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The Clinical Manifestation of Pulmonary Infection in AIDS Patients (국내 일개 대학병원에서 경험한 AIDS 환자의 폐 감염성 질환의 임상적 특성)

  • Jung, Jae Woo;Chung, Jin Won;Song, Ju Han;Jeon, Eun Ju;Lee, Young Woo;Choi, Jae Cheol;Shin, Jong Wook;Park, In Whon;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.554-561
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    • 2006
  • Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.

Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients (간 또는 심장이식을 시행 받은 환자에서의 결핵의 발생률 및 임상양상)

  • Jung, Hoon;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Jae-Joong;Lee, Sung-Gyu;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.440-446
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    • 2006
  • Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

Clinical Characteristics and Prognosis of Acinetobacter Nosocomial Pneumonia between MDR and non-MDR (Acinetobacter 병원내 폐렴에서 다제 내성군과 약제 감수성군 간의 임상적 특징과 예후)

  • Park, In-Il;Kim, Ick-Keun;Koo, Hyun-Cheol;Han, Jae-Pil;Kim, Young-Mook;Lee, Myung-Goo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.13-19
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    • 2006
  • Background: Acinetobacter baumannii has emerged as an important nosocomial pathogen worldwide. The incidence of these infections has recently begun to increase. The mortality rate associated with these infections is high (bacteremia; 52%, pneumonia: 23%~73%) and multidrug resistance has been reported. For the effective control of multidrug-resistant Acinetobacter baumannii(MDR-AB), the impact of these organisms in clinical practice should be determined. This study compared the clinical characteristics, mortality and morbidity of Acinetobacter nosocomial pneumonia between MDR strain and non-MDR strain. Methods: From Jan. 1, 2002 to Nov. 1. 2004, 47 adult patients with Acinetobacter nosocomial pneumonia in Chuncheon Sacred Heart Hospital were recruited and analyzed retrospectively. MDR-AB was defined as showing in vitro resistance to all commercially available antibiotics against A. baumannii. Results: There were 47 patients with Acinetobacter nosocomial pneumonia. MDR-AB and non MDR-AB was the cause of the pneumonia in 17 and 30 patients, respectively. Mean age of the former was $69{\pm}11$ years old and the latter was $70{\pm}13$ years old. The mean APCHE II score, ICU days and mortality were not different between the two groups ($16.1{\pm}5.4$ vs. $14.9{\pm}4.8$, P=0.43, $25.1{\pm}13.6$ vs. $39.1{\pm}31.0$, P=0.2, 58.8% vs. 40%, P=0.21). Conclusion: There are no significant differences in mortality and morbidity between MDR and non-MDR Acinetobacter baumannii. The mortality of the two groups is surprisingly high, therefore proper infection control practices are essential.

Smoking Status and Serum NSE Level, as Prognostic Factors in Adenocarcinoma of Lung (원발성 폐선암 환자에서 예후인자로 흡연 및 NSE 수치의 의의)

  • Kim, Hee Kyoo;Ok, Chul Ho;Jung, Mann Hong;Jang, Tae Won
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.582-589
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    • 2005
  • Background : The incidence of lung adenocarcinoma, which is more prevalent in women and nonsmokers, is increasing. The aim of this study was to determine the prognostic factors of an adenocarcinoma of the lung. Material and method : The clinical information of patients diagnosed with an adenocarcinoma of the lung at the Kosin University Gospel Hospital from January 1994 to July 2004 was reviewed retrospectively. The survival time of these patients was analyzed by the patient's age, gender, performance status, weight loss, smoking history, location of the primary tumor, clinical stage, serologic tumor markers, and treatment modality. Results : For all 422 patients with an adenocarcinoma of the lung, 247 (58.5%) were male, and their mean age was 59.8 years the. The majority of patients were smokers (58.3%), and the tumors were located in the periphery (59.7%). In the smokers, the tumor was located more in the central airway compared to the non-smokers (42.8% vs. 31.9%, p=0.12). The overall median survival time was 390 days (95% CI;304-436 days). Univariate survival analysis revealed that an older age (${\geq}65$ years old), male, weight loss, smoker, central type, advanced clinical stage, elevated serum carcinoembryonic antigen (CEA, >5 ng/ml) and neuron specific enolase (NSE, >15 ng/ml), and the supportive care only were significantly poor prognostic factors. The median survival time was shorter in the smokers than nonsmokers (289 days vs. 533 days, p<0.001). In addition, it was also shorter in the elevated NSE group than in the normal range group (207 days vs. 469 days, p<0.001). Multivariate analysis showed that age, clinical stage, serum NSE, smoking status, and treatment modality were independent predictors of survival (hazard ratios: 1.68, 1.94, 1.92, 2.39 and 1.57, respectively). Conclusions : Smoking is an important prognostic factor in an adenocarcinoma of the lung, but not gender. This suggests that the better prognosis of women is more related with the lower rate of smoking. In addition, the elevated serum NSE is also an important prognostic in an adenocarcinoma of the lung.

Particulate Matter from Asian Dust Storms Induces the Expression of Proinflammatory Cytokine in A549 Epithelial Cells (PM10이 A549 Cells에서 전염증성 Cytokine발현에 미치는 영향)

  • Kim, Jung Ho;Jeon, Hyo Keun;Kim, Mi Kyeong;Kyung, Sun Yong;An, Chang Hyeok;Lee, Sang Pyo;Park, Jung Woong;Jeong, Sung Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.663-672
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    • 2006
  • Background: $PM_{10}$(Particulate matter with a diameter ($<10{\mu}m$), which is characterized by different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also produce unique particulate matter in affected areas. This study investigated the cytokine produced by A549 epithelial cells exposed to particles collected during both the Asian dust pfenomenon and ambient air particles in a non-dusty period. Method: Air samples were collected using a high volume air sampler(Sibata Model HV500F) with an air flow at $500{\ell}/min$ for at least 6 hours. The cytokine messenger RNA(mRNA) was measured using a reverse transcriptase polymerase chain reaction(RT-PCR). The A549 cells were exposed to 10 to $500{\mu}g/m{\ell}$ of a suspension containing $PM_{10}$ for 24 hours. Each was compared with those in the non-exposed control cells. Result: The mRNA levels of interleukin(IL)-$1{\alpha}$, $IL-I{\beta}$, IL-8, and the granulocyte macrophage colony stimulating factor(GM-CSF) increased after veing exposed to $PM_{10}$ in the ambient air particles, compared with those in the non-exposed control cells. The increase in $IL-1{\alpha}$ and IL-8 were dose dependent at a $PM_{10}$ concentration between $100{\mu}g/m{\ell}$ and $500{\mu}g/m{\ell}$. The mRNA level of IL-8 in the A549 epithelial cells was higher during the in the Asian dust period($500{\mu}g/m{\ell}$) than during the non dust period. Conclusion: A549 cells exposed to the $PM_{10}$ collected during the Asian dust period produce more proinflammatory cytokine than during non-dusty period. This cytokine enhances the local inflammatory response in the airways and can also contribute to the systemic component of this inflammatory process.

Comparison of Thinprep (Liquid-Based Cytology) and Conventional Cytology : Abnormal Lesion on Bronchoscopy (기관기내시경상 이상병변을 보이는 환자에게 있어 Thinprep검사법과 기존세포검사법의 효율성 및 유용성에 대한 비교)

  • Lee, Jung Ho;Yang, Jung Kyung;Jung, In Bum;Lee, Jung Hea;Sul, Hae Jung;Kim, Yoon Mi;Kim, Bum Kyeng;Choi, Yue Jin;Na, Moon Joon;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.547-553
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    • 2006
  • Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.

A Study on the Smog Reduction Strategies in China (중국의 스모그 저감정책에 대한 고찰)

  • Jeon, So Hyeon;Kim, Yong Pyo
    • Particle and aerosol research
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    • v.11 no.3
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    • pp.63-75
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    • 2015
  • Atmospheric environment in Korea is influenced by outside, especially China. The concentrations of air pollutants in China have showed decreasing trends since 2000. However, these concentration levels in China are still higher than other developed countries. The Chinese Government has tried several measures to control the air pollution. In this study, the details of the amendments and smog reduction strategies in China, especially for Beijing are reviewed and the strategies for Korean side to promote cooperation in Northeast Asia are suggested and discussed. The Chinese State Council amended the Environmental Protection Provisions and Clean Air Act and announced The Action Plan for Air Pollution Control (2013-2017), focusing on three key regions, Beijing-Tianjin-Hebei area (Jing-Jin-Ji), Yangtze River Delta (YRD) and Pearl River Delta (PRD). These policy actions and plan are mainly for the reducing coal usage and emissions from vehicles. It is suggested that, Korea should actively promote multi-national cooperation in the region to take an initiative role in environmental areas.

Kimchi Intake Patterns and Preferences among Elementary School, Middle School, and High School Students in Rural Areas - Focusing on the School in Chungbuk Province - (농촌지역 초중고 학생들의 김치 섭취실태 및 기호도 분석 - 충청북도에 위치한 학교를 중심으로 -)

  • Moon, Sung-Won;Lee, Myung-Ki;Na, Tae-Kyun
    • Culinary science and hospitality research
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    • v.17 no.1
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    • pp.142-154
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    • 2011
  • The purpose of this research is to examine the awareness and preference for a variety of Kimchi and Kimchi intake patterns among the students living in Chungbuk province. Four hundred samples, consisting of elementary, middle, and high school students, were surveyed; and a total of 366 usable, completed copies of the questionnaire were used for the research. The collected data were statistically analyzed using SPSS 10.0. The results of the analysis were as follows: First, Kimchi was considered traditional (24.3%), nutritious (20.5%), fermented (l9.2%), and healthy (16.1%). Second, the main reason Kimchi was preferred was its "hot taste" (25.4%), "chewy texture" (17.4%), and "sour taste" (14.0%). The students preferred their Kimchi a little hot, moderately salty, and properly fermented with a moderate amount of seasoning and did not care much about any particular parts of Kimchi. Third, 75.4% of the students ate Kimchi more than twice a day, and 78.0% of the students consumed more than 3 pieces($2.5{\times}3.0cm$) of Kimchi per meal. Fourth, elementary students wanted the school foodservice to develop bite-sized Kimchi while middle school students wanted to eat their favorite parts of Kimchi without the fishy smell. High school students wanted to eat cool and fresh Kimchi. Finally, the students wanted Kimchi to contain the following fruit and vegetables: pears (48.9%), apples (34.2%), and pineapples (30.0%), young radishes (44.9%), turnips (37.5%), and sesame leaves (34.9%). This study concludes that it is necessary to educate young students about traditional Korean food culture, serve them various types of Kimchi, change the service style, and develop new Kimchi recipes to increase Kimchi intake in school foodservices.

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A Study on the Effects of Brand Individuality of Specialty Coffee Shops on Brand Loyalty (커피 전문점의 브랜드 개성이 브랜드 충성도에 미치는 영향에 관한 연구)

  • Kim, Joon-Seok;Choi, Sung-Hwan
    • Culinary science and hospitality research
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    • v.17 no.1
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    • pp.124-141
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    • 2011
  • The domestic food culture in Korea has gone through great changes, among which dining out is considered most prominent. These changes are caused by a number of factors: development of several related industries, increase in dining out chances, diversification of consumer needs, change in consumption awareness and quality, increase in disposable income, women's advance into the society, etc. Under these circumstances, the fast food industry has been experiencing slow growth, whereas family restaurants and take out coffee franchises are consistently increasing the number of restaurants and shops as a part of aggressive management to increase sales. This study aims, first, to examine the effects of consumer's brand individuality and satisfaction on brand trust, brand emotion, brand identification, and brand loyalty of specialty coffee shops. Subsequently, this study observes how consumer's brand individuality and satisfaction affect the formation of brand trust, brand emotion, brand identification, and brand loyalty in accordance with preferred type of specialty coffee shops, frequency of experience, and life style in order to establish relevant strategies. The results of this study are as follows. First, brand individuality had a positive effect on customer satisfaction. Second, customer satisfaction had a positive effect on brand trust. Third, customer satisfaction had a positive effect on brand loyalty. Fourth, customer satisfaction had a positive effect on brand emotion. Fifth, brand trust had a positive effect on brand loyalty. Sixth, brand emotion had a positive effect on brand loyalty. These results have the following implications. First, the dimensions of brand individuality are presented as a means to form brand loyalty, thereby demonstrating the significance of the effect. Accordingly, developing a proper brand individuality in forming brand loyalty is imperative. Second, consumers using specialty coffee shops had the greatest effect on the relation between dimensions of brand individuality and customer satisfaction in this study, while the interrelation between customer satisfaction and brand loyalty was not concretely supported in the preceding studies.

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Physicochemical Characteristics of Loaf Bread Added with Waxy Black Rice Flour by Storage Period (찰흑미분 첨가 식빵의 저장기간별 이화학적 특성 변화)

  • Kim, Weon-Mo;Lee, Yoon-Shin
    • Culinary science and hospitality research
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    • v.17 no.1
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    • pp.248-258
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    • 2011
  • To analyze die quality characteristics of loaf bread added with waxy black rice flour by its storage period, this study stored loaf bread made of wheat flour added with 10% 20% 30% and 40% of waxy black rice flour for 4 days while measuring water activity, pH, chromaticity and texture. The results of die study are as follows. Based on die results of measurements of water activity of loaf bread added with waxy black rice flour by storage period, die control group and die groups added with 10% and 20% of waxy black rice flour showed significantly low water activity from the $3_{rd}$ day of storage and die groups added with 30% and 40% of waxy black rice flour from the $2_{nd}$ day of storage. As for pH changes over the storage period, only die group added with 40% of waxy black rice flour showed significant pH decreases from die $3_{rd}$ day of storage while the control group and the groups added with 10% and 30% of waxy black rice flour showed significant pH decreases from die $2_{nd}$day of storage. As for the pH of each group of loaf bread by storage days, die loaf bread added with 40% of waxy black rice flour showed significantly higher pH compared to the control group. Brightness decreased significantly from the 2nd day of storage and die yellowness from the $3_{rd}$ day of storage. As for chromaticity changes by storage days, as die amount of added waxy black rice flour increased, L values and b values decreased while redness values significantly increased. Over die storage period, hardness, gumminess and chewiness increased and die waxy black rice flour added groups showed lower increase rates compared to die control group. Especially, die groups added with 30% and 40% of waxy black rice flour showed low hardness changes. Springiness level was decreased as die addition rate of waxy black rice flour was increased, and the group added with 40% of waxy balck rice flour showed die lowest springiness level. It also showed lower cohesiveness up to the 3rd day of storage compared to die day of manufacturing. Therefore, it could be seen that die loaf bread made from wheat flour added with 30% of waxy black rice flour showed better quality feature until die $3_{rd}$ day of storage than die other experimental groups.

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