한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Brain Topological Correlates of Motor Performance Changes After Repetitive Transcranial Magnetic Stimulation

Park, Chang-hyun,Chang, Won Hyuk,Yoo, Woo-Kyoung,Shin, Yong-Il,Kim, Sung Tae,Kim, Yun-Hee Mary Ann Liebert 2014 Brain connectivity Vol.4 No.4

<P>Repetitive transcranial magnetic stimulation (rTMS) influences the brain temporally beyond the stimulation period and spatially beyond the stimulation site. Application of rTMS over the primary motor cortex (M1) has been shown to lead to plastic changes in interregional connectivity over the motor system as well as alterations in motor performance. With a sequential combination of rTMS over the M1 and functional magnetic resonance imaging (fMRI), we sought changes in the topology of brain networks and specifically the association of brain topological changes with motor performance changes. In a sham-controlled parallel group experimental design, real or sham rTMS was administered to each of the 15 healthy subjects without prior motor-related dysfunctions, over the right M1 at a high frequency of 10 Hz. Before and after the intervention, fMRI data were acquired during a sequential finger motor task using the left, nondominant hand. Changes in the topology of brain networks were assessed in terms of global and local efficiency, which measures the efficiency in transporting information at global and local scales, respectively, provided by graph-theoretical analysis. Greater motor performance changes toward improvements after real rTMS were shown in individuals who exhibited more increases in global efficiency and more decreases in local efficiency. The enhancement of motor performance after rTMS is supposed to be associated with brain topological changes, such that global information exchange is facilitated, while local information exchange is restricted.</P>

건축 프로젝트 적정 설계변경 관리를 위한 사례조사

김성욱(Kim Sung-Wook),남혜원(Nam Hye-Won),이종식(Lee Jong-Sik),신창현(Shin Chang-Hyun),전재열(Chun Jae-Youl) 대한건축학회 2009 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.29 No.1(구조계)

Recent design changes in the existing research on the factors and issues of design changes and analysis, responsible for analyzing the relationship, procedural issues, and issues of research that can be active. However, changes in the design of problems are essentially designed to complement the book is for the procedure. Methodology for dealing with design changes in the characteristics of the country and to reflect more realistically, and various design changes and looked at trends in related research. the design Change of this study to examine the domestic status and problems, identify the status of the country about the design changes, and in suggesting the direction to the development of the design changes.

펠던크라이스 기법, 탄성밴드 운동 및 복합운동 적용이 현대무용전공자의 체간근력에 미치는 영향

김채수(Kim Chae-Soo),권혜영(Kwon Hye-Young),이원재(Lee Won-Jae),조창모(Jo Chang-Mo),김진환(Kim Jin-Hwan),주성범(Ju Sung-Bum),이미경(Lee Mi-Kyoung) 한국체육과학회 2011 한국체육과학회지 Vol.20 No.1

This study is carried out to examine the effect of applying Feldenkrais method, elastic band training and combined training on trunk muscle. The subjects of this study were 32 modern dance majors and they were divided into four groups which consists of 8 peoples each, Feldenkrais method group(modern dance + Feldenkrais method), elastic band training group(modern dance + elastic band training), combined training group(modern dance + Feldenkrais method + elastic band training), and control group(modern dance). Measurement variables which are trunk muscle were measured before training, and after 4 and 8 weeks training and the results are as follow: In the left muscle strength change at Centaur 0°, Feldenkrais method group, elastic band training group and combined training group showed significant increase after 8 weeks training compared to before training. In the right muscle strength change, Feldenkrais method group and combined training group had significant increase after 8 weeks training. In the left muscle strength change at Centaur 45°, Feldenkrais method group and combined training group showed significant increase after 8 weeks training compared to before training and after 4 weeks training. Also elastic band training group showed significant increase after 8 weeks training compared to before training. In the right muscle strength change, Feldenkrais method group and elastic band training group significantly increased after 8 weeks training compared to before training. In the left muscle strength change at Centaur 90°, Feldenkrais method group and combined training group showed significant increase after 4 and 8 weeks training compared to before training. In the right muscle strength change, Feldenkrais method group showed significant increase after 4 and 8 weeks training compared to before training, and elastic band training group significantly increased after 8weeks training compared to before training. In the left muscle strength change at Centaur 135°, there was no significant changes. In the right muscle strength change, elastic band training group and combined training group showed significant increase after 8 weeks training compared to before training. In the left muscle strength change at Centaur 180°, combined training group showed significant increase after 4 and 8 weeks training compared to before training. In the right muscle strength change, combined training group showed significant increase after 4 and 8 weeks training compared to before training. From above results, applying 8 weeks regular program of Feldenkrais method, elastic band training and combined training to modern dance majors showed positive changes on improvement of trunk muscle strength and physical strength. Also this study implemented to verify the effects of trunk muscle strength and body balance through supplementary training program, and showed the effects in the training group and control group after 8 weeks trunk muscle strengthening program. Feldenkrais method, elastic band training and combined training are very effective to improve trunk muscle strength of modern dance majors so that continuous implementation and application of these effective training program shall be provided for strengthening trunk muscle.

정상면역을 가진 성인에서 발생한 식도 방선균증

김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

TRANSIENT ISCHEMIA-INDUCED EXPRESSION AND CHANGES OF TYROSINE KINASE A IN THE HIPPOCAMPAL DENTATE GYRUS OF THE GERBIL

HWANG, IN,LEE, HYEON,YOO, KI-YEON,KIM, DAE,KIM, JUNG,KIM, CHANG,LIM, BEONG,KANG, TAE-CHEON,BANG, KYUNG,SEONG, NAK,LEE, HAK,KIM, JONG,WON, MOO Taylor Francis 2006 International journal of neuroscience Vol.116 No.8

<P>The present study examined ischemia-related changes in tyrosine kinase A (trkA) immunoreactivity and its protein content in the dentate gyrus after 5 min of transient forebrain ischemia in gerbils. One day after ischemic insult, cresyl violet-positive polymorphic cells showed ischemic degeneration. The ischemia-induced changes in trkA immunoreactivity were found in the polymorphic layer (PL) and granule cell layer (GCL) of the dentate gyrus. In the sham-operated group, trkA immunoreactivity in the dentate gyrus was very weak. From 30 min after ischemia, trkA immunoreactivity was increased in the dentate gyrus and peaked in the dentate gyrus at 12 h after ischemia-reperfusion. Thereafter, trkA immunoreactivity was decreased time-dependently after ischemia-reperfusion. Four days after ischemic insult, trkA immunoreactivity was similar to that of the sham-operated group. In addition, it was found that ischemia-related changes in trkA protein content were similar to the immunohistochemical changes. These results suggest that the chronological changes of trkA in the dentate gyrus after transient forebrain ischemia may be associated with ischemic damage in polymorphic cells of the dentate gyrus.</P>

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.

정체경락(整體經絡)마사지가 슬내,외반 하지 변형의 교정에 미치는 영향

김송자 ( Song Ja Kim ),김우원 ( Woo Won Kim ),장완성 ( Wan Song Chang ) 한국정체경락학회(구 정체경락연구학회) 2009 한국정체경락학회지 Vol.1 No.1

본 연구는 정체경락마사지와 운동요법이 슬내반과 슬외반 하지변형의 교정에 미치는 영향을 알아보고자 하였다. 특이한 지병이 없이 후천적인 하지 변형이 있는 22세-59세까지의 여성 45명을 대상으로 슬내반집단, 슬외반집단 그리고 대조집단으로 나누어 정체경락마사지와 운동요법을 8주간 주 3회씩 총 24회를 실시하였다. 각 집단의 Q각과 고관절각, 대퇴경골각의 변화를 분석하기 위하여 평균과 표준편차를 구하였으며, 처치에 따른 평균차이를 알아보기 위하여 Two-way repeated measured ANOVA, paired t-test를 실시하였다. 그 결과 슬내·외반 집단의 하지변형에 정체경락마사지 적용 전·후의 Q각에서는 우측 모두 유의한 차가 나타나지 않았으며, 좌측에서는 측정시기에서만 유의한 차(p<.05)가 나타났다. 슬내·외반 집단의 하지변형에 정체경락마사지 적용 전·후의 고관절각에서는 좌·우측에서 집단간의 유의한 차(p<.05, p<.01)이가 나타났으며, 우측에서는 상호작용효과에서도 유의한 차(p<.01)가 나타났다. 슬내·외반 집단의 하지변형에 정체경락마사지로 관리 전·후의 대퇴·경골각의 변화에서는 좌·우에서 집단 간, 측정시기, 상호작용에서 각각 통계적으로 유의한 차(p<.05), (p<.01, p<.001)가 나타났다. 무릎간의 간격과 발목간의 간격에서도 통계적으로 유의한 차(p<.001)가 나타났다. 결론적으로 정체경락마사지는 하지변형 변인, 그리고 고관절 주변 골반의 변형에 영향을 미침으로 슬내·외반 하지변의 교정에 효과가 있는 것으로 판단된다. In this study, Jung-che massage on meridian pathways and exercise therapy, Genu varus group and Genu valgus group do not want to sort out the impact was. Subjects without the disease between 20-50 women 45 men Genu varus group, Genu valgus group, and Control group was divided into the experiment. Experiments A and B, 3 times a week, 8 weeks 24 anniversary was applied. Research subjects to analyze changes in the dependent variable, mean and standard deviation were saving. Learn the difference between the treatment based on the average to Two-way ANOVA, paired t-test was conducted. As a result, There was significant difference (p<.05, p<.01) between groups at the right and left side in coxa angle before and after treatment by Jung-che massage on meridian pathways in the change of low limb of genu varus & valgus group, and also significant difference was seen in the interactive effect at the right side. For the change of low limb in genu varus & valgus group, there was significant difference (p<.05), (p<.01, p<.001) between groups at the right and left sides, measuring periods, interactions, in terms of statistics respectively as the result of looking into changes on thigh tibia angle before and after the treatment by Jung-che massage on meridian pathways. The gap between knees, which becomes the standard of judging its shape for the change on low limb of the genu varus & valgus and means genu varus, showed significant difference (p<.001) in terms of statistics. The gap between ankles, which shows genu valgus and the standard of judging low limb change of genu varus & valgus group in shape, showed significant difference (p<001) in terms of statistics. In conclusion, Jung-che massage on meridian pathway is applied to look like their give change.

아세틸 콜린 유발 검사시 허혈성 심전도 변화와 흉통의 발생이 내피세포 기능장애에 미치는 영향

최철웅(Cheol Ung Choi),나승운(Seung-Woon Rha),김선원(Sun Won Kim),나진오(Jin Oh Na),임홍의(Hong Euy Lim),김진원(Jin Won Kim),김응주(Eung Ju Kim),한성우(Seong Woo Han),박창규(Chang Gyu Park),서홍석(Hong Seog Seo),오동주(Dong Joo Oh) 대한임상노인의학회 2010 대한임상노인의학회지 Vol.11 No.4

연구배경: 아세틸 콜린 유발 검사시 발생하는 흉통과 허혈성 심전도 변화가 아세틸 콜린에 의해 발생하는 관상동맥의 내피세포 기능에 어떤 영향을 주는지 알아보고자 했다. 방법: 흉통으로 내원하여 관상동맥 조영술과 아세틸 콜린 유발검사를 시행받은 1,085명의 환자를 대상으로 하였다. 아세틸 콜린 유발 검사를 하는 동안 허혈성 심전도 변화 및 흉통의 발생 유무에 따른 관상동맥 내피세포 기능의 특징을 비교하였다. 결과: 539명의 환자에서 아세틸 콜린 검사시 내피세포 기능 장애가 발생 하였다. 허혈성 심전도 변화가 있었던 그룹이 심전도 변화가 없었던 그룹보다 흉통이 더 많았고(78.1% vs. 60.8%, P=0.007), 관상동맥 조영술상 다발성 관상동맥 경련이 빈번하였고(59.4% vs. 40.6%, P=0.004), 관상동맥의 경련 정도도 더 심하였다(64.1% vs. 46.5%, P=0.006). 흉통이 있었던 그룹이 흉통이 없었던 그룹보다 허혈성 심전도 변화의 빈도가 더 높았다(14.7% vs. 7.5%, P=0.007). 또한 흉통이 있었던 그룹이 관상동맥 경련이 다발성으로 발생하는 경우가 많았고 (50.7% vs. 29.5%, P<0.001), 미만성으로 발생하는 경우가 많았고(87.1% vs. 75%, P<0.001), 관상동맥의 경련의 정도도 더 심하였다(51.6% vs. 43.5%, P=0.041). 결론: 아세틸 콜린 유발검사시 발생하는 허혈성 심전도 변화와 흉통은 관상동맥 경련의 정도와 경련이 발생하는 관상동맥 개수와 연관이 있다. Background: ECG changes and chest pain during acetylcholine (Ach) provocation tests may constitute important clinical parameters for Ach-induced endothelial dysfunction. We investigated the association between ischemic ECG changes and chest pain during the Ach-provocation test and angiographic characteristics of Ach-induced endothelial dysfunction. Methods: A total of 1,085 patients with anginal symptoms underwent diagnostic coronary angiography (CAG) and Ach-provocation tests. We compared angiographic characteristics of Ach-induced endothelial dysfunction according to the presence of ECG change and chest pain. Results: A total of 539 patients experienced Ach-induced endothelial dysfunction. Patients who experienced ECG change group suffered more frequent chest pain (78.1% vs. 60.8%, P=0.007), angiographically more frequent multiple coronary artery spasm (59.4% vs. 40.6%, P=0.004), and more severe coronary artery spasm (64.1% vs. 46.5%, P=0.006) than patients without ECG change. However, there was no difference in the length of endothelial dysfunction between the groups. The incidence of ischemic ECG changes in patients with chest pain was higher than in patients without chest pain (14.7% vs. 7.5%, P=0.007). Patients who experienced chest pain more often experienced multiple (50.7% vs. 29.5%, P<0.001), diffuse (87.1% vs. 75%, P<0.001), and severe coronary artery spasm (51.6% vs. 43.5%, P=0.041) than patients without chest pain. Conclusion: Ischemic ECG changes and chest pain during the Ach-provocation test are associated with multi-vessel involvement and severe coronary artery spasm. Chest pain is associated with the length of endothelial dysfunction, but ischemic ECG change is not.

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.