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.

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.

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.

N Use Efficiency and Nitrate Leaching by Fertilization Level and Film Mulching in Sesame Cultivated Upland

Dong-Wook Lee,Ki-Do Park,Chang-Young Park,Il-Soo Son,Ui-Gum Kang,Jee-Yeon Ko,Kang-Bo Shim,Young-Son Cho,Sung-Tae Park 韓國作物學會 2007 Korean journal of crop science Vol.52 No.3

This study was conducted to evaluate the effect of slow release fertilizers (SRF), crotonylidene diurea (CDU) and latex coated urea (LCU), on nitrogen (N) use efficiency (NUE) and nitrate-N leaching in a silty clay loam soil under polyethylene film mulching (PFM) for sesame cultivation. In PFM plot, concentrations of NO3-N and NH4-N in SRF applied soils were less than that in the urea plot during the whole growing period. However, NO3-N and NH4-N in all the non-mulched plots (NM) were not significantly different. Urea-N in soil treated with SRF was higher than urea plot until 50 days after application and was comparable in all the treatments after 50 days. NO3-N concentrations in leached solution in 21 days after urea fertilization in PFM and NM were 26 mg L-1 and 83 mg L-1 , respectively. However, NO3-N in leached solution at applied CDU and LCU was less than that of urea similar to nitrate concentration in soil. NO3-N in leached solution in applied CDU and LCU in 44 days after application was about 25% lower than that urea plot and PFM, while the NO3-N concentration of CDU and LCU treatment in NM did not changed. Application of SRF increased the yield of sesame and N recovery compared to urea and there was a little difference between SRF and N levels. In conclusion, application of 80% N level with SRF increased N recovery and reduced nitrate leaching without reduction of yields compared with urea application.

Development of vitrification protocol in Rubia akane (nakai) hairy roots using a systematic approach.

Park, Sang-Un,Kong, Hyunjung,Shin, Dong-Jin,Bae, Chang-Hwan,Lee, Sheong-Chun,Bae, Chang-Hyu,Rha, Eui-Shik,Kim, Haeng-Hoon Royal Veterinary College 2014 Cryo letters Vol.35 No.2

<P>A solution-based vitrification protocol is a process of sequentially changing-solutions from which both influx of cryoprotectants (loading) and efflux of water (dehydration) were accomplished before cryo-exposure. Hence, we need to properly control the concentration /composition of the cryoprotectant solutions.</P>

Hypersensitivity Reaction Incidence Patterns and Risk Factors of Iodinated Contrast Media

김동휘(Dong-Hwi Kim),문종현(Jong-Hyeon Mun),김준환(Jun-Hwan Kim),윤승완(Seung-Wan Yun),박환상(Hwan-Sang Park),김창곤(Chang-Kon Kim),김영덕(Yeong-Deok Kim) 대한CT영상기술학회 2023 대한CT영상기술학회지 Vol.25 No.1

본 연구의 조사 대상은 본 원 에서 요오드화 조영제를 정맥으로 투여받고 CT 검사를 시행한 72,910명과 과거 조영제 과민반응을 겪었던 환자 2,798명을 대상으로 후향적 조사를 시행하였다. 나이, 성별, 과민반응 증상, 조영제 과민반응 기왕력 환자 전처치방법, 사용한 조영제 등을 분석하였다. 조영제 과민반응 발생은 여성과 60대 미만에서 발생 위험이 높고 과거 조영제 과민반응기왕력이 있더라도 적절한 전처치 약물 투여, 조영제 성분 변경을 시행하면 과민반응 발생 위험이 감소한다. 조영제 성분별과민반응 발생률은 Iopromide가 유의하게 과민반응 발생률이 높았고, Iohexol과 Ioversol이 낮은 발생률을 보였다. 조영제 과민반응 재발을 예방하기 위해서는 전처치 약물 단독 사용보다 선행적으로 원인 조영제를 재사용하지 않고 다른 성분의 조영제로 변경하여 사용하는 것이 우선적으로 시행되어야 하고 더불어 전처치 약물 투여와 함께하는 것이 재발을 예방할 수 있을 것이다. The subjects of this study were 2,798 patients who experienced hypersensitivity reaction of contrast media among 72,910 who had had iodinated contrast media administered intravenously and CT examination at our hospital. Retrospective survey was conducted with these subjects. Their age, gender, hypersensitivity reaction symptoms, prepare methods for the patients who had previous hypersensitivity reaction of contrast media, and contrast media administered were analyzed. When it came to the hypersensitivity reaction incidence of contrast media, women and patients aged less than 60 had the high risk of the reaction. Even if patients had previous contrast media hypersensitivity reaction, their hypersensitivity reaction incidence risk was reduced as they had an appropriate premedication drug administered and contrast media were changed. Regarding the hypersensitivity reaction incidence rate by contrast media, Iopromide’s hypersensitivity reaction incidence rate was significantly high, whereas Iohexol and Ioversol had low incidence rates. In order to prevent contrast media hypersensitivity reaction recurrence, it is preferentially necessary to change a contrast media to a different one without reuse of causative contrast media, rather than to use a premedication drug only. Along with that, it is necessary to administer a premedication drug.

Dipyridamole 부하 심근 SPECT에서 Dipyridamole의 작용과 부작용

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최창운(Chang Woon Choi),배상균(Sang Kyun Bae),양형인(Hyung In Yang),여정석(Jeong Suk Yeo) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

N/A Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamole, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension 0.9% showed no change of blood pressure, 5.5% had increased blood pressure 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patients without perfusion defects on SPECT(y=7.1x+48.4r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y=-11.6x+68.9 r=0.17 p〈0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizzness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

계절에 따른 토양 방선균의 속 다양성 분포

박동진,이상화,박상호,김창진,Park, Dong-Jin,Lee, Sang-Hwa,Park, Sang Ho,Kim, Chang-Jin 한국미생물학회 1998 미생물학회지 Vol.34 No.3

산림, 밭, 초지, 논 토양의 두 깊이(0~2cm, $50{\pm}1cm$)에서 계절별로 채취한 토양 시료로부터 서로 다른 방선균주를 분리, 동정하여 계절별 토양 방선균의 속 다양성을 조사하였다. 토양 표층에 분포하는 Streptomyces속 방선균주의 계절별 변동율은 논(18%)과 산림(18%) 토양에 비해 초지(41%)와 밭(39%) 토양에서 더 높게 나타났으며 $50{\pm}1cm$깊이에서는 논(36%), 밭(28%), 초지(26%), 산림(16%) 토양 순으로 높게 나타났다. 한편 희소 방선균의 계절별 분포 변동율을 토양 표층의 경우 논 토양(26%)을 제외하고는 모두 45%이상이었으나 $50{\pm}1cm$깊이에서는 산림(79%), 논(36%), 밭(24%), 초지(10%) 토양 순으로 높게 나타났다. 따라서, 토양 중에 분포하는 방선균의 속 다양성은 계절 변화에 의지하며 또한 이는 방선균군의 종류, 토양의 유형, 그리고 토양 깊이에 의해서 영향을 받을 것으로 고려된다. From soils seasonally collected at two depths (0~2 cm, $50{\pm}1cm$) of forest, field, grass land, or paddy field, distinct strains of actinomycetes were isolated and identified to the genus level. The genus-diversity of soil actinomycetes was revealed to be considerably different by seasonal change. It was also affected by soil depths, soil types, or actinomycete groups. At the soil depth of 0~2 cm, the seasonal distribution fluctuation (%) of streptomycete strains was higher in grass land (41%), field (39%) soil than paddy field (18%), or forest (18%), whereas that of streptomycete strains at the soil depth of $50{\pm}1cm$ was high in order of paddy field (36%), field (28%), grass land (26%), and forest (16%). On the other hand, the seasonal distribution fluctuation ratio of rare actinomycete strains at the soil depth of 0~2 cm was above 45% except for paddy field (26%). At the soil depth of $50{\pm}1cm$, the seasonal distribution of rare actinomycete strains exhibited high fluctuation (%) in order of forest (79%), paddy field (36%), field (24%), and grass land (10%).