Acute exacerbation of interstitial lung disease; subgroup analysis for causes, risk factors for mortality rate, and steroid responsiveness

( Seung Hyun Yong ),( Ah Young Leem ),( Song Yee Kim ),( Kyung Soo Chung ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam Kim ),( Joon Chang ),( Moo Suk Park ),( Hye Jin Jang ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Interstitial Lung Disease (ILD) has known as a poor prognosis disease, particularly idiopathic pulmonary fibrosis (IPF). Corticosteroid is widely used for treatment of acute exacerbation (AE)-ILD. This study aims to clarify efficacy of corticosteroid use, and compare the mortality rate depending on the subgroups of ILD. Materials and Methods: We collected the data from the patients who have diagnosed ILD and visited emergency room (ER) with the respiratory symptoms from January 1, 2016 to December 31, 2018. We classified AE-ILD patients into 3 groups depending on methylprednisolone dose per kilogram. Also, we compared the mortality of IPF patients to that of non-IPF patients. Results: A total case of AE-ILD visited ER from 2016 to 2018 was 209 cases, including IPF cases (n=122) and non-IPF cases (n=87). We divided total patients (n=209) into three groups depending on steroid use, and these include group 1 of 0-0.49 mg/kg (n=78), group 2 of 0.5-0.99 mg/kg (n=58), and above 1.0 mg/kg (n=41), each. We found poor prognosis from the cases of IPF compared to non-IPF cases (p=0.029, OR 2.463). Furthermore, there was significant differences of mortality rate according to steroid dose (p=0.036, OR 1.712), CRP elevation (p=0.016, OR 1.004), and intubated case (p=0.000, OR 8.152). Also, we categorized IPF (n=122) to non-IPF cases (n=87) and analyzed the mortality rate. Most of the patients were death from ILD itself (n=23, 63.9%), Pneumonia(n=8, 22.2%), and Lung cancer (n=5, 13.9%). Bacterial infection (n=26) was dominant cause of AE, followed by fungal infection (n=15), and viral infection (n=10). Conclusions: This retrospective analysis of corticosteroid treatment shows more fatal outcome when we use high dose steroid in AE-ILD cases, and there was significant difference in mortality rate depending on the subgroup of ILD and medical background, such as intubation status, higher CRP level, and IPF cases.

폐질환환자의 동맥혈가스분석

현정애,김재룡,전동석 啓明大學校 醫科大學 1986 계명의대학술지 Vol.5 No.2

Arterial blood gas anlysis has been established as an important aid to diagnosis, therapy, and prognosis in pulmonary diseases. Authors analyzed the results of arterial blood gas analysis of 136 pulmonary disease patients requiring oxygen therapy at the emergency room. In patients with chronic obstructive pulmonary disease, the findings are consistent with respiratory acidosis, PCO₂being abnormally high in 53.3% of the cases and PO₂below 80mmHg in 88.9%. In patients with bronchial asthma, the PO₂levels were higher than ones with chronic obstructive pulmonary disease but the results of remaining parameters were essentially similar. The patients of lung cancer were significantly iincreased in pH, comparing with ones of other pulmonary diseases (p<0.005), and significantly fell in PCO₂comparing with ones of bronchial asthma (p<0.01).

전자정부 구현을 위한 전자문서관리시스템(EDMS)에 관한 연구 : 대전·충남지역 지방자치단체의 전자문서 유통과 관리 실태분석을 중심으로 An Empirical Analysis on the Electronic Document Exchange and Management Practices in the Local Authorities of Daejeon·Chungnam Area

정현애 大田大學校 社會科學硏究所 2004 社會科學論文集 Vol.22 No.2

우리나라의 행정기관은 전자정보화로 인해 행정업무를 뒷받침할 전자적 업무처리 및 관리시스템을 운영하고 있으나 전자적 업무시스템자체의 한계와 함께 이를 직접 활용하고 있는 행정실무 공무원들의 정보활용기반과 활용능력의 취약, 전자문서의 유통 및 관리 불편 등으로 하여 전자정보화 시스템의 투자가 행정생산성 및 국민편리성 제공으로 원활하게 연계되지 못하고 있는 실정이다. 이러한 상황에서 전자적 업무처리의 전자문서유통 및 관리시스템을 분석하고, 전자적 업무처리에 대한 고찰을 통하여 운영 및 관리의 문제점을 진단하여 보다 나은 전자적 업무처리의 활성화방안을 모색하는 것은 매우 중요하다고 할 수 있다. 그리하여 본 연구는 행정업무영역의 실사용자인 공무원을 대상으로 현재의 대한민국 전자정부구현 및 전자문서관리시스템(EDMS)부분의 미진한 기능 및 사용자 편의성을 찾아보고 이 부분을 집중적으로 연구·분석하여 대전·충남 지방자치단체의 전자적 업무처리 활성화 방안을 모색하였다. e-Government is a kernel subject that response to the paradigm change of new country operation on 21th century knowledge information society and secures country competitive power. This is the most important practical means that e-Government can provide service of good quality to people and enterprise that is customer. And at the same time, it plays essential roles in governmental productivity and efficiency rising through small but efficient government. In spites of our country is evaluated to the country that take the shape of e-Government than the other country, the efficiency of administration is getting a lot of criticisms that is not improved greatly. The major cause of these criticisms is that the propulsion of our e-Government construction process is not associated with administrative reform. In present, our administration put in practices the electronic business processing and executive system that support the administration duty of electron information. But, owing to the limitations of electronic business system itself, unskilled of practical use ability of government employees, and inconvenience of circulation and management of electronic documents, the investment of electron information system is not associated smoothly to administration productivity and convenience offer to peoples. In these circumstance, it is very important to grope activation plan of better electronic business processing following to analyze circulation and control system of electronic documents, diagnose problems of operation and management through investigation about electronic business processing. This study investigated the previously discussions which connected with electronic business processing of administration inside, examined laying stress on electronic business processing system, the practical use conditions of electronic document management system(EDMS) in Daejeon metropolitans and municipalizations, and analysis to the problems about electronic business processing and improvement plan.

효과적인 우유 섭취지침에 관한 연구

신현아;이애정;이지선;우혜임;조아라;채유진;엄애선 한양대학교 2010 韓國 生活 科學 硏究 Vol.30 No.1

Over the past decade, there has been growing scientific evidence that dietary milk plays a role in beneficial effects for human health. Milk provides a number of good ingredients, in particular with growth factors and different types of proteins such as α -lactalbumin and β-casein. As well as essential amino acids of leucine and isoleucine are make to a positive way of human physical conditions. Therefore, those ingredients are directly involved in the human body, fluid composition and involved in metabolism of protein or carbohydrate. In addition, the development of physical strength and bone health associated with milk consumption. Thus, milk is one of good food for prevention of osteoporosis. Nowadays, several dietary guidelines suggest that people should intake two or three cups of dairy products including milk a day. However, some people cannot drink milk because they appear many adverse effects with regard to intake of milk like allergic reactions, lactose intolerance and weight gain problem. Consequently, it is worthy to discuss about these matters. Person pose the health problems regarding milk consumption should select dairy products carefully. Milk substitutes such as partially-hydrolyzed formula, yogurt, cheese and non- and low-fat dairy products are suggested. They prevent the allergy and lactose intolerance due to lactase in fermented milk digesting the lactose into glucose and galactose. Taking all of these into account, milk consumption is very important to maintain the human health. Although there are several adverse effects with regard to milk consumption, it would not be shown any health problem only if it follows the milk dietary guidelines. Therefore, a milk drinking should be actively encouraged for the public health.

Mulligan 치료법과 고유수용성 신경근 촉진법이 동결견 환자의 치료에 미친 효과

양정애,윤홍일,박현식,신영일,전범수 대한정형도수치료학회 2006 대한정형도수물리치료학회지 Vol.12 No.1

The purpose of this study was to compare the effects of Mulligan method and PNF method on the pain and limitation of range of motion in patients with frozen shoulder. The subjects of this study were 20 patients, 10(50%) males and 10(50%) females. They visited clinic for physical treatment within 6 months after onset of shoulder pain and limitation of range of motion with frozen shoulder. One group was applied with Mulligan method and other group was with PNF method . The patient were treated 5 times session weekly for 6 weeks from March 4th, 2002. And each treatment session was 15min. with physiotherapy. The pain was measured by visual analogue scale (VAS) and rage of motion (ROM) of flexion, abduction, external rotation, internal rotation were measured by goniometer. The data was analysed by paired T-test and independent T-test. The results of this study were summarized as follow : 1. The ROM of Mulligan method group increase in after treatment in comparison with ROM in before treatment, it is significant increase. Although the VAS of MMG decrease in before than after treatment, it is significant difference. 2. There is significant difference in before and after treatment of ROM of shoulder flexion, abduction, internal rotation, external rotation between PNF method group. The VAS of PMG is decreasing in before than after treatment, it is significant difference. 3. There is significant difference in before movement and after movement ROM of flexion, abduction, internal rotation, external rotation and VAS between Mulligan method session and PNF method session then the scale which measured by Mulligan method was more increased than that of PNF method. The results showed that both Mulligan method and PNF method were effective in pain reduce and ROM increase, but Mulligan method was superior to PNF method in ROM increase and pain reduce.

이식폐장의 핵의학검사

전석길,현정애 啓明大學校 醫科大學 1995 계명의대학술지 Vol.14 No.4

젓갈로부터 유용 박테리오신 생산균주의 탐색

이나경,전송애,하정욱,백현동 경남대학교 환경문제연구소 1998 환경연구 Vol.21 No.-

Bacteriocins are proteins produced by heterogeneous group of bacteria that have a bactericidal effect on closely related organisms. Recently, bacteriocins from lactic acid bacteria(LAB) and other food-related organisms have been the subject of much research of their potential as food biopreservatives. The goal of this study were to isolate LAB from commercial fermented fish products and identify their bacteriocin activity. All bacteriocin-producing isolates were identified as LAB. The NK24, NK34, and SA72 isolates were as identified as Lactococus lactis subsp. Lactis where as SA131 isolate was Lactobacillus brevis according to database of API50 CHL kit. All antimicrobial substance(s) produced from 4 LAB isolates were lost their antibacterial activity completely by treatment of some proteases, which indicate its proteinaceous nature. The bacteriocins produced from NK24, NK34, and SA72 isolate showed broad spectrum of activity when compared to SA131 bacteriocin.

흰쥐에서 다시마 식이가 메트폴민의 체내동태 및 당 흡수에 미치는 영향

최한곤,장보현,이종달,김정애,유봉규,용철순 한국약제학회 2003 Journal of Pharmaceutical Investigation Vol.33 No.3

Drug interactions with food, on occasion, led to serious nutritional and functional changes in the body as well as alterations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterized by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of microvascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remins unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo-or hyperglycemia and preventing complications. Laminaria japonica is a brown macroalgae which can be used as a functional diet due to high content of diatery fiber. the purpose of this study was to investigate the effect of Laminaria japonica diet on the pharmacokinetics of metformin which are frequently used in the treatment of diabetes. Diabetic rats induced by strep-tozotocin were employed in this study. Blood concentrations of oral hypoglycemic agent, metformin, were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as k_(a), t_(1/2), C_(max), t_(max), and AUC, C_(max), and k_(a), and increase in t_(max), compared to those with normal diet. This oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of metformin caused by ong-term Laminaria japonica diet.

미취학 아동에 있어 신체발달, 손목 골밀도 및 영양섭취와의 상관성

명금희,나현주,최미경,김애정 동아시아식생활학회 2004 동아시아식생활학회지 Vol.14 No.2

This study was conducted to examine the correlation among growth development, bone mineral density, and nutrient intakes in preschool children. A total of 62 preschool children measured the anthropometric characteristics and the bone mineral density of carpus using DEXA. The questionnaires categorized to determine health status, life style, dietary behaviors, and dietary intakes were filled out by children's mothers. The average ages of the study subjects were 62.4 months in boys and 62.1 months in girls. The birth height and weight of the subjects were 50.9 ㎝ and 3.4 ㎏ in boys and 50.3 ㎝ and 3.3 ㎏ in girls, respectively. The average height, weight, % body fat, and obesity index were 111.7 ㎝, 19.6 kg, 15.0%, -2.1% in boys and 109.4 ㎝, 18.7 ㎏, 17.5%, 0.2% in girls, respectively. The bone mineral density in carpus was 0.25 g/㎠ in boys and 0.24 g/㎠ in girls. Proportions of children having regular meals were 69.0%, 94.7% and 69.0% for breakfast, lunch, and dinner, respectively. The major reasons for irregular meal were poor appetite and lack of time for breakfast and snacks for dinner. Most of the children(52.6%) had breakfast with the whole family together, and all the children had lunch and dinner with a part of the family. Most of the children answered they had snack more than once a day, and 64.3% had an unbalanced diet. The intakes of energy, calcium, iron, zinc, vitamin A, vitamin B₁, niacin, and vitamin C did not meet the Korean RDAs. The intakes of energy, calcium, iron, zinc, vitamin A, vitamin B₁, niacin, and vitamin C did not meet the Korean RDAs. Average bone mineral density in carpus was positively correlated to the body weight, the total body water, the lean body mass, and obesity index, respectively(p<0.01, p<0.01, p<0.01 and p<0.01). The body weight, the total body water, and the lean body mass showed the significant negative correlation with the animal iron intake(p<0.05, p<0.01 and p<0.01). The bone mineral density the distal carpus was negatively correlated to the animal protein intake and the animal iron intake(p<0.05 and p<0.05). And the bone mineral density in the ultradis carpus and the average bone mineral density in the carpus were positively correlated to the plant calcium intake(p<0.05 and p<0.05). Therefore, more systematic studies to investigate the roles of protein, iron, and calcium in growth development of preschool children were required.

양호교사의 역할수행에 관한 조사연구

문희자,박신애,강현숙,고정은 慶熙大學校 1985 論文集 Vol.14 No.-

It is the ultimate purpose of school health management to protect, maintain, and prormote the students' health and to help for them to form a wholesome habit of health. To do this, school nurse is an actual professional personnel of school health management in our country. therefore, role performance of a school nurse is directly related to the quality of school health planning, we think. With this belief, this study intends to revise, supplement Rustia model for school health promotion and develop in into a suitable model for our actual situation. In so doing, based on Rustia model, we had surveyed the actual situation of a school nurse's role performance by making 77 school nurses in Boys' and Girls' Middle and High Schools in Seoul as the scope of this research for a period of two months beginning on September 1, 1984. The results were analyzed by employing percentage and mean value. The results of the investigation are as follows: 1. General Characteristics of the school nurses and schools. (1) The average age of the surveyed school nurses is 31.64± 6.6 years old. 81.6% of them was proved to have acquired academic background above Colleges and Graduate Schools; 74% were married; 61% were religious persons. And the average on-duty term was 6.42±5.03 years. 66.2% of them employed in the hospitals before this present job and 31.2% have worked at school as school nurses immediately after their graduation. In college, most of them (81.8%) went through a course of study for the teaching profession and only 9.1% of the taught other courses of study. (2) The majority of the surveyed schools (51.9%) were public schools and 62.3% of them were middle Schools. The average number of students in the school was 2628.52;that of school pesonnel was 66.17±9.7;that of classes was 39.68±12.0. 2. Role performance for primary prevention. (1) Among the serveyed schools, 83.1% of them performed epidemiological analysis of health problem for the promotion of health. As for health planning among health management plan, all of them put it in force, however, only 35% of them participated in preparation of the budget to achieve it. As to the evaluation program, 64.9% of them carry out it into operation and in case of being carried out once in a year marked the most frequency of enforcement as 32.4%. On guidance and support related to health planning, 42.9% of them held a staff meeting; of which 53.2% were school nurse-teacher meeting; 28.6%, school nurse-parent meeting. (2) To protect the students and school personnel from danger and injury, 67.5% of them participated in alleviating health problems-that is, the maintenance of health standard and safety within school, and inserting the means of settling those problems into curriculum and management of school events. Especially, only 14.3% administered school lighting and 35.1% observed safety standards of desks and chairs in class. Consequently, the result of this survey revealed that there is much to be desired in the administration for the maintenance of health standard and safety. As for pervention of infectious disease, the following were implemented; a) disinfection of toilets (92.2%); b) control of drinking water (75.5%); c) purification of sewage and garbage incineration (74%). What is pecular is that 71.4% of them have controlled vaccination but enforcement rate shows lack of enthusiasm when viewed from the kinds of vaccination: Typhoid fever (51.9%), cholera (41.6%) hepatitis (9.0%), encephalitis (23.4%) and that one or two sorts of vaccination were treated. As for the technical improvement of personnels who handled health problems, all of them put it in practice, and for prevention program and use of health resources, 87.5% participated in it. 3. Role performance for secondary prevention (1) 92.2% of them carried out screening tests of a physical assessment for an early detect on health problem and 24.7% did a screening tests which made a part of students its object after the first screening tests. A selection and check-up of measurement tool during a developmental evaluation was taken effect by 98.7% and a preliminary education on the persons who administered that examination and determine to select a place for it by 100%. Of discrimination and screening tests, various kinds of examination for finding disease was detected effectively by 98.7% and of this operation nothing could be come into force more than a check-up of parasites and urine with 97.4%. As to the methods explaning danger of health and safety, the case to be offered school personnels information in a staff meeting marked 96.1% and the one to offer students information in the case of generating such danger as infectious diseases was 100% (2) Control of health problem to be required regular treatment for taking a proper measure on that problem at an earlier time was carried into effect by 93.5%. 98.7% of them imposed a role of communication and intervention of offering and observation method for finding health problem and encourging this method to teacher in charge. All of them executed emergency care, School-nurses helped 33 persons a day on the average, and 89.6% of them did for students to get through a serious crisis. (3) In order to prevent complication and an disable, 83.1% of them carried out a continuous follow-up care of the students who were discharged from the hospitals. 4. Role performance for tertiary prevention (1) In order to care and treat the students who needed their rehabilitation and adaptation for activities of daily living, 89.6% of them performed reeducation after reevaluate their health status, 94.8% performed a role on motivation, 85.7% put in effect a continuous control of the students who needed rehabilitation and correction, and 15.6% did counselling for taking a measure to meet the situation of the disabled. 5. Role performance for health education. Unifying health education from the view points of the first, secondary and tertiary prevention against diseases, we surveyed the content, method, objectives of health education which is now in effect and should be emphasized in the future. Upon this study, we came to conclude as the following; as to the content of health education which is now is effect, prevention of infectious diseases has an absolute majority of all contents as 98.7%, and prevention against parasites, personal hygiene and oral hygiene second place. as 97.4% But education on prevention of venereal diseases shows inactiveness as 42.9%. On the contents to be emphasized, mental health (42.9%), sex education (40.3%) were enumerated but nobody stated about prevention of infectious diseases. As a method practising health education, all of them used that of counselling, and as an indirect education utilizing media, it comes printed matters (96.1%), poster (83.1%), interclass broadcasting casting (75.35) in that order. And the case of regular class on health education marked 23.4%, of the object of health education, 98.7% made students its object; 87.0% school personnels; 51.9% parents of students.