The disease concept of interstitial lung disease with idiopathic pulmonary fibrosis at its core has been relied on for many years depending on morphological classification. The separation of non-specific interstitial pneumonia with a relatively good prognosis from usual interstitial pneumonia is also based on the perception that morphology enables predict the prognosis. Beginning with dust-exposed lungs, initially, interstitial pneumonia is classified by anatomical pathology. Diagnostic imaging has dramatically improved the diagnostic technology for surviving patients through the introduction of high-resolution computed tomography scan. And now, with the introduction of therapeutics, the direction of diagnosis is turning. It can be broadly classified into to make known the importance of early diagnosis, and to understand the importance of predicting the speed of progression/deterioration of pathological conditions. For this reason, the insight of "early lesions" has been discussed. There are reports that the presence or absence of interstitial lung abnormalities affects the prognosis. Searching for a biomarker is another prognostic indicator search. However, as is the case with many chronic diseases, pathological conditions that progress linearly are extremely rare. Rather, it progresses while changing in response to environmental factors. In interstitial lung disease, deterioration of respiratory functions most closely reflect prognosis. Treatment is determined by combining dynamic indicators as faithful indicators of restrictive impairments. Reconsidering the history being classified under the disease concept, the need to reorganize treatment targets based on common pathological phenotype is under discussed. What is the disease concept? That aspect changes with the discussion of improving prognosis.
Endobronchial tuberculosis is a serious disease which is frequently complicated with bronchial stenosis, and it may simulate a bronchial asthma or bronchogenic carcinoma. We have analyzed the clinical characteristics of endobronchial tuberculosis in 166 patients, and we introduce new classification of endobronchial tuberculosis. Endobronchial tuberculosis is classified into seven subtypes as stenotic type with fibrosis, stenotic type without fibrosis, actively caseating type, tumorous type, ulcerative type, granular type and nonspecific bronchitic type, according to the bronchoscopic findings. Actively caseaing type, stenotic type without fibrosis, nonspecific bronchitic type and stenotic type with fibrosis are predominant in the order of frequency, but ulcerative type and granular type are relatively rare. Stenotic type with or without fibrosis, actively caseating type and tumorous type of endobronchial tuberculosis are closely related to bronchial stenoses. We believe that our new classification of endobronchial tuberculosis, which is based on bronchoscopic features, is helpful to understand the pathogenesis of disease and to make a therapeutic plan for preventing or minimizing bronchial stenosis.
Seven specimens of salmon(Oncorhynchus keta) purchased directly, in Oct. 10. 1990, in the Taep'o port. Kang-won-do were examined for infection state of anisakid larvae and classification of extracted larvae according to morphological characters. The results were as follows. 1) From seven salmon 202 anisakid larvae were found, and mean infection number of anisakid larvae per individual salmon was 28.86. 2) From total extracted anisakid larvae 198 larvae(98%) were found in muscle. Therefore the distribution of anisakid larvae in intestine was extremely rare compared to in muscle. 3) The percentage of anisakid larvae in II, IV muscle region was 93% and from this we could surmise that most anisakid larvae in salmon did not penetrate to the very distanted muscle from intestine. 4) Three types of anisakid larvae(Anisakis Type I, Contracaecum Type B, Contracaecum Type D) were identified and, among them, Contracaecum Type B was the first recording type in Korea 5) Larvae of Contracaecum it genus were found only in intestine. Therefore it surmised that penetration neture to muscle of Contracaecum larvae was less than that of Anisakis Type I.
The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.
Schembri, Emanuel;Barrow, Michelle;McKenzie, Christopher;Dawson, Andrew
The Korean Journal of Pain
/
제35권1호
/
pp.4-13
/
2022
Changes in diagnostic criteria, for example, the various International Classification of Headache Disorders criteria, would lead to changes in the outcomes of epidemiological studies. International Classification of Headache Disorders-1 was based mainly on expert opinion, yet most of the diagnostic criteria were reliable and valid, but it did not include chronic migraine. In its second version, the classification introduced chronic migraine, but this diagnosis resembled more a high-frequency migraine rather than the actual migraine transformation process. It also introduced medication overuse headache, but it necessitated analgesic withdrawal and subsequent headache improvement to be diagnosed as such. Hence patients having medication overuse headache could only be diagnosed in retrospect, which was an awkward situation. Such restrictive criteria for chronic migraine and medication overuse headache omitted a high proportion of patients. International Classification of Headache Disorders-3 allows a diagnosis of medication overuse headache due to combination analgesics if taken for at least 10 days per month for more than three months. Hence the prevalence rate of medication overuse headache and chronic migraine can increase compared to the previous version of the headache classification. Different criteria have been used across studies to identify chronic migraine and medication overuse headache, and therefore the information acquired from previous studies using earlier criteria becomes uncertain. Hence much epidemiological research would need to be interpreted cautiously or repeated with the most updated criteria, since the subjects in studies that apply the latest criteria may be phenotypically different from those in older studies.
Three types of serotypically atypical Shigella flexneri isolates were collected between 2007 and 2008 from Korean patients at the Korea National Institute of Health (NIH). These atypical isolates were characterized and compared with serologically typical S. flexneri. The first grouping of 11 atypical isolates displayed agglutination only with polyB antiserum and exhibited no reaction with any typing or grouping sera (PolyB:un). The second group of 3 isolates displayed reactions with typing sera IV, but also did not bind with any grouping sera (IV:un). The third group of 14 isolates exhibited a plural agglutination pattern, reacting with typing sera II, and two grouping sera (II:(3)4,7(8)). Amongst these atypical isolates, isolates belonging to IV:un and II:(3)4,7(8) exhibited greater antibiotic resistance, in particular to ampicillin, streptomycin, and trimethoprim-sulfamethoxazole, than typical S. flexneri strains. Furthermore, all II:(3)4,7(8) strains harbored integrons. This study suggests that these multiple antibiotic-resistant atypical S. flexneri are new subserotypes of S. flexneri that await further serological classification.
Objectives : This study was designed to examine and analyze the recent trend of Korean medicine research on retinal and optic nerve diseases, which is increasing. Methods : This study examines papers related to diseases occurring in the retina and optic nerve that were published in Korean journals of Korean medicine, and analyzes the results of research so far by classifying them by year, journal, disease type and type of paper. Results : 1. Since it was first published in 1995, a total of 17 articles have been published until 2018, with 2 articles(11.1%) each in 1997, 2014 and 2018, and 1 article(5.6%) each in other years. 2. The number of searched journals was 17 paper; 4 review articles, 1 original articles, 12 case reports. 3. Distribution of journals; the percentage of Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology ranked the highest(41.2%). 4. Classification of 12 case reports into three categories; 7 retinal diseases, 3 optic nerve diseases, 2 other diseases. Conclusions : Currently, researches on retinal and optic nerve involvement in the Korean medicine journals have been conducted mainly through case reports. In the future, more clinical research and case reports are necessary to give practical application to patients.
Objectives: In this study, we analyze statistics on industrial accidents caused by chemical skin contact and provide skin toxicity hazard information on the related domestic system and circulation volumes. Methods and Results: We analyzed occupational fatalities and skin diseases caused by chemical leaks and contact from 2007 to 2016(10 years) and surveyed data on occupational skin diseases using the 2014 work environment survey data. The NIOSH Skin Notation Profiles for 57 chemical substances, which are provided to prevent occupational skin diseases, were searched and hazard information on skin contact with chemical substances was classified. In order to identify skin toxicity information among domestically distributed and legally regulated substances and to investigate skin-toxic substances, MSDS basic data on 19,740 chemical substances provided on the homepage of Korea Occupational Safety & Health Agency were searched. Acute toxicity(dermal) category 1-4 substances totaled 1,020, and the number of chemical substances classified as category 1 and 2 substances were 135 and 137, respectively. In the chemical substances prescribed by the Ministry of Employment and Labor, 173 substances were classified into acute toxicity(dermal) categories 1-4, 58 of which correspond to category 1 or 2. Conclusions: Within the present range of industrial accidents, the proportion of skin diseases due to contact with chemicals is not high. However, there is always a risk of occupational skin diseases due to increasing chemicals and due to the use of new chemicals. It is hoped that this information will be used by workplace safety and health officials and health and safety experts to prevent acute toxity(dermal) due to chemical skin contact.
In order to secure practising rapid pattern(證, zheng) differentiation against acute infectious diseases like corona virus disease-19(COVID-19) showing rapid variation and contagion, a simplified classification of stages centering on the exterior-interior pattern identification with 2 step-subdivision by cold, heat, deficiency, excess pattern and pathogens is proposed. Pattern differentiation by compound patterns of 8 principles is made for the non-severe stage of general cold and the early mild stage of epidemic disease. Compound pattern's names of 8 principles about external infectious diseases are composed of three stages, that is disease site-characters-etiology. Based on early stage symptoms of fever or chilling etc., exterior, interior and half exterior and half interior patterns are determined first, and then cold, heat, deficiency, excess patterns of exterior and interior pattern respectively are determined, and then more concrete differentiation on pathogens of wind, dryness, dampness and dearth of qi, blood, yin, yang accompanied with constitutional and personal illness factors. Summarizing above descriptions, 4 patterns of exterior cold, exterior heat, exterior deficiency, exterior excess and their secondary compound patterns of exterior cold deficiency and exterior cold excess and so on are classified together with treatment method and available decoction for a standard measure of eight principle pattern differentiation.
Particulate matter exposure leva1 of welders and grinding workers was evaluated in Banwol and Changwon industry complexes. Full period single sample and full period consecutive samples were collected with personal air samplers attached to workers. Compliance difference with 8-hour time weighted average (TWA) was compared by Korean strategy and the classification system recommended by OHSA for employee exposure to particulates. And difference of compliance was compared according to precision of measurement and analysis (total precision). Compliance rate was depended on the total precision, therefore, quality control of measurement and analysis was important.
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