• Tuberculosis and Respiratory Diseases
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• 제78권1호
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• pp.1-7
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• 2015

Background: The incidence of tuberculosis (TB) in Korea is relatively high compared to the other Organisation for Economic Co-operation and Development (OECD) countries, with a prevalence of 71 per 100,000 in 2012, although the incidence is declining. Real-time polymerase chain reaction (PCR) has been introduced for the rapid diagnosis of TB. Recently, its advantage lies in higher sensitivity and specificity for the diagnosis of TB. This study evaluated the clinical accuracy of real-time PCR using respiratory specimens in a clinical setting. Methods: Real-time PCR assays using sputum specimens and/or bronchoscopic aspirates from 2,877 subjects were reviewed retrospectively; 2,859 subjects were enrolled. The diagnosis of TB was determined by positive microbiology, pathological findings of TB in the lung and pleura, or clinical suspicion of active TB following anti-TB medication for more than 6 months with a favorable response. Results: Sensitivity, specificity, and accuracy were 44%, 99%, and 86% from sputum, and 65%, 97%, and 87% from bronchoscopic aspirates, respectively. For overall respiratory specimens, sensitivity was 59%, specificity was 98%, and accuracy increased to 89%. Conclusion: Positivity in real-time PCR using any respiratory specimens suggests the possibility of active TB in clinically suspected cases, guiding to start anti-TB medication. Real-time PCR from selective bronchoscopic aspirates enhances the diagnostic yield much more when added to sputum examination.

• Tuberculosis and Respiratory Diseases
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• 제74권1호
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• pp.7-14
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• 2013

Background: Fractional exhaled nitric oxide (FeNO) can be measured easily, rapidly, and noninvasively for the assessment of airway inflammation, particularly mediated by eosinophil, such as asthma. In bronchiectasis (BE), the pathogenesis has been known as chronic airway inflammation and infection with abnormal airway dilatation; however, there are little studies to evaluate the role of FeNO in BE. Methods: From March 2010 to February 2012, 47 patients with BE, diagnosed by high resolution computed tomography (HRCT), performed FeNO, compared with asthma and chronic obstructive pulmonary disease (COPD). All patients carried out a complete blood count including eosinophil count, chemistry, sputum examination, and spirometry, if indicated. A retrospective analysis was performed to elucidate the clinical role of FeNO in BE patients. Results: The mean FeNO levels in patients with BE was $18.8{\pm}1.5$ part per billion (ppb), compared to $48.0{\pm}6.4$ and $31.0{\pm}4.3$ in those with asthma and COPD, respectively (p<0.001). The FeNO levels tended to increase along with the disease severity scores by HRCT; however, it was statistically not significant. FeNO in BE with a co-infection of nontuberculous mycobacteria was the lowest at $17.0{\pm}3.5$ ppb among the study population. Conclusion: FeNO in BE was lower than other chronic inflammatory airway diseases, particularly compared with asthma. For clinical application of FeNO in BE, more large-scaled, prospective studies should be considered.

• Tuberculosis and Respiratory Diseases
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• 제67권2호
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• pp.95-104
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• 2009

Background: The pathophysiologic mechanisms of early acute lung injury (ALI) differ according to the type of primary insult. It is important to differentiate between direct and indirect pathophysiologic pathways, and this may influence the approach to treatment strategies. NF-$\kappa$B decoy oligodeoxynucleotide (ODN) is a useful tool for the blockade of the expression of NF-$\kappa$B-dependent proinflammatory mediators and has been reported to be effective in indirect ALI. The purpose of this study was to investigate the effect of NF-$\kappa$B decoy ODN in the lipopolysaccharide (LPS)-induced direct ALI model. Methods: Five-week-old specific pathogen-free male BALB/c mice were used for the experiment. In the preliminary studies, tumor necrosis factor (TNF)-$\alpha$, interleukine (IL)-6 and NF-$\kappa$B activity peaked at 6 hours after LPS administration. Myeloperoxidase (MPO) activity and ALI score were highest at 36 and 48 hours, respectively. Therefore, it was decided to measure each parameter at the time of its highest level. The study mice were randomly divided into three experimental groups: (1) control group which was administered 50 ${\mu}L$ of saline and treated with intratracheal administration of 200 ${\mu}L$ DW containing only hemagglutinating virus of Japan (HVJ) vector (n=24); (2) LPS group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing only HVJ vector (n=24); (3) LPS+ODN group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing 160 ${\mu}g$ of NF-$\kappa$B decoy ODN and HVJ vector (n=24). Each group was subdivided into four experimental subgroups: (1) tissue subgroup for histopathological examination for ALI at 48 hours (n=6); (2) 6-hour bronchoalveolar lavage (BAL) subgroup for measurement of TNF-$\alpha$ and IL-6 in BAL fluid (BALF) (n=6); (3) 36-hour BAL subgroup for MPO activity assays in BALF (n=6); and (4) tissue homogenate subgroup for measurement of NF-$\kappa$B activity in lung tissue homogenates at 6 hours (n=6). Results: NF-$\kappa$B decoy ODN treatment significantly decreased NF-$\kappa$B activity in lung tissues. However, it failed to improve the parameters of LPS-induced direct ALI, including the concentrations of tumor necrosis factor-$\alpha$ and interleukin-6 in BALF, myeloperoxidase activity in BALF and histopathologic changes measured by the ALI score. Conclusion: NF-$\kappa$B decoy ODN, which has been proven to be effective in indirect models, had no effect in the direct ALI model.

• 대한화학회지
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• 제55권5호
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• pp.857-874
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• 2011

이 연구의 목적은 학문 통합적 비유를 활용한 창의적 문제해결력 지향 수업 전략을 개발하고 이 전략이 학생들의 창의적 사고력, 비판적 사고력, 창의적 인성, 학업적 자기 조절에 미치는 효과를 알아보는 것이다. 이를 위하여 기존의 창의적 문제 해결력 지향 탐구 수업 모형에 비유 활동의 PDCA 네 단계 모형을 활용한 '학문 통합적 비유를 활용한 창의적 문제 해결력 지향 탐구 수업 모형'을 개발하여 이 모형에 따라 구체적인 대학교 화학 실험 수업 전략을 개발하였다. 그리고 예비 과학 교사를 대상으로 개발한 수업 전략을 한 학기 동안 실시하였다. 그 결과 문제 인식 및 가설 설정, 가설 설정, 변인 통제 영역에서 창의적 사고력 하위 범주 중 독창성이 유의미하게 향상되었다. 또한, 문제 인식 및 가설 설정, 자료 해석 및 자료 변환의 영역에서 비판적 사고력이 향상된 것으로 나타났다. 또한, 학업적 자기 조절에 대해서는 확인된 조절과 통합된 조절에서 유의미한 차이를 나타냈다. 그러나 창의적 인성에 대해서는 모든 하위 영역에 대하여 유의미한 차이가 나타나지 않았다.

• Tuberculosis and Respiratory Diseases
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• 제68권1호
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• pp.16-21
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• 2010

Background: Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy. Methods: This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light. Results: Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44~81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ. Conclusion: NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.

• Journal of Welding and Joining
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• 제21권7호
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• pp.49-58
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• 2003

It has been well known that ductile fracture of steel is accelerated by triaxiality stresses. The characteristics of ductile crack initiation in steels are evaluate quantitatively using two-parameter criterion based on equivalent plastic strain and stress triaxiality. Recently, the characteristics of critical crack initiation of steels are quantitatively estimated using the two-parameter, that is, equivalent plastic strain and stress triaxiality, criterion. This study is paid to the fundamental clarification of the effect of geometrical heterogeneity and strength mismatching, which can elevate plastic constraint due to heterogeneous plastic straining, and loading rate on critical condition to initiate ductile crack using two-parameter. Then, the crack initiation testing were conducted under static and dynamic loading. To evaluate the stress/strain state in the specimens especially under dynamic loading, thermal elastic-plastic dynamic FE-analysis considering the temperature rise was used. The result showed that the critical global strain to initiate ductile fracture in specimens with strength mismatch under various loading rate cu be estimated based on the local criterion, that is two-parameter criterion obtained on homogeneous specimens under static tension, by mean of FE-analysis taken into account accurately both strength mismatch and dynamic loading effects on stress/strain behavior.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.289-292
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• 2015

Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma. Initial examination revealed a retropharyngeal abscess; hence, intravenous ceftriaxone and steroid were initiated empirically. However, pulmonary thromboembolism developed and methicillin-resistant S. epidermidis was identified in the bacterial culture. Despite intensive antibiotic and anticoagulation therapies, extensive septic thrombophlebitis involving the bilateral IJV and superior vena cava developed. Adjunctive catheter-directed thrombolysis and superior vena cava stenting were performed and the patient received antibiotic therapy for an additional 4 weeks, resulting in complete recovery.

• 한국화재소방학회논문지
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• 제22권2호
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• pp.30-37
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• 2008

건축용 바닥재의 화재예방을 위하여 국제규격으로 정해져 있는 바닥재 시험평가 방법인 KSISO 9239-1을 이용하여 각종 바닥재에 대한 연소성 시험을 복사열 판넬 시험기를 사용하여 실시하였다. 복사열 판넬 시험기를 이용하여 각종 바닥재에 대한 화염 전파거리, 임계 열류량 그리고 연기 발생농도 측정하였다. 측정결과 바닥재의 구성 물질 별로 서로 다른 연소특성을 나타내었으며, 바닥재의 표면 재질 및 구성성분이 열 방출과 연기 발생량에 있어 중요한 영향을 미치게 된다는 것을 확인할 수 있었다. 위의 평가방법은 화재위험성을 연구하는데 중요한 인자인 임계 열류량, 연기 발생량 및 화염 전파거리를 정량적으로 평가하는 중요한 시험방법임을 알 수 있었고 국내 건축용 바닥재 화재평가 방법을 국내실정에 맞게 제정 및 적용하는 것이 적합할 것으로 판단되었다.

• Tuberculosis and Respiratory Diseases
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• 제65권4호
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• pp.308-312
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• 2008

저자들은 폐결핵으로 진단받고 결핵 약제를 복용하던 환자에서 발생한 여성형 유방에 대하여 검사를 시행한 결과 Isoniazid를 포함한 항결핵약제를 복용 후 발생한 여성형 유방 사례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.269-276
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• 2019

Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.