• Title/Summary/Keyword: 질병이환

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The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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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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Topical Steroid Therapy using Stent on Chronic Ulcerative Gingival Lesions (스텐트를 이용한 만성 궤양성 치은 병소의 국소 스테로이드 치료)

  • Park, Hyung-Uk;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.259-264
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    • 2010
  • The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

Civil Law Study on the Arbitrary Uninsured Medical Benefits (임의비급여 진료행위에 관한 민사법적 검토)

  • Bae, Byungil
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.75-103
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    • 2017
  • There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

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DEVELOPMENTAL DENTAL COMPLICATIONS AFTER ANTICANCER THERAPY IN CHILDREN (항암 치료를 받은 아동의 치아 발육 장애)

  • Kim, Min-Jeong;Lee, Hyung-Sook;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.607-612
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    • 2009
  • The malignant tumor in childhood is one of the main causes of children s death due to disease. The traditional treatment for the malignancy is known for the radiation therapy and the chemical therapy or both. However, the treatments tend to induce intraoral complications. Different from adults, almost all children on cancer therapy are expected to have dental complications, because their permanent teeth are on the developmental stage. The degree of dental complication depends on the patient's age, type of chemical and other factors-radiation dose and frequency. In this report, 3 children who had experienced the anti-cancer therapy on their age between 1 and 4 years were selected and dental complications were examined. The children have chance for the various oral complications including the developmental problems such as agenesis, microdontia and hypoplasia of the teeth. Therefore, it's important to understand the side-effects of anticancer therapy during the permanent teeth had been developmental stage in young patients. Also, oral health care specialists, including pediatric and hospital dentist can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment undergoing anticancer treatment.

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A pathological observation on the experimental rabbit viral hepatitis (실험적 토끼 바이러스성 간염의 병리학적 관찰)

  • Jyeong, Jong-sik;Kwon, Young-ran;Lee, Cha-soo;Shin, Tae-kyun
    • Korean Journal of Veterinary Research
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    • v.32 no.4
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    • pp.605-608
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    • 1992
  • This paper dealt with the clinical and pathological observations on the experimental rabbit viral hepatitis. Rabbits with 2-14 months of ages were intramuscularly inoculated with virus suspension. The results were summarized as follows. Ninety percents of experimental rabbits inoculated with virus died within 96 hours postinoculation. Common clinical signs were inappetence, increase in body temperature, depression, mild diarrhea and in three cases, bloody foam from nostrils was recognized. At necropsy, in most of the experimental cases, there were hyperemia or haemorrhages in many organs and pale liver. Intestinal catarrh and retention of turbid urine in urinary bladder were seen in some cases. Histopathologically, liver necrosis was found in all the cases died of this disease. However, there was a difference in the severity of hepatic necrosis. Haemorrhages were Iecognized in lungs, heart, liver, spleen, kidneys and thymus, in order. Liver necrosis was marked even in the cases with no haemorrhage. Perivascular cuffing in brain and catarrhal enteritis in small intestine were seen in many cases. From these results, consistent and primary lesion in this viral disease is hepatitis in susceptible rabbits. It was concluded that rabbit hepatitis virus might have the properties of hepatotropism and consequently induce peripheral necrosis in the liver leading to acute viremia with haemorrhages.

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$^{99m}Tc$-DMSA Scintigram for Renal Function Recovery after Therapy in Infants and Children (유소아 신질환에서 치료후 신기능회복에 대한 $^{99m}Tc$-DMSA 신티그램의 임상적 고찰)

  • Moon, Tae-Yong;Son, Hyun-Ju;Kim, In-Ju;Yoon, Chong-Byung;Lee, Suck-Hong;Kim, Byung-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.69-74
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    • 1994
  • Authors retrospectively analysed 20 cases of follow-up $^{99m}Tc$-DMSA renal scans to evaluate renal function recovery after treatment in urologic disorders of infants and children. There were 20 cases with both $^{99m}Tc$-DMSA renal scans prior to and after therapy in 15 patients below 9 years old. Among them, 10 patients underwent ureteroneocystostomy under the diagnosis of vesicoureteral reflux, two patients pyeloplasty because of obstructive uropathy and one was treated with antibiotics even diagnosis of UPJ stricture. We have got the quantified uptake rate of $^{99m}Tc$-DMSA renal scan by using the regression equation as "y=0.591x-2.105" (y=the quantified uptake rate, x=the simple uptake rate). The number of kidneys performed proper therapy were 29, and the cases with more increased radiotracer uptake rate in the follow-up $^{99m}Tc$-DMSA renal scans were 20 in number as 69% in frequency. 19 cases with improved renal function on $^{99m}Tc$-DMSA renal scans didn't show any significant difference related to aging or recovery duration after therapy. The $^{99m}Tc$-DMSA renal scans were not useful to evaluate renal function recovery in infants and children, but could be good tests to assess residual renal function prior to or after treatment.

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Review of Myositis Ossificans (골화성 근염에 대한 고찰)

  • Bae Sung-Soo;Park Rae-Joon;Han Dong-Uk
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.255-265
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    • 2000
  • The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.

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Epidemiologic and Clinical Features of Pertussis in Children(2000. 3-2001. 3) (소아 백일해 감염의 유행 및 임상 양상(2000. 3-2001. 3))

  • Yoo, Shin;Ahn, Kyong Ouk;Park, Eun Hye;Cho, Hyun Sang;Park, Chong Young;Lee, Hae Ran
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.603-608
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    • 2002
  • Purpose : Pertussis is a highly communicable infectious disease in children with high mortality, especially in young infants. The incidence of pertussis in South Korea has decreased to about 10 cases a year in late '90s. Doubting previously reported incidences of pertussis, we designed this study to establish exact epidemiology and a diagnostic basis of pertussis. Methods : From Mar. 2000 to Mar. 2001, polymerase chain reaction(PCR) and cultures of nasopharyngeal aspirates were taken from 49 patients who were clinically suspected of pertussis in Kangdong Sacred Heart Hospital. Results : Among 49 patients suspected of pertussis, 10 cases showed positive results by PCR method. Four out of those 10 cases were positive in culture. The peak outbreak was noticed in the spring(Mar.-May) and the autumn(Sep.-Nov.). The mean age of the patients was 3.6 months. Eight of the 10 cases which were PCR positive results proved not to be immunized against pertussis. Conclusion : Most of the pertussis patients in our study were diagnosed as bronchiolitis, pneumonia or bronchitis at the beginning of the disease and only a few patients showed typical clinical manifestations of pertussis, including whooping. When the above results are taken together, we suggest the possibility that the actual prevalence of pertussis in South Korea might be higher than that of previous reports. The importance of pertussis screen tests should be emphasized in children with severe coughs.

Study of pH and Gas Analysis of Umbilical Arterial Blood and Apgar Score as Indicators of Newborn Health (신생아 건강지표로서 제대동맥혈의 pH와 Gas Analysis 및 Apgar Score에 관한 연구)

  • Cho, Dae-Hyun;Lee, Mi-Na;Koh, Min-Whan;Lee, Tae-Hyung;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.98-106
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    • 1991
  • Apgar score is most widely used evaluating indicator of newborn health, but it is very Subjective. Umbilical cord blood gas analysis is more objective and effective than Apgar score in evaluation of newborn status. Cord blood gas was changed slightly by processing of time after fetal birth. This study was undertaken to observe objectiveness and effectiveness of umbilical arterial blood gas analysis and effects of time interval of cord clamping to newborn health with 122 pregnant women and their babies. We observed following results : 1. There were poor correlation between Apgar score and umbilical cord arterial blood analysis in evaluating of newborn health (P>0.05). 2. There was no clinical significance of Apgar score or umbilical arterial blood gas analysis as single indicator in evaluating of newborn health (P>0.05). 3. Gas analysis and pH of umbilical arterial blood was more helpful in evaluating of newborn health than Apgasr score. 4. There were no significant effects of time interval of umbilical cord clamping to newborn health. 5. If there were no indications of early umbilical cord clamping, cord blood sampling at immediately after birth without cord clamping was more effective to evaluate newborn status.

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