• Tuberculosis and Respiratory Diseases
• /
• v.56 no.1
• /
• pp.40-50
• /
• 2004

Background : Radiation pneumonitis(RP) is the major serious complication of thoracic irradiation treatment. In this study, we attempted to retrospectively evaluate the long-term prognosis of patients who experienced acute RP and to identify factor that might allow prediction of RP. Methods : Of the 114 lung cancer patients who underwent thoracic radiotherapy between December 2000 and December 2002, We performed analysis using a database of 90 patients who were capable of being evaluated. Results : Of the 44 patients(48.9%) who experienced clinical RP in this study, the RP was mild in 33(36.6%) and severe in 11(12.3%). All of severe RP were treated with corticosteroids. The median starting corticosteroids dose was 34 mg(30~40) and median treatment duration was 68 days(8~97). The median survival time of the 11 patients who experienced severe RP was significantly poorer than the mild RP group. (p=0.046) The higher total radiation dose(${\geq}60Gy$) was significantly associated with developing in RP.(p=0.001) The incidence of RP did not correlate with any of the ECOG performance, pulmonary function test, age, cell type, history of smoking, radiotherapy combined with chemotherapy, once-daily radiotherapy dose fraction. Also, serum albumin level, uric acid level at onset of RP did not influence the risk of severe RP in our study. Conclusion : Only the higher total radiation dose(${\geq}60Gy$) was a significant risk factor predictive of RP. Also severe RP was an adverse prognostic factor.

• Pediatric Infection and Vaccine
• /
• v.26 no.2
• /
• pp.81-88
• /
• 2019

Purpose: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). Methods: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at $-70^{\circ}C$ until use. Tests with Ribotest $Mycoplasma^{(R)}$ were performed and interpreted independently by two investigators who were blinded to the culture results. Results: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$. When culture was used as the standard test, the sensitivity and specificity of Ribotest $Mycoplasma^{(R)}$ were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest $Mycoplasma^{(R)}$ were 94.9%, 67.2%, and 77.2%, respectively. Conclusions: A positive test result of Ribotest $Mycoplasma^{(R)}$ suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.

• Advances in pediatric surgery
• /
• v.17 no.2
• /
• pp.133-138
• /
• 2011

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.

• The Journal of Korean Society for School & Community Health Education
• /
• v.12 no.3
• /
• pp.65-87
• /
• 2011

Objectives: The purpose of this study was to perform basic study on environmental and respiratory diseases in Ulsan and vicinities. Also, this study evaluated the actual state of environmental disease and health education at middle and high schools in Ulsan and surroundings. Methods: For this study, we conducted a survey on the health of the general public, environmental effects, and investigated the characteristics of environmental disease, health and hygiene education, etc. The populations of this study were middle and high school students in Ulsan, Korea. This study investigated the knowledge of environmental disease and health education at schools in Ulsan and vicinities from November 2009 to December 2009. All statistical calculations were performed with Statistical Package for Social Sciences (SPSS) for Windows, and gained the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA. Results: As more and more environmental diseases are increased, the interest of the people has been increasing on this. The incidence rates of asthma and atopy were represented the top 25% of the country in Korea. The source of heavy metal, PAHs and VOCs in Ulsan includes the Petrochemical Complex at Nam-gu and Ulju-gun, the Nonferrous Metal Industrial Complex at Onsan-eup, Ulju-gun, and the Heavy Industrial Complex at Dong-gu and Buk-gu. Especially, there are a number of fossil fuel combustion facilities such as waste incineration plants and boilers at Nam-gu and the Onsan Industrial Complex. It may help greatly to investigate the characteristics of environmental pollutants such as environmental air pollutant and indoor contaminant to better manage the local student's health. Conclusions: It has been revealed that the hazardous chemicals and environmental contaminants are main substances of cause for asthma, atopy, dermatitis, and allergy disease. Therefore, through with collecting basic data such as environmental disease of inhabitants, health education, conscious and knowledgeable level in parents of students and students, We have to exert to improve knowledge and prevention with health life in school through development of health education program systematically for preventing of environmental disease.

• Journal of Society of Preventive Korean Medicine
• /
• v.17 no.3
• /
• pp.1-18
• /
• 2013

Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.4
• /
• pp.442-448
• /
• 2000

Developmental anomalies arising from the branchial apparatus include cysts, external sinuses, internal sinuses, and complete fistulas. Second branchial cleft cysts are by far the most common among these anomalies. It may occur at any age, being most common in the third decade, and more frequent in the male than in the female. It usually presents a smooth, round, nontender fluctuant mass located between the level of the tragus and the clavicle along the anteromedial border of the sternocleidomastoid muscle. It is lined by respiratory or squamous epithelium unless inflammation is present. The considerable amount of lymphoid tissue may be found beneath the epithelium. The treatment of choice of branchial cleft cyst is surgical excision. If the lesion is acutely infected, however, it is essential to relieve the infection prior to the surgery. This report deals with two cases of second branchial cleft cyst. In case 1, the cyst had rapidly increased in size over pregnant period. In case 2, the patient presented the swelling in the left neck, and had the history of incision and drainage because of misdiagnosis as submandibular space abscess. The infection was treated by antibiotic therapy in the first place, and then complete surgical excision was made. There was no evidence of any recurrence or complications for these $3{\sim}4$ years.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.10 no.4
• /
• pp.243-249
• /
• 2016

In this paper, we evaluate the effectiveness of mechanical horseback riding exercise training for cardiopulmonary responses in 26 healthy adults (male 14, female 12) and suggest its clinical applicability. Exercise was performed using a mechanical horseback riding machine, JOBA(R) (Panasonic Electric Works, Osaka, Japan) and riding movement speed was increased from level 2 (0.73Hz), to 4 (0.9Hz), to 6 (1.03Hz), to 8 (1.2Hz), to 9 (1.3Hz) and maintained 3minutes in each level. Heart rate, blood pressure, maximum oxygen consumption (VO2max) were measured by respiratory gas analysis system (TruOne 2400, Parvo Medics, USA) and exercise tolerance test system(Q Stress, Cardiac Science, USA). To measure exercise intensity, metabolic equivalent (MET) were measured and percent of Heart rate reserve (%HRR), percent of peak heart rate (%peak HR) and calorie consumption were calculated. The results were analysed by SPSS 18.0. We found that the exercise intensity of mechanical horseback riding exercise using JOBA(R) for 15 minutes is moderate in healthy adult who received pre-training.

• Journal of Periodontal and Implant Science
• /
• v.39 no.3
• /
• pp.303-310
• /
• 2009

Purpose: The aerosol generated by ultrasonic scaler can contain bacteria or virus which can penetrate into body through respiratory systems of dentists, dental hygienist or patients. The aim of this study is to evaluate the effect of chlorhexidine digluconate as preoperative mouthrinse or lavage for ultrasonic scaler on the reduction of viable organisms in aerosol produced during periodontal treatment using ultrasonic scaler. Methods: 30 patients with moderate chronic periodontitis were included and divided into 3 groups: Control (no preoperative mouthrinse and tap water as lavage), CHG (preoperative mouthrinse with 0.1% chlorhexidine digluconate and tap water as lavage), CHL (no preoperative mouthrinse and 0.1% chlorhexidine digluconate as lavage). Each patient received scaling or subgingival curettage for 30 min. In CHG group, mouthrinse with chlorhexidine digluconate was performed for 1 min. before treatment. Before, during and after scaling or subgingival curettage, air sampling was performed for 7 min. each (1000 L/7 min.) with trypticase-soy agar plate. Agar plates were incubated in $37^{\circ}C$ aerobically. The numbers of colony-forming units (CFU) were counted and compared. Results: The numbers of CFUs of the samples obtained during treatment were $97{\pm}14.0$ in control, $73.1{\pm}14.9$ in CHG group and $44.5{\pm}9.0$ in CHL group. The difference among the 3 groups was determined to be statistically significant (one-way ANOVA with Bonferroni's correction, p-value: 0.0003). In contrast, the numbers of CFU of samples obtained before and after treatment were not significantly different among the groups. Conclusions: Chlorhexidine digluconate used as preoperative mouthrinse or lavage for ultrasonic scaler can reduce the microorganisms in aerosol produced during periodontal treatment using ultrasonic scaler. Less number of microorganisms were detected when chlorhexidine was used as lavage for ultrasonic scaler.

• Journal of Chest Surgery
• /
• v.32 no.7
• /
• pp.653-659
• /
• 1999

Background: Despite the recent promising efforts to improve survival in patients with esophageal carcinoma, the long term survival results of patients with esophageal cancer have seldom been reported in Korea. To establish standard control for future studies, we re trospectively analyzed the surgical treatment results of the esophageal cancer patients managed in our department at Seoul National University Hospital. Material and Method: From January 1984 to December 1996, 734 patients were diagnosed with esophageal cancer. Among them, 253 patients underwent surgery in our department. We retrospectively analyzed the operative results and long term survival rates of these patients. Result: The majority of patients(237) had squamous cell histology and only 6 patients had adenocarcinoma. The final TNM stage grouping for these patients was based on the 1988 revised American Joint Commitee on Cancer classification. Twenty one patients were surgically classified as stage I, 109 as stage II, and 107 as stage III. C respiratory failure in 8, sepsis in 1, hepatic failure in 1, bleeding in 1 and unknown etiology in the remaining 3. The actuarial survival of 222 patients in whom the curative resection was accomplished at 1-, 2-, 3- and 5 years was 74.7${\pm}$3.1%, 46.5${\pm}$3.7%, 32.3${\pm}$3.7%, and 19.9${\pm}$3.3%, respectively. CONCLUSION: The poor long term survival rates suggest that an alternative treatment method such as intensive combined modality therapy should be developed for the management of esophageal cancer.

• Journal of Chest Surgery
• /
• v.31 no.11
• /
• pp.1089-1093
• /
• 1998

Background: In 1992, we first developed the technique for video-assisted thoracoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Clinically, patients suffereing from distressing hyperhidrosis in their heads and faces were observed. Materials and methods: From March 1997 to March 1998, the vidio-assisted thoracoscopic sympathectomy and sympathicotomy were performed in 60 patients suffering from craniofacial hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Thirty-nine patients underwent a conventional sympathectomy(T1 sympathectomy group), and twenty-one patients underwent division of the sympathetic nerve trunk above the T2 sympathetic ganglion(T2 sympathicotomy). The median follow up was 9 months. Results: All of the treated patients obtained satisfactory alleviation of craniofacial hyperhidrosis. No recurrence was observed in group T1 sympathectomy whereas one occurred in sympathicotomy. The global rate of compensatory sweating was about the same in both groups ; 76.9% in T1 sympathectomy and 76.2% in T2 sympathicotomy. The rate of embarrassing and disabling compensatory sweating was 38.5% in T1 sympathectomy and 38.1% in T2 sympathicotomy with no significant in the statistic analysis(p> 0.05). No transient Horner's syndrome was observed in group T2 sympathicotomy whereas seven occurred in T1 sympathectomy with improvement in follow-up. Only an overnight hospital stay was required in both group. Conclusions: The video-assist thoracoscopic sympathicotomy is minimally invasive and effective. Video-assisted thoracoscopic T2 sympathicotomy has proven to be effective method and less complicated in treating patients with distressing craniofacial hyperhidrosis and consistent in obtaining the same results as T1 sympathectomy.