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.

Sphingosine 1-Phosphate and Sphingosine Kinase Activity during Chicken Embryonic Development

Choi, Chang-Hwan,Jeong, Ji-Seon,Yoo, Bo-Im,Jin, You-Xun,Moon, Dong-Cheul,Yoo, Hwan-Soo,Oh, Seik-Wan,Hong, Seon-Pyo,Lee, Yong-Moon 대한약학회 2007 Archives of Pharmacal Research Vol.30 No.4

The chicken embryo has been weil used in studies of the developmental process, and during development sphingosine and sphingosine 1-phosphate (So1P) are considered critical mediators of cell death and survival. In this study, we compared the sphingolipid contents of chicken embryos during the early embryonic development period from day 3 to day 6. HPLC analyses of sphingosine and So1P in chicken embryos revealed that sphingosine levels were greatly reduced on day 4 whereas So1P levels were not significantly changed. Sphingosine kinase(Sphk) activities, which require sphingosine as substrate to produce So1P, were also greatly reduced on day 4. Collectively, we found sphingosine levels and Sphk activities, but not So1P levels are changed in early stage of chicken embryos development.

Expression of cellular retinoic acid-binding protein-I (CRABP-I) in the cerebrospinal fluid of adult onset moyamoya disease and its association with clinical presentation and postoperative haemodynamic change

Jeon, Jin Sue,Ahn, Jun Hyong,Moon, Youn-joo,Cho, Won-Sang,Son, Young-Je,Kim, Seung-Ki,Wang, Kyu-Chang,Bang, Jae Seung,Kang, Hyun-Seung,Kim, Jeong Eun,Oh, Chang Wan BMJ Publishing Group Ltd 2014 Journal of neurology, neurosurgery and psychiatry Vol.85 No.7

<P><B>Objective</B></P><P>The elevation of cellular retinoic acid-binding protein-I (CRABP-I) has been suggested as a candidate in the pathogenesis of paediatric moyamoya disease (MMD). However, few studies have addressed CRABP-I in adult onset MMD. The aim of this study was to examine the expression of CRABP-I in the cerebrospinal fluid (CSF) of adult onset MMD, and to evaluate its association with clinical presentation and postoperative haemodynamic change.</P><P><B>Methods</B></P><P>This study examined the CSF from 103 patients: bilateral MMD, n=58 (56.3%); unilateral MMD, n=19 (18.4%); atherosclerotic cerebrovascular disease (ACVD), n=21 (20.4%); and control group, n=5 (4.9%). The intensity of CRABP-I was confirmed by western blotting and expressed as the median (25th–75th percentile). The differences in CRABP-I expression according to disease entity (unilateral MMD vs bilateral MMD vs ACVD), initial presenting symptoms (haemorrhage vs ischaemia) and postoperative haemodynamic change (vascular reserve in single photon emission CT and basal collateral vessels in digital subtraction angiography) were analysed.</P><P><B>Results</B></P><P>CRABP-I intensities in bilateral MMD (1.45(0.86–2.52)) were significantly higher than in unilateral MMD (0.91(0.78–1.20)) (p=0.044) or ACVD (0.85(0.66–1.11)) (p=0.004). No significant differences were noted based on the initial presenting symptoms (p=0.687). CRABP-I was not associated with improvement in vascular reserve (p=0.327), but with decrease in basal collateral vessels (p=0.023) postoperatively.</P><P><B>Conclusions</B></P><P>Higher CRABP-I in the CSF can be associated with typical bilateral MMD pathogenesis in adults. Additionally, postoperative basal collateral change may be related to the degree of CRABP-I expression.</P>

Hoffmann반사를 이용한 선택적 척수 후근 절제술을 위한 근전도 기기와 프로그램의 개발 : 척수 신경근 자극시의 근전도 양상에 대한 연구 A Study on the EMG Patterns Generated by Stimulation of the Spinal Nerve Roots

오창완,권성훈,김희찬,왕규창,김현집 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.6

토양으로부터 항세균성 물질을 생산하는 Streptomyces sp. 의 분리

오현정,정완석,김세재,김창진,고영환 제주대학교 생명과학연구소 1999 제주생명과학연구 Vol.2 No.-

제주도의 토양에서 분리된 방선균 307주를 대상으로, paper disc법과 시험관 희석 배양법을 사용하여 항세균성 물질을 생산하는 균주를 선별하였다. 약 3.3%에 상당하는 분리주들이 Escherichia coli 8749, Staphylococcus aureus 6538 그리고 Pseudomonas solanacearum 10692에 대해 항균효과를 나타냈고, 그 중에서 가장 높은 항균활성을 나타내는 BL93 균주를 최종선별하여 동정하였다. BL93 균주의 배양학적, 형태학적, 생리학적, 생화학적 그리고 화학분류학적 특성을 기준으로 볼 때 Streptomyces violaceus와 유사하였기에, Streptomyces sp. BL93으로 명명하였다. 이 균주가 생산하는 항세균성 물질은 butanol보다도 물에 더 잘 녹는 극성화합물로 chloroform이나 ethylacetate에는 거의 용해되지 않았다. 100℃에서 30분간 가열 처리해도 활성의 소실이 거의 없었고, pH 3∼9범위에서 안정하였다. 분리균주 BL93은 aspartocin을 생산하는 Streptomyces violaceus와 유사함으로, BL93이 생산하는 항세균성 물질의 동정 및 aspartocin과의 비교 검토가 선행되어야 할 것이다. Three hundred and seven isolates of Actinomycetes were isolated and purified from soil samples in Cheju Is. to screen antibacterial compounds. About 3.3% of the isolates showed antibacterial activity, and one of them, BL93, showed relatively higher antibacterial activity against Escherichia coli 8749, Staphylococcus aureus 6538 and Pseudomonas solanacearum 10692 by both paper disc method and tube dilution incubation method. The isolate BL93 was similar to Streptomyces violaceus based upon its cultural, morphological, physiological, biochemical and chemotaxanomic characteristics. It was designated as Streptomyces sp. BL93. The antibacterial substance produced by the isolate BL93 had higher affinity for water than butanol and was insoluble in chloroform or ethylacetate. Most of its antibacterial activity was retained even after heating at 100℃ for 30min and was stable at pH ranges 3 to 9. As the isolate BL93 was tentatively identified to be Streptomyces violaceus, the antibacterial substance preferentially need to be identified and compared with aspartocin, an antimicrobial compound produced by Streptomyces violaceus.

두개강내 해면상혈관종의 임상양상 및 수술적 치료의 효용

오창완,정영섭,김동규,백선하,조병규,왕규창,한대희 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.6

콩코드 납축전지의 SOC 추정

전창완,채광석,임준규,오명섭,박명신 순천향대학교 부설 산업기술연구소 2004 순천향 산업기술연구소논문집 Vol.10 No.1

Nowadays many battery-based systems like electric vehicle have appeared. As a result efficient battery management becomes important. In this paper, state-of-charge (SOC) estimation of a Concode lead acid battery is discussed. The SOC estimation problem plays an important role in battery management system(BMS). In this paper, an SOC table is established by many charge and discharge experiments. This table can be used to development advanced SOC estimation algorithms.

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서 보다 10.9배 높았다. 결론 : 2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background : This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods : A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results : In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion : The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

골수구성 백혈병 환자에게 발생한 결핵성 림프절염

이창섭,송진수,최평균,조재현,방지환,박경화,박완범,김홍빈,김남중,윤성수,박선양,김병국,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.5

혈액질환 가운데 결핵 발생이 증가한다고 알려진 것은 호지킨 림프종을 포함한 림프증식성질환 그리고 모양세포성 백혈병 등이 있다. 또한 동종 골수이식을 받은 환자에서도 결핵은 증가한다고 알려져있다. Kaplan 등은 골수구성 백혈병 환자에서 결핵 발생이 증가한다고 보고하였다. 그러나 골수구성 백혈병 환자에서 결핵의 발생이 증가하는 이유에 대해서는 아직까지 정확하게 밝혀지지 않았다. 저자들이 2년 동안 후향적으로 조사한 180명의 성인 골수구성 백혈병 환자들 가운데 결핵이 발생한 환자는 4명이었고, 발생 부위는 모두 림프절이었다. 결핵은 골수구성 백혈병의 특정 아형에만 국한되어 발생하지 않았지만, 50%에서 FAB 분류에 의한 M4였다. 림프절이 종대된 골수구성 백혈병 환자에서 특히, 결핵의 유병율이 높은 나라에서는 결핵성 림프절염도 감별진단에 포함시켜야 한다. During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.