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.

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.

The clinical manifestations of stasis dermatitis and analysis of association with other vascular diseases

( Jeong Won Jo ),( Chang Il Kwon ),( Young Bin Shin ),( Yun Sun Moon ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Stasis dermatitis is a common dermatologic disorder. It is caused by venous hypertension results from venous backward flow. However, research on the association with specific vascular disease is insufficient. Objectives: This study was intended to investigate in clinical manifestations of stasis dermatitis and analysis of association with other vascular diseases in our hospital outpatients. Methods: In this study, we investigated 37 patients with a diagnosis of stasis dermatitis in our hospital from 2014 to 2019. We reviewed clinical manifestations and relation with other vascular disease. Results: In total 37 cases, 20 (54.1%) patients were female and 17 (45.9%) patients were male. Twelve two (59.5%) patients were presented as erythema, followed by 14 (37.8%) as purpuric lesions and 11 (29.7%) as brownish changes. There were 4 (10.8%) patients showed crust, 3 (8.1%) as edema, 2 (5.4%) as scale, 2 (5.4%) as ulcer. For symptoms, 15 (40.5%) patients complained itching, 4 (10.8%) as tenderness, 3 (8.1%) as pain, 1 (2.7%). In relation with other vascular disease, 16 (43.2%) patients represented with vein related disease such as deep vein thrombosis, varicose vein and thrombophlebitis. However, there was no arterial disease such as arteriosclerosis obliterans. Conclusion: The result shows clinical manifestations of stasis dermatitis and association with other specific vascular diseases. By understanding these findings, it is expected that better treatment outcome will be obtained.

A survey of counseling and behavior regarding skin cancer

( Young Bin Shin ),( Chang Il Kwon ),( Jeong Won Jo ),( Yun Sun Moon ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: As the incidence of skin cancer increases, more information and education on skin cancer are needed. Although skin cancer is not rare, most patients are little known about general awareness of skin cancer. Objectives: The purpose of this study is to investigate the post-education effects on skin cancer in our hospital outpaitents and carers. Methods: We reviewed a written questionnaire and patients’ self-checked records including patients’ basic medical information and knowledge of skin cancer protective modalities. Results: In total 340 cases, 215 (63.2%) patients were female and 125 (36.8%) patients were male. 6 people in their teens, 56 people in their 20s and 30s, 156 people in their 40s and 50s, 122 people in their 60s or older. Before education, 142 people said sunlight can cause a skin cancer and 178 did not. After education, 246 people said Yes and 94 people did not. When asked how you wanted to get more information on skin cancer, 104 (30.6%) people said that they were printed handout, 142 (41.8%) were visit to dermatologists, 52 (15.3%) were photos of skin symptoms, and 42 (12.3%) were phone calls. Conclusion: This result showed that people are little known about risk factor of skin cancer such as sunlight and artificial tanning. However, we found that through education, people's perceptions could change. The education on behavior for skin cancer prevention should be continued so that the awareness of the risk of skin cancer can be changed.

6-OHDA가 흰쥐 등쪽솔기핵내 도파민성 신경세포와 별아교세포에 미치는 영향

홍은석(Eun Seog Hong),남성안(Seong Ahn Nam),조승묵(Seung Mook Jo),강태천(Tae-Cheon Kang),원무호(Moo Ho Won),최창도(Chang Do Choi) 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.4

신경독성물질인 6-hydroxydopamine (6-OHDA)이 중추신경계통 내 도파민성 신경세포에 미치는 영향과 이에 따른 별아교 세포들의 반응을 형태학적으로 규명하고자 본 연구를 시행하였다. 흰쥐의 가쪽뇌실에 6-OHDA를 투여한 후 면역조직화학 염색을 시행하여 광학현미경 하에서 등쪽솔기핵 내 도파민성 신경세포에 나타나는 퇴행성변화와 주위 별아교세포들의 반응양상 등을 경시적으로 제 3일, 제 5일, 제10일 및 제20일에서 관찰하였던 바 아래와 같은 결과를 얻었다. 6-OHDA에 의한 도파민성 신경세포의 퇴행성변화는 약물투여후 제 3일군에서 세포돌기가 팽대되고, 제 5일군과 제 10일군에서는 세포돌기의 소실과 함께 세포체가 위축되었고, 제20일군에서는 세포체가 소실되었다. 또한 6-OHDA에 의해 도파민성 신경세포들의 손상이 진행되면서 별아교세포들의 반응양상은 제 5일에서 대조군에 비해 급격하게 증가하였으며, 제20일에 이르러 최고값을 보였다. 이상의 결과로부터 6-OHDA가 중추신경계통 내 도파민성 신경세포들에 선택적이고 강한 세포독성을 유발하여 퇴행성 변화가 진행되고, 세포 손상이 시간 경과에 따라 진행되면서 주위의 별아교세포들이 지속적으로 증가된 활동을 보인다는 사실을 알게 되었다. This study was designed to clarify the cytotoxic effects of 6-hydroxydopamine (6-OHDA) on the dopaminergic neurons and astrocytes in the dorsal raphe nucleus (DRN), and to investigate neurodegenerative changes by immunohistochemistry. Adult male rats (Sprague-Dawley strain) weighing from 250 to 350 g were used as experimental animals. 6-OHDA (100 μg dissolved in 0.1% ascorbic acid) was injected into the lateral ventricle of the rat brain with the Hamilton syringe. The control rats were treated with the similar volume of 0.1 % ascorbic acid. The rats were sacrificed at the 3rd, 5th, 10th and 20th day, respectively, after the injection of 6-OHDA. The cytotoxicity of 6-OHDA resulted in severe neurodegeneration of the dopaminergic neurons in the DRN. In the 3rd day, the dopaminergic fibers were dilated. In the 5th and 10th days, the dopaminergic fibers were depleted, and dopaminergic cell bodies were shrunken. In the 20th day, the dopaminergic cell bodies were almost completely disappeared. Astroglial reactions induced by 6-OHDA were also observed in the DRN. In the 5th day, astrocytes were significantly increased as compared with that of the control value. The value were reached at its maximum by the 20th day. Based on the present results, it suggests that 6-OHDA may act as a specific neurotoxin to dopaminergic neurons in the DRN, and induce severe neurodegenerative changes. Also, it suggests that the astroglial reaction in the DRN is gradually activated during the neurodegerative changes

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

방사선조사와 Paclitaxel의 병합요법에 의한 신내막 과증식억제

장기육,승기배,강동헌,임상현,정해억,임효영,김태균,김연실,채장성,김재형,홍순조,윤세철,최규보 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.6

유전적 탐색 알고리듬을 이용한 계조영상의 복원

조영창,이태홍 嶺南大學校 工業技術硏究所 1997 工業技術硏究所論文集 Vol.25 No.2

In image restoration for the severe degradation of noise, the solution spaces which have many local optima around global solution appear. Thus the algorithms which find the global optima among many local optima in the solution space are superior to the general restoration technique like gradient methods. We introduce genetic algorithm is this paper and restore the image degraded by severe noise. And we proposed genetic operators, crossover and mutation, suited for gray scaled images. Finally we also proposed the local fine tuning of window size and visit number for delicate searching mechanism in the vicinity of the global solution. Through the experimental results we verified the effectiveness of the proposed genetic operators on the gray scaled images over the conventional ones, as well as the improved performance of local fine tuning.

최대하 운동시 온도·습도 변화에 따른 피부온도와 발한량의 변화

전태원,장창현,정덕조 師範大學 體育硏究所 1994 서울大學校 體育硏究所論集 Vol.15 No.1

The study was to investigate the difference of the total sweat rate, local sweat and skin temperature according to environments during submaximal exercise. For this, eight male field hockey athletes were made to take bicycle exercise of 40% Vo₂max for 60min. The environmental conditions were divided into four groups ; Environment Ⅰ (Temperature 18℃, Relative Humidity 40%). Environment Ⅱ (Temperature 18℃, Relative Humidity 70%). Environment Ⅲ (Temperature 30℃, Relative humidity 40%). Environment Ⅳ (Temperature 30℃, Relative Humidity 70%). Local sweat rate, rectal temperature and main skin temperature were recorded every 10 minutes by thermister, total sweat rate measured by the weight loss during the exercise. Local sweat rate according to environments during submaximal exercise increased mainly by relative humidity. The other local skin temperature and the rising-rate of body temperature had an effect on it. Total sweat rate according to environments during submaximal exercise was more influenced by hot-high humidity rather than by temperature especially led to the 1,400g's weight loss during the one hour exercise. Local skin temperature according to environments during submaximal exercise was significantly differentiated by temperature and humidity as well as by time. Mean skin temperature according to environments during submaximal exercise was varied, up-and-down repeatedly. No relationships between rectal temperature or local skin temperature and total sweat rate or local sweat rate but these factors were partly interrelated. To conclude, total sweat rate was influenced most by humidity and local sweat rate differed according to local skin temperature and the rising-rate of body temperature.

Vogt - Koyanagi - Harada Syndrome 의 8 예

우태하,고창조 대한피부과학회 1974 大韓皮膚科學會誌 Vol.12 No.3

The clinical findings in the Vogt-Koyanagi-Harada syndrome ae reviewed and eight cases reported emphasizing the cutaneaus changes. The syndrome consists of symptoms of poliosis, vitiligo, alopecia, meningeal irritation sign, nontraumatic uveitis, and dysacousia. Meningeal or ocular symptons usually appear first, but in some patients thc cutanious changes have been observed beforc the uveitis. The etiology rernains unsettied, but an allergic mechanism or a virus infection is favaveci by most observers. Early diagnosis is important because ocular mobidity can be reduced significantly in some patients if treated in the early stages. During the course of treatment of our patients, corticosteroid is appeared to be the most effective drug for this uncertain etiologic syndrome and this fact may eventually support. the theory nf autoimmue mechanisn. The daily does of corticosteroid is prednisolone 60mg and the duration of administration is from 15 days to 2 months, after that the dose is graclually decreased in relation with the degree of symptoms. The ophthalrnologic symptoms were markedly improved 10 days after the administvation of prednisolonc. The purpose of this report is to emphasize the cutaneous findings in this syndrome, to point out that the cutaneous manifestations may lead to establishing tne diagnosis and on the basis of that, those patients can be received prompt, suitable treatment to avoid the grave ocular morbidity.