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National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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Home Economics teachers' concern on creativity and personality education in Home Economics classes: Based on the concerns based adoption model(CBAM) (가정과 교사의 창의.인성 교육에 대한 관심과 실행에 대한 인식 - CBAM 모형에 기초하여-)

  • Lee, In-Sook;Park, Mi-Jeong;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.24 no.2
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    • pp.117-134
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    • 2012
  • The purpose of this study was to identify the stage of concern, the level of use, and the innovation configuration of Home Economics teachers regarding creativity and personality education in Home Economics(HE) classes. The survey questionnaires were sent through mails and e-mails to middle-school HE teachers in the whole country selected by systematic sampling and convenience sampling. Questionnaires of the stages of concern and the levels of use developed by Hall(1987) were used in this study. 187 data were used for the final analysis by using SPSS/window(12.0) program. The results of the study were as following: First, for the stage of concerns of HE teachers on creativity and personality education, the information stage of concerns(85.51) was the one with the highest response rate and the next high in the following order: the management stage of concerns(81.88), the awareness stage of concerns(82.15), the refocusing stage of concerns(68.80), the collaboration stage of concerns(61.97), and the consequence stage of concerns(59.76). Second, the levels of use of HE teachers on creativity and personality education was highest with the mechanical levels(level 3; 21.4%) and the next high in the following order: the orientation levels of use(level 1; 20.9%), the refinement levels(level 5; 17.1%), the non-use levels(level 0; 15.0%), the preparation levels(level 2; 10.2%), the integration levels(level 6; 5.9%), the renewal levels(level 7; 4.8%), the routine levels(level 4; 4.8%). Third, for the innovation configuration of HE teachers on creativity and personality education, more than half of the HE teachers(56.1%) mainly focused on personality education in their HE classes; 31.0% of the HE teachers performed both creativity and personality education; a small number of teachers(6.4%) focused on creativity education; the same number of teachers(6.4%) responded that they do not focus on neither of the two. Examining the level and type of performance HE teachers applied, the average score on the performance of creativity and personality education was 3.76 out of 5.00 and the mean of creativity component was 3.59 and of personality component was 3.94, higher than standard. For the creativity education, openness/sensitivity(3.97) education was performed most and the next most in the following order: problem-solving skill(3.79), curiosity/interest(3.73), critical thinking(3.63), problem-finding skill(3.61), originality(3.57), analogy(3.47), fluency/adaptability(3.46), precision(3.46), imagination(3.37), and focus/sympathy(3.37). For the personality education, the following components were performed in order from most to least: power of execution(4.07), cooperation/consideration/just(4.06), self-management skill(4.04), civic consciousness(4.04), career development ability(4.03), environment adaptability(3.95), responsibility/ownership(3.94), decision making(3.89), trust/honesty/promise(3.88), autonomy(3.86), and global competency(3.55). Regarding what makes performing creativity and personality education difficult, most HE teachers(64.71%) chose the lack of instructional materials and 40.11% of participants chose the lack of seminar and workshop opportunity. 38.5% chose the difficulty of developing an evaluation criteria or an evaluation tool while 25.67% responded that they do not know any means of performing creativity and personality education. Regarding the better way to support for creativity and personality education, the HE teachers chose in order from most to least: 'expansion of hands-on activities for students related to education on creativity and personality'(4.34), 'development of HE classroom culture putting emphasis on creativity and personality'(4.29), 'a proper curriculum on creativity and personality education that goes along with students' developmental stages'(4.27), 'securing enough human resource and number of professors who will conduct creativity and personality education'(4.21), 'establishment of the concept and value of the education on creativity and personality'(4.09), and 'educational promotion on creativity and personality education supported by local communities and companies'(3.94).

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Kim Eung-hwan's Official Excursion for Drawing Scenic Spots in 1788 and his Album of Complete Views of Seas and Mountains (1788년 김응환의 봉명사경과 《해악전도첩(海嶽全圖帖)》)

  • Oh, Dayun
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.54-88
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    • 2019
  • The Album of Complete Views of Seas and Mountains comprises sixty real scenery landscape paintings depicting Geumgangsan Mountain, the Haegeumgang River, and the eight scenic views of Gwandong regions, as well as fifty-one pieces of writing. It is a rare example in terms of its size and painting style. The paintings in this album, which are densely packed with natural features, follow the painting style of the Southern School yet employ crude and unconventional elements. In them, stones on the mountains are depicted both geometrically and three-dimensionally. Since 1973, parts of this album have been published in some exhibition catalogues. The entire album was opened to the public at the special exhibition "Through the Eyes of Joseon Painters: Real Scenery Landscapes of Korea" held at the National Museum of Korea in 2019. The Album of Complete Views of Seas and Mountains was attributed to Kim Eung-hwan (1742-1789) due to the signature on the final leaf of the album and the seal reading "Bokheon(painter's penname)" on the currently missing album leaf of Chilbodae Peaks. However, there is a strong possibility that this signature and seal may have been added later. This paper intends to reexamine the creator of this album based on a variety of related factors. In order to understand the production background of Album of Complete Views of Seas and Mountains, I investigated the eighteenth-century tradition of drawing scenic spots while travelling in which scenery of was depicted during private travels or official excursions. Jeong Seon(1676-1759), Sim Sa-jeong(1707-1769), Kim Yun-gyeom(1711-1775), Choe Buk(1712-after 1786), and Kang Se-hwang(1713-1791) all went on a journey to Geumgangsan Mountain, the most famous travel destination in the late Joseon period, and created paintings of the mountain, including Album of Pungak Mountain in the Sinmyo Year(1711) by Jeong Seon. These painters presented their versions of the traditional scenic spots of Inner Geumgangsan and newly depicted vistas they discovered for themselves. To commemorate their private visits, they produced paintings for their fellow travelers or sponsors in an album format that could include several scenes. While the production of paintings of private travels to Geumgangsan Mountain increased, King Jeongjo(r. 1776-1800) ordered Kim Eung-hwan and Kim Hong-do, court painters at the Dohwaseo(Royal Bureau of Painting), to paint scenic spots in the nine counties of the Yeongdong region and around Geumgangsan Mountain. King Jeongjo selected these two as the painters for the official excursion taking into account their relationship, their administrative experience as regional officials, and their distinct painting styles. Starting in the reign of King Yeongjo(r. 1724-1776), Kim Eung-hwan and Kim Hong-do served as court painters at the Dohwaseo, maintained a close relationship as a senior and a junior and as colleagues, and served as chalbang(chief in large of post stations) in the Yeongnam region. While Kim Hong-do was proficient at applying soft and delicate brushstrokes, Kim Eung-hwan was skilled at depicting the beauty of robust and luxuriant landscapes. Both painters produced about 100 scenes of original drawings over fifty days of the official excursion. Based on these original drawings, they created around seventy album leaves or handscrolls. Their paintings enriched the tradition of depicting scenic spots, particularly Outer Inner Geumgang and the eight scenic views of Gwandong around Geumgangsan Mountain during private journeys in the eighteenth century. Moreover, they newly discovered places of scenic beauty in the Outer Geungang and Yeongdong regions, establishing them as new painting themes. The Album of Complete Views of Seas and Mountains consists of four volumes. The volumes I, II include twenty-nine paintings of Inner Geumgangsan; the volume III, seventeen scenes of Outer Geumgangsan; and the volume IV, fourteen images of Maritime Geumgangsan and the eight scenic views of Gwandong. These paintings produced on silk show crowded compositions, geometrical depictions of the stones and the mountains, and distinct presentation of the rocky peaks of Geumgangsan Mountain using white and grayish-blue pigments. This album reflects the Joseon painting style of the mid- and late eighteenth century, integrating influences from Jeong Seon, Kang Se-hwang, Sim Sa-jeong, Jeong Chung-yeop(1725-after 1800), and Kim Hong-do. In particular, some paintings in the album show similarities to Kim Hong-do's Album of Famous Mountains in Korea in terms of its compositions and painterly motifs. However, "Yeongrangho Lake," "Haesanjeong Pavilion," and "Wolsongjeong Pavilion" in Kim Eung-hwan's album differ from in the version by Kim Hong-do. Thus, Kim Eung-hwan was influenced by Kim Hong-do, but produced his own distinctive album. The Album of Complete Views of Seas and Mountains includes scenery of "Jaundam Pool," "Baegundae Peak," "Viewing Birobong Peak at Anmunjeom groove," and "Baekjeongbong Peak," all of which are not depicted in other albums. In his version, Kim Eung-hwan portrayed the characteristics of the natural features in each scenic spot in a detailed and refreshing manner. Moreover, he illustrated stones on the mountains using geometric shapes and added a sense of three-dimensionality using lines and planes. Based on the painting traditions of the Southern School, he established his own characteristics. He also turned natural features into triangular or rectangular chunks. All sixty paintings in this album appear rough and unconventional, but maintain their internal consistency. Each of the fifty-one writings included in the Album of Complete Views of Seas and Mountains is followed by a painting of a scenic spot. It explains the depicted landscape, thus helping viewers to understand and appreciate the painting. Intimately linked to each painting, the related text notes information on traveling from one scenic spot to the next, the origins of the place names, geographic features, and other related information. Such encyclopedic documentation began in the early nineteenth century and was common in painting albums of Geumgangsan Mountain in the mid- nineteenth century. The text following the painting of Baekhwaam Hermitage in the Album of Complete Views of Seas and Mountains documents the reconstruction of the Baekhwaam Hermitage in 1845, which provides crucial evidence for dating the text. Therefore, the owner of the Album of Complete Views of Seas and Mountains might have written the texts or asked someone else to transcribe them in the mid- or late nineteenth century. In this paper, I have inferred the producer of the Album of Complete Views of Seas and Mountains to be Kim Eung-hwan based on the painting style and the tradition of drawing scenic spots during official trips. Moreover, its affinity with the Handscroll of Pungak Mountain created by Kim Ha-jong(1793-after 1878) after 1865 is another decisive factor in attributing the album to Kim Eung-hwan. In contrast to the Album of Famous Mountains in Korea by Kim Hong-do, the Album of Complete Views of Seas and Mountains exerted only a minor influence on other painters. The Handscroll of Pungak Mountain by Kim Ha-jong is the sole example that employs the subject matter from the Album of Complete Views of Seas and Mountains and follows its painting style. In the Handscroll of Pungak Mountain, Kim Ha-jong demonstrated a painting style completely different from that in the Album of Seas and Mountains that he produced fifty years prior in 1816 for Yi Gwang-mun, the magistrate of Chuncheon. He emphasized the idea of "scholar thoughts" by following the compositions, painterly elements, and depictions of figures in the painting manual style from Kim Eung-hwan's Album of Complete Views of Seas and Mountains. Kim Ha-jong, a member of the Gaeseong Kim clan and the eldest grandson of Kim Eung-hwan, is presumed to have appreciated the paintings depicted in the nature of Album of Complete Views of Seas and Mountains, which had been passed down within the family, and newly transformed them. Furthermore, the contents and narrative styles of Yi Yu-won's writings attached to the paintings in the Handscroll of Pungak Mountain are similar to those of the fifty-one writings in Kim Eunghwan's album. This suggests a possible influence of the inscriptions in Kim Eung-hwan's album or the original texts from which these inscriptions were quoted upon the writings in Kim Ha-jong's handscroll. However, a closer examination will be needed to determine the order of the transcription of the writings. The Album of Complete View of Seas and Mountains differs from Kim Hong-do's paintings of his official trips and other painting albums he influenced. This album is a siginificant artwork in that it broadens the understanding of the art world of Kim Eung-hwan and illustrates another layer of real scenery landscape paintings in the late eighteenth century.

National Survey of Mycobacterial Diseases Other Than Tuberculosis in Korea (비결핵항산균증 전국 실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.277-294
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    • 1995
  • Background: The prevalence of tuberculosis in Korea decreased remarkably for the past 30 years, while the incidence of disease caused by mycobacteria other than tuberculosis is unknown. Korean Academy of Tuberculosis and Respiratory Diseases performed national survey to estimate the incidence of mycobacterial diseases other than tuberculosis in Korea. We analyzed the clinical data of confirmed cases for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1981 to October 1994. We collected the data retrospectively by correspondence with physicians in the hospitals that referred the specimens to Korean Institute of Tuberculosis, The Korean National Tuberculosis Association for the detection of mycobacteria other than tuberculosis. In confirmed cases, we obtained the records for clinical, laboratory and radiological findings in detail using protocols. Results: 1) Mycobacterial diseases other than tuberculosis were confirmed that 1 case was in 1981, 2 cases in 1982, 4 cases in 1983, 2 cases in 1984, 5 cases in 1985, 1 case in 1986, 3 cases in 1987, 1 case in 1988, 6 cases in 1989, 9 cases in 1990, 14 cases in 1990, 10 cases in 1992, 4 cases in 1993, and 96 cases in 1994. Cases since 1990 were 133 cases(84.2%) of a total. 2) Fifty seven percent of patients were in the age group of over 60 years. The ratio of male to female patients was 2.6:1. 3) The distribution of hospitals in Korea showed that 61 cases(38.6%) were referred from Double Cross Clinic, 42 cases(26.6%) from health centers, 21 cases(13.3%) from tertiary referral hospitals, 15 cases(9.5%) from secondary referral hospitals, and 10 cases(6.3%) from primary care hospitals. The area distribution in Korea revealed that 98 cases(62%) were in Seoul, 17 cases(10.8%) in Gyeongsangbuk-do, 12 cases(7.6%) in Kyongki-do, 8 cases(5.1%) in Chungchongnam-do, each 5 cases(3.2%) in Gyeongsangnam-do and Chungchongbuk-do, 6 cases(3.8%) in other areas. 4) In the species of isolated mycobacteria other than tuberculosis, M. avium-intracellulare was found in 104 cases(65.2%), M. fortuitum in 20 cases(12.7%), M. chelonae in 15 cases(9.5%), M. gordonae in 7 cases(4.4%), M. terrae in 5 cases(3.2%), M. scrofulaceum in 3 cases(1.9%), M. kansasii and M. szulgai in each 2 cases(1.3%), and M. avium-intracellulare coexisting with M. terrae in 1 case(0.6%). 5) In pre-existing pulmonary diseases, pulmonary tuberculosis was 113 cases(71.5%), bronchiectasis 6 cases(3.8%), chronic bronchitis 10 cases(6.3%), and pulmonary fibrosis 6 cases(3.8%). The timing of diagnosis as having pulmonary tuberculosis was within 1 year in 7 cases(6.2%), 2~5 years ago in 32 cases(28.3%), 6~10 years ago in 29 cases(25.7%), 11~15 years ago in 16 cases(14.2%), 16~20 years ago in 15 cases (13.3%), and 20 years ago in 14 cases(12.4%). Duration of anti-tuberculous treatment was within 3 months in 6 cases(5.3%), 4~6 months in 17 cases(15%), 7~9 months in 16 cases(14.2%), 10~12 months in 11 cases(9.7%), 1~2 years in 21 cases(18.6%), and over 2 years in 8 cases(7.1%). The results of treatment were cure in 44 cases(27.9%) and failure in 25 cases(15.8%). 6) Associated extra-pulmonary diseases were chronic liver disease coexisting with chronic renal failure in 1 case(0.6%), diabetes mellitus in 9 cases(5.7%), cardiovascular diseases in 2 cases(1.3%), long-term therapy with steroid in 2 cases(1.3%) and chronic liver disease, chronic renal failure, colitis and pneumoconiosis in each 1 case(0.6%). 7) The clinical presentations of mycobacterial diseases other than tuberculosis were 86 cases (54.4%) of chronic pulmonary infections, 1 case(0.6%) of cervical or other site lymphadenitis, 3 cases(1.9%) of endobronchial tuberculosis, and 1 case(0.6%) of intestinal tuberculosis. 8) The symptoms of patients were cough(62%), sputum(61.4%), dyspnea(30.4%), hemoptysis or blood-tinged sputum(20.9%), weight loss(13.3%), fever(6.3%), and others(4.4%). 9) Smear negative with culture negative cases were 24 cases(15.2%) in first examination, 27 cases(17.1%) in second one, 22 cases(13.9%) in third one, and 17 cases(10.8%) in fourth one. Smear negative with culture positive cases were 59 cases(37.3%) in first examination, 36 cases (22.8%) in second one, 24 cases(15.2%) in third one, and 23 cases(14.6%) in fourth one. Smear positive with culture negative cases were 1 case(0.6%) in first examination, 4 cases(2.5%) in second one, 1 case (0.6%) in third one, and 2 cases(1.3%) in fourth one. Smear positive with culture positive cases were 48 cases(30.4%) in first examination, 34 cases(21.5%) in second one, 34 cases(21.5%) in third one, and 22 cases(13.9%) in fourth one. 10) The specimens isolated mycobacteria other than tuberculosis were sputum in 143 cases (90.5%), sputum and bronchial washing in 4 cases(2.5%), bronchial washing in 1 case(0.6%). 11) Drug resistance against all species of mycobacteria other than tuberculosis were that INH was 62%, EMB 55.7%, RMP 52.5%, PZA 34.8%, OFX 29.1%, SM 36.7%, KM 27.2%, TUM 24.1%, CS 23.4%, TH 34.2%, and PAS 44.9%. Drug resistance against M. avium-intracellulare were that INH was 62.5%, EMB 59.6%, RMP 51.9%, PZA 29.8%, OFX 33.7%, SM 30.8%, KM 20.2%, TUM 17.3%, CS 14.4%, TH 31.7%, and PAS 38.5%. Drug resistance against M. chelonae were that INH was 66.7%, EMB 66.7%, RMP 66.7%, PZA 40%, OFX 26.7%, SM 66.7%, KM 53.3%, TUM 53.3%, CS 60%, TH 53.3%, and PAS 66.7%. Drug resistance against M. fortuitum were that INH was 65%, EMB 55%, RMP 65%, PZA 50%, OFX 25%, SM 55%, KM 45%, TUM 55%, CS 65%, TH 45%, and PAS 60%. 12) The activities of disease on chest roentgenogram showed that no active disease was 7 cases(4.4%), mild 20 cases(12.7%), moderate 67 cases(42.4%), and severe 47 cases(29.8%). Cavities were found in 43 cases(27.2%) and pleurisy in 18 cases(11.4%). 13) Treatment of mycobacterial diseases other than tuberculosis was done in 129 cases(81.7%). In cases treated with the first line anti-tuberculous drugs, combination chemotherapy including INH and RMP was done in 86 cases(66.7%), INH or RMP in 30 cases(23.3%), and not including INH and RMP in 9 cases(7%). In 65 cases treated with the second line anti-tuberculous drugs, combination chemotherapy including below 2 drugs were in 2 cases(3.1%), 3 drugs in 15 cases(23.1%), 4 drugs in 20 cases(30.8%), 5 drugs in 9 cases(13.8%), and over 6 drugs in 19 cases (29.2%). The results of treatment were improvement in 36 cases(27.9%), no interval changes in 65 cases(50.4%), aggravation in 4 cases(3.1%), and death in 4 cases(3.1%). In improved 36 cases, 34 cases(94.4%) attained negative conversion of mycobacteria other than tuberculosis on cultures. The timing in attaining negative conversion on cultures was within 1 month in 2 cases(1.3%), within 3 months in 11 cases(7%), within 6 months in 14 eases(8.9%), within 1 year in 2 cases(1.3%) and over 1 year in 1 case(0.6%). Conclusion: Clinical, laboratory and radiological findings of mycobacterial diseases other than tuberculosis were summarized. This collected datas will assist in the more detection of mycobacterial diseases other than tuberculosis in Korea in near future.

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