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.

대학수학능력시험 도입후의 고교교육 변화에 관한 연구

박병량,변영계,한대동,성병창 교육연구소 1994 敎育硏究 Vol.4 No.1

Under the current school system in which secondary schools aim at the preparation for college entrance, the college entrance examination has a crucial impact on high school education. The former college entrance examination has been accused of causing many problems in high school education such as training students, in a recital mode, by giving fragmentary knowledges and skills picked up by teachers largely for the college entrance emanination. Under the examination system students were not recommended either in school or at home to pursue their own interests and concerns which are supposed to enhance higher order thinking including creativity. In order to reform this change-resisting high school education a new type of college entrance examination called College Scholastic Aptitude Test (CSAT, hereafter) replaced the former one in 1990 in the worldwide tide of educational reform toward the quality education. This study is to examine whether and/or to what extent the newly introduced CSAT has brougght changes to high school education. This study began with two concrete research problems. First, to what degree did the CSAT affect high school students particularly in the areas of attitudes toward school, classroom learning and instruction, and study habits? This refers to personal effects separated from school education. Second, to what extent did the CSAT make changes in high school education? This refers to institutional effects. As a survey, this study collected questionnaire data from 1,600 male and female high school third graders from 33 high schools locatedin Pusan City and its surrounding KyungNam-Do province. The CSAT was firstly introduced in 1990 when the survey respondents were then high school freshmen. The sample method is a systematic cluster random sample. After schools had been randomly selected about 60 students(2 classes) were sampled from each school. The questionnaire consisted of questions asking largely whether any changes were made in the areas such as individual student's studying strategies and their perceptions of schooling. The students' responses were analyzed according to concrete research problems using appropriate statistical methods. The research results are summarized as follows. First, according to students' responses they evaluated that CSAT was somewhat successful in measuring higher order thinking and somewhat conducive to lessening social problems cuased by excessively competitive high-cost private lessons. The new exam, however, unexpectedly did not have affirmative effects on such areas as: undesirable operation of high school; measurement of learning ability; selection of college qualifiers; and test item difficulty and discrimination. Second, the effects of CSAT on school-based tests were found to be both slightly positive and negative. For the positive side of the effects, the test content was not confined to textbooks but taken either from other non-text sources or from what was taught in classrooms beside textbooks; in solving the test questions not only correct answers were not required but also the problem-solving processess were also emphasized in schools. In following areas, however, there were almost no changes made: the dominance of multiple-choice test items; anxiety of testers; the utilization of test results for own learning improvement; and the frequent school testing. Third, since the introduction of CSAT there have been almost no improvements in school organizational practices, management, and climates such as; extracurricular activities, communications with teachers, guidance and discipline, teachers' expectations of students, grouping of students according to ability and talent, and friendship among classmates. One exception was that classroom climate has become somewhat open and democratic than before. Fourth, with regard to classroom activities some improvements have been detected. The classroom instruction has been somewhat changed into one emphasizing higher order thinking. It was revealed through teachers' efforts to employ new teaching methods and to carry out curriculum in a regular basis, to try to upgrade expectations of students, and to make classroom learning more explorative. On the other hand, in other areas of classroom activities it was hard to find any noticeable improvements. Finally, it was the area of individual student's studying methods and attitudes that the most noticeable changes were found since the introduction of CSAT. To mention some of them, the dependency on private lessons and private academic institutes was much lessened; the learning materials were varied beside school textbooks; the students' autonomy has been increased in the area of learning need and motivations, studying strategy from memorizing to understanding, and selecting educational or occupational careers based on one's own character and talent. As a result, the introduction of CSAT seems to give student more confidence in studying and learning. Compared to these changes in individual-based studying attitudes, perceptions and learning methods connected to schooling did not change noticeably. This contrasting finding is in a sense a main point of this study. All in all, and in short, the introduction of the new College Scholastic Aptitude Test (CSAT) were somewhat effective in changing individual students' studying or learning attitudes, methods, and strategies in preparation for college entrance, but it was found to be unexpectedly ineffective in improving institutionally school organizational practices, instructional methods, guidance and disciplines, curricular implementation, and other school management and operations. This result reminds us a fact that and educational policy could not be easily rooted in the practical soil.

Effect of Inhomogeneous Nucleation of Hydride at α/β Phase Boundary on Microstructure Evolution of Zr–2.5 wt%Nb Pressure Tube

Sung‑Soo Kim,Sangyeob Lim,Dong‑Hyun Ahn,Gyeong‑Geun Lee,Kunok Chang 대한금속·재료학회 2019 METALS AND MATERIALS International Vol.25 No.4

We analyzed the microstructural characteristics such as number density and length and width of hydrides in Zr–2.5 wt%Nbpressure tube. The hydrogen was charged cathodically and the hydride-contained sample was evaluated using the advancedanalysis methodologies. We performed a diff erential scanning calorimetry analysis to more quantitatively understand thethermodynamics of the hydride formation/growth process. We characterized the micrograph of hydride-contained Zr samplesto estimate the microstructural characteristics of the matrix and hydrides. We investigated eff ects of hydrogen concentrationand microstructure of matrix on determining microstructural measures of the hydrides. Particularly, we found that β phasein the matrix becomes isolated during the heat treatment same or above 475 °C and this change increases the inhomogeneousnucleation sites signifi cantly. We claim that the microstructure change of this matrix phase greatly increases the numberdensity of hydride.

한국인의 우울증 진단기준의 특성

장성만,손지훈,이준영,최지환,조성진,전홍진,함봉진,이동현,조맹제 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

목적 국내의 여러 역학 조사에 따르면 한국인은 서구에 비하여 우울증의 유병률이 낮은 것으로 보고되고 있다. 낮은 유병률에 대하여 서구에서 정의하는 우울증의 진단 기준이 한국인의 문화에 맞지 않다는 진단 기준의 오류를 제시하거나, 실제로 유병률이 낮다는 설명을 시도하기도 하였다. 본 연구는 DSM-IV에서 제시하는 우울증의 진단 기준에 대하여 한국인의 반응 특성을 알아보고자 한다. 방법 2001년 KECA 연구에 응답한 만 18세 이상 65세 미만의 6,275명을 대상으로 하였다. 한국어판 CIDI (K-CIDI)를 통해 정신장애의 이환을 진단하였으며, K-CIDI 내의 우울장애 진단 기준만을 추출하여 분석하였다. 분석은 문항반응이론(Item Response Theory)을 적용하였다. 결과 한국인에서 DSM-IV의 주요우울장애 진단 기준의 오류는 없었으나, 진단 기준의 역치는 높았다. 한국인이 호소하는 우울증상으로서 "피로감"과 "집중력 저하", "수면 변화"는 진단되는 우울증의 초기부터 잘 나타나는 증상 들이며, "정선운동변화", "죽음/자살사고", "무가치함/죄책감"은 보다 심한 우울증에서 잘 나타나는 증상들이었다. 결론 DSM-IV가 제시하는 주요우울장애 진단 기준은 한국인의 우울증을 평가하는 데 있어 타당하기는 하나, 진단 기준의 역치가 높다. 우울증의 중증도에 따라 호소하는 증상들이 달랐다. Baekgrounds : Many Korean epidemiologic studies reported lower prevalence rates of depression than those of Western countries. For the low prevalence, it is explained that there's something wrong in the direct application of diagnostic criteria of depression to Korean culture, i.e. categorical fallacy, or it may be truly low-prevalent. We will analyze diagnostic criteria for depression detined by Western. Methods : Six thousand and two hundred seventy-five cummunity dwelling subjects, aged 18-64 years were interviewed by using Korean version of Composite International Diagnostic Interview (K-CIDI). Diagnostic criteria for depression defined by DSM-IV were analyzed using the item response theory. Rcsults : We could not find any fallacies of diagnostic critcria tbr depression defined by DSM-IV when assessing depre-ssion among Koreans. Fatigue, concentration difficultics, and sleep disturbance appeared more fequently in mild depression, while psychomotor change, death/suicide, and worthlessness/guilt did not appear until severe depression. Cunclusion : The diagnostic criteria for depression defined by DSM-IV arc appropriate for the Koreans. There are different responding levels, i.e. threshold, of depressive criteria according to severities of depression. Koreans with depression are more likely to complain of appetite change, but less of worthless or guilty feelings than Western people.

Diagnostic Significance of Brainstem Auditory Evoked Potentials in Microvascular Decompression of Patients with Hemifacial Spasm or Trigeminal Neuralgia

( Sang-koo Park ),( Sung-hyuk Lim ),( Chan-woo Park ),( Jin-woo Park ),( Sung-ho Chang ),( Keun-hye Park ),( Hae-ja Park ),( Ji-hye Song ),( Dong-ok Uhm ),( Ki-bong Kim ) 대한임상검사과학회 2011 대한임상검사과학회지(KJCLS) Vol.43 No.1

The purpose of this study was to analyse brainstem auditory evoked potentials (BAEP) wave change data during microvascular decompression (MVD). The nerve function of Cranial Nerve VIII is at risk during MVD. Intraoperative monitoring of BAEP can be a useful tool to decrease the danger of hearing loss. Between January and December 2009, 242 patients had MVD for hemifacial spasm (HFS) and trigeminal neuralgia (TN). Among intraoperative BAEP changes, amplitude of V-V’ was the most frequently observed during cerebellar retraction and decompression step of the MVD procedure. 138 patients (57%) had no BAEP change while 104 patients (42.98%) had BAEP change. 69 patients (28.5%) had Type A-I, 16 patients (6.6%) had Type A-II, 5 patients (2.1%) had Type B, and 13 patients (5.37%) had Type C. MVD is a surgical procedure to relieve the symptoms (e.g. pain, muscle twitching) caused by compression of a nerve by an artery or vein. During BAEP intraoperative monitoring, the surgical step is important in interpreting the changes of wave V. Several potential mechanisms of injury may affect the cochlear nerve, and complete loss of BAEP is often associated with postoperative hearing loss. Intraoperative BAEP monitoring may provide an early warning of hearing disturbance after MVD.

Necrotizing soft tissue infection

Sung Jin Park,Dong Heon Kim,Chang In Choi,Sung Pil Yun,Jae Hun Kim,Hyung Il Seo,Hong Jae Jo,Tae Yong Jun 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.91 No.1

Purpose: Necrotizing soft tissue infection is the infection of the soft tissue with necrotic changes. It is rare, but results in high mortality. We analyzed the characteristics of patients, prognosis, and mortality factors after reviewing 30 cases of a single hospital for 5 years. Methods: From January 2009 to December 2013, 30 patients diagnosed with necrotizing fasciitis or Fournier’s gangrene in Pusan National University Hospital were enrolled for this study. The following parameters were analyzed retrospectively: demographics, infection site, initial laboratory finding, initial antibiotics, isolated microorganisms, number of surgeries, time to first operation, length of intensive care unit, and total hospital stays. Results: The overall mortality rate was 23.3%. Mean body mass index (BMI) of the survival group (24.7 ± 5.0 kg/㎡) was significantly higher than the nonsurvival group (22.0 ± 1.4 kg/㎡, P = 0.029). When BMI was less than 23 kg/㎡, the mortality rate was significantly higher (P = 0.025). Two patients (6.7%) with chronic kidney disease requiring hemodialysis died (P = 0.048). Initial WBC count (>13×10<SUP>3</SUP>/μL), CRP (>26.5 mg/dL), and platelet (PLT) count (<148×10<SUP>3</SUP>/μL) were found to have negative impact on the prognosis of necrotizing soft tissue infection. Factors such as potassium level, blood urea nitrogen (>27.6 mg/dL), serum creatinine (>1.2 mg/dL) that reflected kidney function were significant mortality factors. Conclusion: Patients with low BMI or abnormal values of WBC count, CRP, and PLT count reflecting the degree of infection or abnormal renal function will need more intensive care.

Diagnostic Significance of Brainstem Auditory Evoked Potentials in Microvascular Decompression of Patients with Hemifacial Spasm or Trigeminal Neuralgia

Park, Sang-Koo,Lim, Sung-Hyuk,Park, Chan-Woo,Park, Jin-Woo,Chang, Sung-Ho,Park, Keun-Hye,Park, Hae-Ja,Song, Ji-Hye,Uhm, Dong-Ok,Kim, Ki-Bong 대한임상검사과학회 2011 대한임상검사과학회지(KJCLS) Vol.43 No.1

The purpose of this study was to analyse brainstem auditory evoked potentials (BAEP) wave change data during microvascular decompression (MVD). The nerve function of Cranial Nerve VIII is at risk during MVD. Intraoperative monitoring of BAEP can be a useful tool to decrease the danger of hearing loss. Between January and December 2009, 242 patients had MVD for hemifacial spasm (HFS) and trigeminal neuralgia (TN). Among intraoperative BAEP changes, amplitude of V-V' was the most frequently observed during cerebellar retraction and decompression step of the MVD procedure. 138 patients (57%) had no BAEP change while 104 patients (42.98%) had BAEP change. 69 patients (28.5%) had Type A-I, 16 patients (6.6%) had Type A-II, 5 patients (2.1%) had Type B, and 13 patients (5.37%) had Type C. MVD is a surgical procedure to relieve the symptoms (e.g. pain, muscle twitching) caused by compression of a nerve by an artery or vein. During BAEP intraoperative monitoring, the surgical step is important in interpreting the changes of wave V. Several potential mechanisms of injury may affect the cochlear nerve, and complete loss of BAEP is often associated with postoperative hearing loss. Intraoperative BAEP monitoring may provide an early warning of hearing disturbance after MVD.

한국인의 건강관련 행동변인에 관한 연구

김상국,장주호,김경지,강동원,전병관 경희대학교 사회체육연구소 1996 體育科學論叢 Vol.- No.9

This study is for research on the cause of behavioral change in relation to health of Koreaans in order to enhance the quality of life. For this We have surveyed against 3,000 adults of 8 cities and provinces nationwide. Looking the result of this study synthetically, most of the subjects of study were thinking that they are 'jealthy'(62.9% for male, 50.0%) and of drinker(83.2%) formale, which harm our health are high. The ratio of having stress often were high for voth male and female(27.1% for male 31.4% for female), and the main cause of the stress were shown as wok related to their company(56.7%) for male and as family problem (44.1%) for female, They responded to resolve it mainly in 'patient'(36.5% for male, 51.0% for female). This shows that they need something positive way of resolving the stress. Korean people likes modicines too much and it was surveyed to have worsened their health due to ovenuse of medicines. They hardly have medical check up and even there were people who don't know is medical check up, so it was shown to nood activ promotion of it. As the result of study on te cause of behavioral change related to health of Koreans for the enhancement of people[s' lives, We would like to suggest some guidelines for healithy life. A. It needs to promote and educate for reducing smoking and drinking which harm our health B. The plan or programs for resolving stress of the people must be studied concretely on the level of gorvernment. C. For the checking condition of health well, ti must be done and consulted with specialists. D. The eating habits of our people must be changed in consulting with specialists in order to protcet and cure from the most serious digestive troubles.

오리고기에 關한 硏究(Ⅱ) : 오리고기 통조림의 貯藏中 罐內變化 Various Changes in the Canned Duck-meat during the Storage Period

조덕봉,김동필,성하진,장인애 광주보건대학 1978 論文集 Vol.4 No.-

Various changes, especially leaching of heavy metals, in .the canned dock-meat during the 10 months storage period were investigated. Detinning reached to 57.28 ppm level, and the leaching of Pb and Fe levels were equivalent to 3.88 and 60.00 ppm respectively in the stored 10 months cans. The changes of pH and vacuum degrees were not significant and swelled cans were not observed. . Corrosion of tin-plate was increased as the during storage period in each sample.