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Incidence of Fever Following Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

  • Kim, Seo Yun;Lee, Jin woo;Park, Young Sik;Lee, Chang-Hoon;Lee, Sang-Min;Yim, Jae-Joon;Kim, Young Whan;Han, Sung Koo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.1
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    • pp.45-51
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    • 2017
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic method for mediastinal and hilar lymphadenopathy. This study aimed to investigate the incidence of fever following EBUS-TBNA. Methods: A total of 684 patients who underwent EBUS-TBNA from May 2010 to July 2012 at Seoul National University Hospital were retrospectively reviewed. The patients were evaluated for fever by a physician every 6-8 hours during the first 24 hours following EBUS-TBNA. Fever was defined as an increase in axillary body temperature over $37.8^{\circ}C$. Results: Fever after EBUS-TBNA developed in 110 of 552 patients (20%). The median onset time and duration of fever was 7 hours (range, 0.5-32 hours) after EBUS-TBNA and 7 hours (range, 1-52 hours), respectively, and the median peak body temperature was $38.3^{\circ}C$ (range, $137.8-39.9^{\circ}C$). In most patients, fever subsided within 24 hours; however, six cases (1.1%) developed fever lasting longer than 24 hours. Infectious complications developed in three cases (0.54%) (pneumonia, 2; mediastinal abscess, 1), and all three patients had diabetes mellitus. The number or location of sampled lymph nodes and necrosis of lymph node were not associated with fever after EBUS-TBNA. Multiple logistic regression analysis did not reveal any risk factors for developing fever after EBUS-TBNA. Conclusion: Fever is relatively common after EBUS-TBNA, but is transient in most patients. However, clinicians should be aware of the possibility of infectious complications among patients with diabetes mellitus.

A High Viscosity of Curdlan at Alkaline pH Increases Segregational Resistance of Concrete (염기성 pH에서의 고점도 커들란에 의한 콘크리트의 재료분리 억제 효과 증진)

  • 이인영;김선원;이중헌;김미경;조인성;박영훈
    • KSBB Journal
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    • v.14 no.1
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    • pp.114-118
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    • 1999
  • In order to use a polysaccharide, curdlan, as a concrete admixture, we first developed a pilot-scale fermentation process for the mass production of curdlan. We also examined the rheological properties of curdlan, and tested how well the curdlan obtained in this work increased the segregational resistance of the cement slurry. Fermentation was performed in a 300-liter fermenter equipped with 3 disk-turbine impellers. Since curdlan production is stimulated under nitrogen-limiting conditions, the culture pH was shifted from the optimal pH for cell growth (pH 7.0) to the optimal pH for curdlan production (pH 5.5) at the onset of ammonium exhaustion. We obtained a curdlan production of 65 g/L in 120 hr batch cultivation of Agrobacterium species. The insoluble curdlan at the final stage of fermentation was readily harvested by centrifugation together with the cells. The freeze-dried sample contained 78% (w/w) of curdlan. The solubility and viscosity of the curdlan increased with the increase of the solution pH, which enhances the viscosity of concrete since the pH of concrete is extremely high (pH 13.0). Test results of the curdlan as a concrete admixture with cement slurry demonstrated that it prohibits the leakage of water. In conclusion, this work certifies and enlarges curdlan's industrial potential as a concrete admixture.

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Study of Gastric Electrical Activity and Clinical Characteristics in Patients with Gastroparesis or Non-gastroparetic Functional Dyspepsia in Eastern Traditional Medicine (한방병원에 내원한 위마비 및 비위마비성 기능성 소화불량증 환자에 대한 위 운동성 및 임상적 속성에 관한 연구)

  • Lee, Joon-Suk;Lee, Seon-Young;Eom, Guk-Hyeon;Kim, Hyun-Kyung;Jang, Sun-Young;Ryu, Jong-Min;Kim, Jin-Sung;Ryu, Bong-Ha;Ryu, Ki-Won;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.26 no.4
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    • pp.785-794
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    • 2005
  • Little is known concerning the pathophysiology and symptomatology of gastric dysmotility of patients who have sought treatment in eastern traditional medicine. The aim of this study was to investigate gastric electrical activity and clinical characteristics between gastroparesis and non-gastroparetic functional dyspepsia(FD) and assess the necessity to distinguish them for eastern traditional medical treatment. 60 patients were surveyed by questionnaire. Gastric electrical activity was recorded and analyzed using electrogas-trography. Patients were divided into gastroparesis and non-gastroparetic FD by 1.0 of power ratio. Healthy persons were used as reference. Postprandial normogastria of gastroparesis decreased and that of non-gastroparetic functional dyspepsia increased compared before and after meals. Suggested causes of onset were the meat diets that most patients were on in the gastroparesis group, and that drugs that patients in the non-gastroparetic FD group were taking. Distribution of main symptom was equally regular in patients with gastroparesis, but patients with non-gastroparetic FD showed mainly upper abdominal pain and fullness. Values for the gastroparesis group were double those for the non-gastroparesis FD group in frequency of upper GI endosopic examination. Results suggest that effective application of eastern traditional medical treatment requires that first a clear distinction be made in state of gastric dysmotility and clinical characteristics of gastroparesis and non-gastroparesis FD when treating dyspepsia.

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A Study on the Patient's Attitude of Korean Medicine by Social Classes (계층별 한방의료 이용 실태에 관한 연구)

  • Lee, Han-Wool;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.71-86
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    • 2007
  • This study aims at looking into the use of oriental medical services in treating disease and patient's attitude of oriental medicine by social classes. The first to be explored through this study is medical accessibility, classifying them by age, gender and job. Second is to examine kinds of oriental medical services and expenses incurred in treating the disease. Third is to compare satisfaction for the services offered and investigate into relations between disease and oriental medicine through cross-analysis by class, and provide fundamental materials for enhancing accessibility to oriental medical centers for treating chronic diseases. The 1,376 households for the period of time from Apr. to Jun. 2005, were asked to answer to the questionnaires offered. The conclusion from the survey can be summarized as follows. Medical services for the onset of disease were less offered to females, older group, low schooling, and low-income bracket. It is attributable to an economic cause, in both genders. The in- and outpatients' rate were found higher in groups of female, older age, low-income and blue-color workers. Use of oriental medical centers were higher in outpatients than inpatients probably for low-income brackets were less frequently put on regular physical checkups, more exposing to diseases. Each hospitalization was found over six days longer in average; 19.7 days for oriental medical hospitals, 12.5 for hospitals. The hospital charges that patients should pay for one hospitalization showed 909,000 won in oriental medical hospitals, much higher than 518,000 won in hospitals. Outpatients were also found to pay more for oriental medical services; 55,000 won for oriental medical hospitals, 19,000 for hospitals. As to outpatients' satisfaction, oriental medical hospitals were generally found to be a little more satisfactory than general hospitals; 11.2% of respondents answered Very Satisfactory. Satisfaction to services offered to outpatients showed 82.2% of respondents responded to Over Satisfactory for herb clinics, 76% for general hospitals. For future intention to use oriental medical services, females, over 51 years old, lower education and income, and blue color workers showed more intention to use them. To be more competitive in treating chronic diseases, it is necessary that oriental medical services become more accessible through extending its coverage of insurance into more medical herbs and their prepared packs, as well as mapping out extensive publicity strategies to make known to the public about high efficacy of medical herbs and their safety.

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Steroid Responsive Tremor Syndrome in a Maltese Dog (말티즈 견에서 발생한 스테로이드 반응성 진전 증후군)

  • Kang, Byeong-Teck;Jung, Dong-In;Park, Chul;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Ko, Ki-Jin;Cho, Sue-Kyung;Lee, So-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.337-339
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    • 2006
  • A 4-year-old, spayed female Maltese dog was presented for evaluation of acute onset of generalized tremor, right-sided head tilt, horizontal nystagmus, and mild ataxia with 4-day duration. However, the dog was bright, alert, and responsive. The neurological examinations revealed that bilateral horizontal-, positional nystagmus, and mild ataxia. Menace responses were also absent in both eyes. Typically, moderate generalized intension tremors were noted in four limbs and the head. No abnormalities were found in hemogram, radiography, and magnetic resonance imaging(MRI). Cytologic examination of cerebrospinal fluid(CSF) revealed a mild nonsuppurative inflammation. Thus, steroid responsive tremor syndrome(SRTS) was strongly suspected because of its inflammatory and idiopathic features. The dog excellently responded to immunosuppressive doses of corticosteroid. Therefore, we definitively diagnosed the dog as SRTS based on the exclusion of other causes of the tremor, clinical signs, and response to treatment. This is a first case report of SRTS in our country and we here describe clinical and neurological features in SRTS.

Primary Dilated Cardiomyopathy in a Miniature Pinscher Dog (미니어쳐 핀셔견에서 발생한 확장성 심근질환)

  • Kim, Jung-Hyun;Park, Chul;Ko, Ki-Jin;Kang, Byeong-Teck;Jung, Dong-In;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Lee, So-Young;Cho, Sue-Kyung;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.349-354
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    • 2006
  • A 9-month-old, female Miniature Pinscher(MP) dog weighing 1.97kg was presented because of periodic syncopal episode for 5 months. This case was diagnosed as primary dilated cardiomyopathy based on respiratory distress history, weak femoral pulse, generalized cardiomegaly, pulmonary edema, marked dilation of left atrium(LA) and left ventricle(LV), decreased wall thickness of LV and interventricular septum(IVS), increased EPSS in echocardiography, and young age of onset in the absence of other cardiovascular disorders. The patient was stabilized by application of diuretics(Furosemide, 2 mg/kg, SC, q 1 hr) and venodilator(Nitroglycerine patch, 0.5 mg/kg, q 12 hrs). Clinical signs were improved with medical management of positive inotropic vasodilator(Pimobendan, 0.2 mg/kg, PO, q 12 hrs) and angiotensin-converting enzyme(ACE) inhibitor(benazepril, 0.5 mg/kg, PO, q 12 hrs), potassium gluconate gel(2 mEq/dog, PO, q 12 hrs) and, L-carnitine(50 mg/kg, PO, q 12 hrs). The dog still maintains stable clinical status 10 months after the first visit. We report the rare case of DCM in small breed dog, which corresponds to the diagnosis and treatment of typical DCM in large breed dog.

Ovarian response and surgical collection of embryos after induction of estrus in the bitch (발정유기견(發情誘起犬)의 난소반응(卵巢反應)과 수정란(受精卵)의 외과적(外科的) 회수(回收))

  • Kang, Byong-kyu;Choi, Han-sun;Na, Jin-su;Oh, Ki-seok;Son, Chang-ho;Lee, Cha-bum
    • Korean Journal of Veterinary Research
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    • v.29 no.3
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    • pp.373-381
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    • 1989
  • The aim of the present study was to test the efficiency of estrous induction in the premature, metestrous and anestrous bitches. The estrus was induced with prostaglandin $F_{2{\alpha}}$, estradiol-$17{\beta}$, pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin(HCG) in the treatment A, and with PMSG and HCG in the treatment B. Day 0 was the first day of estrone injection in the treatment A and the day of PMSG injection in the treatment B. Twenty three of the twenty six bitches were laparotomized under general anesthesia between 11 and 18 days after onset of behavioral estrus, whereas three bitches were not laparotomized and remained until parturition. Ovarian responses were evaluated with the total number of corpora lutea or ovulation sites. The uterine horns were flushed with phosphate-buffered saline added heat treated canine serum(10%), the flushing media was collected into watch glass and the ova were examined under stereomicroscope. The results obtained were as follows: 1. Standing estrus was observed on the day $17.7{\pm}1.5$ after injection of estrone in the treament A, but ovarian responses were not detectable. 2. Standing estrus was observed on the day $12.2{\pm}0.2$ after injection of PMSG in the treament Band 14 of 17 bitches showed ovarian responses. Ova were recovered in 9 of the 14 bitches. 3. Ovarian responses were observed in one of the three premature bitches. two of the three metestrous bitches and all of the 11 anestrous bitches. The average number of the ova collected from 9 bitchs were $12.2{\pm}1.4$. 4. Three bitches in the treament B exhibited behavioural estrus and all of them were mated with fertile male dog, resulting the pregnancy in only one bitch. The pregnant bitch gave the birth of two pups.

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Surgical Treatment of Obstructive Lobar Emphysema. A Report of Four Cases. (폐쇄성 엽성 폐기종의 외과적치료 - 4례 보고 -)

  • 김근호
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.109-118
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    • 1975
  • This is a report on four cases of the lobar emphysema due to proximal bronchial obstruction in the Department of Thoracic Surgery, Hanyang University Hospital, during the period of three and half years from 1972 to 1975. First case, a two years old male child was referred to our Department with the lobar emphysema of the lower lobe of the right lung with pneumonia. This emphysema was developed after aspiration of a piece of peanut. Bronchoscopy revealed that the bronchus of the right lower lobe was obstructed with the foreign body, however removal of the peanut through bronchoscope was not attempted because of corruption and softening of the peanut. The removal of the peanut by bronchotomy was performed after subsiding of acute phase of pulmonary infection. Postoperative course was uneventful and the emphysema was disappeared. Second case, a twenty months old female baby was referred to our Department with lobar emphysema of the lower lobe of the left lung. The emphysema was suddenly developed with coughing and dyspneic symptoms and the diagnosis was made roentgenologically. She gave a history of reccurrent infections of the respiratory tract after birth. Bronchoscopy showed an obstruction of the left main bronchus with the growing of fibrinous tissue on the bronchial mucosa. The protruded tissue in the left main bronchus taken out about O.8ml with biopsy forceps for histological examination. After this procedure, the emphysema of the left lung was disappeared. Histological finding was reported to be a chronic inflammatory granulation tissue. Third case, a two and half years old male child was referred to our Department with roentgenological lobar emphysema. Two weeks prior to admission he had an episode of sudden onset of coughing attack with dyspnea. Bronchoscopy revealed that the bronchus of the left lower lobe was obstructed with a mass which was strongly suspected of a neoplastic tissue. At operation, there was found a perforation of enlarged tuberculous lymph node in the bronchus of the left lower lobe and protrusion of granulation tissue into the bronchus. Ruptured orifice on themembranous wall of the left lower lobe bronchus was closed with interrupted suture after the" removal of a perforated tuberculous lymph node. Postoperative course was uneventful and antituberculous chemotherapy was given. Fourth case, a 47 years old man was admitted to our Department with the complaint of severe dyspnea of few months duration. Twenty years ago, he had a history of lung tuberculosis and was treated for many years. X-ray examination including tomography and bronchography revealed that the upper lobe of the right lung was destroyed with cavities, the lower lobe was completely shrunk, and the right middle lobe was strongly overdistended with narrowing bronchial trees. Differential bronchospirometry and lung scanning confirmed that the respiratory function of the affected lung was impaired almost totally. The value of the right lung was calculated on 6% of oxygen uptake, 1% of Minute volume, and 32% of vital capacity. The right pneumonectomy was performed under the careful consideration of anesthetic and surgical procedures. Postoperative course was uneventful and the respiratory function was improved nearly to the normal level.evel.

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The Evaluation Analysis of Competitiveness among Ports in ASEAN & Korea - An Application of HFP Model - (HFP방법을 적용한 ASEAN과 한국항만의 경쟁력 평가분석)

  • 김진구;전일수
    • Proceedings of the Korean Association for Survey Research Conference
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    • 2003.06a
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    • pp.140-160
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    • 2003
  • The purpose of this study is to identify and evaluate the competitiveness of ports in ASEAN(Association of Southeast Asian Nations), which plays a leading role in basing the hub of international logistics strategies as a countermeasure in changes of international logistics environments. This region represents most severe competition among Mega hub ports in the world in terms of container cargo throughput at the onset of the 21st century. The research method in this study accounted for over lapping between attributes, and introduced the HFP method that can perform mathematical operations. The scope of this study was strictly confined to the ports of ASEAN, which cover the top 100 of 350 container ports that were presented in Containerization International Yearbook 2002 wi th reference to container throughput. The results of this study show Singapore in the number one position. Even compared with major ports in Korea (after getting comparative ratings and applying tile same data and evaluation structure), the number one position still goes to Singapore and then Busan(2) and Manila(2), followed by Port Klang(4), Tanjung Priok(5), Tanjung Perak(6), Bangkok(7), Inchon(8), Laem Chabang(9) and Penang(9). In terms of the main contributions of this study, it is the first empirical study to apply the combined at tributes of detailed and representative attributes into the advanced HFP model which was enhanced by the KJ method to evaluate the port competitiveness in ASEAN. Up-to-now, none have comprehensively conducted researches with sophisticated port methodology that has discussed a variety of changes in port development and terminal transfers of major shipping lines. Moreover, through the comparative evaluation among major ports in Korea and ASEAN, the presentation of comparative competitiveness for Korean ports is a great achievement in this study. In order to reinforce this study, it needs further compensative research, including cost factors which could not be applied to modeling the subject ports by lack of consistently qualified data in ASEAN.

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Study of The Diagnostic Indicators of Dampness-Phlegm Pattern Identification In Stroke Patients (중풍환자의 습담변증 진단지표에 관한 연구)

  • Kang, Byeong-Kab;Go, Ho-Yeon;Kang, Kyung-Won;Park, Sae-Wook;Kim, Jeong-Chul;Go, Mi-Mi;Kim, Bo-Young;Seol, In-Chan;Lee, In;Jo, Hyun-Kyung;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.53-58
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    • 2007
  • Background and Purpose : The purpose of this study was to investigate that which symptoms are adequate indicator of the Dampness-Phlegm pattern in the stroke patients. Methods : In the time period Jul. 2005 to Sep. 2006, 136 patients with a first-ever stroke admitted in the department of Internal Medicine of Daejeon University Oriental Medical Hospital in Daejeon city, Wonkwang Oriental Medical Hospital in Iksan, JeonJu city were included. Patients were hospitalized within 3 months after the onset of stroke. Stroke patients had been interviewed by resident who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. Gi-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Results : Dampness-Phlegm group included 37 case, Non Dampness-Phlegm group 45 case out of 136 patients. white tongue coating, slippery purse, yellowish complexion, enlarged tongue, swollen tongue were higher among Dampness-Phlegm group. Dampness-Phlegm and Non Dampness-Phlegm patients do not significantly differ in heavy sensation in the head, voice with sputum, teeth printed tongue, borborygmus, dizziness with nausea. Conclusions : This study was insufficiency because sample size is very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the Stroke.

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