• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.646-653
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• 1995

Background: The confirmative diagnosis of pulmonary tuberculosis(Tb) can be made by the isolation of Mycobacterium Tuberculosis(MTb) in the culture of the sputum, respiratory secretions or tissues of the patients, but positive result could not always be obtained in pulmonary Tb cases. Although there are many indirect ways of the diagnosis of Tb, clinicians still experience the difficulty in the diagnosis of Tb because each method has its own limitation. Therefore development of a new diagnostic tool is clinically urgent. It was reported that silica cause some lysosomal enzymes to be released from macrophages in vitro and one of these enzymes is elevated in workers exposed to silica dust and in silicotic subjects. In pulmonary Tb, alveolar macrophages are known to be activated after ingestion of MTb. Activated macrophages can kill MTb through oxygen free radical species and digestive enzymes of lysosome. But if macrophages allow the bacilli to grow intracellularly, the macrophages will die finally and local lesion will enlarge. Then it is assumed that the lysosomal enzymes would be released from the dead macrophages. The goal of this investigation was to determine if there are differences in the plasma activities of lysosomal enzymes, ($\beta$-glucuronidase(GLU) and $\beta$-N-acetyl glucosaminidase(NAG), among the groups of active and inactive pulmonary Tb and healthy control, and to see if there is any possibility that the plasma activity of GLU and NAG can be used as diagnostic indicies of active pulmonary Tb. Methods: The plasma were obtained from 20 patients with bacteriologically proven active pulmonary Tb, 15 persons with inactive Tb and 20 normal controls. In 10 patients with active pulmonary Tb, serial samples after 2 months of anti-Tb medications were obtained. Plasma GLU and NAG activities were measured by the fluorometric methods using 4-methylumbelliferyl substrates. All data are expressed as the mean $\pm$ the standard error of the mean. Results: The activites of GLU and NAG in plasma of the patients with active Tb were $21.52{\pm}3.01$ and $325.4{\pm}23.37$(nmol product/h/ml of plasma), respectively. Those of inactive pulmonary Tb were $24.87{\pm}3.78$, $362.36{\pm}33.92$ and those of healthy control were $25.45{\pm}4.05$, $324.44{\pm}28.66$(nmol product/h/ml of plasma), respectively. There were no significant differences in the plasma activities of both enzymes among 3 groups. The plasma activities of GLU at 2 months after anti-Tb medications were increased($42.18{\pm}5.94$ nmol product/h/ml of plasma) in the patients with active pulmonary Tb compared with that at the diagnosis of Tb(P-value <0.05). Conclusion: The results of the present investigation suggest that the measurement of the plasma activities of GLU and NAG in the patients with active pulmonary Tb could not be a useful method for the diagnosis of active Tb. Further investigation is necessary to define the reasons why the plasma activities of the GLU was increased in the patients with active pulmonary Tb after Tb therapy.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.151-183
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• 1999

The object of this study was 200 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 9 months from Jan. 1999 to sept. 1999. We proceeded the judgment of Sasang Constitution according to 'Questionnaire of Sasang Constitution Classification (I)', and 'Questionnaire of Sasang Constitution Classification II(QSCCII)' and the diagnosis by a medical specialist. The following conclusion were made in comparison with Sasang Constitution and Questionnaire. 1. We selected the 84 subjects what had the statistical value out of the 196 subjects('Questionnaire of Sasang Constitution Classification (I)' had the 71 subjects and 'Questionnaire of Sasang Constitution Classification II(QSCCII)', had the 121 subjects). And we selected again the 73 subjects('Questionnaire of Sasang Constitution Classification (I)', had the 33 subjects and 'Questionnaire of Sasang Constitution Classification II (QSCC II)' had the 40 subjects) out of the 84 subjects, because it had a repeated subjects. 2. We made the Questionnaire what has the 85 subjects, including the subjects what was approved its statistical value by 'A CLINICAL STUDY OF THE JUDGMENT OF SASANG CONSTITUTION ACCORDING TO QUESTIONNAIRE' and 'A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION'. The subject what ask the physique and the body form was 7, the subject what ask the external appearance and the posture was 7, the subject what ask the habit and the character was 3, the subject what ask the physiology and the pathology was 3, the subject what ask the phenomenon that he has frequency was 4, the subject what ask the eating was 3, the subject what ask the symptom that he has frequency was 14, the subject what ask the work and the qualities-defects was 6, the subject what ask the friendly intercourse was 7, the subject what ask the usual mind was 5, the subject what ask the emotional inclination was I, the subject what ask the behavioral inclination was 10, the subject what ask the character was 15. 3. In the new Questionnaire, the subject what has relevance to Soyang was 84, the subject what has relevance to Soeum was 87, the subject what has relevance to Taeeum was 70. And we made the point of subject with the statistical ratio. The total point of Soyang was 7785.04, the total point of Soeum was 7742.80, the total point of Taeeum was 7746.60. 4. As a result of judgment of Sasang Constitution between the clinical diagnosis by a medical specialist and the new Questionnaire, the diagnostic accuracy of new Questionnaire was 73.33%. The diagnostic accuracy of Soyang was low, the others was high. And the Taeyang was excepted.

• Advances in pediatric surgery
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• v.5 no.1
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• pp.75-81
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• 1999

A survey on the intestinal atresias was made among 34 members of Korean Association of Pediatric Surgeons. The response rate was 82.4 %. Two hundred and fifteen patients from the January 1, 1994 to December 31, 1996 were analyzed. The lesions were 73 cases of duodenum(DA), 72 cases of jejunum(JA), 71 cases ileum(IA) and 2 cases cecum and sigmoid colon respectively. There were 2 cases of combined anomalies (DA + JA + IA and DA + JA). Male to female ratio was 1:1 in DA, and 1.8:1 in JA. Seventy four cases(34.3 %) were premature babies(DA 35.2 %, JA:48.6 %, IA:19.2 %), and 62 cases(28.7 %) had low birth weight (DA:39.4 %, JA 33.0 %, IA:13.7 %). Antenatal diagnosis was made in 92 cases(43.6 %). However 22 cases (23.9 %) of them were transferred to pediatric surgeon after delivery. Maternal polyhydramnios was observed in 63 cases(28.9 %). Seventy· five cases(34.4 %) were taken only simple abdominal film for diagnostic studies. The associated malformations were observed in 54 aresia and were observed more frequently in DA(35 cases, 47.9 %). Meconium peritonitis due to intrauterine bowel perforation was more frequently associated with IA compared to DA and JA. The overall mortality rate was 30 %. (Abbreuations: $P_{T}$;p-value in total, $P_{DJ,DI,JI}$;p value between two groups among duodenal, jejunal and ileal groups).

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.6 no.1
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• pp.77-87
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• 1996

In order to compare the difference of the measurement of delta aminolevulinic acid(${\delta}$-ALA) in urine between HPLC method(HALA) and colorimetric method(CALA), and also to provide useful information for the new diagnostic criteria of ${\delta}$-ALA in urine in lead poisoning, if at all possible in the future, authors studied 234 male lead workers who were selected from 7 storage battery factories, 3 secondary smelting industries, and 2 litharge making industries. Study subjects were selected on the basis of blood Zinc protoporphyrin(ZPP) level from low to high concentration to cover wide range of lead exposure. Study variables for this study were ${\delta}$-ALA measured by two different methods, blood lead(PbB), and blood ZPP. The results were as follows: 1. There was very high correlation between ${\delta}$-ALA measured by two method(r = 0.989 : HALA = -0.8194 + 0.8110 ${\times}$ CALA), but the value of CALA was measured about 2mg/L greater than HALA. 2. While the correlations of ${\delta}$-ALA by two method with blood lead and blood ZPP were 0.46 and 0.37 respectively, they were increased to 0.63 and 0.57 if ${\delta}$-ALA values were log-transformed. 3. Simple linear regression of ${\delta}$-ALA measured by two method on ZPP were as follows: CALA = 2.0421 + 0.0341 ${\times}$ ZPP ($R^2=0.1385$ p = 0.0001) HALA = 0.8006 + 0.0280 ${\times}$ ZPP ($R^2=0.1389$ p = 0.0001) 4. Simple linear regression of ${\delta}$-ALA measured by two method on PbB were as follows: CALA = - 0.4134 + 0.1545 ${\times}$ PbB ($R^2=0.2085$ p = 0.0001) HALA = -1.2893 + 0.1287 PbB ($R^2=0.2154$ p = 0.0001), 5. Simple linear regression of log-transformed ${\delta}$-ALA by two method on ZPP and PbB were as follows: logHALA = 0.3078 + 0.0060 ZPP ($R^2=0.3329$ p = 0.0001) logCALA = 1.0189 + 0.0044 ZPP ($R^2=0.3290$ p = 0.0001) logHALA = -0.0221 + 0.0246 PbB ($R^2=0.4046$ p = 0.0001) logCALA = 0.7662 + 0.0184 PbB ($R^2=0.4108$ p = 0.0001) 6. The cumulative percent of colorimetric method to detect lead workers whose value of PbS and ZPP were over screening level such as $40{\mu}/dl$ and $100{\mu}/dl$ respectively was higher than HPLC method if cut-off level of ${\delta}$-ALA for screening of lead poisoning was 5 mg/L. But if cut-off level of ${\delta}$-ALA measured by HPLC was reduced to 3 mg/L which is compatible to 5 mg/L of ${\delta}$-ALA measured by colorimetric method, there were good agreement between two methods and showed dose-response relationship with other lead exposure indices such as PbB and ZPP.

• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.158-169
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• 2004

Purpose : Although influenza is one of the most important cause of acute respiratory tract infections in children, virus isolation is not popular and there are only a few clinical studies on influenza and diagnostic methods. We evaluated the epidemiological and clinical features of influenza in children and rapid antigen detection test(QuickVue influenza test) on fist half of the year 2004 in Busan. Methods : From January 2004 to June 2004, throat swab and nasal secretion were obtained and cultured for the isolation of influenza virus and tested by rapid antigen detection test(QuickVue influenza test) in children with suspected influenza infections. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Influenza viruses were isolated in 79(17.2%) out of 621 patients examined. Influenza virus was isolated mainly from March to April 2004. The ratio of male and female with influenza virus infection was 1.2 : 1 with median age of 4 years 6month. The most common clinical diagnosis of influenza virus infection was bronchitis. There was no difference between influenza A and B infection in clinical diagnosis and symptoms. All patients recovered without severe complication. The sensitivity obtained for rapid antigen detection test (QuickVue influenza test) was 93.6% and the specificity was 80.2%, the positive predictive value 40.8%, the negative predictive value 98.8%. Conclusion : With rapid antigen detection test, it is possible early detection of influenza in children. reduction in use of antimicrobial agent and early use of antiviral agent.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.660-668
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• 1995

Background: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. Methods: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age, sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. Results: 1) Group 1 patients had lower glucose level{$63.3{\pm}30.8$(mg/dl)} than that of the group 2{$98.5{\pm}34.2$(mg/dl), p<0.05}, and higher LDH level{$776.3{\pm}266.0$(IU/L)} than the group 2 patients{$376.3{\pm}123.1$(IU/L), p<0.05}, and also longer duration of symptom before treatment{$2.0{\pm}1.7$(month)} than the group 2{$1.1{\pm}1.2$(month), p<0.05}, respectively. 2) In group 1, FVC changed from preoperative $2.55{\pm}0.80$(L) to postoperative $2.99{\pm}0.78$(L)(p<0.05), and FEV1 changed from preoperative $2.19{\pm}0.70$(L/sec) to postoperative $2.50{\pm}0.69$(L/sec)(p<0.05). 3) There was no difference in pleural fluid protein level($5.05{\pm}1.01$(gm/dL) and $5.15{\pm}0.77$(gm/dl), p>0.05) and WBC differential count between group 1 and group 2. Conclusion: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.

• Journal of the Korean Society of Radiology
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• v.7 no.1
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• pp.17-24
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• 2013

This study estimate radiation biological danger factor by measuring patient's exposed dose and propose the low way of patient's exposed dose in panoramic radiography. We seek correcting constant of OSL dosimeter for minimize the error of exposed dose's measurement and measure the Left, Right crystalline lens, thyroid, directly included upper, lower lips, the maxillary bone and the center of photographing that indirect included in panoramic radiography by using the human body model standard phantom advised in ICRP. In result, the center of photographing's level of radiation maximum value is $413.67{\pm}6.53{\mu}Gy$ and each upper, lower lips is $217.80{\pm}2.98{\mu}Gy$, $215.33{\pm}2.61{\mu}Gy$. Also in panoramic radiography, indirect included Left, Right crystalline lens's level of radiation are $30.73{\pm}2.34{\mu}Gy$, $31.87{\pm}2.50{\mu}Gy$, and thyroid's level of measured exposed dose can cause effect of radiation biological and we need justifiable analysis about radiation defense rule and substantiation advised international organization for the low way of patient's exposed dose in panoramic radiography of dental clinic and we judge need the additional study about radiation defense organization for protect the systematize protocol's finance and around internal organs for minimize until accepted by many people that is technological, economical and social fact by using panoramic measurement.

• Tuberculosis and Respiratory Diseases
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• v.62 no.5
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• pp.374-381
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• 2007

Background: This study evaluated which CT findings could be used to predict the negative results of a sputum smear in patients with active pulmonary tuberculosis and multiple cavities. Methods: Thirty-eight patients with active pulmonary tuberculosis and multiple cavities on CT were classified into 2 groups: smear-positive (n = 30) and -negative (n = 8). The CT findings were reviewed retrospectively. The maximum internal diameter of the largest cavity, the number of the cavities and lobes with cavities, and the characteristics of the associated findings such as consolidation, ground glass opacity, micronodules and nodule were accessed. The number of cavities above 20 mm in the maximum internal diameter and a necrotizing pneumonia-like pattern were also evaluated. Result: The maximum internal diameter and number of cavities was $32.23{\pm}17.66mm$ and $15.50{\pm}11.12mm$ (p = 0.0042), and $5.53{\pm}3.17$ and $2.43{\pm}1.13$ (p = 0.0002) in the smear-positive and -negative group, respectively. Three or more cavities were observed at 76.7% and 12.5% in the smear-positive and -negative group, respectively (p < 0.005). There were $2.00{\pm}1.34$ and $0.25{\pm}0.46$ (p = 0.001), and $1.5{\pm}1.50$ and $0.38{\pm}0.52$ (p =0.0016) lobes with consolidation and ground glass opacity in the smear-positive and -negative group, respectively. A necrotizing pneumonia-like pattern was observed in 43.3% of the smear-positive group only. The other findings were similar in both two groups. The sensitivity, specificity, positive and negative predictive value for the presence of at least a finding of consolidation, more than 3 cavities or the largest cavity > 20 mm in the maximum internal diameter were 100%, 62.5%, 90.9%, and 100%, respectively. Conclusion: Two cavities 20 mm or less in the maximum internal diameter without consolidation on CT might be associated with a negative result of the sputum smear in patients with active pulmonary tuberculosis and multiple cavities.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.353-361
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• 2007

Background: Malignancies are a common and important causes of exudative pleural effusions. Several tumor markers have been studied because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions. In an attempt to overcome this limitation, procalcitonin and C-reactive protein (CRP) in pleural effusions and serum, which are known to be inflammation markers, were measured to determine if they can differentiate an exudate from trasndate as well as the diverse causes of exudative pleural effusion. Methods: 178 consecutive patients with pleural effusion (malignant 57, tuberculous 51, parapneumonic 31, empyema 5, miscellaneous benign 7, transudative 27)were studied prospectively. The standard parameters of pleural effusion and measured serum and pleural procalcitonin were examined using in immunoluminometric assay. The level of CRP in serum and pleural fluid was determined by turbidimetric immunoassay. Results: The pleural procalcitonin levels in the exudate were significantly higher than those in the transudate, $0.81{\pm}3.09ng/mL$ and $0.12{\pm}0.12ng/mL$, respectively (p=0.007). The pleural CRP levels were significantly higher in the exudate than the transudate, $2.83{\pm}3.31mg/dL$ and $0.74{\pm}0.67mg/dL$, respectively (p<0.001). The pleural procalcitonin levels in the benign effusion were significantly higher than those in the malignant effusion, $1.15{\pm}3.82ng/mL$ and $0.25{\pm}0.92ng/mL$, respectively (p=0.032). The pleural CRP levels were significantly higher in the benign effusion than in the malignant effusion, $3.68{\pm}3.78mg/dL$ and $1.42{\pm}1.54mg/dL$, respectively (p<0.001). The pleural procalcitonin levels in the non-tuberculous effusion were significantly higher than those in the tuberculous effusion, $1.16{\pm}3.75ng/mL$ and $0.13{\pm}0.37ng/mL$, respectively (p=0.008). Conclusion: Measuring the level of procalcitonin and CRP in the pleural fluid is helpful for differentiating between transudates and exudates. In addition, it is useful for differentiating between benign and malignant pleural effusions.

• Journal of East-West Nursing Research
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• v.7 no.1
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• pp.18-31
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• 2002

This study, as a basic research to manage a Chinese Medicine Health Promotion Center by way of showing an example, is a before and after experiment research for simple group to verify a difference with cholesterol, health status and perception of health in order to confirm a effectiveness of diet and regimen according to the 4th status of physical constitution. Research object was chosen of 42 persons who operate a physical constitutional dietary regimen among them after selecting professors and clinical nurses (55 persons) majoring in the science of nursing who participated in Chinese Medicine-oriented Nurse Training Course from Aug. of 2001 to Feb. of 2002 all over the country. Diagnostic tools for physical constitution was used of the questionary that is currently consisted of physical constitution grouping test in Eastern & Western Diagnose Center of K Medical Center, and rating of health status was used of the tool that standardized CMI(Cornell Medical Index) to be available for Korean, and perception measurement for health status was used of a visual analogue scale for the health status that each one perceive personally, and physiological status was measured of cholesterol in blood. Analysis for the collected data was carried out by percentage, $X^2$ test, paired t-test according to research object by using SPSS, and the results of this study are as follows. 1) There was no difference with cholesterol before or after the experiment for objects. As a result of estimation about difference with health status by areas before or after the experiment, there are more improved result in eyes, ears, digestive organs, bones and sinews organs, frequency of a disorder, habit, adaptation status, angry, healthy status than before the experiment. As a whole, after the experiment the health was more improved than before the experiment. As the result to inspect a difference of health perception between before and after experiment, after the experiment the health perception level was improved than before, however there was no meaningful differences. 2) As the result to inspect a difference of cholesterol between before and after experiment according to object's physical constitution, in the case of So-yang-in(a person with the minimum male: according to the male and female principles(the sun and the moon)) among the 4th status of physical constitution there was only meaningful difference statistically, however, after the experiment their cholesterol's value was increased. As the result to inspect the difference of health status between before and after the experiment according to physical constitution, all of Ta-um-in(a person with maximum the female), So-yang-in(with the minimum male), So-um-in(with the minimum female) had a meaningful difference before and after the experiment, which means that in all case by physical constitutional groups, after the experiment their health status was more improved than before the experiment. As the result to inspect a difference of health perception between before and after according to physical constitutions, in the case of Tae-um-in and So-um-in, average score after the experiment was risen than before the experiment so that it means that the level of health perception was improved, however, there was no meaning statistically. According to the above results, if continuous diet and regimen by each physical constitutions could be implemented, it is certain that the health could be maintained and promoted. And, what we are healthy is for oneself to feel it subjectively. However, I think that cholesterol score in blood that we can view objectively could be changed distinctly if we can implement a strict diet and regimen. Accordingly, it is necessary for a method and period of experiment to be more strict and longer. According to the above results, I would like to suggest as follows. 1) In order to understand health status by Korean's physical constitutions and to generalize it, these research will be repeated against much more objects that could be selected by proper grouping method to consider a representative. 2) It is necessary for a research to inspect health status by physical constitution by developing a health status measurement tool that has higher confidence and propriety based on physical constitutional theory.