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.

대학생의 성교육 효과측정을 위한 기초 연구

장순복,최연순,강희선,박소미,Chang, Soon-Bok,Choi, Yun-Soon,Kang, Hee-Sun,Park, So-Mi 대한간호협회 1997 대한간호 Vol.36 No.2

This study was performed to provide preliminary data for the development of a useful instrument to measure the effect of sex education. The study was conducted with the voluntary participation of 155 college students enrolled in the course "Sexuality and Relationship" at Y university in Seoul. At the end of that course, they were asked to write freely about the change they had experienced on sexuality. All meaningful statements were elicited and classified into 7 categories; "Change of Knowledge", "Enlightenment", "Change of Attitude on Sexuality", "Buildup of Ability", "Buildup of. Identity", "Change of Emotion", "Change of Behavior:' There were significant changes in the areas of knowledge(28. 6%), enlightenment(27.4%), and attitudes(20.3%) about sexuality among these 7 categories. The Change of Knowledge category consists of 3 areas: "concretion of knowledge", "increase of information", and "correction of misunderstanding." In the category of Enlightenment, total 12 areas are included: "sex role", "erception of lack of knowledge", "importance of family", "life plan", "parent role", "value of life", "equality", "sexual autonomy", "importance of sexuality", "freedom of sexuality", "perception of sexual problem", and "meaning of love." The Attitude Change category consists of 8 areas. These are "being natural", "being progressive", "being sensitive", "being truthful", "being expressive", "being cautious", "being responsible", and "being confident". The category of Buildup of Ability includes 4 areas: "problem solving", "sex education", "relationship", and "communication". The category of Buildup of Identity includes "sexual identity", and "value of sexuality". The Emotional Change category includes 3 areas: "positive feeling", "negative feeling", and "breaking from negative feeling on sexuality". The Behavior Change category includes "sex-related behavioral change". In conclusion, up to now most researches on sex education effect measures only changes of knowledge, attitude, and behavior. But we believe the changes in "Enlightenment", "Buildup of Ability", "Buildup of Identity", "Change of Emotion", should be included in addition to knowledge, attitude, and behavior in the development of an instrument to measure the sex education effects. And the effect of sex education should measure the degree of learning of autonomy, enlightenment, and ability of behavior and so on rather than studying the simple changes in sexuality.enment", "Buildup of Ability", "Buildup of Identity", "Change of Emotion", should be included in addition to knowledge, attitude, and behavior in the development of an instrument to measure the sex education effects. And the effect of sex education should measure the degree of learning of autonomy, enlightenment, and ability of behavior and so on rather than studying the simple changes in sexuality.ng the simple changes in sexuality.

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.

Aflatoxin B_1 투여가 急性 肝 病變에 미치는 영향에 對한 病理學的 硏究

장선문,이충식,강대영 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.1

In an attempt of elucidate the pathologic and histochemical changes of aflatoxin B_2-induced hepatie lesions, the present study in male Sprague-Dawley rats was undertaken to evalute the relation between pathologic change of the liver and histochemical changes of several enzymes : alkaline phosphatase, acid phosphatase and succinic dehydrogenase at 3. 9. 24. 48. 72, and 144 hours after single administration of aflatoxin B_1 by gastric tube. The aflatoxin B_1 was dissolved in peanut oil(0.5㎎ aflatoxin B_1 to 0.5ml peanut oil). Grouop of male rats received aflatoxin B_1 1㎎ per ㎏ of body weight, respectively. Control animals were given a similar volume of peanut oil alone. The results on morphologic and histochemical changes were as follows: 1. The necrotic change of liver was mainly periportal, and it became most severe at 24 hours and was more prominent in the large dose group than the small dose group. 2. Biliary ductular cell proliferation started to appear within 72 hours and after became regressed later in the small dose group, but it remained approximately 144 hours after exposure in the large dose group. 3. Electron microscopically, all three groups showed irregular nuclear membrane and nucleolar change characterized by segregation of granular and fibrillar elements. All the group showed cytoplasmie changes such as dilatation of rough endoplasmic reticulum with detached ribosome, hyperplasia of smooth endoplasmic reticulum, increased numbers of lipid droplets and mitochondrial alteration. The above change in the large dose group was more severe than those of the small dose group. 4. In the histochemical study of experimental animals, there was a decrease in the intensity of the staining reaction of alkaline phosphatase and succinic dehydrogenase within 24 hours and a progressive decrease in staining intensity was noted at 144 hours. And then the staining intensity of the acid phosphatase was similar to that shown by the control animal. In summary, the data obtained by present experiments indicate aflatoxin B_1 exerts periportal necrosis of hepatic lobules accompanied by bile ductular cell proliferation, and inhibition of protein synthesis, as jedged by elertron microscopic and histochemical changes.

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.

Changes in Spatiotemporal Parameters and Lower Limb Coordination During Prosthetic Gait Training in Unilateral Transfemoral Amputees

Yunhee Chang,Chang-Yong Ko,Bo Ra Jeong,Jung Sun Kang,Hyuk-Jae Choi,Gyoosuk Kim,Hyunjun Shin,Sehoon Park 한국정밀공학회 2022 International Journal of Precision Engineering and Vol.23 No.3

When applying prosthetic gait training to patients with lower limb amputation, monitoring the gait change process is crucial for establishing and modifying rehabilitation training plans. In addition, since human gait involves complex movement of several joints, it is necessary to analyze the organic movement of adjacent joints rather than a single joint in the lower extremities for understanding the process of gait change. Therefore, this study aimed to analyze changes in spatiotemporal parameters and lower limb coordination during prosthetic gait training in unilateral transfemoral amputees (TFAs). This retrospective case–control study included 10 unilateral TFAs and 10 healthy individuals as controls. TFAs received prosthetic gait training for 12 weeks and gait changes were analyzed every 2 weeks using a 3D motion analysis system. The measured variables were spatiotemporal parameters and the continuous relative phase between hip and knee joints. The highest improvement in walking speed was seen at week 4 of training, and the continuous relative phase was most symmetric at week 8. The lower limb coordination pattern was more in-phase in the TFAs than in the controls, and the coordination variability was also lower for the TFAs than for the controls. In addition, the rate of change in lower limb coordination of TFAs was lower than that of spatiotemporal parameters and was significantly different from that of the controls even after training. Considering that the decrease in lower limb coordination is related to gait efficiency, balance, and risk of fall, there is a need to develop therapeutic strategies that can further improve the coordination of TFAs.

濟州道 겨울 作物(채소류)의 流通 및 對日 輸出增大에 대한 硏究

姜景璿,宋昌吉 제주대학교 1983 논문집 Vol.15 No.2

(1) The mean atmospheric timperature of Jeju area is higher than that of Seoul by 3'c and in the coldest month by 8'c, so Jeju-do is regarded as important place to cultivate subtropical plants. Such a natural state has accelerated the crop production suitable to warm region front time immemorial. Jeju-do has become a main producing district of tingerines, sweet potatos, barleys and rapes since the beginning of 1960's and Jeju-do's latest main products are wintering vegetables such as cabbages, carrots, garlics and onions. Such a term favorable to an off-crop season is developing Truck Farming. (2) A milder winter causes us to save petroleum needed to cultivate plants under vinyl plastic hot houses, where some 200cc of petroleum is needed to cultivate a tomato, some 100cc to cultivate a cucumber, some 18cc to cultivate a melon, some 200cc to cultivate a tangerine, and some 50-60cc to cultivate an eggplant. (3) A case study on sales method of carrots, garlics and cabbagges shows that 64-60% of farmers sell out a crop estimate on vegetable garden before harvesting. (4) A case study on distribution margin shows that gross margin rate is 66.2% in carrots, 77.2% in cabbages and 53.6% in garlics, and the income rate of above-mentioned products in a farmhouse is 33.8%, 22.8% and 46.4% respectively, while transporting expenses…cabbages (23.2%), carrots (12.1%) and garlics (8.7%)…are given much more weight than any other expense. (5) Japan limitted the total output of vegetables with 16 million ton of vegetables in 600,000 ha of vegetable culture area to keep the change of demand safe in 1979, but the increase of vegetable culture area, both by changing rice fields and by the propensity to consume energy, is becoming primary factors in the alteration of vegetable product stucture. (6) The amount of annual vege table consumption per headof population has changed into 110kg, and the vegetables consumed over 5kg are cabbages, onions and radishes and sweet potatos. Cucumbers are staying between 4kg and 5kg. The present propensity to consume vegetables represents multiformity, annual plants and high-grade food, with western vegetables as the central one. (7) The amout of Jepanese in agricultural, forestry and marine fields came up to $ 29,055, 000,000 in 1980. The income amount in agricultural products reaches $ 14,911,000,000 wich is equal to 51.3% of total. The income amount in fruits and vege tables reaches $ 1,420,000,000 which is equal to 95%, America holds the foremost place as importer Country of agricultural and marine producss and Taiwan the sixth place, but Korea fakes 11th place, earning $ 738,000,000 annually. The income amount from Korea in agricutural comes up to $ 152,000,000. (8) The income amount of vegetables in Japan reached $ 107,800,000,000, and the change of vegetable income (1965-1978) tells that income amount has increased the quantity by 17 times. Main articles of vegetables are frozen vegetables and salted ones. (9) No importer countries surpass America and Taiwan. The export share of fish and vegetables in Taiwan and Korea shows that Taiwan exports 24.3% of total Japanese import (2nd position) , while Korea does 2.8% (5th position). For frozen vegetables, America holds the first position, exporting 48.6% and Taiwan the 2nd position, exporting 31.4% , while for dried vegetables, Taiwan holds the first position, exporting 42.9% and Korea 5th position, exporting 2,8%. Also, for salted vegetables Taiwan exports 63.4% (1st) and Korea 3.1% (3rd), while for prepared vegetables, Taiwan exports 78% (nst) , and Korea 2% (5th). (10) The agricultural effort amount of Korea came up to $182,000,000 which corresponded to 0.9% of total export, $20,993,000,000, while the export amount of Jeju-do reached $ 593,000, corresponding to 0.3%. The raw silks of Korean agricultural products in 1975 were main export articles, corresponding to 58% of total agricultural products, but they are remarkably decreasing into 14.3%. The vegetable export share was 2.2% in 1975, but 11.8 percent increase in 1981 is a characteristic found only in the vegetable export. Thus, the fact that vegetables are given much weight in the export structure of agricultural products shows an important change and the probablility to develope in the future. Therefore, in the aspect of vegetable export, diversified studies are needed to prepare good vegetable-producing center and to foster special artfole like dried, salted, frozen, and manufactured vegetables.

A Re-evaluation of the Concept of Topic

( Kang¸ Sun Young ),( Chang¸ Kyung Ki ) 현대영미어문학회 1983 현대영미어문학 Vol.1 No.-

Overlapping and unique toxic effects of three alternative antifouling biocides (Diuron, Irgarol 1051^®, Sea-Nine 211^®) on non-target marine fish

Moon, Young-Sun,Kim, Moonkoo,Hong, Chang Pyo,Kang, Jung-Hoon,Jung, Jee-Hyun Elsevier 2019 Ecotoxicology and environmental safety Vol.180 No.-

<P><B>Abstract</B></P> <P>The use of alternative biocides has increased due to their economic and ecological relevance. Although data regarding the toxicity of commercial alternative biocides in marine organisms are accumulating, little is known about their toxic pathways or mechanisms. To compare the toxic effects of commercial alternative biocides on non-target pelagic fish (flounder) embryos, we investigated the adverse effects of developmental malformation and transcriptional changes. Three biocides including Diuron, Irgarol 1051<SUP>®</SUP> and Sea-Nine 211<SUP>®</SUP> produced a largely overlapping suite of developmental malformations, including tail-fin fold defects and dorsal body axis curvature. In our test, the potencies of these biocides were ranked in the following order with respect to malformation and mortalities: Sea-Nine 211<SUP>®</SUP> > Irgarol 1051<SUP>®</SUP> > Diuron. Consistent with the toxicity rankings, the expression of genes related to heart formation was greater in embryonic flounder exposed to Sea-Nine 211<SUP>®</SUP> than in those exposed to Irgarol 1051<SUP>®</SUP> or Diuron, while expression of genes related to fin malformation was greater in the Irgarol 1051<SUP>®</SUP> exposure group. In analyses of differential gene expression (DEG) profiles (fold change of genes with a cutoff <I>P < 0.05</I>) by high-throughput sequencing (RNA-seq), genes associated with nervous system development, transmembrane transport activity, and muscle cell development were significantly changed commonly. Embryos exposed to Diuron showed changes related to cellular protein localization, whereas genes associated with immune system processes were up-regulated significantly in embryos exposed to Irgarol 1051<SUP>®</SUP>. Genes related to actin filament organization and embryonic morphogenesis were up-regulated in embryos exposed to Sea-Nine 211<SUP>®</SUP>. Overall, our study provides a better understanding of the overlapping and unique developmental toxic effects of three commercial booster biocides through transcriptomic analyses in a non-target species, embryonic flounder.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Developmental defects of the most commercially used booster biocides were investigated on non-target marine species. </LI> <LI> Sea-Nine 211® was most developmental toxic biocides among three biocides regarding malformation and mortalities analysis. </LI> <LI> Three biocides were produced common toxic effects associated with nervous system development. </LI> <LI> Genes related to immune system processes were variated in embryos exposed to Irgarol 1051<SUP>®</SUP>. </LI> <LI> Genes related to embryonic morphogenesis were up-regulated in embryos exposed to Sea-Nine 211. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Clinical Experiences and Usefulness of Cervical Posterior Stabilization with Polyaxial Screw-Rod System

Hwang, In-Chang,Kang, Dong-Ho,Han, Jong-Woo,Park, In-Sung,Lee, Chul-Hee,Park, Sun-Young The Korean Neurosurgical Society 2007 Journal of Korean neurosurgical society Vol.42 No.4

Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.