Background: Mediastinoscopy is generally performed to confirm mediastinal lymph node metastasis in lung cancer patients. It still remains controversial whether mediastinoscopy should be performed in all patients with resectable non-small cell lung cancer (NSCLC). We studied the clinical value of mediastinoscopy in preoperative staging in NSCLC. Material and Method: We retrospectively studied 90 NSCLC patients who underwent radiological evaluation and mediastinoscopy followed by surgical resection from March 2002 to December 2004. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each evaluation method were assessed and compared. Result: Specificity, PPV, NPV, and accuracy of mediastinoscopy were superior to those of radiological evaluation, but there was no significant difference in sensitivity. The sensitivity of mediastinoscopy was 28.6% in 62 patients with radiological N0/1 disease and 72.7% in 28 patients with radiological N2/3 disease. Seven of eight patients in whom positive nodes were not detected by the mediastinoscopy had subcarinal lymph node metastasis. Conclusion: Considering its invasiveness, the difficulty to reach certain node stations, and its low sensitivity in radiological N0/1 disease, mediastinoscopy should be selectively performed in radiological N2/3 disease rather than in all radiological cancer stages.
This study explored how media and interpersonal communication affected voters in Busan mayoral by-election, focusing on the mutual relations among media use and attentive use of political campaign, interpersonal communication, and voting participation. Also, comparative analysis between image factor and the factor of political party influencing the decision of a candidate were examined. Additionally, it was analysed differential media effects on candidates' image. According to the results, the local media use and attentive use of political campaign had the influence on the increase of interpersonal communication about the election. Voters who had much interpersonal discussion with others participated more than voters who had less interpersonal discussion. Media use did not directly affect the participation of voting, but indirectly contributed to participation of voting through interpersonal discussion. The assumption of differential media effects on candidates image was partly proved. There were statistically significant differences in the factor of competence of candidates' image among three experimental groups (attentive use of TV discussion program, Internet web sites of two candidates, and printing materials of political advertisement). Furthermore, with three main vote variables, issues, candidates image, party identification, the results of comparative analysis between image factor and the factor of political party influencing the choice of a candidate suggested that a sense of oneness with a party was highly related to the choice of the candidates of the party, however, candidates' image was not related to the decision of a candidate. Political party had more impact on for whom to vote than candidates' image in this study.
Purpose : As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. Methods : The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. Results : Penile length was $3.02{\pm}0.25cm$ (F=36.467, $R^2=0.180$, P<0.001) when measured with CPLM, and $3.29{\pm}0.26cm$ (F=9.149, $R^2=0.052$, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. Conclusion : In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.
Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.
Chung, Sa Jun;Chung, Hye Jeon;Choi, Young Mi;Cho, Eu Hyun
Clinical and Experimental Pediatrics
/
v.45
no.12
/
pp.1559-1570
/
2002
Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.
An epidemiological study of Metogonimus infection was undertaken along the upper reaches of the Nmhn River, with special consideration on the species (type) of the worms collected from humans. Eggs of Metogonimus spp. were detected from 15 (9.7%) of 154 people examined in Umsong-gun, and from each Infected person (5 cases) 6.015- 24,060 worms (mean 13,2331 were recovered after treatment with praziquantel (10 mg/kg). Eggs were also detected from 37 (48.1% of 77 people In Yongwol-gun, from whom (27 casesl 1-4,965 worms (mean 1,2151 were collected. The worm from Umsong-gun consisted of both Metagonimus Miyata type and Metagonimus takohashii, whereas those from Yongwol-gun consisted of only Metqsonimus Miyata type. When the uterine eggs of the two kinds and M. yokogawoi (obtained from people In Tamjin River basin) were morphologically compared, it was suggested that the egg size should be a good Indicator for discrlmination of the species or type. The source of human Infection was proved to be fresh water fleshes: 49 of 52 Znsco plntvpus examined, 6 of 8 Hemibcrbus loniroskis, 13 of 15 Pseunogobio esuinl:, 4 of 6 Odontobutis obscura intemfptn, and 17 of 18 Corqssiw carassiw were found Infected with Metosonimw metacercariae. From the results, it is concluded that the upper reaches of the Namhan River are endemic foci of Metogonimn Miyata type and M. takahashii.
Purpose: The aim of this study was to evaluate the clinical features and factors contributing to treatment outcome for chronic functional constipation in children. Methods: We analyzed the medical records of patients with constipation, who visited the inpatient or outpatient clinic of the Department of Pediatrics of Pusan National University Hospital, between January 1998 and December 2007. The clinical features, outcomes, and factors affecting the treatment response according to the main drug (lactulose vs. PEG 4000) were analyzed retrospectively. Results: Two hundred forty children (142 males and 98 females) were enrolled in this study. The mean age was 51.2${\pm}$37.9 months. The duration of symptoms was 32.6${\pm}$33.7 months. The accompanying symptoms were as follows: encopresis, 91 (30.4%); abdominal pain, 76 (31.6%); and blood-tinged stool, 37 (15.4%). The treatment response was achieved earlier in females (p<0.001), patients with accompanying symptoms (p<0.05), and patients treated with PEG 4000 (p=0.001). The duration of symptoms (p<0.05) and stool frequency before treatment (p<0.05) were related to a delayed treatment response. Relapse occurred in 7 children, all of whom were treated successfully later. Conclusion: Factors contributing to treatment response are female gender, accompanying symptoms, duration of symptoms, and stool frequency before treatment. PEG 4000 is superior to lactulose in response time and taken into consideration as a primary drug for the treatment of functional constipation of children. Early treatment and sufficient treatment time may also be important factors to achieve an early response and prevent relapse.
Kim, Won-Taek;Nam, Ji-Ho;Kyuon, Byung-Hyun;Wang, Su-Gun;Kim, Dong-Won
Radiation Oncology Journal
/
v.20
no.4
/
pp.295-302
/
2002
Purpose : The Purpose of this study was to establish general guidelines for the treatment of patients with early glottic carcinoma (T1-2N0M0), by assessing the role of primary radiotherapy and by analyzing the tumor-related and treatment-related factors that have an influence on the treatment results. Materials and Methods : This retrospective study was composed of 80 patients who suffered from early glottic carcinoma and were treated by primary radiotherapy at Pusan National University Hospital, between August 1987 and December 1996. The distribution of patients according to T-stage was 66 for stage T1 and 14 for stage T2. All of the patients were treated with conventional radical radiotherapy using a 6MV photon beams, a total tumor dose of $60\~75.6\;Gy$ (median 68.4 Gy), administered in 5 weekly fractions of $1.8\~2.0\;Gy$. The overall radiation treatment time was from 40 to 87 days, median 51 days. All patients were followed up for at least 3 years. Univariate and multivariate analysis was done to identify the prognostic factors affecting the treatment results. Results : The five-years survival rate was $89.2\%$ for all patients, $90.2\%$ for T1 and $82.5\%$ for T2. The local control rate was $81.3\%$ for all patients, $83.3\%$ for T1 and $71.4\%$ for T2. However, when salvage operations were taken into account, the ultimate local control rate was $91.3\%,\;T1\;94.5\%,\;T2\;79.4\%$, reprosenting an increase of $8\~12\%$ in the local control rate. The voice preservation rate was $89.2\%,\;T1\;94.7\%,\;T2\;81.3\%$. Fifteen patients suffered a relapse after radiotherapy, among whom 12 patients underwent salvage surgery. We included T-stage, tumor location, total radiation dose, fraction size, field size and overall radiation treatment time as potential prognostic factors. T-stage and overall treatment time were found to be statistically significant in the univariate analysis, but in the multivariate analysis, only the over-all treatment time was found to be significant. Conclusion : The high cure and voice preservation rates obtained when using a procedure, comprising a combination of radical radiotherapy and salvage surgery, may make this the treatment of choice for patients with early glottic carcinoma. However, the prognostic factors affecting the treatment results must be kept in mind, and more accurate treatment planning and further optimization of the radiation dose are necessary.
Even after the Constitutional Court decided on August 23, 2012 that the provisions of abortion were constitutional, discussions on the abolition of abortion continued. The controversy about abortion is not only happening recently, but it has already existed since the time when the Penal Code was enacted, and it shares the history of modern legislation with the Republic of Korea. Legislators whom submitted amendment while insisting upon the eradication of abortion in the process of enacting criminal law at that time, presented social and economic adaptation reasons as the core reason. From then on, the abolition of abortion has been discussed during the development dictatorship, but this was not intended to guarantee women's human rights, but it was closely connected to the national policy projects of "Contraception" and "Family Planning" of the Park's dictatorship. Since then, the enactment of the Mother and Child Health Law, which restrictively allow artificial abortion, was held on February 8, 1973, in an emergency cabinet meeting that replaced the legislative power after the National Assembly was disbanded. It became effected May 10th. The reason behind the Mother and Child Health Law that included legalization of abortion in part was that the Revitalizing Reform at that time did not allow any opinion, so it seem to be it was difficult for the religious to express opposition. The "Maternal and Child Health Law" enacted in this way has been maintained through several amendments. It can be seen that the question of maintenance of abortion has been running on parallel lines without any significant difference from the time when the Penal Code was enacted. On August 23, 2012, the Constitutional Court decided that the Constitutional Opinion and the unonstitutional Opinion were 4: 4. However, it was decided by the Constitution without satisfying the quorum for unconstitutional decision of the Constitutional Court. This argument about abolition of abortion is settled for the the time being with the decision of the constitutional inconsistency of the Constitutional Court, and now, the National Assembly bears the issue of new legislation. In other words, the improved legislation must be executed until December 31, 2020, and if the previous improved legislation is not implemented, the crime of abortion (Article 269, Paragraph 1, Article 270 of the Criminal Code) Article 1 (1) will cease to be effective from 1 January 2021. Therefore, in the following, we will look into the reason of the Constitutional Court's constitutional discordance adjudication on criminal abortion(II), and how it structurally differs from the previous Constitutional Court and the Supreme Court. After considering key issues arised from the constitutional discordance adjudication(III), the legislative direction and within the scope of legislative discretion in accordance with the criteria presented by the Constitutional Court We reviewed the proposed revisions to the Penal Code and the Mather and Child Health Act of Korea(IV).
Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.
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