prevalence in urban and rural areas in '71 was 69.7%, and 63.1% respectively and decreased to 19.5% and 29.0% respectively in '81. By age, the prevalence reached a peak at the 10-14 age group and showed relatively even distribution throughout all age groups. By sex, the prevalence was close in young age groups, but in the 30s or over age group, especially in rural area, the prevalence was significantly higher in the female than in the male. The prevalence has much fluctuated depending in the area. The prevalence in rural areas surveyed in the '80s shows a range between 20.9% and 73.7% by locality. It is anticipated that the prevalence of Trichuris infection will drop more rapidly, when mass treatment is conducted. Hookworms Hookworm infection by mostly Ancylostoma duodenale and a few by Necator americanus has decreased to a negligible levels in recent years. In the national prevalence surveys, the prevalence was 10.7% in '71, 2.2% in '76, and 0.5% in '81. The prevalence was higher in rural areas than in urban areas. Wide application of multi-specific anthelminthics in the ascariasis control programmes conducted in the past decade appear to have been effective against hookworm infection. Trichostrongylus orientalis As in the case with hookworm infection, the prevalence of Trichostrongylus infection has reached a negligible levels. In the national prevalence surveys, the prevalence was 7.7% in '71, 1.0% in '76 and 0.2% in '81. Enterobius vermicularis In the national prevalence survey in '81, the egg positive rate was 12.0%. Higher prevalence is expected when examined repeatedly. The prevalence rate was 10.3% in urban area and 14.6% in rural area. In recent surveys conducted in rural areas among schoolchildren, the prevalence was 32.4% in Gimhae Gun in '82 and 64.1% in Yeongyang Gun in '83. By age, the egg positive rate was higher in young age groups of around 10 and sharply decreased in age groups of around 20 and then somewhat increased again in middle age groups. By sex, the prevalence was higher in the female than in the male. Strongyloides stercoralis Strongyloides stercoralis infection has rarely been found in Korea. Three cases were reported in 1914. And 0.1-0.5% were found infected out of 2,642 persons examined at the prisoner-of-war camp on Geojedo in 1956. One case was reported in '54 and '82, respectively. Anisakis spp. No systematic survey has been conducted for anisakiasis In Korea. So far, only several cases have been found 1 case in Seoul in '71, 5 cases in Busan in '81 and 1 case in Busan in '84. Intestinal trematodes Metagonimus yokogawai In the national prevalence survey conducted in 1981, the egg positive rate was 1.24% on the average. High endemic areas are located in the southwestern part of Korea. The prevalence in Hadong Gun was 29.1% on the average in '79. In a survey conducted in 76, the prevalence was 44.0% in Gwangyang, 55.0% in Gogseung and 29.0% in Gurye. The infection is closely correlated with raw sweetfish consumption in these areas. Other intestinal trematodes A human case of Heterophyes heterophyes was reported in 1914. Several species were reported in the '80s : 17 cases of Fibricola seoulensis, 9 cases of Pygidiopsis summa, 8 cases of Heterophyes heterophyes nocens, 1case of Heterophyopsis continua, 2 cases of Stellantchasmus falcatus, 1 case of Stictodora sp., 1 case of Echinostoma hortense, and 4 cases of Echinochasmus japonicus. As the intermediate hosts, snakes and frogs play a role for F.seoulensis and fish for the rest of the species. Intestinal cestodes Taenia saginata and T. solium Egg positive rates in the national prevalence survey were 0.7% in '76 and 1.1% in '81. The prevalence in '81 was 0.6% in urban area and 1.8% in rural area. The proglottid positive rate in Jeju Do was 19.2% on the average. On Udo, Jeju Do in 1983, the egg positive rate among the inhabitants was 2.9%. Hymenolepis nana In the national prevalence survey, egg positive rates were 0.6% in '76 and 0.4% in '81. No difference was seen in the prevalence by area and sex. Hymenolepis diminuta Infected cases were reported : 3 in '64 and I in '66. Egg positive rate in '81 was 0.01% in the national prevalence survey. Diphylobothrium latum So far, about 30 cases have been reported. The cases have been reported more frequently in recent surveys. Mesocestoides sp. A case was reported from a hospitalized patient in Seoul in '67. Spirometra erinacei Two cases were reported in '84 following reidentification of the adult worms collected in '74. Intestinal protozoa Out of a total of 23 species of human protozoan infections in Korea, 13 species were reported as intestinal protozoa : Entamoeba histolytica, E coli, Endolimax nana, Iodamoeba b$\ddot{u}$tschlii, Dientamoeba fragilis, Giardia lamblia, Chilomastix mesnilii, Embadomonas sp., Enteromonas hominis, Trichomonas hominis, Isospora belli, I. Hominis(Sarcocystis hominis), and Balantidium coli. Since the first report on intestinal protozoan infections in 1925, there have been quite a few survey data on the prevalence of the infection. It was found reviewing the data chronologically that up to the early '70s the infection was prevalent around a 30-50%. After that, the protozoan cyst positive rate has shown the tendency of gradual decrease throughout the country. Protozoan cyst survey conducted in Seoul and several provinces in 1981 revealed infection rates of 8.9%(1,310) in Gangweondo, 10.7%(1,703) in Gyenggi Do, 11.7%(1,032) in Jeonra Buk Do, 9.1%(4,116) in Jeonra Nam Do, and 1.4%(5,275) in Seoul. Entamoeba histolytica In the survey conducted by province in '81, the cyst positive rate was 0.8% in Gangweon-do, 0.3% in Gyeonggi Do, 1.4% in both Jeonra Buk Do and Jeonra Nam Do, and 0.2% in Seoul. Giardia lamblia In the survey by province in '81, cyst positive rates were 2.2% in both Gyeonggi Do and Jeonra Buk Do, 1.9% in Jeonra Nam Do, 0.5% in Gangweon Do, and 0.9% in Seoul. Balantidium coli Two cases were reported. One in 1930 and the other in '74. Isospora belli and I. Hominis(Sarcocystis hominis) Isospora belli was reported : 1 case in '56 and 3 cases in '66. I. Hominis, recently identified to be synonymous with Sarcocystis hominis, was reported : 3 cases in '66. Other intestinal protozoa The protozoan parasites other than the above mentioned are generally treated as commensal, although some of them are considered to be pathogenic. The data of '81 show that about 10% of the inhabitants are still infected with protozoa.

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