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.

중증 화상 환자에서 영양지원

박지영,목혜숙,신현선,노순예,김애심,백금선,김도헌,허준,전욱 대한화상학회 2003 대한화상학회지 Vol.6 No.2

여대생의 흡연에 대한 태도 및 요인 분석 : 김천대학 여대생 중심

송애랑 ; 박지원 김천대학교 2004 김천대학교 논문집 Vol.25 No.-

The purpose of this study was to explore the attitudes about smoking and factor analysis among college women. The subject were 347 female students selected by random sampling from Gimcheon College in Korea. The data were collected by survey methods a period of 7days. The data were analyzed by SPSS 10.0 version, T-test. F-test and factor analysis. Analysis of the data resulted in identification of 8 factors in general group and 5 factors in smoking group. Major factor were involved in curiosity, viewpoint of smoking, health belief, friend-relationship, image, body weight loss, fault, and viewpoint of opposite sex The characteristics of smoking behavior: 1. The meaning of smoking behavior in college women is justifiable orregretable. 2. Smoking behavior is related to the perception of harmfulness to health, influence of 2nd generation. 3. Smoking in college women is not caused by antagonism toward male smokers. 4. The first smoking time was middle school students It is suggested that the results of this study may contribute to the development of strategies for the purpose of decreasing smoking behav-ior among female college students.

신경세포의 Outgrowth 향상을 위한 마이크로 파이버 지지체와 전단응력의 영향

김인애,박수아,김영직,김수향,신호준,이용재,신지원,신정욱 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

We introduced mechanical stimuli and micro patterned substrate with micro fibers to investigate the effects of those on neurite outgrowth along with nerve growth factor (NGF) in vitro. Micro fiber substrates were fabricated using an electros pinning process. And PC-12 cells cultured on substrates were simulated with newer growth factor and laminar flow shear stress in a fluid flow system. The results suggest that micro fiber substrates and fluid-induced shear stress are promising for simulating neuronal regeneration in a desired direction.

과학영재교육 교사 교수방법 전문지식의 수준 분석

서혜애,박경희,박지은 이화여자대학교 교과교육연구소 2007 교과교육학연구 Vol.11 No.1

본 연구에서는 우리나라 과학영재교육을 담당하는 교사들의 과학영재교육 교수방법 전문지식의 수준을 조사하는 데 목적을 두었다. 2005년 기준 전국 16개 시·도 교육청 산하 영재학급 및 영재교육원에서 과학영재교육을 담당하는 교사 수는 총1,883명으로 조사되었다. 이 가운데 531명(28.2%)의 과학영재교육 교사는 ‘과학영재교육 교사 교수방법 전문지식 측정도구(서혜애·박경희, 2005)’에 응답하였으며, 응답한 교사의 교수방법 전문지식 수준은 최종학력, 연수이수여부, 학교급에 따라 차이가 있는 것으로 나타났다. ‘과학지식 및 과학교육학 지식’과 ‘영재교육학 지식’은 영재교육 연수 이수 유무와 관련 없이 교사의 성별 및 최종학력에 따라 차이를 보였으며, ‘과학영재교육과정 지식’은 교사가 어떤 영재교육 연수를 이수했는지, 어떤 학교급을 지도하고 있는 지에 따라 차이가 있는 것으로 나타났다. ‘교사 전문성 계발 지식’은 학교급, 성별에 따라 차이를 보였다. 연구결과에 근거하여 다음과 같이 과학영재교육의 질을 제고하는 방향을 제안하였다. 첫째, 효과적 과학영재교육교사 연수를 개발하기 위해서는, 연수기관은 연수 대상 교사의 학교급에 따라 연수프로그램의 교육내용을 달리하여 구성해야 할 것이다. 둘째, 과학영재교육 교사 임용정책에서는 최종학력 조건을 강화하고 교사 전문성 계발의 동기 수준을 고려하는 것이 바람직할 것이다. The research aims to investigate the status of teacher's professional knowledge level of teaching the gifted in science. As of 2005, there were 1,883 teachers who teach at gifted educational institutions affiliated with sixteen provincial offices of educations in Korea. Research subjects include 531 out of 1,883 teachers (28.2%) and they responded to the 'Science Teacher Scale of Professional Knowledge for Teaching the Gifted' (Seo & Park, 2005). It was found that there were significant differences in the levels of science teachers' professional knowledge for teaching the gifted in terms of highest degrees earned, school level, completion of inservice training programs of gifted education, etc. It was also found that ‘subject matter content knowledge in science and pedagogical content knowledge in science’ and ‘general pedagogical knowledge in gifted education’ varied along teachers' gender and highest degrees earned. ‘Science curriculum knowledge in gifted education’ were varied along completion of inservice teacher training programs and school levels. In conclusion, in order to raise the quality of gifted education, first, host institutions of inservice teacher training programs of gifted education are recommended to provide program contents in consideration with different schools levels of participating teachers. Second, policy makers may strengthen requirements of highest degrees earned for employing teachers in gifted education.

Amplatzer Septal Occluder를 이용한 심방중격결손 폐쇄의 초기 성격

이형두,박지애 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

복막투석복막염 환자에서 발생한 창자벽공기증 1예

정선영,나지훈,최윤정,고성애,조규향,박종원,도준영,윤경우 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.1

Peritonitis is a serious problem in patients undergoing peritoneal dialysis. Rarely pneumatosis intestinalis can occur as a complication of this infectious process. Pneumatosis intestinalis is a potential life threatening condition with a challenging management. The mortality of peritoneal dialysis patients with pneumatosis intestinalis secondary to mesenteric ischemia is almost 100%. We describe a rare case of pneumatosis intestinalis in a peritoneal dialysis patient who developed Staphylococcus aureus peritonitis which was initially treated with appropriate antibiotics. Since initial response to therapy was not achieved, an abdominal computerized tomography was done which revealed a pneumatosis intestinalis. A laparotomy was performed and small bowel necrosis was seen. A segmented resection with ileostomy, jejunostomy was done. Though surgical treatment was performed, the patient died in 2 weeks after admission. Pneumocystitis intestinalis in peritoneal dialysis peritonitis is a uncommon complication which requires prompt evaluation to rule out mesenteric ischemia as it carries a high mortality and its management will be surgical.

특발성 과호산구 증후군 환자의 치료 도중 발생한 간혈종 1례

이영태,김동기,박지훈,김윤정,김기향,박보민,권민정,김애란,이원식,주영돈,손창학 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Idiopathic hypereosinophilic syndrome is characterized by marked elevation of eosinophil count ( >1,500/㎣) in peripheral blood without explaining etiology. It shows tissue involvement in many organs such as liver, G-I tract, myocar dium, lung, skin, kidney and nerve. Some case of hypereosinophilic syndrome with hepatic involvement have been reported, but not much. We have recently experienced a case with idiopathic hypereosinophilic syndrome of a 40 year old man who presented with RUQ pain. By abdominal CT, ill- defined subcapsular hematoma was detected. Liver biopsy showed eosinophilic infiltration within the portal tract and sinusoid. Drain procedure and corticosteroid adminiiatbrought marked improvement of clinical manifestation, hematologic abnormality and radiologic abnormality.

베체트병 환자에서 Azathioprine으로 유발된 급성 췌장염 1례

김기향,권민정,김동기,김애란,김윤정,박지훈,이영태,박보민,김동욱 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Although many drug are thought capable of initiating acute pancreatitis, following azathioprine administration represents the 5% incidence by far the highest recorded incidence to date. We report a 35-year-old male who developed acute pancreatitis in the course of treatment with azathioprine for Behcet's disease. He was admitted due to abdominal pain, diarrhea, and fever for 10 days. Serum amylase and lipase levels were 510U/L and 3702U/L respectively. The abdominal CT scan revealed diffuse enlargement of the pancreas. There was no history of alcohol use or gall bladder disease. We considered drugs, especially azathioprine, as the cause of acute pancreatitis. We diagnosed it as acute pancreatitis. The patient was treated conservatively with hydration and analgesics. The symptom subsided within four days. Five days later, azathioprine was resumed. And the patient complained of abdominal pain. The elevated levels of serum amylase and lipase confirmed the recurrence of pancreatitis. His symptom subsided when azathioprine intake the stopped, and the serum amylase and lipase levels returned to normal level within five days.

産業災害로 인한 手脂切斷 患者의 療養期間과 診療費의 變異

이종호,이종영,손지연,하영애,박순우,감신,이영숙,김건엽,강윤식 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.3

This study was conducted to analyze variation in patient days and medical care benefits among finger-amputated patients due to industrial injury. The 242 personal data on medical care for finger-amputated patients due to industrial injury(131 in 1994, 111 in 1995) of Regional Labor Office were analyzed. The major results of this study were as follows: Patient days per case were 69. And the ratio of the maximum and the minimum among patient days for case was 26.6. Patient days per case in university hospital were 134.8 and the longest than other medical facilites. The ratio of the maximum and the minimum among the patient days per case was higher in hospital(24.7) than in other medical facilities. Benefits per case were 1,258,000 Won. And the ratio of the maximum and the minimum among benefits of case was 232.0. Case benefits was higher in university hospital (2,685,000 Won) than in other medicl facilities. The ratio of the maximum and the minimum among the benefits per case was higher in hospital(232.0) than in other medical facilities. Variation in patient days and medical care benefits per finger-amputated patient in industrial injury was large. This study results indicated need for a new industrial injury compensation insurance policy initiative for efficient utilization of medical resources and quality assurance. And the author thought that the results of this study would influence the policy for the industrial injury compensation insurance policy.