• Title/Summary/Keyword: 외국인 환자

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Clinical Usefulness and the Accuracy of Korean Reference Equation for Diffusing Capacity (한국인 폐확산능 정상예측식의 임상적 유용성과 정확성)

  • Ra, Seung Won;Park, Tai Sun;Hong, Yoonki;Hong, Sang-Bum;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.80-86
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    • 2008
  • Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park's equation) with that of the foreign equation (Burrows' equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity ($D_LCO$) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of $D_LCO$ in trials employing Burrows' equation and Park's equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows' equation and Park's equation, agreement of clinical assessment and $D_LCO$ interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows' equation and Park's equation) for $D_LCO$. Results: Agreement between clinical assessment and interpretation of $D_LCO$ was 22% for the use of Burrows' equation and 78% for the use of Park's equation. The sensitivity and specificity of the Burrows' equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park's equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park's equation for diagnosing ILD was significantly higher than that of Burrows' equation (p<0.001). Conclusion: The Korean reference equation (Park's equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows' equation).

A New Reference Range of Serum Anion Gap (혈청 Anion gap의 새로운 범위에 관한 연구)

  • Shin Young-Ju;Cheon Hae-Won;Choi Byung-Min;Yoo Kee-Hwan;Hong Young-Sook;Lee Joo-Won;Kim Soon-Kyum
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.9-13
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    • 1998
  • Purpose: The old reference range of serum anion gap(AG) may be excessive compared with value measured by new electrolyte analyzers. Therefore, we studied to establish a new reference range of AG using an autoanalyzer. Methods: With the use of analyzer(Hitachi 747 by enzymatic methods), serum Na and Cl were measured, and with the use of analyzer(CX-3 by differental rage pH), serum $TCO_2$ was measured. We measured AG(=Na-($Cl+HCO_3$)) in 395 stable patients with normal serum albumin and creatinine levels of the pediatric in-patients and out-patients for preoperative examination from march 1997 to July 1997. Results: The normal serum$ AG(mean{\pm}SD)$ were neonate, $11.2{\pm}3.2$ mEq/L; infancy, $11.8{\pm}2.7$ mEq/L; early childhood, $12{\pm}2.7$ mEq/L; late childhood, $11.7{\pm}3.2$ mEq/L; adolescence, $9.6{\pm}2.7$ mEq/L; adult, $9.0{\pm}2.7$ mEq/L. Normal serum AG in more than 10 years of age was significantly lower than the previous normal value and also the difference of AG between more than 10 years and less than 10 years was statistically significant(P<0.05). Conclusions: We suggest to measure serum AG according to each type of analyzers.

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Current State of Senile Dementia and Improvement of the Long Term Care Insurance for Elderly People (치매노인의 현황과 노인장기요양보험법상의 개선방안)

  • Cho, Hyun;Ko, Zoonki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5816-5825
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    • 2012
  • As the society has been ageing, senile dementia increase rapidly. Thus social costs of dementia treatment and management increase exceedingly. There is a desperate need of finding out improvements.. For example, foreign countries come with the solutions about this issue by establishing national strategy about Dementia, setting effective Dementia Management in national level and preparing legal systems. Older Welfare Act, Long Term Care Insurance Act for the Aged and Dementia Management Act exist as legal system of improvements. Improvement about this issue is needed due to more effective Dementia management and pushing ahead policies. First of all, the government needs to include dementia checkup into the list of national health insurance checkup toward senior citizen of older than 65-year-old. Secondly, as one of the characteristics of dementia, when more symptoms of dementia appear, there is less effect of treatment. Therefore, in order to reduce the social costs of Dementia, the government needs to promote Dementia prevention industry and early checkups. Thirdly, there is a need of setting a class judgement standard appeasement policy and expansion of using target. The reason of processing this statement is that there are difficulties of satisfying the needs of senior citizens due to current conformity of long-term pay recuperation according to laws of welfare.

The Results of the Survey about Present Situation of Quality Assurance for Radiotherapy Machine of Korea (한국의 방사선치료 기기 품질관리 현황에 관한 설문 결과)

  • Jeong, Seonghoon;Yoon, Myonggeun;Lee, Hyunho
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.185-191
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    • 2015
  • As radiation therapy is one of three major cancer treatment methods, many cancer patients get radiation therapy. Because of the invisible and scattering characteristics of radiation, it is impossible to identify the quality and the amount of radiation and secondary cancer could be induced by scattered radiation. Because of advanced technique of radiation therapy and the reasons mentioned above, quality assurance of radiotherapy machine should be performed completely. International organizations such as International Atomic Energy Agency (IAEA), American Association of Physicists in Medicine (AAPM) suggest report of quality assurance to recommend united method of radiotherapy machine quality assurance. Domestic society of medical physics, however, is too small to make such a report, domestic hospitals selectively choose some of contents in global suggestions. As there are no suggestions for domestic hospitals and global suggestions are being updated, we did a survey about quality assurance for radiotherapy machine. The questionnaire is composed of possession of radiotherapy machine, items performed for quality assurance and manpower, etc. 37 of 72 hospitals answered to survey. These results could be used for making domestic standard quality assurance procedure.

Adverse Events Associated with MMR Vaccination in Korea - Prospective Study Using Telephone Surveillance Method - (MMR 백신 부작용 발생 실태 - 보건소 전화 조사를 통한 전향적 연구 -)

  • Lee, Jin Soo;Ki, Mo Ran;Sohn, Young Mo
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.183-192
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    • 2000
  • Purpose : Adverse events(AE) associated with vaccination have not been systematically monitored in Korea. But since 1994, several deaths after inactivated mouse brain derived Japanese encephalitis vaccine injection arouse the safety problem of immunization in the public, and a evaluation of vaccination program including the effectiveness and safety problem had been started. We have been using MMR vaccine containing Japanese mumps vaccine strains, which are known to be associated with the high rate of adverse events including aseptic meningitis, for the last decade. Methods : We conducted a prospective study of vaccine adverse events associated with MMR vaccine through a tracking system using telephone calls. We followed up 7,594 cases of MMR vaccinees. Results : Reported adverse events included fever, couvulsion, parotitis, and aseptic meningitis. Nine cases of parotitis and seven cases of aseptic meningitis were recognized during follow up period. The incidence of both parotitis and aeptic meningitis was $85.1/10^5$, for Urabe mumps strain. For Hoshino strain, the incidence of parotitis and aseptic meningitis was $158.0/10^5$ and $94.8/10^5$, respectively. Conclusions : The incidence of adverse events was to be a higher than that of natural infection in Korea and was comparable to the results of studies done in other countries.

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A Study on the Distribution of Heavy Metal Elements in Arc Welding Fume (아크용접 Fume의 중금속 분포에 관한 연구)

  • 채현병;김정한
    • Proceedings of the Safety Management and Science Conference
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    • 1999.11a
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    • pp.343-343
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    • 1999
  • 아크용접은 산업전반에 걸쳐 그 생산기반에 없어서는 안될 필수기술로써 자동차 및 조선, 항공우주산업에 이르기까지 경제기반에 미치는 파급효과가 매우 크다. 그러나 이 아크용접을 하게 되면 각종 가스와 미세입자로 이루어진 흄이 발생하게 되는데 이들은 작업자들의 건강에 많은 영향을 미치는 것으로 보고되어 있다. 용접흄에는 용접재료 및 용접공정에 따라 다양한 유해원소가 포함되어 있고 그 종류에 따라 인체에 미치는 잠재적 독성효과도 매우 광범위하다. 최근 국내에서는 용접사들 중에 용접흄에 포함된 중금속 중 Mn중독에 의한 파킨스씨병 환자들과 Cr중독에 의하여 콧속 연골에 구멍이 뚫리는 비중격천공(鼻中隔穿孔) 환자들이 직업병으로 판정 받아 산재요양이 승인된 사례가 있다. 이러한 계기로 인하여 용접사들의 용접기피 현상이 심화되고 작업환경에 대한 법적규제는 선진 외국뿐만 아니라 국내에서도 한층 엄격하게 강화되고 있는 실정이다. 따라서 이제는 작업자와 사용자 모두 용접흄에 대한 인식의 전환이 요구되는 때이며 여러 분야에서 이러한 용접흄에 대한 연구가 활발히 진행되어야 한다. 해외에서는 이미 용접흄에 대한 연구가 활발히 진행되어 왔으나 국내의 경우는 매우 미비한 상태이며 용접산업의 미래 영향력이나 필요성을 고려할 때 국내에서도 적극적인 관심을 가져야 할 부분으로 판단된다. 본 연구에서는 아크용접공정에서 발생하는 흄의 특정 중금속 성분이 인체에 치명적인 악영향을 미치는 것에 착안하여 여러 종류의 용접재료에서 발생되는 용접흄의 중금속 분포를 조사하여 비교하였다. 이것은 향후 용접재료별 및 용접공정별 발생되는 흄의 유해원소를 저감시킬 수 있고 또한 각종 유해원소의 노출기준 및 평가기준을 마련할 수 있는 기초data로써 도움이 되리라 사료된다.동, 공정중재고가 줄어드는 결과를 보였고, 가동률 수준이 높을수록 ORR 방법간의 차이가 크게 나타났다. 그리고 부하평준화 기능은 Order Release 정책의 유효성에 별 영향을 주지 않는 것으로 나타났다. 결론적으로, Order Release 방법은 우선순위규칙간의 성능차이를 줄이거나, 대체할 수 통제 기법이라기보다는 우선순위규칙을 보완하여 공정중재고와 작업현장에서의 리드타임, 리드타임의 편차를 줄여주는 역할을 한다고 볼 수 있다. 그리고, 계획시스템이 존재하여 계획오더가 일정기간간격으로 이송되는 환경에서 특히 유용하다는 결론을 얻었다. 알 수 있었다. 것인데, 제조업에서의 심각한 고비용, 저효율 문제 를 해결하기 위해 필수적으로 도입해야만 하는 실정이다. 또한 소비자의 다양한 요구로 인 하여 제품의 종류와 사양면에서 심한 변동을 보이는 시장 수요에, 신속한 정보처리로 대응 하는데도 크게 기여하고 있다. 이에 본 연구에서는, 자동차 Job Shop의 동기화 생산방식을 지원하는 동기화 생산시스템의 구축 모델을 제시하고자 한다.과로 여겨지며, 또한 혈청중의 ALT, ALP 및 LDH활성을 유의성있게 감소시키므로서 감잎 phenolic compounds가 에탄올에 의한 간세포 손상에 대한 해독 및 보호작용이 있는 것으로 사료된다.반적으로 홍삼 제조시 내공의 발생은 제조공정에서 나타나는 경우가 많으며, 내백의 경우는 홍삼으로 가공되면서 발생하는 경우가 있고, 인삼이 성장될 때 부분적인 영양상태의 불충분이나 기후 등에 따른 영향을 받을 수 있기 때문에 앞으로 이에 대한 많은 연구가 이루어져야할 것으로 판단된다.태에도 불구하고 [-wh]의미의 겹의문사는 병렬적 관계의 합성어가 아니라 내부구조를 지니지 않은 단순한 단어(min

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Tetracycline and Erythromycin Resistant Mutants of the Mycoplasma pneumoniae Isolated from Patients with Respiratory Diseases (호흡기질환 환자로부터 분리된 Mycoplasma pneumoniae의 tetracycline과 erythromycin에 대한 저항성 변이)

  • Chang Myung-Woong;Park In-Dal;Kim Kwang-Hyuk;Song Gap-Young;Kim Sung-Won
    • Journal of Life Science
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    • v.15 no.6 s.73
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    • pp.863-870
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    • 2005
  • One hundred and twenty three strains of Mycoplasma pneumoniae were isolated from patients with respiratory diseases from February 2002 to April 2005 in Busan, Korea. The MICs of tetracycline and erythromycin up to $90\%$ of the 123 M. pneumoniae isolates tested were $0.5\~1.0$, and $0.5\~512{\mu}/ml$, respectively. Plasmid DNA was not isolated from all of the M. pneumoniae isolates. Out of 323 strains of M. pneumoniae, 57 ($46.3\%$) stains contain tetM gene on their chromosomal DNA, and 60 ($48.8\%$) strains were mutated in domain V of 23S rRNA for erythromycin resistance. Out of 63 strains of M. pneumoniae which were not mutated in domain V of 235 rRNA for erythromycin resistance, 36 ($57.1\%$) strains contained tetM gene, and out of 60 strains of M. pneumoniae which were mutated in domain V of 23S rRNA for erythromycin resistance, 21 ($35.0\%$) strains contained tetM gene. These results suggest that the isolation rate of erythromycin and tetracycline resistant M. pneumoniae is higher than those of other countries, and erythromycin and tetracycline are not first choice drug for M. pneumoniae infection in Korea, and it need confirm by a nationwide surveilance of antimicrobial resistance.

The Etiologies and Initial Antimicrobial Therapy Outcomes in One Tertiary Hospital ICU-admitted Patient with Severe Community-acquired Pneumonia (국내 한 3차 병원 중환자실에 입원한 중증지역획득폐렴 환자의 원인 미생물과 경험적 항균제 치료 성적의 고찰)

  • Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.522-529
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    • 2005
  • Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

Implication of Quantitative Culture of Bronchoalveolar Lavage Fluid in the Diagnosis of Ventilator Associated Pneumonia in Patients with Antimicrobial Therapy (항생제 사용 중 발생한 기계 호흡기 관련 폐렴에서 기관지 세포 세척술의 진단적 의미)

  • Chang, Yoon-Soo;Ahn, Chul-Min;Chung, Byung-Chun;Kim, Hyung-Jung;Kim, Seong-Kyu;Lee, Won-Yong;Shin, Jeung-Su
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.72-81
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    • 2000
  • Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

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Consideration about LINAC movable range by H&N patient immobilization device manufacture (두경부환자 고정기구제작을 통한치료기 가동범위에 관한 고찰)

  • Jung DoHyung;Shim JinSeop;Youm DuSeok;Choi GyeSuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.63-67
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    • 2004
  • Purpose : New therapy technique appeared in 3D-CRT or IMRT according to a radiation treatment developing and worked. Such treatment technique requires the radiation irradiation of many direction. It has many restriction at radiation irradiation of many direction to the linear acceleration deception of now actually. Consequently We make new fix device and measure consequently the improvement of the activate range. Method and Material : We upload the fix device on a linear accelerator Couch. We fixed Gantry at 45, 90, 135 and Couch is spin and measure the clearance of the equipment. Couch is fixed at 0 45 90 and measures the clearance of Gantry. We upload the Extended head holder(EHH) on a linear accelerator Couch. and We measure with the experiment of the front. Result : The action range did not have big difference to increase Gantry45. but The activate range of Couch increases the angle in Gantry 90 and Gantry 135 when it uses EHH. The activate range of Gantry increases the angle in Couch 45 when it uses EHH. We showed good activate situation all in Couch 0 and Couch 90. The utility of EHH could keep a behind radiation diminution. Conclusion : The radiation irradiation of many direction comes to be possible the utility of the fix instrument(EHH). The safety space between the patient and equipment or between equipment and equipment increased the utility of the fix device. Also, The manufacture is possible imports to rather cheap price. and We could bring the frugality of the treatment expendable supplies.

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