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.

Design of a shape memory composite(SMC) using 4D printing technology

Kang, Minkyu,Pyo, Youngjun,Jang, Joon young,Park, Yunchan,Son, Yeon-Ho,Choi, MyungChan,Ha, Joo wan,Chang, Young-Wook,Lee, Caroline Sunyong Elsevier 2018 Sensors and actuators. A Physical Vol.283 No.-

<P><B>Abstract</B></P> <P>A fused deposition modeling (FDM) tool was used to fabricate a shape memory composite (SMC) that combined a shape memory alloy (SMA) with a shape memory polymer (SMP). The SMA caused a shape memory effect due to a phase change between martensite and austenite phases, in turn due to a temperature change. Also, the SMP had a shape memory effect caused by changes in the proportions of hard and soft segments near the glass transition temperature (T<SUB>g</SUB>). Usually, common SMAs and SMPs are not reversible, so these materials do not go back to their original shapes once they are deformed. In this study, we fabricated 4D printing actuator via reversible SMC actuations using 3D printing technology. Nylon 12 was used as the 3D printing material in filament form. Moreover, the volume fraction of SMA to SMP was varied to find the optimum ratio for good operation cycles. A volume fraction of SMA:SMP of 1:5 showed the largest length change, of 8 mm, and the most rapid response time, of 4 s in overall dimension of 140mm×10mm×1mm (length×width×thickness).Thus, the SMC showed promising results for the application of stents and valve controllers that could be manufactured by 3D printing technology.</P> <P><B>Highlights</B></P> <P> <UL> <LI> An 4D printed SMC actuator was fabricated using SMA and SMP with a FDM 3D printer. </LI> <LI> A volume fraction of SMA:SMP of 1:5 showed the largest length change of 8 mm, and the most rapid response time of 4 s. </LI> <LI> The reversible actuator mechanism explains the SMC actuation via each shape memory effect. </LI> <LI> SMC showed potential application for stents and valve controllers via 3D printing technology to achieve customized designs. </LI> </UL> </P>

전면문제중심학습이 치의학교육의 자기주도적 학습, 의사소통, 문제해결 능력에 미치는 영향

이강욱 ( Kang-wook Lee ),홍진실 ( Jin-sil Hong ),장기완 ( Kee-wan Chang ) 대한구강보건학회 2016 大韓口腔保健學會誌 Vol.40 No.4

Objectives: The purpose of this study was to examine the effect of problem-based learning (PBL) on dental education to dental students. The following were investigated in this study: 1. Does PBL improve the ability of self-directed learning? 2. Does PBL change communication ability? 3. Does PBL change the strategy of problem solving? Methods: The participants of this study were 39 students in the experimental group and 68 students in the control group. The measurement tools of this study were self-directed learning, communication, and problem solving abilities tests designed by the Korean Educational Development Institute. The data was analyzed by the two-way ANOVA and ANOVA with repeated measures. Results: In self-directed learning ability during 3 semesters, the experimental group showed a U-shape change but the control group showed a reverse U-shape change. In the experimental group, the selfdirected learning ability was decreased after one year (after the first and second semester). The level of communication ability decreased every day during the three semesters monitored in both the control and experimental groups. The level of communication ability in the experimental group continuously decreased during the three semesters, with the exception of one semester. Finally, for the problem solving ability during the three semesters, the experimental group showed a reverse U-shape change while the control group showed a U-shape change. In the experimental group, there was no change after two semesters. Conclusions: On the basis of the findings in this study, the following conclusions can be made. First, problem-based learning has a positive educational effect compared to didactic-based learning within one year. Second, the appropriate length of PBL is two semesters, or one year. It could be recommended that dental education in Korea should be combined or hybridized with PBL; for example, PBL could be used in combination with brief lectures or block lectures by teachers.

Characterization of changes in global gene expression in the brain of neuron-specific enolase/human Tau23 transgenic mice in response to overexpression of Tau protein.

Woo, Jong-Min,Park, So Jung,Kang, Ho Il,Kim, Byoung Guk,Shim, Sun Bo,Jee, Seung Wan,Lee, Su Hae,Sin, Ji Soon,Bae, Chang Joon,Jang, Mee Kyung,Cho, Chunghee,Hwang, Dae Youn,Kim, Chuel Kyu D.A. Spandidos 2010 INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE Vol.25 No.5

<P>Tau is a neuronal phosphoprotein responsible for the formation of the neurofibrillary tangles in Alzheimer's disease. To characterize the changes in global gene expression in the brain of transgenic mice that overexpress human Tau23 protein in response to the increase of Tau23 phosphorylation, total RNA extracted from the hippocampus of 12-month-old transgenic and wild-type mice was converted to cDNA, labeled with biotin and hybridized to oligonucleotide microarrays. The microarray results were confirmed by real-time RT-PCR and Western blotting method. It was determined that 43 genes were up-regulated and 8 genes were down-regulated by Tau23 in transgenic mice compared to controls, based on the arbitrary difference in the 2-fold change. Among the up-regulated transcripts, those encoding for transporter and oxidoreductase were dramatically over-represented, followed by those related to regulatory molecule, cytoskeletal protein, signaling molecule, and extracellular matrix protein. Genes encoding for transcription factor, regulatory molecule, miscellaneous function, and chaperone were significantly reduced in the down-regulated group. The major genes in the up-regulated categories included Ecrg4, Folr1, Defb11, Aqp1 and Soctdc1. The major genes in the down-regulated categories were Ncor1, Gpm6a, and Hspd1. These results indicate that the microarray analysis identifies several gene functional groups and individual genes that respond to a sustained increase in Tau23 phosphorylation levels in the brain of transgenic mice. In addition, the results suggest the microarray test is a useful tool for increased understanding of the role of Tau23 protein in regulating neurodegenerative disorders.</P>

Expression of cellular retinoic acid-binding protein-I (CRABP-I) in the cerebrospinal fluid of adult onset moyamoya disease and its association with clinical presentation and postoperative haemodynamic change

Jeon, Jin Sue,Ahn, Jun Hyong,Moon, Youn-joo,Cho, Won-Sang,Son, Young-Je,Kim, Seung-Ki,Wang, Kyu-Chang,Bang, Jae Seung,Kang, Hyun-Seung,Kim, Jeong Eun,Oh, Chang Wan BMJ Publishing Group Ltd 2014 Journal of neurology, neurosurgery and psychiatry Vol.85 No.7

<P><B>Objective</B></P><P>The elevation of cellular retinoic acid-binding protein-I (CRABP-I) has been suggested as a candidate in the pathogenesis of paediatric moyamoya disease (MMD). However, few studies have addressed CRABP-I in adult onset MMD. The aim of this study was to examine the expression of CRABP-I in the cerebrospinal fluid (CSF) of adult onset MMD, and to evaluate its association with clinical presentation and postoperative haemodynamic change.</P><P><B>Methods</B></P><P>This study examined the CSF from 103 patients: bilateral MMD, n=58 (56.3%); unilateral MMD, n=19 (18.4%); atherosclerotic cerebrovascular disease (ACVD), n=21 (20.4%); and control group, n=5 (4.9%). The intensity of CRABP-I was confirmed by western blotting and expressed as the median (25th–75th percentile). The differences in CRABP-I expression according to disease entity (unilateral MMD vs bilateral MMD vs ACVD), initial presenting symptoms (haemorrhage vs ischaemia) and postoperative haemodynamic change (vascular reserve in single photon emission CT and basal collateral vessels in digital subtraction angiography) were analysed.</P><P><B>Results</B></P><P>CRABP-I intensities in bilateral MMD (1.45(0.86–2.52)) were significantly higher than in unilateral MMD (0.91(0.78–1.20)) (p=0.044) or ACVD (0.85(0.66–1.11)) (p=0.004). No significant differences were noted based on the initial presenting symptoms (p=0.687). CRABP-I was not associated with improvement in vascular reserve (p=0.327), but with decrease in basal collateral vessels (p=0.023) postoperatively.</P><P><B>Conclusions</B></P><P>Higher CRABP-I in the CSF can be associated with typical bilateral MMD pathogenesis in adults. Additionally, postoperative basal collateral change may be related to the degree of CRABP-I expression.</P>

정상 성인에 경구 투여한 Cefixime 두 정제의 생물학적 동등성 비교

강진양,서성훈,이경태,문창훈,강진한,이동건,최정현,신완식 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.4

목적 : 식품의약안전청 고시 제 1998-86호(1998. 8.26) "생물학적 동등성 시험 기준"에 의하여 섹심 캅셀(시험약, 한국유나이트제약)과 슈프락스 캅셀(대조약, 동아제약)의 생물학적 동등성을 비교 검토하였다. 방법 : 2×2 라틴 방격법에 따라 건강한 성인 남성 지원자 20명에게 cefixime 100㎎씩 경구투여하였다. 약제투여 후 12시간까지 일정간격으로 채혈하였고 각 피험자들의 혈중약물농도 데이터로부터 구한 Area under the concentration (AUC), C_(max), T_(max) 등의 생체이용률 파라미터에 대해 통계학적으로 고찰하여 두 제제간의 생물학적 동등성을 평가하였다. 결과 : AUC, C_(max), T_(max)에 대한 평균값의 차가 각각 1.26%, 3.73%, 6.21%로서 모두 대조약의 20% 이내에 들어 생물학적 동등성 판정기준의 전제조건을 만족하였다. 분산분석 결과 AUC, C_(max), T_(max)의 각 비교 항목에 있어서 모두 유의수준 α=0.05의 군/순서효과 검정에서 F비가 F 분석표의 한계값보다 작아 교차시험이 제대로 이루어졌음을 확인할 수 있었으며, AUC, C_(max), T_(max) 각 비교항목에 있어서 유의수준 α=0.05에서 대조약에 대한 최소검출차(Δ)가 각각 17.74%, 17.05%, 15.67%로 모두 20% 이내이었으며, 검출력(1-β)도 모두 0.8 이상으로 나타나 생물학적 동등성 판정기준을 만족시켰다. 또 AUC, C_(max), T_(max) 각 비교항목에 있어서 대조약에 대한 생체이용률 차이의 신뢰한계(δ)가 ±20% 이내이어야 한다는 생물학적 동등성 판정기준을 모두 만족시켰다. 결론 : 이상의 실험결과로 시험약은 대조약에 대하여 생물학적 동등성 평가항목인 AUC, C_(max), T_(max)에서 모두 판정기준을 만족시켜 시험약은 대조약과 생물학적으로 동등하다고 사료된다. Background : The study was designed to compare the bioeqivalence between the test (CEXIME®. United Korea. Co., Ltd) and control (SUPRAX®. Dong-a Pharm. Co.. Ltd) capsules of cefixime. Methods : Twenty. healthy, male volunteers completed the study Each subject ingested single dose (100 ㎍) of the control and test drugs in 2?2 crossover design with a week drug-free interval between the doses. Blood samples were collected serially up to 12 hours and plasma concentrations of cefixime were measured by high-performance liquid chromatography with UV detection. A non-compartmental approach was used for analysis of the concentration-time data. Results : The area under the curve (AUC), the maximum concentration of drug (C_(max)). and time to reach C_(max)(T_(max)) did not show any significant difference between the two preparations by ANOVA. The mean differences of AUC, C_(max), and T_(max) were within 20% of the control drug, those were 1.26%. 3.73%. and 6.21%. respectively. The confidence limits of three parameters were satisfied the bioeqivalence criteria. Conclusion : These results suggest that the test drug was bioequivalent with the control drug.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

가속도가 없을 때의 쌍둥이 역설 고찰

강정우,강창완 濟州大學校 師範大學 科學敎育硏究所 1999 科學敎育 Vol.16 No.-

The students, who study the twin paradox in the special theory of relativity, usually think that a direct cause of twin's age difference is the acceleration. Not considering the acceleration, but a case of using three person who are born simultaneously in one place, we could lead the three kind of notion of special theory of relativity, i.e., time dilation, length contraction and simultaneity and could explain a cause of twin's age difference. In S' system, when u1 and Byung, who are born simultaneously and in the distance far away Lo, travel for the same time in the state of unexperienced any acceleration, the age of UI and Byung observed by an observer in S system that does uniform motion relative to S'system is that UI is gamma Υv~L_(o)/c^(2) older than that in S" system and they are far from as gamma ΥL_(0) as each other. Using the Lorentz transformation the coordinates of two people belonging to one system that does uniform motion relative to an observer' system and simply comparing that results, we know could that the age difference of two people occurs. From these results, we could conclude that the acceleration is not unique cause of the age difference. Also without applying general theory of relativity, the twin paradox could be easily understand.

원시적 지속성 삼차신경동맥 동맥류 : 증례보고 A Case Report

강현승,한대희,권오기,오창완,정희원,최길수 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.5