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Esophageal Atresia and Tracheoesophageal Fistula in Korea - A National Survey of Its Members by the Korean Association of Pediatric Surgeons - (선천성 식도 무공증 및 기관식도 누공 - 대한 소아외과학회 회원을 대상으로 한 전국 조사 -)

  • Park, W.H.;Kwon, S.I.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, H.H.;Park, K.W.;Park, Y.S.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Lee, S.K.;Lee, T.S.;Chang, S.I.
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.149-161
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    • 1995
  • The first national survey on esophageal atresia and tracheoesophageal fistula was conducted to access the current status of its incidence, clinical manifestation, preoperative diagnosis and management, type of its anomaly, associated anomalies, and surgical results and course. The 43 members of the Korea Association of Pediatric Surgeons received questionnaires and registration forms to be filled out on each patient who were born during the three years from January 1, 1992 through December 31, 1994. Questionnaires composed of six broad areas which include 1) preoperative diagnosis and management, 2) surgical technic, 3) long gap, 4) postoperative management, and 5) complications and courses. A total of 148 cases was returned by 28 members working at 23 institutions and 27 members returned questionnaires. We obtained the following results by analysis of the 148 cases of tracheoesophageal anomalies. The incidence of tracheoesophageal anomaly was about 1/10,000-11,000 in 1994, which is one third of that of anorectal malformations in Korea and the distribution of the patients was almost proportionate to the size of each province. Both sexes are about equally affected. Majority of the members make diagnosis of tracheoesophageal anomaly by taking a simple infantogram with a radiopaque tube in upper pouch and a little under half(46%) prefers to perform echocardiography as a part of preoperative management to identify congenital heart disease and lateralize the aorta. Esophageal atresia with distal TEF(87.5%) was by far the most common and there were pure esophageal atresia(5.6%), H-type TEF(2.1%), and so on. About half(49%) of the patients had one or more associated anomalies in addition to tracheoesophageal anomalies. Congenital heart disease was associated in 46 cases(31%), anorectral malfomations in 19 cases(13%), musculoskeletal anomalies in 15 cases(10%), genitourinary anomalies in 10 cases(7%) and gastrointestinal anomalies in 7 cases(5%). Postoperatively, parenteral nutrition and assisted ventilation were given in 66% and 52% of patients respectively. Ninety three(74%) of 126 cases who underwent sugical procedure, experienced one or more complications such as respiratory complication(65%), leak(22%), stricture(21%) and so on. The survival rates related to the Waterston risk categories were 90.2% in group A, 71.4-75% in $B_1$, $B_2$, and $C_1$, groups, and 28% in group $C_2$, and the overall survival rate was 71.4%. Thirty six(28.6%) of 126 cases died of pneumonia/sepsis(12 cases), respiratory failure(12 cases), and congenital heart disease(4 cases). With short term follow-up, 69% of patients have been excellent whereas remainders of the cases have suffered from some sort of morbidity related to gastroesophageal reflux, recurrent respiratory infection, and esophageal stricture.

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Clinical Characteristics of Pneumococcal Bacteremia in Adults : The Effect of Penicillin Resistance on the Mortality of Patients with Pneumococcal Bacteremia (폐렴구균 균혈증에서 폐렴구균의 페니실린 내성 여부가 사망률에 미치는 영향)

  • HwangBo, Bin;Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;Park, Gye-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Min, Kyung-Up;Kim, You-Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.184-194
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    • 1999
  • Backgrounds : The advent of penicillin has led to the marked reduction in the mortality from pneumococcal bacteremia, however, the mortality is still relatively high in this post-antibiotic era. Actually the prevalence of infection due to penicillin-resistant penumococci is increasing worldwide, and it is especially high in Korea due to irrelevant use of antibiotics. So, the high mortality of pneumococcal sepsis might be related to the emergence of penicillin-resistant strains, however, many other antibiotics, which eradicate pneumococci effectively, are available in these days. This has led us to suspect the role of penicillin-resistance in the high mortality rate. In this study, we evaluated the effect of penicillin resistance on the mortality of patients with penumococcal bacte remia. Methods: The study population consisted of 50 adult patients with penumococcal bacteremia who were admitted between Jan, 1990 and July, 1997. Medical records were analyzed retrospectively. Results: Most of the patients (96%) had underlying diseases. The most common local disease associated with pneumococcal bacteremia was pneumonia (42%), which was followed by spontaneous bacterial peritonitis (14%), cholangitis (10%), meningitis (8%), liver abscess (4%), pharyngotonsillitis (4%), sinusitis (2%) and cellulitis (2%). While the overall case-fatality rate in this study was 24%, it was higher when peumococcal bacteremia was associated with pneumonia (42%) or meningitis (50%). The rate of penicillin resistance was 40%, which was increased rapidly from 1991. The rate of penicillin resistance was significantly higher in patients with the history of recent antibiotics use and hospitalization within 3 months respectively. The clinical manifestations, that is, age, severity of underlying diseases, nosocomial infection, associated local diseases, and the presence of shock or acute renal failure were not statistically different between the patients with penicillin-resistant and -sensitive pneumococcal bacteremia. The mortality of patients infected with penicillin-resistant pneumococci was not statistically different from those with penicillin-sensitive pneumococcal bacteremia. Conclusion: Penicillin resistance is not associated with high mortality in adult patients with pneumococcal bacteremia. As the overall mortality is high, active penumococcal vaccination is recommended in patients with high risk of infection.

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The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005~2009 (일개 부산지역 3차 병원에서 관찰한 다제내성 결핵의 실태, 2005~2009)

  • Yoon, Neul-Bom;Lee, Sung-Woo;Park, Su-Min;Jeong, Il-Hwan;Park, So-Young;Han, Song-Yee;Lee, Yu-Rim;Jung, Jin-Kyu;Kim, Joon-Mo;Kim, Su-Young;Um, Soo-Jung;Lee, Soo-Keol;Son, Choon-Hee;Hong, Young-Hee;Lee, Ki-Nam;Roh, Mee-Sook;Kim, Kyeong-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.2
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    • pp.120-125
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    • 2011
  • Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.

Permanent Preservation and Use of Historical Archives : Preservation Issues Digitization of Historical Collection (역사기록물(Archives)의 항구적인 보존화 이용 : 보존전략과 디지털정보화)

  • Lee, Sang-min
    • The Korean Journal of Archival Studies
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    • no.1
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    • pp.23-76
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    • 2000
  • In this paper, I examined what have been researched and determined about preservation strategy and selection of preservation media in the western archival community. Archivists have primarily been concerned with 'preservation' and 'use' of archival materials worth of being preserved permanently. In the new information era, preservation and use of archival materials were faced with new challenge. Life expectancy of paper records was shortened due to acidification and brittleness of the modem papers. Also emergence of information technology affects the traditional way of preservation and use of archival materials. User expectations are becoming so high technology-oriented and so complicated as to make archivists act like information managers using computer technology rather than traditional archival handicraft. Preservation strategy plays an important role in archival management as well as information management. For a cost-effective management of archives and archival institutions, preservation strategy is a must. The preservation strategy encompasses all aspects of archival preservation process and practices, from selection of archives, appraisal, inventorying, arrangement, description, conservation, microfilming or digitization, archival buildings, and access service. Those archival functions should be considered in their relations to each other to ensure proper preservation of archival materials. In the integrated preservation strategy, 'preservation' and 'use' should be combined and fulfilled without sacrificing the other. Preservation strategy planning is essential to determine the policies of archives to preserve their holdings safe and provide people with a maximum access in most effective ways. Preservation microfilming is to ensure permanent preservation of information held in important archival materials. To do this, a detailed standardization has been developed to guarantee the permanence of microfilm as well as its product quality. Silver gelatin film can last up to 500 years in the optimum storage environment and the most viable option for permanent preservation media. ISO and ANIS developed such standards for the quality of microfilms and microfilming technology. Preservation microfilming guidelines was also developed to ensure effective archival management and picture quality of microfilms. It is essential to assess the need of preservation microfilming. Limit in resources always put a restraint on preservation management. Appraisal (and selection) of what to be preserved was the most important part of preservation microfilming. In addition, microfilms with standard quality can be scanned to produce quality digital images for instant use through internet. As information technology develops, archivists began to utilize information technology to make preservation easier and more economical, and to promote use of archival materials through computer communication network. Digitization was introduced to provide easy and universal access to unique archives, and its large capacity of preserving archival data seems very promising. However, digitization, i.e., transferring images of records to electronic codes, still, needs to be standardized. Digitized data are electronic records, and st present electronic records are very unstable and not to be preserved permanently. Digital media including optical disks materials have not been proved as reliable media for permanent preservation. Due to their chemical coating and physical character using light, they are not stable and can be preserved at best 100 years in the optimum storage environment. Most CD-R can last only 20 years. Furthermore, obsolescence of hardware and software makes hard to reproduce digital images made from earlier versions. Even if when reformatting is possible, the cost of refreshing or upgrading of digital images is very expensive and the very process has to be done at least every five to ten years. No standard for this obsolescence of hardware and software has come into being yet. In short, digital permanence is not a fact, but remains to be uncertain possibility. Archivists must consider in their preservation planning both risk of introducing new technology and promising possibility of new technology at the same time. In planning digitization of historical materials, archivists should incorporate planning for maintaining digitized images and reformatting them in the coming generations of new applications. Without the comprehensive planning, future use of the expensive digital images will become unavailable. And that is a loss of information, and a final failure of both 'preservation' and 'use' of archival materials. As peter Adelstein said, it is wise to be conservative when considerations of conservations are involved.

Immunization Practices in Children with Renal Disease : A Survey of the Members of Korean Society of Pediatric Nephrology (신질환 소아의 예방접종 현황 : 대한소아신장학회 회원들의 접종 방식에 대한 조사)

  • Park Seong-Shik;Ahn Sung-Ryou;Lee Ju-Suk;Kim Su-Yung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.198-208
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    • 2002
  • Purpose : There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists Methods : Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. Results : Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% us 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b ($54.3{\sim}77.1%$). Conclusion : Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.

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Prediction of a hit drama with a pattern analysis on early viewing ratings (초기 시청시간 패턴 분석을 통한 대흥행 드라마 예측)

  • Nam, Kihwan;Seong, Nohyoon
    • Journal of Intelligence and Information Systems
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    • v.24 no.4
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    • pp.33-49
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    • 2018
  • The impact of TV Drama success on TV Rating and the channel promotion effectiveness is very high. The cultural and business impact has been also demonstrated through the Korean Wave. Therefore, the early prediction of the blockbuster success of TV Drama is very important from the strategic perspective of the media industry. Previous studies have tried to predict the audience ratings and success of drama based on various methods. However, most of the studies have made simple predictions using intuitive methods such as the main actor and time zone. These studies have limitations in predicting. In this study, we propose a model for predicting the popularity of drama by analyzing the customer's viewing pattern based on various theories. This is not only a theoretical contribution but also has a contribution from the practical point of view that can be used in actual broadcasting companies. In this study, we collected data of 280 TV mini-series dramas, broadcasted over the terrestrial channels for 10 years from 2003 to 2012. From the data, we selected the most highly ranked and the least highly ranked 45 TV drama and analyzed the viewing patterns of them by 11-step. The various assumptions and conditions for modeling are based on existing studies, or by the opinions of actual broadcasters and by data mining techniques. Then, we developed a prediction model by measuring the viewing-time distance (difference) using Euclidean and Correlation method, which is termed in our study similarity (the sum of distance). Through the similarity measure, we predicted the success of dramas from the viewer's initial viewing-time pattern distribution using 1~5 episodes. In order to confirm that the model is shaken according to the measurement method, various distance measurement methods were applied and the model was checked for its dryness. And when the model was established, we could make a more predictive model using a grid search. Furthermore, we classified the viewers who had watched TV drama more than 70% of the total airtime as the "passionate viewer" when a new drama is broadcasted. Then we compared the drama's passionate viewer percentage the most highly ranked and the least highly ranked dramas. So that we can determine the possibility of blockbuster TV mini-series. We find that the initial viewing-time pattern is the key factor for the prediction of blockbuster dramas. From our model, block-buster dramas were correctly classified with the 75.47% accuracy with the initial viewing-time pattern analysis. This paper shows high prediction rate while suggesting audience rating method different from existing ones. Currently, broadcasters rely heavily on some famous actors called so-called star systems, so they are in more severe competition than ever due to rising production costs of broadcasting programs, long-term recession, aggressive investment in comprehensive programming channels and large corporations. Everyone is in a financially difficult situation. The basic revenue model of these broadcasters is advertising, and the execution of advertising is based on audience rating as a basic index. In the drama, there is uncertainty in the drama market that it is difficult to forecast the demand due to the nature of the commodity, while the drama market has a high financial contribution in the success of various contents of the broadcasting company. Therefore, to minimize the risk of failure. Thus, by analyzing the distribution of the first-time viewing time, it can be a practical help to establish a response strategy (organization/ marketing/story change, etc.) of the related company. Also, in this paper, we found that the behavior of the audience is crucial to the success of the program. In this paper, we define TV viewing as a measure of how enthusiastically watching TV is watched. We can predict the success of the program successfully by calculating the loyalty of the customer with the hot blood. This way of calculating loyalty can also be used to calculate loyalty to various platforms. It can also be used for marketing programs such as highlights, script previews, making movies, characters, games, and other marketing projects.

Predictors on In-hospital Mortality Following In-hospital Diagnosis of Tuberculosis (결핵으로 입원한 환자의 병원내 사망과 관련된 인자)

  • Shin, Su Rin;Kim, Chang Hwan;Kim, Sung Eun;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung;Kim, Cheol Hong;Eom, Kwang Seok;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Gu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.233-238
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    • 2006
  • Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

Female Gender is a Poor Predictive Factor of Functional Dyspepsia Resolution after Helicobacter pylori Eradication: A Prospective, Multi-center Korean Trial (기능성 소화불량증 환자에서 헬리코박터 파일로리 제균 치료 효과 및 관련 요인: 국내 전향적, 다기관 연구)

  • Kim, Sung Eun;Kim, Nayoung;Park, Seon Mee;Kim, Won Hee;Baik, Gwang Ho;Jo, Yunju;Park, Kyung Sik;Lee, Ju Yup;Shim, Ki-Nam;Kim, Gwang Ha;Lee, Bong Eun;Hong, Su Jin;Park, Seon-Young;Choi, Suck Chei;Oh, Jung Hwan;Kim, Hyun Jin
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.286-294
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    • 2018
  • Background/Aims: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. Methods: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. Results: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. Conclusions: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.

Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals (국내 민간병원에서 치료한 다제내성결핵 환자의 치료 결과 및 예후 인자)

  • Park, Jin-Kyeong;Koh, Won-Jung;Kim, Deog-Kyeom;Kim, Eun-Kyung;Kim, Yu-Il;Kim, Hee-Jin;Kim, Tae-Hyung;Kim, Jae-Yeol;Park, Moo-Suk;Park, I-Nae;Park, Jae-Seuk;Lee, Ki-Man;Song, Sook-Hee;Lee, Jin-Hwa;Lee, Seung-Heon;Lee, Hyuk-Pyo;Yim, Jae-Joon;Lim, Jae-Min;JeGal, Yang-Jin;Jung, Ki-Hwan;Huh, Jin-Won;Choi, Jae-Chol;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.2
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    • pp.95-102
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    • 2010
  • Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75~80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000. Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals. We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors. Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean body-mass-index was $20.2kg/m^2$. None of the patients tested positive for HIV. Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation. Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159). Default rate was high, 21.8% (37/170). Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality. Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data. The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high. Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea.

Clincal Manifestations of Patients Dying of Severe Community Acquired Pneumonia (중증 원외폐렴으로 사망한 환자의 임상적 분석)

  • Choi, Won-Il;Sohn, Jeong-Ho;Kwun, Oh-Yong;Heo, Jeong-Sook;Whang, Jae-Seok;Han, Seong-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.537-545
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    • 1994
  • Background: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with community-acquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of dying of severe community-acquired pneumonia. Methods: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. Results: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnca, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+) cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Seven patients death(70%) occured after admission within the first five days, and a mean duration of hospitaliztion was 11.2 days. Conclusion: As the results show most death occured within the first five days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.

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