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The Usefulness of Serologic Diagnosis for Tuberculosis with Two Rapid Immunochromatographic Assay Devices (혈청학적 방법을 이용한 결핵 진단 방법의 효용성)

  • Kim, Deog-Kyeom;Kwon, Sung-Youn;Lee, Suk-Young;Park, Gye-Young;Jung, Kyung-Hae;Lee, Chun-Taek;Yoo, Churl-Gyoo;Kim, Young-Whan;Han, Sung-Koo;Shim, Yong-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.586-597
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    • 1999
  • Background: Many diagnostic tests have developed to diagnose tuberculosis and other mycobacterial diseases but the diagnosis of tuberculosis relies largely on radiological findings and acid-fast staining of sputum and/or culture. Recently, new serologic diagnostic methods, which are safe and easy to use have been introduced into Korea. In this study, the usefulness of serologic diagnosis for tuberculosis and the disease pattern induced variation of the test were evaluated. Methods: Serological assay was performed upon 108 patients with two test kits, the ICT tuberculosis and the BioSign$^{TM}$TB, which are based upon a rapid immunochromatographic assay technique, capable of being interpreted within 15 minutes. The case groups consisted of 61 patients with active pulmonary tuberculosis(36 patients), extrapulmonary tuberculosis(3 patients), or both(22 patients). Control groups consisted of 47 patients with inactive old pulmonary tuberculosis(17 patients), nontuberculous pulmonary disease(16 patients) and nonpulmonary cardiac disease(14 patients). Results : The diagnostic sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of the ICT tuberculosis were 64.3%, 91.5%, 90.0% and 68.3% respectively. The diagnostic sensitivity, specificity, PPV and NPV of the BioSign$^{TM}$TB were 76.5%, 95.3%, 94.1 % and 78.8% respectively. Differences in sensitivity were not significant between patients with previous history of tuberculosis or patients without prior history of tuberculosis. The ICT tuberculosis test showed higher sensitivity in pulmonary tuberculosis patients(76.5%) than extrapulmonary tuberculosis patients(33.3%). There was no difference in sensitivity between patients with or without cavitary lesion by chest X-ray. Conclusion: Considering high specificity and PPV, serologic diagnosis using a rapid immunochromatographic assay device is another helpful diagnostic method in the diagnosis of tuberculosis, when combined with previous diagnostic methods such as chest X-ray, microbiologic study but it has limitation in terms of confirming the diagnosis for tuberculosis as the only diagnostic method because of relatively low sensitivity and NPV.

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Effect of Nasal Continuous Positive Airway Pressure after Early Surfactant Therapy in Moderate Respiratory Distress Syndrome (중등도 신생아 호흡 곤란 증후군에서 폐 표면 활성제 조기 투여 후 Nasal CPAP의 치료 효과)

  • Kim, Eun Ji;Kim, Hae Sook;Hur, Man Hoe;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1204-1212
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    • 2002
  • Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

Analysis of Military Capability Balance on the Korean Peninsula Using the Net Assessment Methodology With a Focus on South and North Korean Naval Forces (Surface Combatants) (총괄평가 방법론을 활용한 한반도 군사력 균형분석 - 남·북한 해군력(수상함)을 중심으로 -)

  • Han, Jung-kyeong
    • Maritime Security
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    • v.7 no.1
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    • pp.61-96
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    • 2023
  • Amidst the ongoing instability and military tensions between North and South Korea, it is essential for us to comprehend and assess North Korea's military capabilities, while preparing for potential contingencies through military reinforcement. However, to conduct a comprehensive analysis of the military balance on the Korean Peninsula, it is imperative to move beyond simplistic quantitative comparisons of combat capabilities and embrace a broader perspective, which includes qualitative comparisons of military strength, operational capabilities, and a nation's ability to wage war. To address this need, this study employs the method of "Net Assessment" to evaluate the relative combat power of South and North Korean conventional naval forces, with a particular focus on surface combatants. This evaluation involves both quantitative and qualitative comparisons of military assets (personnel and equipment) and intangible factors (naval strategies, geography, etc.). By conducting a holistic assessment, the research aims to identify and analyze strategic asymmetries that may exist between the two navies.

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The Relationship between Alcohol Drinking Patterns and Blood Pressure in Some Rural Elderly Aged 60~64 (일부 60~64세 농촌노인에서 음주양상과 혈압과의 관련성)

  • Lee, Moo-Sik;Bae, Jang-Ho;Park, Ki-Rack;Lee, Choong-Won
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.1-17
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    • 2001
  • This study was conducted to investigate the role of drinking pattern in the relationship of alcohol consumption by face-to-face interview in rural elderly(n=994) aged 60~64 in Dalsung County, April to September in 1996. Pattern of alcohol drinking included drinking status, alcohol drinking at the morning without breakfast, average drinks per day, frequency of drinks per month, quantity of alcohol drinking, kind of preferred alcoholic beverage and duration of alcohol drinking. Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Difference in means of systolic blood pressure, alcohol drinking status, alcohol drinking at the morning without breakfast, and kind of alcoholic beverage were statistically significant before adjusting covariates, but alcohol drinking status and alcohol drinking at the morning without breakfast were statistically significant after adjusting covariates. And difference in means of diastolic blood pressure, kinds of alcoholic beverage was statistically significant before adjusting covariates, but no variables was significant after adjusting covariates. Model I multiple regression for systolic blood pressure that included average drinks per day as the variable of drink pattern, age, educational attainment and, previous history of cardiovascular disease were statistically significant, and multiple regression for diastolic blood pressure, educational attainment, BMI, and previous history of cardiovascular disease were statistically significant. Model II multiple regression for systolic blood pressure that included drinking patterns variables except average drinks per day, previous history of cardiovascular disease were statistically significant. However, multiple regression for diastolic blood pressure, no variables were significant. So, inconsistent with prior research, a positive relationship was not found between average drinks per day and diastolic and systolic blood pressure. The effect of alcohol drinking patterns on blood pressure has public health as well as clinical relevance. The study should be replicated to determine the reliability of our findings.

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Late-onset Hypotension and Late Circulatory Collapse Due to Adrenal Insufficiency in Preterm Infants with Gestational Age Less than 32 Weeks (재태주령 32주 이하 미숙아에서 생후 1주 이후 후기 저혈압 및 부신기능부전과의 관계)

  • Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.211-220
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    • 2011
  • Purpose: Late-onset hypotension in preterm infants is not a rare condition. Late circulatory collapse due to adrenal insufficiency (AI) is one of the major causes of late-onset hypotension. We assessed the incidence and causes of late-onset hypotension. We also compared the clinical findings according to the presence of AI. Methods: In total, 244 preterm infants with a gestational age ${\leq}$32 weeks and who were admitted to the neonatal intensive care unit (NICU) of Seoul National University Boramae Hospital and Seoul National University Hospital from January 2009 to April 2011 were included. Clinical findings were analyzed retrospectively. Results: Forty-four infants (18%) suffered from late-onset hypotension. Hydrocortisone was administered to 30 infants (68.2%) and AI occurred in 16 infants (36.4%). Cesarean section, sepsis before hypotension, and gastrointestinal surgery were independently associated with late-onset hypotension. Intrauterine growth retardation (IUGR) was less frequent in the hydrocortisonetreated group than in infants not treated with hydrocortisone. The AI group had fewer IUGR infants, and the duration of hospitalization was shorter in the AI group than in infants who were not administered hydrocortisone. Blood pressure tended to normalize more quickly in the AI group, however, the difference was not significant. Conclusion: AI was a major cause of late-onset hypotension, and the use of hydrocortisone shortened the length of hospitalization.

Why Do Individuals Postpone Their Enrollments for Military Service under a Conscription System? : Investigating Individuals' Psychological and Demographic Characteristics (징병제하에서 왜 군 입대를 늦추는가? : 심리적, 인구통계학적 특성 검토)

  • Kim, Sang-Hoon;Kim, Jin-Gyo;Jeong, Yong-Gyun
    • Journal of the military operations research society of Korea
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    • v.32 no.2
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    • pp.188-211
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    • 2006
  • This study aims to empirically investigate the effects of the individual-level characteristics on their timing decisions for their enlistments even though military services are their duties under a draft system. The individual characteristics considered include five psychological factors, such as attitude, uncertainty, information search level, future expectation, and perceived risk towards army, and other several demographic variables. Measurement scales for these psychological variables are developed and a duration model for individuals' enrollment timing decisions is also proposed. The proposed model is fitted to a survey data set collected from both those who have completed military service and those who have not. The estimation results show that two of five psychological variables, negative attitude and perceived risk, and several demographic variables, including education level, income level, residence area, and the number of family members serving the army, have meaningful impacts on the timing decisions for military service. Specifically, the enlistment timings are found to be more delayed as negative attitude towards army is stronger, perceived risk on army is higher, education level is higher, academic performance is better, income level is either low or high, residence area is either Seoul or big cities, and the proportion of family members enlisted is smaller. Several important managerial implications for alleviating problems resulting from enrollment postponements are also discussed.

Changes of Risk factors of Metabolic Syndrome among the Elderly in the Rural Area after Two Years (농촌지역 노인에서 대사증후군 위험인자의 2년 후 변화)

  • Oh, Suk-Hee;Kim, Ha-Jeong;Sohn, Seok-Joon;Sim, Jeong-Sin
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.36-45
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    • 2010
  • Objectives: This study was performed to examine the healthy lifestyle influenced on the metabolic syndrome among the elderly in the rural area. We examined the changes of risk factors of metabolic syndrome after two years. Method: Out of 134 who did health screening at the J county health center from July 1 to August 31, 2006, 65 aged people confirmed to metabolism syndrome were selected as subjects. For the final analysis, 62 aged people who revisited after two years were selected our subjects. The data were analyzed using SPSS PC+ 12.0 program for descriptive, Chi-square test, t-test and ANOVA analysis. Result: The result of this study indicated that 62 metabolic syndrome patients in 2006 decreased into 53, and women were higher than men. The difference in the metabolic syndrome came from level of education, smoking, health practices, and past illness history. Conclusion: Therefore, the change of lifestyle needs to be induced by the level of education, and for the group of smoking, non-exercise, and past illness history not only regular checkups to prevent metabolic syndrome but also education to have interest on themselves may need intensively.

Dissociative Symptoms in Patients with Somatization Disorder (신체화 장애 환자의 해리 증상)

  • Kim, Seong-Hwan;Choe, Byeong-Moo;Kim, Yoon-Won;Hahn, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.116-123
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    • 1999
  • Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

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Serum Immunoglobulin levels in Coal Worker's Pneumoconiosis Patients (진폐증 환자에서의 혈청 면역 글로불린의 변화)

  • Yoo, Kwang-Ha;Ahn, Chul-Min;Kim, Hyung-Joong;Kim, Young-Ho;Lee, Yong-Kyoo;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.165-174
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    • 1999
  • Background: Coal-worker's pneumoconiosis(CWP) is radiologically divided into two major groups: simple pneumoconiosis (SP), in which small, rounded or irregular opacities smaller than 1cm are observed, and progressive massive fibrosis(PMF), which is characterized by opacities larger than 1cm. SP has a life expectancy equivalent to miners with no radiographic evidence of CWP, but PMF is associated with more obvious impairments of ventilatory capacity and premature death. But only minority of workers develop PMF when exposed to dust concentrations similar to those experienced by workers who develop only SP. In this study, immune status in patients with CWP were evaluated by measurement of the serum immunoglobulin levels between control, SP and PMF groups. Method: Coal workers selected for this study were emplyees of the Tae-Baek and Dong-Hae Hospital. All the patients were men of 45-76 years old and the mean duration of exposure to coal dust were 23.2 years. By X-ray examination, 51 patients were classified in SP, 59 in PMF category. The normal controls examined were 58 men of 26-70 years old. Serum Ig levels were estimated by using Nephelometer(Behring Nephelometer : Germany) and serum were collected 51 in SP, 49 in PMF and 57 cases in control group. Results: The levels of IgG were increased but the levels of IgM were decreased with increasing age in control groups. There were no statistical difference of immunoglobulin levels between smokers and nonsmokers in control groups. There were no statistical difference of immunoglobulin levels between Control, SP and PMF groups. Multiple regression analysis were undertaken to determine the statistical significance of the apparent trends and estimate the effects associated with age, smoking habit and radiological category of CWP. According to this analysis, the levels of IgG were decreased significantly in SP group and had decreasing tendancy, but not statistically significant in PMF group. Conclusion : From the observations described, CWP patients had decreased IgG concentration compared to control gorup. Therefore, there was some relation between CWP and immunoglobulin concentration.

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A Radiographic Study on the Horizontal Angle of the Mandibular Condyle in Relation to Temporomandibular Disorders (하악과두의 수평각과 측두하악장애와의 연관성에 관한 방사선학적 연구)

  • Park, Sang-Gyun;Suh, Bong-Jik;Kim, Do-Yun
    • Journal of Oral Medicine and Pain
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    • v.24 no.1
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    • pp.25-36
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    • 1999
  • 저자는 이하두정방사선사진 (願下頭頂放射線寫眞, submentovertex radiographs)을 이용하여 하악과두의 수평각과 측두하악장애와의 연관성을 평가하고자 측두하악장애의 병력 및 증상이 없고, 자연치열로 형성된 정상교합을 가진 성인 34명과 전북대학교병원 구강내과에 내원한 측두하악장애환자 38명을 대상으로, 환자군을 임상검사 및 방사선학적 검사를 통해 편측 정복성 관절원판 전방변위 환자군, 양측 정복성 관절원판 전방변위 환자군 및 편측 비정복성 관절원판 전방변위 혹은 골관절염 환자군으로 세분한 후, 좌우측 외이도의 위치를 확인할 수 있도록 소강구 (小鋼球)가 내재된 장치물을 이용하여 채득한 규격화된 이하두정방사선사진상에서 하악과두의 내측극과 외측극을 이은 선과 양측 외이공에 위치한 소강구를 이은 선으로부터 하악과두의 수평각을 측정하였다. 평가 결과 정상군에서의 좌(평균 25.3도), 우(평균 24.8도)측 하악과두의 수평각 (평균 25.0도)은 유의한 차이를 보이지 않았으며 환자군에서는 이환측 하악과두의 수평각 (평균 28.5도)이 비이환측 하악과두 (평균 26.2도)보다 유의성있게 증가된 수치를 보였다 (p<0.05). 또한 환자군 (평균 27.55도)에서의 하악과두의 수평각이 정상군 (평균 25.0도)에서 보다 유의하게 증가된 수치를 보였다 (p<0.05). 임상적으로 세군으로 구분된 환자군의 경우, 각군의 이환측 또는 비이환측, 각 군을 합한 이환측 또는 비이환측의 경우에 있어서도 정상군에서 보다 하악과두 수평각이 유의성있게 증가된 수치를 보였다 (p<0.05). 세가지로 구분된 환자군 각각의 상호 비교에 있어서는 유의성있는 차이를 나타내지 않았다. 그리고 편측으로 이환된 환자군에서의 이환된 수평각 (평균 29.1도)은 비이환측 (평균 26.2도)보다 유의성있게 증가된 수치를 보였으나 (p<0.05), 양측으로 이환된 환자군에서의 좌우측 수평각은 유의한 차이를 보이지 않았다. 이로써 측두하악장애의 진단 차원에서 측두하악장애를 유발하는 여러 요소 중외 하나로 하악과두 수평각에 대한 평가가 고려되어야 할 것으로 사료된다.

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