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.

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.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

Adaptive Maximum Power Point Tracking Algorithm for Photovoltaic Power Systems

AHN, Chang Wook,CHOI, Ju Yeop,LEE, Dong-Ha,AN, Jinung The Institute of Electronics, Information and Comm 2010 IEICE TRANSACTIONS ON COMMUNICATIONS - Vol.93 No.5

<P>This paper presents an adaptive maximum power point tracking (MPPT) algorithm. The aim is to dynamically adjust the step length for updating duty ratio (or operating voltage) so as to make full utilization of the output power of photovoltaic (PV) systems, even under the rapidly changing atmospheric conditions. To this end, the average slope in terms of voltage and power is exploited for reducing the harmful effect of noise and error (incurred in measurement or quantization) on the slope. Also, a statistical decision-making scheme is employed for reliably deciding the time instant at which atmospheric conditions actually change. Empirical study has adduced grounds for its dominance over existing references.</P>

층류 순산소 연소에서 CO₂몰분율에 따른 매연 배출 특성에 관한 연구

최도욱(Do Wook Choi),김규보(Gyu Bo Kim),전충환(Chung Hwan Jeon),장영준(Youg June Chang),송주헌(Ju Hun Song) 대한기계학회 2009 대한기계학회 춘추학술대회 Vol.2009 No.11

Oxy-fuel combustion is a reliable way for the reduction of pollutants, the higher combustion efficiency and the separation of carbon dioxide. In this study, An experimental study was performed to investigate the influence of soot emission in laboratory-scale oxy-fuel burner. The experimental conditions are fixed up fuel(CH₄) and oxidizer(O₂) rate. But inert gas(CO₂) rate was changed. Also the study was performed in the laminar diffusion flame. As an optical method, laser induced incandescence is useful to get the information for spatial and temporal soot emission. Therefore, Soot emission measurements were performed to the technique of laser induced incandescence(LII) and 2D image was detected by ICCD camera. As a result of this experimental study, confirmed to Characteristic of soot emission in Oxy-fuel combustion.

농촌지도직공무원 지방직 전환 첫 해의 예비평가

김성수(Sung Soo Kim),최창욱(Chang Wook Choi),최영창(Young Chang Choe) 한국농촌지도학회 1997 농촌지도와 개발 Vol.4 No.2

The objectives of this study were 1) to evaluate the first year of localization of agricultural extension in Korea, 2) to present the development directions and implications of agricultural extension service in the next year of localization. The major results and implications were as follows. 1. The positive changes in localization were to establish local special projects and to work in agricultural extension without personnel changes. 2. The negative changes in localization were increase of unnecessary work load and decrease of morale because of lowered status. 3. The development directions were m cut back unnecessary work load, to rearrange an office, and to return to the national status of extension personnels.

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>

3분 및 4분 상완골근위부 골절에서의 외반형 및 내반형에 따른 임상적 비교

최창혁,권굉우,김신근,이상욱,신동규,이승진 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 수술적으로 치료한 3분, 4분 상완골 근위부 골절을 외반형과 내반형으로 재분류하여 임상적 결과를 비교하고자 하였다. 대상 및 방법 : Neer 분류상 3분, 4분 상완골근위부 골절로 분류된 21례에 대해 수술적 치료를 시행하고 12개월 이상 추시된 증례를 대상으로, 골절부위의 각형성, 상완골두의 방향성, 그리고 우세 전위결절의 양상에 따라 외반형과 내반형으로 재분류하여 UCLA shoulder rating scale에 따른 기능적 평가를 시행하였다. 결 과 : 단순 방사선 소견을 기준으로 Neer의 3, 4분 상완골 근위부골절을 외반형과 내반형 및 각각의 아형(subtype)으로 분류할 수 있었다. 견관절 반치환술을 시술한 2례를 제외하고 분석한 각 그룹의 UCLA 기능적 평가는 외반형에서 양호 이상의 결과가 9례중 8례(89%), 내반형에서 10례중 4례(40%)로 외반형에서 더 우수한 임상적 경과를 보였다. 결 론 : 상완골 근위부 골절에서 골두의 방향성은 골절의 각형성 및 우세 전위결절의 양상과 높은 상관관계를 가졌으며, 내반형의 경우 혈행과 신경장애가 좀더 빈번하고 예후도 불량한 것으로 나타났고, 이러한 경우 수술시 도달 방법, 연부조직 상태에 대한 평가가 더욱 신중하게 고려되어야 할 것으로 생각되었다. Purpose : We reclassified three-and four-part proximal humerus fracture by Neer's classification into valgus & varus type, and compared the results of these groups. Materials & methods : 21 cases classified as three- and four-part fracture in Neer's classifiation were treated surgically and followed for 12 months. We reclassified the 21 cases vlagus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale. Results : Neer's three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellent in 8 of 9 cases of valgus type(89%), and at 4 in cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type. Conclusion : Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head and domonant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.

가족성 정신분열병 환자에서 임상 특성의 가족내 연관성

최경숙,이유상,장용이,조은영,전현옥,김창현,김상욱,홍경수 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : This study aims at examining familial associations of symptoms and clinical characteristics in affected sibling or relative pairs of schizophrenia as an effort to identify genetically homogeneous phenotypes. Methods : Forty-seven relative pairs with DSM-IV diagnosis of schizophrenia from thirty-five Korean families multiply affected with schizophrenia were ascertained. Direct interviews were done using the Korean version of Diagnostic Interview for Genetic Studies (DIGS). The Krawieka Rating Scale and the Schedule for the Deficit Syndrome were also applied for further evaluation of psychopathologies. Intra-familial concordances and correlations of clinical characteristics and symptoms were tested using χ² -test and Spearman's correlation. Results : Significantly high concordance rate within relative pairs was found for the diagnosis of paranoid vs. non-paranoidsubtype (χ²=7.623, P=0.006, df=1). Deficit vs. non-deficit syndrome also showed significant concordance (χ² =3.850, p=0.0497, df=1). Among single symptom items in DIGS, only 'auditory hallucination' showed significant concordance rate ( χ² =5.503, P=0.019, df=1). Factor analysis for symptoms items in the Rrawiecka Rating Scale indicated three symptom dimensions ; negative, psychotic and affective, Psychotic (P =0.442, P=0.003) and affective dimension scores (p =0.427, P=0.004) showed significant intra-familial correlations. Age at onset of recognized psychotic symptoms showed significant correlation only within the male sibling pairs. Conclusion : Familial factors, Possibly genetic factor contribute to the phenotypic characteristics of paranoid vs. non-para-noid subtype, deficit vs. non-deficit syndrome, auditory hallucination, and affective syndrome, It supports their use in the delineation of homogeneous subgroups for future genetic studies.

골수강내 금속정 및 나사못 맞물림을 이용한 경골의 치료

최창혁,권굉우,김신근,이상욱,강창진 대구효성카톨릭대학교 1997 연구논문집 Vol.56 No.2

Fracture of the tibial shaft is the most common among the long bone fractures, and it is difficult to treat because of a high incidence of delayed union, nonunion and malunion. Interlocking Intramedullary mailing is considered to be valuable method in treating long bone fracture such as tibial fracture these days because it enables rigid fixation, early joint motion exercise and weight bearing. Between April 1993 and March 1997, we treated 63 cases of tibia fractures with interlocking intramedullary nailing. The results were as follows: 1. Among the 63 cases, 51 cases were closed fractures and 12 cases were open fractures. 2. Static interlocking nailing was done in all cases and dynamization was done in 7 cases in postoperative 13 weeks. 3. Average union time was 19.9 weeks, 19 weeks with closed tibia fracture and 2.4 weeks with open tibia fracture. According to fracture site, 22 weeks with proximal tibia fracture, 19.2 weeks with mid-tibia fracture and 21.4 weeks with distal tibia fracture. According to the Winquist-Hansen classification, Type I was 19.8 weeks, Type Ⅱ was 20.4 weeks, Type Ⅲ was 22 weeks and Type Ⅳ was 26 weeks. 4. Weight bearing was started at the time of subsidence of pain and tenderness of the fracture site, 11.5 weeks with closed fracture and 12.3 weeks with open fracture. 5. According to the functional result of Klemm and Borner, 44 cases were excellent, 9 cases were good, 7 cases were fair and 3 cases were poor.