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Study about the clinical features and Pulmonary function Tst of Endobronchial Tuberculosis (기관지결핵의 임상상 및 폐기능검사에 관한 연구)

  • Chung, Hee-Soon;Lee, Jae-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.147-158
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    • 1996
  • Background : Endobronchial tuberculosis(ET) is known to affect frequently young female and serious complication like bronchial stenosis would occur if early diagnosis and treatment for ET is not performed immediately. But ET shows normal chest roentgenogram in about 10% of patients, and is often confused with bronchial asthma because ET presents clinical features like cough, dyspnea, wheezing in history and physical examination. The pulmonary function test(PFT) feature of ET is not well known, but when we consider the fact that ET is pathophysiologically different from bronchial asthma, if there is any feature of PFT in ET, and we know it, PFT will be very helpful for diagnosis and follow up of ET. Methods : We performed both PFT and bronchoscopy in 68 ET patients who visited Boramae hospital, and were confirmed as ET by bronchoscopic biopsy and were followed prospectively from November 1991 to March 1995. After history taking and physical examination, we performed chest roentgenogram, complete blood count, sputum AFB stain and culture, and also performed PFT before anti-tuberculosis chemotherapy. PFT was classified as restrictive, if only PVC was reduced below 80%, and obstructive, if only FEV1 was reduced below 75%. In the case of both FVC and FEV1 were reduced, PFT was classified as restrictive if FEY1/FVC was greater than 75%, and mixed if FEV1/FVC was reduced below 75%. We repeated the PFT and bronchoscopy for 68 ET patients who were proven by biopsy in the first month and sixth month after starting anti-tuberculosis chemotherapy, and studied the feature and change of PFT of the ET and the relation between PFT and the bronchoscopic finding, and obtained following results. Results: 1) Number of male patients was 12, and that of female patient was 56, and mean age was $35.4{\pm}17yr$.(17-74yr). Clinical symptom was in the order of cough(86.8%), dyspnea(63.2%), fever(17.6%) and hemoptysis (10.3%), and the wheezing and stridor were audible among the 40 patients(58.4%) in the physical examination. 2) Hemoglobin level was below 12g/dl among 25 patients (36.8%), and WBC level was above $10,000/mm^3$ among 9 patients(13.2%) and ESR was above 20 among 46 patients (67.6%) and AFB stain and culture were positive among 50 patients(73.5%). 3) The dominant roentgenographic finding of ET was fibronodular feature in 35 patients(51.5%), pneumonic feature in 14 patients (20.6%), collapse in 11 patients(16.2%), mass-like lesion in 3 patients(4.4%), cavitary lesion in 2 patients(2.9%), and normal in 3 patients(4.4%). 4) PFT feature at the time of diagnosis of ET was normal in 16 patients(23.5%), restrictive pattern in 32 patients (47%), obstructive in 4 patients(5.8%), and mixed in 14 patients(23.5%). So restrictive pattern was the dominate feature of ET. 5) The PFT feature was little correlated with the gross finding of bronchoscopy, but the change of PFT during treatment of ET showed relatively good correlation with the change of bronchoscopic finding. 6) FVC(2.30L vs. 2.61L) and FEV1(1.74L vs. 2.06L) increased significantly (p < 0.01), but FEV1/FVC(82% vs. 83%) and PEF(3.45L/sec vs. 3.95L/sec) did not change significantly after 1 month of treatment (p > 0.01), and there was no significant change among all parameters during first and sixth month of treatment(p > 0.01). Conclusion : PFT may be useful in the diagnosis and treatment follow up of ET but further study would be needed to confirm it.

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Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents (성장기 청소년의 혈압변화와 결정요인)

  • Suh, Il;Nam, Chung-Mo;Jee, Sun-Ha;Kim, Suk-Il;Kim, Young-Ok;Kim, Sung-Soon;Shim, Won-Heum;Kim, Chun-Bae;Lee, Kang-Hee;Ha, Jong-Won;Kang, Hyung-Gon;Oh, Kyung-Won
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.308-326
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    • 1997
  • Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

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Incidence of Hypertension in a Cohort of an Adult Population (성인코호트에서 고혈압 발생률)

  • Kam, Sin;Oh, Hee-Sook;Lee, Sang-Won;Woo, Kook-Hyeun;Ahn, Moon-Young;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.141-146
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    • 2002
  • Objectives : This study was peformed in order to assess the incidence of hypertension based on two-years follow-up of a rural hypertension-free cohort in Korea. Methods : The study cohen comprised 2,580 subjects aged above 20 (1,107 men and 1,473 women) of Chung-Song County in Kyungpook Province judged to be hypertensive-free at the baseline examination in 1996. For each of two examinations in the two-year follow-up, those subjects free of hypertension were followed for the development of hypertension to the next examination one year (1997) and two years later (1998). The drop-out rate was 24.7% in men and 19.6% in women. Hypertension was defined as follows 1) above mild hypertension as a SBP above 140 mmHg or a DBP above 90 mmMg,2) above moderate hypertension as a SBP above 160 mmHg or a DBP above 100 mmHg or when the participant reported having used antihypertensive medication after beginning this survey. Results : The age-standardized incidence of above mild hypertension was 6 per 100 person years (PYS) in men and that of above moderate hypertension was 1.2. In women, the age-standardized rate for above mild hypertension was 5.7 and 1.5 for above mild and moderate hypertension, respectively. However, the rates of incidence as calculated by the risk method were 4.8% and 1.0% in men and 4.6%, 1.2% in women, respectively. In both genders, incidence was significantly associated with advancing age(p<0.01), In men, the incidences of above moderate hypertension by age group were 0.5 per 100 PYS aged 20-39, 0.7 aged 40-49, 1.7 aged 50-59, 3.6 aged 60-69, and 5.8 aged above 70(p<0.01). In women, those the incidence measured 0.6 per 100 PYS aged 20-39, 1.8 aged 40-49, 1.3 aged 50-59, 3.3 aged 60-69, and 5.6 aged above 70(p<0.01). After age 60, the incidence of hypertension increased rapidly. Conclusions : The incidence data of hypertension reported in this study may serve as a reference data for evaluating the impact of future public efforts in the primary prevention of hypertension in Korea.

A Grounded theory Approach on the Experience of Sexual Abuse Victims (성폭력 피해여성의 경험에 관한 연구)

  • Kim, Kyung-Hee;Nam, Sun-Young;Chee, Soon-Ju;Kwon, Hye-Jin;Chung, Yeon-Kang
    • Journal of the Korean Society of School Health
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    • v.9 no.1
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    • pp.77-98
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    • 1996
  • This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiosity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", "avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging, "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "information availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporating the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthiness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthiness. 6. The older the victims, The weaker the senses of being taken aback and filthiness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 13. The more closed the personality of tile subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more lilely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuses, the more likely response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping. 17. The less available information concerning sexual abuses, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 21. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping. 22. The more likely the response to 'being taken aback' and 'filthiness' is 'informing and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypotheses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined with weak sexual curiosity and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness', further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 3) In case the level of violence is strong and 'being taken abuse' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protective and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despite the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong and 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequency is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohesion is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

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A Brief Review of Backgrounds behind "Multi-Purpose Performance Halls" in South Korea (우리나라 다목적 공연장의 탄생배경에 관한 소고)

  • Kim, Kyoung-A
    • (The) Research of the performance art and culture
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    • no.41
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    • pp.5-38
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    • 2020
  • The current state of performance halls in South Korea is closely related to the performance art and culture of the nation as the culture of putting on and enjoying a performance is deeply rooted in public culture and arts halls representing each area at the local government level. Today, public culture and arts halls have multiple management purposes, and the subjects of their management are in the public domain including the central and local governments or investment and donation foundations in overwhelming cases. Public culture and arts halls thus have close correlations with the institutional aspect of cultural policies as the objects of culture and art policies at the central and local government level. The full-blown era of public culture and arts halls opened up in the 1980s~1990s, during which multi-purpose performance halls of a similar structure became universal around the nation. Public culture and arts halls of the uniform shape were distributed around the nation with no premise of genre characteristics or local environments for arts, and this was attributed to the cultural policies of the military regime. The Park Chung-hee regime proclaimed Yusin that was beyond the Constitution and enacted the Culture and Arts Promotion Act(September, 1972), which was the first culture and arts act in the nation. Based on the act, a five-year plan for the promotion of culture and arts(1973) was made and led to the construction of cultural facilities. "Public culture and arts" halls or "culture" halls were built to serve multiple purposes around the nation because the Culture and Arts Promotion Act, which is called the starting point of the nation's legal system for culture and arts, defined "culture and arts" as "matters regarding literature, art, music, entertainment, and publications." The definition became a ground for the current "multi-purpose" concept. The organization of Ministry of Culture and Public Information set up a culture and administration system to state its supervision of "culture and arts" and distinguish popular culture from the promotion of arts. During the period, former President Park exhibited his perception of "culture=arts=culture and arts" in his speeches. Arts belonged to the category of culture, but it was considered as "culture and arts." There was no department devoted to arts policies when the act was enacted with a broad scope of culture accepted. This ambiguity worked as a mechanism to mobilize arts in ideological utilizations as a policy. Against this backdrop, the Sejong Center for the Performing Arts, a multi-purpose performance hall, was established in 1978 based on the Culture and Arts Promotion Act under the supervision of Ministry of Culture and Public Information. There were, however, conflicts of value over the issue of accepting the popular music among the "culture and arts = multiple purposes" of the system, "culture ≠ arts" of the cultural organization that pushed forward its establishment, and "culture and arts = arts" perceived by the powerful class. The new military regime seized power after Coup d'état of December 12, 1979 and failed at its culture policy of bringing the resistance force within the system. It tried to differentiate itself from the Park regime by converting the perception into "expansion of opportunities for the people to enjoy culture" to gain people's supports both from the side of resistance and that of support. For the Chun Doo-hwan regime, differentiating itself from the previous regime was to secure legitimacy. Expansion of opportunities to enjoy culture was pushed forward at the level of national distribution. This approach thus failed to settle down as a long-term policy of arts development, and the military regime tried to secure its legitimacy through the symbolism of hardware. During the period, the institutional ground for public culture and arts halls was based on the definition of "culture and arts" in the Culture and Arts Promotion Act enacted under the Yusin system of the Park regime. The "multi-purpose" concept, which was the management goal of public performance halls, was born based on this. In this context of the times, proscenium performance halls of a similar structure and public culture and arts halls with a similar management goal were established around the nation, leading to today's performance art and culture in the nation.

A Study on the Effect of Booth Recommendation System on Exhibition Visitors Unplanned Visit Behavior (전시장 참관객의 계획되지 않은 방문행동에 있어서 부스추천시스템의 영향에 대한 연구)

  • Chung, Nam-Ho;Kim, Jae-Kyung
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.175-191
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    • 2011
  • With the MICE(Meeting, Incentive travel, Convention, Exhibition) industry coming into the spotlight, there has been a growing interest in the domestic exhibition industry. Accordingly, in Korea, various studies of the industry are being conducted to enhance exhibition performance as in the United States or Europe. Some studies are focusing particularly on analyzing visiting patterns of exhibition visitors using intelligent information technology in consideration of the variations in effects of watching exhibitions according to the exhibitory environment or technique, thereby understanding visitors and, furthermore, drawing the correlations between exhibiting businesses and improving exhibition performance. However, previous studies related to booth recommendation systems only discussed the accuracy of recommendation in the aspect of a system rather than determining changes in visitors' behavior or perception by recommendation. A booth recommendation system enables visitors to visit unplanned exhibition booths by recommending visitors suitable ones based on information about visitors' visits. Meanwhile, some visitors may be satisfied with their unplanned visits, while others may consider the recommending process to be cumbersome or obstructive to their free observation. In the latter case, the exhibition is likely to produce worse results compared to when visitors are allowed to freely observe the exhibition. Thus, in order to apply a booth recommendation system to exhibition halls, the factors affecting the performance of the system should be generally examined, and the effects of the system on visitors' unplanned visiting behavior should be carefully studied. As such, this study aims to determine the factors that affect the performance of a booth recommendation system by reviewing theories and literature and to examine the effects of visitors' perceived performance of the system on their satisfaction of unplanned behavior and intention to reuse the system. Toward this end, the unplanned behavior theory was adopted as the theoretical framework. Unplanned behavior can be defined as "behavior that is done by consumers without any prearranged plan". Thus far, consumers' unplanned behavior has been studied in various fields. The field of marketing, in particular, has focused on unplanned purchasing among various types of unplanned behavior, which has been often confused with impulsive purchasing. Nevertheless, the two are different from each other; while impulsive purchasing means strong, continuous urges to purchase things, unplanned purchasing is behavior with purchasing decisions that are made inside a store, not before going into one. In other words, all impulsive purchases are unplanned, but not all unplanned purchases are impulsive. Then why do consumers engage in unplanned behavior? Regarding this question, many scholars have made many suggestions, but there has been a consensus that it is because consumers have enough flexibility to change their plans in the middle instead of developing plans thoroughly. In other words, if unplanned behavior costs much, it will be difficult for consumers to change their prearranged plans. In the case of the exhibition hall examined in this study, visitors learn the programs of the hall and plan which booth to visit in advance. This is because it is practically impossible for visitors to visit all of the various booths that an exhibition operates due to their limited time. Therefore, if the booth recommendation system proposed in this study recommends visitors booths that they may like, they can change their plans and visit the recommended booths. Such visiting behavior can be regarded similarly to consumers' visit to a store or tourists' unplanned behavior in a tourist spot and can be understand in the same context as the recent increase in tourism consumers' unplanned behavior influenced by information devices. Thus, the following research model was established. This research model uses visitors' perceived performance of a booth recommendation system as the parameter, and the factors affecting the performance include trust in the system, exhibition visitors' knowledge levels, expected personalization of the system, and the system's threat to freedom. In addition, the causal relation between visitors' satisfaction of their perceived performance of the system and unplanned behavior and their intention to reuse the system was determined. While doing so, trust in the booth recommendation system consisted of 2nd order factors such as competence, benevolence, and integrity, while the other factors consisted of 1st order factors. In order to verify this model, a booth recommendation system was developed to be tested in 2011 DMC Culture Open, and 101 visitors were empirically studied and analyzed. The results are as follows. First, visitors' trust was the most important factor in the booth recommendation system, and the visitors who used the system perceived its performance as a success based on their trust. Second, visitors' knowledge levels also had significant effects on the performance of the system, which indicates that the performance of a recommendation system requires an advance understanding. In other words, visitors with higher levels of understanding of the exhibition hall learned better the usefulness of the booth recommendation system. Third, expected personalization did not have significant effects, which is a different result from previous studies' results. This is presumably because the booth recommendation system used in this study did not provide enough personalized services. Fourth, the recommendation information provided by the booth recommendation system was not considered to threaten or restrict one's freedom, which means it is valuable in terms of usefulness. Lastly, high performance of the booth recommendation system led to visitors' high satisfaction levels of unplanned behavior and intention to reuse the system. To sum up, in order to analyze the effects of a booth recommendation system on visitors' unplanned visits to a booth, empirical data were examined based on the unplanned behavior theory and, accordingly, useful suggestions for the establishment and design of future booth recommendation systems were made. In the future, further examination should be conducted through elaborate survey questions and survey objects.

The Difference in Chemokine Expression in Airway Epithelial Cells According to the Virulence of Tubercle Bacilli (결핵균 독성 여부에 따른 기도 상피세포의 Chemokine 발현에 관한 연구)

  • Kwon, O-Jung;Kim, Ho-Joong;Kim, Jung-Hee;Kim, Ho-Cheol;Suh, Gee-Young;Park, Jeong-Woong;Park, Sang-Joon;Chung, Man-Pyo;Choi, Dong-Chull;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.729-741
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    • 1997
  • Background : We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli suggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therefore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. Methods : Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes (PBM) were stimulated with LPS($10{\mu}g/ml$), H37Rv, or H37Ra($5{\times}10^5$ bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of $TNF{\alpha}$ and IL-$1{\beta}$ production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. Results : $TNF{\alpha}$ and IL-$1{\beta}$ productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in $TNF{\alpha}$ and IL-$1{\beta}$ production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. Conclusion : Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.

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Diagnostic Approach to the Solitary Pulmonary Nodule : Reappraisal of the Traditional Clinical Parameters for Differentiating Malignant Nodule from Benign Nodule (고립성 폐결절에 대한 진단적 접근 : 악성결절과 양성결절의 감별 지표에 대한 재검토)

  • Kho, Won Jung;Kim, Cheol Hyeon;Jang, Seung Hun;Lee, Jae Ho;Yoo, Chul Gyu;Chung, Hee Soon;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.500-518
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    • 1996
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

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Four-year change and tracking of serum lipids in Korean adolescents (강화지역 청소년의 4년간 혈청 지질의 변화와 지속성)

  • Lee, Kang-Hee;Suh, Il;Jee, Sun-Ha;Nam, Chung-Mo;Kim, Sung-Soon;Shim, Won-Heum;Ha, Jong-Won;Kim, Suk-Il;Kang, Hyung-Gon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.1 s.56
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    • pp.45-59
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    • 1997
  • It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.

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Usefulness of Stomach Extension after Drinking Orange Juice in PET/CT Whole Body Scan (PET/CT 전신 영상에서 오렌지 주스(Orange Juice)를 이용한 위장 확장 영상의 유용성)

  • Cho, Seok-Won;Chung, Seok;Oh, Shin-Hyun;Park, Hoon-Hee;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.86-92
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    • 2009
  • Purpose: The PET/CT has a clear distinction on the lesion of the functional image by adding anatomical information. It also could reduce the examination time using CT data as the attenuation-correction. When the stomach was contracted from a fast, it could bring a misinterpretation of the cancer of the lesion with a presence of physiological $^{18}F$-FDG uptake in stomach and it occasionally would bring an additional scan to confirm. To complement this shortcoming, the method that the patients had water before the examination to extend the stomach had been attempted. However, a short excretion time of the stomach did not give sufficiently extended image of the stomach. Then the patients had additional water and had the examination again. Therefore, the noticed fact is that the stomach excretion time depends on calories, protein content, and the level of carbohydrate. In this study, we use an orange juice to evaluate the extension of the stomach and usefulness of it. Materials and Methods: PET/CT scan were obtained on total 150 of patient from February 2008 to October2008, There were 3 groups in this study and each group had 50 patients. First group drank nothing, Second group drank water and third group drank orange juice. The patients (man 25, female 25) not drinking are the age of 30~71 years old (average: 54), the patients (man: 25, female: 25) drinking water (400 cc) are the age of 28~71 years old (average: 54) and the patients (man: 25, female: 25) drinking orange juice (400 cc) are the age of 32~74 years old (average: 56). The patients were fasted in 6-8 hours before the test, the patients were not diabetic. $^{18}F$-FDG 370~555 MBq were injected intravenously. The patients were in stable position for 1 hour, than the image was obtained. The patients drank water and other patients drank orange juice before Whole body scan. The image scan started from mid-femur to skull base. The emission scan acquired for three minutes per bed and the images were reconstructed. Stomach extension analysis is measured from vertical and horizontal length. Results: Stomach Extension was described as the vertical length of the Non Drink Group was $1.20{\pm}0.50\;cm$, horizontal length was $1.4{\pm}0.53\;cm$, the vertical length of the Water Drink Group was $1.67{\pm}0.63\;cm$, horizontal length was $1.65{\pm}0.77\;cm$, the vertical length of Orange juice Drink Group was $3.48{\pm}0.77\;cm$, horizontal length was $3.66{\pm}0.77\;cm$ in coronal image. Stomach Extension was described the vertical length of the Non Drink Group was $2.03{\pm}0.62\;cm$, horizontal length was $1.69{\pm}0.68\;cm$, the vertical length of Water Drink Group was $5.34{\pm}1.62\;cm$, horizontal length was $2.45{\pm}0.72\;cm$, the vertical length of Orange juice Drink Group was $7.74{\pm}1.62\;cm$, horizontal length was $3.57{\pm}0.77\;cm$ in transverse image. The Stomach Extension has specific differences (p<0.001). The SUVs shows the Non Drink Group were measured as Liver $2.52{\pm}0.42$, Lung $0.51{\pm}0.14$, the Water Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$, Orange juice Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$. The SUVs did not have specific differences (p>0.759). Conclusions: There was not a large difference of SUV in three groups. When the patients drank Orange juice and water, the range extension of stomach was higher than without drinking nothing and it was possible to acquire fully extended images. Therefore, it will be possible that unnecessary additional stomach scans will be reduced by drinking orange juice before the examination so that the patients' claim from uncomfortable and long period of fast will be minimized.

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