Acute exacerbation of interstitial lung disease; subgroup analysis for causes, risk factors for mortality rate, and steroid responsiveness

( Seung Hyun Yong ),( Ah Young Leem ),( Song Yee Kim ),( Kyung Soo Chung ),( Ji Ye Jung ),( Young Ae Kang ),( Young Sam Kim ),( Joon Chang ),( Moo Suk Park ),( Hye Jin Jang ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Interstitial Lung Disease (ILD) has known as a poor prognosis disease, particularly idiopathic pulmonary fibrosis (IPF). Corticosteroid is widely used for treatment of acute exacerbation (AE)-ILD. This study aims to clarify efficacy of corticosteroid use, and compare the mortality rate depending on the subgroups of ILD. Materials and Methods: We collected the data from the patients who have diagnosed ILD and visited emergency room (ER) with the respiratory symptoms from January 1, 2016 to December 31, 2018. We classified AE-ILD patients into 3 groups depending on methylprednisolone dose per kilogram. Also, we compared the mortality of IPF patients to that of non-IPF patients. Results: A total case of AE-ILD visited ER from 2016 to 2018 was 209 cases, including IPF cases (n=122) and non-IPF cases (n=87). We divided total patients (n=209) into three groups depending on steroid use, and these include group 1 of 0-0.49 mg/kg (n=78), group 2 of 0.5-0.99 mg/kg (n=58), and above 1.0 mg/kg (n=41), each. We found poor prognosis from the cases of IPF compared to non-IPF cases (p=0.029, OR 2.463). Furthermore, there was significant differences of mortality rate according to steroid dose (p=0.036, OR 1.712), CRP elevation (p=0.016, OR 1.004), and intubated case (p=0.000, OR 8.152). Also, we categorized IPF (n=122) to non-IPF cases (n=87) and analyzed the mortality rate. Most of the patients were death from ILD itself (n=23, 63.9%), Pneumonia(n=8, 22.2%), and Lung cancer (n=5, 13.9%). Bacterial infection (n=26) was dominant cause of AE, followed by fungal infection (n=15), and viral infection (n=10). Conclusions: This retrospective analysis of corticosteroid treatment shows more fatal outcome when we use high dose steroid in AE-ILD cases, and there was significant difference in mortality rate depending on the subgroup of ILD and medical background, such as intubation status, higher CRP level, and IPF cases.

일 전문대학 간호과 학생들이 인지하는 강의평가 기준에 대한 조사연구

김정애,이애경,주미경,정안순,장은정,김정수,강정희,이정애 경복대학 2004 京福論叢 Vol.8 No.-

일개 전문대학 간호과 학생들을 대상으로 강의평가 기준을 파악하고자 하였다. 개방형 질문지를 이용하였으며 7개의 교수관련 강의평가 문항 각각에 대해 좋은 점수 및 나쁜 점수를 부여하는 기준을 조사하였다. 각 문항별로 다양한 기준이 확인되었으며, 간호과 학생들의 강의 만족도를 높일 수 있는 교수설계를 위한 기초 자료로 활용할 수 있을 것이다. We aimed to set standards for the student evaluation of instruction for college students of Nursing. We used an open questionaire and surveyed the standards for how students judge the instruction good of bad by using seven questions related to the instructor. Various standards set from each question could be used as basic materials to meet the students' needs in the classroom when the instructors try to find out new instructional design.

임상실습 교육개선을 위한 간호학생의 간호활동시간 분석

이애경,김정애,주미경,정안순,장은정,김정수,강정희,이정애 경복대학 2001 京福論叢 Vol.5 No.-

신규간호사의 능력은 간호학생 때의 다양한 임상경험에 기초를 둔다. 따라서, 간호대학의 교수, 병원 지도자, 임상지도자는 간호학생들이 다양한 지식을 획득하고 간호기술을 경험할 수 있도록 도와주는 중요한 역할을 한다. 이 연구의 목적은 이러한 간호학생들의 임상실습에서 수행하는 간호활동과 간호활동 시간을 분석하고자 하는데 있다. 연구결과 간호학생 1인당 직접간호활동 시간은 185.5분(직접간호비율은 56.7%)으로 141.65분(간접간호 비율은 43.3%)인 간접간호활동 시간보다 많았다. 직접간호활동 시간 중 활력징후 측정이 51.9분으로 가장 많은 시간을 차지하였고, 간접간호활동 시간 중에는 차트보기가 22.98분으로 가장 많은 시간을 차지하였다. 전반적으로 기본적인 임상간호 수행기술에 소요되는 시간이 고도의 숙련된 간호기술을 수행하는데 드는 시간보다 많은 것으로 나타났다. 따라서, 본 연구결과를 토대로 간호대학의 지도자와 병원의 지도자 및 임상지도자가 함께 임상실습 교육과정의 지침서와 평가서를 평가할 필요가 있다고 제언하는 바이다. The competence of newly graduated nurses is based on various clinical experiences gained when they were students. Therefore, professors in nursing schools, directors in hospitals or preceptors must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study is to investigate nursing care activities and nursing care hours practiced by nursing students in clinical experience. The results of this study showed that the direct nursing care hours per each nursing student are 185.5 mins(direct nursing care rate 56.7%) and it is higher than indirect nursing care hours, 141.65 mins(indirect nursing care rate 43.3%). The hours of checking vital signs are the longest(51.9mins) among the direct nursing care activities, and the hours of reviewing chart are the longest(22.98mins) among the indirect nursing care activities. In general, the time of performing basic clinical nursing technique was higher than that of performing high skilled nursing technique. And nursing observation was higher than that of directly performing task. So, we suggest based on the results of this study as follows. It is needed for nursing instructors in nursing schools and hospitals together to evaluate the guidelines and check-list of clinical practice courses.

마늘의 효능과 안전성에 관한 연구

이애정;이상화;조강진;김인혜;엄애선 한양대학교 2010 韓國 生活 科學 硏究 Vol.30 No.1

Galic is the fresh or dehydrated bulb obtained from Allium scorodorpasum var. viviparum Regel, a genus of the lily family. Garlic has been widely used as oriental medicine having various health benefits, such as cardiovascular, antineoplastic, antimicrobial and antiinflammatory. The average daily intake in western people is 4g/day of fresh garlic whereas it in Koreans 5.8g/day. However, consumption of excessive amount of raw garlic can cause gastrointestinal disease, dermatitis, asthma, allergic reaction, anticoagulant action, breath and body odor. Additionally, its antithrombotic properties prompt patients to stop taking garlic 14 days before having surgery or dental work. Therefore, we reviewed the safety of garlic on the basis of literatures published and then further studies on the safe amount of garlic consumption should be considered.

치열 공간 부조화와 두개안면골격 형태의 상관성

김요숙,정애진,강경화,김상철 대한치과교정학회 2003 대한치과교정학회지 Vol.33 No.4

치열 공간 부조화에 영향을 미치는 골격 및 치성요소를 알아보기 위하여 하악 치열궁내 총생을 보이는 성인 45명과 공극을 보이는 성인 39명의 Ⅰ급 부정 교합 환자와 정상적인 배열을 갖는 성인 40명을 선정하여 측모 두부방사선사진과 모형을 분석하여 다음과 같은 결론을 얻었다. 1.공극군보다 총생군의 ANB각이 컸다. 2.공극군보다 총생군이 하악골 및 상악골의 전하방 경사가 커서 안모의 수직적 양상이 심했다. 3. 총생군보다 공극군이 전두개저와 하악체 길이가 컸다. 4. ANB 각, 전안면 고경과 하악지 길이가 공간 부조화 양의 예측에 기여하며, 다음과 같은 회귀방정식이 산출되었다. space discrepancy = 46.51 - 2.51ANB - 0.58AFH + 0.65RH (R² = 0.40) The purpose of this study was to investigate the relationship between the space discrepancy of the mandibular dentition and craniofacial morphology in adults with good Angle class I occlusion. Dental casts of normal group, crowded group and spaced group were selected on the basis of dental crowding and spacing. Subjects with excessive space to accomodate the lower teeth were classified as spaced group(39). Subjects with a space discrepancy of more than 4mm were classified as crowded group(45). Normal subjects had little or no dental crowding and spacing(40). Various skeletodental measurements in lateral cephalograms were evaluated and compared by ANOVA, Pearson correlation analysis and multiple stepwise regression analysis. The results were as follows : 1. ANB angle was larger in crowded group than in spaced group. 2. Maxilla and mandible in crowded group were inclined more downward and forward than in spaced group, so crowded group was found to have vertical tendency. 3. Anterior cranial base length and mandibular body length were longer in spaced group than in crowded group. 4. According to the multiple stepwise regression analysis with space discrepancy as dependent variable, 40% of variance of space discrepancy could be explained by ANB angle, anterior facial height and ramus height. Multiple regression equation was as follows Space discrepancy=46.51-2.51ANB-0.58AFH+0.65RH

고등급 이형성을 보인 편평톱니샘종

권경주,정성애,심기남,정정화,강석형,송도경,전승정,김혜인 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.1

Until recently, colorectal polyps were classified predominantly as hyperplastic or adenomatous. While adenomatous polyps are well-characterized precursor lesions of adenocarcinomas, hyperplastic polyps have been considered as benign lesion. However, some hyperplastic polyps with serrated morphology of the crypts have been recognized to have distinctive features and these polyps were termed ‘serrated adenomas’. Recent data show that sessile serrated adenomas (SSA) might be the precursors of serrated colonic cancers, underlining the necessity of identifying them. SSA is approximately 3% of all polyps, commonly appears as flat or sessile and yellowish due to mucus production. In the pathogenesis of SSA, progression to high grade dysplasia or early invasive carcinoma may be associated with serrated neoplasia pathway different from adenoma-carcinoma sequence. We report a case with a colon polyp diagnosed as sessile serrated adenoma with high grade dysplasia after endoscopic submucosal dissection.

다형성 교모세포종에서 광범위 전적출술후 단기 재발된 치험 1예

박호권,강중식,조준,문창택,장상근,임정애 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Glioblasty/ma Multiforme(GBM) is the one of the most common malignant tumors in central nervous system(CNS). The incidence of the tumor is about 12% of all CNS tumors and about 50% of all intracranial tumors. Though the development of the microsurgical technique, radiosurgical technique, and chemotherapy works effectively, complete cure of the GBM has not been achieved. It has been known that the prognosis of GBM depends on the extent of surgical tumor removal, remained tumor volume, radiation dose, and chemotherapy. Not only patient's age but also tumor characteristics such as MRI enhancement, angiogenesis and necrosis are also very important prognostic factors. Authors experienced very aggressive GBM in aged woman, who received gross total tumor removal, but refused other therapeutic motalities postoperatively. Very rapid recurrence of GBM and global cerebral edema in aged woman should be considered fatal. This case demonstrates the effectiveness of aggressive removal and the limited usefulness of neurosurgical tools in GBM recurrence. Authors would suggest that the early diagnostic effort and the verified neurosurgical therapy for malignant tumor are still strongly requested to make better prognosis.

한국절식에 대한 초등학교 영양사의 의식조사 : 서울과 인천지역을 중심으로

박수진,강영림,김애정 동아시아식생활학회 1998 동아시아식생활학회지 Vol.8 No.3

The purpose of this study was to investigate perceptions and uses of Korean festive foods by dietitians in elementary school food service. Questionnaires were distributed to 217 dietitians in Seoul(117) and Inchon(100). Statistical data analysis was completed by SAS package program. Results were as follows ; 1. Most dietitians(89.8%) who answered the inquiry had knowledge about Korean festive foods. 2. Most respondents applied Korean festive foods to their menu planning. 3. More than 85% of respondents used festive foods, especially Ddukguk, Mandu, Yaksik, Yukgaejang, Galbiggim, Tangpyungchae, Patjuk, among the 43 kinds considered for their menu planning. 4. The higher the perception of traditional foods, the more the respondents applied them to their menu planning, especially Injulmi, Shikhae, Yaksik, Bamchoe, Jeongpyun, Kalkuksu, Torantang, Hobakgigim, Namul. 5. Respondents got information sources about traditional foods from books, school, home, massmedia, and etc, in the order. 6. Most respondents(88.3%) wanted to simplify festive foods' cooking method or standardize the recipes. 7. On the necessity of education about festive food for children, 81.5% of respondents and festive foods were considered to be cultivated and developed to uphold the Korean traditional dietary life.

양잠산물을 이용한 기능성 생식의 기호도 조사

여정숙,김애정,방인수,강영림 혜전대학 식품산업연구소 2003 식품산업연구지 Vol.5 No.-

This study was carried out in order to investigate the sensory evaluation of uncooked powdered food with funtional characteristics by the addition of sericultural products. According to sensory evaluation, A company commercial goods was higher level of color, flavor, taste, texture and overall than other commercial goods. The uncooked powdered food with sericultural products was higher level of sensory evaluation than commercial goods but not significantly.

양호교사의 역할수행에 관한 조사연구

문희자,박신애,강현숙,고정은 慶熙大學校 1985 論文集 Vol.14 No.-

It is the ultimate purpose of school health management to protect, maintain, and prormote the students' health and to help for them to form a wholesome habit of health. To do this, school nurse is an actual professional personnel of school health management in our country. therefore, role performance of a school nurse is directly related to the quality of school health planning, we think. With this belief, this study intends to revise, supplement Rustia model for school health promotion and develop in into a suitable model for our actual situation. In so doing, based on Rustia model, we had surveyed the actual situation of a school nurse's role performance by making 77 school nurses in Boys' and Girls' Middle and High Schools in Seoul as the scope of this research for a period of two months beginning on September 1, 1984. The results were analyzed by employing percentage and mean value. The results of the investigation are as follows: 1. General Characteristics of the school nurses and schools. (1) The average age of the surveyed school nurses is 31.64± 6.6 years old. 81.6% of them was proved to have acquired academic background above Colleges and Graduate Schools; 74% were married; 61% were religious persons. And the average on-duty term was 6.42±5.03 years. 66.2% of them employed in the hospitals before this present job and 31.2% have worked at school as school nurses immediately after their graduation. In college, most of them (81.8%) went through a course of study for the teaching profession and only 9.1% of the taught other courses of study. (2) The majority of the surveyed schools (51.9%) were public schools and 62.3% of them were middle Schools. The average number of students in the school was 2628.52;that of school pesonnel was 66.17±9.7;that of classes was 39.68±12.0. 2. Role performance for primary prevention. (1) Among the serveyed schools, 83.1% of them performed epidemiological analysis of health problem for the promotion of health. As for health planning among health management plan, all of them put it in force, however, only 35% of them participated in preparation of the budget to achieve it. As to the evaluation program, 64.9% of them carry out it into operation and in case of being carried out once in a year marked the most frequency of enforcement as 32.4%. On guidance and support related to health planning, 42.9% of them held a staff meeting; of which 53.2% were school nurse-teacher meeting; 28.6%, school nurse-parent meeting. (2) To protect the students and school personnel from danger and injury, 67.5% of them participated in alleviating health problems-that is, the maintenance of health standard and safety within school, and inserting the means of settling those problems into curriculum and management of school events. Especially, only 14.3% administered school lighting and 35.1% observed safety standards of desks and chairs in class. Consequently, the result of this survey revealed that there is much to be desired in the administration for the maintenance of health standard and safety. As for pervention of infectious disease, the following were implemented; a) disinfection of toilets (92.2%); b) control of drinking water (75.5%); c) purification of sewage and garbage incineration (74%). What is pecular is that 71.4% of them have controlled vaccination but enforcement rate shows lack of enthusiasm when viewed from the kinds of vaccination: Typhoid fever (51.9%), cholera (41.6%) hepatitis (9.0%), encephalitis (23.4%) and that one or two sorts of vaccination were treated. As for the technical improvement of personnels who handled health problems, all of them put it in practice, and for prevention program and use of health resources, 87.5% participated in it. 3. Role performance for secondary prevention (1) 92.2% of them carried out screening tests of a physical assessment for an early detect on health problem and 24.7% did a screening tests which made a part of students its object after the first screening tests. A selection and check-up of measurement tool during a developmental evaluation was taken effect by 98.7% and a preliminary education on the persons who administered that examination and determine to select a place for it by 100%. Of discrimination and screening tests, various kinds of examination for finding disease was detected effectively by 98.7% and of this operation nothing could be come into force more than a check-up of parasites and urine with 97.4%. As to the methods explaning danger of health and safety, the case to be offered school personnels information in a staff meeting marked 96.1% and the one to offer students information in the case of generating such danger as infectious diseases was 100% (2) Control of health problem to be required regular treatment for taking a proper measure on that problem at an earlier time was carried into effect by 93.5%. 98.7% of them imposed a role of communication and intervention of offering and observation method for finding health problem and encourging this method to teacher in charge. All of them executed emergency care, School-nurses helped 33 persons a day on the average, and 89.6% of them did for students to get through a serious crisis. (3) In order to prevent complication and an disable, 83.1% of them carried out a continuous follow-up care of the students who were discharged from the hospitals. 4. Role performance for tertiary prevention (1) In order to care and treat the students who needed their rehabilitation and adaptation for activities of daily living, 89.6% of them performed reeducation after reevaluate their health status, 94.8% performed a role on motivation, 85.7% put in effect a continuous control of the students who needed rehabilitation and correction, and 15.6% did counselling for taking a measure to meet the situation of the disabled. 5. Role performance for health education. Unifying health education from the view points of the first, secondary and tertiary prevention against diseases, we surveyed the content, method, objectives of health education which is now in effect and should be emphasized in the future. Upon this study, we came to conclude as the following; as to the content of health education which is now is effect, prevention of infectious diseases has an absolute majority of all contents as 98.7%, and prevention against parasites, personal hygiene and oral hygiene second place. as 97.4% But education on prevention of venereal diseases shows inactiveness as 42.9%. On the contents to be emphasized, mental health (42.9%), sex education (40.3%) were enumerated but nobody stated about prevention of infectious diseases. As a method practising health education, all of them used that of counselling, and as an indirect education utilizing media, it comes printed matters (96.1%), poster (83.1%), interclass broadcasting casting (75.35) in that order. And the case of regular class on health education marked 23.4%, of the object of health education, 98.7% made students its object; 87.0% school personnels; 51.9% parents of students.