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Detection of Mycobacterium Tuberculosis in Bronchial Specimens Using a Polymerase Chain Reaction in Patients with Bronchial Anthracofibrosis (기관지 탄분 섬유화증 환자의 기관지내시경 검체에서 PCR을 이용한 결핵균의 검출)

  • Na, Joo-Ock;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.161-172
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    • 2002
  • Background : To Investigate the association between bronchial anthracofibrosis (AF) and tuberculosis (TB), and the clinical utility of a polymerase chain reaction (PCR) on bronchial specimens for rapid diagno-sis of active pulmonary TB in patients with bronchial AF. Method : Thirty patients (25 women and 5 men ranging in age from 53 to 88), who were diagnosed with bronchial AF by a bronchoscopic exami-nation, were enrolled in this study. PCR targeting the IS6110 segment of Mycobacterium tuberculosis was performed on the bronchial wash fluid and anthracofibrotic bronchial tissue. The PCR results were compared with the bacteriological, histological, and clinical findings. Results : Eighteen of the 30 patients (60%) were associated with TB, nine of whom were confirmed as having active TB. The remaining 9 had a past history of TB. The sputum or bronchial aspirate AFB smear, culture, and histological findings were positive in 4 (13%), 9 (30%), and 5 (17%) patients, respectively. PCR of the AF tissue and bronchial wash fluid was positive in 5 (17%) and 11 (37%) of the 30 patients, respectively. PCR was more sensitive than the AFB smears for diagnosing pulmonary TB (22 % us 89 %, respectively, p<0.05). All 5 patients with positive AF tissue PCR results also had both histological findings and positive bronchial wash fluid PCR results. Of the 3 patients with positive PCR but negative bacteriological or histological results, 2 of these patients appeared to have active tuberculosis on a clinical basis. Conclusion: Although TB-PCR did not reveal an increased association between bronchial AF and TB compared with traditional methods, PCR on the bronchial wash fluid appears to be useful for the rapid diagnosis of pulmonary TB in patients with bronchial AF. TB-PCR on AF bronchial tissue itself did not yield additional benefits for diagnosing TB, which suggests that an AF lesion itself may not be an active or original site of the infection, but a secondary change of TB.

Comparison of Bite Forces between Pre- and Post-Treatment in Patients with Temporomandibular Disorders (측두하악장애 환자의 치료 전후 교합력 비교)

  • Lee, Sang-Il;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.211-218
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    • 2007
  • The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

Oral Cleft Risk Factors in Rural Area of Indonesia(Sintang) (인도네시아 농촌지역의 구순구개열 위험요인 사례조사)

  • Park, Dae-jin;Lim, Young-soo;Oh, Jee-young;Koh, Kwang-Wook;Song, Sung-Eun;Jo, Eun-Joo
    • Journal of agricultural medicine and community health
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    • v.31 no.2
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    • pp.187-208
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    • 2006
  • Objectives: This study was carried out to evaluate the risk factors of Oral cleft and to inspect the living environments of the rural areas of Sintang, Indonesia Methods: During 3 to 9 August 2004, A questionnaire survey was done for the risk factors of oral cleft. Case group was composed of 11 oral cleft patients who admitted Missionary Hospital whose mother's bloods were analyzed for anemia and hyperlipidemia. Control group was composed of 56 reproductive rural women recruited from near rural villages. Also we surveyed 4 rural areas of Indonesia with simple water test kits. $x^2-test$ for significant difference was analysed. Results: Drinking water was statistically significant risk factor(p<0.05) of oral cleft. Other factors had no statistical significancy. The kind of drinking water was river-originated water. In rural villages, water sanitation state, even boiled water, was very poor. Although $NO_2-N$, $NO_3-N$ was negative, E. coli-form microorganisms were strongly positive in most samples. Total food intake amount was not enough, and vitamin supplements were also under the need. Conclusions: Drinking the contaminated river-water around pregnancy was supposed to be one of the risk factors of oral cleft in Indonesia. Further study is needed for nitrate and mercury.

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The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

The Role of the Endometrium and Embryo in Human Implantation (인간 착상 과정에 자궁내막과 배아의 역할)

  • Jee, Byung-Chul
    • Development and Reproduction
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    • v.13 no.1
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    • pp.1-11
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    • 2009
  • Implantation itself is governed by an array of endocrine, paracrine and autocrine modulators, of embryonic and maternal origin. Window of implantation is the unique temporal and spatial expression of factors allows the embryo to implant via signaling, appositioning, attachment, and invasion in a specific time frame of $2{\sim}4$ days. When the embryo has arrived in the uterine cavity, a preprogrammed sequence of events occurs, which involves the production and secretion of a multitude of biochemical factors such as cytokines, growth factors, and adhesion molecules by the endometrium and the embryo, thus leading to the formation of a receptive endometrium. Cytokines such as LIF, CSF-1, and IL-1 have all been shown to play important roles in the cascade of events that leads to implantation. Integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF and pinopodes are involved in appositioning and attachment. The embryo also produces cytokines and growth factors (ILs, VEGF) and receptors for endometrial signals such as LIF, CSF-1, IGF and HB-EGF. The immune system and angiogenesis play an important role. The usefulness of these factors to assess endometrial receptivity and to estimate the prognosis for pregnancy in natural and artificial cycles remains to be proven. Integrins, pinopodes, glycodelin and LIF (from biopsies) are promising candidates; from uterine flushings, glycodelin and LIF are also candidates. The ideal serum marker is not available, but VEGF, glycodelin and CSF have some clinical implications. Further evaluation that includes larger groups of infertile women and fertile controls are needed to elucidate whether their presence in plasma, flushing fluid, or endometrial samples can be used as some kind of a screening tool to assess endometrial function and prognosis for pregnancy before and after artificial reproductive therapy. A better understanding of their function in human implantation may lead to therapeutic intervention, thereby improving the success rate in reproduction treatment. New molecular techniques are becoming available for measuring both embryonic and endometrial changes prior to and during implantation. The use of predictive sets of markers may prove to be more reliable than a single marker. Ultimately, the aim is to use these tools to increase implantation in artificial cycles and consequently improve live-birth rates.

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Characteristics and Clinical Course of Ovarian Hernias in Infants (1세 미만 여아 난소 탈장의 특성과 임상 경과)

  • Choi, Kyoung-Eun;An, So-Yoon;Kim, Kyung-Ah;Ko, Sun-Young;Lee, Yeon-Kyung;Shin, Son-Moon;Han, Byung-Hee
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.80-83
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    • 2008
  • Purpose : Inguinal hernias are common in children and sometimes are associated with dangerous complications, such as incarceration. There are no established management guidelines for ovarian hernias. We have reviewed the clinical course of ovarian hernias in infants. Methods : We reviewed the medical records of female infants diagnosed with ovarian hernias by ultrasonogram at Kwandong University College of Medicine, Cheil General Hospital, and the Women's Healthcare Center between March 2001 and August 2007. We analyzed the patients gestational age, birth weight, age at the time of detection of the inguinal mass, the patients chief complaints, operative time, post-operative complications, and ultrasonographic findings. Results : Eight female infants had ovarian hernias, four of whom were born prematurely. Seven infants had left-sided ovarian hernias, and one infant had a right-sided ovarian hernia. Five infants underwent surgery and there were no postoperative complications or recurrences. Three girls did not have surgery, and the ovarian hernias regressed spontaneously, with no recurrences or complications. The regression time of inguinal masses ranged from 70-161 days after birth. Conclusion : Physical examination to detect movable masses within the labium major in premature female infants is important because the incidence of premature inguinal hernias is much higher than in term infants. No rational medical treatment plans for female ovarian hernias have been published to date. We cared for three girls with spontaneous regression of ovarian hernias. Pediatricians should be aware whether emergent surgery for ovarian hernias is indicated.

A Randomized, Double-Blind, Placebo-Controlled Trial of Early Ursodeoxycholic Acid Administration for Prevention of Total Parenteral Nutrition-Induced Hepatobiliary Complications (총정맥영양법의 간담도 합병증에 대한 Ursodeoxycholic Acid 조기투여의 이중맹검 위약대조군 연구)

  • Choe, Yon-Ho;Beck, Nam-Sun;Kim, Ji-Hee;Lee, Suk-Hyang;Park, Tae-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.174-180
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    • 2002
  • Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.

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Factors Influencing the Activation of Brown Adipose Tissue in 18F-FDG PET/CT in National Cancer Center (양전자방출단층촬영 시 갈색지방조직 활성화에 영향을 미치는 요인 분석)

  • You, Yeon Wook;Lee, Chung Wun;Jung, Jae Hoon;Kim, Yun Cheol;Lee, Dong Eun;Park, So Hyeon;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.21-28
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    • 2021
  • Purpose Brown fat, or brown adipose tissue (BAT), is involved in non-shivering thermogenesis and creates heat through glucose metabolism. BAT activation occurs stochastically by internal factors such as age, sex, and body mass index (BMI) and external factors such as temperature and environment. In this study, as a retrospective, electronic medical record (EMR) observation study, statistical analysis is conducted to confirm BAT activation and various factors. Materials and Methods From January 2018 to December 2019, EMR of patients who underwent PET/CT scan at the National Cancer Center for two years were collected, a total of 9155 patients were extracted, and 13442 case data including duplicate scan were targeted. After performing a univariable logistic regression analysis to determine whether BAT activation is affected by the environment (outdoor temperature) and the patient's condition (BMI, cancer type, sex, and age), A multivariable regression model that affects BAT activation was finally analyzed by selecting univariable factors with P<0.1. Results BAT activation occurred in 93 cases (0.7%). According to the results of univariable logistic regression analysis, the likelihood of BAT activation was increased in patients under 50 years old (P<0.001), in females (P<0.001), in lower outdoor temperature below 14.5℃ (P<0.001), in lower BMI (P<0.001) and in patients who had a injection before 12:30 PM (P<0.001). It decreased in higher BMI (P<0.001) and in patients diagnosed with lung cancer (P<0.05) In multivariable results, BAT activation was significantly increased in patients under 50 years (P<0.001), in females (P<0.001) and in lower outdoor temperature below 14.5℃ (P<0.001). It was significantly decreased in higher BMI (P<0.05). Conclusion A retrospective study of factors affecting BAT activation in patients who underwent PET/CT scan for 2 years at the National Cancer Center was conducted. The results confirmed that BAT was significantly activated in normal-weight women under 50 years old who underwent PET/CT scan in weather with an outdoor temperature of less than 14.5℃. Based on this result, the patient applied to the factor can be identified in advance, and it is thought that it will help to reduce BAT activation through several studies in the future.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

A Study on the Traumatic Teeth Damage of Children (어린이의 외상성 치아손상에 관한 연구)

  • Yoo, Su-Min;Park, Ho-won
    • Journal of dental hygiene science
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    • v.4 no.1
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    • pp.21-25
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    • 2004
  • In modern times, children's trauma is increasing every year because of car accidents and life environment changes. There is a limit to prevent traumatic damage for oral cavity organization. The fundamental data of trauma treatment and prevention will be presented through the survey and analysis of traumatic teeth damage. I examined 113 patients from Oct. 4th, 2000 to Feb. 27th, 2004 at Dept. of Children's Dental Clinic, Kangnung National University. The results are as follows. (1) The trauma frequency of male subjects is higher than that of female at a rate of 2.05:1. The average age is 5.27 for men and 5.27 for women. The highest percentage of trauma patients is among 2 year old children. It is 21.2%. (2) A patient survey was taken at a trauma treatment hospital. On the first day 34.4% of the patients had come to receive treatment of their first set of teeth. However, after a week, 38.8% of the patients had received treatment on their permanent teeth. (3) As a result of falling, 59% of patients needing treatment on their first set of teeth. 55.1% of patients is permanent teeth. As a result of bump against physical solid, 26.6% of patients is the first set of teeth and 26.5% of patients is permanent teeth. (4) Teeth damage happened at home. 42.1% were male. 35.1% were female. According to trauma, 59.4% of teeth damage happened at home. 28.6% of permanent teeth damage happened at school or kindergarten. (5) According to trauma, the number of teeth damaged was in the first set of teeth are as follows: 56.3%, one-31.3%, three or four-6.3% each. For permanent teeth: two-46.9%, one-28.6%, four over-16.3% and three-8.2%. Over four teeth is larger number for permanent teeth. (6) 56% of first set of teeth patients and 43.4% of permanent teeth patients were male. 56.8% of first set of teeth patients and 43.2% of permanent teeth were female. Trauma happened to both male and female frequently in the first set of teeth. (7) Most of the tooth damage which was in the first set of teeth and permanent teeth was done to the upper jaw. 75% of patients are the first set of teeth. 63.8% of patients are permanent teeth. Trauma is very high in the two mid teeth of the upper jaw. (8) According to trauma survey, 30.2% is from impulse. 28.0% is from crown fracture, 14.7% is from depression. 8.9% is from concussion. 7.1% is from full dislocation of a joint. 2.2% of patients are extrusion. 1.8% is from displacement. According to teeth damage trauma, 35.8% is pulse in the first set of teeth. The breaking of the crown of a tooth happened a lot in permanent teeth. (9) According to data, 43.2% of teeth damage in the first set of teeth goes without treatment. In permanent teeth, it is 38.9%. After treatment, 22.0% of first set of teeth treatment requires a dental pulp treatment. In permanent teeth, which is used for temporary acid etching resin restoration.

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