• Tuberculosis and Respiratory Diseases
• /
• v.51 no.4
• /
• pp.334-345
• /
• 2001

Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.2
• /
• pp.165-174
• /
• 1999

Background: Coal-worker's pneumoconiosis(CWP) is radiologically divided into two major groups: simple pneumoconiosis (SP), in which small, rounded or irregular opacities smaller than 1cm are observed, and progressive massive fibrosis(PMF), which is characterized by opacities larger than 1cm. SP has a life expectancy equivalent to miners with no radiographic evidence of CWP, but PMF is associated with more obvious impairments of ventilatory capacity and premature death. But only minority of workers develop PMF when exposed to dust concentrations similar to those experienced by workers who develop only SP. In this study, immune status in patients with CWP were evaluated by measurement of the serum immunoglobulin levels between control, SP and PMF groups. Method: Coal workers selected for this study were emplyees of the Tae-Baek and Dong-Hae Hospital. All the patients were men of 45-76 years old and the mean duration of exposure to coal dust were 23.2 years. By X-ray examination, 51 patients were classified in SP, 59 in PMF category. The normal controls examined were 58 men of 26-70 years old. Serum Ig levels were estimated by using Nephelometer(Behring Nephelometer : Germany) and serum were collected 51 in SP, 49 in PMF and 57 cases in control group. Results: The levels of IgG were increased but the levels of IgM were decreased with increasing age in control groups. There were no statistical difference of immunoglobulin levels between smokers and nonsmokers in control groups. There were no statistical difference of immunoglobulin levels between Control, SP and PMF groups. Multiple regression analysis were undertaken to determine the statistical significance of the apparent trends and estimate the effects associated with age, smoking habit and radiological category of CWP. According to this analysis, the levels of IgG were decreased significantly in SP group and had decreasing tendancy, but not statistically significant in PMF group. Conclusion : From the observations described, CWP patients had decreased IgG concentration compared to control gorup. Therefore, there was some relation between CWP and immunoglobulin concentration.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.4
• /
• pp.330-337
• /
• 2002

Background : A pulmonary tuberculoma is one of the most common causes of a solitary pulmonary lesion. Treating a tuberculoma is still controversial and there are few reports on antituberculosis chemotherapy. In this study, the clinical findings and changes in the size of tuberculomas on a radiograph after completing antituberculosis chemotherapy was investigated. Methods : The medical records, an chest radiographs of 18 pulmonary tuberculoma patients who were admitted to the Gachon medical school, Ghil medical center between April 1998 and August 2001, were reviewed. The symptomatic changes were recorded and the size of the tuberculomas following treatment were compared. To compare the size, the long distance of each tuberculoma on the chest radiographs were measured and the additional radiological findings of calcification, satellite nodules and cavities were investigated. Results : Fifteen patients were men and 3 were women. The median age was 46 (24-74). Among these 18 patients, 14 patients had clinical symptoms. The other 4 patients were diagnosed incidentally as during a routine chest radiograph. The mean size of the tuberculomas on the initial plain chest film was $4.3{\pm}2.3cm$(range : 1.7-10 cm) and after 6 months treatment, it had decreased to $1.68{\pm}2.00cm$(range : 1.5-6.5 cm) (P<0.05). At least 6 months of antituberculosis chemotherapy resulted in the findings of a tuberculoma with a disappearance in 9, a decreased size in 4, and no change in 5 on the chest radiograph. Calcifications were found in 3 patients on the initial chest film and the chest CT and all calcified tuberculomas had disappeared after treatment. Conclusion : Although a pulmonary tuberculoma can remain as an inactive lesion for a long time, if it is confirmed by pathological or bacteriological methods, antituberculosis chemotherapy will be beneficial despite the presence of calcification.

• Tuberculosis and Respiratory Diseases
• /
• v.57 no.3
• /
• pp.226-233
• /
• 2004

Background : Interferon-gamma (IFN-${\gamma}$) is a critical cytokine in the defense against a Mycobacterium tuberculosis infection. Even though IFN-${\gamma}$ has occasionally been used in the treatment of refractory multidrug-resistant tuberculosis (MDR-TB) with some promising results, there is still some controversy regarding the therapeutic efficacy of IFN-${\gamma}$. This study was performed to examine the effect of subcutaneous IFN-${\gamma}$ in the treatment of MDR-TB patients. Methods : Six patients with refractory MDR-TB were enrolled in this study. Two million IU of IFN-${\gamma}$ was administered subcutaneously three times a week with the concomitant administration of antituberculous drugs for at least for 28 weeks. During the IFN-${\gamma}$ therapy, the sputum smear and culture, radiological and clinical evaluations were performed every 4 weeks throughout the study period. Results : The mean age of the 6 patients was 37 years (ranges, 15-61 years). The drug susceptibility test to standard antituberculous drugs revealed resistance to an average of 6.8 (${\pm}1.2$) agents including isoniazid and rifampicin. An average of 10.8 (${\pm}1.3$) antituberculous drugs were prescribed before IFN-${\gamma}$ therapy. The culture became negative in 2 patients (33%) after initiating IFN-${\gamma}$ therapy; one at 8 weeks, and the other at 24 weeks. Finally, after stopping the IFN-${\gamma}$ therapy after 28 weeks, the culture became positive again in the two patients who were culture-negative. The other 4 patients who failed in the culture conversion are still on antituberculous treatment except for one who died of tuberculosis. Conclusion : Even though 28 weeks of subcutaneous IFN-${\gamma}$ therapy in combination with antituberculous drugs was successful in inducing the culture-negative conversion in some patients with refractory MDR-TB, the culture became positive again after stopping the IFN-${\gamma}$ therapy. This suggests that subcutaneous IFN-${\gamma}$ therapy may have suppressive effect on tuberculosis only during the IFN-${\gamma}$ therapy period in some patients. Further studies will be needed to determine the optimum dose, the administration route, the duration of therapy, and the predicting factors of the response to adjuvant IFN-${\gamma}$ therapy.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.3
• /
• pp.285-289
• /
• 2006

Background : North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. Material and Methods : From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. Results : A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. Conclusion : The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.

• Progress in Medical Physics
• /
• v.26 no.4
• /
• pp.280-285
• /
• 2015

In radiation therapy fields, a brachytherapy is a treatment that kills lesion of cells by inserting a radioisotope that keeps emitting radiation into the body. We currently verify the consistency of radiation treatment plan and dose distribution through film/screen system (F/S system), provide therapy after checking dose. When we check dose distribution, F/S systems have radiation signal distortion because there is low resolution by penumbra depending on the condition of film developed. In this study, We fabricated a $HgI_2$ Semiconductor radiation sensor for base study in order that we verify the real dose distribution weather it's same as plans or not in brachytherapy. Also, we attempt to evaluate the feasibility of QA system by utilizing and evaluating the sensor to brachytherapy source. As shown in the result of detected signal with various source-to-detector distance (SDD), we quantitatively verified the real range of treatment which is also equivalent to treatment plans because only the low signal estimated as scatters was measured beyond the range of treatment. And the result of experiment that we access reproducibility on the same condition of ${\gamma}$-ray, we have made sure that the CV (coefficient of variation) is within 1.5 percent so we consider that the $HgI_2$ sensor is available at QA of brachytherapy based on the result.

• Journal of the Korean Society of Radiology
• /
• v.6 no.5
• /
• pp.343-349
• /
• 2012

Intensity Modulated Radiotherapy (IMRT) is increasing its use recently due to its benefits of minimizing the dose on surrounding normal organs and being able to target a high dose specifically to the tumor. The study aims to measure and evaluate the dose distribution according to its dynamic changes in Mapcheck. In order to verify the dose distribution by EDW angle($10^{\circ}$,$15^{\circ}$,$20^{\circ}$,$25^{\circ}$,$30^{\circ}$,$45^{\circ}$,$60^{\circ}$), field size (asymmetric field) and depth changes (1.5 cm, 5.0 cm) using IMRT in Clinac ix, a solid phantom was placed on the Mapcheck and 100MU was exposed by 6 MV, 10MV X-ray. Using a 6MV, 10MV energy, the percentage depth dose according to a dynamic changes at a maximum dose depth (1.5 cm) and at 5.0 cm depth showed the value difference of maximum 0.6%, less than 1%, which was calculated by a treatment program device considering the maximum dose depth at the center as 100%, the percentage depth dose was in the range between 2.4% and 7.2%. Also, the maximum value difference of a percentage depth dose was 4.1% in Y2-OUT direction, and 1.7% in Y1-IN direction. When treating a patient using a wedge, it is considered that using an enhanced dynamic wedge is effective to reduce the scattered dose which induces unnecessary dose to the surroundings. In particular, when treating a patient at clinic, a treatment must be performed considering that the wedge dose in a toe direction is higher than the dose in a heel direction.

• Journal of the Korean Society of Radiology
• /
• v.11 no.6
• /
• pp.493-500
• /
• 2017

In this study, data analysis has been conducted by INFINITT program to analyze the effect of signal to noise ratio(SNR) and contrast to noise ratio(CNR) of flow related enhancement(FRE) and computed tomography Angiography(CTA) on cerebrovascular diseases for qualitative evaluations. Based on the cerebrovascular image results achieved from 63 patients (January to April, 2017, at C University Hospital), we have selected 19 patients that performed both FRE-MRA and CTA. From the 19 patients, 2 were excluded due to artifacts from movements in the cerebrovascular image results. For the analysis conditions, we have set the 5 part (anterior cerebral artery, right and left Middle cerebral artery, right and left Posterior cerebral artery) as the interest area to evaluate the SNR and CNR, and the results were validated through Independence t Test. As a result, by averaging the SNR, and CNR values, the corresponding FRE-MRA achieved were: anterior cerebral artery ($1500.73{\pm}12.23/970.43{\pm}14.55$), right middle cerebral artery ($1470.16{\pm}11.46/919.44{\pm}13.29$), left middle cerebral artery ($1457.48{\pm}17.11/903.96{\pm}14.53$), right posterior cerebral artery ($1385.83{\pm}16.52/852.11{\pm}14.58$), left posterior cerebral artery ($1318.52{\pm}13.49/756.21{\pm}10.88$). by averaging the SNR, and CNR values, the corresponding CTA achieved were: anterior cerebral artery ($159.95{\pm}12.23/123.36{\pm}11.78$), right middle cerebral artery ($236.66{\pm}17.52/202.37{\pm}15.20$), left middle cerebral artery ($224.85{\pm}13.45/193.14{\pm}11.88$), right posterior cerebral artery ($183.65{\pm}13.47/151.44{\pm}11.48$), left posterior cerebral artery ($177.7{\pm}16.72/144.71{\pm}11.43$) (p < 0.05). In conclusion, MRA had high SNR and CNR value regardless of the cerebral infarction or cerebral hemorrhage observed in the 5 part of the brain. Although FRE-MRA consumed longer time, it proved to have less side effect of contrast media when compared to the CTA.

• Molecules and Cells
• /
• v.38 no.3
• /
• pp.210-220
• /
• 2015

Athletic performance is an important criteria used for the selection of superior horses. However, little is known about exercise-related epigenetic processes in the horse. DNA methylation is a key mechanism for regulating gene expression in response to environmental changes. We carried out comparative genomic analysis of genome-wide DNA methylation profiles in the blood samples of two different thoroughbred horses before and after exercise by methylated-DNA immunoprecipitation sequencing (MeDIP-Seq). Differentially methylated regions (DMRs) in the pre-and post-exercise blood samples of superior and inferior horses were identified. Exercise altered the methylation patterns. After 30 min of exercise, 596 genes were hypomethy-lated and 715 genes were hypermethylated in the superior horse, whereas in the inferior horse, 868 genes were hypomethylated and 794 genes were hypermethylated. These genes were analyzed based on gene ontology (GO) annotations and the exercise-related pathway patterns in the two horses were compared. After exercise, gene regions related to cell division and adhesion were hypermethylated in the superior horse, whereas regions related to cell signaling and transport were hypermethylated in the inferior horse. Analysis of the distribution of methylated CpG islands confirmed the hypomethylation in the gene-body methylation regions after exercise. The methylation patterns of transposable elements also changed after exercise. Long interspersed nuclear elements (LINEs) showed abundance of DMRs. Collectively, our results serve as a basis to study exercise-based reprogramming of epigenetic traits.

• Pediatric Infection and Vaccine
• /
• v.17 no.2
• /
• pp.148-155
• /
• 2010

Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.