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Clinical Courses of Cavitary Lesions in Pulmonary Tuberculosis (처음 진단시 발견된 공동성병변의 경과)

  • Park, Seung-Kyu;Choi, In-Hwan;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.323-330
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    • 1996
  • Objective : Cavitary lesion in pulmonary tuberculosis sometimes makes problems in the course of treatment. Especially, retreatment cases tend to respond poorly to current antituberculosis agents. So, authors tried to render a guideline for clinical approach toward cavitary lesions in pulmonary tuberculosis. Methods : Retrospective analysis of 33 pulmonary tuberculosis patients with cavitary lesions was made. All the patients had got treatment at National Masan Tuberculosis Hospital from Jan. 1995 to Aug. 1995. Results: The ratio between male and female was 10:1. Age distribution was 69.7% in 3rd and 4th decades. The locations of cavitary lesion were 60.6% in right upper lung field and 36.4% in left upper lung field. In the extent of disease, there were 12 cases(36.4%) in moderate advanced and 21 cases in far advanced. Cavitary lesions were closed in 5 eases and remained in 28 eases. In the cases of closed cavity, it was happened within $10.6{\pm}4.72$ months after they took treatment, the size of cavity was $35.5{\pm}17.1$ in long diameter, $27.0{\pm}12.2$ in short diameter and $4.6{\pm}2.1\;mm$ in wall thickness. In the cases of remained cavity, the size of cavity was $31.9{\pm}12.3$ in long diameter, $21.0{\pm}9.8$ in short diameter and $5.04{\pm}2.0\;mm$ in wall thickness. In terms of negative conversion, it took $3.8{\pm}2.17$ months in the case of closed cavity but it was happened within 5 months for only 4 patients in the case of remained cavity. In the point of past medication history, there was none in closed cavities but there were none in 1 case, once in 3 cases, two times in 9 cases and more than three times in 13 cases among remained cavitary lesions. Conclusion : In the retreatment cases of pulmonary tuberculosis with cavitary lesions, they tend to respond poorly to current antituberculosis agents. So, if the lesions are localized, operative intervention may be a proper method as adjunctive treatment.

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Significance of Early Esophagoscopy in Corrosive Esophagitis (부식성 식도염에서의 조기 식도경술의 의의)

  • 임병석;봉정표;박순일;문태용;윤강묵
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.12.2-13
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    • 1983
  • Corrosive injuries of the esophagus by accident or suicidal attempt, though decreasing in number, still represent an important problem of our national pathology. One of the most difficult problems facing any physician is the diagnosis and management of caustic ingestion. In order to determine the extent of esophageal bums, to prevent the potential complication, to increase the therapeutic effect, the use of esophagoscopy is an essential step, and it has lessened an unnecessary admission and treatment. The authors have found the value of early esophagoscopy in selected 41 corrosive esophagitis patient who were admitted to Dept. of ENT, Wonju medical college, Yonsei university between 1980. 1-1982. 12

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Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) (편두통의 전 단계인 소아기주기성증후군의 다기관 임상 연구: 국제두통질환분류 제2판 제1차 수정판 적용)

  • Park, Jae Yong;Nam, Sang-Ook;Eun, So-Hee;You, Su Jeong;Kang, Hoon-Chul;Eun, Baik-Lin;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.557-566
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    • 2009
  • Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

Surgical Results and Risk Facor Analysis of the Patients with Single Ventricle Associated with Total Anomalous Pulmonary Venous Connection (총폐정맥연결이상증을 동반한 단심증 환아의 수술결과 및 위험인자 분석)

  • 이정렬;김창영;김홍관;이정상;김용진;노준량
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.862-870
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    • 2002
  • The surgical results of the patients with single ventricle(SV) associated with total anomalous pulmonary venous connection(TAPVC) has been reported with high mortality and morbidity due to their morphologic and hemodynamic complexity. A retrospective review was undertaken to report the outcome of the first-stage palliative surgery in our institution and to determine the factors influencing early death. Material and Method: Between January 1987 and June 2002, 39 patients with SV and TAPVC underwent surgical intervention with or without TAPVC repair. Age at operation ranged from 1day to 10.7months (median age, 2.4month), and 29 patients were male. Preoperative diagnosis included 20 right-dominant SV, 15 SV with endocardial cushion defect, 3 left-dominant SV, and 1 tricuspid atresia. The pulmonary venous connection was supracardiac in 22, cardiac in 5, infracardiac in 11, and mixed in 1, Obstructed TAPVC was present in 11. First-stage palliative surgery was performed in 37. Repair of TAPVC, either alone or in association with other procedures, was performed during the initial operation in 31. Univariate and multivariate analyses were performed to analyze the risk factors influencing the operative death. Result: A mean follow-up period of survivors was 34.3 $\pm$ 43.0(0.53 ~ 146.2)months. Overall early operative mortality was 43.6%(17/39). The causes were low cardiac output in 8, failure of weaning from cardiopulmonary bypass in 3, sepsis in 2, pulmonary hypertensive crisis in 1, pulmonary edema in 1, pneumonia in 1, and postoperative arrhythmia in 1. Risk factors influencing early death in univariate analysis were body weight, surgical intervention in neonate, obstructive TAPVC, preoperative conditions including metabolic acidosis, and need for inotropic support, TAPVC repair in initial operation, operative time, and cardiopulmonary bypass(CPB) time. In multivariable analysis, body weight, age at initial operation, surgical intervention in neonate, preoperative conditions including metabolic acidosis, need for inotropic support and CPB time were the risk factors. Conclusion: In this study, we demonstrated that the patients with SV and TAPVC had high perioperative mortality. Preoperative poor condition, young age, the length of operative and CPB time, the presence of obstructive TAPVC had been proven to be the risk factors. This fact suggests that the avoidance of unnecessarily additional procedures may improve the surgical outcomes of the first-stage palliative surgery. However further observation and collection of the data is mandatory to determine the ideal surgical strategy.

Postoperative Evaluation of Congenital Atrial Septal Defect in Adult (성인 심방중격결손증의 술후평가)

  • Kim, Ae-Jung;Jo, Jung-Gu;Gu, Ja-Hong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.386-392
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    • 1996
  • Preoperative and postoperative evaluation was done in 60 adult patients above 20 years of age among 152 patients, who had operation for the congenital atrial septal defect from January 1984 to June 1993 in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Anatomically, the secundum type defect was present In 58 cases and the other two were ostium primum type defect. The defect were closed directly in 45 cases and with patches in 15 cases. Preopera ive EKG findings revealed regular sinus rhythm in 81%, arrhythmia 19%, RVH 32%, RAD 30%, Postoperative findings were regular sinus rhythm in 76%, arrhythmia 24%, RVH 25%. RAD 25%. In hemodynamic data, the mean SPAP in patients over 40 years old was 41.91 $\pm$ 14.33mmHg compared to 31.46 $\pm$ 13.77 mmHg in patients under 40 years old, and the difference between the two groups was stastistically significant. And then the patients were classified into two groups (group A sinus group, and group B : arrhythmia group) according to their preoperative rhythm. The patients in group B were older, had greater value of mean SPAP and Rp/Rs. Mean Qp/qs was higher in group A. But the difference between two groups about the mean Qp/qs and Rp/Rs was not significant. Postoperative complications such as arrhythmia, pneumothorax or hemothorax occurred in 7 cases, but there was no operative mortality. The functional improvement were remarkable in half of the patients who underwent surgery.

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The Effects of Corneal Eccentricity and Shape on Toric Soft Lens Rotation by Change of Postures (이심률 및 각막형상이 자세변화에 의한 토릭소프트렌즈의 회전에 미치는 영향)

  • Kim, So Ra;Hahn, Shin Woong;Song, Ji Soo;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.4
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    • pp.449-456
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    • 2013
  • Purpose: The present study aimed to investigate the effects of corneal eccentricity and shape on the rotational pattern of toric soft lens by the postural change of lens wearers. Methods: The corneal eccentricity of 41 eyes (aged 20s) having -1.0 D with-the-rule corneal astigmatism (WRCA) was measured, and then toric soft lenses were fitted with the amount of total astigmatism. In lying and straight postures, the rotation of toric soft lenses was recorded by a camera attached to slitlamp and analyzed. Results: Most toric soft lens designed with accelerated stabilization rotated to the temporal direction, which was the lying position direction, regardless of corneal eccentricity, and some lenses rotated to the nasal direction for high corneal eccentricity and corneal type of asymmetric bowtie. There was no correlation between the amount of rotation and corneal eccentricity right after of contact lens wearing in straight and lying posture, however, the amount of rotation was the greater for the cornea with the higher eccentricity after the subjects laying down for some period. The speed of lens rotation started to decrease after the subjects laying down, but the speed was not different according to corneal eccentricity difference. The amount of lens rotation for symmetric and asymmetric bowtie-typed corneas increased more than it for oval-typed cornea, and it was same even with time elapsing. The speed of lens rotation in lying posture was the slowest in asymmetric bowtie-typed cornea compared with other corneal types. Conclusions: From the present study, it was revealed that the rotational pattern of toric soft lens was affected by corneal eccentricity and corneal shape when the wearer's posture changed. Thus, it should be considered for the development of the fitting guideline and the design of toric soft lens.

Effect of Automatic Exposure Control Marker with Chest Radiography in Radiation Reduction (자동노출제어를 사용한 X선 흉부촬영에서 AEC 표지자 사용에 따른 환자 피폭선량 감소 효과)

  • Jung, Ji-Sang;Choi, Byoung-Wook;Kim, Sung-Ho;Kim, Young-Mo;Shim, Ji-Na;Ahn, Ho-Sik;Jin, Duk-Eun;Lim, Jae-Sik;Kang, Sung-Ho
    • Journal of radiological science and technology
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    • v.37 no.3
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    • pp.177-185
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    • 2014
  • This study focused on effects of patient exposure dose reduction with AEC (Auto Exposure Control) marker that is designed for showing location of AEC in X-ray Chest radiography. It included 880 adults who have to use Chest X-ray Digital Radiography system (DRS, LISTEM, Korea). AEC (Ion chambers are posited in top of both sides) are used to every adult and set X-ray system as Field size $17{\times}17inch$, 120kVp, FFD 180cm. 440 people of control group are posited on detector to include both sides of lung field and the other 440 people of experimental group are set to contact their lung directly to Ion chamber (making marker to shows location). Then, measured every DAP and, estimated patient effective dose by using PCXMC 2.0. The average age of control group (M:F=245:195) is 53.9 and the average BMI is 23.4. BMI ranges from under weight: 35, normal range: 279, over weight: 106 to obese: 20 and average DAP is 223.56mGycm2, Mean effective dose is 0.045mSv. The average age of experimental group (M:F=197:243) is 53.7 and the average BMI is 22.7. BMI ranges from under weight: 34, normal range: 315, over weight: 85 to obese: 6 and average DAP is 207.36mGycm2, Mean effective dose is 0.041mSv. Experimental group shows less Mean effective dose as 0.004mSv (9.7%) than control group. Also, patient numbers who got over exposure more than 0.056mSv (limit point to know efficiency of AEC marker) is 65 in control group (14.7%), 19 in experimental group (4.3%) and take statistics with t-Test. The statistical difference between two groups is 0.006. In order to use proper amount of X-ray in auto exposure controlled chest X-ray system, matching location between ion chamber and body part is needed, and using AEC marker (designed for showing location of ion chamber) is a way to reduce unnecessary patient exposure dose.

The Clinical Study of Lung Cancer in Patients Younger than 40 Years of Age (약년자 폐암의 임상적 연구)

  • Kim, Geun-Hwa;Park, Hee-Sun;Kim, Myeng-Hoon;Kang, Dong-Won;Lee, Gyu-Seung;Ko, Dong-Seok;Suh, Jae-Chul;Jeong, Seong-Su;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.748-756
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    • 2000
  • Background : Bronchogenic carcinoma is generally considered as a disease that predominantly affects middleaged and elderly men. A small percentage of patients with lung cancer are diagnosed in the third or fourth decade of life or earlier. The current study was performed to review the clinical characteristics of bronchogenic carcinoma in patients younger than 40 years of age at Chungnam National University Hospital. Method : To determine the clinicopathologic characteristics including survival rates of lung cancer patients younger than 40 years of age and to compare them with those of patients 이der than 40 years of age at diagnosis, data of 905 patients diagnosed as lung cancer from January. 1990 to Marm 1997 were analyzed. Result : Twenty-three of 905 patients(2.5%) belonged to the young age group (less than 40 years). Male to female ratios of young age group and control group were 2.8 : 1 and 5.3 : 1, respectively. The mean duration of symptoms from onset to the definite diagnosis was 3.2 months in the young age group. The most common initial symptoms in the young age group were cough(52.2%) and dyspnea(43.5%). Adenocarcinoma (43.5%) was more frequent in the young age group than in the control group(20.1%). Stage III and IV(70%) tumors were more frequent in the young age group than in the control group(52.3%). Distant metastasis rate of the young age group(56.5%) was higher than that of the control group(22.3%). Conclusion : The predominance of adenocarcinoma, the lower male-female ratio, and the high incidence of advanced stage tumor at diagnosis are the characteristics of lung cancer in patients younger than 40 years of age.

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Effects of Purchasing Factors through Social-commerce of Beauty Service on the Consumer Satisfaction and the Repurchasing Intention (소셜커머스를 통한 뷰티서비스 구매요인이 고객만족과 재구매 의도에 미치는 영향)

  • Hong, Soo-Nam;Lee, Han-Joo
    • Journal of Internet Computing and Services
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    • v.15 no.6
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    • pp.133-144
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    • 2014
  • As the Internet and smartphones prevail, this study investigated the purchasing factors of a new beauty marketing method, the social commerce, and verified the relationship of such purchasing factors to consumer satisfaction and repurchasing intentions. In order to verify the validity of purchasing factors, five sub-factors, such as service, price, interaction, convenience, and interest were classified, while consumer satisfaction and repurchasing intentions are grouped into one factor, using data about 20-39 years old. According to results of this study, purchasing factors in the beauty service markets through social commerce that had effects on the consumer satisfaction were price, service, convenience, and interest, but no relationship was found with interaction. We can predict that consumers buy not based on community activities among buyers or purchasing comments of others, but rather his/her own subjective thoughts and opinions about the services. As the result of repurchasing intention according to purchasing factors, affecting sub-factors were price, service, and convenience. Repurchasing intention is an positive response that reflects satisfactions. Since low price, satisfaction on the service, and convenience for busy modern people should be met, repurchasing intentions are not affected by interest, but rather systematic and professional service. Also, higher satisfaction on service raises repurchasing intention. In this study, it is clear that not only purchasing factors through social-commerce effect the satisfaction and the repurchasing intention, but also consumer satisfaction mediates partly purchasing factors and the repurchasing intention. And as sub-factors of purchasing factors, price, service, or convenience are more important to the consumer satisfaction than community or replies activities. Thus differentiated and professional customer service, the establishment and enhancement of trendy marketing should improve long term repurchasing intentions. This will lead to the increasing revenue of personal-shop and the developments of beauty markets, so strengthening product sourcing and promotion suitable for mobile shoppers are essential.

Clinical Characteristics of Miliary Tuberculosis (속립성 폐결핵의 임상적 특성)

  • Kim, Jin-Ho;Moon, Doo-Seop;Lee, Dong-Suck;Park, Ik-Soo;Yoon, Ho-Joo;Shin, Dong-Ho;Kim, Tae-Wha;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.144-151
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    • 1994
  • Background: Miliary tuberculosis almost always results from the discharge of infected caseous material into the blood stream, usually from a well hidden lymph node in the presentation of this disease in the past four decades, and although it is seen less frequent1y today than previously, its presentation and manifestation may require greater suspicion and diligence by the physician. We investigated the clinical characteristics, predisposing factors and accompanying diseases of miliary tuberculosis and tried to acquire the early diagnosis and treatment of this disease. Methods: A retrospective clinical study was done on 40 cases of miliary tuberculosis admitted to Hanyang University Hospital from Mar. 1989 to Dec.1992. The study investigated age and sex distribution, seasonal distribution, duration of symptoms before admission, pre-disposing factors, clinical symptoms, biochemical findings, chest X-ray findings, extrapulmonary tuberculosis associated with miliary tuberculosis, prognosis and mortality rate. Results: 1) The patients were most common in the age group between 20 and 29(23%) and the ratio of male to female was 1.4:1(male 23 : female 17). 2) Sputum smears for tubercle bacilli were positive in 5 cases(13%). 3) The most common clinical symptoms were fever with chilling(47.5%), coughing(47.5%), second most common symptom was dyspnea(32.5%), and the physical findings on admission were tachycardia(30%), weight loss(27.5%), meningeal signs(17.5%) in order. 4) The predisposing factors were heavy alcohol drinking(6 cases), steroid use(3 cases), pregnancy(2 cases) etc. 5) The chest X-ray findings on admission were miliary shadow only(40%), in addition pneumonic infiltration, pleurisy, and calcification in order. 6) The extrapulmonary tuberculosis associated with miliary tuberculosis were tuberculous meningitis(30%), bone and joint tuberculosis(17.5%), intestinal tuberculosis(15%) in order. 7) Biochemical findings were increased SGOT/SGPT(32.5%), increased alkaline phosphatase(32.5%), hypoalbuminemia(15%), hyponatremia(15%) etc. 8) About 4-6 weeks later after treatment(INH, RFP, PZA, EMB), 26 cases(65%) were improved on clinical symptoms or chest X-ray, 12 cases(30%) were stationary or aggravated, and 2 cases(5%) were died. Conclusion: For the early diagnosis and treatment of miliary tuberculosis, we must see its presentation and manifestation with greater interest and suspicion and investigate its predisposing factors and accompanying diseases.

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