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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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An Analysis of Korean Floral Design Education Program and the Job Satisfaction of Florist and Applicants Florist (우리나라 화훼장식 교육프로그램 분석과 화훼장식가와 지망생 직업만족도 비교)

  • Moon, Hyun Sun;Hong, Jong Won;Han, Koh Woon;Jang, Eu Jean;Pak, Chun Ho
    • FLOWER RESEARCH JOURNAL
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    • v.18 no.4
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    • pp.315-322
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    • 2010
  • To analyze our country's education program for flower decoration and occupational satisfaction of florist, 60 present florists and 60 applicants were surveyed. To investigate satisfaction of florist, the questionnaire items consisted of satisfaction for occupation etc. experienced by attendants, contents of related education, recognition from society, social treatment. And this study analyzed followings : considerations to select occupation, satisfaction on job of person who majored in related subject and non- person without such an educational background, satisfaction on present occupation, satisfaction on education period, significance of florist ability, significance of requirements for occupational development. The points which present florists and applicants consider as important were aptitude for gardening and prospect. From the analysis by major of florists, majored persons had more satisfaction than non-majored persons but there was no statistically significant difference between them. From the analysis by applicant, as in present florists, majored persons had more satisfaction than non-majored persons. For the satisfaction by career and education period of present florists and applicants, the satisfaction on education related to flower decoration or learning experiences and lecturer's teaching method showed that the lower the career is, the less the satisfaction is. Seeing the result by education period of applicants, the satisfaction on job was similar each other regardless of education period. For difference in recognition on ability by major of present florists and applicants, the result of analysis by major of present florists showed that majored persons considered the ability more important comparing to non-majored persons in the fields of gardening and making decorations. In the other hand, in the fields of quality maintenance, flower decoration, and flower distribution and management, there was no significance difference between majored and non-majored persons about the recognition of ability. The result of analysis by major of applicants showed that majored persons considered the ability more important comparing to non-majored persons in the fields of gardening, flower decoration, making decorations, flower distribution and management. For the significance of quality maintenance, majored persons wholly considered the significance more important comparing to non-majored persons but there was no significant difference. Based on the results of this study, in working as a florist, persons who majored in flower decoration had more occupational satisfaction than non-majored persons. And among the contents of education, the education related to gardening was recognized as most important. But at present the systematic and special education programs to cultivate professional florists are deficient. Therefore it is suggested that courses based on systematic educational contents which integrate theory and practice are needed to solve education problem related to flower decoration in this rapidly changing society.

An Analysis on the Knowledge Levels, Attitudes, and Factors Affecting the Choices of Those Who Completed the Education of Persons Conducting Clinical Trial Workers (의약품 임상시험 종사자 교육 이수자의 지식 수준, 태도, 교육 선택 요인 분석)

  • Lee, Yoon Jin;Jang, Hye Yun;Lee, Yu-Mi
    • The Journal of KAIRB
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    • v.3 no.2
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    • pp.19-27
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    • 2021
  • Purpose: This study aimed to analyze the knowledge levels, attitudes, and factors affecting the choices on the education of the participants who completed their education of persons conducting clinical trial workers, and to assess the problems of the current education system for clinical trial workers, leading to improvements. Methods: Clinical trial workers (including principal investigators/subinvestigators, members of the Institutional Review Board [IRB], clinical research coordinators) who were affiliated to one of the 4 university hospitals running their own clinical trial center and IRB in Daegu and completed their education of persons conducting clinical trial workers were the subjects of this study. One hundred seven online questionnaires were answered from 2021-04-02 to 2021-04-17. Descriptive statistics and Pearson correlation analysis were used to analyze the acquired data. Independent t-test and 1-way analysis of variance were used to analyze the differences in the knowledge levels and attitudes following the characteristics of the education participants. Results: The baseline characteristics of the 107 participants were as follows: the majority of the participants were female (72.0%), were in their 30s (36.4%), had a nursing major (29.0%), were clinical research coordinators (63.6%), had never experienced a principal investigator (79.4%), had participated 3 or more educations (58.9%), had completed their maintenance course (55.1%), had 5 or more years of clinical trial experiences (34.6%). The fields on which participants had low levels of objective knowledge were "types and preparations on audits of clinical trials," "regulations on clinical trials (Pharmaceutical Affairs Act, Korea Good Clinical Practice)." The difficulties that the participants faced were on "annual educations" and "lack of information regarding the educations." Factors that showed significant differences in objective knowledge were sex (p=0.02), number of educations (p=0.004), the curriculum of 2020 (p=0.001). Age (p=0.004), having experienced a principal investigator (p=0.006), number of educations (p<0.001), the curriculum of 2020 (p<0.001), clinical trial career (p=0.001) were factors that significantly affected subjective knowledge. Attitudes toward the education were positively correlated with objective knowledge (r=0.20, p=0.04) and subjective knowledge (r=0.32, p=0.001). Major sources through which information on educations was acquired were "institutional notices," and major factors affecting the choices on the education were "when the education took place" and "where the education took place." "Within the affiliated institution," "Online classes (recorded)" and "IRB and review processes" were each the most preferred place, mode, and content of the education. Conclusion: Knowledge levels varied largely among participants who completed their education of persons conducting clinical trial workers, depending on their characteristics such as the number of educations. Participants also complained about their lack of information on educations. The quality of education may be improved if clinical trial organizations are designated as education facilities. Education programs must be developed considering the knowledge level and demand of the participants. Furthermore, as offline classes may be impossible due to pandemics such as the coronavirus disease 2019, the development of diverse and sophisticated online classes is looked forward to.

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Analysis of Fish Ecology and Water Quality for Health Assessments of Geum - River Watershed (금강본류의 건강성 평가를 위한 어류생태 및 수질 특성분석)

  • Park, Yun-Jeong;Lee, Sang-Jae;An, Kwang Guk
    • Korean Journal of Environment and Ecology
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    • v.33 no.2
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    • pp.187-201
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    • 2019
  • This study examined the physicochemical water quality and evaluated the ecological health in 14 sites of Geum River (upstream, mid-stream, and downstream) using the fish community distribution and guilds and eight multi-variable matrices of FAI (Fish Assessment Index) during June 2008-May 2009. The analysis of the water quality variables showed no significant variation in the upstream and mid-stream but a sharp variation due to the accumulation of organic matter from the point where the treated water of Gap and Miho streams flew. The analysis of physicochemical water properties showed that BOD, COD, TN, TP, Cond, and Chl-a tended to increase while DO decreased to cause eutrophication and algae development from the downstream where Miho and Gap stream merged. The analysis of fish community showed that the species richness index and species diversity index increased in the mid-stream area but decreased in the downstream area, indicating the stable ecosystem in the upper stream and the relatively unstable ecosystem in the downstream. The analysis of the species distribution showed that the dominant species were Zacco platypus that accounted for 20.9% of all fish species and Zacco koreanus that accounted for 13.1%. The analysis of the fish tolerance and feeding guild characteristics showed that the sensitive species, the insectivore species, and the aquatic species were dominant in the mid-stream point. On the other hand, contaminants from the sewage water treatment plant of Miho stream had a profound effect in the downstream to show the dominance of tolerant species, omnivorous species, and lentic species. Therefore, it is necessary to improve water quality by reducing the load of urban pollutants and to pay attention to the conservation and restoration of aquatic ecosystems.

Development and Assessment of a Non-face-to-face Obesity-Management Program During the Pandemic (팬데믹 시기 비대면 비만관리 프로그램의 개발 및 평가)

  • Park, Eun Jin;Hwang, Tae-Yoon;Lee, Jung Jeung;Kim, Keonyeop
    • Journal of agricultural medicine and community health
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    • v.47 no.3
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    • pp.166-180
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    • 2022
  • Objective: This study evaluated the effects of a non-face-to-face obesity management program, implemented during the pandemic. Methods: The non-face-to-face obesity management program used the Intervention mapping protocol (IMP). The program was put into effect over the course of eight weeks, from September 14 to November 13, 2020 in 48 overweight and obese adults, who applied to participate through the Daegu Citizen Health Support Center. Results: IMP was first a needs assessment was conducted; second, goal setting for behavior change was established; third, evidence-based selection of arbitration method and performance strategy was performed; fourth, program design and validation; fifth, the program was run; and sixth, the results were evaluated. The average weight after participation in the program was reduced by 1.2kg, average WC decreased by 3cm, and average BMI decreased by 0.8kg/m2 (p<0.05). The results of the health behavior survey showed a positive improvement in lifestyle factors, including average daily intake calories, fruit intake, and time spent in walking exercise before and after participation in the program. A statistically significant difference was seen (p<0.05). The satisfaction level for program process evaluation was high, at 4.57±0.63 point. Conclusion: The non-face-to-face obesity management program was useful for obesity management for adults in communities, as it enables individual counseling by experts and active participation through self-body measurement and recording without restriction by time and place. However, the program had some restrictions on participation that may relate to the age of the subject, such as skill and comfort in using a mobile app.

A Study on the Effect of Elementary Pre-service Teachers on Conceptual Acquisition and Perception Change of Strata and Rocks after Geological Exploration (초등예비교사들의 지질답사를 통한 지층과 암석 개념습득 및 인식변화에 대한 연구)

  • Yong-seob Lee
    • Journal of the Korean Society of Earth Science Education
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    • v.16 no.3
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    • pp.319-327
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    • 2023
  • This study involved 22 students in one class of 4th year science intensive course at B College of Education. We investigated the changes in the acquisition of knowledge in the field of geology and the perception of geological exploration among pre-service teachers. For this study, a period of four weeks was designated for a semester to a geological field trip. For the geological exploration, the Geoparks of City B (Geumjeongsan Mountain, Amnam Park, Igidae, Dusong Peninsula, Jangsan, Taejongdae, and Hwangnyeongsan Mountain) were designated. The concept of geology and rocks has been extracted from the concepts that can be found in the Geopark. The composition of the group was composed of one group of four members autonomously. The other two of the pre-service teachers joined a group of friends with whom they had an affinity. After the geological field trip, the materials were organized by group and PPT presentations were made during the lecture time where all the members could listen. The extent to which the pre-service teachers acquired the concepts of geology and rocks after conducting the geological field trip was interpreted as the result of pre- and post-statistical processing. In addition, we interpreted what kind of perception the pre-service teachers had after the geological field trip as a result of the statistical processing before and after. Based on the results of the study, the following conclusions were drawn: First, it was effective for the pre-service teachers to acquire the concepts of strata and rocks after the geological field trip. The reason for this is that the experience of the pre-service teachers in conducting geological field trips has changed their perception of geological field trips. In addition, it is interpreted that these results were obtained because the pre-service teachers had a high level of interest in geology and rocks. Second, the pre-service teachers were able to gain confidence after the geological field trip. This reason is interpreted as the fact that they were able to gain confidence in geological exploration by exploring and experiencing the sites of the Geopark for each group.

Human Mind Within and Beyond the Culture - Toward a Better Encounter between East and West - (문화속의 인간심성과 문화를 넘어선 인간심성 - 동과 서의 보다 나은 만남을 위하여 -)

  • Bou-Yong Rhi
    • Sim-seong Yeon-gu
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    • v.28 no.2
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    • pp.107-138
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    • 2013
  • The purpose of this article is to awaken our colleagues to the culture and mind issues that have been forgotten or neglected by contemporary psychiatry under the prevalence of materialistic orientation. Cultural psychiatry too, though it has been contributed a great deal to widen the mental vision of psychiatry, has revealed several limitations in its approach. In the course of one sided search for culture specific factors in relation to mental health, conventional cultural psychiatry has neglected an effort to explore the common root underlying the different cultures and the common foundation of human mind. Cross sectional comparisons of the cultures alone have inevitably prevented the global considerations to culutre and mind in historical aspects and the dynamic interactions between mind and culture more in depth. The author suggested that the total view of mind and total approach of analytical psychology of C.G. Jung might be capable to replenish those limitations. Author explained the ways of C.G. Jung's observations and experiences of non-western culture and his concepts of culture and mind. The author demonstrated Jung's view of culture with the example of Filial Piety, Hyo, the Confucian moral norm which can be regarded as components of the collective consciousness though connected with archetypal patterns of behavior of intimacy between parent and child. In regard to the coexistence of multi-religious cultures in Korea the author made a proposal of 'culture spectrum' model for understanding value orientations of person in religious cultures. He identified in case of the Korean 4 types of cultural spectrums: Person with predominantly the Buddhist culture; with the Confucian; with the Shamanist; and with the Christian culture. The author also made an attempt to depict the dynamic interactions of different religious cultures in historical perspectives of Korea. Concepts of mind from the Eastern thoughts were reviewed in comparison with Jung's view of mind. The Dao of Lao Zi, One Mind by Wonhyo, the Korean Zen master from the 7th century, the Diagram of the Heaven's Decree by Toegye, a renowned Neo-Confucianist of Korea from the 16th century and his theory of Li-Ki, were explored and came to conclusion that they represent certainly the symbol of the Self in term of C.G. Jung. The goal of healing is 'the becoming whole person'. Becoming whole person means bringing the person as an individual to live not only within the specific culture but also to live in the world beyond the culture which is deeply rooted in the primordial foundation of human mind.

Dental Assistant and Dental Hygienist-comparison with U.S. (치과 보조 인력과 치과위생사-미국의 제도 비교)

  • Youngyuhn Choi
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.65-77
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    • 2023
  • Background: The shortage of dental hygienists as assistant is a great concern to dental clinics, while dental hygienists are rather pursuing the role of oral hygiene control and preventive treatments which is the main role for dental hygienists in the United States. The dental hygienist and dental assistant system in the United States can be a reference in these discussions. Methods: Educational requirements for licensure and work areas for dental hygienists and dental assistants were investigated through the information provided by the American Dental Association (ADA), American Dental Hygienists Association, National Board Dental Hygiene Examination (NBDHE), Dental Assistants Association of America (ADAA), and Dental Assistants National Board (DANB). Results: In the United States, each state has different systems, but in general, dental hygienists obtain licenses after completing 2~3 years of associate degree programs in dental hygiene after obtaining basic learning skills, and mainly perform tasks related to patient screening procedures, oral hygiene management and preventive care. Dental assistants can take the license test after completing a training course of 9~11 months to obtain a dental assistant certification. Additional expanded work typically requires passing state qualification tests, completing a training program, obtaining a degree, or gaining clinical experience for a certain period of time, depending on the state Conclusion: The scope of work of dental hygienists designated by the Medical Engineer Act and the Enforcement Decree in Korea includes both the work of dental hygienists and dental assistants in the United States, and if a dental assistant system like the United States is introduced to address the current shortage of dental assistants, institutional supplementation such as adjustment of the scope of work and expansion of the role of dental hygienists in oral hygiene management and prevention work is needed and in-depth discussion is necessary.

Purification of antigenic proteins of Paragonimus westermani and their applicability to experimental cat paragonimiasis (폐(肺)디스토마(Paragonimus westermani) 감염(感染) 고양이 혈청(血淸)에 대(對)한 ELISA 항체가(抗體價)의 의의(意義))

  • Choi, Won-Young;Yoo, Jae-Eul;Nam, Ho-Woo;Choi, Hyung-Rak
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.177-186
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    • 1986
  • This study was designed to evaluate the partially purified antigens which were fractionated from crude extract of Paragonimus westermani and to monitor the enzyme-linked immunosorbent assay (ELISA) in experimental cat paragonimiasis during the course of infection as well as before and after chemotherapy. Crude extract of 6-month-old adult P. westermani was fractionated to 5 antigens by successive applications of ammonium sulfate precipitation, ion exchange chromatography and gel filtration. And the cats, 10 in each group, were infected with 60, 30, 15, and 5 metacercariae, then the half of each group was treated with praziquantel 2 times in one day of 100mg per kilogram of weight on 150 days after the infection. Sera were collected every 10 days. ELISA was performed with the concentration of $2{\mu}g/ml$ antigen, 100 times diluted sera and 1,000 times diluted alkaline phosphatase conjugated anti-cat IgG. The results were as follows: 1. Absorbance by ELISA with proteins precipitated by differential concentration of ammonium sulfate was the highest at $51{\sim}65%$ precipitate (PA2), followed by $0{\sim}50%$ precipitate (PAl), $66{\sim}80%$ precipitate (PA3), and $81{\sim}90%$ precipitate (PA4). Unprecipitated protein over 90% ammonium sulfate (PA5) showed the lowest antigenicity. 2. Fractionation of PA1, PA2, and PA3 through the DEAE-cellulose column did not differentiate the antigenic proteins. 3. By passing through the Sephadex G-200 column, PA1 and PA2 were fractionated to high molecular weight proteins and those of low molecular weight which showed high absorbance by ELISA (PA1-I, II and PA2-I, II). But PA3 was shown to have a fraction of high molecular weight proteins (PA3-I) which showed high antigenicity. 4. SDS-polyacrylamide gel electrophoresis of PA1-I, P A1-II, PA2-I, PA2-II, PA3-I, and crude extract was performed. Fraction PA1-I was composed of proteins which had the molecular weight of 270 kilodaltons(KD) to 196 KD; of them 220KD protein was major band. Fraction PA2-I was composed of $255{\sim}225\;KD$, and PA3-I, $255{\sim}240\;KD$, respectively. Fraction PA1-II and fraction PA2-II consisted of 30 KD proteins. 5. Absorbance by ELISA began to increase within $10{\sim}20$ days after the infection and reached the highest on $140{\sim}180$ days, then made plateau thereafter. 6. Absorbance by ELISA decreased after praziquantel treatment. In 60 metacercariae infection group, the absorbance had been decreasing, but remained within the positive range during observation period, while those of 30, 15, and 5 metacercariae infection groups turned to negative range. 7. Fraction PA1-II showed the highest antigenicity in ELISA, then fraction PA2-I, fraction PA1-I, fraction PA2-II, fraction PA3-I and crude extract followed. In early phase of infection, the absorbance of fraction PA1-II showed more rapid increase than those of the other fractions and it came to positive range at $20{\sim}30$ days after infection.

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Clinical Characteristics of Pulmonary Aspergilloma (폐국균종의 임상적 고찰)

  • Kang, Tae-Kyung;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Sohn, Jeong-Ho;Lee, Jun-Ho;Han, Seong-Beom;Jeon, Young-Jun;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Shin, Hyeon-Soo;Lee, Sang-Chae;Kweon, Sam
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1308-1317
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    • 1997
  • Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

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