• Title/Summary/Keyword: 치료기관

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Clinical Utility of Bronchial Washing PCR for IS6110 and Amplicor for the Rapid Diagnosis of Active Pulmonary Tuberculosis in Smear Negative Patients (객담도말 음성인 폐결핵환자의 기관지세척액에서 Amplicor PCR과 IS61110 PCR의 임상적 유용성에 관한 비교 연구)

  • Lee, Jun-Gu;Kim, Young-Sam;Park, Jae-Min;Ko, Won-Ki;Yang, Dong-Goo;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Choi, Jong-Rak
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.213-221
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    • 2001
  • Background : There is a well recognized interlaboratory variation in the results using the polymerase chain reaction(PCR) to detect the IS6110 sequence. The clinical utility of a commercially developed PCR test(Amplicor) in bronchial washings for detecting pulmonary tuberculosis in smear negative patients was evaluated. The sensitivity and specificity of Amplicor was compared with that of an in-house PCR test used for detecting the IS6110 sequence of Mycobacterium tuberculosis(M.tbc) in the bronchial washing fluid. Methods : 66 patients whose sputum smear for M. tbc were negative or who could not produce any sputum were recruited from January 1999 to July 1999. They all had a bronchoscopy performed to determine if there were signs of hemoptysis, patients who could not cough up sputum, lung lesion that exclude pulmonary tuberculosis. Pulmonary tuberculosis was diagnosed on the basis of a positive culture or a response to anti-tuberculosis therapy. Results : 19 patients with tuberculosis were identified and samples from 16 patients were later confirmed by culture. Bronchial washing for Amplicor PCR revealed a sensitivity, specificity, positive and negative predictive values of 94.7%, 97.9%, 94.7%, 97.9%, respectively. Using IS6110 based PCR, the sensitivity, specificity, positive and negative predictive values were of 73.7%, 87.2%, 70%, 89.1% respectively. Conclusion : Bronchial washing for Amplicor PCR proved to be more useful than IS6110 based PCR in rapidly diagnosing smear negative pulmonary pulmoary tuberculosis in patients where tuberculosis was likely to be differential and rapid diagnosis was essential for optimal treatment.

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The Evaluation and Development of Head and Neck Radiation Protective Device for Chest Radiography in 10 Years Children (소아(10세) 흉부 방사선촬영에서의 두경부 방사선 방어기구 개발 및 평가)

  • Lee, Jun Ho;Lim, Hyun Soo;Lee, Seung Yeol
    • Journal of Radiation Protection and Research
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    • v.40 no.2
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    • pp.118-123
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    • 2015
  • The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

Oral Health and Related Factors for the Elderly (Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析))

  • Seung, Jeung-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.91-95
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    • 2004
  • This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

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A Study on Health Statue of the Elderly in Rural Community according to Drinking Pattern (일부 농촌지역 노인의 음주양상에 따른 건강상태)

  • Baek, Dal-Hyun;Hwang, Byung-Deog;Moon, Hyo-Jung;Yoon, Hee-Jung;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.31 no.3
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    • pp.263-273
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    • 2006
  • Objectives: This study was conducted to investigate the trend of health statue of the elderly living in rural area according to drinking patterns. Methods: This study was conducted with 2,421 elderly people (male 1,273 and female 1,148) residing in the selected 25 villages, with exclusion of a few elderly people who were in hospital, out for a long time or had an unknown address. This study were carried out, face-to-face interviews with the subjects were made from January to March 2002. Results: The investigation of drinking state showed that for male subjects, drinkers accounted for 48.8%, nondrinkers 35.1% and abstainers from drinking 16.1%, whereas for female subjects, drinkers accounted 15.3%, nondrinkers 80.2% and abstainers from drinking 4.5%. The health status was analyzed according to drinking pattern. For elderly men, abstainers from drinking showed worse health state than nondrinkers and drinkers. Elderly women showed the same result. It is widely known that drinking are the important causes of chronic diseases. Therefore, it is needed to provide the elderly with education on control of preventable health risk factors and effect of living state on health, in order to prevent aggravation of health level of the elder population aged 65 and over. This will also help them promote their health. It will be desirable that for the elderly, the objective will focus on health promotion rather than treatment of diseases. Conclusions: Carry out health plan for rural communities and health maintenance programs and health promotion of the elderly in those communities shall be developed. In addition, preventive education and health examination shall be conducted more frequently with the elderly who drink but are still healthy.

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Development of Questionnaire Measuring Quality of Life in Pneumoconioses (진폐증 환자의 삶의 질 설문지 개발)

  • Baak, Young-Mann;Ahn, Byoung-Yong;Mun, Je-Hyeok;Jeong, Jin-Sook;Kim, Ji-Hong;Kim, Kyoung-Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.54-66
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    • 2000
  • Background: Pneumoconiosis, like other chronic respiratory diseases, is essentially incurable and, for many, progressive. While improved survival time is an important aim of treatment, there is growing recognition that for some people, improving the quality of life is more important than extending the length of life. Currently the measurement of the quality of life is used to assess the efficacy of therapeutic agents. Methods: Sixty-three pnemoconiotics who were admitted to St. Mary's Hospital between April and August 1999 were interviewed using COOP charts, Chronic Respiratory Questionnaire(CRQ) and Pneumoconiotic Respiratory Questionnaire(PRQ), a newly developed questionnaire concerning clinical and socioeconomic features of pneumoconiotics. Also, ILO classification of the chest film, pulmonary function test, and arterial blood gas analysis of the patients were evaluated. The scores between Industrial Accident Compensation Insurance(IACI) covered and uncovered patients and between clinically stable and unstable patients were compared. Results: Domains of CRQ and PRQ showed a high internal consistency reliability($\alpha$=0.86-0.89, 0.77-0.81) except the dyspnea domain($\alpha$=0.63) of CRQ. The scores on the CRQ and PRQ showed statistically significant correlations with the results of COOP charts, pulmonary function test and arterial blood gas analysis. The dyspnea domain and social activity domain of the PRQ showed significant difference between IACI covered and uncovered patients and between clinically stable and unstable patients. Conclusion : Korean translation of the Chronic Respiratory Questionnaire and the newly developed Pneumoconiotic Respiratory Questionnaire are reliable and valid methods and are likely to be useful in measuring the quality of life in patients with the chronic respiratory disease including pneumoconiosis.

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Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor (발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석)

  • Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.34-40
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    • 2006
  • Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

Epidermal Changes of the Adhesive Disks During Wall Attachment in Parthenocissus tricuspidata (착생에 따른 담쟁이덩굴 흡착근 표피조직의 변화)

  • Kim, Jung-Ha;Kim, In-Sun
    • Applied Microscopy
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    • v.37 no.2
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    • pp.83-91
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    • 2007
  • The present study examined the epidermal changes of adhesive disks which occur during attachment in Parthenocissus tricuspidata using scanning and transmission electron microscopy. Several adhesive disks, each covered with a bract, develop from the shoot apical meristem during early development. In the initial stage, the adhesive disks are club-shaped and their upper and lower epidermis are indistinguishable. However, in the actively growing stage, they become spherical and both epidermis are clearly differentiated into the adventitious roots. Prior to wall attachment, the adhesive disks exhibit adaxial convex and abaxial concave shapes, and electron-dense substances are abundant in the vacuoles of epidermal cells. The peripheral area of the adhesive disk is adhered first to the wall surface, while the central area is drawn inward in a vacuum-like state during attachment. As the attachment progresses and the electron-dense substances continue to discharge, the upper and lower epidermis rapidly undergo deterioration and the disks shrink considerably. At this stage, structural changes of the lower epidermis occur much faster than in the upper one. The discharged substance is accumulated on the wall surface, and this aids the attachment of adhesive disks on the wall for long periods. In this manner, the shape and structure of the adhesive disk epidermis change drastically from initial growth to the mature stage. Further, the role of electron-dense substance and shrinkage of the disk during attachment has been discussed in Parthenocissus tricuspidata.

Etiology and Analysis of Severity in Childhood Pancreatitis (소아 췌장염의 원인과 중증도 분석)

  • Park, Jun-Eun;Kim, Kyong-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.194-203
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    • 1999
  • Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

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Classification of submitted KSNMT dissertation (대한핵의학기술학회 투고 논문 분류)

  • Han, Dong-Chan;Lee, Hyuk;Hong, Gun-Chul;Ahn, Byeong-Ho;Choi, Seong-Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.65-69
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    • 2017
  • Purpose KSNMT(Korea Society of Nuclear Medicine Technology) stepping first step in 1997, has published first journal related with nuclear medicine technology in 1985. With classifying In Vivo Session Dissertation reported in the entire journal, trend of the Dissertation will be studied. Materials and Methods Dissertations which published from 1985 to first half of 2016 in the journal are classified with presentation form and with scanner, And all the data is organized with Excel program. Through the data, the number of dissertations published in each year, the number of dissertation published in details, and keyword distributions in each period are analyzed. Results The number of In-vivo section dissertations was 1151 and the number of In-vivo section dissertations that have common subject with In-vitro section was 28. The number of In-vivo section dissertation in 1980s was 46, in 1990s was 149, in 2000 was 467 and from 2010 to the first half of 2016 was 517. The number of dissertation with original articles was 571, with abstract was 529, with symposium was 31, with special lecture was 25, with review was 11, with interesting image was 7, with poster was 3 and with case report was 2. With symposium and special lecture excluded, which count 56, the number of dissertation with PET was 319, with Planar was 302, with SPECT was 172, with radiopharmaceutical was 113, with guard and safety management 103, with BMD was 28, etc. was 86. The number of dissertation about oncology was 201, about scanner was 179, about cardiovascular and circulatory system was 102, about safe environment was 82, about musculoskeletal system was 76, about nervous nuclear medicine was 66, about quality assurance was 61, about genitourinary system was 56, about endocrine system was 49, about digestive system was 44, about Therapy, about industrial safety was 24, about molecular imaging was 15, infection and inflammation was 9, about respiratory system was 8 and etc. was 108. The mostly used keyword through 1999 to 2005 was PET and through 2006 to 2016 was PET/CT. Conclusion To encourage various dissertations to be submitted, Korea Society of Nuclear Medicine should analyze date about not only about dissertations that are already published, but also about various research materials. Moreover, Korea Society of Nuclear Medicine also have to provide technical support such as sharing big data from homepage and systematical support to its member to publish dissertation that has high impact factor. It is important each individual researcher to have continuing effort as well as each organization cooperation.

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A Study on the Tendency of Dose value According to Dose calibrator Measurement Depth and Volume (Dose calibrator 측정 깊이와 용량의 변화에 따른 선량 값의 성향에 대한 고찰)

  • Kim, Jin Gu;Ham, Jun Cheol;Oh, Shin Hyun;Kang, Chun Koo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.24 no.1
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    • pp.20-26
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    • 2020
  • Purpose It is intended to figure out the errors derived from changes in depth and volume when measuring the Standard source and 99mTc-pertechnetate by using a Dose calibrator. Then recommend appropriate measurement depth and volume. Materials and Methods As a Dose calibrator, CRC-15βeta and CRC-15R (Capintec, New Jersey, USA) was used, and the measurement sources were 57Co, 133Ba, 137Cs and 99mTc-pertechnetate was also adopted due to its high frequency of use. The Standard source was respectively measured the changes according to its depth without changing the volume, in a range of 0 cm to 15 cm from the bottom of the ion chamber. 99mTc-pertechnetate was measured at each depth by changing the volume with 0.1 mL, 0.3 mL, 0.5 mL, 0.7 mL and 0.9 mL Respectively. And the depth range was from 0 cm to 15 cm at the bottom of the ion chamber. Results In the case of Standard source 57Co, 133Ba, 137Cs and 99mTc-pertechnetate, there were significant differences according to the measurement depth(p<0.05). 99mTc-pertechnetate has a negative correlation coefficient according to the depth, and the error of the measured value was negligible at a depth from 0 cm to 7 cm at 0.3 mL and 0.5 mL, and the range of error increased as the volume increased. Conclusion In clinical practice, it is sometimes installed differently than the Standard depth recommended by the equipment company. If it's measured at the recommended depth and volume, it could be thought that unnecessary exposure of the operator and the patient will be reduced, and more accurate radiation exams will be possible in quantitative analysis.