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.

만성 화농성 중이염의 세균학적 고찰

조남순,이영훈,강기훈,최제환,송태현,이병돈,장혁순,강주원,김연준 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background and Objectives : Chronic suppurative otitis media is one of the frequent diseases in otolaryngologic field. It is important to choose of antibiotics in the management of infectious disease. But the organisms in infections have been changed and resistance to antibiotics has been grown as the development of antibiotics has been achieved. And so it has been necessary to recognize the changes of organisms and resistance in antibiotics. Our study was performed to identify the pathogens isolated from discharges in chronic otitis media and evaluate the antibiotic agents, to recognize the change of to resistance to·antibiotic agents and to use the appropriate anitiotics. Materials and Methods : Retrospectively, authors reviewed the backeriologic study of 114 cases of chronic suppurative otitis media who visited the Department of Otolaryngology, Soonchunhyang University in Seoul from Nov. 1996 to Oct. 1999 and analyzed 101 strains and its sensitivity test to various antibiotics. Result : In 93 cases in which pathogenic organism was isolated, single infection was 85 cases(91.4%) and mixed infection was 8 cases(8.6%). The most frequent pathogenic organism was Staphylococcus aureus(59.4%), Pseudomonas aeruginosa(13.9%), Providencia(4.8%), Alcaligenes(3.0%) and Streptococcus pneumoniae(2.9%) were the next. Methicilline-Resistance Staphylococcus aureus was 34 cases(57.6%) of Staphylococcus aureus. Staphylococcus aureus was sensitive to Vancomycin(96.7%), Trimethoprim-Sulfamethoxazole (57.6%), Cefuroxime(42.4%) and Ciprofloxacin(40.7%) but resistant to Penicillin(94.9%). Pseudomonas aeruginosa was sentitive Amikacin(100%), Ciprofloxacin(100%) and Gentamicin(67%). Conclusion : As MRSA recently was wide spread in community accquired infection as well as nosocomial infection, we must consider strict control of MRSA.

흉부 CT 검사에서 Scan Direction이 Automatic Exposure Control을 적용한 선량에 미치는 영향에 관한 연구

남태현(Tae Hyun Nam),정용환(Yong Hwan Jeong),김주현(Joo Hyun Kim),권순안(Soon Ahn Gwon),대창민(Chang Min Dae),김성룡(Sung Ryong Kim),민관홍(Kwan Hong Min) 대한CT영상기술학회 2012 대한CT영상기술학회지 Vol.14 No.2

목적 적정한 영상의 질과 합리적인 선량위해 이용되고 있는 Automatic Exposure Control에 대한 다양한 연구가 진행되고 있는 가운데 scan direction의 영향에 대한 연구는 미비한 실정이기에, 본 논문에서는 AE를 적용한 흉부 CT검사에서 scan direction이 선량에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법 Somatom Definition Flash(Siemens Healthcare, 이하 S사), Aquilion 64(Toshiba Medical System, 이하 T사), LightSpeed VCT(General Electric Medical System, 이하 G사), Brilliance iCT(Philips healthcare, 이하 p시)와 인체 등가물질의 whole body phantom을 이용하였다. Phantom position은 supine, feet first로 위치시키고, SPR parameter 중 관전압을 120, 100, 80 kV로 각각 group 1, group 2, group 3으로 분류 후, cranio-caudal scan direction, caudo-cranial scan direction으로 각 5회 반복 scan 하고 선량 비교는 장비에서 제공하는 CTDIvol 값의 평균값을 구하여 scan direction에 따른 변화를 각 제조사별로 비교하였다. 결과 S사의 평균 CTDIvol 값을 비교해 본 결과 cranio-caudal scan direction에 대한 caudo-cranial scan direction의 증감률은 group 1에서 -4.22%, group 2에서 -5.27%, group 3에서 -4.50%로 나타났고, T사의 증감률은 group 1에서 -9.41%, group 2에서 -8.20%, group 3에서 -9.31%로 측정되었다. G사의 증감률은 group 1에서 -1.65%, group 2에서 -3.41%, group 3에서 -3.23%로 나타났으며. P사의 증감률은 group 1에서 +1.21%, group 2에서 -1.58% group 3에서 -2.41%로 나타났다. 결론 AEC를 적용한 흉부 CT검사에서 scan direction이 변화함에 따라 환자에 적용되는 선량에 차이가 발생하는 것으로 나타났다. 이러한 결과를 통해 기존에 AEC에 영향을 주는 것으로 알려진 요인 외에 scan direction 또한 영향을 미치는 것을 알 수 있었다. 따라서, 제조사별 AEC에 대한 심도있는 이해를 바탕으로 그 영향인자에 대한 추가적인 연구가 필요할 것이며, 이러한 연구들을 통해 검사부위에 맞는 최적화된 기법을 적용한다면 더욱 합리적인 선량감소를 달성할 수 있을 것으로 사료된다. I. Purpose There are many studies about automatic exposure control system. However, there is not enough study between scan direction and ABC. The purpose of this study was to compare radiation exposure dose in chest CT depending on scan direction. II. Meterial and Methods Somatom Definition Flash(Siemens Healthcare), Aquilion 64(Toshiba Medical system), LightSpeed VCT(General Electric Medical System), Brilliance iCT(Philips healthcare) and whole body phantom(KUPBU - 50 Kyoto kagaku Co.Ltd) are used in this study, Phantom position was supine, feet first. Study was devided into 3 groups depending on scan projection radiography tube voltage: group 1(120kV), group 2(100 kV), group 3(80 kV). Average CTDIvol values are compared between cranio-caudal scan direction and caudo-cranial scan direction in each group. III. Result The CTDIvol between cranio-caudal scan direction and caudo-cranial scan direction is changed. Siemens result is -4.22% in group 1, -5.27% in group 2, -4.50% in group 3. Toshiba result is -9.41% in group 1, -8.20% in group 2, -9.31% in group 3. GE result is -1.65% in group 1, -3.41% in group 2, -3.23% in group 3. Philips result is +1.21% in group 1, -1.58% in group 2, -2.41% in group 3. IV. Conclusions Radiation exposure dose was changed between cranio-caudal scan direction and caudo-cranial scan direction in Chest CT with ABC. Therefore, scan direction can affect to AEC. We should consider about many factors of AEC and create suitable protocol for each body part in order to reduce radiation dose.

Age-Associated Changes in the Vascular Renin-Angiotensin System in Mice

Yoon, Hye Eun,Kim, Eun Nim,Kim, Min Young,Lim, Ji Hee,Jang, In-Ae,Ban, Tae Hyun,Shin, Seok Joon,Park, Cheol Whee,Chang, Yoon Sik,Choi, Bum Soon Hindawi Publishing Corporation 2016 Oxidative medicine and cellular longevity Vol.2016 No.-

<P><I>Background</I>. This study evaluated whether the change in the renin-angiotensin system (RAS) is associated with arterial aging in mice.<I> Methods</I>. Histologic changes and expressions of transforming growth factor-<I>β</I> (TGF-<I>β</I>), collagen IV,<I> fibronectin</I>, angiotensin II (Ang II), angiotensin-converting enzyme (ACE), angiotensin-converting enzyme 2 (ACE2), angiotensin II type 1 receptor (AT1R), angiotensin II type 2 receptor (AT2R), prorenin receptor (PRR), Mas receptor (MasR), endothelial nitric oxide synthase (eNOS), NADPH oxidase 2 and oxidase 4 (Nox2 and Nox4), 8-hydroxy-2′-deoxyguanosine (8-OHdG),<I> 3-nitrotyrosine</I>, and superoxide dismutase 1 and dismutase 2 (SOD1 and SOD2) were measured in the thoracic aortas from 2-month-old, 12-month-old, and 24-month-old C57/BL6 mice.<I> Results</I>. Twenty-four-month-old mice showed significantly increased aortic media thickness and expressions of TGF-<I>β</I>, collagen IV, and fibronectin, compared to 2-month-old and 12-month-old mice. The expressions of PRR, ACE, and Ang II, and AT1R-positive area significantly increased, whereas expressions of ACE2 and MasR and AT2R-positive area decreased with age. The expressions of phosphorylated serine<SUP>1177</SUP>-eNOS, SOD1, and SOD2 decreased, and the 8-OHdG-positive area and the 3-nitrotyrosine-positive area increased with age. The expression of Nox2 significantly increased with age, but that of Nox4 did not change.<I> Conclusions</I>. The enhanced PRR-ACE-Ang II-AT1R axis and reduced ACE2-MasR axis were associated with arterial aging in mice. </P>

S-상 심실중격의 임상적 고찰

이동민,장경식,양종태,장대용,김종오,서영욱,고영엽,홍순표 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background: The sigmoid septum described an anatomical variation in the contour of the left ventricular outlet. It is related to degenerative change with aging. We observed clinical significance of sigmoid septum in Korean. Methods: Echocardiographic examination was performed in 434 patients. Sigmoid septum is defined as discrete bulging of the proximal interventricular septum with that thickness is greater than 1.3cm or the thickness is grater 1.5 times than adjacent mid interventricular septum in apical 3 chamber view. Result: The incidence of patient with sigmoid septum(septum patient) is 24.8% (male 8.4%, female 16.3%) . The incidence increases with age and is more common in women. The patients with sigmoid septum were compared with targeted groups, there was no significant difference in blood pressure between them, but in height and weight, the former were lower. (p<001, p<03). In the patients with sigmoid septum, weight and the surface area of a body have an opposite correlation with increase of age (p<03, r=-0.34) (p<04, r=-0.31) , but no decrease of height was found according to age increase (p=0.47, r=-0.11) The main reason patients with sigmoid septum ask echocardiolography and its clinical symptoms were abnormal results of previous electrocardiography and/or usual chest pain. Compared with control group, interventricular septal thickness is larger in septum patients (p<001). The thickness of interventricular septum located in subaortic left ventricular outflow tract is 1.6±0.3cm. There is another web like structure that continued from interventricualr septum to anterior free wall of left ventricle and the width is 1.6±0.4cm. A sign of insignificant obstruction due to left ventricular outflow was observed from three sigmoid septum patients. Conculusion: Septum patient is largely found in older age group and the body weight and body surface area are lower than control group. The body weight and body surface area are opposite correlation with age. So sigmoid septum is considered as structural change by weight reduction with aging. It is assumed that septum patients are related with asymptomatic ischemia because they have more abnormal ECG finding such as T wave inversion on precordial leads or standard leads, nonspecific ST-T change, LBBB etc. Sigmoid septum is not only proximal interventricular septal bludging but also another web like structure continuing to anterior wall of left ventricle.

편측안면경련에 대한 미세혈관압술시 수술시야 확보를 위한 방법으로서 소뇌피질동맥 박리술 - 수 술 수 기 -

김범태,임수빈,장재칠,신윈한,최순관,변박장 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.11

폐타이어 담체를 이용한 유동상 생물막공정의 고도처리 효율에 관한 연구

송창열,이택순,서규태,문병현 7개 국립대학교 환경연구논문집 공동발행 위원회 2005 공업기술연구 Vol.5 No.-

Organic and nutrient removal was investigated in a full scale fluidized phase biofilm process of 800m-(3)/day using waste tire media for domestic wastewater treatment. Various internal reciculation ratio was set as an operation condition to enhance nitrogen removal efficiency. The process operation results are as follows. Significantly high removal efficiency above 94% could be obtained by the biofilm process in terms of organics(BOD&COD_(Mn)) and suspended solid(SS). Relatively low nitrogen removal of 53% was observed at the internal recycling 100% of influent flow rate. However the removal efficiency could be increased to 70% at 200% internal recycling. The process showed also considerably high T-P removal efficiency of 80% producing effluent concentration of 0.68mg/L for 3.38mg/L influent.

분말야금법에 의해 제조된 소결 GEAR 및 RATCHET의 조직 특성

임태환,이창순,박인규 선문대학교 중소기업기술지원연구소 1997 선문공대 연구/기술 논문집 Vol.2 No.1

성장조건 및 후-열처리에 따른 ZoN 박막의 구조적 성질

이창효,임원택,박성순 漢陽大學校 自然科學硏究所 1999 自然科學論文集 Vol.18 No.-

고주파 반응성 스퍼터링 방법으로 증착한 ZnO 박막의 증착조건 및 후-열처리에 따른 구조적 성질을 조사하였다. ZnO 박막은 Zn 금속 타겟을 산소분위기에서 스퍼터링 하여 얻었다. 입력 고주파 전력, 기판온도, 가스비 등의 증착조건에 따른 ZnO 박막의 결정성과 이를 후속 열처리했을 때의 결정성 변화를 알아보았다. 또한 기판의 종류에 따른 ZnO 박막의 결정성도 조사하였다. ZnO 박막은 입력 고주파 전력이 클수록 기판온도가 높을수록 좋은 결정성을 보였고, 전체 주입가스중의 산소량이 많은 질수록 증착속도와 X-선 회절 피크의 강도는 감소하였다. 700℃에서 5시간 동안 공기 중에서 열처리하는 과정에서 결정성이 향상되었고, AFM을 통해 열처리 전과 후의 표면 거칠기 변화를 관찰한 결과 별다른 변화가 나타나지 않았다. ZnO 박막의 결정성은 기판종류에 영향을 받았으며, 특히 슬라이드 글래스 기판일 때 좋은 결정성을 나타냈다. We have studied the structural properties of ZnO thin films which were fabricated by rf reactive magnetron sputtering method with various growing conditions. ZnO thin films were deposited in oxygen atmosphere using Zn metal target. We have investigated not only the crystallinity of the ZnO films with deposition parameter such as input rf power, substrate temperature and gas ratio but also annealing conditions. In addition, we have investigated the crystallinity of the films deposited on many kinds of substrates. ZnO thin films had good crystallinity when their substrate temperature and their input rf power increased. Deposition rate and XRD intensity reduced with the increasing oxygen content in injected gases. The crystallinity of the ZnO films increased after annealing at 700℃ for 5 hours in air, but the surface roughness of the ZnO films did not change. The crystallinity of the ZnO films was affected by the types of substrates. In particular, the ZnO thin films deposited on the slide glass showed excellent crystallinity.