• Korean Journal of Radiology
• /
• v.21 no.6
• /
• pp.736-745
• /
• 2020

Objective: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. Results: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. Conclusion: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.

• 한국석유지질학회:학술대회논문집
• /
• autumn
• /
• pp.63-65
• /
• 2001

The Chosen Supergroup (Cambro-Ordovician), mid-east Korea consists mainly of shallow marine carbonates and contains a variety of limestone conglomerates. These conglomerates largely comprise oligomictic, rounded lime-mudstone clasts of various size and shape (equant, oval, discoidal, tabular, and irregular) and dolomitic shale matrices. Most clasts are characterized by jigsaw-fit (mosaic), disorganized, or edgewise fabric and autoclastic lithology. Each conglomerate layer is commonly interbedded with limestone-dolomitic shale couplets and occasionally underlain by fractured limestone layer, capped by calcareous shale. According to composition, characteristic sedimentary structures, and fabric, limestone conglomerates in the Hwajol, Tumugol, Makkol, and Mungok formations of Chosen Supergroup can be classified into 4 types: (1) disorganized polymictic conglomerate (Cd), (2) horizontally stratified polymictic conglomerate (Cs), (3) mosaic conglomerate (Cm), and (4) disorganized/edgewise oligomictic conglomerate (Cd/e). These conglomerates are either depositional (Cd and Cs) or diagenetic (Cm and Cd/e) in origin. Depositional conglomerates are interpreted as storm deposits, tidal channel fills, or transgressive lag deposits. On the other hand, diagenetic conglomerates are not deposited by normal sedimentary processes, but formed by post-depositional diagenetic processes. Diagenetic conglomerates in the Chosen Supergroup are characterized by autoclastic and oligomictic lithology of lime-mudstone clasts, jigsaw-fit (mosaic) fabric, edgewise fabric, and a gradual transition from the underlying bed (Table 1). Autoclastic and oligomictic lithologies may be indicative of subsurface brecciation (fragmentation). Consolidation of lime-mudstone clasts pre-requisite for brecciation may result from dissolution and reprecipitation of CaCO3 by degradation of organic matter during burial. Jigsaw-fit fabric has been considered as evidence for in situ fragmentation. The edgewise fabric is most likely formed by expulsion of pore fluid during compaction. The lower boundary of intraformational conglomerates of depositional origin is commonly sharp and erosional. In contrast, diagenetic conglomerate layers mostly show a gradual transition from the underlying unit, which is indicative of progressive fragmentation upward (Fig. 1). The underlying fractured limestone layer also shows evidence for in situ fragmentation such as jigsaw-fit fabric and the same lithology as the overlying conglomerate layer (Fig, 1). Evidence from the conglomerate beds in the Chosen Supergroup suggests that diagenetic conglomerates are formed by in situ subsurface fragmentation of limestone layers and rounding of the fragments. In situ subsurface fragmentation may be primarily due to compaction, dewatering (upward-moving pore fluids), and dissolution, accompanying volume reduction. This process commonly occurs under the conditions of (1) alternating layers of carbonate-rich and carbonate-poor sediments and (B) early differential cementation of carbonate-rich layers. Differential cementation commonly takes place between alternating beds of carbonate-rich and clay-rich layers, because high carbonate content promotes cementation, whereas clay inhibits cementation. After deposition of alternating beds and differential cementation, with progressive burial, upward-moving pore fluid may raise pore-pressure in the upper part of limestone layers, due to commonly overlying impermeable shale layers (or beds). The high pore-pressure may reinforce propagation of fragmentation and cause upward-expulsion of pore fluid which probably produces edgewise fabric of tabular clasts. The fluidized flow then extends laterally, causing reorientation and further rounding of clasts. This process is analogous to that of autobrecciation, which can be analogously termed autoconglomeration. This is a fragmentation and rounding process whereby earlier semiconsolidated portions of limestone are incorporated into still fluid portions. The rounding may be due mainly to immiscibility and surface tension of lime-mud. The progressive rounding of the fragmented clasts probably results from grain attrition by fluidized flow. A synthetic study of limestone conglomerate beds in the Chosen Supergroup suggests that very small percent of the conglomerate layers are of depositional origin, whereas the rest, more than $80\%$, are of diagenetic origin. The common occurrence of diagenetic conglomerates warrants further study on limestone conglomerates elsewhere in the world.

• The Journal of the Korean bone and joint tumor society
• /
• v.10 no.1
• /
• pp.13-21
• /
• 2004

Purpose: We analyzed the result of autologous bone marrow stromal cell transplantation with or without cancellous chip bone allograft for benign long bone lesions. Materials and methods: Since July 1996, eight benign bone lesions treated by curettage, cancellous chip bone allograft and bone marrow or marrow stromal cell transplantation were observed for resolution of clinical symptoms, new bone formation and consolidation. There were 6 males and 2 females. Average age was 24 (range 8 to 47) years old. Histologic diagnoses were 5 fibrous dysplasia, 2 simple bone cysts and one chondroblastoma and fibrous cortical defect each. Mean follow-up period was 16.3 (range 3 to 84) months. Results: In all four symptomatic patients, the pain was subsided in two weeks after surgery. New bone formation in the lesion was observed at 4 weeks, which incorporated into surrounding normal bone around 8 weeks. There were one pathologic fracture through the lesion at 3 weeks and one recurrence of simple bone cyst at 5 months postoperatively. Conclusion: Bone marrow or marrow stromal cell transplantation for bone defects from curettage of benign bone lesions, with or without cancellous chip bone allograft revealed rapid healing. Though it was the result of short-term follow up, it supports that bone marrow stromal cell transplantation will be very useful for the treatment of benign long bone cysts or other lesions. The complete curettage of inner cystic wall is important to prevent later recurrence, and the rigid internal fixation is also needed in selected high risk lesions of fracture.

• (The)Study of the Eastern Classic
• /
• no.37
• /
• pp.217-248
• /
• 2009

'Pil-dam-chang-su-jib'(collection of conversation by writing about poetry or sentences) which was remained in Japan through the dispatching of Tong-sin mission belong to the Joseon dynasty is a valuable historical records directly to verify sincere relationships with Korea and Japan in the past. At the center of the 'Pil-dam-chang-su-jib', a conversation of senators who was technocrat both countries at that time was not a little contained. Because they need to exchange information and opinions which they had been curious at an appointed hour, the most impending medical problems of that period had to be brought out in the senator's 'Pil-dam-chang-su-jib' and the value of material is high as much. If you examine the 'Pil-dam' records which was exchanged from senators to senators of both countries at that time, you can directly confirm the universality and difference of the medical science and medicine tradition of various East Asian countries. The purpose of a paper was in consolidation to a base of translation and investigation hereafter to consider the characters embodied in medical conversation in the first half of $18^{th}$ centuries. '~ Rok(錄)' can be an opportunity to organize the customs history through the studying an illness, medicines and a remedy. The necessity of the investigation about medical related conversation by writing is in this place. '~ Ui-dam(醫談)' is considering with the all factors above, the first half of 18th century's medical conversation materials are certificated remarkably valuable materials to the cultural history around the physician at that time. '~ Pil-ur(筆語)' is to use of questions and answers form gives presence and reality at the conversation by writing. So, conversation was let the readers to gain the feeling of movement. Also, the contents are substantially reflected the long history of Eastern medical and revealed medical science, treatment reality at that time. Not correspondent with normal collection of conversation by writing, the medical conversation by writing shows a special quality at rich material to confirm the technocrat's identity. The first half of $18^{th}$ century medical conversation by writing had been a foundation of the rational description system at the coming medical conversation to change the description system according to the envoy's coming situation.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.671-682
• /
• 1996

Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.