국내 익수손상의 역학적 특성

Purpose: In spite of preventive measures and excellent prognosis with immediate treatments, drowning and drowning-related injuries remain as one of the leading causes of accidental death in Korea. However, abundant statistical data for drowning has yet to be collected. Thus, this study aimed to describe the epidemiologic characteristics of drowning in terms of demographic characteristics, geopolitical factors and socio-economic status. Methods: This study was conducted with drowning patients who either visited hospitals or died between January 2001 and December 2003. Of these patients, we enrolled individuals registered for such coverages as automobile insurance, national health service and work injury insurance and we reviewed death records reported to the Korea National Statistical office. NISS (New Injury Severity Scale) and EMR-ISS (the Excessive Mortality Ratio -adjusted Injury Severity Score) values were calculated for each patients and the results were classified 4-into four different severity groups. After analysis, we drew conclusions in terms of year, gender, age, region, insurance type, daily rate of incidences and severity. Results: The incidences of drowning-related injury were 2,486 in 2001, 2,364 in 2002, and 2,595 in 2003 (average of 2,482). The average annual death were 1,954. Victims were more likely to be male and especially high incidence rates were found for two groups: (1) Children aged 5-9 years, (2) Adults aged 40 and older. Seoul and Gyeonggi had the largest total numbers of injury cases, while JeJu had the highest per capita incidence rate (106 per 1,000,000 population). The seasonal distribution of incidence rates showed that predictably, incidents were most frequent between the beginning of July and September. Conclusion: The average number of incidents was 55.73 per 1,000,000 population, which constitutes approximately 0.02% of all injuries. Based on this data, we recommand continuing studies and further evaluations in order to develop specific measures to combat drowning

유방암 환자에서 3차원 조직 배양 항암제 감수성 검사의 유용성

Purpose: The behavior of invasive carcinomas in human can be very varied with different individual responses to chemo- therapy. Individualization is crucial to the optimization of che- motherapy. Therefore, the prediction of a tumor? sensitivity to anticancer agents has been the subject of intensive inve- stigation. In order to investigate the pathobiology of breast cancer, it is necessary to maintain or recreate the characte- ristics of the three-dimensional architecture of the tissues in culture. In this study, we have evaluated the relationship bet- ween the Histoculture Drug Response Assay (HDRA) assess- ment and chemotherapy responses in breast cancer patients. Method: Tumor specimens from 30 patients with breast cancer were evaluated using the HDRA. Tumor tissues were cultured on gelfoam sponge gel in 24-well plates, followed by treatment with a variety of chemotherapeutic agents. All treatments were conducted in triplicate. The sensitivity of a chemotherapy regimen was defined as a tumor inhibition rate (IR) in excess of 30%. Neoadjuvant or palliative chemothe- rapy for patients, using anthracycline or taxane, was conduct- ed on the basis of the established protocols. The responses to treatments were compared with the results of the HDRA. Results: The mean IR for the combinations of doxorubicin and docetaxel and for FAC and AC were 48, 45, and 36%, respectively. The above partial rate of response to chemo- therapy was 81.1%. The sensitivity and specificity of the HD- RA assessment, with a 30% inhibition rate, were 81.5 and 66.7%, respectively. The positive and negative response prediction values were 91.7 and 44.4%, respectively. The responses to treatments and the results of the HDRA asse- ssment were not correlated with the expressions of the hor- monal receptor or c-erbB2. Conclusions: In cases in which the inhibition rate is in excess of 30%, the HDRA assessment yielded a high positive res- ponse prediction value. The sensitivity to chemotherapy, as determined by the HDRA, appears to be a good guide for selection in breast cancer patients. Thus the results presented herein should be integrated into future research on the sub- ject

Evaluation of Water Supply Stability for Upland Crop in Reservoir Irrigation Districts

As the agricultural land use shifts from paddy to upland, ensuring reservoir water supply stability for upland crop irrigation becomes essential. The objectives of this study were to estimate the irrigation water requirements considering the upland irrigation scenario and to evaluate the reliability of the water supply from the agricultural reservoir using resilience indexes. Two study sites, Sinheung and Hwajeong, were selected, and soybean and red peppers, the most water-intensive crops, were selected as study crops, respectively. For the irrigation scenario, two irrigation methods of traditional scheduling (which irrigates all sites at once) and rotational scheduling (which distributes irrigation by districts), along with the upland conversion rate, were considered. The net irrigation requirement was estimated through a water balance analysis. The stability of the reservoir was evaluated using resilience indexes based on the simulated 10-years reservoir water levels and drought criterion. Overall, the water supply of the reservoir was evaluated as stable during the simulated 10 years, except for the one year. Compared to the two irrigation methods, rotational scheduling resulted in lower irrigation water usage in both sites, with reductions of 1.6%, and 0.3%, respectively. As the upland conversion rate increases, the water deficit could be intensified in Hwajeong with a conversion rate exceeding 50%, showing the number of deficit(ND) over the one and a rapid increase in the deficit ratio(DR). It was confirmed that the reservoir operation criteria can be enhanced by incorporating resilience indicators along with crop growth information, thus, this will be a further study.N

유두 미세 갑상선암: 임상병리적 특성과 치료전략

Purpose: The clinical importance of papillary microcarcinoma (PTMC) is debatable. Because PTMC is being diagnosed with increasing frequency, it is important to describe the clinical and histological characteristics that confer aggressive behavior to this cancer. This study was carried out to evaluate the clinical and histological characteristics of PTMC and to determine an appropriate treatment strategy for such cases. Methods: From Jan. 2000 to Dec. 2005, 1,255 patients with small papillary carcinoma, which measured less than 2.0 cm in its greater dimension, underwent total thyroidectomy at our institution. Among these patients, 633 (50.4%) had a thyorid carcinoma less than or equal to 1 cm in diameter (Group A). The clinicopathologic features and treatment outcome of these patients were evaluated and compared with the remaining 622 cases (49.6%) (Group B). Results: For the patients with PTMC (Group A), there were 70 men and 563 women with a median age of 44 years (range; 12∼86). During a mean follow-up of 32.5?18.2 months, 6 patients (0.9%) developed locoregional recurrences and 3 patients (0.5%) showed distant metastases. There was no disease-related mortality in both groups. The disease of group B was more likely to show extracapsular invasion (P＜0.001), invasion to adjacent structures (P＜0.001), and lateral neck node metastasis (P＜0.001) than that of group A. However, there were no significant differences in multifocality (P=0.189), bilaterality (P=0.203), the locoregional recurrence rate (P=0.065) and the distant metastasis rate (P=0.325) between the two groups. On multivariate analysis, locoregional recurrent disease was associated with central lymph node metastases (P=0.033) and lateral neck node metastases (P=0.022). Conclusion: Despite PTMC having less aggressive clinicopathologic parameters as compared with clinical cancer (＞1 cm), some PTMCs show aggressive clinical behavior and locoregional recurrence. The treatment of PTMC should be individualized based on its tumor risk profiles and the clinical presentations. Moreover, performing close follow-up is essential, especially for those patients who present with cervicolateral lymph node metastases