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Clinical Investigation of Recurrent Pneumonia in Adults - Analysis of Patients From Hallym University Medical Center - (성인 재발성 폐렴에 대한 임상적 고찰 - 한림대학교 의료원 내원 환자를 대상으로 -)

  • Eom, Kwang-Seok;Jeon, Gang;Shin, Taerim;Jang, Seung Hun;Bahn, Joon-Woo;Lee, Jae Young;Park, Yong Bum;Kim, Cheol Hong;Jeon, Man-Jo;Park, Sang Myeon;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.47-54
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    • 2004
  • Background : Recurrent pneumonia in adults is not uncommon. However, there is no domestic data about recurrent pneumonia in adults. Therefore, we investigated the associated diseases and clinical findings of recurrent pneumonia in adults. Methods : Among 5513 patients who were treated in five teaching hospitals of Hallym medical center?over a 5-year period, we retrospectively reviewed the medical records of the 58 who were compatible with diagnostic criteria of recurrent pneumonia. Results : The number of patients with recurrent pneumonia was 58 (1.05%, 58/5513) during the 5 years. Thirtyseven patients were male and 21 were female. Mean age was 66.4 (${\pm}14.9$) years. Median interval between each pneumonic episode was 18.5 months. Associated diseases were 25 cases of respiratory diseases, 13 of heart diseases, 13 of diabetes mellitus, 7 of lung malignancies, 11 of malignancies other than lung, 7 of neurologic disease, and 8 of miscellaneous diseases. Three cases had no underlying illness. Of the 8 cases with 2 or more times of recurrence, 4 were associated with respiratory diseases, 2 with aspiration pneumonia due to neurologic diseases, 1 with heart disease and 1 with no underlying illness. Recurrent pneumonic episodes affecting the same location were 30 of the total recurrent pneumonic episodes (30/67, 47.8%) and common associated diseases were respiratory diseases including lung malignancies. The etiology of recurrent pneumonia was Streptococcus pneumoniae, methicillinresistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, atypical organisms, etc. Conclusion : Recurrent pneumonia in adults had a low incidence rate compared with children, but most cases had associated illness. Respiratory diseases including lung cancer were the most common associated illness of recurrent pneumonia.

Clinical Investigation of Tuberculous Pneumonia (결핵성 폐렴환자의 임상적 고찰)

  • Lee, Seung Heon;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Lee, Sang Yeub;Kim, Jae Hyung;Park, Sang Myun;Shin, Chul;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Ryu, Sae Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.19-24
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    • 2004
  • Background : It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. Methods : We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. Result : The male to female ratio was 1:1 and the mean age at diagnosis was $54.5{\pm}18.6$ years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). Conclusion : We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.

Semi-quantitative Procalcitonin Assay in Critically ill Patients with Respiratory infections (중환자 호흡 감염에서 반정량적 Procalcitonin 분석)

  • Kim, Ji-Youn;Kim, Cheol-Hong;Park, Sunghoon;Lee, Chang-Youl;Hwang, Yong Il;Choi, Jeong-Hee;Shin, Taerim;Park, Yong-Bum;Jang, Seung-Hun;Lee, Jae Young;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.205-211
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    • 2009
  • Background: Serum procalcitonin level has been considered prognostic during sepsis and septic shock. We investigated the significance of procalcitonin in critically ill patients with respiratory infections. Methods: The patients who had radiographically diagnosed diffuse lung infiltrations were enrolled on a prospective basis. Bronchoalveolar lavage (BAL) fluid for the purpose of quantitative cultures (${\geq}10^4$ cfu/mL) was obtained from all patients. Serum procalcitonin levels determined by PCT-Q kit were measured on BAL day and classified as follows; <0.5 ng/mL, 0.5~2.0 ng/mL, 2.0~10.0 ng/mL and >10.0 ng/mL. We analyzed the patient's characteristics according to outcome; favorable or unfavorable, defined as death. Results: Patients from the following categories were included: medical 17 (47.2%), surgical 9 (25%), and burned 10 (27.8%). APACHE II scores on admission to intensive care unit were 11.5${\pm}$6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ${\geq}$0.5 ng/mL was in 17 (47.2%) of all. On univariate analysis, the frequencies of burn injury, mechanical ventilation, multiple organ failure, and a procalcitonin level ${\geq}$0.5 ng/mL were more often increased in patients with unfavorable outcomes than in those with favorable outcomes (p<.05). Also, a higher procalcitonin range and ventilator-associated pneumonia (VAP) were more closely associated with an unfavorable outcome (p<.05). However in multivariate analysis, a strong predictor of unfavorable outcome was burn injury (p<.05). A procalcitonin level ${\geq}$0.5 ng/mL was more sensitive in predicting VAP than unfavorable outcome. Conclusion: A higher procalcitonin level seems to be associated with VAP, but further study is required to know that procalcitonin would be a prognostic marker in critically ill patients with respiratory infections.

Two Cases of Chemical Pneumonitis Caused by Hydrogen Sulfide (황화수소로 인한 화학성 폐렴 2예)

  • Kim, Jung Ha;Lee, Kyung Joo;Jung, Jin Yong;Lee, Eun Joo;Jung, Ki Hwan;Kang, Eun Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.210-214
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    • 2008
  • Chemical pneumonitis is an occupational lung disease that's caused by the inhalation of chemical substances. Its severity depends on the characteristics of the substances, the exposure time and the susceptibility of the patients. Hydrogen sulfide is not only emitted naturally, but it also frequently found in industrial settings where it is either used as a reactant or it is a by-product of manufacturing or industrial processes. Inhalation of hydrogen sulfide causes various respiratory reactions from cough to acute respiratory failure, depending on the severity. Two pharmaceutical factory workers were admitted after being rescued from a waste water disposal site that contained hydrogen sulfide. In spite that they recovered their consciousness, they had excessive cough and mild dyspnea. The simple chest radiographs and high resolution computed tomography showed diffuse interstitial infiltrates, and hypoxemia was present. They were diagnosed as suffering from chemical pneumonitis caused by hydrogen sulfide. After conservative management that included oxygen therapy, their symptoms, hypoxemia and radiographic abnormalities were improved.

Comparison of Extractive Nitrogenous Constituents in Cultured and Wild Olive Flounder (Paralichthys olivaceus) Muscle (양식 및 자연산 넙치의 함질소엑스성분 비교)

  • 박춘규
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.1
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    • pp.174-179
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    • 2000
  • The nitrogenous compounds in the muscle extracts of cultured and wild olive flounder, Paralichthys olivaceous, were analyzed. The analyzed coumpounds were extractive nitrogen, free amino acids, oligopeptides, ATP and its related ompounds, quaternary ammonium bases, and guanidino compounds. The distribution pattern of these compounds in cultured and wild fish was found to be very similar. Although the ATP and its related compounds and creatine in the muscle of cultured fish were slightly abundant than those in the muscle of wild one, the extractive nitrogen, total free amino acid, oligopeptides, and TMAO were found to be slightly rich in the muscle of wild fish than those in the muscle of cultrued one. The moisture content of cultured fish was relatively lower but the protein and fat contents of cultured one were higher than those of wild fish. However the differences in the proximate composition, extractive nitrogen and nitrogenous compounds between two fishes were not significantly different.

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Antioxidant Compounds and Antioxidant Activities of Sweet Potatoes with Cultivated Conditions (재배조건에 따른 고구마의 항산화성분 및 항산화활성)

  • Woo, Koan-Sik;Seo, Hye-In;Lee, Yong-Hwan;Kim, Hyun-Young;Ko, Jee-Yeon;Song, Seuk-Bo;Lee, Jae-Saeng;Jung, Ki-Yuol;Nam, Min-Hee;Oh, In-Seok;Jeong, Heon-Sang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.4
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    • pp.519-525
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    • 2012
  • Effects of cultivated conditions on antioxidant compounds and antioxidant activities of sweet potatoes (Ipomoea batatas (L.) Lam) were determined. The cultivated variety was Shinyulmi, and they were cultivated in a conventional culture, successful cropped hairy vetch culture, successful cropped barley cultivation, successful cropped rye cultivation, successful cropped mix-seeding of hairy vetch and barley, successful cropped mix-seeding of hairy vetch and rye, and not fertilizer. The brix degree, moisture, protein, and ash content of the sweet potatoes did not significantly change with the cultivated conditions. However amylose, total dietary fiber, and mineral content had significant changes. The total polyphenol, flavonoid, and tannin content of the methanolic extracts of the sweet potato's pericarp showed significant differences from cultivated conditions, however, the sweet potato's sarcocarp did not significantly change. The highest DPPH and ABTS radical scavenging activities of the methanolic extracts of the sweet potatoes were 958.81 and 663.53 mg TE/100 g in the sweet potato's pericarp on the successful cropped hairy vetch culture. Generally, there was a difference in antioxidant compound content and radical scavenging activity on the methanolic extract of sweet potato with cultivated conditions.

ATM Cell Encipherment Method using Rijndael Algorithm in Physical Layer (Rijndael 알고리즘을 이용한 물리 계층 ATM 셀 보안 기법)

  • Im Sung-Yeal;Chung Ki-Dong
    • The KIPS Transactions:PartC
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    • v.13C no.1 s.104
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    • pp.83-94
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    • 2006
  • This paper describes ATM cell encipherment method using Rijndael Algorithm adopted as an AES(Advanced Encryption Standard) by NIST in 2001. ISO 9160 describes the requirement of physical layer data processing in encryption/decryption. For the description of ATM cell encipherment method, we implemented ATM data encipherment equipment which satisfies the requirements of ISO 9160, and verified the encipherment/decipherment processing at ATM STM-1 rate(155.52Mbps). The DES algorithm can process data in the block size of 64 bits and its key length is 64 bits, but the Rijndael algorithm can process data in the block size of 128 bits and the key length of 128, 192, or 256 bits selectively. So it is more flexible in high bit rate data processing and stronger in encription strength than DES. For tile real time encryption of high bit rate data stream. Rijndael algorithm was implemented in FPGA in this experiment. The boundary of serial UNI cell was detected by the CRC method, and in the case of user data cell the payload of 48 octets (384 bits) is converted in parallel and transferred to 3 Rijndael encipherment module in the block size of 128 bits individually. After completion of encryption, the header stored in buffer is attached to the enciphered payload and retransmitted in the format of cell. At the receiving end, the boundary of ceil is detected by the CRC method and the payload type is decided. n the payload type is the user data cell, the payload of the cell is transferred to the 3-Rijndael decryption module in the block sire of 128 bits for decryption of data. And in the case of maintenance cell, the payload is extracted without decryption processing.

S-MADP : Service based Development Process for Mobile Applications of Medium-Large Scale Project (S-MADP : 중대형 프로젝트의 모바일 애플리케이션을 위한 서비스 기반 개발 프로세스)

  • Kang, Tae Deok;Kim, Kyung Baek;Cheng, Ki Ju
    • KIPS Transactions on Software and Data Engineering
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    • v.2 no.8
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    • pp.555-564
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    • 2013
  • Innovative evolution in mobile devices along with recent spread of Tablet PCs and Smart Phones makes a new change not only in individual life but also in enterprise applications. Especially, in the case of medium-large mobile applications for large enterprises which generally takes more than 3 months of development periods, importance and complexity increase significantly. Generally Agile-methodology is used for a development process for the medium-large scale mobile applications, but some issues arise such as high dependency on skilled developers and lack of detail development directives. In this paper, S-MADP (Smart Mobile Application Development Process) is proposed to mitigate these issues. S-MADP is a service oriented development process extending a object-oriented development process, for medium-large scale mobile applications. S-MADP provides detail development directives for each activities during the entire process for defining services as server-based or client-based and providing the way of reuse of services. Also, in order to support various user interfaces, S-MADP provides detail UI development directives. To evaluate the performance of S-MADP, three mobile application development projects were conducted and the results were analyzed. The projects are 'TBS(TB Mobile Service) 3.0' in TB company, mobile app-store in TS company, and mobile groupware in TG group. As a result of the projects, S-MADP accounts for more detailed design information about 'Minimizing the use of resources', 'Service-based designing' and 'User interface optimized for mobile devices' which are needed to be largely considered for mobile application development environment when we compare with existing Agile-methodology. Therefore, it improves the usability, maintainability, efficiency of developed mobile applications. Through field tests, it is observed that S-MADP outperforms about 25% than a Agile-methodology in the aspect of the required man-month for developing a medium-large mobile application.

Dynamic Behavior of Reactor Internals under Safe Shutdown Earthquake (안전정기지진하의 원자로내부구조물 거동분석)

  • 김일곤
    • Computational Structural Engineering
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    • v.7 no.3
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    • pp.95-103
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    • 1994
  • The safety related components in the nuclear power plant should be designed to withstand the seismic load. Among these components the integrity of reactor internals under earthquake load is important in stand points of safety and economics, because these are classified to Seismic Class I components. So far the modelling methods of reactor internals have been investigated by many authors. In this paper, the dynamic behaviour of reactor internals of Yong Gwang 1&2 nuclear power plants under SSE(Safe Shutdown Earthquake) load is analyzed by using of the simpled Global Beam Model. For this, as a first step, the characteristic analysis of reactor internal components are performed by using of the finite element code ANSYS. And the Global Beam Model for reactor internals which includes beam elements, nonlinear impact springs which have gaps in upper and lower positions, and hydrodynamical couplings which simulate the fluid-filled cylinders of reactor vessel and core barrel structures is established. And for the exciting external force the response spectrum which is applied to reactor support is converted to the time history input. With this excitation and the model the dynamic behaviour of reactor internals is obtained. As the results, the structural integrity of reactor internal components under seismic excitation is verified and the input for the detailed duel assembly series model could be obtained. And the simplicity and effectiveness of Global Beam Model and the economics of the explicit Runge-Kutta-Gills algorithm in impact problem of high frequency interface components are confirmed.

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Dental Health Promotion behavior and Dental Health Belief of Dental Hygiene Students in Gwangju Chunnam (광주·전남지역 치위생과 학생들의 구강건강신념 및 구강건강 증진행위)

  • Lee, Hyang-Nim;Cho, Min-Jung
    • Journal of dental hygiene science
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    • v.4 no.2
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    • pp.75-80
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    • 2004
  • This study was conducted to evaluated dental health promotion behavior and dental health belief of dental hygiene students in Gwangju and Chunnam. The results of this study were as follow: (1) Higher perceived susceptibility was more decreased grade(p<0.001) and more decreased economic level(p<0.05), more perceived dental healthy(p<0.001). Higher perceived benefit was more increased grade(p<0.001), at perceived health was very unhealth(p<0.05), at perceived dental health was very unhealth(p<0.05), in case of dental office visit before 1 year was highier(p<0.01). Higher perceived seriousiness was at middle economic level(0.01), more increased perceived unhealth status(p<0.05) and perceived unhealthy dental status(p<0.01). Higher perceived salience was more increased grade(p<0.001), in case of dental office visit before 1 year was highier(p<0.001). Higher perceived barrier was more increased grade(p<0.001), more increased economic level(p<0.05), at perceived health was very unhealth(p<0.01). (2) Higher dental health promotion behavior was more increase grade in preventive dental utilization and user dental health recomended device and selection eating case of healthful food to dental health and selection uneating case of harmful food to dental health(p<0.05). (3) performance in dental health promotion behavior was significantly correlated with perceived susceptibility(r=-0.081), perceived benefit (r=0.133), perceived seriousiness(r=0.210), perceived salience(r=0.187).

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