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Clinical and Radiographic Characteristics of 12 Patients with Mycobacterium abscessus Pulmonary Disease (Mycobacterium abscessus 폐질환 환자 12명의 임상적, 방사선학적 특징)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.45-56
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    • 2003
  • Background : Mycobacterium abscessus is the most common respiratory pathogen in rapidly growing mycobacteria and is resistant to all of the first-line antituberculosis drugs. This report describes the clinical and radiographic characteristics in patients with pulmonary disease caused by M. abscessus. Materials and Methods : Twelve patients with pulmonary disease caused by M. abscessus who fulfilled the 1997 American Thoracic Society diagnostic criteria for a nontuberculous mycobacterial pulmonary infection were observed over a five-and-a-half year period. The clinical characteristics and chest radiographic findings were analyzed, retrospectively. Results : The patients were predominantly female(11/12, 92%) and nonsmokers(12/12, 100%). Coughing (10/12, 83%), sputum(10/12, 83%) and hemoptysis(10/12, 83%) were the common symptoms and they had prolonged periods from the onset of symptoms to the diagnosis of their disease(median 6.5 years). Eleven (92%) patients had a previous history of being treated for pulmonary tuberculosis. The sputum specimens were acid-fast bacilli smear-positive in all patients. All patients were administered antituberculosis drugs. Six (50%) patients were treated with second-line antituberculosis drugs on account of persistent smear-positive sputum specimens. The chest radiographs showed that reticulonodular opacities(11/12, 92%) were the most common pattern of abnormality, followed by cavitary lesions(5/12, 42%). The computed tomography findings suggested bronchiolitis from the centrilobular nodules with a tree-in-bud appearances(9/10, 90%) and bronchiectasis (9/10, 90%) were the most common, followed by well-defined nodules smaller than 10-mm in diameter(7/10, 70%). Conclusions : M. abscessus pulmonary disease should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.

Predicting the Goshawk's habitat area using Species Distribution Modeling: Case Study area Chungcheongbuk-do, South Korea (종분포모형을 이용한 참매의 서식지 예측 -충청북도를 대상으로-)

  • Cho, Hae-Jin;Kim, Dal-Ho;Shin, Man-Seok;Kang, Tehan;Lee, Myungwoo
    • Korean Journal of Environment and Ecology
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    • v.29 no.3
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    • pp.333-343
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    • 2015
  • This research aims at identifying the goshawk's possible and replaceable breeding ground by using the MaxEnt prediction model which has so far been insufficiently used in Korea, and providing evidence to expand possible protection areas for the goshawk's breeding for the future. The field research identified 10 goshawk's nests, and 23 appearance points confirmed during the 3rd round of environmental research were used for analysis. 4 geomorphic, 3 environmental, 7 distance, and 9 weather factors were used as model variables. The final environmental variables were selected through non-parametric verification between appearance and non-appearance coordinates identified by random sampling. The final predictive model (MaxEnt) was structured using 10 factors related to breeding ground and 7 factors related to appearance area selected by statistics verification. According to the results of the study, the factor that affected breeding point structure model the most was temperature seasonality, followed by distance from mixforest, density-class on the forest map and relief energy. The factor that affected appearance point structure model the most was temperature seasonality, followed by distance from rivers and ponds, distance from agricultural land and gradient. The nature of the goshawk's breeding environment and habit to breed inside forests were reflected in this modeling that targets breeding points. The northern central area which is about $189.5 km^2$(2.55 %) is expected to be suitable breeding ground. Large cities such as Cheongju and Chungju are located in the southern part of Chungcheongbuk-do whereas the northern part of Chungcheongbuk-do has evenly distributed forests and farmlands, which helps goshawks have a scope of influence and food source to breed. Appearance point modeling predicted an area of $3,071 km^2$(41.38 %) showing a wider ranging habitat than that of the breeding point modeling due to some limitations such as limited moving observation and non-consideration of seasonal changes. When targeting the breeding points, a specific predictive area can be deduced but it is difficult to check the points of nests and it is impossible to reflect the goshawk's behavioral area. On the other hand, when targeting appearance points, a wider ranging area can be covered but it is less accurate compared to predictive breeding point since simple movements and constant use status are not reflected. However, with these results, the goshawk's habitat can be predicted with reasonable accuracy. In particular, it is necessary to apply precise predictive breeding area data based on habitat modeling results when enforcing an environmental evaluation or establishing a development plan.

Plankton Community Response to Physico-Chemical Forcing in the Ulleung Basin, East Sea during Summer 2008 (2008년 하계 울릉분지에서 관측된 물리·화학적 외압에 대한 플랑크톤 군집의 반응)

  • Rho, Tae-Keun;Kim, Yun-Bae;Park, Jeong-In;Lee, Yong-Woo;Im, Dong-Hoon;Kang, Dong-Jin;Lee, Tong-Sup;Yoon, Seung-Tae;Kim, Tae-Hoon;Kwak, Jung-Hyun;Park, Hyun-Je;Jeong, Man-Ki;Chang, Kyung-Il;Kang, Chang-Keun;Suh, Hae-Lip;Park, Myung-Won
    • Ocean and Polar Research
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    • v.32 no.3
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    • pp.269-289
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    • 2010
  • In Summer 2008, a multidisciplinary survey was conducted onboard R/V Haeyang 2000 to understand plankton response to the three distinct physico-chemical settings that developed in the Ulleung Basin of the East Sea. Baseline settings of hydrographic conditions included the presence of the thin (<20 m) Tsushima Surface Water (TSW) on top of the Tsushima Middle Water (TMW). It extends from the Korea Strait to $37^{\circ}N$ along the $130^{\circ}E$ and then turns offshore and encompasses the relatively saline (T>$26^{\circ}C$, S>33.7) Ulleung Warm Eddy surface water centered at $36.5^{\circ}N$ and $131^{\circ}E$. A relatively colder and saline water mass appeared off the southeastern coast of Korea. It was accompanied by higher nutrient and chlorophyll-a concentrations, suggesting a coastal upwelling. Most of the offshore surface waters support low phytoplankton biomass (0.3 mg chl-a $m^{-3}$). A much denser phytoplankton biomass (1-2.3 mg $m^{-3}$) accumulated at the subsurface layer between 20-50 m depth. The subsurface chlorophyll-a maximum (SCM) layer was closely related to the nutricline, suggesting an active growth of phytoplankton at depth. The SCM developed at shallow depth (20-30 m) near the coast and deepened offshore (50-60 m). A fucoxanthin/zeaxanthin ratio was high in coastal waters while it was low in offshore waters, which indicated that diatoms dominate coastal waters while cyanobacteria dominate offshore waters. The community structure and biomass of phytoplanktonare closely related to nitrogen availability. Zooplankton biomass was higher in the coastal region than in the offshore region while species richness showed an opposite trend. Zooplankton community structure retained a coastal/offshore contrast. These suggest that summer hydrography is a stable structure, lasting long enough to allow a hydrography-specific plankton community to evolve.

A Characteristics of 16 Scenes of Chilitan and Management of Chiltanjung, Milyang (밀양 칠탄정 경영과 칠리탄 16경의 경관특성)

  • Kim, Soo-jin;Jung, Hae-Joon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.37 no.3
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    • pp.22-36
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    • 2019
  • This research identified landscape characteristics of Chilitan(칠리탄) area, which had been managed by Son Giyang(1559~1617, p. Ohhan), in order to understand the political viewpoint and ideal landscapes, sought after by Confucian scholars in the 16~17th century. As the research method for the interpretation of each scene's spatial strucutres and meanings, paintings and poems in Chiltanjungsipyukgyeongdo(the Paintings of the 16 Scenes of Chiltanjung Area) were analyzed, which were followed by the on-site survey. Son lived hermit life with the nature after he decided to retire into the country for the chaotic political environment in the 4th year of Gwanghaegun's reign. Admiring Eum Jareung(B.C. 39-41, p. Eumgwang)'s hermit life, he named a headstream to Chilitan, erected pavilion and made place for angling by the stream, as Eum did in the hermitage. However he worried the king and royal politics in spite of his hermit life, which showed his political viewpoint of Confucianism. In addition, every column of buildings in the garden was named in order to imply both thoughts of Neo-Confucianism and Idleness Naturalism, which highlight a moral training and being comfortable amid poverty and taking pleasure in and honest life style. The present landscape of wonlim could be back to 1936, where Unganru, Byeokripjae and Chiltanjung are surrounding Eupcheondang. Chines character, such as Jimamsuseok, Giam, Ohhansonsunseongjanggujiso and Jogi, are inscribed on the rocks in the landscape garden, from which placeness could be inferred. According to the record of the construction, pine, fir, paulownia, ginkgo, peach trees, bamboo and lotus were planted, and ginkgo, bamboo, crape myrtle, pine and chestnut tress are still living in the garden, which mean plants had been planted in the light of their practical values as well as symbolic meanings. The method for describing 16 scenes of Chiltanjung could be characterized to the structure of 「Place+Scene(a particural activity, event, or action), and these placeness could be analyzed by categorizing the scene to near, middle and far views. Each scene symbolically presents a hermit, noble man, Taoist ideology, homeland, or peacetime, which were adpoted to depict landscapes of Chiltanjung area as the Confucian utopia.

Bone Metastasis after a Curative Resection for Gastric Cancer (위암의 근치적 절제술 후 발생한 골 전이)

  • Kim Jin Jo;Song Kyo Young;Chin Hyung Min;Kim Wook;Chun Hae Myung;Park Cho Hyun;Park Seung Man;Park Woo Bae;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.23-28
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    • 2005
  • Purpose: Bone metastasis is not a common event in patients with gastric cancer. Therefore, most studies of bone metastasis in such patients have been in the form of case reports, so the clinical features of the bone metastasis are not well understood. To clarify metastatic patterns, the efficacy of radiation or chemotherapy, and the prognosis, we analyzed 29 cases of patients with bone metastases after curative surgery for gastric cancer. Materials and Methods: Twenty-nine (29) gastric cancer patients with bone metastasis who underwent curative resection from January 1989 to December 2002 at the Departments of Surgery, Kangnam St. Mary's Hospital and Our Lady of Mercy's Hospital, The Catholic University of Korea, were analyzed. Results: Nineteen (19) patients were males and, 10 patients were females. The mean age of the patients was $53\pm12$ years. There were more Borrmann type-3 and type-4 cancers and more undifferentiated histologic types. Most of the original cancers were stage III or IV. The most frequently involved bone was the spine. Treatment after recurrence was done in 16 patients ($55.2\%$). The median survival time after recurrence of the patients who received treatment was seven (7) months ($0\∼75$ months in range), which was significantly longer than that of the patients who did not received treatment (P=0.019). However, there was no difference according to the treatment modality (P=0.388). Conclusion: Bone metastasis after a curative resection of gastric cancer tends to occur in Borrmann type-3 and type-4 cancers, cancers with undifferentiated histology and, in stage III/IV disease. The prognosis of bone metastasis is dismal, and aggressive treatment is the only way to prolong survival.

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Comparison of the Results in Gastric Carcinoma Patients undergoing Billroth I and Billroth II Gastrectomiesy (원위부 위암에서 위절제술 후 위재건술식에 따른 잔위기능 및 영양 증상학적 삶의 질 비교)

  • Kim, Sung Geun;Kim, Young Kyun;Heo, Youn Jung;Song, Kyo Young;Kim, Jin Jo;Jin, Hyung Min;Kim, Wook;Park, Cho Hyun;Park, Seung Man;Lim, Keun Woo;Kim, Seung Nam;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.16-22
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    • 2007
  • Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.

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DNMT3b Promoter Polymorphism and Risk of Gastric Cancer in the Korean Population (한국인에서 DNMT3b 유전자 다형성과 위암의 감수성)

  • Kim, Sung Geun;Jung, Hun;Kim, Sin Sun;Jeon, Kyung Hwa;Song, Kyo Young;Kim, Jin Jo;Jin, Hyung Min;Kim, Wook;Park, Cho Hyun;Park, Seung Man;Lim, Keun Woo;Kim, Seung Nam;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.9-15
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    • 2007
  • Purpose: DNA methylation is an important epigenetic factor in tumorigenesis. We hypothesized that polymorphism of the promoter of the DNA methyltransferase 3b (DNMT3b) genes, which are responsible for regulating the methylation status of tumor suppressor genes, are associated with increased risk of gastric cancer. Materials and Methods: In this hospital-based case-control study, to determine the role of this polymorphism of the promoter of DNA methyltransferase 3b (DNMT3b) genes in gastric cancer, we genotyped 176 cases and 70 control subjects. To determine the genotype, we used a polymerase chain reaction restriction fragment length polymorphism assay. We compared alleles and genotypes between the two groups and revealed an association of DNMT3b promoter polymorphism with increased risk of gastric cancer in the Korean population. Results: Genotype frequencies were 14.8% (Cytosine-Cytosine), 71.6% (Cytosine-Thymine), and 13.6% (Thymine- Thymine) in the case patients and 40.0% (Cytosine-Cytosine), 42.9% (Cytosine-Thymine), and 17.1% (Thymine-Thymine) in the control subjects, respectively. Compared with CC homozygotes, CT heterozygotes had a 4.523-fold increased risk (OR, 2.13; 95% CI, 2.324~8.803), and the TT homozygotes had a 2.154-fold elevated risk (OR, 1.42; 95% CI, 0.899~85.165). For the T variant genotype (CT+TT), there was a 3.846-fold increased risk (OR, 1.88; 95% CI, 2.040~7.251). However, no significance was observed in the genotype distributions of both polymorphisms according to histopathology, stage of stomach cancer. The Ssame results were observed with Helicobacter infection. Conclusion: DNMT3b promoter polymorphism, especially the T variant genotype, is associated significantly with thean increased risk of gastric cancer.

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The Clinical Characteristics of Diffuse Alveolar Hemorrhage : A Retrospective Study of 21cases (미만성 폐포 출혈의 임상 양상과 예후)

  • Ham, Hyoung-Suk;Roh, Gil-Hwan;Kang, Eun-Hae;Kang, Soo-Jung;An, Chang-Hyeok;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.614-623
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    • 2000
  • Background : Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. Method : A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveolar lavage or lung biopsy. Results : Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD ($3.27{\pm}3.15$ mg/dl vs. $1.19{\pm}0.94$ mg/dl, p=0.030). The corresponding drop in hemoglobin level was $2.69{\pm}1.26$ g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by $1.38{\pm}4.22$ days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). Conclusion : The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.

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Clinical Characteristics and Diagnostic Utility of Eosinophilic Pleural Effusion (호산구성 흉막유출의 임상상과 진단적 의의)

  • Roh, Gil-Hwan;Kang, Soo-Jung;Youn, Jong-Wook;Hwang, Jung-Hye;Ham, Hyoung-Suk;Kang, Eun-Hae;Lim, Young-Hee;An, Chang-Hyeok;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.733-739
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    • 2000
  • Background : Pleural eosinophilia is rare and commonly considered to be an indicator of good prognosis. The diagnostic significance of eosinophilic pleural effusions remains controversial despite a century of observation and discussion. This study was conducted to assess the prevalence of eosinophilia in 446 consecutive samples of pleural fluid, to review the cause of eosinophilic pleural effusion and to determine whether the presence of eosinophils increases the likehood of benign conditions. Method : A retrospective analysis was performed upon patients that underwent first thoracentesis due to pleural effusion between January 1999 and December 1999. Results : Eosinophilic pleural effusions were identified in 24 of the 446 patients (5.4%). Malignancy, parapneumonic effusion and tuberculosis were determined the major causes of pleural effusion (80.6%). Malignancy was diagnosed as frequently in eosinophilic effusions as in non-eosinophilic effusions (54.2% vs 50.5%, p=0.725). No difference was found in the prevalence of eosinophilic and non-eosinophilic effusion according to the etiology. The mean blood eosinophil ratio in patients with eosinophilic pleural effusion was 5.4% and no significant correlation existed between the blood and pleural eosinophilic count. Conclusion : Pleural eosinophilia is not helpful for differentiating benign and malignant etiology and is not related with bood eosinophilia or repeated tapping.

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Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.