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임가진,김서현,박인기,박성재,송숙희,김혜옥 대한결핵및호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.76 No.6
Background: We aimed to investigate the role of the physician in practice and the factors that influence the success rate of smoking cessation. Methods: This study retrospectively analyzed 126 adult smokers who had visited the outpatient department of pulmonology, and received motivational interviewing with or without supplement drugs. The findings include continuous smoking abstinence rate, which was evaluated at 6, 12 and 24 weeks, and the factors associated with continuous abstinence for 6 months or longer. Results: The patients with only motivational interviewing accounted for 57.9%, while the nicotine patch therapy was applied to 30.2%; and varenicline was prescribed to 11.9%. The smoking cessation success rates of at 6, 12, and 24 weeks were 55.6%, 47.6%, and 33.3%, respectively. However, even in the failure group at six months, tobacco consumption was decreased under 10 cigarettes per day in 42.1% (53/126). In multivariate logistic regression analysis, degree of Fagerstöm Test for Nicotine Dependence (p=0.034; odds ratio, 3.607; 95% confidence interval [CI], 1.102–1.807), the absence of smoking-related lung disease (p=0.008; odds ratio, 4.693; 95% CI, 1.497–14.707), and education level (p=0.001; odds ratio, 181.420; 95% CI, 8.414–3,911.502) were the predictors of successful smoking cessation. Conclusion: An improved continuous smoking abstinence rate can be obtained by motivational interviewing, regardless of the association with pharmacotherapy.
임가진,( Jin-soo Min ),( Sang-hoon Lee ),( Yeon-joo Lee ),( Jong-sun Park ),( Young-jae Cho ),( Ho-il Yoon ),( Jae-ho Lee ),( Choon-taek Lee ) 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-
Background/purpose: Impairment of diaphragmatic function is one of main pathophysiological mechanisms of COPD and seems to be related with acute exacerbation. Ultrasonography is a safe and handy bedside tool that provides a simple, non-invasive assessment of diaphragm kinetics. The purpose of this study was to investigate the change of diaphragmatic function during acute exacerbation of COPD by ultrasonography. Method: This was a single center prospective study. Patients with acute exacerbation of COPD were enrolled for diaphragm measurement. US measurement were performed within 72 hours after exacerbation and within 24 hours before discharge with improvement of symptoms. Right diaphragm was evaluated by B- and M-mode ultrasonography. Diaphragm movement and its thickening fraction (TF) were measured as a marker of diaphragm`s function. TF was calculated as (thickness at end inspiration thickness at end expiration)/thickness at end expiration. Results: Ten patients were enrolled. All patients were male and mean age was 79.8. A significant increase was found between initial and follow up value in right diaphragm TF (80.1 ± 104.9 mm vs 159.5 ± 224.6 mm, p=0.011), however, no significant difference was found in diaphragm movement (2.4 ± 0.6 cm vs 3.0 ± 1.4 cm, p=0.109). Conclusion: These data support a possibility that a defect of diaphragm thickening was related with acute exacerbation of COPD.
How much do family members satisfy with the intensive care unit in South Korea?
임가진,( Jinsoo Min ),( Guntae Park ),( Jisook Yoon ),( Jeongyeon Shin ),( Sangim Park ),( Sejoong Kim ),( Jongsun Park ),( Hoil Yoon ),( Jaeho Lee ),( Choontaek Lee ),( Youngjae Cho ),( Yeonjoo Lee ) 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-
Meeting the needs of family members of patients in the intensive care unit(ICU) is an important aspect of patient- and family-centered care. We evaluated the satisfaction and ICU experiences of the family members of ICU admitted patients We developed a survey asking the family members about their ICU experience, which evaluated the 3 major outcomes: (1)understanding of general information on ICU, (2) understanding of medical status of ICU patient, and (3)satisfaction of information received. The mean score of three outcomes, which represent overall family satisfaction with the ICU care, was calculated for each variable. The study was conducted at the medical ICU of Seoul National University Bundang Hospital from August, 2014 to February, 2015. One hundred three surveys were returned. The satisfaction of information received had highest score(79.8±20.6), followed by understanding of medical status of ICU patient(76.0±19.4), and understanding of general information on ICU(58.5±23.9). The score of overall family satisfaction was 71.0±16.7. Multi-variate analysis revealed the patient age over than 70 year-old, lower score of satisfaction of previous admission and lower level of patient’s education were significantly associated with decreased overall family satisfaction. The patient age over than 70 year-old, lower score of satisfaction of previous admission and lower level of patient’s education were significant factors associated with overall satisfaction. Further researche using validated questionnaire are essential to improve the family members ICU experience.
The relation between obstructive sleep apnea and gastro-esophageal reflux disease
김유림,임가진,강혜란,이연주,박종선,조영재,윤호일,이재호,이춘택,김세중 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-
Background/Purpose: Obstructive sleep apnea (OSA) is believed as an important risk factor for the gastro-esophageal reflux disease (GERD). However, the link between OSA and GERD is not apparent and incompletely defined. The aim of this study was to assess the relation between OSA and GERD.Methods: Enrolled patients were performed both overnight polysomnography and gastroendoscopy from January, 2005 to July, 2015 at Seoul National University Bundang Hospital. The gastroendoscopic findings were classified as Los Angeles (LA) classification. Nonerosive reflux disease (NERD) was defined as the absence of esophageal mucosal injury with typical GERD symptoms. Result: One hundred ninety eight patients were enrolled. Of all patients, 89 (44.9 %) were NERD group, 63 (31.8 %) were minimal change GERD group, and 46 (23.3 %) were LA-A and B GERD group. Sleep efficiency was significantly worse in NERD group (80.6 [11.6] %) than in LA-A and B GERD group (85.4 [8.4] %) (P=0.007). However, the apnea related findings were worse in LA-A and B GERD group than in NERD group; respiratory distress index was 29.3 (22.1) vs 21.6 (18.5) (P=0.033), longest apnea was 49.6 (23.9) sec vs 40.2 (22.7) sec (P=0.027), lowest O2 saturation was 79.0 (13.8) % vs 83.7 (8.1) % (P=0.013), and oxygen desaturation index was 22.2 (19.6) vs 15.3 (16.2) (P=0.045). Conclusion: Gastroendoscopic proven GERD was associated with the more severe form of OSA.
The associations of mediastinal fat and obstructive sleep apnea
최한솔,강혜란,임가진,김유림,이연주,박종선,조영재,윤호일,이재호,이춘택,김세중 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-
RATIONALE: Obstructive sleep apnea (OSA) is associated with features including cardiovascular and metabolic consequences. Although obesity is a predisposing factor in the development of OSA, it has not been determined whether fat distribution is associated with OSA severity. Mediastinal fat is considered as a local source of pro-inflammatory factors associated with the development of metabolic syndrome and cardiovascular diseases. The aim of this study was to investigate the relationship between mediastinal fat with OSA severity. Methods: Enrolled subjects underwent polysomnography and chest computed tomography within 1 year. Mediastinal fat volume evaluated by chest CT, and parameters of metabolic syndrome (waist circumference, arterial blood pressure, fasting glucose, HDL-cholesterol and triglycerides) were measured. The severity of OSA was evaluated by apnea-hypopnea index (AHI). Results: One hundred forty six subjects were enrolled. Mean mediastinal fat area (mediastinal fat volume/height of the thorax) showed a positive correlation with AHI (r=0.331, p<0.001). The group of metabolic syndrome has significantly more mean mediastinal fat area (18.1 [7.1] cm2 vs 14.4 [7.4] cm2) and higher AHI (37.0 [25.6] vs 21.9 [21.5]) compared with the group of non-metabolic syndrome (p=0.004 vs p=0.001, respectively), even if their body mass index was similar (25.7 [7.5] ㎏/m2 vs 24.3 [5.5] ㎏/m2, p=0.184). Conclusions: This study suggests that mediastinal fat increases the risk of metabolic syndrome and this can contribute the severity of OSA.
김유림,민진수,임가진,이정규,이한나,이진우,김경수,박종선,조영재,조유환,유호걸,김규석,이상민,이연주 대한중환자의학회 2017 Acute and Critical Care Vol.32 No.1
Background: A number of questionnaires designed for analyzing family members’ inconvenience and demands in intensive care unit (ICU) care have been developed and validated in North America. The family satisfaction in the intensive care Unit-24 (FS-ICU-24) questionnaire is one of the most widely used of these instruments. This study aimed to translate the FS-ICU-24 questionnaire into Korean and validate the Korean version of the questionnaire. Methods: The study was conducted in the medical, surgical, and emergency ICUs at three tertiary hospitals. Relatives of all patients hospitalized for at least 48 hours were enrolled for this study participants. The validation process included the measurement of construct validity, internal consistency, and interrater reliability. The questionnaire consists of 24 items divided between two subscales: satisfaction with care (14 items) and satisfaction with decision making (10 items). Results: In total, 200 family members of 176 patients from three hospitals completed the FS-ICU-24 questionnaire. Construct validity for the questionnaire was superior to that observed for a visual analog scale (Spearman’s r = 0.84, p < 0.001). Cronbach’s αs were 0.83 and 0.80 for the satisfaction with care and satisfaction with decision making subscales, respectively. The mean (± standard deviation) total FS-ICU-24 score was 75.44 ± 17.70, and participants were most satisfied with consideration of their needs (82.13 ± 21.03) and least satisfied with the atmosphere in the ICU waiting room (35.38 ± 34.84). Conclusions: The Korean version of the FS-ICU-24 questionnaire demonstrated good validity and could be a useful instrument with which to measure family members’ satisfaction about ICU care.
김세중,연제인,이희재,강혜란,임가진,김유림,이연주,박종선,조영재,윤호일,이춘택,이재호 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-
Introduction: Bacterial pneumonia and pulmonary tuberculosis are significant public health diseases. A prompt differential diagnosis between bacterial pneumonia and pulmonary tuberculosis is essential. However, it is still a difficult problem to make a precise and quick diagnosis. Myeloid-derived suppressor cells (MDSCs) are accumulated in many pathologic conditions including cancer and infectious diseases. They play an important role in suppression of host immune responses. The aim of this study was to explore the diagnostic value of MDSCs in bacterial pneumonia and pulmonary tuberculosis. Methods: Bacterial pneumonia (n=17), pulmonary tuberculosis (n=18) and normal control (n=18) group were prospectively enrolled. We analyzed CD14-CD11b+CD33+ MDSC and their CD15+ granulocytic proportion in peripheral blood. Results: The mean (SD) values of CD14-CD11b+CD33+ MDSC and their CD15+ granulocytic population were significantly different between bacterial pneumonia (35.8 [29.6] %, 95.9 [3.0] %), pulmonary tuberculosis (16.6 [14.9] %, 85.0 [16.9] %) and normal control (7.2 [4.6] %, 63.3 [20.9] %) (P < 0.001, both). In comparison between bacterial pneumonia and pulmonary tuberculosis, CD14-CD11b+CD33+ MDSC and their CD15+ granulocytic population were significantly different (P = 0.025, P = 0.015, respectively). Conclusion: The levels of MDSCs in bacterial pneumonia patients were significantly higher than that in pulmonary tuberculosis patients. Therefore, the measurements of MDSCs can be benefit to distinguish between bacterial pneumonia and pulmonary tuberculosis.