• Title/Summary/Keyword: Chronic Patients

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The Accuracy of Tuberculosis Notification Reports at a Private General Hospital after Enforcement of New Korean Tuberculosis Surveillance System (새로운 국가결핵감시체계 시행 후 한 민간종합병원에서 작성된 결핵정보관리보고서의 정확도 조사)

  • Kim, Cheol Hong;Koh, Won-Jung;Kwon, O Jung;Ahn, Young Mee;Lim, Seong Young;An, Chang Hyeok;Youn, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.178-190
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    • 2003
  • Background : The committee of tuberculosis(TB) survey planning for the year 2000 decided to construct the Korean Tuberculosis Surveillance System (KTBS), based on a doctor's routine reporting method. The successful keys of the KTBS rely on the precision of the recorded TB notification forms. The purpose of this study was to determine that the accuracy of the TB notification form written at a private general hospital given to the corresponding health center and to improve the comprehensiveness of these reporting systems. Materials and Methods : 291 adult TB patients who had been diagnosed from August 2000 to January 2001, were enrolled in this study. The lists of TB notification forms were compared with the medical records and the various laboratory results; case characteristics, history of previous treatment, examinations for diagnosis, site of the TB by the international classification of the disease, and treatment. Results : In the list of examinations for a diagnosis in 222 pulmonary TB patients, the concordance rate of the 'sputum smear exam' was 76% but that of the 'sputum culture exam' was only 23%. Among the 198 cases of the sputum culture exam labeled 'not examined', 43(21.7%) cases proved to be true 'not examined', 70 cases(35.4%) were proven to be 'culture positive', and 85(43.0%) cases were proven to be 'culture negative'. In the list of examinations for a diagnosis in 69 extrapulmonary TB patients, the concordance rate of the 'smear exam other than sputum' was 54%. In the list of treatments, the overall concordance rate of the 'type of registration' in the TB notification form was 85%. Among the 246 'new' cases on the TB notification form, 217(88%) cases were true 'new' cases and 13 were proven to be 'relapse', 2 were proven to be 'treatment after failure', one was proven to be 'treatment after default', 12 were proven to be 'transferred-in' and one was proven to be 'chronic'. Among the 204 HREZ prescribed regimen, 172(84.3%) patients were taking the HREZ regimen, and the others were prescribed other drug regimens. Conclusion : Correct recording of the TB notification form at the private sectors is necessary for supporting the effective TB surveillance system in Korea.

A Case of Acute Eosinophilic Pneumonia after Hematopoietic Stem Cell Transplantation (혈연간 동종 조혈모세포 이식 후 이식편대숙주질환과 함께 발생한 급성 호산구성 폐렴 1예)

  • Park, Hwan-Sung;Ok, Tae-Jin;Kim, You-Jae;Kim, Guang-Un;Park, So-Eun;An, Ji-Hyun;Kim, Yun-Ku;Jeong, Jae-Ho;Kim, Su-Jeong;Lee, Yu-Mi;Lee, Ho-Su;Kang, Bo-Hyoung;Kim, Ga-Hee;Kim, Dae-Young;Kim, Woo-Sung;Kim, Dong-Soon;Song, Jin-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.459-463
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    • 2011
  • Pulmonary complications occur in 40~60% of patients who receive hematopoietic stem cell transplantation (HSCT) and are a source of substantial morbidity and mortality. Acute eosinophilic pneumonia (AEP) is an uncommon, non-infectious pulmonary complication occurring in HSCT recipients. We now report the case of a 52-year-old man with AEP who was treated with allogenic HSCT due to acute myeloid leukemia. He complained of fever, cough and dyspnea 390 days after allogenic HSCT. He also had skin and hepatic graft versus host disease (GVHD). Hypoxemia, diffuse pulmonary infiltrates on a chest x-ray and eosinophilia in bronchoalveolar lavage fluid were also noted in several tests. His symptoms, pulmonary infiltrates, hepatic dysfunction and skin lesions rapidly improved after treatment with corticosteroid therapy. Our case supports the idea that AEP is a late phase non-infectious pulmonary complication and one of the manifestations of chronic GVHD.

Definition of the peptide mimotope of cellular receptor for hepatitis C virus E2 protein using random peptide library (Random peptide library를 이용한 C형 간염바이러스 E2 단백질 세포막 수용체의 peptide mimotope 규명)

  • Lee, In-Hee;Paik, Jae-Eun;Seol, Sang-Yong;Seog, Dae-Hyun;Park, Sae-Gwang;Choi, In-Hak
    • IMMUNE NETWORK
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    • v.1 no.1
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    • pp.77-86
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    • 2001
  • Background: Hepatitis C virus(HCV), a family of Flaviviridae, has a host cell-derived envelope containing a positive-stranded RNA genome, and has been known as the maj or etiological agent for chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. There remains a need to dissect a molecular mechanism of pathogenesis for the development of therapeutic and effective preventive measure for HCV. Identification of cellular receptor is of central importance not only to understand the viral pathogenesis, but also to exploit strategies for prevention of HCV. This study was aimed at identifying peptide mimotopes inhibiting the binding of E2 protein of HCV to MOLT-4 cell. Methods: In this study, phage peptide library displaying a random peptides consisting of 7 or 12 random peptides was employed in order to pan against E2 protein. Free HCV particles were separated from the immune complex forms by immunoprecipitation using anti-human IgG antibody, and used for HCV-capture ELISA. To identify the peptides inhibiting E2-binding to MOLT-4 cells, E2 protein was subj ect to bind to MOLT-4 cells under the competition with phage peptides. Results: Several phage peptides were selected for their specific binding to E2 protein, which showed the conserved sequence of SHFWRAP from 3 different peptide sequences. They were also able to recognize the HCV particles in the sera of HCV patients captured by monoclonal antibody against E2 protein. Two of them, showing peptide sequence of HLGPWMSHWFQR and WAPPLERSSLFY respectively, were revealed to inhibit the binding of E2 protein to MOLT-4 cell efficiently in dose dependent mode. However, few membrane-associated receptor candidates were seen using Fasta3 programe for homology search with these peptides. Conclusion: Phage peptides containing HLGPWMSHWFQR and WAPPLERSSLFY respectively, showed the inhibition of E2-binding to MOLT-4 cells. However, they did not reveal any homologues to cellular receptors from GenBank database. In further study, cellular receptor could be identified through the screening of cDNA library from MOLT-4 or hepatocytes using antibodies against these peptide mimotopes.

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Study of the Factors affecting Unmet Medical Needs in Patients with Cerebrovascular Diseases (뇌혈관질환자의 미 충족 의료에 미치는 영향요인 연구)

  • Lee, Jeong Wook
    • Journal of Digital Convergence
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    • v.16 no.9
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    • pp.279-291
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    • 2018
  • This study is designed to demonstrate risk factors of unmet medical care for people with cerebrovascular disease. To do this, statistical analysis was performed by using hierarchical logistic regression analysis with SPSS/WIN24.0 program using Korean Medical Panel data in 2014. In the final model of the hierarchical logistic regression analysis, which is based on Anderson's Model, adjusted for the factors of the predisposing and enabling factors, the explanatory variables affecting the unmet medical development are gender, economic activity, income level, the experience of lying in a sickbed, restriction on activity, subjective health condition, and the number of chronic diseases. Based on the results of this study, the practical and policy implications for the effective management and treatment of cerebrovascular disease should be included in the countermeasures for cerebrovascular disease, a strategy to reduce the unmet medical incidence of cerebrovascular disease, in order to meet the medical needs, the necessity of comprehensive measures considering various dimensions of variables and the influential variables of unmet medical emergence have been suggested for the necessity of making a detailed service manual that can improve accessibility to medical services.

Sex-related Differences in DNA Copy Number Alterations in Hepatitis B Virus-Associated Hepatocellular Carcinoma

  • Zhu, Zhong-Zheng;Wang, Dong;Cong, Wen-Ming;Jiang, Hongmei;Yu, Yue;Wen, Bing-Ji;Dong, Hui;Zhang, Xiao;Liu, Shu-Fang;Wang, Ai-Zhong;Zhu, Guanshan;Hou, Lifang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.225-229
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    • 2012
  • Background: Males have a higher prevalence of hepatocellular carcinoma (HCC) than females in general, but the reasons for the sex disparity are still obscure. DNA copy number alteration (CNA) is a major feature of solid tumors including HCC, but whether CNA plays a role in sex-related differences in HCC development has never been evaluated. Methods: High-resolution array comparative genomic hybridization (CGH) was used to examine 17 female and 46 male HCC patients with chronic hepatitis B virus (HBV) infection in Shanghai, China. Two-tailed Fisher's exact or ${\chi}^2$ tests was used to compare CNAs between females and males. Results: The overall frequencies and patterns of CNAs in female and male cases were similar. However, female HCC tumors presented more copy number gains compared to those in males on 1q21.3-q22 (76.5% vs. 37.0%, P = 0.009), 11q11 (35.3% vs. 0.0%, P = 0.0002) and 19q13.31-q13.32 (23.5% vs. 0.0%, P = 0.004), and loss on 16p11.2 (35.3% vs. 6.5%, P = 0.009). Relative to females, male cases had greater copy number loss on 11q11 (63.0% vs. 17.6%, P = 0.002). Further analyses showed that 11q11 gain correlated with 19q13.31-q13.32 gain (P = 0.042), 11q11 loss (P = 0.011) and 16p11.2 loss (P = 0.033), while 1q21.3-q22 gain correlated with 19q13.31-q13.32 gain (P = 0.046). Conclusions: These findings suggest that CNAs may play a role in sex-related differences in HBVassociated HCC development.

A Consensus Plan for Action to Improve Access to Cancer Care in the Association of Southeast Asian Nations (ASEAN) Region

  • Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8521-8526
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    • 2014
  • In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.

An 1 year prospective comparative study evaluating the effect of microthread on the maintenance of marginal bone level (임프란트 미세나사선이 주위골 수준변화에 미치는 영향에 대한 1년간의 전향적 비교 연구)

  • Shin, Dong-Hwan;Cho, Kyoo-Sung;Park, Kwang-Ho;Moon, Ik-Sang
    • Journal of Periodontal and Implant Science
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    • v.33 no.3
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    • pp.349-358
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    • 2003
  • The success of dental implant therapy relies mainly upon the presence and maintenance of bone adjacent to implant. An 1-year prospective study was performed, upon the patients who were diagnosed as having chronic adult periodontitis, and had been treated with dental implant. The purpose of this study was to measure the radiographic bone level changes proximal to Astra Tech Single Tooth Implants (ATST, Astra Tech AB, $M{\"{o}}lndal$, Sweden) with microthread and Astra Tech TiOblast Implant (ATTB) without microthread supporting fixed partial prosthesis. Measurements were used to determine mean marginal bone loss during the first year of loading, 17 subjects with its partial prosthesis supported by 37 implants were followed up for an 1-year period. The marginal bone loss of implants was positively correlated with the retention factor, microthread($Microthread^{TM}$) in crestal area of ATST. The results were as follows. 1. The mean marginal bone loss of ATST was 0.226${\pm}$0.395mm, while ATTB was 0.440${\pm}$0.360mm. There was a statistically significant difference between ATST and ATTB (p<0.05). 2. The mean bone loss of the upper jaw fixtures was 0.269${\pm}$0.265mm for ATST and 0.529${\pm}$0.417mm for ATTB . There was a statistically significant difference between ATST and ATTB (p<0.05). In the lower jaw the corresponding figures were 0.167${\pm}$0.231mm and 0.313${\pm}$0.214mm, respectively. There was no significant difference between ATST and ATTB (p>0.05). 3. The mean bone loss of ATST was lower than that of ATTB at all sites according to bone quality. There was a statistically significant difference between ATST and ATTB at bone quality type III(p <0.05). In conclusion, the mean bone loss of ATST was smaller than that of ATTB . Therefore, the retention factor of crestal area, microthread ($Microthread^{TM}$) was effective to maintenance of marginal bone level around fixture.

A Study on the Angle between the Abdominal Aorta and the Superior Mesenteric Artery by 3D Image Reconstruction (3D 영상 재구성을 통한 복부대동맥과 상장간막동맥과의 각도에 관한 연구)

  • Kim, Young-Keun;Choi, Sung-Kwan
    • Journal of radiological science and technology
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    • v.26 no.1
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    • pp.63-70
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    • 2003
  • SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was $50.05{\pm}15.87^{\circ}$ on average, and that the angle in men($53.64{\pm}16.57^{\circ}$) is higher than in women($46.46{\pm}14.98^{\circ}$). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.

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Gas Transfer and Hemolysis Characteristics of a New Type Intravenous Lung Assist Device (혈관 내 신형 폐보조장치의 기체전달 및 용혈 특성)

  • 김기범;권대규;정경락;이삼철
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.121-126
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    • 2003
  • The purpose of this work was to assess and quantify whether the beneficial effects in long-term gas exchange at exciting frequency were obtained at different frequencies as well and then to develop a vibrating intravascular lung assist device(VIVLAD), for Patients suffering from acute respiratory distress syndrome(ARDS) or chronic respiratory problems. We investigate the optimal condition of the frequency band excited with new vibrator at state of limit hemolysis when blood hemolysis came to through a membrane vibration action. The experimental design and procedures were given for a device used to assess the effectiveness of membrane vibrations. Quantitative experimental measurements were performed to evaluate the performance of the device . and to identify membrane vibration dependence on blood hemolysis. We developed an analytical solution for the hydrodynamics of flow through a bundle of sinusoidally vibrated hollow fibers that is used to provide some insight into how wall vibrations might enhance the performance of the VIVLAD. In the result, it was measured that the effect of various excited frequencies in gas transfer rate and hemolysis from the maximum gas transfer rate at no vibration when the maximum gas transfer rates showed at module type 6, module type 6 consisted of 675 hollow fiber membranes The maximum oxygen transfer rate was caused by the occurrence of maximum amplitude and transfer of vibration to hollow fiber membranes when it was excited by the frequency band of 7Hz at each blood flow rate. because this frequency became the End mode resonance frequency of the flexible in blood flow. Also, when module type 6 was excited at an excited frequency of 7Hz. blood hemolysis was low. Therefore, we decided that the limit of hemolysis frequency is 7Hz . because maximum amplitude occurred at this frequency.

Narcolepsy Variant Presented with Difficult Waking (각성장애로 발현한 기면증의 변종)

  • Lee, Hyang-Woon;Hong, Seung-Bong
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.115-119
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    • 2000
  • Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis. Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out. Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DQ6- positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients (DQB1*0602 and DQA1*0102). Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.

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