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호흡기 ; 보건소 균음성 폐결핵 환자의 신고 정확도 연구
허은영 ( Eun Young Heo ),오수연 ( Soo Yon Oh ),정인아 ( In A Jeong ),이재석 ( Jae Seok Lee ),임효정 ( Hyo Jung Lim ),박영식 ( Young Sik Park ),이진우 ( Jin Woo Lee ),한성구 ( Sung Koo Han ),이창훈 ( Chang Hoon Lee ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1
목적: 2000년 이래로 시행되고 있는 결핵정보 감시체계의 발생률 통계는 신고된 환자를 기준으로 하기 때문에 이로써 우리나라의 결핵 규모를 가늠하기 위해서는 자료의 타당성(validity)을 평가하는 것이 필요하다. 우리나라 공공 부분의 결핵관리는 1962년 이래 보건소를 중심으로 국가 결핵 관리의 중추적인 역할을 담당해 왔는데 본 연구자들은 보건소로부터 결핵정보 감시체계를 통해 폐결핵으로 신고된 환자 가운데 실제로 결핵이 아님에도 불구하고 결핵으로 과잉 진단된 환자의 규모가 어느 정도 되는지를 파악하고자 하였다. 방법: 연구자가 무작위로 방문한 전국 보건소에서 2005년 1월 1일부터 2005년 12월 31일까지 폐결핵 신환자로 신고된 환자들 중 객담 도말 및 배양검사 음성인 균음성 환자들을 연구 대상으로 하였다. 증상이 있으면서 진단 당시 활동성 폐결핵의 방사선학적 소견이 있고 항결핵제 치료 후 방사선 병변이 호전된 환자는 `결핵 가능성이 높은 환자`(probable TB)로 분류하였고, 세 가지 소견을 모두 만족하지 못한 환자는 `결핵 가능성이 낮은 환자`(probably not TB)로 분류하였다. 결과: 총 263명의 환자들이 분석되었다. 신고된 폐결핵 신환들의 연령 중앙값은 41세였고, 이중 60.8%가 남성이었다. `결핵 가능성이 높은 환자`는 79명으로서 전체 43.2%(95% CI, 39.6~46.7%)이었고, 증상도 없고 방사선학적으로도 `결핵 가능성이 낮은 환자`는 9명으로서 전체의 4.9%(95% CI, 4.2~5.6%)를 차지하였다. 결론: 결론적으로 보건소 균음성 폐결핵 신환자의 대다수는 실제 결핵의 가능성이 높았다. 그러나 일부의 과잉 진단의 가능성도 확인할 수 있었으며 신고자료의 정확성에 대한 평가가 향후 지속적으로 이루어져야 할 것이다. Background/Aims: The notification rate based on the Korean tuberculosis (TB) surveillance system has been widely used to evaluate the TB burden in Korea. However, few studies have examined the accuracy of TB diagnosis among notified cases. This study evaluated the diagnostic accuracy of microbiologically not proven cases notified as `new pulmonary TB patients` at public healthcare centers. Methods: We reviewed the clinical symptoms and initial and follow-up chest radiographs of notified smear-and-culture-negative TB cases in randomly selected healthcare centers between Jan 2005 and Dec 2005. Patients who had symptoms, initial chest radiographs compatible with pulmonary TB, and radiological improvements after treatment were diagnosed as `probable TB`, while patients who did not meet these three criteria were diagnosed as `probably not TB`. Results: The analysis included 263 patients. The median age of the notified TB cases was 41 years, 60.8% of them were male, and 43.2% were `probable TB` patients. Overall, 82.0% of the patients had either initial chest radiographs compatible with pulmonary TB or radiological improvements after treatment. Ultimately, 4.9% were `probably not TB` patients. Conclusions: Most of the new notified pulmonary TB patients not confirmed microbiologically in public clinics can be considered real TB patients, although there are some over diagnosed cases. (Korean J Med 76:44-51, 2009)
Isoniazid를 포함한 항결핵약제 투여 후 발생한 여성형 유방 증례
허은영 ( Eun Young Heo ),정인아 ( In A Jeong ),이재석 ( Jae Seok Lee ),이창훈 ( Chang Hoon Lee ),정희순 ( Hee Soon Chung ),김덕겸 ( Deog Kyeom Kim ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.4
Gynecomastia is a benign enlargement of the male breast attributable to proliferation of the ductal elements. Gynecomastia has been rarely reported as an adverse effect of isoniazid therapy. We report the case of a 35-year-old man who was prescribed with isoniazid, rifampicin, ethambutol and pyrazinamide to treat pulmonary and lymphatic tuberculosis. After five months of treatment, the patient complained of painful engorgement in the bilateral breasts and the presence of male gynecomastia was confirmed with a physical examination and radiographical methods. The serum level of estradiol was also increased. Common causes of male gynecomastia were excluded through history taking and the laboratory findings. The anti-TB drugs were changed to a second line regimen due to radiographical progression and the intolerance of the patient to gynecomastia. Gynecomastia was relieved very slowly and a tender subareolar palpable mass decreased in size and consistency over five-month period after stopping the probable causative drug, isoniazid. From a review of the literature, gynecomastia has been shown to be a side effect of treatment with first line anti-tuberculosis drugs, and especially with isoniazid. We report the rare case. (Tuberc Respir Dis 2008;65:308-312)
허은영 ( Eun Young Heo ),황보지혜 ( Ji Hye Hwangbo ),이윤희 ( Yoon Hee Lee ),김미주 ( Mi Ju Kim ),배진영 ( Jin Young Bae ),성원준 ( Won Joon Seong ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.5
Pregnancy is a rare event in patients with cirrhosis. But recently, improvements in the treatment of chronic liver disease have resulted in higher conception rates and more successful pregnancy outcomes. A 32-year-old woman with liver cirrhosis underwent cesarean section due to aggravated preeclampsia at 31 3/7 weeks of gestation. After 3 days postoperatively, she complained abdominal distension, and abdominal sonography showed massive amount of ascites. Following paracentesis and administration of diuretics, her course was uneventful. There are increasing numbers of case reports and case series of pregnancy in liver cirrhosis. Nevertheless, morbidity and mortality remains higher than that of the general pregnant population. It is therefore important for physicians caring for pregnant patients with cirrhosis to understand how to approach potential complications and tailor management regimens appropriately.
보문 : 여군의 군복에 대한 인식과 전문직 자기이미지에 관한 연구
허은영 ( Eun Young Heo ),진기남 ( Ki Nam Jin ),고애란 ( Ae Ran Koh ),김진주 ( Jin Joo Kim ) 한국의류학회 2011 한국의류학회지 Vol.35 No.11
This study examines if the uniform-related perceptions influence the formation of professional identity. A self-administered survey was conducted on 346 female nursing officers at military hospitals. The independent variables were the basic characteristics, perception of clothing benefit, perception of nursing uniform, and perception of the officer uniform. For the data analysis, we used paired t-test and hierarchical regression analysis. Using a paired t-test, we found the difference in function and satisfaction between nursing uniforms and officer uniforms. The result of hierarchical regression analysis shows that uniform-related perceptions were statistically significant in predicting professional identity. The nursing uniform explained the major portion of variation of professional identity; subsequently, the improvement of uniforms can enhance professional identity.
허은영(Eun Young Heo),조진숙(Jin Sook Cho) 한국복식학회 1998 服飾 Vol.38 No.-
In Korean clothing industry, most of the manufacturers produce garments by subcontractors partially or entirely. It is very often that the design part is remote from production part and there is miscommunication between these two parts resulting dissatisfaction to both. Threfore it is very important to communicate the manufacturing information clearly and quickly to produce garments exactly the design part intended. Also to automate the clothing manufacturing, it is prerequisite to find out how to produce and use the information objectively and efficiently. As a first step of moving to automation, the purpose of the research is to find out how manufacturing information and data are communicated in clothing manufacturing at present. In order to follow the information flow of a certain manufacturer, the case study method was used. The case study samples were 12 clothing firms of 13 brands. The results and suggestions are as follows:- 1. A manufacturing information is communicated through paper documents such as Production Order, sample and patterns. At present, a production order sheet is the most efficient connunication media, which comprises most of the information being communicated. 2. A manufacturing information comprises control information on the product, design information, pattern information, cutting information, material information, sewing information, production schedule information, quality control information, costing information and information about the subcontractors. 3. A manufacturing information is not quite objective except pattern information and cutting information which is presented by CAD systems. The communication of design information and sewing information should be somehow more objective. 4. There is not musch information from a subcontractor. Considering that a subcontractor is the other partener of the communication, more information from the subcontractor is required for both benefit. 5. A designer produce most of the manufacturing information, but the information is communicated through a production manager to the subcontractor. The difference between the information maker and information communicator can cause any miscommunication. In future automated manufacturing, it will be possible for the designer to communicate to the manufacturer directly from the early stage of designing.