<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

제 7차 교육과정 개정을 위한 가정계 고등학교 교육과정 체제 및 구조 개선 연구

김경애,윤인경,장명희 한국 가정과 교육 학회 1996 한국가정과교육학회지 Vol.8 No.2

This study proposes a model curriculum for Vocational Home Economics High School in the 7th Curriculum Revision. The model in the study is first drawn from the assumptions that reflect ever changing demands of industrial society for Home Economics education. Another perspective employed in the study is historical analysis that focuses on the evolution of the Vocational Home Economics Curricula from the 1st through the 6th revision. This study also employes comparative research tools for the national level comparision such as USA, Japan, Taiwan, and Korea. The proposed model curriculum in this study is concluded from those step-by-step studies as follows: 1) Problem definition and design in current curriculum for Vocational Home Economics high school ; 2) Needs and roles analysis of Vocational Home Economics high school for the future: and 3) Historical analysis of our curriculum revisions in the past and cooparative analysis with other countries. Authors conducted this research project for 3 month period from June 15, 1996 to September 15,1996. During this period, authors collected the data and information through those methods as an extensive literature review, survey and interview, and curriculum specialist conference. The key and critical features of the proposed curriculum in the study are as follows : 1) In the numbers of department, a proposed model curriculum offers 8 as opposed to 6 in the 6th revision, reflecting two additional departments of "Elderly Welfare" and "Cosmotology". 2) In the statement of educational objectives, a model curriculum emphasizes a more concrete statement to each specific skills according to the changing societal needs. 3) In the numbers of total subject matters, there would be 40 in the new as opposed to 23 in the current curriculum. Among these changes, 17 would occur in the newly introduced subject maters while 11 would simply change the subject matter name. Among 40 subject matter, "Introduction to Computer" and "Home Economics in Vocational Education" would be required subject matter. 4) In the total numbers of required unit for graduation in three years, a model offers 86~132 unit A maximum unit for each subject matter would be 12.

高等學校 家政科 敎育의 國際比較 硏究 : 敎育課程을 中心으로 Curriculum Analysis Approach

尹仁卿 한국 가정과 교육 학회 1989 한국가정과교육학회지 Vol.1 No.-

By the comparative analysis of high school Home Economics curricula in the U.S., Japan and Taiwan, this study first attempts to understand the current Home Economics education and to access its trends for each country. Based on the findings of the analysis, the study also seeks to get the major implications of the analysis for the betterment of the Korean Home Economics Education. The main sources of information and data analyzed here are: 1) curricula for both Oklahoma and Ohio state as representatives of the U.S.; 2) Home Economics Teaching Guidelines in Japan; and 3) Home Economics curriculum in Taiwan. Content Analysis technique is applied in this study. The major elements of contents include: 1) structure of the curriculum: 2) subject name; 3) unit(time) allotment; 4) goals ; 5) subject areas and content composition; and 6) other related characteristics for the implementation of the curriculum. Summarized results of the study outline as follows: 1) Home Economics is offered as independently required subject with equal status to mathematics, Science, and Social Studies subject in all three countries; 2) Sex discrimination is prohibited both in the U.S. and Taiwan, while in Japan sex equity is not secured for Home Economics education; 3) Time a allotment for Home Economics in Japan and Taiwan is similiar to that in Korea; 4) Subject area cover such fields as Foods and Nutrtion, Clothing and Textiles, Home Management, and Human Develodment in all three countries, which is similiar to those of Korea. In addition, Consumer Education and Career Education are also covered in the U.S., whereas in Japan Child Care is offered; and 5) Curriculum can be utilized as instructional planning material due to the clear specification of instructional methods, materials, and evaluation methods on the curriculum, especially in the U.S. and Taiwan.

KISE-기초학력검사(KISE-BAAT)개발연구

박경숙,김계옥,송영준,정동영,정인숙 국립특수교육원 2004 연구보고서 Vol.- No.12

본 연구는 학교 학습 특히. 국어와 수학에서 부진을 나타내는 아동을 선별 또는 진단하고, 이들이 부진을 나타내는 영역과 수준을 파악하여 이들의 교육계획 수립과 적용에 필요한 정보를 제공할 수 있는 개인용 기초학력 검사(Korea Institute for Special Education-Basic Academic Achievement Tests KISE-BAAT)의 개발을 위해 기초학력의 개념과 기초학력의 구성요인 등을 탐색하여 KISE-BAAT의 구성모형을 개발한 다음, 그 모형을 토대로 검사문항의 성취기준을 설정하고, 그에 따라 제7차 교육과정의 내용을 토대로 범교과적으로 통용할 수 있는 KISE-BAAT의 검사문항을 개발하였다. 본 연구는 유ㆍ초ㆍ중ㆍ고등학교 및 대학교의 학생 1,499명을 대상으로 KISE-BAAT의 예비검사를 실시하고, 그 결과를 토대로 검사문항의 변별도와 양호도 등을 분석하여 최종 검사문항을 선정하였다. 그리고 본 연구는 KISE-BAAT의 표준화를 위해 전국의 유치원, 초등학교와 중학교에 재학중인 5~l4세의 아동 5,977명을 대상으로 검사를 실시하여 규준의 작성 및 해석에 필요한 기초 통계를 산출하였으며, 신뢰도와 타당도를 검증하였다. 본 연구의 결과를 요약하면 다음과 같다. 첫째, 본 연구는 학력을 기초학력 과 심화학력으로 구성 된다고 가정 하여 심화학력에 의 한 학업성취를 제외한 학업성취를 기초학력으로 규정하고, 만 5세부터 14세까지 아동의 기초학력을 측정하는 개인용 기초학력검사인 KISE-BAAT를 개발하였다. KISE-BAAT는 KISE-BAAT(읽기), KISE-BAAT(쓰기), KISE-BAAT(수학)의 3개 검사로 구성되는 복합심리검사(battery)로서 각각의 소검사는 가형과 나형 2종의 동형검사로 구성되어 교육 프로그램의 사전ㆍ사후효과, 일반화 및 전이효과 측정을 용이하게 하며, 백분위수ㆍ환산점수ㆍ학력지수 학년규준의 제시로 아동의 기초학력의 지체 여부와 정도에 대한 진단과 더불어 교육계획의 수립ㆍ시행 및 평가에 활용할 수 있도록 하였다. 따라서 KISE-BAAT는 학교학습의 도구가 되는 읽기ㆍ쓰기ㆍ수학의 기초학력을 종합적으로 측정할 수 있으며, 결과를 다양하게 분석할 수 있는 개인용 기초학력검사라 할 수 있다. 둘째, KISE-BAAT의 신뢰도를 검증한 결과, 동형검사 신뢰도계수는 KISE-BAAT(읽기) 가형과 나형 .82, KISE-BAAT(쓰기) 가형과 나형 .69, KISE-BAAT(수학) 가형과 나형 .89로 나타났고, 반분신뢰도 계수는 KISE-BAAT(읽기) 가형 .93, 나형 .92, KISE-BAAT(쓰기) 가형 .91, 나형 .94, KISE-BAAT(수학) 가형과 나형 모두 .98로 나타났으며, 문항반응이론 신뢰도 계수는 KISE-BAAT(읽기) 가형과 나형 모두 .90, KISE-BAAT(쓰기) 가형 .99, 나형 .96, KISE-BAAT(수학) 가형 .97,나형 .99로 나타났다. 그리고 측정의 표준오차는 KISE-BAAT(읽기) 가형 .76, 나형 .85, KISE-BAAT(쓰기) 가형 .90, 나형 .92, KISE-BAAT(수학) 가형 2.11, 나형 2.32로 나타났으며, 재검사 신뢰도 계수는 KISE-BAAT(읽기) 가형 과 나형 모두 .96, KISE-BAAT(쓰기) 가형 .95, 나형 .96, KISE-BAAT(수학) 가형과 나형 모두 .98로 나타났으며, 문항의 내적 일치도 계수도 KISE-BAAT(읽기) 가형과 나형 모두 .98, KISE-BAAT(쓰기) 가형과 나형도 모두 .98, KISE-BAAT(수학) 가형과 나형 모두 .99로 나타났다. 따라서 KISE-BAAT의 KISE-BAAT(읽기), KISE-BAAT(쓰기), KISE-BAAT(수학) 가형과 나형은 모두 측정학적으로 아동의 기초학력을 측정하는데 있어 일관된 수치와 정보를 제공해 주는 도구라 할 수 있다. 셋째, KISE-BAAT의 타당도를 검증한 결과, KISE-BAAT(읽기) 가형ㆍ나형과 KEDI-기초학습기능점사 읽기Ⅱ의 상관계수는 각각 .50, .56, KISE-BAAT(쓰기) 가형ㆍ나형과 KEDI-기초학습기능검사 읽기Ⅰ의 상관계수는 각각 .68, .67, KEDI -기초학습기능검사 쓰기와 상관계수는 각각 .51, .68, KISE-BAAT(수학) 가형ㆍ나형과 KEDI-기초학습기능검사 셈하기의 상관계수는 각각 .70, .75로 나타났다. KISE-BAAT와 KEDI-기초학습기능검사는 매우 다른 영역과 내용으로 구성되어 있고, 서로 다른 개념을 기초로 제작된 것이나 두 검사간의 상관계수는 비교적 양호한 상태라 할 수 있다. 그리고 구인 타당도의 한 측면을 나타내는 KISE-BAAT 검사영역 상호간 상관계수는 전체적으로 KISE-BAAT(읽기) 가형이 .23에서 .93을, 나형이 .19에서 .91을 범위로 하고 있으며, KISE-BAAT(쓰기) 가형이 .70에서 .95를, 나형이 .73에서 .95을 범위로 하고 있고, KISE-BAAT(수학) 가형이 .81에서 .94를, 나형이 .83에서 .94를 범위로 하고 있다. 따라서 KISE-BAAT는 개발의 과정에서부터 이루어진 내용 타당도의 확보를 위한 노력 등으로 기초학력을 측정하는데 타당한 도구라 할 수 있다. 따라서 본 연구에서 개발한 KISE-BAAT는 아동들의 읽기ㆍ쓰기ㆍ수학 기초학력을 측정하는 신뢰롭고 타당한 개인용 기초학력검사라 할 수 있다. 그러나 KISE-BAAT는 연구 수행상의 제한점과 함께 앞으로 활용의 과정에서 나타나는 문제점을 계속 수정 보완해야 한다. 뿐만 아니라 KISE-BAAT는 문항 편파성 분석 (item bias analysis)과 일반화 가능도 분석에 대한 연구와 더 폭넓은 타당도 분석을 위해 사고력 검사나 다른 학력검사와 공인타당도 분석 등을 연구해야 한다. 그래야만 KISE-BAAT는 아동의 기초학력을 진단 평가하는데 더욱 유용하고 정교한 검사로 발전해 갈 수 있을 것이다. The purpose of this study is to develop a basic academic achievement test battery, KISE-BAAT(Korea Institute for Special Education-Basic Academic Achievement Tests) which provides information about a student's achievement and performance in reading, writing and math. In order to develop the test battery the concept and construct of basic academic achievement were investigated. Subsequently the framework of the test battery was developed, the achievement standards of test items were established and test items were developed based on the current seventh national curriculum. The item tryout of KISE-BAAT was administered to 1,499 students in grades K, 2, 5, 8, 12 and in college. Item difficulty and discrimination data were obtained. Items were selected by reviewing all data available. The national standardization was administered to 5,977 students in grades K through 9. Data obtained from the standardization test used to develop national norms for the test and reliability and validity of the test. The results of the study is as follows. First, KISE-BAAT, a test battery for an individual, consists of three tests of reading, writing and math. Each test has Form A and Form B. KISE-BAAT is used to assess the achievement of an individual student of age 5 through 14. The data can be used for general instruction, remedial instruction and evaluation of an educational program. Second, Several methods were used to estimate the reliability of KISE-BAAT. Alternate-form reliability coefficient of KISE-BAAT(Reading) is .82, KISE-BAAT(writing) .69, KISE-BAAT(Math) .89. As for Split-half Reliability coefficient of each alternate form of KISE-BAAT(Reading) shows .93 and .92. In KISE-BAAT(writing) .91 and .94 are presented. In KISE-BAAT(Math) .98 in common. Item response theory reliability coefficient of each alternate form of KISE-BAAT(Reading) are .98 in common. In KISE-BAAT(writing) .90 and .92 are presented. In KISE-BAAT(Math) .97 and .99 are presented. The standard error of measurement of each alternate form of KISE-BAAT(Reading) is .76 and .85, for KISE-BAAT(writing) .90 and .92 and for KISE-BAAT(Math) 2.11 and 2.32. Test-retest reliability coefficient of each alternate form of KISE-BAAT(Reading) are .96 in common. In KISE-BAAT(writing) .95 and .96 are presented. In KISE-BAAT(Math) .98 is presented in common. Third, the criterion-related validity of KISE-BAAT in terms of the relationship with KEDI-Basic Academic Ability Test was examined. The validity coefficient of each alternate form of KISE-BAAT(Reading) and Reading II of KEDI-Basic Academic Ability Test showed .50 and .56 repectively. The validity coefficient of each alternate form of KISE-BAAT(Writing) and Reading I of KEDI-Basic Academic Ability Test showed .68 and .67 respectively. Reading I of KEDI-Basic Academic Ability Test was matched to KISE-BAAT(Writing) since it has features of writing ability. The validity coefficient of each alternate form of KISE-BAAT(Reading) and Writing of KEDI-Basic Academic Ability Test showed .51 and .68. The validity coefficient of each alternate form of KISE-BAAT(Math) and Computing of KEDI-Basic Academic Ability Test showed .70 and .75. As for intercorrelation coefficents between subtests KISE-BAAT(Reading) range form .23 to .93. In KISE-BAAT(Writing) from .70 to .96 and in KISE-BAAT(Math) from .81 to .94. Based on all the data mentioned above KISE-BAAT can be said a reliable and valid test battery which assess students' ability in reading, writing and math. However, KISE-BAAT should be modified and complemented in order to compensate its own limitations. Future research on item bias analysis and generalizability needs to be done. Criterion-related validity to examine the relationship with other psychological tests or achievement tests also should be done to validate KISE-BAAT further. Case studies and suggestions from test users will also contribute to improve KISE-BAAT.

Selegiline의 혈관이완반응에 대한 Ginkgo biloba Extract의 영향

김인경,안형수 동덕여자대학교 종합약학연구소 2003 동덕약학연구지 Vol.7 No.-

This research is made to identify the effects of Ginkgo biloba Extract on the vasorelaxation of selegiline which is the MAO_B inhibitor and used in the treatment of ischemic dementia. Investigation was made to find out whether Ginkgo biloba Extract in combined use with selegiline can reduce the orthostatic hypotension caused as side-effect when treated with selegiline alone. And it was tried to identify by what mechanism of action such a vasorelaxation of selegiline was taken place. The isolated rat thoracic aorta was constricted with phenylephrine (10^(-7) M) in organ bath. And it caused the vasorelaxation by injecting graded doses of selegiline (10^(-7)~3×10^(-4) M) to it as controls. The vasorelaxation of disrupted endothelial cell (pD2=4.43±0.13) is more decreased than that of intact endothelial cell (pD2=5.14±0.25). So it meant the endothelium-dependent vasorelaxation. In pretreatment with Nw-Nitro-L-Arginine Methylester·HCl (L-NAME) (10^(-5) M), inhibitor of NO production, the vasorelaxation of selegiline was significantly inhibited compared as that with the control (P<0.05). In pretreatment with indomethacin (10^(-5) M), inhibitor of prostacycline production, there were no effects. And the same result was produced in pretreatment with sulpiride (10^(-5) M), dopamine D₂ antagonist. Accordingly, the vasorelaxation is to be takne place by production and release of NO, not by the increase of dopamine. In pretreatment with Ginkgo biloba Extract (l0^(-5) g/mL), vasorelaxation was significantly inhibited in intact endothelial cell (P<0.01), but no significant inhibition in disrupted endothelial cell. As the experiment of measuring the blood pressure and heart rate of anaesthetized rats, in giving selegiline of 1, 3, 10 mg/kg i.v. as controls, there were temporal decrease of lood pressure and increase of heart rate. In pretreatment with sulpiride (10 mg/kg i.v.), there was significant inhibition compared as that with the control (P<0.05). Pretreatment with Ginkgo biloba Extract (10 mg/kg i.v.) had no significant inhibition. Therefore it shows that the selegiline inhibits the decomposition of dopamine in blood by inhibiting MAO_B only in living body and, as a result, by the increasing dopamine, it causes the relaxation of blood vessel, decrease of blood pressure, and increase of heart rate as the resultant compensatory mechanism. Accordingly, Ginkgo biloba Extract in combined use with selegiline reduces orthostatic hypotension, the virulence of selegiline, by inhibiting vasorelaxation and so it is expected to rise as desirable treatment of ischemic dementia.

오차드그래스(Dactylis glomerata L.)의 품종에 따른 종자유래의 캘러스 형성률과, 캘러스 크기 및 식물체 재분화 효율의 비교

배은경,이인애,김기용,이병현,손대영,이효신,정민섭,조진기 Plant molecular biology and biotechnology research 2002 Plant molecular biology and biotechnology research Vol.2002 No.-

Comparison results of callus formation ratio from seed explants, callus sizes, regeneration ratios from callus and regeneration efficiency [calculated by following formular; callus formation ratio(%) × regeneration ratio(%)/100]for 27 ochardgrass (Dactylis glomerata L.)varieties imported and Hapsung 2 developed in Korea are as follows; 1. Among ochardgrass varieties showing more than 50% callus formation ratios, the descending order of callus formation ratio after bedding the seed explants for 4 weeks was 93>Sparta>Pizza>Condor>Lidaglo>Glorus>Hapsung2>Frode. 2. The callus sizes after bedding for 4 weeks were in the range of φ 0.43cm~4.2cm in which there was 10 times size difference between the largest one and the smallest one but most of them were between φ2.5cm~4cm. 3. The regeneration ratio from callus among varieties were in the range of 0~36% and descending order of the upper 6 varieties was Plano>Akimidori>Justus>Lidacta>Currie>Hall mark. 4. The regeneration efficiency which is calculated by the ratios of regeneration from seed explant numbers was between 0 to 17.4% among which Justus showed the highest value in the 4-week treatment. 5. The correlation between callus formation ratios and the callus sizes, callus formation ratios and regeneration efficiency, and callus sizes and regeneration efficiency were r=0.5765, r=0.6365 and r=0.6246, respectively in 4-week callus and all the correlations were significant on the 1% level. 6. In 6-week callus, the descending order callus formation ratios from seed sxplants for the best 6 varieties was Condor>Sparta>93M>Justus>Potomac>Lidaglo>Frode. 7. The callus sizes formed were between φ1.5~5.7cm in which Sparta, the largest one of φ5.7cm was five times larger than the smallest one. The callus size of the control variety. Hapsung 2 was φ3.8cm, which belonged to larger size. 8. Regeneration ratio showed a great deviation among varieties from 6-week old calli by showing from 0% to 100% in which all the calli were regenerated in Plano while no callus was regenerated in Juno, 9. The range of regeneration effciency was between 0~28% among varieties in which the values from 6-week callus treatment were larger than those from 4-week callus treatment. Especially, the value of Potomac in 6-week was 3 times larger than that in 4-week. 10. The correlation between callus formation ratios and the callus sizes, callus formation ratios and regeneration efficiency, and callus sizes and regeneration effciency were r=0.8369, r=0.6683 and r=0.5937, respectively in 6-week callus, and all the correlations were significant on the 1% level.

일제강점기 초등교육의 본질 : 교육과정 요소를 중심으로 Goals and Objectives, Contents, Teaching Methods, and Evaluations

김경자,김민경,김인전,이경진,김유진 한국초등교육학회 2004 초등교육연구 Vol.17 No.1

이 연구에서는 초등교육의 본질을 탐색하기 위하여 일제강점기 초등교육에 대한 탐구를 하였다. 구체적으로 이 연구에서는 일제 강점기 교육제도, 교육목표, 교과 및 교육내용, 교육방법, 평가, 교원양성 등에 나타난 특수성을 탐구하고, 4차에 걸친 조선교육령 시기에 나타나는 규칙적인 현상을 밝혀보았다. 그리고 연구 결과는 이 연구에서 잠정적으로 전제한 공교육의 이상과 초등교육의 일반성과 관련지어 해석되었고, 이는 다시 현재 진행되고 있는 7차 초등교육과정과 관련하여 어떤 것이 지속되고, 어떤 것이 변화되었는지에 대한 논의로 전개되었다. 가능한 광범위하게 수집한 1차적 사료와 2차적 사료를 교육에 대한 관점별로 범주화하고 연구에서 다루고자 하는 요소별로 정리를 하였다. 필요한 경우, 직접 일제강점기 초등교육을 경험한 사람들을 면접하였다. 연구결과, 일제강점기 초등교육의 목표는 기형적인 "국민"을 길러내는 것이었으며, 이러한 목표를 달성하기 위한 교육내용, 교육방법, 교육평가는 기능적 측면에서 "잘", 효율적으로 기능할 수 있도륵 일관성을 유지하고 있는 것으로 나타났다. 이는 교육적일 수 없는 모순을 내재한 것이 된다. 따라서 일제강점기 초등교육에서 초등교육의 본질을 찾기가 어렵다는 결론을 내릴 수 있다. This research aims to seek the real nature of elementary education by investigating the system in Korea under the rule of Japanese imperialism (1909-1945). Special characteristics are identified in their goals and objectives, contents, teaching methods, and evaluations in elementary education system during the period. Futhermore, some regular phenomena are traced out during the four-time amendments of education rules in the law. Firstly, the results of this study are described in the viewpoint of the ideals in public education, which are tentatively proposed by our authors. Secondly, they are compared and contrasted to the 7th Amended National Curriculum of Korea in terms of the perspectives of curriculum. Some parts in the research are supported by the interviewees who had experienced in the elementary education during the imperialistic period. The result suggests that the system in the colonized period was conducted to cultivate the students who were inappropriate in compared with our ideals in the education. For the goals, the elements of the system in the above were consistently maintained and functionally well-carried out. Therefore, the system was not evaluated as educative intrinsically. Henceforth, the real nature of elementry education would not be drawn in the system during the rule in conclusion.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer

김인아(In Ah Kim),최일봉(Ihl Bhong Choi),강기문(Ki Mun Kang),장지영(Jie Young Jang),문한림(Han Lim Mun),송정섭(Jung Sub Song),이선희(Sun Hee Lee),곽문섭(Mun Sub Kuak),신경섭(Kyung Sub Shinn) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1

목 적 : 국소진행된 III기 비소세포성 폐암에서 방사선감작제로서의 저용량 Cisplatin과 방사선 동시병합요법의 효과를 알아보고자하여, 관해율, 전체생존율, 무병생존율 및 치료에 따른 부작용을 방사선 단독치료군과 후향적으로 비교분석하였다. 대상 및 방법 : 1992년 4월부터 1994년 3월까지 32명의 III기 비소세포성 폐암환자(IIIa 12명, IIIb 20명)가 항암제 및 방사선동시병합요법을 받았다. 방사선치료는 3000cGy/ 10회를 2주간에 걸쳐 시행한 뒤 3주후에 2500cGy/ 10회를 추가하였으며, 방사선감작제로 cis platin 6mg/m2를 매일 방사선치료 전에 정맥주사하였다. 추적관찰기간은 13개월에서 48개월로 중간값은 24개월이었다. 방사선단독치료군 32명(IIIa 13명, IIIb 19명)은 매일 170- 200cGy씩 총 5580- 7000cGy (중간값 5960cGy) 치료받았으며, 추적관찰기간은 36개월에서 105개월로 중간값은 62개월이었다. 결 과 : cis platin- 방사선동시요법군이 방사선 단독치료군에 비해 유의하게 높은완전반응률(18.8% vs . 5.6%)및 낮은 조사야내 재발율(25% vs . 47%)을 나타내었다. 2년 전체생존율은 Cisplatin- 방사선동시요법군이 17%, 방사선단독치료군이 9.4%로 유의한 차이는 보이지 않았다.국소재발 없는 2년 무병생존율(16.5% vs. 5.3%) 및 원격전이 없는 2년 무병생존율(17% vs. 4.6%)도 두군간에 유의한 차이를 보이지 않았다. 그러나 Karnofsky performance scale 80 이상인 환자군만을 대상으로 분석한 결과, cisplatin- 방사선동시요법군이 방사선단독치료군에 비해 유의하게 높은 2년 전체생존율을 보였다(62.5% vs. 15.6%). 전체생존율에 영향을 미치는 예후인자로 cisplatin- 방사선동시요법군에 있어서는 performance status 및 조직학적 진단유형(상피세포암 vs. 비상피세포암)으로 나타났고, 방사선단독치료군에 있어서는 performance status 및 병기(IIIa vs. IIIb)로 나타났다. 치료에 따른 급성부작용으로 RTOG/ECOG grade 2 이상의 오심, 구토는 cisplatin- 방사선동시요법군이 방사선단독치료군 (22% vs. 6%)에 비해 유의하게 높은 빈도를 나타내었다. Gra de 2 이상의 혈액학적 독성은 Cis platin- 방사선동시요법군에서 방사선단독치료군에 비해 높은 빈도를 나타내었다(25% vs. 15.6%). 방사선단독치료군에 비해 cis platin- 방사선동시요법군에서, RTOG/ECOG Grade 2 이상의 폐독성의 빈도(31% vs. 19%)나 WHO Grade 3 이상의 폐섬유화의 빈도(38% vs. 25%)의 유의한 증가는 관찰되지 않았다. 방사선치료부위의 면적이 200cm2 이상이었던 경우, 두군 모두에서 폐독성 빈도의 유의한 증가를 보였다. 결 론 : cisplatin- 방사선동시병합요법이 방사선단독치료군에 비해 높은 국소제어율을 나타내었으나, 전체생존율이나 무병생존율의 유의한 증가는 보이지 않았다. KPS 80이상인 환자군에 있어서는 cisplatin- 방사선동시요법군이 방사선단독군에 비해 높은 전체생존율을 보였다. cisplatin- 방사선동시병합요법군에서 급성부작용이 증가되는 경향을 보였으나, 방사선에 의한 폐독성의 유의한 증가는 관찰되지 않았다. cisplatin- 방사선동시병합요법군이 방사선단독치료군에 비해 1년 이내에 조기사망율이 높은 반면, 2년이상 장기생존율이 높은 경향을 보여, 이러한 환자군에 대한 장기적인 추적조사를 통해 생존율에 대한 본 치료의 영향을 좀더 명확하게 평가할 수 있을것으로 기대되며, 향후 치료효과를 증가시키기위해 large fraction size의 split course RT 대신 continuous course의 conventional RT 혹은 hyperfractionated RT와 Cisplatin의 동시병합요법 등이 고려되어야할 것으로 사료된다. Purpose : This study was tried to evaluate the potential be nefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation thera py alone in stage III non- small cell lung cancer. The end points of analyses were responserate , overalls urvival, 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 (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 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- 200cGy) radiation therapy a lone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months . Results : 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 metastas is (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 pulmona ry 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 s ignificantly 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 performa nce 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 pe rformance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. The refore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

급성 췌장염에서 내시경적 역행성 담췌관 조영술의 임상적 의의

강진경,박인서,송건훈,정재복,송시영,한기준 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.3

The safety of endoscopic retrograde cholangiopancreatography(ERCP) in patients with acute pancreatitis(AP) was confirmed in the past decade. Especially in ease of acute gallstone panereatitis, early ERCP/EST(endoscopic sphincterotomy) may reduce the incidence of complications by removing gallstone which causes acute attack of pancreatitis. To assess clinical usefulness of ERCP/EST in the setting of AP, we reviewed clinical records of 58 patients with AP who had undergone ERCP /EST during the same period of admission. 1) There were thirty-four men and twenty-four women with a mean age of 51.4 (range 14-82). According to the Atlanta classification, forty-two patients were determined to have 'mild' pancreatitis, while the remaining sixteen were determined to have `severe' pancreatitis. 2) The most common indication which urged to perform ERCP was common bile duct(CBD) stones suspected by other imaging reodalities(23 cases). The next common was dilatation of CBD detected on ultrasonography in nine cases. 3) Seven patients received ERCP within 24 hours and seventeen underwent ERCP between the period of 24-72 hours after admission. Therefore 24 patients(41.4%) underuvent ERCP within 72 hours after admission. 4) The rate of visualization of either bile duct(BD) or pancreatic duct(PD) was 93.1 %. There was no significant complication attributable to the procedure itself. 5) In 8 patients(21.1%), pancreatogram revealed chronic pancreatitis. This finding was more commonly encountered in patients who were determined to have 'severe' pancreatitis. Eighteen patients(39.1%) had stones of common bile duct and this was the most common cholangiographic finding. But the incidence of CBD stone was not different between `mild' and 'severe' pancretitis groups. 6) Among various predictors of gallstone panreatitis such as elevated total blirubin, alcalin pbosphatase, gamma-glutamyl transpeptidase and suspected stones on sonography the stones found orb sonography was proceed to be the most sgnificant factor in prediction of gallstaMe pancreatitis(p=0.032). 7) EST was successfully performed in 13 patents without significant procedurerelated complication. 8) In patients who were treated for acute gallstone pancreatitis, there was no significant difference in various clinical paramlters including severity, in-hospital stay, incidence of complication and laboratory indings between the surgery group and the EST group. 9) ERCP was useful in 35 patients(60.3%) by providing diagnostic information or therapeutic modalities. The confirmation and endoscopic removal of CBD stones represented the most part of advantages. In conclusion, we have found ERCP/EST to be a safe and useful modality in both diagnostic and therapeutic aspects for patients with AP. Especially in patients with gallstone pancreatitis, ERCPIEST lave evolved into an important role by early identification and safe removal of gallstone.