• Tuberculosis and Respiratory Diseases
• /
• v.44 no.1
• /
• pp.25-43
• /
• 1997

Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (${\pm}17.2$ years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (${\pm}13.1$ days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, $Pa0_2$, $PaCO_2$, $Sa0_2$, alveolar-arterial oxygen differences, $PaO_2/FIO_2$, and PEEP/$FI0_2$ between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.3
• /
• pp.509-518
• /
• 1998

Background: Short-course chemotherapy for 6 months is well established for pulmonary tuberculosis. However, little is known about the efficacy of the short-course chemotherapy for tuberculous pleural effusion. Tuberculous pleural effusion itself may be self-limiting without any treatment, but about two thirds of the patients with tuberculous pleural effusion may subsequently develop pulmonary tuberculosis within 5 years. After completing treatment for tuberculous pleural effusion. prolonged follow-up is necessary for evaluating the efficacy of the treatment There is still no report on the efficacy of 6-month regimens for tuberculous pleural effusion in Korea, where the incidence of tuberculous disease and drug resistance is high. We studied the efficacy of 6 month short-course chemotherapy comparing with 9 month chemotherapy. Method : Retrospective study was done through medical record review in 238 patients with tuberculous pleural effusion who admitted to Asan Medical Center during May 1989-May 1993. The diagnosis of tuberculous pleural effusion was made by bacteriologic or histopathologic study. Results: Among 238 patients, 38 patients were dropped out during follow-up period. In 2 patients, second line drugs were prescribed according to known drug resistance results. And, in 23 patients, treatment longer than 9 months was done due to accompanying extrapulmonary tuberculosis or durg resistance. In 8 patients, treatment regimen was changed due to hepatotoxicity. Remaining 167 cases (70.2%) completed the treatment as scheduled ; 6 month chemotherapy in 88 cases and 9 month chemotherapy in 79 cases. In 60 patients (35.9%) with pleural effusion only in chest X-ray finding, sputum smear or culture for M.tuberculosis was positive in 6 cases (10.0%), and in 63 patients (37.7%) with radiologically inactive pulmonary tuberculosis, sputum smear or culture was positive in 18 cases (28.6%). In 44 patients (26.3%) with radiologically active pulmonary tuberculosis, the sputum smear or culture was positive in 24 cases (54.5%). In 6-month chemotherapy group (n=88), during mean 23 months (range; 1~61months) follow-up period, pulmonary tuberculosis developed in 1 case (1.4%). In 9-month chemotherapy group(n=79), during mean 23 months (range; 3~70months) follow-up period, pulmonary tuberculosis developed in 2 cases (2.5%). All the cases who developed pulmonary tuberculosis also showed active pulmonary tuberculosis on initial chest X-ray before treatment Conclusion: In patients with tuberculous pleural effusion, the incidence of pulmonary tuberculosis after 6 month chemotherapy showed no difference from that after 9 month chemotherapy. Thus, 6 month short-course chemotherapy seems to be an effective treatment for tuberculous pleural effusion.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.1
• /
• pp.83-89
• /
• 2010

Purpose: The Wide Beam Reconstruction (WBR) algorithms that UltraSPECT, Ltd. (U.S) has provides solutions which improved image resolution by eliminating the effect of the line spread function by collimator and suppression of the noise. It controls the resolution and noise level automatically and yields unsurpassed image quality. The aim of this study is WBR of whole body bone scan in usefulness of clinical application. Materials and Methods: The standard line source and single photon emission computed tomography (SPECT) reconstructed spatial resolution measurements were performed on an INFINA (GE, Milwaukee, WI) gamma camera, equipped with low energy high resolution (LEHR) collimators. The total counts of line source measurements with 200 kcps and 300 kcps. The SPECT phantoms analyzed spatial resolution by the changing matrix size. Also a clinical evaluation study was performed with forty three patients, referred for bone scans. First group altered scan speed with 20 and 30 cm/min and dosage of 740 MBq (20 mCi) of $^{99m}Tc$-HDP administered but second group altered dosage of $^{99m}Tc$-HDP with 740 and 1,110 MBq (20 mCi and 30 mCi) in same scan speed. The acquired data was reconstructed using the typical clinical protocol in use and the WBR protocol. The patient's information was removed and a blind reading was done on each reconstruction method. For each reading, a questionnaire was completed in which the reader was asked to evaluate, on a scale of 1-5 point. Results: The result of planar WBR data improved resolution more than 10%. The Full-Width at Half-Maximum (FWHM) of WBR data improved about 16% (Standard: 8.45, WBR: 7.09). SPECT WBR data improved resolution more than about 50% and evaluate FWHM of WBR data (Standard: 3.52, WBR: 1.65). A clinical evaluation study, there was no statistically significant difference between the two method, which includes improvement of the bone to soft tissue ratio and the image resolution (first group p=0.07, second group p=0.458). Conclusion: The WBR method allows to shorten the acquisition time of bone scans while simultaneously providing improved image quality and to reduce the dosage of radiopharmaceuticals reducing radiation dose. Therefore, the WBR method can be applied to a wide range of clinical applications to provide clinical values as well as image quality.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.41 no.3
• /
• pp.408-417
• /
• 2012

This study examined the satisfaction of a school milk program as well as the preference of school milk and flavored milk. The subjects of this study were $4^{th}$ , $5^{th}$ and $6^{th}$ grade students in 4 different elementary schools, who were attending the school milk program in Ulsan. The survey was conducted from April 10, 2009 to April 30, 2009. Of the 403 questionnaires distributed, 347 responded and analyzed (usage rate: 86%). The results were as follows. Of the 347 respondents, 53.9% were boys and 46.1% were girls. 34%, 31.1% and 34.9% of the students were $4^{th}$, $5^{th}$ and $6^{th}$ graders, respectively. Second, 80.1% of the students reported 'have milk everyday', and 89.9% of the students reported 'have milk as it is'. Third, the overall satisfaction with the school milk program was 3.32 based on a 5-point likert scale, the 'guidance of nutrition teachers and class teacher' was 3.21 and 'taste of school milk' was 3.37. There were significant positive correlations between the school milk satisfaction variables and overall satisfaction (p<0.01). Fourth, the preference for school milk was 3.33. The preference for flavored-milk were 3.63 (coffee milk), 4.44 (chocolate milk), 4.16 (strawberry milk), 4.26 (banana milk) and 3.53 (black bean milk). Fifth, to improve the school milk program, 85.9% of students wanted a provision for flavored milk. In conclusion, schools need to find a way to increase the satisfaction of the school milk program and the preference of school milk to increase the milk intake of students. Nutrition education for students and parents should be conducted systematically and choices for various kinds of milk and milk products should be given to the students.

• Pediatric Infection and Vaccine
• /
• v.11 no.1
• /
• pp.81-89
• /
• 2004

Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

• Journal of Korean Society of Forest Science
• /
• v.77 no.3
• /
• pp.303-314
• /
• 1988

Tong-ri beach has not enough vegetation to be enjoyed by the sea bathers and to be satisfied with preventing the disaster-damages, but mixed forest near the beach can work its funtions and the old forest of Pirus thunbergii $P_{ARL}$. near the beach do a Little. Therefore it is very urgent to plant more trees near the beach for bathers and disaster-damage prevention. This study was carried out for planning an afforestation, with reporting upon the crown amounts and soil properties of disaster-damage prevention forests of P. thunbergii $P_{ARL}$. planted on the coast sand dunes in 1970 and 1976, and with reporting upon the valuation on soil properties of the lands near the beach in order to set the afforestation site. The results are as follows : 1. In disaster-damage prevention forests, crown surface area and crown volume became increasingly greater in proportion to the height. To D.B.H., crown volume also became increasingly greater in proportion, but crown surface area was directly proportional. 2. In comparison to sail characteristics of sand dune, those of the forests were in large quantity in OM, T-N and avail. $SiO_2$, and almost in the same in avail. $P_2O_5$, but in small quantity in exchangeable canons : K, Ca, Mg and Na. 3. EC, Cl and pH were in small value in the forest soils, but CEC was in large value in those soils. 4. Above facts showed that the forests fulfill their functions for preventing disaster-damages and improve their soil properties. 5. The forests have naturally been thinned up to 34% in 17 years and 39% in 11 years, and one can easily pass through the forest(planted in 1970), because of its sufficient clear-length(2.71m) and its space to pass. 6. A plan for afforestation was oracle nut after judging several sites by the evaluation on the soil properties and considering the best relaxation and the prevention of the various disaster-damages upon which were reported in the last issue. 7. Afforestation should be kept for maintaining its appropriate density for best relaxation and disaster-damage prevention.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.42 no.12
• /
• pp.2049-2067
• /
• 2013

The purpose of this study is to present a more effective nutrition education activation plan. As a result of investigating the dietary education operating situation, 58.9% underwent direct education, and 89.5% underwent food life education through traditional food culture succeeding business operation. The results from investigating the recognition regarding dietary education are as follows. The activation level by education types was as low as 2.24 points, the necessity was as high as 4.54 points, the difficult point in performing food life education was 'overwork' with 4.43 points, and the teaching activity ability level was 'can effectively prepare a teaching guidance plan' at 2.96 points. As a result of investigating the nutrition consultation operating situations, 62.8% underwent it and all of the students as well as some parents and teachers performed it. The consumed time per consultation for effective nutrition consultation was 10~20 minutes, the required education equipment and data were 'consultation program' with 40.3%, and the important content during consultation was 'contents related to eating habits' with 70.5%, which was recognized as the most important.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.122-127
• /
• 2010

Purpose: The Xpress3.$cardiac^{TM}$ which is a kind of wide beam reconstruction (WBR) method developed by UltraSPECT (Haifa, Israel) enables the acquisition of at quarter time while maintaining image quality. The purpose of this study is to investigate the usefulness of WBR method for decreasing scan times and to compare to it with filtered back projection (FBP), which is the method routinely used. Materials and Methods: Phantom and clinical studies were performed. The anthropomorphic torso phantom was made on an equality with counts from patient's body. The Tl-201 concentrations in the compartments were 74 kBq (2 ${\mu}Ci$)/cc in myocardium, 11.1 kBq (0.3 ${\mu}Ci$)/cc in soft tissue, and 2.59 kBq (0.07 ${\mu}Ci$)/cc in lung. The non-gated Tl-201 myocardial perfusion SPECT data were acquired with the phantom. The former study was scanned for 50 seconds per frame with FBP method, and the latter study was acquired for 13 seconds per frame with WBR method. Using the Xeleris ver. 2.0551, full width at half maximum (FWHM) and average image contrast were compared. In clinical studies, we analyzed the 30 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Medical Center from January to April 2010. The patients were imaged at full time (50 second per frame) with FBP algorithm and again quarter-time (13 second per frame) with the WBR algorithm. Using the 4D MSPECT (4DM), Quantitative Perfusion SPECT (QPS), and Quantitative Gated SPECT (QGS) software, the summed stress score (SSS), summed rest score (SRS), summed difference score, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were analyzed for their correlations and statistical comparison by paired t-test. Results: As a result of the phantom study, the WBR method improved FWHM more than about 30% compared with FBP method (WBR data 5.47 mm, FBP data 7.07 mm). And the WBR method's average image contrast was also higher than FBP method's. However, in result of quantitative indices, SSS, SDS, SRS, EDV, ESV, EF, there were statistically significant differences from WBR and FBP(p<0.01). In the correlation of SSS, SDS, SRS, there were significant differences for WBR and FBP (0.18, 0.34, 0.08). But EDV, ESV, EF showed good correlation with WBR and FBP (0.88, 0.89, 0.71). Conclusion: From phantom study results, we confirmed that the WBR method reduces an acquisition time while improving an image quality compared with FBP method. However, we should consider significant differences in quantitative indices. And it needs to take an evaluation test to apply clinical study to find a cause of differences out between phantom and clinical results.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.117-121
• /
• 2010

Purpose: In nuclear medicine study, there are two methods, preset count method and preset time method, to acquire static images. We usually use preset count method for static image in $^{99m}Tc$-DMSA renal scan, but occasionally use preset time method. In case of using preset count method, we always acquire same counts but it causes a difference of scan time. In case of using preset time method, it takes same scan time to acquire images but it causes different counts. Therefore, the purpose of this study is to investigate any differences of function and formal information in both kidney by acquisition counts Materials and Methods: From January 11, 2010 to March 31, 2010, we analyzed the 30 patients (M: 11, W: 19). who were examined by $^{99m}Tc$-DMSA scan and have one side of functioning kidney relatively between 40~60%. And the patients who have cold and hot region in image were analyzed but we did not accept images of patients when it was hard to divide kidney into cortex. There was no division between subjects and age of subjects is $14.83{\pm}22.07$ old. We used the BrightView gamma camera from PHILIPS. To analyze function and formal of kidney, we used JET stream release 3.0 version from PHILIPS. Using SPSS 12.0 program, we compared descriptive statistics and paired T-test. Images were acquired sequentially in the same parameters, but there are three methods which different from acquisition time and scan time, 100 kcounts, 300 kcounts and 7 minutes method (exceed 300 kcounts). To assess function and formal information of kidney, we measured renal relative function, geometric mean and size of kidney and analyzed each difference. Results: In case of renal relative function in both kidney, 100 kcounts method was $50.52{\pm}3.64%$. 300 kcounts method was $50.38{\pm}3.66%$ and 7 minutes method was $49.91{\pm}3.40%$ and there were no statistical significant differences between each method. In case of geometric mean, 100 kcounts method was $50.08{\pm}3.25%$. 300 kcounts method was $49.89{\pm}3.40%$ and 7 minutes method was $49.91{\pm}3.24%$. And also, there were no statistical significant differences. When comparing size of kidney, 100 kcounts method was $8.23{\pm}1.96$ cm. 300 kcounts method was $8.12{\pm}1.90$ cm and 7 minutes method was $8.35{\pm}1.97$ cm. In case of right kidney, 100 kcounts method was $7.91{\pm}1.88$ cm. 300 kcounts method was $8.12{\pm}1.90$ cm and 7 minutes method was $8.25{\pm}1.96$ cm. From those values, we recognized that there were significant differences each method (p<0.05). Conclusion: From results of this study, there were no statistical differences in renal relative function and geometric mean by acquisition counts. However, in shape of kidney, the more acquisition counts are increasing, the more size of kidney is getting big. And there were statistical significant differences. Therefore, to perform reliable quantitative result, preset count method is more desirable than preset time method. Especially, in case of a follow-up test, if we use preset time method, it will cause differences of formal results in kidney due to acquisition counts each time we examine patients.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.1
• /
• pp.26-34
• /
• 1999

Background : Generally $VO_2$ max is higher in treadmill exercise than cycle ergometer exercise. According to Hassen and Wasserman, $VO_2$ max with treadmill exercise is higher at ratio of 1.11 than that with cycle ergometer. $VO_2$ max also is influenced by race, sociocultural background, exercise habit In this study, $VO_2$ max and AT were evaluated between Treadmill and cycle exercise in male Korean college students. Method: Study subjects were 44 male college students. We randomized them into 2 groups; 24 students did treadmill exercise at first and 1 week later did cycle ergometer. Another 20 students did in opposite method. They made symptom limited maximal exercise. Author defined maximal exercise as followings: 1) respiratory exchange ratio(RER)> 1.1, 2) plateau>30 sec, 3) heart rate reserve(HRR) <15%, or 4) breathing reserve (BR)<30%. Otherwise their results are excluded as submaximal exercise. Anaerobic threshold(AT) was estimated by V-slope method. Results: $VO_2$ max and AT was $45.1{\pm}6.66m\ell$/kg/min and $26.0{\pm}6.78m\ell$/kg/min in treadmill and $34.9{\pm}5.89m\ell$/kg/min, $19.5{\pm}4.77m\ell$/kg/min in Cycle Ergometer. The measured-$VO_2max$/pred-$VO_2max$ was $98.8{\pm}13.24%$ in treadmill; $84.4{\pm}13.42%$ in cycle ergometer. Comparing $VO_2$ max in treadmill with that obtained by Hassen's method, there were significant differences.(p<0.01). At maximal exercise there were differences in HRR, $O_2$/pulse, BR, $V_E$/MVV, $V_E/VCO_2$ between treadmill and cycle but not in $V_E/VO_2$, Vd/Vt, Ti/Ttot. At AT there were differences in $O_2$/pulse, BR, $V_E$/MVV, Ti/Ttot between treadmill and cycle, otherwise not. Conclusion: According to the result of this study, there are larger gap between treadmill and cycle ergometer in normal Korean adults than foreign data, and it needs further study to obtain reference value of Korea.