• Journal of Korean Academy of Nursing
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• v.4 no.2
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• pp.1-16
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• 1974

This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.1
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• pp.5-28
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• 2001

Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.65-83
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• 2000

To know the relationship of general characteristics with activities of daily living(ADL) and instrumental activities of daily living(IADL), we carried out the study on the elderies living in Chollabuk-Do area during 6 months, from June to December in 1999. Study subjects were 281, women and men were 195(69.6%) and 85(30.4%) respectively. Mean ages of women and men were 71.9 and 70.8 respectively. 81.1% elderies has disease and 18.9% were disease free. Disease prevalences of movement joint disease, others, circulatory disease, digestive disease, dental disease, respiratory disease were 50.1%, 25.0%, 10.5%, 9.4%, 8.5%, and 6.3% respectively. The percentages to the use of medical institution in recent were 40.0% for hospital, 16.8% for oriental hospital, 14.5% for public health center, 10.9% for drug store, 10.0% for others, and 7.8% for dental service. The percentages to the improvement of symptom after the use of medical institution were 62.3% for normal, 19.4% for improvement, and 18.2% for non-improvement. The percentages to the health situation were 37.1% for bad, 35.7% for good, and 27.1% for normal. Activities of daily living were 67.1% for 6 scores, 27.9% for 5 scores, 2.1% for 4 scores and ADL of women was lower than the men's. Instrumental activities of daily living were 50.4% for 5 scores, 19.3% for 3 scores, 12.1% for 4 scores and IADL of women was lower than the men's. Frequencies of disability in ADL were 28.9% for incontinence, 6.1% for bathing, 2.9% for meal, 2.5% for walking around house, 1.8% for toilet use, 1.4% for dressing and disability frequencies of women in 6 items of ADL were higher than the men's. The percentages of high, intermediate, low ADL in activities of daily living were 67.1%, 32.5%, 0.4% respectively and decrease of high ADL, increase of intermediate ADL were found with the increasing of age. Frequencies of disability in IADL were 42.9% for payment in and out, 31.8% for payment of written claim, 21.1% for shopping, 16.4% for preparation of meal, and 11.8% for use of bus. All items of women in IADL was higher than the men's but preparation of meal. The percentages of high, intermediate, low IADL in instrumental activities of daily living were 50.4%, 42.5%, 7.1% and decrease of high IADL, increase of intermediate IADL were found with the increasing of age. Mean of ADL with the general characteristics was 5.56 and 2 variables of level of education, health situation were statistically significant. Mean of IADL with the general characteristics was 3.76 and 8 variables of age, sex, level of education, occupation, presence of spouse, duty of living cost, health situation, category of ADL were statistically significant. With the result of stepwise regression, ADL was statistically related with religion, health situation and ADL was statistically related with level of education, living together with family, duty of living cost, health situation.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.51-63
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• 2000

Ten Dongs were selected according to the systematic cluster sampling in Koryong Gun, and the survey was conducted on 571 women in the age between 30-69 years. The first survey was performed for 6 days between August 27 to September 1, 1999 with the investigation rate of 60.3%, and the second survey was performed in November with the investigation rate of 91.8%. The contents of survey included demographic characteristics, health behaviors, dyspepsia symptom score, sleeping induction time and the degree of sleep satisfaction, and degree of stress in the subjects. The dyspepsia symptom score was in the average 13.4 points out of a total 44 points and was the highest in the 50-59 year-old age group with 13.9 points. The sleep induction time was in the average of 35 minutes and was the highest in the 50-59 year-old age group with 40.9 minutes; the degree of sleep satisfaction was in the average of 7.9 points and was the lowest in the 50-59 year-old age group with 7.5 points. The stress score was in the average of 18.3 points and was highest in those subjects in their 40's and 50's with 18.7 points. When the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was analyzed, the results showed that he stress score and the degree of sleep satisfaction showed a significant negative correlation and that the stress score and dyspepsia symptom score showed a significant positive correlation. Also, a significant negative correlation was found between the degree of sleep satisfaction and dyspepsia symptom score. According to each age group, a significant correlation was revealed among the stress score, dyspepsia symptom score and the degree of sleep satisfaction in those subjects over 40 years of age compared to those subjects who were younger than 40 years of age. As for educational level, the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was higher in those subjects with less than middle school education compared to those subjects with more than high school education. When those factors that effects on the dyspepsia symptom score were analyzed with multiple regression, the results showed that the level of stress and chronic diseases were selected as significant variables. When those factors that affected on the degree of sleep satisfaction were analyzed, the sleep induction time and presence of chronic diseases and stress were selected as significant variables. Those women in their 50's who live in rural areas showed the highest level of stress, lowest the degree of sleep satisfaction, and highest level of dyspepsia, indicating that they need stress management. Also, since stress was showed to be a significant variable effecting on dyspepsia or the degree of sleep satisfaction, it is concluded that health promotion is possible through stress management. More studies are needed in the future on coping resources that would strengthen coping against stress, and by conducting studies on stress and related factors on community people, the measures of mental health promotion need to be developed.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.713-722
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• 1995

Background: Chest X-ray of coal workers' pneumoconiosis and shipyard welders' lung show similar and regular opacities mostly, it is very difficult that we distinguish the former from the latter by only chest X-ray. so we performed this study to understand the progression of the disease and to provide the disease by considering pulmonary function and other factors in proportion to the profusion of small regular opacities of chest X-ray in both groups. Method: 430 coal workers' pneumoconiosis were compared with 311 shipyard welders' lung by the number, the age, the duration of dust exposure, %vital capacity(%VC), %FEV1.0, the type of ventilatory impairment, the combined pulmonary disease according to the profusion of small regular opacities on the chest radiographs, which were classified into category 0/1, category 1, and category 2. Result: 1) the percent of category 2 in coal workers' pneumoconiosis was 54.4%. the percent of category 1, and category 2 in welders' lung were 60.0%, 7.4%. the progression to the category 2 was higher in coal workers' pneumoconiosis than in welders' lung 2) The mean age was higher in coal workers' pneumoconiosis than in welders' lung, significantly increased in proportion to the progresion of profusion of small regular opacities in both groups 3) There was no difference in the duration of dust exposure by category 1/0, but the duration of dust exposure by category 1, 2 in coal workers' pneumoconiosis more significantly increased than in welders' lung. the duration in the proportion of category 2 to category 0/1, 1 significantly increased in the proportion to small regular opacities in coal workers' pneumoconiosis. but there was no significant difference in the proportion to small regular opacities in duration of dust exposure in welders' lung. 4) There was no significant difference of mean values of %VC(%vital capacity)in both groups except for category 1. the mean values of %VC had no relationship between the progression of small regular opacities in both groups. 5) The mean values of %FEV1.0 decreased more significantly in coal workers' pneumoconiosis than in welders' lung except for category 0/1. and decreased significantly in proportion to the profusion of small regular opacities in coal workers' pneumoconiosis. there was significant difference of %FEV1.0 in the proportion of category 2 to category 011 in welders' lung. 6) there were no significant difference of %FEV1.0, %VC in smoker and nonsmoker in both groups. 7) With regard to the type of ventilation in both groups in coal workers' pneumoconiosis 21.4 percent of patients belonged to the restrictive type, 11.6 percent to the obstructive type, 5.6 percent to the combined type, but in welders' lung 21.8 percent to the restrictive type, 2.9 percent to the obstructive type, 1.9 percent to the combined type. 8. in the pulmonary disease, the incidence of the pulmonary tuberculosis was the most in both groups, was more in coal workers' pneumoconiosis than welders' lung Conclusion: If we compare coal workers' pneumoconiosis with electric arc welders'lung by considering pulmonary function and other factors in proportion to the profusion of chest X-ray, I think that we will have the better result in understanding the progression of the disease and provision of the disease in both groups.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.201-209
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• 1996

Background : Auto-PEEP which develops when expiratory lung emptying is not finished until the beginning of next inspiration is frequently found in patients on mechanical ventilation. Its presence imposes increased risk of barotrauma and hypotension, as well as increased work of breathing (WOB) by adding inspiratory threshold load and/or adversely affecting to inspiratory trigger sensitivity. The aim of this study is to evaluate the relationship of auto-PEEP with WOB and to evaluate the effect of PEEP applied by ventilator (external PEEP) on WOB in patients with auto-PEEP. Method : 15 patients, who required mechanical ventilation for management of acute respiratory failure, were studied. First, the differences in WOB and other indices of respiratory mechanics were examined between 7 patients with auto-PEEP and 8 patients without auto-PEEP. Then, we applied the 3 cm $H_2O$ of external PEEP to patients with auto-PEEP and evaluated its effects on lung mechanics as well as WOB. Indices of respiratory mechanics including tidal volume ($V_T$), repiratory rate, minute ventilation ($V_E$), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), peak inspiratory pressure (PIP), $T_I/T_{TOT}$, auto-PEEP, dynamic compliance of lung (Cdyn), expiratory airway resistance (RAWe), mean airway resistance (RAWm), $p_{0.1}$, work of breathing performed by patient (WOB), and pressure-time product (PTP) were obtained by CP-100 Pulmonary Monitor (Bicore, USA). The values were expressed as mean $\pm$ SEM (standard error of mean). Results : 1) Comparison of WOB and other indices of respiratory mechanics in patients with and without auto-PEEP : There was significant increase in WOB ($l.71{\pm}0.24$ vs $0.50{\pm}0.19\;J/L$, p=0.007), PTP ($317{\pm}70$ vs $98{\pm}36\;cm$ $H_2O{\cdot}sec/min$, p=0.023), RAWe ($35.6{\pm}5.7$ vs $18.2{\pm}2.3\;cm$ H2O/L/sec, p=0.023), RAWm ($28.8{\pm}2.5$ vs $11.9{\pm}2.0cm$ H2O/L/sec, p=0.001) and $P_{0.1}$ ($6.2{\pm}1.0$ vs 2.9+0.6 cm H2O, p=0.021) in patients with auto-PEEP compared to patients without auto-PEEP. The differences of other indices including $V_T$, PEFR, $V_E$ and $T_I/T_{TOT}$ showed no significance. 2) Effect of 3 cm $H_2O$ external PEEP on respiratory mechanics in patients with auto-PEEP : When 3 cm $H_2O$ of external PEEP was applied, there were significant decrease in WOB ($1.71{\pm}0.24$ vs $1.20{\pm}0.21\;J/L$, p=0.021) and PTP ($317{\pm}70$ vs $231{\pm}55\;cm$ $H_2O{\cdot}sec/min$, p=0.038). RAWm showed a tendency to decrease ($28.8{\pm}2.5$ vs $23.9{\pm}2.1\;cm$ $H_2O$, p=0.051). But PIP was increased with application of 3 cm $H_2O$ of external PEEP ($16{\pm}2$ vs $22{\pm}3\;cm$ $H_2O$, p=0.008). $V_T$, $V_E$, PEFR, $T_I/T_{TOT}$ and Cdyn did not change significantly. Conclusion : The presence of auto-PEEP in mechanically ventilated patients was accompanied with increased WOB performed by patient, and this WOB was decreased by 3 cm $H_2O$ of externally applied PEEP. But, with 3 cm $H_2O$ of external PEEP, increased PIP was noted, implying the importance of close monitoring of the airway pressure during application of external PEEP.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.862-870
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• 1995

Background: Oxygen free radicals have generally been considered as cytotoxic agents. On the other hand, recent results suggest that small nontoxic amounts of these radicals may act a role in intracellular signal transduction pathway and many efforts to reveal the role of these radicals as secondary messengers have been made. It is evident that the oxygen radicals are released by various cell types in response to extracellular stimuli including LPS, TNF, IL-1 and phorbol esters, all of which translocate the transcription factor $NF{\kappa}B$ from cytoplasm to nucleus by releasing an inhibitory protein subunit, $I{\kappa}B$. Activation of $NF{\kappa}B$ is mimicked by exposure to mild oxidant stress, and inhibited by agents that remove oxygen radicals. It means the cytoplasmic form of the inducible tanscription factor $NF{\kappa}B$ might provide a physiologically important target for oxygen radicals. At the same time, it is well known that LPS induces the release of oxygen radicals in neutrophil with the activation of $NF{\kappa}B$. From above facts, we can assume the expression of IL-8 and IL-$1{\beta}$ gene by LPS stimulation may occur through the activation of $NF{\kappa}B$, which is mediated through the release of $I{\kappa}B$ by increasing amounts of oxygen radicals. But definitive evidence is lacking about the role of oxygen free radicals in the expression of IL-8 and IL-$1{\beta}$ gene in mononuclear phagocytic cells. We conducted a study to determine whether oxygen radicals act a role in the expression of IL-8 and IL-$1{\beta}$ gene in mononuclear phagocytic cells. Method: Human peripheral blood monocytes were isolated from healthy volunteers. Time and dose relationship of $H_2O_2$-induced IL-8 and IL-$1{\beta}$ mRNA expression was observed by Northern blot analysis. To evaluate the role of oxygen radicals in the expression of IL-8 and IL-$1{\beta}$ mRNA by LPS stimulation, pretreatment of various antioxiants including PDTC, TMTU, NAC, ME, Desferrioxamine were done and Northern blot analysis for IL-8 and IL-$1{\beta}$ mRNA was performed. Results: In PBMC, dose and time dependent expression of IL-8 and IL-$1{\beta}$ mRNA by exogenous $H_2O_2$ was not observed. But various antioxidants suppressed the expression of LPS-induced IL-8 and IL-$1{\beta}$ mRNA expression of PBMC and the suppressive activity was most prominant when the pretreatment was done with TMTU. Conclusion: Oxygen free radical may have some role in the expression of IL-8 and IL-$1{\beta}$ mRNA of PBMC but that radical might not be $H_2O_2$.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.962-974
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• 1998

Background: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects cells from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is still obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose: The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method: 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2. Results : The histologic classification of the tumor was based on WHO criteria., and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1 %). p53 immunoreactivity was noted in 47 cases of 84 cases(56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases(17.9%). The mean survival duration was $64.23{\pm}10.73$ months in bcl-2 positive group and $35.28{\pm}4$. 39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was $34.71{\pm}6.12$ months in p53 positive group and $45.35{\pm}6.30$ months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2 expression in our study. Conclusions : The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small cell lung cancer.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1012-1021
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• 1998

Background : It is known that airway inflammation is present in most patients with asthma, but the relationship between symptoms and the severity and nature of airway inflammation has not been established. Cough variant asthma is defined as an asthma in which the dominant symptom is cough, and the condition can be successfully treated with inhaled steroids. This study was performed to evaluate the time course of bronchial responsiveness according to an inhaled anti-inflammatory therapy and the factors which affect the resolution of bronchial responsiveness, and an efficacy of nedocromil to cough asthma. Method: A prospective study for the investigation of bronchial responsiveness according to an inhaled anti-inflammatory treatment in sixty-one cough asthmatics was performed. Twenty-three entered budesonide ($400{\mu}g{\times}2/day$), twenty-two entered nedocromil ($4mg{\times}2/day$) and sixteen patients entered combined group. The bronchial hyperresponsiveness (BHR) was estimated by methacholine challenge test using counted breath method. The symptom was estimated by 'symptom score'. Reevaluation of BHR and symptom was performed at 2 month after treatment, and if BHR was not resoluted at this time, regarded as a non-responder, and then follow-up of BHR and symptom was performed at 4- and/or 6 month after treatment. Results: The improvement of BHR and symptom was significant in 2 month (p<0.05), but there was no change of them during follow-up period of 4- and/or 6 month in non-responders. In comparison of allergic markers such as serum total IgE, peripheral eosinophil count and skin test reactivity between responders and non-responders, there was no difference in each other. However, in comparison of other factors such as cumulative pack-years, symptom duration, age, gender, and the initial degree of PC20, there was a significant difference in each other(p<0.05). The percent of patients with the resolution of BHR in 2 month was not different in each group(p=0.95). There was no significant difference in the degree of improvement of BHR and symptom in each group. Conclusion: Bronchial responsiveness and symptom was not significantly improved in non-responders during follow-up period of 4- and/or 6 month. The effect of inhaled nedocromil was equivalent to that of inhaled steroid in cough asthmatics, and the response to combined treatment is not superior to that achieved by either of these agents used alone.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.250-256
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• 2003

Background : Anthracofibrosis, a descriptive term for multiple black pigmentation with fibrosis on bronchoscopic examination, has a close relationship with active tuberculosis (TB). However, TB activity is determined in the later stage by the TB culture results in some cases of anthracofibrosis. Therefore, it is necessary to identify early markers of TB activity in anthracofibrosis. There have been several reports investigating the serum levels of IL-2 $sR{\alpha}$, IFN-${\gamma}$ and TBGL antibody for the evaluation of TB activity. In the present study, we tried to measure the above mentioned serologic markers for the evaluation of TB activity in patients with anthracofibrosis. Methods : Anthracofibrosis was defined when there was deep pigmentation (in more than two lobar bronchi) and fibrotic stenosis of the bronchi on bronchoscopic examination. The serum of patients with anthracofibrosis was collected and stored under refrigeration before the start of anti-TB medication. The serum of healthy volunteers (N=16), patients with active TB prior to (N=22), and after (N=13), 6 month-medication was also collected and stored. Serum IL-2 $sR{\alpha}$, IFN-${\gamma}$ were measured with ELISA kit (R&D system, USA) and serum TBGL antibody was measured with TBGL EIA kit (Kyowa Inc, Japan). Results : Serum levels of IL-2 $sR{\alpha}$ in healthy volunteers, active TB patients before and after medication, and patients with anthracofibrosis were $640{\pm}174$, $1,611{\pm}2,423$, $953{\pm}562$, and $863{\pm}401$ pg/ml, respectively. The Serum IFN-${\gamma}$ levels were 0, $8.16{\pm}17.34$, $0.70{\pm}2.53$, and $2.33{\pm}6.67$ pg/ml, and TBGL antibody levels were $0.83{\pm}0.80$, $5.91{\pm}6.71$, $6.86{\pm}6.85$, and $3.22{\pm}2.59$ U/ml, respectively. The serum level of TBGL antibody was lower than of other groups (p<0.05). There was no significant difference of serum IL-2 $sR{\alpha}$ and IFN-${\gamma}$ levels among the four groups. Conclusion : The serum levels of IL-2 $sR{\alpha}$, IFN-${\gamma}$ and TBGL antibody were not useful in the evaluation of TB activity in patients with anthracofibrosis. More useful ways need to be developed for the differentiation of active TB in patients with anthracofibrosis.