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Endobronchial Tuberculosis in Patients with Pulmonary Tuberculosis (폐결핵에 병발하는 기관지 결핵에 관한 연구)

  • Kim, Sun-Young;Suhr, Ji-Won;Shin, Kyoung-Sang;Jeong, Seong-Su;Park, Sang-Gee;Kim, Ae-Kyoung;Cho, Hai-Jeong;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.138-146
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    • 1996
  • Background : Known as a kind of complication or a specific form of pulmonary tuberculosis, endobronchial tuberculosis caused several kinds of problems in diagnosis and managements. But the frequency of this disease are is widely variable, generally reported from as low as 10 - 20 % to as high as 40 - 50 %. We prospectively performed bronchoscopy in patients diagnosed as pulmonary tuberculosis to evaluate the frequency of endobronchial tuberculosis and its related findings. Method : From March, 1995 to February, 1996, we prospectively performed bronchoscopy in patients newly diagnosed as pulmonary tuberculosis and evaluated the frequency of endobronchial tuberculosis, its clinical features and laboratory findings including raiologic, microbiologic and physiologic aspects. Results : Number of patients diagnosed as pulmonary tuberculosis was 103 and 55 patients(53.4%) were found to have endobronchial tuberculosis. But the frequency were 43.8% in male and 76.7% in female, respectively. Frequently noted symptoms were nonspecific including cough, sputum, fever, weight loss in the order of frequency but cough was more frequent than in pulmonary tuberculosis. Physical examination showed rale, decreased breathing sound and wheezing and wheezing was more frequent than in pulmonary tuberculosis. All 7 subtypes were noted bronchoscopically and edema-hyperemia (stenotic without fibrosis) type was most frequently(32.7%) noted, and followed by chronic nonspecific bronchitis type, stenotic with fibrosis type and actively caseating type in the order of frequency. The relationship between subtypes of endobronchial tuberculosis and radiologic findings was insignificant. Right lung was involved more frequently than left lung and left upper lobe was most commonly involved site, and followed by right upper lobe and trachea. Acid-fast bacilli(AFB) positivity in sputum and / or bronchial washing fluid was 73% and suggested high risk of infectivity. Conclusion : The frequency of endobronchial tuberculosis in patients with pulmonary tuberculosis was higher than known and also suggested bronchoscopic examination to detect endobronchial involvement should be recommanded and careful management is also needed to prevent complications.

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Effect of a public health center-based nutrition education program for hypertension in women older than 50 years of age (50세 이상 여성을 대상으로 한 보건소 기반 고혈압 영양교육의 효과 평가)

  • Park, Seoyun;Kwon, Jong-Sook;Kim, Hye-Kyeong
    • Journal of Nutrition and Health
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    • v.51 no.3
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    • pp.228-241
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    • 2018
  • Purpose: The health risk of women increases after menopause. This study evaluated the effectiveness of a public health center-based nutrition education program for hypertension in women older than 50 years of age. Methods: The program included 8-week nutrition education and 8-week follow-up with keeping a health diary and nutrition counseling. The program was evaluated three times: before and after the nutrition education, and after the follow-up. The subjects were classified into hypertensives (n = 44) or normotensives (n = 71). Results: The rate of taking antihypertensive drugs in the hypertensive group was 86.4%. The systolic blood pressure decreased in the hypertensive and normotensive groups after nutrition education (p < 0.05). The body weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001), and percent body fat (p < 0.01) were also decreased after nutrition education in both groups. The hypertensive group showed an increase in HDL-cholesterol level (p < 0.001) and decreases in triglycerides (p < 0.01) and LDL-cholesterol (p < 0.05) levels after completion of the program. The normotensive group also displayed significant changes in HDL-cholesterol (p < 0.001) and triglycerides (p < 0.01). The dietary habits and nutrition knowledge on sodium and hypertension were improved in both groups (p < 0.001). The total score of dietary behavior related to the sodium intake was improved in the normotensive group (p < 0.001). The total score of the high sodium dish frequency questionnaire decreased in both groups after nutrition education and completion of the program compared to that before the program. Decreases in the consumption frequencies of noodles, pot stews and stews, Kimchi, and beverages were significant. The total self-efficacy score was increased in both groups by the program (p < 0.001). In particular, the hypertensive group showed improvement in all items. Conclusion: This public health center-based nutrition education program may contribute to the prevention and management of hypertension and chronic diseases in women over 50 years of age.

Entrance Skin Dose According to Age and Body Size for Pediatric Chest Radiography (소아 흉부촬영 시 나이와 체격에 따른 입사피부선량)

  • Shin, Gwi-Soon;Min, Ki-Yeul;Kim, Doo-Han;Lee, Kwang-Jae;Park, Ji-Hwan;Lee, Gui-Won
    • Journal of radiological science and technology
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    • v.33 no.4
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    • pp.327-334
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    • 2010
  • Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

Comparison of the Reconstruction Routes after Esophagectomy for Esophageal Cancer (식도암 절제후 식도 재건경로의 비교)

  • Lee, Seung-Yeoll;Kim, Kwang-Taik;Choi, Young-Ho;Kim, Il-Hyun;Baik, Man-Jong;Sun, Kyung;Lee, In-Sung;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.806-812
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    • 1999
  • Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

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Changes of Hemodynamic and Central Pulmonary Artery Dimension After Bidirectional Cavopulmonarv Shunt (양방향성 체정맥-폐동맥 단락술후 혈역학 및 중심 폐동맥 크기의 변화)

  • 이정렬;이해원
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1306-1315
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    • 1996
  • This study reviewed the changes of hemodynamlcs and centrAl pulmonary artery dimension in 54 patients who underwent bidirectional cavopulmonary shunt(BCPS) between February 1992 and December 1995 at Seoul National University Childrell's Hospital. Ag and body weight of patients averaged 36.8 $\pm$ 37.7 months and 8.0$\pm$3.0 kg, respectively Eightynine percent of patients had more than 2 violations of the risk factors for Fontan operation, resulting overall hospital mortality of 16.6%(9154). Serial hemodynamic and anglographic examinations before and mean 16.3 $\pm$ 14.3 months iirter BCPS were compared. The arterial oxygen saturation improved from a preoperative value of 71 9: 10.1 % to 79.H $\pm$ 8. 5% (n:4), p<0.05). The values of arterial oxygen saturation were lower as the age of the patients with BCPS in place was older(n=22, R'=0.341, p=0.004). A mean pulmonary artery pressure and pulmonary vascular resistance reduced from 31 $\pm$17 to 1).5$\pm$3.SmmHg(n=22, p<0.05) and from ).2$\pm$2.1 to 2.3$\pm$2.7 unit (n=7. p>0.05), respectively. Follow-up study showed a significant Increase of absolute values of ipsilateral pulmoanry artery (n: 14, p<0.05), but no change of contralateral pulmonary artreries (n: 14. p=not significant(HSI). However, there w re significant decreases in diameters of both ipsilateral and contralateral pulmonary arteries standardized by patients' body surface areas(16.8% decrease, n: 14, p< 0. 05 for ipsilatreal, 25.1%, n=14, p<0.05 for contralateral). Pulmonary artery indices for cross sectional areas of both pulmonary arterises decreased 9.3 $\pm$ 13.8% with showing a trend of more decrease as the follow-up duration was longer, We conclude that the bidirectional cavopulmonary shunt provide an excellent.

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Analysis of Palivizumab Prophylaxis in Patients with Acute Lower Respiratory Tract Infection Caused by Respiratory Syncytial Virus (Respiratory syncytial virus로 인한 급성 하기도 감염 입원 환자에서 Palivizumab 예방요법 유무에 따른 비교 분석)

  • Min, Sung Ju;Song, Jung Sook;Choi, Jang Hwan;Seon, Han Su;Kang, Eun Kyeong;Kim, Do Hyun;Kim, Hee Sup
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.154-162
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    • 2011
  • Purpose : The aim of this study was to identify the clinical characteristics of lower respiratory tract infection due to respiratory syncytial virus (RSV) in young children and to provide information for an effective guideline for palivizumab administration in Korea. Methods : We reviewed medical charts of 167 patients under 3 years of age who were hospitalized in Dongguk University Ilsan Hospital for lower respiratory tract infection between January 2007 and February 2011. Diagnosis of the virus was made based on the multiplex real time polymerase chain reaction. Results : There were 113 patients who were infected by respiratory syncytial virus. 90 patients were term infants and 23 patients were preterm infants. No difference was shown between term and preterm infants except the days of admission which was 9.0${\pm}$6.0 days and 12.6${\pm}$21.0 days respectively. In the preterm group their mean age at the time of admission was 5.21${\pm}$4.9 months and the mean gestational age was 33.1${\pm}$4.3 weeks, and the mean birth weight was 2,152${\pm}$950 g. Only 4 patients were born under 28 weeks gestational age and were candidates for palivizumab administration. Conclusion : Most of the patients with severe RSV lower respiratory tract infection were term or near term infants who were not candidates for palivizumab prophylaxis. A nationwide study is needed to make a new risk stratified guideline for RSV prophylaxis for our country.

Association between picky eating behaviors and growth in preschool children (유아기 까다로운 식습관과 성장상태 간의 연관성)

  • Shim, Jae Eun;Yoon, Ji Hyun;Kim, Kijoon;Paik, Hee Young
    • Journal of Nutrition and Health
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    • v.46 no.5
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    • pp.418-426
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    • 2013
  • This study was conducted in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. In this study, picky eating behaviors were defined as containing four constructs of 'eating a small amount (ES),' 'neophoic behavior (NB),' 'refusal of specific food groups (RF),' and 'preference for specific food-preparation methods (PP).' A 7-point scale was used for the multi-item questionnaire, which consisted of 21 items (three items for ES, two items for NB, nine items for RF, and seven items for PP), in order to evaluate picky eating behaviors of children. Subjects were recruited among visitors at a medical clinic in Seoul. A total of 150 self-administered survey responses from parents of preschool children were analyzed in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. Height for age (HFA) and weight for height (WFH) z-scores were used for assessment of preschool children's growth. The prevalence of ES, NB, RF, and PP was 44%, 57%, 73%, and 53%, respectively. Children with ES had lower HFA (p < 0.05) and WFH (p < 0.0001) than those without ES, while children with NB, RF, or PP had HFA and WFH were similar to their counterparts. The mean HFA z-score of children with ES was less than 0 (p < 0.05) and the mean WFH z-scores of children with ES, NB, RF, or PP were less than 0 (p < 0.05). According to the study results, related growth outcome differed depending on constructs of picky eating behaviors. In particular, picky eating of ES showed a risk of faltering height growth in preschool children. Further comprehensive studies on the reason for ES and intervention approach is warranted.

Dental Hygienists Work on the Impact of Factors Associated with Musculoskeletal Pain (치과위생사 작업과 관련된 근골격계 통증의 영향요인)

  • Kim, Min A;Seo, Hwa Jeong
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.558-565
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    • 2012
  • The purpose of this study was to work related musculoskeletal disorders are a major. Occupational disease of the dental care profession is no exception. The survey was self-reported questionars of 300 dental hygienists that 268 dental hygienists reply to self-reported survey. This study results are as follows: Subjects of research analyzing the degree of physical musculoskeletal disorders pain, shoulder 90.3%, neck 89.2%, leg 83.6%, 81.7% back, hand/wrist/fingers 75.7%, arm/elbow, according to 52.8%. Therefore the work province of the research object people the musculoskeletal disorders appeared different. Generally characteristic was taller dental hygienists lower back pain and were out of less weight, study subjects had neck and arm pain. 29~33 year-old age the shoulder, over the age of 34 the arm/elbow to be high (p<0.05). Working environment to become a career, the more hand/wrist/fingers and the pain increased (p<0.05). The neck, shoulders (p<0.05), arm (p<0.01), waist high in the 3~4 years experience. And leg/foot was in the 1~2 years experience. This increase in working hours had increased pain in the neck but the hand/wrist/finger pain in the small hours of experience in the high pain(p<0.01). Conclusion of the musculoskeletal disorders of the dental hygienists often than the average for this risk is recognized. When it occurs early in treatment can be simple, but time is left to revert to normal when you do not already. Therefore, maintaining proper posture and dental hygienists, pain or fatigue appeared to accumulate immediately treated continued efforts are needed.

Estimation of Heading Date using Mean Temperature and the Effect of Sowing Date on the Yield of Sweet Sorghum in Jellabuk Province (평균온도를 이용한 전북지역 단수수의 출수기 추정 및 파종시기별 수량 변화)

  • Choi, Young Min;Choi, Kyu-Hwan;Shin, So-Hee;Han, Hyun-Ah;Heo, Byong Soo;Kwon, Suk-Ju
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.64 no.2
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    • pp.127-136
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    • 2019
  • Sweet sorghum (Sorghum bicolor L. Moench), compared to traditional crops, has been evaluated as a useful crop with high adaptability to the environment and various uses, but cultivation has not expanded owing to a lack of related research and information in Korea. This study was conducted to estimate heading date in 'Chorong' sweet sorghum based on climate data of the last 30 years (1989 - 2018) from six regions (Jeonju, Buan, Jeongup, Imsil, Namwon, and Jangsu) in Jellabuk Province. In addition, we compared the growth and quality factors by sowing date (April 10, April 25, May 10, May 25, June 10, June 25, and July 10) in 2018. Days from sowing to heading (DSH) increased to 107, 96, 83, 70, 59, 64, and 65 days in order of the sowing dates, respectively, and the average was 77.7 days. The effective accumulated temperature for heading date was $1,120.3^{\circ}C$. The mean annual temperature was the highest in Jeonju, followed in descending order by Jeongup, Buan, Namwon, Imsil, and Jangsu. The DSH based on effective accumulated temperature gradually decreased in all sowing date treatments in the six regions during the last 30 years. DSH of the six regions showed a negative relationship with mean temperature (sowing date to heading date) and predicted DSH ($R^2=0.9987**$) calculated by mean temperature was explained with a probability of 89% of observed DSH in 2017 and 2018. At harvest, fresh stem weight and soluble solids content were higher in the April and July sowings, but sugar content was higher in the May 10 ($3.4Mg{\cdot}ha^{-1}$) and May 25 ($3.1Mg{\cdot}ha^{-1}$) sowings. Overall, the April and July sowings were of low quality and yield, and there is a risk of frost damage; thus, we found May sowings to be the most effective. Additionally, sowing dates must be considered in terms of proper harvest stage, harvesting target (juice or grain), cultivation altitude, and microclimate.

Effect of Sulgidduk containing pine needle juice on lipid metabolism in high fat-cholesterol diet induced dyslipidemic rats (이상지질혈증 동물 모델을 이용한 솔잎 착즙액 첨가 설기떡의 지질개선 효과)

  • Lee, Yunjung;Park, Jae-Hee;Park, Eunju
    • Journal of Nutrition and Health
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    • v.52 no.1
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    • pp.6-16
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    • 2019
  • Purpose: Dyslipidemia is a major risk factor for cardiovascular disease. Pine needles (Pinus densiflora seib et Zucc) are a traditional medicine used to treat dyslipidemia in clinical settings. This study examined the potential effects of sulgidduk, a Korean traditional rice cake containing pine needle juice to protect against dyslipidemia induced by a high-fat/sugidduk diet in a rat model. Methods: Twenty one male Sprague-Dawley rats were divided randomly into three groups: normal control (NC), Sulgidduk diet (SD), Sulgidduk diet containing pine needle juice (PSD). The blood lipid levels, production of lipid peroxide in the plasma and liver, total cholesterol and triglyceride in the liver and feces, antioxidant enzyme activities in plasma and erythrocytes were measured to assess the effects of PSD on dyslipidemia. Results: A high-fat/Sulgidduk diet induced dyslipidemia, which was characterized by significantly altered lipid profiles in the plasma and liver. The food intake was similar in the three groups, but weight gain and food efficiency ratio (FER) were reduced significantly in the PSD group compared to those in the SD group. The level of total cholesterol, LDL-cholesterol and TBARS in the plasma showed tendencies to decrease in the PSD group compared to those in the SD group. The levels of high-fat/Sulgidduk diet-induced sterol regulatory element-binding protein 2 (SREBP2) gene expression were reduced significantly in the PSD group. The supplementation of PSD reduced the hepatic triglyceride and total cholesterol levels significantly, and enhanced the fecal excretion of triglyceride and hepatic antioxidant enzyme activities compared to the SD group. Conclusion: These results suggest that the addition of 0.4% pine needle juice to Sulgidduk may be an alternative snack to control dyslipidemia.