Causes and Predictive Factors Associated with “Diagnosis Changed” Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

( Byung Ju Kang ),( Kyung Wook Jo ),( Tai Sun Park ),( Jung Wan Yoo ),( Sei Won Lee ),( Chang Min Choi ),( Yeon Mok Oh ),( Sang Do Lee ),( Woo Sung Kim ),( Dong Soon Kim ),( Tae Sun Shim ) 대한결핵 및 호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the “diagnosis changed” rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: “diagnosis maintained”, “diagnosis changed” (initially notified as TB, but ultimately diagnosed as non-TB), and “administrative error” (notified as TB due to administrative errors). Results: Excluding 17 patients in the “administrative error” group, the “diagnosis maintained” and “diagnosis changed” groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of “diagnosis changed” were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn`s disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a “diagnosis changed” result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high “diagnosis changed” rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the “diagnosis changed” rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of “diagnosis changed” cases is desirable.

Causes and Predictive Factors Associated with "Diagnosis Changed" Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

Kang, Byung Ju,Jo, Kyung-Wook,Park, Tai Sun,Yoo, Jung-Wan,Lee, Sei Won,Choi, Chang-Min,Oh, Yeon-Mok,Lee, Sang-Do,Kim, Woo Sung,Kim, Dong Soon,Shim, Tae Sun The Korean Academy of Tuberculosis and Respiratory 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

Comparison of Bradykinin - and Platelet - Derived Growth Factor - Induced Phosphoinositide Turnover in NIH 3T3 Cells

Kim, Chang Min,BAI, DONG HOON,Yu, Ju Hyun,Lee, Kee Ho,Ryu, Yong Wun,Yoo, Young Do 생화학분자생물학회 1982 BMB Reports Vol.29 No.6

Phosphoinositide turnover in response to platelet-derived growth factor, epidermal growth factor, and bradykinin was evaluated in NIH 3T3 cells. Platelet-derived growth factor and bradykinin induced a significant increase in incorporation of ^(32)P into phosphatidylinositol (PI), phosphatidylinositol 4-monophosphate (PIP), and phosphatidylinositol 4,5-bisphosphate (PIP₂) in serum-starved NIH 3T3 cells. However, epidermal growth factor increased incorporation of BHP into these phosphoinositides by only a small amount. Stimulation with platelet-derived growth factor, not bradykinin, caused a rapid elevation of PI and PIP kinase activities that were maximally activated within 10 min. The maximal levels of their elevation in cells with plateletderived growth factor stimulation were 3.2-fold for PI kinase, and 2.1-fold for PIP kinase. Short term pretreatment of NIH 3T3 cells with phorbol 12-myristate 13-acetate, activator of protein kinase C, caused an approximately 60% decrease in platelet-derived growth factor-induced PI kinase activities, indicating the feedback regulation of phosphoinositide turnover by protein kinase C. These results suggest that although the enhancement of phosphoinositide turnover is a rapidly occurring response in platelet-derived growth factor- or bradykinin-stimulated NIH 3T3 cells, phosphoinositide kinases may be associated with initial signal transduction pathway relevant to platelet-derived growth factor but not to bradykinin.

청소년의 자살생각 변화궤적과 예측요인:

유창민(Yoo Chang Min),강상경(Kahng Sang Kyoung) 연세대학교 사회복지연구소 2015 한국사회복지조사연구 Vol.46 No.-

It is well known that individual and environmental factors are associated with adolescents’suicide ideation. Because of limitations in available data and analysis methods, however, little is known about what factors are associated with suicidal ideation trajectory among adolescents. This study aims to (1) estimate the trajectory of suicidal ideation among adolescents (2) identify the predictors of suicidal ideation trajectory. For these purposes, we used latent growth curve modeling(LGCM) involving 3,185 students participated in the Korean Youth Panel Survey. The results are as follows. First, adolescent’s suicidal ideation has decreased with time. Second, academic stress and broken family which are risk factors were significantly associated with the initial level of suicide ideation, but these were not significantly associated with the rate of change. Self-esteem and peer-relationship which are protective factors were significantly associated with the initial level of suicide ideation, but these were not significantly associated with the rate of change. Based on these results, we discussed implications and suggested directions for future research on suicide ideation among adolescents. 청소년들의 개인적 요인과 환경적 요인이 자살생각과 밀접한 관련이 있다는 것은 기존 연구를 통해 널리 알려진 사실이다. 그러나 기존 연구들은 횡단자료를 이용한 분석방법 및 종단자료의 한계로 주요 변수들과 자살생각 변화궤적의 관계에 대해 확인한 경우는 많지 않다. 이에 따라 본 연구에서는 (1) 청소년의 자살생각 변화궤적에 대해 살펴보고, (2) 청소년의 자살생각 변화과정을 예측할 수 있는 위험요인과 보호요인을 확인하였다. 이를 위해 한국청소년정책연구원에서 2003년에 수집한 ‘한국청소년패널조사 (Korea Youth Panel Survey: KYPS)’ 중학교 2학년 2차~5차년도 자료(N=3,185)를 활용하여 잠재성장모형 Latent Growth Curve Model)을 분석 하였다. 분석 결과 (1) 중학교 3학년에서 고등학교 3학년에 이르는 4년 동안 청소년의 자살생각은 점차 감소하는 변화궤적을 보였고, (2) 학업스트레스와 비양부모 가족구조는 자살생각의 초기수준을 높였으나 기울기에는 영향을 미치지 않아 그 영향이 시간이 흘러도 지속되는 위험요인으로 나타났으며, 자아존중감과 또래관계는 자살생각의 초기수준을 낮췄으나 기울기에는 영향을 미치지 않아 그 영향이 시간이 흘러도 지속되는 보호요인으로 나타났다. 이러한 연구결과를 바탕으로, 청소년의 자살생각을 예방할 수 있는 함의를 논의하였다.

흉부 X선촬영 기술의 변천에 관한 연구

이창엽,조평곤,김지닐,최소영,김창균,최종학,김정민,김유현 高麗大學校 倂設 保健大學 保健科學硏究所 2002 保健科學論集 Vol.28 No.2

To find elements which enable improving Quality of image of chest radiography, we attempted to make comparison between chest radiography used currently with that of the past, and following conclusion was reached: 1) It could be confirmed that a dependance on chest radiography was declining, because proportion of chest radiography against overall radiography decreased. 2) There was a change of kVp to a high voltage in a chest radiography, and use of high kVp became a generalization 3) Exposure time was reduced and exposure dose was curtailed accordingly. 4) Apparatus was mainly comprised of 3-phase rectifier circuit and inverter type. 5) It could be confirmed that frequency of applying additional filters for high kVp radiography was insufficient. 6) There was almost no difference in the condition of exposure between hospitals using film/screen and hospitals using CR. But when CR is used for radiography, it was increase in exposure dose due to increase in tube current and it will be necessary to have continuous study on exposure dose by an increase use of CR in the future.

Free Paper Presentation : OS-53 ; Factors Associated with Smokers` will for Smoking Cessation in Korea

( Ah Young Leem ),( Chang Hoon Han ),( Chul Min Ahn ),( Tae Hoon Jung ),( Yu Il Kim ),( Jae Yeol Kim ),( Sang Haak Lee ),( Eun Mi Chun ),( Kwang Ha Yoo ),( Ji Ye Jung ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-

Background: Smoking is known to increase the risk of chronic disease. Understanding of factors that contribute to smoking cessation may help to develop strategies for smoking behavior change. Methods: Pooled cross-sectional data of 11,924 subjects from the Korea National Health and Nutrition Examination Survey II-V were analyzed. The stages of change in smoking cessation were categorized into pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological characteristics, and tobacco-related factors were compared between the groups. Results: The study population consisted of 32.4% in pre-contemplation, 54.4% in contemplation, and 13.1% in preparation group. While the proportion for pre-contemplation group (37.4% to 28.4%) tended to decrease from 2001 to 2012, that of preparation group (6.4% to 18.1%) tended to increase. The mean age of pre-contemplation group (48.4±16.2) is higher than comtemplation and preparation group (42.2±13.9 and 44.4±15.3; P=0.02). As levels of education and income status increased, the proportion of pre-contemplation tended to decrease, and that of preparation tended to increase. Proportion of blue collar job in pre-contemplation group was higher than in preparation group (67.9% vs 58.1%; P<0.001). In pre-contemplation group, percentage of suicidal ideation within 1 year was higher than contemplation and preparation group (19.3% vs 16.0% and 16.1%). Upon adjusting analysis, the proportion of pre-contemplation group increased with increasing age (OR=1.01; 95%CI 1.01-1.02), and smoking amount (OR=1.04; 95%CI 1.03-1.05). People of pre-contemplation group (vs. preparation) are be less educated (OR=1.99; 95% CI 1.51-2.62), are in single marital status (OR=1.25; 95%CI 1.04-1.50), have lower prevalence of cardiovascular disease (OR=0.48; 95%CI 0.31-0.76), and do less exercise walking (OR=1.36; 95%CI 1.09-1.69) and weight training (OR=1.59; 95%CI 1.35-1.85). Conclusions: We demonstrated a significant association between the stages of change in smoking cessation and age, education, marital status, cardiovascular disease, and amount of exercise.

GARP 모형과 기후변화 시나리오에 따른 잣나무의 지리적 분포 변화

천정화 ( Jung Hwa Chun ),이창배 ( Chang Bae Lee ),유소민 ( So Min Yoo ) 한국농림기상학회 2015 한국농림기상학회지 Vol.17 No.4

본 연구는 그간 우리나라에서 경제적인 가치를 인정 받아온 수종인 잣나무를 대상으로 잣나무의 현존 분포를 파악하고, RCP (Representative Concentration Pathway) 8.5 기후변화 시나리오와 생태적 지위 모형에 기반하여 향후 잣나무의 분포 변화를 예측하기 위해 수행되었다. 이를 위해 5년간의 NFI 자료에서 조사지점별 잣나무의 풍부도 자료를 추출하여 사용하였으며, 수종에 영향을 미치는 환경요인변수를 선정하기 위해 생태적지위 모형 가운데 하나인 GARP (Genetic Algorithm for Rule-set Production)를 이용하였다. 총 27개의 환경요인변수에 대해 각각 모형을 구동하고 컨퓨전 매트릭스(Confusion Matrix) 기반 산출 통계량인 AUC (Area Under Curve)가 0.6 이상인 변수들을 선발하여 최종 잠재분포모형을 작성하였다. 그 결과 작성된 모형은 비교적 높은 적합도를 나타냈는데 잣나무는 현재 표고의 범위가 300m에서 1,200m 사이인 지역 및 남부에서 북부에 이르기까지 넓게 자리 잡고 있는 것으로 나타났다. 작성된 모형에 RCP 8.5 기후변화 시나리오를 적용한 결과, 잣나무는 2020년대부터 잠재분포역이 큰 폭으로 축소되며, 2090년대에는 우리나라 대부분의 지역이 잣나무의 생육에 불리할 것으로 예측되었다. 본 연구를 통해 기후변화가 잣나무 분포에 미치는 영향을 파악하고, 잣나무와 기후변화와의 상관성에 대한 이해를 높임으로써 향후 지역별 조림수종 선정 및 경제수종 교체 등의 조림적 관점에서 도움이 될 수 있을 것으로 판단된다. The main purpose of this study is to understand the potential geographic distribution of P. koraiensis, which is known to be one of major economic tree species, based on the RCP (Representative Concentration Pathway) 8.5 scenarios and current geographic distribution from National Forest Inventory(NFI) data using ecological niche modeling. P. koraiensis abundance data extracted from NFI were utilized to estimate current geographic distribution. Also, GARP (Genetic Algorithm for Rule-set Production) model, one of the ecological niche models, was applied to estimate potential geographic distribution and to project future changes. Environmental explanatory variables showing Area Under Curve (AUC) value bigger than 0.6 were selected and constructed into the final model by running the model for each of the 27 variables. The results of the model validation which was performed based on confusion matrix statistics, showed quite high suitability. Currently P. koraiensis is distributed widely from 300m to 1,200m in altitude and from south to north as a result of national greening project in 1970s although major populations are found in elevated and northern area. The results of this study were successful in showing the current distribution of P. koraiensis and projecting their future changes. Future model for P. koraiensis suggest large areas predicted under current climate conditions may be contracted by 2090s showing dramatic habitat loss. Considering the increasing status of atmospheric CO2 and air temperature in Korea, P. koraiensis seems to experience the significant decrease of potential distribution range in the future. The final model in this study may be used to identify climate change impacts on distribution of P. koraiensis in Korea, and a deeper understanding of its correlation may be helpful when planning afforestation strategies.

사회인지이론 기반 중산층 노인 식품안전 교육 프로그램의 효과 평가

최정화(Jung-Hwa Choi),유효이(Hyo-E Yoo),정하림(Harim Chung),이혜상(Hye-Sang Lee),이민준(Min-June Lee),장혜자(Hye-Ja Chang),이경은(Kyung-Eun Lee),이나영(Na-Young Yi),곽동경(Tong-Kyung Kwak) 한국식품영양과학회 2018 한국식품영양과학회지 Vol.47 No.8

현대의학의 발달은 인간의 수명을 연장시키고 그 결과 노인인구 증가를 가져와 노인 의료비 문제가 사회적으로 대두되고 있다. 이에 적절한 방안으로는 노인들의 건강한 노화(healthy aging)를 도모하는 것이며, 이는 사회의 의료비용을 감소시킴으로써 사회 전체의 효율성을 제고시킬 수 있다. 본 연구는 중산계층 노인을 대상으로 사회인지이론 기반의 식품안전 관리 교육 프로그램을 적용하여 시범실시를 하여 교육 효과 평가를 실시하였다. 본 연구에서는 교육군 212명, 대조군 42명의 자료가 분석되었으며, 사전 사후 지식 총점의 변화는 교육군이 2.80점에서 3.80점으로 유의적으로 상승하였다(P<0.001). 교육군의 식품안전 식태도/건강신념의 교육 전과 후의 총점은 20점 만점에 15.28점에서 16.50점으로 유의적인 상승을 보였다(P<0.001). 대조군은 사전 15.21점에서 사후 15.29점으로 상승하였으나 유의적인 차이를 보이지 않았다. 노인의 식품안전 식행동은 교육군의 교육 전과 후의 총점이 28점 만점에 20.07점에서 22.50점으로 2.43점 상승하여 유의적인 향상을 보였다(P<0.001). 가정 내 식품 취급실태를 살펴보면 식품을 직접 구매한다고 한 응답자가 교육군의 87.3%, 대조군의 95.2%로 나타났으며, 식품 조리 여부 항목에 대해서는 교육군의 87.7%, 대조군의 95.2%가 직접 가정에서 조리한다고 응답하였다. 식태도/건강신념 변화와 식행동 변화값 간에 상관관계가 가장 높으며(r=0.447, P<0.001), 식행동 변화값과 지식의 변화 값과의 상관관계가 높은 것으로 나타났다(r=0.152, P<0.05). 경로별 교육 효과를 보기 위하여 사전, 사후 점수와 점수변화량을 비교 분석한 결과 지식, 식태도/건강신념, 식행동의 모든 경로에서 유의적인 향상을 보였다. 개발된 교육 프로그램의 효과 평가는 2차 시 교육의 사전, 사후 평가를 대조군의 평가 결과와 비교 분석하였는데, 교육의 기간이 2차시로 제한되어 있고 교육 후 행동 변화의 유지를 평가하지 못하였다. 또한, 교육경로와 대상자의 수가 적어 연구 결과를 일반화하기에는 무리가 있으며, 향후 교육의 확대를 통한 후속연구들이 진행되어야 할 것으로 사료된다. This study assessed the educational effectiveness of a developed food safety management education program based on social cognitive theory for elderly in the middle class. The subjects participated in the food safety education program two times at a public health center, community welfare center, senior citizens’ center, and center for children’s foodservice management. For food safety intervention education, data from the intervention group (212 subjects) and control group (42 subjects) were analyzed. Significant (P<0.001) differences in the scores for food safety knowledge, food attitude, and food behavior were observed in the intervention group before and after the study, but no significant difference was observed in the control group. A significant positive correlation also detected between knowledge, food attitude/health belief, and food behavior in the intervention group, which indicates that the study contributed to perception changes in the intervention group and eventually behavioral changes. Accordingly, this program can induce cognitive and behavioral changes by conducting food safety training for the elderly.

Dose-linear pharmacokinetics of oleanolic acid after intravenous and oral administration in rats

Jeong, Dong Won,Kim, Young Hoon,Kim, Hui Hyun,Ji, Hye Young,Yoo, Sun Dong,Choi, Won Rack,Lee, Soo Min,Han, Chang-Kyun,Lee, Hye Suk WILEY PUBLISHERS 2007 BIOPHARMACEUTICS AND DRUG DISPOSITION Vol.28 No.2

<P>The pharmacokinetics of oleanolic acid was evaluated in vitro and in vivo. From Caco-2 cell permeation studies, oleanolic acid was a low permeability compound with no directional effects, suggesting a low in vivo absorption mediated by a passive diffusion. Oleanolic acid was metabolically unstable following incubation with rat liver microsomes in the presence of NADPH. After intravenous injection at doses of 0.5, 1 and 2 mg/kg doses, oleanolic acid showed dose-linear pharmacokinetics as evidenced by unaltered CL (28.6–33.0 ml/min/kg), V<SUB>ss</SUB> (437–583 ml/kg), dose-normalized AUC (16.0–17.9 µg min/ml based on 1 mg/kg) and t<SUB>1/2</SUB> (41.9–52.7 min). Following oral administration of oleanolic acid at doses of 10, 25 and 50 mg/kg, T<SUB>max</SUB>, t<SUB>1/2</SUB>, dose-normalized C<SUB>max</SUB> (66–74 ng/ml based on 25 mg/kg) and dose-normalized AUC (5.4–5.9 µg min/ml based on 25 mg/kg) were comparable between 25 and 50 mg/kg dose, but the plasma concentrations at 10 mg/kg dose were not measurable as they were below the limit of quantitation (2 ng/ml). The absolute oral bioavailability was 0.7% for oral doses of 25 and 50 mg/kg. The extent of urinary excretion was minimal for both i.v. and oral doses. The very low oral bioavailability of oleanolic acid could be due to a poor absorption and extensive metabolic clearance. Copyright © 2007 John Wiley & Sons, Ltd.</P>

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.