The Clinical Efficacy of an Individualized Pulmonary Rehabilitation Program in Patients with Coal-worker Pneumoconiosis / 대한내과학회지

BACKGROUND/AIMS: It is unknown whether pulmonary rehabilitation (PR) is an effective intervention to manage coal-worker pneumoconiosis (CWP). We evaluated the efficacy and safety of an individualized PR program in 53 patients with CWP hospitalized in two medical institutions. METHODS: The PR program consisted of upper and lower extremity exercises to improve exercise endurance and skeletal musculoskeletal strength. All subjects performed treadmill and ergometer exercise with steady loading weights three times/week for 12 weeks. The following tests were performed before and after the study to investigate the efficacy of the PR program: modified Borg scale, pulmonary function test, mid-thigh circumference, maximum muscular strength, 6-min walk distance (6MWD), and the St. George's Respiratory Questionnaire (SGRQ), Korean version. RESULTS: Forty patients (75.5%) completed their PR programs. They improved significantly on the modified Borg scale, mid-thigh circumference, maximum muscular strength, 6MWD (all p < 0.000), and SGRQ (p = 0.007); however, no significant improvement was observed on the pulmonary function test. A significant improvement in dyspnea (p = 0.004) and 6MWD (p = 0.002) was observed in 12 patients with forced expiratory volume in 1 sec < 60%. The PR program with smoking cessation resulted in significantly more improvement on the 6MWD (p < 0.0001) and the SGRQ score (p = 0.002), as compared to those of patients who did not quit smoking. CONCLUSIONS: Our results show that an individualized 12-week PR program improves exercise capacity and quality of life for patients with CWP.

Acute Pulmonary Toxicity and Body Distribution of Inhaled Metallic Silver Nanoparticles

The purpose of this study was to determine the acute pulmonary toxicity of metallic silver nanoparticles (MSNPs, 20.30 nm in diameter). Acute pulmonary toxicity and body distribution of inhaled MSNPs in mice were evaluated using a nose-only exposure chamber (NOEC) system. Bronchoalveolar lavage (BAL) fluid analysis, Western blotting, histopathological changes, and silver burdens in various organs were determined in mice. Mice were exposed to MSNPs for 6 hrs. The mean concentration, total surface area, volume and mass concentrations in the NOEC were maintained at 1.93 x 10(7) particles/cm3, 1.09 x 10(10) nm2/cm3, 2.72 x 10(11) nm3/cm3, and 2854.62 microg/m3, respectively. Inhalation of MSPNs caused mild pulmonary toxicity with distribution of silver in various organs but the silver burdens decreased rapidly at 24-hrs post-exposure in the lung. Furthermore, inhaled MSNPs induced activation of mitogen-activated protein kinase (MAPK) signaling in the lung. In summary, single inhaled MSNPs caused mild pulmonary toxicity, which was associated with activated MAPK signaling. Taken together, our results suggest that the inhalation toxicity of MSNPs should be carefully considered at the molecular level.

Regional Differences in Taste and Food Preferences of College Students Attending Nutritional Education via Internet I. Main and Side Dishes / 대한지역사회영양학회지

The purpose of this study was to investigate the regional differences in food preference among college students participating in a nutrition education program via internet. The subjects were 1672 college students (male: 762, female: 910) and divided into 4 regional groups. A survey using a self-administered questionnaire was conducted using a self-administered questionnaire on taste and food preferences. Data was collected via internet or by mail. Prevalence of the food preferences among regional groups was examined using SPSS statistical package. Food preferences were significantly associated with sex and region. Female students in Chungcheong and Kyungsang areas showed significantly higher preference of the hot taste compared to Seoul and Kyunggi areas. Female students in Seoul, Kyunggi and Chungcheong areas showed significantly higher preference of the boiled bean rice compared to the Kyungsang area. The preference for Kimchi stew of female students in Seoul and Kyunggi was significantly higher than those in Chungcheong and Kyungsang areas. Male students in the Chungcheong area showed significantly higher preferences of the Young radish kimchi, while female students in this area showed significantly higher preference of the Radish kimchi compared to other areas. The preference for roasted laver of female students in Seoul, Kyunggi and Kyungsang areas was significantly higher compared to the Chungcheong area. The preference for fried chicken of male students in Seoul was significantly higher than that in other areas. The preference for bean sprouts and season bonnet bellflower of male students in Seoul, Chungcheong and Kyungsang areas were significantly higher compared to the Kyunggi area. Therefore, these results provide nation-wide information on food preferences among Korean college students.

Supplement Use of Age-Related Chronic Disease Outpatients in Korea

In order to investigate supplement use in middle-aged and elderly outpatients suffering from age-related diseases over the last year, a cross-sectional survey was conducted from July to December 2001. The subjects were 1702 (male 731, female 971) age-related disease outpatients over age 50. Data was collected using a standardized questionnaire and in-person interviews. The prevalence of supplement use and the different categories of supplements taken by the subjects were examined using SPSS statistical package. Supplements were used by 48.9% of the subjects. The mean number of kinds of dietary supplements taken by subjects was 1.7. Chinese medicine was the most commonly used supplements in both the male and female subjects. Among the reasons for using supplements, health promotion ranked as the most common. Most of the supplement users, however, did not know or only knew roughly about the health claims of their supplements. Subjects reported the information source on supplements as family, friends or relatives followed by doctors or pharmacists. These results may provide basic information for proper supplement use among Korean middle-aged and elderly outpatients with age-related diseases.

Clinical Features of Bronchogenic Large Cell Carcinoma Confirmed by Surgical Resection

BACKGROUND: To define the final outcome of large cell carcinomas (LCC) after surgical treatment, the histopathology, clinical features and follow-up results of 28 cases were reviewed. METHODS: Twenty eight patients, with LCC that underwent a surgical resection between 1986 and 2001, at the Severance Hospital, were retrospectively reviewed. We analyzed clinical data, radiological findings, pathologic findings, treatment modalities, and survival. RESULTS: The prevalence of LCC was 2.9% (29 cases) among the surgically resected primary lung cancer cases (1003 cases) during the 15 year period of the study. The mean age of the patients was 59 years old, with 25 male cases. There were 23 smokers, smoking an average of 33 pack years. A cough was the most frequent symptom. There were 15 cases located in the peripheral part of the lung and 26 consisted of a lobulated mass. From a chest CT scan, 26 cases had necrotic portions, which appeared to be low density. The postoperative stages were IA, IB, IIB, IIIA and IV in 1 (3.6%), 11 (39.3%) 8 (28.5%), 7 (25%), 1 case (3.6%), respectively. The concordance rate of the pre- and postoperative stage was 43%. The median survival time and 5 year-survival rate were 54.5 months and 45%, respectively. CONCLUSION: Our results suggested that a LCC in the lung was predominant in males, and equally located at the center and periphery of the lung in the surgically resected cases. To define the treatment outcome and risk factors of a LCC of the lung, further multicenter studies are needed.

Eating Behaviors, Perception of Body Image, Hematological Indices and Nutrient Intake of Adolescent Female Athletes in Incheon / 대한지역사회영양학회지

The purpose of this study was to investigate the eating behaviors, the self-perception of body images, the hematological indices and the nutrient intake of adolescent female athletes in Incheon. The subjects were 112 female athletes (track and field: n = 32, target shooting: n = 27, fencing: n = 29, swimming: n = 14, badminton: n = 10) from middle and high schools in Incheon. This cross-sectional study was conducted by means of a self-administered questionnaire. Fasting blood samples were obtained and analyzed for hemoglobin (Hb), hematocrit (Hct), ferritin, serum iron, mean cor-puscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC) and transferrin saturation (TS). Nutrient intakes obtained by means of the 3 day-recall method were analyzed using the Computer Aided Nutritional Analysis Program. Statistical analysis was conducted using the SPSS 10.0 program. Most of the female athletes had dietary problems such as eating unbalanced meals, skipping meals, and preferences for processed foods. More than 60% of the female athletes skipped breakfast. As for perception of their body images, track and field athletes in particular, controlled their weights significantly better than the other athletes (p < 0.05). With regard to their physical exertion during exercise, 56.3% of the swimmers and 31.3% of the track and field athletes answered "very hard", which was a significant difference (p < 0.001). More than 80% of the female athletes experienced vertigo during exercise (p < 0.01). Also more than 50% of the female athletes, with the exception of the badminton players, had experienced irregular menstruation (p < 0.05). The average serum iron levels (p < 0.05), the serum ferritin levels (p < 0.05) and TS (p < 0.05) of the track and field athletes was significantly lower as compared to that of the other athletes. The nutrient intakes of the female athletes, with the exception of Vitamin B6, niacin and phosphorus were lower than the Korean Recommended Daily Allowances (RDA). In particular, the calcium and iron intakes of the female athletes were under 50% of the Korean RDA. Therefore, proper nutritional education and supplementation are required for female athletes to encourage desirable eating habits, as well as to improve their nutritional status and exercise performances.

Endobronchial Metastasis of Extrapulmonary Malignancies / 결핵

BACKGROUND: The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. METHODS: The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. RESULTS: The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal nodule, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. CONCLUSION: An endobronchial metastasis is an ominous finding, and is associated with advanced-stage disease. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.

Clinical features of bronchogenic large cell carcinoma confirmed by surgical resection / 대한내과학회지

BACKGROUND: To define the final outcome of large cell carcinoma (LCC) after surgical treatment, we reviewed the histopathology, clinical features and follow-up results of 28 cases. METHODS: We retrospectively reviewed 28 patients with LCC who underwent surgical resection during the last 15 years from 1986 to 2001 in Severance Hospital. We evaluated clinical data, radiologic findings, pathologic findings, treatment modalities, and survival. RESULTS: The prevalence of LCC was 2.9% (29 cases) among the surgically resected cases in primary lung cancer (1003 cases) during 15 years. The mean age was 59 years old and twenty five cases were male. There were 23 smokers and the average pack year was 33. The cough was the most frequent symptom. Fifteen cases were located in the peripheral part of the lung. Twenty cases consisted of lobulated mass. In chest CT scan, twenty six cases had necrotic portions which appeared to be lower density. Postoperative stage was IA in 1 case (3.6%), IB in 11 cases (39.3%), IIB in 8 cases (28.5%), IIIA in 7 cases (25%), and IV in 1 case (3.6%). Preoperative and postoperative stage concordance rate was 43%. Median survival time was 54.5 months and 5 year-survival rate was 45%. CONCLUSION: Our results suggest that LCC in the lung is predominant in male and is equally located in the central and peripheral parts of the surgically resected cases. To define the treatment outcome and risk factors of LCC of the lung, further multicenter studies are needed.

Surgical Correction of Microform Cleft Lip by Small Triangular Flap

Cleft lip is one of the most common major facial malformation. The defect of the midline tissue on the upper lip is due to failure of the contact and fusion between mesenchymal tissues of the lip. Microform cleft lip is defined as the cleft of the lip with the minor degree of the deformity on the lip and the nose. The hallmarks of the microform cleft lip are a small notching of the vermilion, a vertical congenital fibrous band extending from the vermilion to the nostril floor, and a displaced alar cartilage on the cleft side. The surgical methods of microform cleft lip include Rose-Thomson straight line closure and Millard Rotation- advancement repair. Although those methods repaired the functional impairment effectively, they failed to achieve the cosmetic improvement because of the long incision scar on the upper lip. The authors applied Tennison's small triangular flap to the microform cleft lips of the 10 patients from July 1998 to January 2001. We excised the scar on the notch of the vermilion with minimal incision using Tennison's small triangular flap and repaired the discontinuity of orbicularis oris musculture. The asymmetric nostrils were also corrected appropriately. We followed up each case with constant intervals and could get good results esthetically without shortening of the upper lip and the contracture of the scar band.

Development and Clinical Application of Critical Pathway for Cleft Lip and Palate

Objectives of this study is to determine the effect of a critical pathway on hospital stays and outcomes after cleft lip and palate repair. During a period of eleven months from March 2000 to January 2001, twenty six cases to applied by critical pathway for cleft lip and palate were followed up. Comparisions were made between the precritical pathway and postcritical pathway groups. The results of this study showed that expenses of treatment for cleft lip and palate was reduced to 20%, 30% respectively, after critical pathway. After critical pathway, hospital stays for cleft lip and palate was reduced to from 7 days to 4 days, from 9 days to 6 days, respectively. Postoperative complications was not increased. Patient satisfactions was increased because of the detailed explanations and reduced hospital stays. Conclusively, significant decreases in length of hospital stay are seen, and cost reductions can be realized after critical pathway.

Nutritional Risk Factors, Perceptions on Nutrition and Health, Nutritional Knowledge, Food Habits and Their Correlation to Supplement Use in Middle-Aged and Elderly Koreans / 대한지역사회영양학회지

The purpose of this study was to investigate nutritional risk factors, perceptions on nutrition and health, nutritional knowledge, flood habits and their correlation to supplement use in middle-aged and elderly Koreans. A nationwide survey was conducted in the metropolitan areas (6 cities) and middle-sized cities (8 cities) of Korea from October to December, 2000. Subjects were randomly selected based on population, and 2,188 non-institutionalized adults aged over 50, and elderly (male 765, female 1,423) were studied. Data were collected using a standardized questionnaire administered in personal interviews. Nutrition and health-related scores of nutritional risk factors, perceptions on nutrition and health, nutritional knowledge, and flood habits were significantly higher in supplement users as compared to non-users. There was a negative correlation between nutritional risk factors and other nutrition and health-related scores on perceptions on nutrition and health, nutritional knowledge, flood habits, and pocket money. Also there was a positive correlation between nutritional risk factors and age. Therefore, these results may provide basic information for proper supplement use by middle-aged and elderly Koreans.

A Comparative Study on the Dietary Attitudes, Dietary Behaviors and Diet Qualities of Food and Nutrition Major and Non-major Female University Students / 대한지역사회영양학회지

The purpose of this study was to compare dietary attitudes, dietary behaviors and diet qualities of Food and Nutrition major and non-major female students at a university located in Inchon. The subjects included 74 female Food and Nutrition majors and 45 non-Food and Nutrition major female university students. This cross-sectional survey was conducted using a self-administered questionnaire, and the data were analyzed by a SPSS 10.0 program. The nutrient intake data collected from Three-day recalls were analyzed by the Computer Aided Nutritional Analysis Program and then the diet quality was estimated using the Mean Adequacy Ratio (MAR), the Nutrient Adequacy Ratio (NAR) and the Index of Nutritional Quality (INQ). There was no significant difference in dietary behaviors between Food and Nutrition majors and non-majors. However, most of the female university students had poor eating habits, such as overeating, unbalanced meals, and skipping of meals. In particular, more than 50% of the female university students skipped breakfast. As for weighing themselves once a week, changing dietary lifestyles, calculating food calories and having interest in information on nutrition and health, the ratio of Food and Nutrition majors was significantly higher as compared to that of the non-majors. There was a significant difference in food consumption frequency except for milk and milk products, and iron-rich foods between the Food and Nutrition majors and non-majors. However, there was a significant difference in the frequency scores of iron-rich foods between the Food and Nutrition majors and non-majors. The MAR of Food and Nutrition majors and non-majors were 0.80 +/- 0.13, 0.79 +/-0.13, respectively. However, in the Food and Nutrition majors and non-majors, the NARs of calcium were 0.61 +/- 0.21 and 0.59 +/-0.20, and that of iron were 0.61 +/-0.21 and 0.59 +/-0.16, respectively, which was extremely low when compared to that of the other nutrients. This result was similar to that of the INQ. Therefore, nutritional education is necessary if female university students are to practice optimal nutrition, including well-balanced diets and eating foods of high nutritional quality.

Comparison of OK-432 and Doxycycline Pleurodesis for Malignant Pleural Effusions Caused by Lung Cancer / 결핵

BACKGROUND: Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleural effusions. PATIENTS AND METHODS: 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan. 1994 and Aug. 2001, were retrospectively reviewed. Resopnses 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. RESULTS: The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). CONCLUSION: with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.

Comparison of OK-432 and Doxycycline Pleurodesis for Malignant Pleural Effusions Caused by Lung Cancer / 결핵

BACKGROUND: Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleural effusions. PATIENTS AND METHODS: 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan. 1994 and Aug. 2001, were retrospectively reviewed. Resopnses 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. RESULTS: The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). CONCLUSION: with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.

A Reconstruction of Upper Lip using Abbe Flap

Reconstruction of upper lip defects presents a challenge to the facial plastic and reconstructive surgeons. Flatness, shortness, and retrusion of the upper lip of cleft patients are caused by a combination of the initial maxillary hypoplasia, the subnormal maxillary growth, and the lack of upper lip soft tissue. Although the routine use of Abbe flaps has been questioned, various modifications of the flap have been used for the repair of deficient upper lip soft tissue. Between 1991 and 2000, the author performed a variety of Abbe flaps in 10 patients. The patients consisted of 5 males and 5 females (3 unilateral clefts, 3 bilateral clefts, 2 cancers and 2 traumas). Mean age at the time of the procedures was 28.5 years (from 16 to 48 years). The pedicles of the flaps were divided 10 to 14 days postoperatively. The follow-up period ranged from 9 to 27 months (mean=17 months). To evaluate the outcome of Abbe flaps objectively, an anthropometic ratio was measured in preoperative and postoperative photographs. This values were compared with the values found in non-cleft patients. Each patient showed a more natural contour of the upper lip. We have found that Abbe flaps were clinically useful, and our results were functionally and cosmetically acceptable. This study indicates that the lips are in better harmony postoperatively than they were preoperatively.

A Study on Supplements Use in the Middle-Aged and Elderly / 대한지역사회영양학회지

In order to investigate the current status of supplements use in the elderly during the last one year, a nationwide survey was conducted in metropolitan areas(6 cities) and middle-sized cities(8 cities). The subjects were 2188(male 765, female 1423) non-institutionalized adults and elderly people aged 50 and over, and information was collected by in-person interviews. Prevalence of supplements use and different types of supplements taken by subjects were examined using SPSS statistical package. Different category of supplements was used by 30.2% of the subjects. On the average, the subjects consumed at least one kind of supplements. Chinese medicine was the most commonly used supplements in both male and female subjects. Among the reasons for using supplements, health promotion ranked the highest, however, most supplement users did not know(35.3%) or knew roughly(48.9%) about the health claims of their supplements. Subjects reported the information source for supplements as family, friends or relatives(43.6%) followed by TV and radio(23.3%). Chinese medicine was most commonly used supplement in male subjects who have chronic diseases(40.7%), and vitamin and mineral supplements were most commonly used by female subjects who have chronic diseases(39.0%). Therefore, these results may provide basic information on different category of supplements used by the middle-aged and elderly,

A Case of Global Aphasia without Hemiparesis

In addition to severe deficits in speech production and auditory comprehension, patients with global aphasia general-ly have a dense hemiplegia. However, acute global aphasia without hemiparesis (GAWH) occurs rarely and only a few cases of GAWH have been reported with variable conclusions regarding lesion localization, etiology, and prognosis. We report an unusual case of GAWH in which magnetic resonance imaging (MRI) and single photon emission comput-ed tomography (SPECT) revealed only a single lesion of the left superior temporal area. Our case supports the notion that the functional anatomy of aphasia may be complex and that GAWH may have a more benign prognosis than typi-cal global aphasia with hemiparesis.

Sympathetic skin response in spinal cord injury patients

No abstract available.

Energy expenditure of the unilateral lower extremity amputees by submaximal treadmill exercise

No abstract available.