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A Case of Pulmonary Paragonimiasis with Recurrent Pleural Effusion and Cured by Four Cycles of Chemotherapy (세 차례 재발하여 4회 약물 요법으로 치료한 폐흡충증 1예)

  • Cho, Gye Jung;Lim, Jung Hwan;Chae, Dong Ryeol;Chi, Su Young;Ban, Hee Jung;Yoon, Byeong Kab;Kwon, Yong Soo;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.451-456
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    • 2009
  • Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.

Partial Interferon-γ Receptor Deficiency in Patients with Disseminated Tuberculosis (파종성 결핵 환자에서 interferon-γ 수용체의 부분결핍에 관한 연구)

  • Hwang, Jung Hye;Koh, Won-Jung;Lee, Shin Hye;Kim, Eun Joo;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.11-17
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    • 2005
  • Background : Interferon-gamma ($IFN-{\gamma}$) is essential in the immune response to mycobacterial infections, and a complete or partial deficiency in the $IFN-{\gamma}$ receptor 1 ($IFN{\gamma}R1$) or the $IFN-{\gamma}$ receptor 2 ($IFN{\gamma}R2$) have been reported to confer susceptibility to a disseminated infection with nontuberculous mycobacteria. However, similar mutations in the $IFN-{\gamma}$ receptor have not been specifically examined in the patients with clinical tuberculosis. Methods : This study searched for mutations in the $IFN-{\gamma}$ receptor gene that resulted in a partial $IFN-{\gamma}$ receptor deficiency in six patients with disseminated tuberculosis. The previously identified $IFN{\gamma}R1$ and $IFN{\gamma}R2$ coding regions were sequenced after amplification. Results : There was no partial $IFN{\gamma}R1$ deficiency including a homozygous recessive missense mutation causing an amino-acid substitution in the extracellular domain of the receptor (I87T) and a hotspot for small deletions (818delT, 818del4, 818insA) found in any of the patients. In addition, a partial $IFN{\gamma}R2$ deficiency of the homozygous missense mutation (R114C) was not found in any of the patients. Conclusion : Genetic defects causing a partial $IFN-{\gamma}$ receptor deficiency were not identified in our patients with disseminated tuberculosis.

Comparison of Serum Osteopontin Levels in Patients with Stable and Chronic Obstructive Pulmonary Disease and Exacerbation (안정된 만성 폐쇄성 폐질환환자와 급성 악화상태의 혈중 Osteopontin 농도 비교)

  • Ma, Jeong-Eun;Lee, Seung-Hun;Kim, Yu-Eun;Lim, Su-Jin;Lee, Seung-Jun;Jeong, Yi-Yeong;Kim, Ho-Cheol;Lee, Jong-Deog;Hwang, Young-Sil;Cho, Yu-Ji
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.195-201
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    • 2011
  • Background: Osteopontin (Opn) is recognized as an important adhesive bone matrix protein and a key cytokine involved in immune cell recruitment and tissue repair and remolding. However, serum levels of osteopontin have not been evaluated in patients with chronic obstructive pulmonary disease (COPD). Thus, the aim of this study was to evaluate and compare the serum levels of osteopontin in patients experiencing COPD exacerbations and in patients with stable COPD. Methods: Serum samples were obtained from 22 healthy control subjects, 18 stable COPD patients, and 15 COPD with exacerbation patients. Serum concentrations of osteopontin were measured by the ELISA method. Results: Serum levels of osteopontin were higher in patients with acute exacerbation than with stable COPD and in healthy control subjects ($62.4{\pm}51.9ng/mL$, $36.9{\pm}11.1ng/mL$, $30{\pm}11ng/mL$, test for trend p=0.003). In the patients with COPD exacerbation, the osteopontin levels when the patient was discharged from the hospital tended to decrease compared to those at admission ($45{\pm}52.1ng/mL$, $62.4{\pm}51.9ng/mL$, p=0.160). Osteopontin levels significantly increased according to patient factors, including never-smoker, ex-smoker and current smoker ($23{\pm}5.7ng/mL$, $35.5{\pm}17.6ng/mL$, $58.6{\pm}47.8ng/mL$, test for trend p=0.006). Also, osteopontin levels showed a significantly negative correlation with forced expiratory volume in one second ($FEV_1$%) predicted in healthy controls and stable COPD patients (r=-0.389; p=0.013). C-reactive protein (CRP) was positively correlated with osteopontin levels in patients with COPD exacerbation (r=0.775; p=0.002). Conclusion: The serum levels of osteopontin increased in patients with COPD exacerbation and tended to decrease after clinical improvement. These results suggest the possible role of osteopontin as a biomarker of acute exacerbation of COPD.

The Regulation of FOXP3 Expression by the Treatment of TGF-${\beta}$ and the Modification of DNA Methylation in Lung Cancer Cell Lines

  • Um, Sang-Won;Lee, Sang-Hee;Kim, Ho-Joong;Kwon, O-Jung;Kim, Hang-Rae;Kang, Jae-Seung;Lee, Wang-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.3
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    • pp.206-217
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    • 2011
  • Background: Transcription factor FOXP3 characterizes the thymically derived regulatory T cells. FOXP3 is expressed by cancer cell itself and FOXP3 expression was induced by TGF-${\beta}$ treatment in pancreatic cancer cell line. However, the expression of FOXP3 expression is not well known in patients with lung cancer. This study was conducted to investigate the expression of FOXP3 in patients with lung cancer and to investigate the regulation of FOXP3 expression by the treatment of TGF-${\beta}$ and DNA methyltransferase inhibitor in lung cancer cell lines. Methods: FOXP3 expression in the tissue of patients with resected non-small cell lung cancer (NSCLC) was evaluated by immunohistochemistry. The regulation of FOXP3 expression was investigated by Western blot and RT-PCR after lung cancer cell lines were stimulated with TGF-${\beta}1$ and TGF-${\beta}2$. The regulation of FOXP3 expression was also investigated by RT-PCR and flow cytometry after lung cancer cell lines were treated with DNA methyltransferase inhibitor (5-AZA-dC). Results: FOXP3 expression was confirmed in 27% of patients with NSCLC. In NCI-H460 cell line, TGF-${\beta}2$ decreased FOXP3 mRNA and protein expressions. In A549 cell line, both TGF-${\beta}1$ and TGF-${\beta}2$ decreased FOXP3 mRNA and protein expressions. 5-AZA-dC increased FOXP3 mRNA expression in NCI-H460 and A549 cell lines. Moreover, 5-AZA-dC increased intracellular FOXP3 protein expression in A549 cell lines. Conclusion: It was shown that FOXP3 is expressed by cancer cell itself in patients with NSCLC. Treatment of TGF-${\beta}2$ and DNA methyltransferase inhibitor seems to be associated with the regulation of FOXP3 expression in lung cancer cell lines.

A study on quality of handicapped inpatients' service satisfaction at special dental clinic and their transformed perceptions toward to the dental treatment services (일부 복지관 장애인치과 내원 환자들의 서비스 만족도 및 진료 후 변화 인식도 연구)

  • Park, Soon-Ju;Choi, Seong-Woo;Park, Sun-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.6
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    • pp.1001-1014
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    • 2010
  • Objectives : The purpose of this study is about discovering the basic references to find the ways to vitalize handicapped dental clinics. Methods : The study was analyzed by the satisfactions of those patients who took the advantages of using the dental care at B-welfare center and also their transformed perceptions after the services are influenced. The analysis was the questionnaire consisting of 100 items and survey data. Results : 1. The satisfaction of the dental service for the disabled was respectively high which was the average of 4.49. 2. Their satisfactions of receiving kindness services by volunteers and employees were the highest in the entire research of successful handicapped dental services and it was 4.78 overall. 3. The satisfaction of using handicapped dental clinic has the higher range of female users than male's. In the mean time treatment details of the dental care and the satisfaction towards to the volunteers and faculty at the center show the statistical significance gap. 4. The oral care service after experiencing the dental clinic for handicapped relived their discomforts of using the regular dental clinic which shows their highest satisfaction as it is the point of 4.75. 5. the change perception after dental treatment for handicapped has the higher range of females than men's and solving the problems of mouth reference and discomfort of using regular clinics show the statistical significance gap. 6. In the change perception after having dental treatment for handicapped the thought of the possibility of periodical dental care shows the highest perception when the number of visiting is usually shorter and it shows the statistical significance. Conclusions : According to the satisfaction of those inpatients who use free dental care services that belong to dental clinics for handicapped in a part of Seoul welfare centers human services were appeared as the most important factor due to their advantages of taking services from volunteers and staff members. On the other hand to enhance the medical treatment information and environment which showed the weakest factors each inpatient should be specifically specialized for their needs and also further study on plans which enhance their perceptions toward to a better quality of oral-related life is required after using dental treatment service.

The Continuum of Rehabilitation Care and the Rehabilitation Services that are Needed by People with Severe Disabilities (재가 중증 장애인의 지속적 재활 관리 실태와 재활 서비스 요구)

  • Jang, Soong-Nang;Kim, Wan-Ho;Lee, Kyu-Beom;Kim, Su-Kyung;Lim, Jae-Young;Rhee, Seon-Ja
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.3
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    • pp.263-269
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    • 2006
  • Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

Effects of LGBT Nursing Education Using Simulation (시뮬레이션을 활용한 LGBT 간호 교육의 효과)

  • Kang, Sook Jung;Min, Hye Young
    • Women's Health Nursing
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    • v.25 no.4
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    • pp.379-391
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    • 2019
  • Purpose: As health care needs for Lesbian, Gay, Bisexual and Transgender (LGBT) are becoming increasingly important, it has become imperative for the nurses to be attentive towards their health problems and provide nursing care with an open-minded attitude. Due to limited opportunity to provide direct nursing care to LGBT patients, it is hypothesized that simulation would provide good opportunity for students to experience LGBT nursing care in a safe environment. This study was conducted to develop and apply simulation of LGBT nursing care to ultimately provide unbiased nursing care for LGBT population and prepare basic data for LGBT nursing education. Methods: This study was a single-group pre-post experimental design study for 57 senior nursing students based on the comparison of existing LGBT knowledge, general attitude towards LGBT, and nursing attitude towards LGBT before and after simulation. The scenario content included discussion of coming out issue, providing sexual health information, and supportive nursing care for LGBT population. Data were analyzed with descriptive statistics and Wilcoxon signed rank. Results: Simulation education-led to a significant increase in LGBT knowledge and nursing attitude. However, there was no change in the general attitude towards LGBT. Conclusion: The results of this study suggest that LGBT education using simulation may be effective for nursing students and nurses from the point of concern for LGBT population. It is hypothesized that future LGBT educational programs might need more detailed information from both care recipients and nurses. Finally, LGBT education needs to be included in the nursing education curriculum.

Clinical Nutrition Services of a Long-term Care Hospital in Korea (전국 요양병원에서의 임상영양서비스 실태 조사)

  • Um, Mi Hyang;Lyu, Eun Soon;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Park, Yoo Kyoung
    • Korean Journal of Community Nutrition
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    • v.20 no.3
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    • pp.220-235
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    • 2015
  • Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

Policy Network Analysis on Korean Child Care Cash Benefit Expansion (한국 양육수당의 확대는 어떠한 정책형성과정을 거쳤는가?: 정책네트워크 분석을 활용하여)

  • Lee, Sophia Seung-yoon;Kim, Min Hye;Lee, Ju-yong
    • 한국사회정책
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    • v.20 no.2
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    • pp.195-232
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    • 2013
  • Child care cash benefit policy in Korea started in 2009 limited to the those under 2 years old in the poverty group entitled to National Basic Living Security Act and the near poor group (100,000 won a month). However, in 2013 the coverage has been expanded to everyone under 5 (200,000 won for those between babies in their first year, 150,000 won for the second year and 100,000 won for those between 2 to 5 years old) regardless of the household income level. The policy change between year 2012 and year 2013 requires a rapid increase in child care budget - 760% increase. This paper examines this exceptional expansion in child care cash benefit using policy network analysis. We found that local election as well as general election immediately effect the interaction between policy actors and the types of networks. This suggest that policy actors recognize child care cash benefit to be more directly related to the election result compared with child care services. Also conflictive interaction between the parties and government bodies with budget restraint also facilitated the diversification on the child care cash benefit discussion. The policy making process of child care cash benefit was led to policy adoption immediately after the presidential election suggesting that policy formation process and the policy adoption had an close relationship in the Korean child care cash benefit policy process.

Changes in concentration of VSCs after home oral care interventions based on community care in older adults (커뮤니티케어 기반 방문구강관리 중재에 의한 노인의 구취 농도 변화)

  • Myeong-Hwa Park;Min-Sook Jeong;Jong-Hwa Jang
    • Journal of Korean society of Dental Hygiene
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    • v.23 no.2
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    • pp.91-103
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    • 2023
  • Objectives: This case study was conducted to assess changes in the concentration of volatile sulfur compounds (VSCs) of older adults following home oral health care interventions based on community care. Methods: The participants were three elderly people with the halitosis. An oral health intervention programs including oral massage, oral hygiene care, and oral muscle training strenghtening were conducted for 12 weeks. Halitosis was measured using an oral malodor-checking device. Results: The program showed positive effects on changes in halitosis. The concentration of VSCs of the first case decreased rapidly from 44.5 Refres Oral Volume (ROV) on pre-test to 15.5 ROV on the first post-test. In the second case, the score decreased from 14.5 ROV on pre-test to 12 ROV on 2nd post-test. In the third case, the score decreased slightly from 6.5 ROV on pre-test to 6 ROV on the first post-test. Conclusions: Oral health care interventions contributed to decreasing the concentration of VSCs and improving the quality of life of older adults. The active promotion and customization of these programs are required.