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.

수정진동자를 이용한 박막의 상거동 분석

장상목,김종민,이현우,정재헌 동아대학교 공과대학부설 생산기술연구소 1996 生産技術硏究所硏究論文集 Vol.1 No.2

This paper shows that an AT-cut quartz crystal analyzer(Q.C.A) can be applied to the investigation of the microheological change of the polymer blend solution during solvent evaporation process casting blend on the surface of quartz crystal. he blend is made from various compositions of poly(methyl methacrylate) (PMMA) and poly(vinyl acetate)(PVAc), and ethyl acetate as slovent. The resonant frequency and resonant admittance of the blend casting Q.C.A are measured simultaneously and the microheological behavior of the blend is analyzed during ethyl acetate evaporation. The PMMA/PVAc blend solution behaves several informative changes of resonant frequency and resonant admittance during ethyl acetate evaporation, depending on the evaporation time and the blend ratio. The PMMA/PVAc blend solution in ethyl acetate exhibited critical changes of resonant frequency and resonant admittance depending on the evaporation time and blend ratio. From this study, it is known that the quartz crystal analyzer can be successfully applicable to analyze viscoelastic changes on the microrheology and phase separation at the initial stage of the blends of PMMA and PVAc during the solvent, ethyl acetate evaporation process by maesuring the resonant freaquency and the resonant resistance in situ.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

한국불교문화의 세계화 - 한계와 대응 -

장상목 ( Chang Sang Mok ) 사단법인 한국교수불자연합회 2016 한국교수불자연합학회지 Vol.22 No.3

한국불교문화의 특성과 제반 문제점들을 최근 사회발전과 변화에 수반되는 현상으로 보지 않고 사바세계의 내재적 문제점들로 인식하고 사바세계를 불국정토로 만들라고 하신 석가세존의 대자 대비한 부촉에 부응하여 변화하고 발전하여 온 불교문화들을 21세기 문화운동의 일환으로 고찰하고자 하였다. 순수문학과 대중문학의 경계를 허물어야 한다고 주장하는 포스트모더니즘에서 일어나고 있는 주요한 변화들을 간단히 개괄함으로써, 사바세계에 대한 불교 문화적 관점이 불교교리를 견강부회한 교리 중심적인 접근이 아니라 보다 합리적이고 다양한 관점에서 접근하였음을 밝히고자 하였다. 21세기 사회 변화발전이 사회전반에 걸쳐, 그리고 종교적으로 어떤 영향을 주었으며, 앞으로 불교문화 운동의 방향성 정립에 어떤 영향을 주었는지 고찰하고자 하였다. 불교문화가 21세기 사회의 특수상황뿐만 아니라 인류사적 측면에서 인간해방과 불국정토 구현이라는 인류 보편적 사상의 실천이었다는 점을 강조하고자 한다. 그런 측면에서 불교의 정신문화적 토양이 21세기 시대정신을 반영하는 문화로 더욱 빛을 발휘할 것이며 발전할 것이라는 점을 논하였다. This paper recognizes the various characteristics and problems arising in the Korean Buddhist culture as an intrinsic properties of the world of suffering(sabha) instead of a phenomena accompanying the recent social development and change. Sakyamuni Buddha gave a sermon to his disciples and followers to seek a path building the Buddhist Elysium Elysium (Sukkavati). The Buddhist cultures, which were changed and developed in response to the requests of Sakyamuni Buddha, are considered as part of the 21st century cultural movement. By a brief overview of major changes in the postmodernism, which argues that the boundary of pure literature and popular literature should be broken, it is tried to elucidate that the Buddhist cultural perspectives of the world of suffering are not farfetched interpretation and religious approach, which distort the society phenomenon to religious doctrine of Buddhism, but more reasonable and diverse approach. This paper investigates how the 21st century social change and development have an influence on the whole society, specifically the religious world, and the establishment of future Buddhist cultural movement direction. Furthermore, it emphasizes the Buddhist culture gives a direction for not only the special situations of the 21st century society, but also by the universal values of human freedom and liberty and manifestation of the Buddhist Elysium. At this point, the fundamental mental culture soil of Buddhism will be shared and developed as the culture that reflects the zeitgeist of the 21st century.

SV40 T 항원의 온도조건부 변이형 유전자가 포함된 Amphotropic Retrovirus 에 의한 사람 태아 간세포의 불멸화

이정일(Joung Il Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),장영운(Young Woon Chang),장린(Rin Chang),성세라(Se Ra Seong),박재경(Jae Kyung Park),김승보(Seung Bo Kim),이상목(Sang Mok Lee) 대한내과학회 1999 대한내과학회지 Vol.57 No.1

N/A Human cells are almost never spontaneously immortalized in vitro. We tried to immortalize human fetal hepatocytes (h-FH) and evaluate the differentiational status and its change. Methods : Hepatocytes were isolated from a liver fragment of 20 week old fetus and infected with amphotropic recombinant retrovirus containing a temperature- sensitive mutant of SV40 large T antigen and neomycin phosphotransferase gene. G418 resistant colonies were cloned and expanded. The cells which were able to divide more than 30 times were used to analyze various functions. Results : The immortalization rate was 3.3 x 10-8 and two cell lines (C11, D21) were established. C11-60, C11-80, D21-30 and D21-60 (suffix number means the cell division counts) were evaluated. D21-30 was thougt to be imcompletely immortalized because a considerable portion of cells died during culture. The morphology was similar to that of epithelial cells except for D21-30 which looked like fibroblast. The cells grew rapidly at 33oC but stopped growing at 39oC. T antigen and p53 was expressed at 33oC but disappeared at 39oC, which suggest that T antigen binds to p53. Chromosomal changes were so marked that it was impossible to discriminate exact number. Albumin was secreted as about 1/10 as that of h-FH, but alpha-fetoprotein secretion stopped after immortalization. Telomerase was activated in both cell lines except for the incompletely immortalized cells D21-30. Telomere was elongated in competely immortalized cell lines, but it was rather shortened in D21-30 compared to that of h-FH. Macroscopic colonies did not develop in soft agar assay. Conclusions : We successfully immortalized human fetal hepatocytes. Although the cells are not likely to have oncogenicity, the functions are not so good, possibly due to marked chromosomal changes which are thought to occur before telomerase is activated during immortalization step.

Langmuir-Blodgett(LB) 누적막을 이용한 화학센서의 개발

장상목,권영수 경북대학교 센서기술연구소 1991 센서技術學術大會論文集 Vol.2 No.1

The present trends and development of chemical sensors by using Langmuir-Blodgett( LB ) ultra thin films have been reviewed. Chemical sensors are defined and classified according to the types of transduce and the kinds of analysis, and the sensors by using LB films already reported are described. Especially, the odorant sensor system using piezoelectric crystal and the glucose sensors incorporating LB film have been described in detail.

백서의 복강내에 투여한 Mitomycin-C-Polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

송규상,강대영,최정목,노승무,정경수,오정연,김진향,양준목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

To evaluate the in-vivo effects of mitomycin-C-polyglycolic acid composite(MMC-PGA) the disk: shaped composite were implanted into the peritoneal cavity of the Sprague-Dawley rats. The pathologic changes were examined at various time points up to 12 weeks. Initially the soft tissue around the inserted disks showed capillary congestion at 3 days. Inflammatory infiltrates with foreign body giant cells appeared from the 2nd week and reached peak response at 6-8 weeks. These reaction diminished prominently at 12 weeks. No specific pathologic change was found in the liver, the kidneys, and the heart. The above results suggest that the MMC-PGA composite can serve as a new device for intraperitoneal chemotherapy of various types of cancers.

선형지반응답해석에서 동강성 행렬법의 적용

오창목,조성호 中央大學校 建設環境硏究所 2002 環境科學硏究 Vol.13 No.2

본 연구에서는 지반내진해석에서 동적하중에 대한 지반의 거동을 동강성행렬법을 이용하여 수치해석기법을 발전시켰는데, 동적하중에 대한 지반의 거동을 해석하는 동강성 행렬법의 이론을 적용하여 기반암에 지진하중이 가해졌을 때 지표면과 지반내에서의 선형지반응답을 구하는 알고리듬과 해석 프로그램(DSMM)을 개발하였다. 동강성 행렬법을 구현한 DSMM은 지반가속도, 전단변형률, 전단응력의 측면에서 SHAKE91보다 합리적인 결과를 제시하였다. 한편, 연약층 하부에 기반암이 존재하는 경우와 전단강성이 기하급수적으로 증가하는 지반의 경우 DSMM과 SHAKE91은 상호 비슷한 경향을 보이고 있으나, SHAKE91이 DSMM보다 매우 큰 값으로 결과를 보여주었다. 결과적으로 신뢰성을 검토하기위해 상용프로그램의 결과와 비교하여 평가할 때, 새롭게 개발된 지진응답해석기법으로 수행하는 것이 더 합리적이라는 것을 보여주고 있다. In this study, a numerical method for earthquake response analysis of a geotechnical site using dynamic stiffness matrix method is developed. The theory of DSMM to analyze ground behaviors over dynamic loading was applied. From the case that earthquake loading was afflicted to bed rock, algorithm and analysis program was developed to seek linear ground response from surface and ground. After ground response analysis using DSMM and SHAKE91 was carried with the same ground model, loading condition and boundary condition the results were compared and analyzed. DSMM showed a more resonable outcome than SHAKE91 in the aspect of ground acceleration and shear strain and stress. While both of them showed similar trends in the case of soft layer over bed rock and layered system with curvilinear stiffness, SHAKE91 produced the results in larger numbers. In conclusion, the reliability of the newly developed earthquake response analysis was verified by comparing the results with those which could be obtained from using other authentic and valid programs.

고속 신호 획득을 위한 SoC GPS수신기의 설계 및 구현

한상목,박찬식 충북대학교 컴퓨터정보통신 연구소 2004 컴퓨터정보통신연구 Vol.12 No.2

본 연구에서는 SOC을 목표로 GPS 수신기를 설계 및 구현 하였다. 5채널 GPS 수신기를 Altera사의 10만 게이트 Excalibur를 이용하여 구현할 수 있었다. 여기에 초기 신호 획득 시간을 줄이기 위해 다중 상관 방식을 추가하였다. 질제 측정치를 이용하여 실험한 결과는 이중 장관기일 경우 40% 그리고 사중 상관기일 경우 60% 이상 성능 향상됨을 보여주었다. 본연구의 결과는 차세대 GPS 수신기와 갈리레오 수신기설계 및 제작에 쉽게 적용할 수 있을 것이다. A design and implementation of SoC based GPS receiver is given in this paper. A 5 channels GPS receiver is implemented using Alteta's Excalibur with 100 thousand gates. A multiple correlation method is added to SoC based GPS receiver to reduce signal acquisition time. Experimental results show that improvement of more than 40% and 60% can be made by using dual-correlator and quad respectively. It is expected that these results can be easily applied into the design and implementation of GPS/Galileo receivers.