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.

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.

아세틸 콜린 유발 검사시 허혈성 심전도 변화와 흉통의 발생이 내피세포 기능장애에 미치는 영향

최철웅(Cheol Ung Choi),나승운(Seung-Woon Rha),김선원(Sun Won Kim),나진오(Jin Oh Na),임홍의(Hong Euy Lim),김진원(Jin Won Kim),김응주(Eung Ju Kim),한성우(Seong Woo Han),박창규(Chang Gyu Park),서홍석(Hong Seog Seo),오동주(Dong Joo Oh) 대한임상노인의학회 2010 대한임상노인의학회지 Vol.11 No.4

연구배경: 아세틸 콜린 유발 검사시 발생하는 흉통과 허혈성 심전도 변화가 아세틸 콜린에 의해 발생하는 관상동맥의 내피세포 기능에 어떤 영향을 주는지 알아보고자 했다. 방법: 흉통으로 내원하여 관상동맥 조영술과 아세틸 콜린 유발검사를 시행받은 1,085명의 환자를 대상으로 하였다. 아세틸 콜린 유발 검사를 하는 동안 허혈성 심전도 변화 및 흉통의 발생 유무에 따른 관상동맥 내피세포 기능의 특징을 비교하였다. 결과: 539명의 환자에서 아세틸 콜린 검사시 내피세포 기능 장애가 발생 하였다. 허혈성 심전도 변화가 있었던 그룹이 심전도 변화가 없었던 그룹보다 흉통이 더 많았고(78.1% vs. 60.8%, P=0.007), 관상동맥 조영술상 다발성 관상동맥 경련이 빈번하였고(59.4% vs. 40.6%, P=0.004), 관상동맥의 경련 정도도 더 심하였다(64.1% vs. 46.5%, P=0.006). 흉통이 있었던 그룹이 흉통이 없었던 그룹보다 허혈성 심전도 변화의 빈도가 더 높았다(14.7% vs. 7.5%, P=0.007). 또한 흉통이 있었던 그룹이 관상동맥 경련이 다발성으로 발생하는 경우가 많았고 (50.7% vs. 29.5%, P<0.001), 미만성으로 발생하는 경우가 많았고(87.1% vs. 75%, P<0.001), 관상동맥의 경련의 정도도 더 심하였다(51.6% vs. 43.5%, P=0.041). 결론: 아세틸 콜린 유발검사시 발생하는 허혈성 심전도 변화와 흉통은 관상동맥 경련의 정도와 경련이 발생하는 관상동맥 개수와 연관이 있다. Background: ECG changes and chest pain during acetylcholine (Ach) provocation tests may constitute important clinical parameters for Ach-induced endothelial dysfunction. We investigated the association between ischemic ECG changes and chest pain during the Ach-provocation test and angiographic characteristics of Ach-induced endothelial dysfunction. Methods: A total of 1,085 patients with anginal symptoms underwent diagnostic coronary angiography (CAG) and Ach-provocation tests. We compared angiographic characteristics of Ach-induced endothelial dysfunction according to the presence of ECG change and chest pain. Results: A total of 539 patients experienced Ach-induced endothelial dysfunction. Patients who experienced ECG change group suffered more frequent chest pain (78.1% vs. 60.8%, P=0.007), angiographically more frequent multiple coronary artery spasm (59.4% vs. 40.6%, P=0.004), and more severe coronary artery spasm (64.1% vs. 46.5%, P=0.006) than patients without ECG change. However, there was no difference in the length of endothelial dysfunction between the groups. The incidence of ischemic ECG changes in patients with chest pain was higher than in patients without chest pain (14.7% vs. 7.5%, P=0.007). Patients who experienced chest pain more often experienced multiple (50.7% vs. 29.5%, P<0.001), diffuse (87.1% vs. 75%, P<0.001), and severe coronary artery spasm (51.6% vs. 43.5%, P=0.041) than patients without chest pain. Conclusion: Ischemic ECG changes and chest pain during the Ach-provocation test are associated with multi-vessel involvement and severe coronary artery spasm. Chest pain is associated with the length of endothelial dysfunction, but ischemic ECG change is not.

트라이애슬론 스포츠폭력 사건에 투영된 트라이애슬론 선수들의 경험과 인식

김희주 ( Kim Hee-ju ),장덕선 ( Chang Duk-sun ) 한국융합과학회 2022 한국융합과학회지 Vol.11 No.8

연구목적 본 연구는 故 최숙현 선수의 희생이 헛되지 않기를 바라는 마음으로 시작되었다. 연구대상은 2020년 스포츠폭력에 의해 고인이 된 최숙현 선수의 사망사건을 직·간접적으로 경험한 철인3종경기 선수 30명이다. 연구방법 연구방법은 내러티브의 3차원적 공간 중 개인적·사회적 차원과 내적·외적 지향에 중점을 두고, 연구 참여자의 스포츠폭력에 대한 인식과 경험을 개방형 질문으로 조사하였다. 이 후 추가적 심층면담을 실시하였다. 특히 참여자들이 현역선수들이기 때문에 연구참여중단의 가능성과 익명성을 보장하였다. 연구자는 25년간 트라이애슬론 선수로 활동을 하였으며, 직접 피해자이기도 하다. 결과 자료의 귀납적 범주화 결과, 스포츠폭력 사건에 대한 인식에는 기본신념 붕괴, 제도적 문제, 우려, 감정 등이 나타났다. 인지된 내적 변화에는 부정적 영향 없음, 제도적 문제, 간접 트라우마 등이 나타났다. 인지된 외적 변화로는 부정적 영향 없음, 간접 트라우마 등이 나타났다. 지각된 변화로는 변화와 기타로 나타났다. 변화의 시발점은 처벌에 대한 생각, 감정, 제도적 문제 등이 도출 되었으며 변화의 방향성으로는 2차 피해 우려, 확실한 변화 요구, 제도적 해결책 필요 등으로 나타났다. 결론 결과를 토대로 트라이애슬론의 스포츠폭력 사건에 대한 답변을 시간의 흐름 순으로 정리하여 새로운 패러다임 모형을 제시하였다. Purpose This study was started with the hope that the sacrifice of the deceased player, Sook-Hyun Choi, would not be in vain. The subjects of this study were 30 Korean triathletes who directly or indirectly experienced the case of Choi Sook-hyeon, who died of sports violence in 2020. Methods The research method focused on personal and social dimensions and internal and external orientation among the three-dimensional space of the narrative, and conducted an open-ended questionnaire about the research participants' perceptions and experiences of sports violence. After that, additional in-depth interviews were conducted during the analysis process to collect data. In particular, since the participants are active players, the possibility of discontinuation of research participation and anonymity were guaranteed in consideration of ethical issues that may arise from this. In addition, the research was conducted in consideration of the fact that the researcher had been active as a triathlete for 25 years and was also a victim. Result As a result of inductive categorization of the collected data, the perception of sports violence incidents revealed a breakdown of basic beliefs, institutional problems, concerns, and emotions. There were no negative effects on perceived internal changes, institutional problems, and indirect trauma. As for the perceived external changes, there were no negative effects and indirect trauma. Changes and others were perceived as changes. As the starting point of change, thoughts, feelings, and institutional problems about punishment were derived. As for the direction of change, concerns about secondary damage, a clear demand for change, and the need for an institutional solution were shown. Conclusion A new paradigm model was presented by arranging the responses to the three types of sports violence cases in the order of time flow.

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.

在日韓國人의 生活文化의 異質化와 適應過程에 關한 保健學的 硏究

金正根(Jong-Kun Kim),張昌谷(Chang-Gok Chang),林達旿(Dar-Oh Lim),金武采(Mu-Chae Kim),李州烈(Ju-Yul Lee) 한국인구학회 1992 한국인구학 Vol.15 No.2

After world war Ⅱ Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japnaese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese is high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most drama tical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : The ranking of leading cause of death in 1981 were congenital asnomali

S-580 : Vitamin D and carotid subclinical atherosclerosis in SLE

( Chang Bum Bae ),( Ju Yang Jung ),( Bo Ram Go ),( Hyun Ah Kim ),( Chang Hee Suh ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Vitamin D and carotid subclinical atherosclerosis in SLE Chang-Bum Bae, Ju-Yang Jung, Bo-ram Go, Hyun-Ah Kim, Chang-Hee Suh Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea Introduction Atherosclerosis develops earlier in systemic lupus erythematosus (SLE) and is the important cause of mortality. It has been suggested that vitamin D deficiency contributed cardiovascular disease and immune dysregulation in SLE. Methods One-hundred two female patients with SLE and 52 normal controls (NC) were recruited. The carotid artery intima-media thickness (cIMT) and plague were assessed by B-mode ultrasound at the carotid artery level. Vitamin 25(OH)D3 levels were checked by immunoradiometric assay using the Bio-Line 25(OH)D3-Ria CT kit (Bio-Line S.A., Belgium). Disease activity markers were checked at the time of enrollment. Results The cIMT of SLE is 0.41±0.08mm, which is higher than NC (0.37±0.11 mm, p=0.012). Also, carotid artery plague index (PI) of SLE is higher than NC (0.68±1.39 vs 0.26±0.87, p=0.026). The cIMT was correlated with age (r=0.442, p<0.001), body mass index (r=0.246, p=0.013), waist-hip ratio (r=0.245, p=0.013), SLE disease activity index (r=0.239, p=0.016), taking aspirin (r=0.244, p=0.013), and the carotid artery PI was correlated with renal involvement (r=0.224, p=0.023) in patients with SLE. Vitamin 25(OH)D3 was not showed correlation with cIMT and carotid artery PI. Also, it was not correlated with disease activity markers. Conclusion In patients with SLE, the risk of cardiovascular disease measured by cIMT and carotid artery plaque was higher than NC, which may be derived from systemic inflammation. However, vitamin D levels were not showed significant correlations with carotid subclinical atherosclerosis. It may be not suitable to assess vitamin D as marker of disease activity or subclinical atherosclerosis.

Finding key vulnerable areas by a climate change vulnerability assessment

Kim, Ho Gul,Lee, Dong Kun,Jung, Huicheul,Kil, Sung-Ho,Park, Jin Han,Park, Chan,Tanaka, Riwako,Seo, Changwan,Kim, Ho,Kong, Wooseok,Oh, Kyusik,Choi, Jinyong,Oh, Young-Ju,Hwang, Gangseok,Song, Chang-Keun Springer Netherlands 2016 Natural hazards Vol.81 No.3

<P>Extreme climate events such as typhoons, heat waves, and floods have increased in frequency with climate change. Many municipalities within the Republic of Korea (ROK) have experienced damage from these events, necessitating countermeasures. Vulnerability assessment has been suggested in the implementation of a national plan for reducing damage resulting from climate change. Thus, in this study, we assess the vulnerability of the ROK and identify key vulnerable municipalities in support of the national adaptation plan. We create a framework for assessing the vulnerability of all 232 municipalities of the ROK with respect to 32 items in 7 fields. The framework regards decision makers' comprehension and availability of data as important factors. We assess the vulnerability index of each municipality by using variables of climate exposure, sensitivity, and adaptation capacity. The weights of variables are determined by the Delphi method. We used the representative concentration pathways 8.5 climate scenario to reflect future climate exposure for the vulnerability assessment. From the analysis, vulnerability maps are prepared for the 32 items of 7 fields, and key vulnerable municipalities are identified by aggregating the maps. The distribution of vulnerable municipalities changes with the future climate conditions. These maps provide a scientific and objective basis for the ROK government to establish adaptation plans and allocate resources. The ROK government can utilize the results to identify the characteristics of highly vulnerable areas, and municipalities can use the results as a basis for requesting support from the national government.</P>

제왕절개 수술반흔에서 점액성 변화와 탈락막 변 화가 일어난 자궁내막증 2 예 및 조직면역학적연구

김주현(Ju Hyun Kim),한치동(Chi Dong Han),허창규(Chang Kyu Huh),조창호(Chang Ho Cho),고석봉(Suk Bong Koh) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1

Decidualized cutaneous endometriosis infrequently arises in the absence of pelvic disease. It is described in which the histologic features included cytologic atypia, circumscription of endometrial epithelial cells with glandular or cystically dilated space, mononuclear cells within and around the endometrial nodules, and accompanied myxoid change. This histologic pseudomalignancy is not common and be misinterpreted as metastatic carcinoma or malignant tumors arising from soft tissue due to location of nodule and histologic feature. We have experienced two cases of myxoid change in decidualized cutaneous endometriosis in the abdominal scar following Cesarean section, which is presented with a brief review of the literature.

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>