• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.705-713
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• 1998

Background: An association between diabetes and tuberculosis has long been implied. The severity of diabetes appears to correlate with the degree of tuberculous activity. Methods: A retrospective chart review of 82 patients with active pulmonary tuberculosis in diabetics (DMTB) and 83 patients with active pulmonary tuberculosis in nondiabetics (Non-DMTB) admitted to the Kyung Hee Medical Center between January 1995 and December 1996 was underiaken. Results: The sex ratio of DMTB was 58 : 24, and that of Non-DMTB was 62 : 21. Male patients predominated in both groups. The highest incidence of DMTB was 6th and 7th decades and that of Non-DMTB was 3rd and 4th decades. In case which the tuberculosis developed after diagnosis of diabetes, the prevalence of pulmonary tuberculosis was the highest in diabetes for 5-10 years. On chest X-ray findings, the moderate advanced tuberculosis cases were the most common (60.9% in DMTTB and 50.6% in Non-DMTB). There was no relation between the degree of tuberculosis activity on chest x-ray(minimal, moderate, and far advanced tuberculosis) and presence of diabetes. The incidence of lower lung field tuberculosis in DMTB was significantly higher than Non-DMTB(p<0.05). The multiple lobe involvement was the predominant chest roentgenographic finding in both groups. There was no significant difference of treatment response between DMTB and Non-DMTB. There was no relationship between initial HbA1c and the severity of pulmonary tuberculosis on chest X-ray. During treatment of pulmonary tuberculosis in excellently and well controlled diabetes, the cure rate of pulmonary tuberculosis was significantly higher than the poorly controlled diabetes and the rate of treatment failure was significantly lower than poorly controlled diabetes. (p<0.05). Conclusion: Poor control of blood glucose is related with increased rate of treatment failure in pulmonary tuberculosis with diabetes mellitus. Further investigation will be needed to study the mechanisms of treatment failure in poorly controlled diabetics with pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.471-477
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• 1999

Background : Smoking and high-risk occupation have been known to be the risk factors of lung cancer. The carcinogen-metabolizing enzymes in human body such as glutathione S-transferase M1, T1 and N-acetyltransferase 1 have also been regarded as risk factors in many cancers, because the activities of those enzymes play a role in metabolizing the carcinogen. A case-control study was conducted to evaluate the genetic polymorphism of GSTM1, T1 and NAT1 in lung carcinogenesis in Korean men. Methods : The histologically proven lung cancer cases were recruited from Seoul National University Hospital. The patients of more than 40-year-old with the nonmalignant urinary tract diseases were recruited as controls from the same hospitals. The informations of demographical characteristics and smoking were obtained by interview or chart review and the genetic polymorphisms of GSTM1, T1 and NAT1 were determined by PCR-based assay. The statistical analyses were performed by linear logistic regression. Results : The number of case-control was 118 and 150, respectively. The smoking history was significantly higher in the lung cancer patients than the controls. The prevalence of GSTM1 null-type was statistically higher(OR=2.25 ; 95% CI=1.12-4.51) in squamous cell carcinoma than other genotypes, but other histologic types were not The prevalence of GSTT1 null-type were not statistically higher than other genotypes in all histologic types. The fast acetylator of NAT1 was more prevalent than normal(OR=2.13 ; 95% CI=1.04-4.40) in all lung cancer patients. Conclusion : The null-type of GSTM1 and fast acetylator of NAT1 are associated with development of lung cancer in Korean men.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1166-1172
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• 2018

Purpose: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. Methods: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ${\geq}20%$ of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. Results: The mean pretreatment IOP was $23.17{\pm}6.96mmHg$. The mean IOP reduction was $5.59{\pm}4.78mmHg$ (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was $4.70{\pm}4.67mmHg$ (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). Conclusions: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1199-1213
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• 1998

Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.

• Journal of Digital Convergence
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• v.12 no.9
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• pp.237-244
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• 2014

Pathogenic fungal infections are predominantly occurred in patients with severe immune or metabolic defects. In the present study, we aimed to investigate the last five years (2007~2011) 190,250 cases clinical specimens of yeast 3,487 results that had shown positive culture and to look at the significance of regional difference and identify relationship between provide the characteristics about association between clinical isolates and gender, age, and type of specimens. The yearly strain-specific isolation frequency of yeast separated was 1,925(55.2%) for C. albicans the largest of them. All kinds of clinical specimen was 1,495(42.9%) in urine, 998(28.6%) in sputum. Strain-specific gender differences in C. albicans for males was 1,177(57.8%) of the total of 2,037 and 748(51.6%) of 1,450 and as for age, those between 70 and 79 were the largest with 639(55.1%) of the 1,925 strain. In this study, well presented the general characteristics of pathogenic yeast seen in diverse specimens. This limitation has been implemented in a single area, Future research is expected to examine more on nationwide distribution chart, dynamic characteristics and future antibiotic sensitivity.

• Korean Journal of Clinical Pharmacy
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• v.18 no.2
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• pp.114-119
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• 2008

Alendronate is a bisphosphonate that selectively inhibits osteoclast-mediated bone resorption. Dosing convenience is an important element for the enhancement of patient compliance and the effective management of osteoporosis. The purpose of this study was to compare the effectiveness and compliance among alendronate pharmaceutical products (oral once-weekly alendronate 70 mg, daily alendronate 10 mg, and once-weekly alendronate 70 mg with Vitamin $D_3$ 2800 IU) in terms of the change in bone mineral density (BMD), biochemical markers, and compliance estimates. A retrospective chart review was conducted in patients with osteoporosis who received alendronate 70 mg (Group 1), alendronate 10 mg (Group 2), or alendronate 70 mg with Vitamin D3 2800 IU (Group 3) at the endocrinology department of a hospital in Korea from Jan. 1, 1998 to Mar. 31, 2008. The primary endpoints were the increases in spine antero-posterior BMD T-score and femur trochanter BMD T-score, and the compliance of alendronate products. Secondary endpoints included changes in bone turnover-related biochemical markers including bone-specific alkaline phosphatase, urinary N-terminal telopeptides (NTX) and osteocalcin, and in serum vitamin $D_3$ concentration. There was no statistical difference in the BMD increase among the three alendronate products; spine BMD T-score increased by $0.49{\pm}0.52$, $0.39{\pm}0.48$ and $0.50{\pm}0.41$, and femur trochanter BMD T-score by $0.29{\pm}0.42$, $0.21{\pm}0.53$ and $0.24{\pm}0.22$ in Group 1, 2 and 3, respectively. With respect to the increases in femur trochanter BMD T-score and the decreases in NTX and osteocalcin, 70 mg once-weekly group was remarkably superior to 10 mg daily group (p < 0.05) The compliance of 70 mg once-weekly group was significantly higher than that of 10 mg daily treatment group (p < 0.001). In conclusion, all three alendronate treatment groups were equivalent in effectiveness, and the compliance of 70 mg once-weekly group was better than that of 10 mg daily treatment group.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.239-245
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• 2010

Objectives : The aim of this study is to evaluate the effect of cervical Hyeopcheok(Jiaji) point for neck pain. Methods : The twenty-nine patients who feel neck pain, are chosen from chart review, received acupuncture treatment on cervical Hyeopcheok(Jiaji) point. The evaulation of progress was checked by NDI(neck disability index), and VAS(visual analog scale). Data were analyzed by Friedman two way analysis of variance and Wilcoxon matched pairs signed rank test. Results : NDI value(mean${\pm}$SD) was $17.76{\pm}8.26$(n=29) at the first visit, $13.41{\pm}8.04$(n=29) at 3days after treatment, $10.85{\pm}8.46$(n=26) at 5days, $11.00{\pm}7.80$(n=13) at 9days, $7.22{\pm}4.76$(n=9) at 15days, $3.86{\pm}4.06$(n=7) at 20days, and $3.33{\pm}3.78$(n=6) at 30days. VAS value(mean${\pm}$SD) was $4.07{\pm}1.33$(n=29) at the first visit, $12.97{\pm}1.05$(n=29) at 3days after treatment, $2.15{\pm}1.12$(n=26) at 5days, $2.15{\pm}0.99$(n=13) at 9days, $1.56{\pm}0.73$(n=9) at 15days, $1.29{\pm}0.49$(n=7) at 20days, and $0.83{\pm}0.41$(n=6) at 30days. The value of NDI and VAS gradually decreased. Repeated measurement results(the difference between the first visit and each measurement day) and the difference between before and after the interval(except between 5 and 9days, between 20 and 25days) were statistically significant. Conclusions : This result was shown that treatment of cervical Hyeopcheok(Jiaji) acupuncture point for neck pain can be effective. Further systematic research will be needed.

• Journal of agricultural medicine and community health
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• v.42 no.1
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• pp.24-35
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• 2017

Objectives: This study aimed to evaluate the primary care quality of a public health center in a rural area using the Korean Primary Care Assessment Tool (KPCAT). It also examined some methodological issues in applying the KPCAT and interpreting its results. Methods: Seventy-nine patients who had visited their doctor more than four times responded to the KPCAT questionnaire. Descriptive statistics and a radar chart were used in analyzing data. Sign test was used to test the KPCAT score difference by don't know option scoring methods. Results: Median and interquartile range of the public health center's KPCAT scores were forty-five and sixteen points, respectively. Only the median of the first contact domain reached the expected value of seventy-five points. The proportions of those who scored under the expected value were under fifty percent in two of four comprehensiveness items, all of three coordinating function items, two of five personalized items and all of four family/community orientation items. There were some methodological issues including, how to score don't know option and make sure response scale consistency. Conclusions: There was much room to improve the primary care quality of the rural public health center. Especially, improvement is needed in the domain of coordinating function and family/community orientation. We also hope that methodological improvement of the KPCAT contributes to more valid and reliable primary care assessment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.3
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• pp.247-258
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• 1994

We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.81-88
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• 2020

Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.