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성인원외폐렴의 원인미생물에대한 전향적 다기관 연구 : 성인원외폐렴의 원인으로 세균의 역할을 중심으로
우준희,강재명,김양수,신완식,류진홍,최정현,김양리,정희진,어수택,박춘식,정문현,정기석,이찬주,류지소 대한감염학회 2001 감염 Vol.33 No.1
Background : Communite-acquired peumonia (CAP) is one of the leading causes of mortality and morbidity. Despite progress in diagnostic techniques and treatments, management of pneumonia remains challenging, because the precise etiology remains uncertain in as many as 49% of cases. The limitaions of identifying etiologic agents make it necessary to use empiric antibiotics in almost all patients, and furthermore emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric antibiotic regimen. For the optimal choice of empirical antibiotics, we should know the frequency of etiologic agents and antimicrobial resistance rates in the community. Methods : A prospective multicenter study of community-acquired pneumonia in Korea was carried out between May 1997 and April 2000. The microbiologic diagnosis was based on the results of sputum culture, blood culture and pleural culture. Results : Five hundred eighty eight cases of community-acquired peumonia in 562 patients admitted to the hospitals. The mean age was 59.9 with male predominance (58.3%), and 370 (63%) had underlyin gillness. The etiologic agents were identified in 38.3%, and the list of individual agents, in decreasing order, was Streprococcus pneumoniae (21.7%), Klebsiella pneumoniae (14.8%) Pseudomonas aeruginosa (9.8%), Staphylococcus aureus (9.5%), viridans group streptococci (5.7%), Enterobacter cloacae (4.2%), Hemophillus Influenza (3.8%), The rates of admission to the intensive care unit was 10.4%. The motality was 7.1%. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Forty percents of S. aureus were methicillin-resistant S. aureus. K. penumoniae were susceptible to cephalosporin and quinolone. Conclusion : In Korea, S.pneumoniae is the most important agent causing community-acquired pneumonia. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Gram negative bacteria such as K. pneumoniae, P. aeruginosa showed high incidence when compared with that of other countries. Most of them had underlying diseases including bronchiectasis and chronic obstructive pulmonary diseases. (Korean J Infect Dis 33:1∼7, 2001)
Jung, Sang Hoon,Yoon, Sang Min,Park, Sung Ho,Cho, Byungchul,Park, Jae Won,Jung, Jinhong,Park, Jin-Hong,Kim, Jong Hoon,Ahn, Seung Do The American Association of Physicists in Medicine 2013 Medical physics Vol.40 No.1
<P>In order to evaluate the dosimetric impact of respiratory motion on the dose delivered to the target volume and critical organs during free-breathing radiotherapy, a four-dimensional dose was evaluated using deformable image registration (DIR).</P>
Postoperative radiotherapy for ependymoma
Jung, Jinhong,Choi, Wonsik,Ahn, Seung Do,Park, Jin Hong,Kim, Su Ssan,Kim, Young Seok,Yoon, Sang Min,Song, Si Yeol,Lee, Sang-Wook,Kim, Jong Hoon,Choi, Eun Kyung The Korean Society for Radiation Oncology 2012 Radiation Oncology Journal Vol.30 No.4
Purpose: To evaluated the patterns of failure, survival rate, treatment-related toxicity and prognostic factors in postoperative radiotherapy of patients with ependymoma. Materials and Methods: Thirty patients who underwent surgery and postoperative radiotherapy for ependymoma between the period of June 1994 and June 2008 were reviewed retrospectively. The age of patients ranged from 21 months to 66 years (median, 19 years). Seventeen patients had grade II ependymoma, and 13 had grade III anaplastic ependymoma according to the World Health Organization grading system. The postoperative irradiation was performed with 4 or 6 MV photon beam with median dose of 52.8 Gy (range, 45 to 63 Gy), and radiation field including 2 cm beyond the preoperative tumor volume. Median follow-up period was 51 months (range, 12 to 172 months). Results: Fourteen out of 30 (46.7%) patients experienced recurrence, and 12 of those died. Among those 14 patients who experienced recurrence, 11 were in-field and 3 were out-of-field recurrence. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66.7% and 56.1%, respectively. On univariate analysis, tumor grade was a statistically significant prognostic factor for OS and PFS. There were two complications after surgery and postoperative radiotherapy, including short stature and facial palsy on the left side. Conclusion: We observed good survival rates, and histologic grade was a prognostic factor affecting the OS and PFS. Almost all recurrence occurred in primary tumor site, thus we suggest further evaluation on intensity-modulated radiotherapy or stereotatic radiosurgery for high-risk patients such as who have anaplastic ependymoma.
Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer
Jung, In-Hye,Song, Si Yeol,Jung, Jinhong,Cho, Byungchul,Kwak, Jungwon,Je, Hyoung Uk,Choi, Wonsik,Jung, Nuri Hyun,Kim, Su Ssan,Choi, Eun Kyung The Korean Society for Radiation Oncology 2015 Radiation Oncology Journal Vol.33 No.2
Purpose: To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS). Materials and Methods: From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21. Results: The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression. Conclusion: The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.
Jung, Jinhong,Yoon, Sang Min,Kim, So Yeon,Cho, Byungchul,Park, Jin-hong,Kim, Su Ssan,Song, Si Yeol,Lee, Sang-wook,Ahn, Seung Do,Choi, Eun Kyung,Kim, Jong Hoon BioMed Central 2013 Radiation oncology Vol.8 No.-
<P><B>Background</B></P><P>To investigate the clinical and dose–volumetric parameters that predict the risk of radiation-induced liver disease (RILD) for patients with small, unresectable hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).</P><P><B>Methods</B></P><P>Between March 2007 and December 2009, 92 patients with HCC treated with SBRT were reviewed for RILD within 3 months of completing treatment. RILD was evaluated according to the Common Terminology Criteria for Adverse Events, version 3.0. A dose of 10–20 Gy (median, 15 Gy) per fraction was given over 3–4 consecutive days for a total dose of 30–60 Gy (median, 45 Gy). The following clinical and dose–volumetric parameters were examined: age, gender, Child-Pugh class, presence of hepatitis B virus, gross tumor volume, normal liver volume, radiation dose, fraction size, mean dose to the normal liver, and normal liver volumes receiving from < 5 Gy to < 60 Gy (in increments of 5 Gy).</P><P><B>Results</B></P><P>Seventeen (18.5%) of the 92 patients developed grade 2 or worse RILD after SBRT (49 patients in grade 1, 11 in grade 2, and 6 in ≥ grade 3). On univariate analysis, Child-Pugh class was identified as a significant clinical parameter, while normal liver volume and normal liver volumes receiving from < 15 Gy to < 60 Gy were the significant dose–volumetric parameters. Upon multivariate analysis, only Child-Pugh class was a significant parameter for predicting grade 2 or worse RILD.</P><P><B>Conclusions</B></P><P>The Child-Pugh B cirrhosis was found to have a significantly greater susceptibility to the development of grade 2 or worse RILD after SBRT in patients with small, unresectable HCC. Additional efforts aimed at testing other models to predict the risk of RILD in a large series of HCC patients treated with SBRT are needed.</P>
Postoperative radiotherapy for ependymoma
Jinhong Jung,Wonsik Choi,Seung Do Ahn,Jin Hong Park,Su Ssan Kim,Young Seok Kim,Sang Min Yoon,Si Yeol Song,Sang-Wook Lee,Jong Hoon Kim,Eun Kyung Choi 대한방사선종양학회 2012 Radiation Oncology Journal Vol.30 No.3
Purpose: To evaluated the patterns of failure, survival rate, treatment-related toxicity and prognostic factors in postoperative radiotherapy of patients with ependymoma. Materials and Methods: Thirty patients who underwent surgery and postoperative radiotherapy for ependymoma between the period of June 1994 and June 2008 were reviewed retrospectively. The age of patients ranged from 21 months to 66 years (median, 19 years). Seventeen patients had grade II ependymoma, and 13 had grade III anaplastic ependymoma according to the World Health Organization grading system. The postoperative irradiation was performed with 4 or 6 MV photon beam with median dose of 52.8 Gy (range, 45 to 63 Gy), and radiation field including 2 cm beyond the preoperative tumor volume. Median follow-up period was 51 months (range, 12 to 172 months). Results: Fourteen out of 30 (46.7%) patients experienced recurrence, and 12 of those died. Among those 14 patients who experienced recurrence, 11 were in-field and 3 were out-of-field recurrence. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66.7% and 56.1%, respectively. On univariate analysis, tumor grade was a statistically significant prognostic factor for OS and PFS. There were two complications after surgery and postoperative radiotherapy, including short stature and facial palsy on the left side. Conclusion: We observed good survival rates, and histologic grade was a prognostic factor affecting the OS and PFS. Almost all recurrence occurred in primary tumor site, thus we suggest further evaluation on intensity-modulated radiotherapy or stereotatic radiosurgery for high-risk patients such as who have anaplastic ependymoma.
Technical Analysis of Clearwell in Water works using CF
Jinhong Jung,Gyewoon Choi 보안공학연구지원센터 2016 International Journal of u- and e- Service, Scienc Vol.9 No.3
The purpose of this study was to evaluate retention time distribution and flow line clearwell in water works using computational fluid dynamics. With the finite volume method using the computational fluid dynamics (CFD), a technical diagnosis of clearwell in the water purification process was performed using an unstructured hexahedral grid system. A vector simulation showed stagnation for over 400 seconds at the circulation areas. Where clearwell have an average flow rate, a vector analysis at a height of 1.0 m showed a normal flow downstream. However, some sections of the L-shaped rear section at the left bottom of Clearwell No. 1 partially had the vortex that could cause stagnation. An analysis of flow speed contour line showed that a row of dividers in clearwell partially served as partitions. The results of the analysis can be used as basic data for the creation of alternatives such as the installation of supplementary training walls within clearwell.