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.

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.

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.

하순에 발생한 Keratoacanthoma 증례보고

이철원,배창,최목균 의치학사 1986 치과임상 Vol.6 No.11

Keratoacanthoma is a benign self-limiting tumor which closely resembles squamous cell carcinoma clinically and histopathologically. The etiology of keratoacanthoma is uncertain but it has been considered* many factors, including sun exposure, viral infection, occupational exposure, genetic factors and etc. We experienced a case of solitary type of keratoacanthoma, about 1.5 cm of size, with typical clinical and histopathologic findings which presented on the lower left lip area of a 66-year-old male patient. In the H-E stainted sections, there was horn filled invagination, dyskeratotic cell, horn pearl in the epidermis and an inflammatory cell infiltration in dermis. This case was treated by surgical excision and its prognosis was fairly good.

개에 있어서 유선 종양의 1례

이시예,정성목,박창식,김명철 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

A 6-years-old 2.5kg female maltese dog with history of multiple mass around mammary gland was referred to Veterinary Medical Teaching Hospital, Chungnam National University. There was no evidence of metastasis in survey radiograph. Cytological finding revealed cell crumps of linear structures of epithelial cell origins. Histopathological finding revealed fibrous stroma, myxomatous lesion, catilagenous metaplasia, hyperplasia of lobular alveoli and ductules. Mass was removed by total mastectomy. After surgery, CBC values showed mild anemia, neutropenia and lymphocytosis. General condition was good. For the appropriate evaluation, more periodical and continuous monitoring is needed.

개에 있어서 유선 종양의 1례

이시예,정성목,박창식,김명철 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

A 6-years-old 2.5kg female maltese dog with history of multiple mass around mammary gland was referred to Veterinary Medical Teaching Hospital. Chungnam National University. There was no evidence of metastasis in survey radiograph. Cytological finding revealed cell crumps of linear structures of epithelial cell origins. Histopathological finding revealed fibrous stroma. myxomatous lesion. catilagenous metaplasia. hyperplasia of lobular alveoli and ductules. Mass was removed by total mastectomy. After surgery, CBC values showed mild anemia. neutropenia and lymphocytosis. General condition was good. For the appropriate evaluation, more periodical and continuous monitoring is needed.

양이장단자극을 이용한 각성유지 및 수면유도

정환목,배기성,김형식,우창진,최평,이만기 경북대학교 센서기술연구소 2002 센서技術學術大會論文集 Vol.13 No.1

지진동에 대한 지반응답을 구하기 위한 등가선형해석과 유한요소해석

오창목,조성호,이일화 중앙대학교 건설환경연구소 2001 環境科學硏究 Vol.12 No.2

지진으로 인한 지반의 액상화 평가, 구조물에 대한 동적 응답해석 등을 위한 지반응답해석으로 가장 보편적으로 활용되는 해석은 SHAKE(Schnabel, et at.,1972)를 사용한 등가선형해석이다. 등가선형해석은 비선형 정도가 크지 않은 지진동의 경우에는 합리적인 해석방법이 될수 있지만, 입력지진동에 의해 지반 내에 횡방향으로 큰 변위가 발생할 가능성이 있는 경우 합리적인 해석방법이 될 수 없다. 따라서, 본 연구에서는 등가선형해석과 유한요소해석에 의한 지반응답해석을 실제 현장에 대해 적용하여 각 해석결과를 비교 검토함으로써 각 해석의 특징을 살펴보았고, 이를 바탕으로 보다 합리적인 지반응답해석을 위한 제언을 하였다. 본 연구에서 수행한 지반응답해석은 지하철 9호선 철도 통과예정지역인 반포아파트 부지에 대해 수행되었고, 등가선형해석에 의한 지반응답해석은 SHAKE91에 의해서, 유한요소해석은 상용 유한요소해석 프로그램인 ABAQUS에 의해 수행하였다. The most widely accepted analysis, which evaluates the ground response for the liquefaction analysis and dynamic response analysis of structures, is the linear equivalent analysis such as SHAKE(Schnabel, et al., 1972). The concept of the equivalent linear analysis holds true only when the nonlinearity of the ground material is not significant and the large lateral displacement due to the earthquake loading is not expected. Thus, in this study the equivalent linear analysis and the finite element analysis are applied to evaluate the ground response of the real site, and the characteristics of the each algorithm are compared. The equivalent linear analysis was performed by SHAKE91, and the finite element analysis was performed by ABAQUS.

김해지역 호스피스를 위한 보건의료정보망의 개발

조 현,이창은,허 목 인제대학교 김해발전연구소 1997 김해발전연구 Vol.1 No.2