in

Original Article Purpose There is no regimen that is strongly recommended for more than second-line treatment. We investigated the efficacy and safety of platinum/vinorelbine as more than second-line treatment. Materials and Methods We selected patients with advanced non-small cell lung cancer (NSCLC) who received treatment with platinum/vinorelbine at Chungnam National University Hospital from August 2001 to December 2013. The primary end point was the response rate, and secondary end points were progression-free survival (PFS), overall survival (OS), and toxicity. 020). The median PFS was 4 months (range, 1 to 21 months). Patients with adenocarcinoma and non-smokers had a significantly longer PFS than patients with non-adenocarcinoma and smokers (5 months vs. 2 months, p=0.007; 4.5 months vs. 2 months, p=0.046, respectively). The median OS was 10 months (range, 1 to 41 months). Patients with good performance status and non-smokers had a significantly longer OS than patients with poor performance status and smokers (14 months vs. 4 months, p=0.02; 18.5 months vs. 6 months, p=0.049, respectively). The main serious adverse event (grade 3 or 4) was neutropenia (15 events, 13.3%) in a total of 113 cycles. Conclusion Platinum/vinorelbine was effective as more than second-line chemotherapy, and the toxicity was tolerable, in patients with advanced NSCLC

A Comparative Study of Governance in State Management: Focusing on the Roh Moo-hyun Government and the Lee Myung-bak Government

This study aims to explore development discourses of the Roh Moo-hyun and Lee Myung-bak governments and evaluate their governance in achieving their respective visions of development. The two governments advocate sustainable development and green growth, respectively, as their national development paradigms, and strategies, laws, and organizations were developed to realize their goals. This research analysis reveals that the Roh administration perceived and reflected the concept and the importance of governance into its own policy framework while the Lee administration has not. The Roh administration perceived civil society as the subject of governance and policy process whereas the Lee administration perceives it as the object. In conclusion, the Roh administration can summarily be described as non-authoritarian with civil societycentered governance that pursues sustainable development, while the Lee administration is authoritarian with token state-centered governance that pursues green growth. This difference results from the difference between the nature of development discourse, principles of government management, perception of governance, leadership style and values, and the support basis of each government

Pediatric application of cuffed endotracheal tube: a secondary publication translated into Korean

A young child’s larynx was formerly believed to be narrowest at the cricoid level, circular in section, and funnel shaped. This supported the routine use of uncuffed endotracheal tubes in young children despite the benefits of cuffed tubes, such as lower risk for air leakage and aspiration. In the late 1990s, evidence supporting the pediatric use of cuffed tubes emerged largely from anesthesiology studies, while some technical flaws of the tubes remained a concern. Since the 2000s, imaging-based studies have clarified laryngeal anatomy, revealing that it is narrowest at the glottis, elliptical in section, and cylindrical in shape. The update was contemporaneous with technical advances in the design, size, and material of cuffed tubes. The American Heart Association currently recommends the pediatric use of cuffed tubes. In this review, we present the rationale for using cuffed tubes in young children based on our updated knowledge of pediatric anatomy and technical advances

A study on the tuning parameter of continuous variable valve for reverse continuous damper

Paper presented at the 5th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, South Africa, 1-4 July, 2007.Semi-active suspension systems are greatly expected to be in the mainstream of future controlled suspensions for passenger cars. In this study, a continuous variable damper for a passenger car suspension is developed, which is controlled actively and exhibits high performance with light weight, low cost, and low energy consumption. To get a fast response of the damper, a reverse damping mechanism is adapted, and to get small pressure change rate after blow-off, a pilot controlled proportional valve is designed and analyzed. The reverse continuous variable damper is designed as a HS-SH damper which offers good body control with reduced transferred input force from the tire, compared with any other type of suspension system. The damper structure is designed, so that rebound and compression damping forces can be tuned independently, of which the variable valve is placed externally. The rate of pressure change with respect to the flow rate after blow-off becomes smooth when the fixed orifice size increases, which means that the blow-off slope is controllable using the fixed orifice size. Damping forces are measured with the change of the solenoid current at the different piston velocities to confirm the maximum hysteresis of 20 N, linearity, and variance of damping force. The damping force variance is wide and continuous, and is controlled by the spool opening, of which scheme is usually adapted in proportional valves. The reverse continuous variable damper developed in this study is expected to be utilized in the semi-active suspension systems in passenger cars after its performance and simplicity of the design is confirmed through a real car test

Comparison of the Transcutaneous Bilirubin Readings at the Forehead during Crying with Those during Quiet State in Neonatal Jaundice

We compared TcB readings at the forehead and the mid-sternum during crying with those during quiet state in 70 healthy full-term neonates in order to investigate the effect of crying on TcB readings by using a Minolta/ Air-Shields Jaundice Meter. The average TcB reading at the forehead during quiet state was 18.37 + 2.41, while during crying the average reading were 17.07 + 2.20. TcB readings at the forehead during crying was significantly decreased compared with the TcB readings during quiet state with a difference of 1.30+0.96(r=0.78, P<O.OI). The average TcB reading at the mid-sternum during quiet state was 17.07+ 1.66, while during crying the average reading was 16.80 + 1.66. TcB readings at the mid-sternum during crying were not significantly decreased compared with TcB readings during quiet state with the difference of 0.20+0.90(P>0.05). The decreasing effect of crying at the forehead was more influential -at the higher TcB reading(TcB>20) than at the lower TcB reading(l5<TcB<20), while at the mid-sternum there was no crying effect on both the lower and the higher TcB readings. As mechanisms of the effect of crying on TcB readings at the forehead, we suggest that wrinkling causes the scattering of light by poor contact between the TcB probe and the surface of the forehead skin and the hemodynamyc effect, that of hemoconcentration and changes of skin color during crying. In conclusion, we should be careful when measuring TcB at the forehead because the babies often cry during measurements. We recommend that TcB measurements at the forehead should be taken during quiet state at the newborn nursery

Extracellular matrix cues regulate the differentiation of pluripotent stem cell-derived endothelial cells

The generation of endothelial cells (ECs) from human pluripotent stem cells (PSCs) has been a promising approach for treating cardiovascular diseases for several years. Human PSCs, particularly induced pluripotent stem cells (iPSCs), are an attractive source of ECs for cell therapy. Although there is a diversity of methods for endothelial cell differentiation using biochemical factors, such as small molecules and cytokines, the efficiency of EC production varies depending on the type and dose of biochemical factors. Moreover, the protocols in which most EC differentiation studies have been performed were in very unphysiological conditions that do not reflect the microenvironment of native tissue. The microenvironment surrounding stem cells exerts variable biochemical and biomechanical stimuli that can affect stem cell differentiation and behavior. The stiffness and components of the extracellular microenvironment are critical inducers of stem cell behavior and fate specification by sensing the extracellular matrix (ECM) cues, adjusting the cytoskeleton tension, and delivering external signals to the nucleus. Differentiation of stem cells into ECs using a cocktail of biochemical factors has been performed for decades. However, the effects of mechanical stimuli on endothelial cell differentiation remain poorly understood. This review provides an overview of the methods used to differentiate ECs from stem cells by chemical and mechanical stimuli. We also propose the possibility of a novel EC differentiation strategy using a synthetic and natural extracellular matrix

Effects of Berberine and Hwangryunhaedok-Tang on Oral Bioavailability and Pharmacokinetics of Ciprofloxacin in Rats

Hwangryunhaedok-Tang (HR) and berberine-containing single herbs are used to treat bacterial infection and inflammatory diseases in eastern Asia. The combination of berberine-containing herbal medicines and ciprofloxacin can be an excellent antibacterial chemotherapy against multidrug resistance bacteria. To evaluate the pretreatment effect of berberine and HR, vehicle, berberine (25 and 50 mg/kg/day), and HR (1.4 g/kg/day) were daily administered to rats for five consecutive days. On day 6, ciprofloxacin was administered (10 mg/kg, i.v. and 20 mg/kg, p.o.) to rats. To assess cotreatment effect of berberine and ciprofloxacin, berberine (50 mg/kg) and ciprofloxacin (20 mg/kg) were coadministered by single oral gavage. Pharmacokinetic data were estimated by noncompartmental model. Compared with ciprofloxacin alone (control group), coadministration of berberine (50 mg/kg) and ciprofloxacin significantly decreased Cmax of ciprofloxacin (P<0.05). In addition, the pretreatment of berberine (50 mg/kg/day) and HR (1.4 g/kg/day) significantly decreased Cmax and AUC0→∞, compared with control group (P<0.05). The oral bioavailability of ciprofloxacin was reduced by cotreatment of berberine and pretreatment of berberine and HR. Our results suggest that the expression of P-glycoprotein and organic anion and/or organic cation transporters (OAT/OCT) could take a role in reduced oral bioavailability of ciprofloxacin by berberine and HR

Effects of Acute Hyperoxia on Hyaluronic Acid and Histopathology of the Lung in Neonatal Ratst

We studied the effects of hyperoxia()95% oxygen for 10 days) on changes in body weight, changes in wet to dry lung weight ratio, changes in hyaluronic acid of the lung, and morphologic changes in lung tissue compared with those of normoxia (room air for 10 days) in Sprague-Dawley neonatal rat pups. In this acute hyperoxic neonatal rat model, we tried to analyze the relationship of relative water content of the wet lung and the amount of hyaluronic acid and morphologic change in lung tissue. The results were as follows: 1) Increase of postnatal body weight among survivors was stunted significantly under hyperoxia compared with normoxia during 10 days-experiment. 2) No appreciable difference of wet to dry lung weight ratio was noted on the beginning and the tenth day of experiment in neonatal rat pups between normoxia and hyperoxia, but considerable increased wet to dry lung weight ratio was noted significantly at 5, 7 days of hyperoxia suggesting that the relative water content of the wet lung was increased on the fifth, seventh day of experiment in hyperoxia compared with normoxia, 3) The amount of hyaluronic acid per wet lung decreased sequentially according to increase of postnatal age in normoxia, but a considerably increased amount of hyaluronic acid per wet lung was noted significantly on the fifth, the seventh day of experiment in hyperoxia. The difference in amount of hyaluronic acid per wet lung was not significant on the tenth day of experiment between normoxia and hyperoxia. These results suggested that the changing pattern of amount of hyaluronic acid per wet lung coincided with that of the relative water content of the wet lung in hyperoxia. 4) Pulmonary edema, interstitial inflammatory cell hypercellularity, and localization of hyaluronic acid in interstitial lung lesion were observed by light microscope at 7 days of exposure in hyperoxia compared with normoxia. These results suggest the possible role of hyaluronic acid on increase of water content and interstitial inflammatory cells in acute lung injury due to hyperoxia in an experimental neonatal rat model