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.

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.

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.

Ischemia-Related Changes in Galanin Expression in the Dentate Hilar Region after Transient Forebrain Ischemia in Gerbils

LEE, Hyeon Yong,HWANG, In Koo,KIM, Dae Ho,KIM, Jung Hwa,KIM, Chang Ho,LIM, Beong Ou,KANG, Tae-Cheon,BANG, Kyung Hwan,SEONG, Nak Sul,LEE, Hak Ju,KIM, Jong Dai,WON, Moo Ho Japanese Association for Laboratory Animal Science 2005 EXPERIMENTAL ANIMALS Vol.54 No.1

<P>Although galanin (GAL) protects hippocampal neurons from ischemic damage, no study has examined ischemia-related changes in endogenous GAL in the hippocampal dentate gyrus. We investigated the chronological changes of GAL, well-known as the potassium channel opener, expression in the dentate gyrus at various times after 5 min of transient forebrain ischemia in gerbils. A few GAL-immunoreactive (IR) neurons were found in the polymorphic layer of the sham-operated group. Three hours after ischemia-reperfusion, the pattern of GAL immunoreactivity was similar to that of the sham-operated group and the number of GAL-IR neurons and immunoreactivity were highest 12 h after ischemic insult. At this time, GAL-IR neurons in the polymorphic layer showed strong GAL immunoreactivity. Thereafter, GAL-IR neurons and immunoreactivity significantly decreased in the dentate hilar region. Four days after ischemic insult, GAL-IR neurons were not detectable. In addition, the results of a Western blot study showed a pattern of GAL expression similar to the immunohistochemical changes. GAL protein content also was highest 12 h after ischemia. In conclusion, the increased expression of endogenous GAL in the dentate gyrus after ischemia is related to response to the ischemic damage.</P>

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

사염화탄소 투여 흰쥐에서 간섬유화 진행에 따른 Propranolol 의 약동학적 지표들의 변화

이민호,강주섭,강문수,윤병철,이오영,함준수,변재원,윤창옥 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.2

Background/Aims : This study was designed to determine the effect of hepatic fibrotic severity on pharmacokinetics of propranolol in CC1q - treated rats. Methods - 1 mL/kg of 10% CC14 in olive oil was injected intramuscularly to rats twice weekly for 4, 6, 8 and 10 weeks, respectively (n=6). Control (n=6) was a sham - injected equal dose of olive oil for 10 weeks. After intravenous bolus injection of 2 mg/kg propranolol to rats, the serum propranolol concentrations were analyzed for 4 hours at various time points by a HPLC - fluorimetric system, and pharmacokinetic parameters such as Co, MRT, AUC, Vdss, tl/2(p) and CLp were determined. Then, a small amount of hepatic tissue was obtained and subjected to determination of the hepatic 4 - hydroxyproline content, which confirmed the hepatic fibrotic severity. Results : The serum concentrations of propranolol at 0.5, 1, 2 and 4 hours were significantly increased in CC1q-treated rats (p$lt;0.01). In proportion to the duration of CC4 treatment, Co and AUC were significantly increased, and Vdss and CLp were significantly decreased (p$lt;0.001). But MRT and t1/2(β) were not significantly changed. The hepatic 4 -hydroxyproline content was gradually increased in CC4-treated rats (p$lt;0.001). Conclusion - Gradual changes in pharmacokinetic parameters of propranolol were seen to be dependent on the hepatic fibrotic severity. We suggest that gradual dosage modification, according to their hepatic fibrotic severity, is necessary for many drugs administered to patients with chronic liver disease.(Korean J Hepatol 2001;7:181-188)

Near-Normalized Gene Expression Profiles in Bladder With Detrusor Overactivity in Rats With Bladder Outlet Obstruction After Deobstruction

Lee, Tack,Lim, U-Sung,Kang, Dong Hyuk,Jung, Hae-Do,Kim, Hyunzu,Choi, Bo-Hwa,Kang, Ju-Hee,Yoon, Sang-Min,Park, Chang-Shin Korean Continence Society 2017 International Neurourology Journal Vol.21 No.4

<P><B>Purpose</B></P><P>The pathophysiological role of detrusor overactivity (DO) in the bladder, which is commonly observed in various bladder diseases, is not well understood. DO appears in bladder outlet obstruction (BOO), and may continue even after subsequent deobstruction. DO therefore provides an excellent opportunity to observe molecular biological changes.</P><P><B>Methods</B></P><P>In this study, to understand the molecular effects of persistent DO after BOO induction and deobstruction, we performed awake cystometry on female Sprague-Dawley rats divided into 4 groups: a sham group, a BOO group, a deobstructed group with DO after BOO (DDO), and a deobstructed group without DO after BOO (non-DDO). Total RNA was extracted from the bladder samples, and gene expression profiles were compared between the sham and model groups.</P><P><B>Results</B></P><P>DO was observed in 5 of the 6 rats (83%) in the BOO group, and in 6 of the 13 rats (46%) in the deobstructed group. The non-DDO group showed a significantly greater residual volume than the DDO group. Through a clustering analysis of gene expression profiles, we identified 7,532 common upregulated and downregulated genes, the expression of which changed by more than 2 fold. In the BOO group, 898 upregulated and 2,911 downregulated genes were identified. The non-DDO group showed 3,472 upregulated and 4,025 downregulated genes, whereas in the DDO group, only 145 and 72 genes were upregulated and downregulated, respectively.</P><P><B>Conclusions</B></P><P>Abnormal function and gene expression profiles in bladders after BOO were normalized in the BOO rats with DO after deobstruction, whereas in those without DO, abnormal function persisted and the gene expression profile became more abnormal. DO may play a protective role against the stress to the bladder induced by BOO and deobstruction as a form of adaptive neuroplasticity.</P>

Al³^(+) 존재가 ^(99m)Tc-MDP의 표지효율과 생체내 분포에 미치는 영향

장영수,정재민,김영주,곽철은,이동수,정준기,이명철,고창순 大韓核醫學會 1996 핵의학 분자영상 Vol.30 No.3

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

치수절단술에 사용되는 약제가 백서 치배 및 치배주위조직세포에 미치는 영향에 관한 ^3H-thymidine을 이용한 자기방사법적인 연구

박경주,이종헌,임창윤 단국대학교 치의학연구소 1992 논문집 Vol.4 No.-

Formocresol(FC) had been widely used as medicament for pulpotomy, but because FC have strong toxicity, carcinogenic potential, and strong diffusible properties in tissues, Glutaraldehyde, another medicament for pulpotomy was greatly presented by many investigators and practitioners. Although many investigators had studied difference of two medicament's effects on periodontal tissues and tooth germ, there were no manuscripts of cellular activity about these medicaments applied to teeth, but there were almost clinical, histopathological studies. Especially in the investigative effects on tooth germ, the results were controversal. Thus to investigate about effects on cellular actiity of perigerminal tissue and tooth germ of rat, author presented the cellular activity and the pathologic change through calculating Thymidine labelling index(TLI) from autoradiographic technique using 3H-thymidine after these medicaments were applied to tooth. The obtained results were as follows. 1. Inflammation was initiated after one week of FC and two weeks of GA. It was thought that diffusible property of GA was lesser than that of FC. 2. In group treated with FC, inflammation, vasodilation and bone destruction continuously increased for all periods of experiment and the feature of 8 weeks was very severe. But in group treated with GA, inflammation, vasodilation and bone destruction slightly incresed for all period of experment. 3. TLI was increased after two weeks of FC, but decreased after four weeks because of different accumulative concentration between 2 and 4 weeks. 4. GA treated group which did not show the change of the cellular activity of perigerminal tissue and tooth germ presented the slight effects on these cells. 5. Changes of cellular activities in FC treated group did not result from inflammation, but formocresole's property itself. And bone destruction was derived from secondary effects of inflammation. 6. The fact that FC arose severe inflammation and change of cellular activity reflected that FC might affected