• Title/Summary/Keyword: Korean American

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Usefulness of Bronchoscopy for the Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease (비결핵 항산균 폐질환의 진단에서 기관지내시경술의 유용성)

  • Jeon, Kyeongman;Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kim, Tae Sung;Lee, Kyung Soo;Lee, Nam Yong;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.242-249
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    • 2004
  • Background : Because of the low sensitivity of sputum smear and culture, diagnosis of nontuberculous mycobacterium (NTM) pulmonary disease, especially in patients with bronchiectasis, is often difficult. We investigated the usefulness of bronchoscopy for the diagnosis of NTM pulmonary disease including M. avium complex (MAC) and M. abscessus in patients with bronchiectasis and multiple pulmonary nodules on chest computed tomography (CT). Methods : We reviewed 48 cases of patients who were performed bronchoscopic bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) under suspect of NTM pulmonary disease based on CT findings of bronchiectasis and multiple nodules from April 2002 to June 2003. Results : Twenty five of the 48 patients (54%; 12 MAC, 14 M. abscessus) were diagnosed as NTM pulmonary disease on the basis of the American Thoracic Society diagnostic criteria for NTM pulmonary disease. Sixteen of the 21 patients (76%; 5 MAC, 11 M. abscessus) with 3 or more positive sputum cultures of NTM were confirmed tissue invasion by TBLB. Five of the 24 patients (21%; 4 MAC, 1 M. abscessus) who could not be diagnosed with sputum cultures were diagnosed by bronchoscopic BAL and TBLB. Conclusion : Bronchoscopy is helpful for the diagnosis of NTM pulmonary disease and confirmation of tissue invasion by NTM, not only MAC but also M. abscessus, in patients with bronchiectasis and multiple nodules on chest CT scan.

Clinical Value of a Desktop Spirometer (HI-801) for Spirometry Screening (선별 검사를 위한 탁상용 폐활량기 (HI-801)의 임상적 유용성에 관한 고찰)

  • Choi, Hye Sook;Choi, Cheon Woong;Park, Myung Jae;Kang, Hong Mo;Yoo, Hong Ji
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.276-283
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    • 2007
  • Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled. Pulmonary function measurements (FVC, $FEV_1$, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, $FEV_1$ +0.16 L, PEFR +1.85 L/s, FEF25%-75%-0.13 L/s. With the exception of $FEV_1$, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for $FEV_1$ and FVC and acceptable differences for clinical use.

Commissioning Experience of Tri-Cobalt-60 MRI-guided Radiation Therapy System (자기공명영상유도 Co-60 기반 방사선치료기기의 커미셔닝 경험)

  • Park, Jong Min;Park, So-Yeon;Wu, Hong-Gyun;Kim, Jung-in
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.193-200
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    • 2015
  • The aim of this study is to present commissioning results of the ViewRay system. We verified safety functions of the ViewRay system. For imaging system, we acquired signal to noise ratio (SNR) and image uniformity. In addition, we checked spatial integrity of the image. Couch movement accuracy and coincidence of isocenters (radiation therapy system, imaging system and virtual isocneter) was verified. Accuracy of MLC positioing was checked. We performed reference dosimetry according to American Association of Physicists in Medicine (AAPM) Task Group 51 (TG-51) in water phantom for head 1 and 3. The deviations between measurements and calculation of percent depth dose (PDD) and output factor were evaluated. Finally, we performed gamma evaluations with a total of 8 IMRT plans as an end-to-end (E2E) test of the system. Every safety system of ViewRay operated properly. The values of SNR and Uniformity met the tolerance level. Every point within 10 cm and 17.5 cm radii about the isocenter showed deviations less than 1 mm and 2 mm, respectively. The average couch movement errors in transverse (x), longitudinal (y) and vertical (z) directions were 0.2 mm, 0.1 mm and 0.2 mm, respectively. The deviations between radiation isocenter and virtual isocenter in x, y and z directions were 0 mm, 0 mm and 0.3 mm, respectively. Those between virtual isocenter and imaging isocenter were 0.6 mm, 0.5 mm and 0.2 mm, respectively. The average MLC positioning errors were less than 0.6 mm. The deviations of output, PDDs between mesured vs. BJR supplement 25, PDDs between measured and calculated and output factors of each head were less than 0.5%, 1%, 1% and 2%, respectively. For E2E test, average gamma passing rate with 3%/3 mm criterion was $99.9%{\pm}0.1%$.

Antithrombin-III as an early prognostic factor in children with acute lung injury (급성 폐손상 소아 환자에서 조기 예후 인자로서의 antithrombin-III)

  • Lee, Young Seung;Kim, Seonguk;Kang, Eun Kyeong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.443-448
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    • 2007
  • Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

Possibility of Substituting Softwoods for Tropical Hardwoods of Door Frames (침엽수재(針葉樹材)의 남양활엽수(南洋闊葉樹) 문틀재(材) 대체(代替) 가능성(可能性) 조사(調査))

  • Kang, Ho-Yang;Jang, Sang-Sik;Lee, Hwa-Hyoung
    • Korean Journal of Agricultural Science
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    • v.21 no.2
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    • pp.103-110
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    • 1994
  • Since the supply of the Southeast Asian tropical timber decreases and its price steeply increases in the international lumber market, door and window frame manufacturers in this country are eagerly searching for their substitutes. This is the first step to replace Southeast Asian tropical timber by low grade North American softwoods, whose reliable and steady supply is expected, but their appearances are not as good as the tropical timber. In this study, knot distribution on the softwood boards and their warp were examined The yield and production cost were also calculated. The average numbers of knots on a door frame were 7.2 for Douglas-fir and 3.4 for Western hemlock. Only 11% of the knots of Douglas-fir door frames are larger than 5cm in diameter, while are 35% of the knots of Western hemlock. The deformations of door frames, after 2 months air-drying, were measured with a warp table. The deformations of Western hemlock door frames were mostly less than 6mm, while those of Douglas-fir distributed in the range of 0.5 and 9.5mm. The yield of Western hemlock is higher than that of Douglas-fir. It can be concluded that the door frames made of the softwoods are compatible with those made of the tropical timber in most aspects except appearance.

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Radical Radiotherapy of Head and Neck Cancer (두경부 종양의 방사선 치료 성적)

  • Ban Sung Beom;Kim Chul Young;Choi Myung Sun;Suh Won Hyuck
    • Radiation Oncology Journal
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    • v.4 no.1
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    • pp.35-43
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    • 1986
  • Study patients with head and neck carcinoma were studied retrospectively to assess the impact of treatment on survival and local control rate by stage in the Dept of Radiation Therapy, Korea University Hae Wha Hospital between March 1981 and March 1986. Prior to definite radiotherapy, patients were evaluated by physical examination and radiologic studies including chest, laryngogram and CT scan and then these patients were grouped according to the American Joint Committee (AJC) staging system. They were treated with RT alone or postoperative irradiation to the dose of 7,200 cGy/8 weeks and 6,000 cGy/7 weeks respectively. The results were obtained and as follows; 1. Overall male to female sex ratio was 3.6:1. The peak age of patients with head and neck cancer was 6th decade. 2. In all patients treated by RT, the ratio of squamous cell 1 carcinoma to non-squamous cell carcinoma was 3.5:1 (60/77 patients). 3. The incidence according to the anatomic site of primary tumor was 22 cases in the larynx, 12 cases in PNS, 7 cases in nasopharynx, 6 cases in oropharynx, and 3 cases in hypopharynx. 4. According to AJC staging system,4 cases were Stage 1,7 in Stage II, 19 in Stage III and 27 in Stage IV. 5. The overall incidence of cervical lymph node metastases was $43\%$ and subdigatric and submaxillary triangle lymph nodes were the most frequent site of metastases. 6. Local control was achieved in $48\%$ of patients treated by radio-therapy. 7. The lung was the most common site for distant metastases, comprising 4 cases among 7 cases in which distant metastases occured. 8. The overall estimated 5-year survival rate was $43\%$ in the head and neck cancer treated with radiotherapy by life-table analysis.

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Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema (비디오 흉강경을 이용한 농흉수술의 임상분석)

  • Oh, Sang-Gi;Song, Sang-Yun;Yun, Chi-Hyeong;Na, Kook-Ju;Kong, Kang-Eun;Park, Song-Ran;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.139-143
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    • 2010
  • Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.

The Relationship of Serum Angiotensin Converting Enzyme(ACE), Angiotensin II and Clinical Markers in the Idiopathic Interstitial Pneumonia (특발성 간질성 폐렴 환자에서 임상적 지표와 혈청 Angiotensin Converting Enzyme(ACE) 및 Angiotensin II와의 관계)

  • Kyung, Sung-Young;Hahn, Hye-Sook;Song, Suk-Ho;Hwang, Jun-Kyu;Lim, Young-Hee;An, Chang-Hyeok;Park, Gye-Young;Park, Jung-Woong;Jeong, Seong-Hwan;Ha, Seung-Yeon;Lee, Jae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.506-518
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    • 2002
  • Background : There have been several studies showing that angiotensin II and the angiotensin converting enzyme (ACE) contribute to the activation of fibroblast including the pulmonary fibrosis, and apoptosis of the alveolar epithelium in idiopathic intersititial pneumonia. This study was performed to identify the relationship between the serum angiotensin II, ACE and the pulmonary function test (PFT), the dyspnea score, and the cell fraction of the bronchoalveolar lavage fluid(BALF). Materials and Methods : Twenty three patients with idiopathic interstitial pneumonia from March, 1999 to October, 2001 at Gachon medical school were enrolled in this study. They were divided into IPF(UIP) (16) and NSIP (7) groups. Twelve of the idiopathic interstitial pneumonia patients (UIP : 5, NSIP : 7) were diagnosed by an open lung biopsy, 11 of IPF patients were diagnosed by the American Thoracic Society (ATS) diagnostic criteria. The PFT values, dyspnea score, serum ACE and angiotensin II were measured, and a bronchoscopy was performed to obtain the BALF. Results : Of all the patients, 7 were in the normal range and 14 showed an increase in the serum level of angiotensin II. In terms of the serum ACE level, 14 patients had an increased level. The DLCO% of the angiotensin II in increased group was significantly lower than the not-increased group (p=0.021). Other factors did not correlate with the serum ACE or the angiotensin II increased group and not-increased group. Conclusion : These results suggest that an increased angiotensin II serum level may be associated with increase in the of alveolar capillary block in the progression of pulmonary fibrosis in idiopathic interstitial pneumonia.

A Study on Effective Management & Administration System for Deluxe Hotel Kitchen in Seoul Area. (관공호텔 조리직무의 분업과 통합에 따른 문제점과 개선방안에 관한 연구)

  • 라영선
    • Culinary science and hospitality research
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    • v.1
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    • pp.57-89
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    • 1995
  • Despite prologed business stagnation of both international and domestic economy, hotel business as well as tourist industry has continuously been keeping growing, owing to increase of surplus income and world flowing population. During recent 4 years, growth rate of yearly mean in domestic hotels reached 9.9% and especially that of the superior class hotels 15.2%. In the composition of domestic tourist hotel's revenue, the earnings of guest rooms form 37.4%, on the other hand those of food & beverage 39.9%. This result is that our hotel business is concentrated on its interest in FOOD & BEVERAGE of which productivity per unit dimension can be increased to an unlimited extent and extent and superior class hotels strengthened in F&B are increasing in comparison with European or American hotels which are focused on guest rooms in their management. For value added rate of F&B is low as compared with increase of their earnings, they are interested in the management techniques which focus on rising the rate. As for the cost of Food & Beverage, personnel expenditure forms 36.5% and the direct materials 31.5%. Therefore how to manage personnel and materials costs which compose as much as 68% of total revenue will greatly affect net profit. We can say that an effective management technique in cost of Food & Beverage is one of the most important know-hows in hotel management. Especially management know-how for the Kitchen Department where the most of foods come out makes a great effects on various expenses, productivity and it is the achievement from hotel management. For the most of the hotel's top managers, they don't seriously take the fact that KITCHEN SYSTEM affects greatly total expenditure. This study starts from the point of recognizing the question of fundamental cause affecting tow largest cost elements incurred in Food & Beverage and trying to present an effective kitchen system. To settle the questions raised, I compared and analyzed productivity and cost of food & beverage and unit kitchen centered around superior class hotels in Seoul, which vary in Kitchen Systems. In order to attain the aforementioned study effectively purpose of this study, I compared Room-Service and Coffee-Shop Menu, flow of basic food in the kitchen, extent and result of division of labor and integration in the kitchen, scale of outlet kitchen, productivity, the turnover rate of food in store, food cost rate one another which all vary in Kitchen Systems. All these elements are compared and analyzed each other being divided into two main groups such as①. Main Production kitchen and Banquet Kitchen, and ②. coffee-shop kitchen and Room-service Kitchen. Therefore this study is to point out the problems in managing kitchens of superior class hotels which are different in systems. An effort was made to find out the better Kitchen System for superior deluxe hotels. I emphasize the followings on the proper scale of division of labor and integration of unit kitchen and a disposition plan for outlet kitchens of restaurant. First, KITCHEN SYSTEM as a sub-system of Hotel Management System is composed of sub-systems of outlet unit kitchen. Basic food materials are cooked and served for the guests while support kitchen and out restaurant kitchen interact organically each other. So Kitchen should be considered as a system composed of integrated sub-systems. Second, support and banquet kitchens should be integrated to be managed. And these unit kitchens have to be designed to be placed in the back of banquet rooms area. Third, coffee-shop kitchen and room-service kitchen should be integrated to be managed. Fourth, several unit business kitchens should be place on the same floor. Fifth, main production kitchens ought to be located near the loading duck, food store and large refrigerator. Sixth, considering the limits of supervision, duties should be adjusted as 12-20 cooks in two shifts a day for a sub-kitchen, and 18-30 cooks in three shifts a day so that labor division can be made. Last, I would like to two points for direction and task of future study. Firstly, I compare the effective income and increasing costs each other, which are incurred by increasing the use rate of the second processing materials for foods perched outside and through the results. I can find out the better points of the processing production and circulation system, and then I study this effects made on hotel kitchen system. Secondly, I can point out that more efficient kitchen system shall be established through comparing and analyzing the matter of amount of indirect costs and flow of food in different kitchen systems.

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Effects of Iterative Reconstruction Algorithm, Automatic Exposure Control on Image Quality, and Radiation Dose: Phantom Experiments with Coronary CT Angiography Protocols (반복적 재구성 알고리즘과 관전류 자동 노출 조정 기법의 CT 영상 화질과 선량에 미치는 영향: 관상동맥 CT 조영 영상 프로토콜 기반의 팬텀 실험)

  • Ha, Seongmin;Jung, Sunghee;Chang, Hyuk-Jae;Park, Eun-Ah;Shim, Hackjoon
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.28-35
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    • 2015
  • In this study, we investigated the effects of an iterative reconstruction algorithm and an automatic exposure control (AEC) technique on image quality and radiation dose through phantom experiments with coronary computed tomography (CT) angiography protocols. We scanned the AAPM CT performance phantom using 320 multi-detector-row CT. At the tube voltages of 80, 100, and 120 kVp, the scanning was repeated with two settings of the AEC technique, i.e., with the target standard deviations (SD) values of 33 (the higher tube current) and 44 (the lower tube current). The scanned projection data were reconstructed also in two ways, with the filtered back projection (FBP) and with the iterative reconstruction technique (AIDR-3D). The image quality was evaluated quantitatively with the noise standard deviation, modulation transfer function, and the contrast to noise ratio (CNR). More specifically, we analyzed the influences of selection of a tube voltage and a reconstruction algorithm on tube current modulation and consequently on radiation dose. Reduction of image noise by the iterative reconstruction algorithm compared with the FBP was revealed eminently, especially with the lower tube current protocols, i.e., it was decreased by 46% and 38%, when the AEC was established with the lower dose (the target SD=44) and the higher dose (the target SD=33), respectively. As a side effect of iterative reconstruction, the spatial resolution was decreased by a degree that could not mar the remarkable gains in terms of noise reduction. Consequently, if coronary CT angiogprahy is scanned and reconstructed using both the automatic exposure control and iterative reconstruction techniques, it is anticipated that, in comparison with a conventional acquisition method, image noise can be reduced significantly with slight decrease in spatial resolution, implying clinical advantages of radiation dose reduction, still being faithful to the ALARA principle.