• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.3
• /
• pp.229-234
• /
• 2008

Purpose: A urea breath test (UBT) using C-14 or C-13 has been developed for identifying Helicobacter (H) pylori infection on the basis of urease production with release of labeled $CO_2$. We investigated if the C-14 and C-13 UBT have the difference to reflect the presence and degree of H. pylori infection detected by gastro-duodenoscopic biopsies (CBx) in the same patients. Materials and methods: Thirty eight patients (M:F = 28:10, age $53.4{\pm}13.0$ yrs) with upper gastrointestinal symptoms such as indigestion, gastric fullness or pain consecutively underwent C-14 UBT, GBx and C-13 UBT within one week before medications. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (37 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive (${\ge}$ 200 dpm), intermediate (50-199 dpm) or negative (50 dpm). For the C-13 UBT, the results were classified as positive (${\ge}2.5\%_{\circ}$) or negative ($<2.5\%_{\circ}$). The results of GBx with Giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT and C-13 UBT results with GBx grade as a gold standard. Results: The prevalence of H. pylori infection by GBx with Giemsa stain was 25/38 (65.8%). In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.0%, 92.3%, 95.8%, 91.7% and 92.1%, respectively. However, the C-13 UBT had sensitivity, specificity, PPV, NPV and accuracy of 96.0%, 84.6%, 92.3%, 91.7% and 92.1%, respectively. The more significant correlation in C-14 than C-13 UBT (r=0.948 vs r=0.819, p <0.001) was found between the value of UBT and the grade of distribution of H. pylori infection. Conclusion: We conclude that the diagnostic performance between C-14 and C-13 UBT to detect H. pylori infection is not significantly different, but the value of C-14 UBT more significantly reflects the degree of bacterial distribution.

• Journal of Chest Surgery
• /
• v.30 no.9
• /
• pp.899-907
• /
• 1997

Recently, primary lung cancer has increased markedly in incidence & prevalence in korea. Prom July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:P=8.6: 1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asymptomatic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveol r cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, stagmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage H 14.8%, stage llla 31.1%, and stage IIIb 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage 153.0%, stage H 46.5%, stage I[la 28.2%, and stage IIIb 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were Nl 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3 (p>0.05).

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.1
• /
• pp.57-65
• /
• 1999

Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

• Clinical and Experimental Pediatrics
• /
• v.46 no.9
• /
• pp.898-902
• /
• 2003

Purpose : To determine the clinical association of diagnostic criteria and the prevalence of autoantibodies in newly diagnosed children with juvenile dermatomyositis(JDM). Methods : Thirty-two children with JDM were identified at Seoul National University Children's Hospital from March 1985 to March 1999 by retrospective review. The diagnosis of JDM was based on the criteria proposed by Bohan and Peter. We investigated for the presence of several autoantibodies: antinuclear(ANA), double-stranded DNA, anti-Sm, anti-ribonucleoprotein(RNP), anti-SSA/ SSB, anti-Jo1, anti-Scl-70 antibodies and rheumatoid factor(RF). Results : Sex ratio and age at diagnosis were similar to data published in other studies. All the newly diagnosed children with JDM had a typical rash(100%) and proximal muscle weakness(100%); 17(53%) had muscle pain or tenderness; 10(31%) calcinosis; eight(25%) dysphagia; eight(25%) arthritis, and seven(22%) fever. Muscle enzymes were elevated in 90% of the patients. Of the 27 patients who had an electromyogram, 20(70%) had diagnostic results. Sixteen(70%) of biopsied patients had appropriated results for JDM. Patients were negative for all autoantibodies except ANA and RF. ANA and RF were detected in 47% and 7% of the patients respectively. Conclusion : Although the sensitivity of the criteria proposed by Bohan and Peter is superior, each of these criteria has possible confounding factors. Additional criteria may be needed for early diagnosis of JDM. Based on our findings of autoantibodies in JDM, we do not recommend routine testing for autoantibodies in children with typical JDM.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.3 no.2
• /
• pp.151-159
• /
• 2000

Purpose: Recently, a wide application of gastrofiberscopy in the pediatric group have revealed that nodular duodenitis is not an uncommon disease in children and is suspected to be associated with H. pylori infection. The aim of this retrospective study was to investigate the clinical and histopathologic features in children with nodular duodenitis, and to assess the correlations beween both. Methods: During a period of 5 years (Jan. 1995~Dec. 1999), we investigated clinical, endoscopic and histopathologic features of 39 consecutive patients diagnosed as having nodular duodenitis at Pediatric department of Seoul Red Cross Hospital. In 35 children with nodular duodenitis endoscopic biopsy specimens were stained with Hematoxylin & Eosin and Giemsa's stain, and were graded according to the criteria outlined by Triadafilopoulos, Whitehead et al., and Prieto et al.. Statistical analyses were performed with Graph PAD InStat. Results: The prevalence rate of nodular duodenitis was 17.1% and the most frequent chief complaint was abdominal pain (69.2%). Endoscopically grade 1 was the most common (45.7%) and nodular gastritis was coexistent in 28.3%. The most common histology of the duodenum was grade 2 (54.3%), and the most common histologic score of the stomach was 2 (42.9%). H. pylori was found in the duodenum in 37.1%, and in the stomach in 31.4%. The correlation coefficient between the endoscopic grade and the histologic grade of nodular duodenitis was 0.3983 (p=0.0178). And the correlation coefficient between the histologic grade and the grade of H. pylori colonization in the duodenum was 0.5154 (p=0.0018). Conclusion: There was significant correlation between the endoscopic grade and the histologic grade of nodular duodenitis, and was also significant correlation between the histologic grade and the grade of H. pylori colonization in the duodenum. Therfore H. pylori infection should be regarded as an etiologic factor of nodular duodenitis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6521-6526
• /
• 2015

Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

• Journal of agricultural medicine and community health
• /
• v.9 no.1
• /
• pp.56-66
• /
• 1984

Giardia lamblia is a pathogenic flagellate causing intestinal disorders such as diarrhea, abdominal pain and malabsorption of nutrients. Giardia is mainly infected by the ingestion of contaminated foods per os. Craun (1979) has recently reported that mass infection of this flagellate through the contaminated water supply systems is one of public health hazards. Also, so-called traveller's diarrhea is sometimes caused by Giardia infection (CDC, U.S.A., 1971). However, a few epidemiological studies figuring out the mode of infection or control measures of Giardia infection has been done so far in Korea. The present study was aimed to know the prevalence of Giardia infection in several Korean populations, detectability of this flagellate in water systems and the viability of the cysts against sewages and disinfectants applying to drinking water. In the present study, 388 stool specimens from orphanage children in Chun-joo, Chung-joo, On-yang and Chun-an areas and 538 stool specimens from inhabitants in Woo-do, In-chon, and Chun-joo were examined by formalin-ether concentration technique to detect out Giardia cysts. On the other hand, water samples from 14 sites of Han River and its tributaries were collected in May through July, 1984. Fifty liter of water sample in each sampling site was then filtered through water filtering system deviced by U.S. Environmental Proutection Agency and the sediments rinsed out from the thread rolls, a part of water filtering system, were examined to detect out the Giardia cysts. In order to observe the viability of Giardia cysts in the sewage samples, the cysts were treated in it at $4^{\circ}C$ or $25^{\circ}C$ for 7 through 28 days. For this purpose, the cysts were also exposed to various concentrations of disinfectants such as chlorine, iodine and ozone gas for proper time intervals. After treatment, the viability test of the Giardia cysts were carried out by method of Rice and Schaefer (1981) with minor modification. The results obtained in this study were as follows : 1) The detection rates of G lamblia cysts in the stool specimens were 18.3% in orphans and 4.3% in general examinees. 2) The prevalences of Giardia Infection were higher in the young age groups than in-adults. The highest positive rate was 18.4% in the age group less than 10. 3) Of 14 water specimens sampled from Han River system and its tributaries around the Seoul area, the Giardia cysts were detected from 4 samples, and no cyst was found in the water supply systems. 4) The cysts treated in the sewage survived for 28 days at $4^{\circ}C$ and for 13 days at $25^{\circ}C$. 5) The cysts were completely destroyed within 60 minutes by exposure to 8 mg/l of residual chlorine at 4g and within 30 minutes by exposure to the same concentration of chlorine at $25^{\circ}C$. 6) The cysts were all dead when exposed to 1 mg/1 of iodine for 60 minutes at $4^{\circ}C$ or $25^{\circ}C$. 7) The cysts were destroyed after 10 minute exposure in 0.15 mg to 0.25mg of residual ozone gas per liter. Summarizing the above results, it is considered that Giardia infection is regarded as water-borne disease and the cysts are able to be controlled by the application with the disinfectants in the water supply systems.

• Journal of agricultural medicine and community health
• /
• v.25 no.2
• /
• pp.245-263
• /
• 2000

This study was conducted to provide the basic data about the health effects of pesticide exposure among farmers for agricultural health study. We analyzed 412 self-administered questionnaires collected from the male farmers who spray pesticides in Kyoung-ju area, Korea. Survey questions were about chronic symptoms, acute symptoms while pesticide spraying, pesticide intoxication accident, safety rules, protective equipments etc. The correlations among the variables related to pesticide exposure and the factors in acute pesticide poisoning and chronic symptoms of farmers were also analyzed. For chronic symptoms, the prevalence of 'tiredness and languor', 'lumbago', 'nocturia', 'shoulder pain', 'numbness', and, for acute symptoms while pesticide spraying, the experience rate of 'itching sense of skin', 'dizziness/headache', 'fatigue', 'eye glaring' were high compared with other symptoms. For 'experience of intoxication accident by pesticide in family', 7.1% of the subjects experienced the accident and the causes were pesticide spraying, food contamination by pesticide, suicide etc. Among safety rules, 'take a bath after spraying', 'change clothes after spraying' were kept relatively well, and, for protective equipments, hat, boots, mask, gloves, protective clothes(lower) were put on relatively well. The factors associated with acute pesticide poisoning were the extent of keeping safety rules, spraying time, orchard cultivation, agricultural area and spraying days per year etc. And the factors associated with chronic symptoms were acute symptoms while pesticide spraying, agricultural area, farming career, extent of keeping safety rules, extent of agricultural work and the pesticide exposure index etc. From these results, it is suggested that to reduce the health effects by pesticide exposure among farmers, the education to promote to keep safety rules and wear protective equipments, and information services should be recommended. And further studies on the long term health effects of pesticide exposure among farmers are required.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.5
• /
• pp.584-594
• /
• 1993

Background: Among the respiratory diseases, there are a lot of cases of pleural effusion. The most common cause is tuberculosis. But the other cause such as lung malignancy is in an increasing tendency because of the development of diagnostic procedure, the decrease of the prevalence of the tuberculosis and the increase of the longevity. We need to know the accurate diagnosis as soon as possible for the correct therapy. Method: A clinical observation was made on 315 cases of pleural effusion seen at Pusan Adventist Hospital, from Jan, 1989 to Dec, 1992. For diagnostic procedure, thoracentesis, lymph node biopsy, bronchoscopy and percutaneous biopsy of the parietal pleura with Cope needle were performed. The following are parameters used in seperating the exudate from the transudate: pleural protein 3.0 g/dl, pleural protein/serum protein ratio 0.5, pleural LDH 200 IU, pleural LDH/serum LDH ratio 0.6, pleural cholesterol 60 mg/dl and pleural cholesterol/serum cholesterol ratio 0.3. Each parameters were compared, and misclassified rate and diagnostic efficiency were calculated. Results: The most common cause of exudate pleurisy was tuberculosis (82.3%) and malignancy was next (12.2%). The chief complaints of pleural effusion were noted as dyspnea (58.7%), chest pain (54.9%), coughing (50.2%) and fever (36.2%). Location of pleural effusion was noted as right side (51.4%), left side (41.3%) and both sides (7.3%). Amount of pleural effusion of the chest X-ray was minimum (46.8%), moderate (40.5%) and maximum (12.7%). Misclassified rates for each parameters in seperating the exudates from the transudates were as follows; protein: 5.2%, pleural protein/serum protein:7.6%, LDH: 13.9%, pleural LDH/serum LDH: 6.9%, cholesterol: 8.0%, pleural cholesterol/serum cholesterol: 5.6%. On the pleural biopsy, the tuberculosis granuloma was 60.8%, malignancy was 13.6%, infection was 2.3% and nonspecific inflammatory reaction was 23.3%. Conclusion: on the basis of the above results, the most common cause of exudative pleurisy was tuberculosis. We think that the plerual cholesterol/serum cholesterol ratio is the most useful supportive parameter in separating the exudates from the transudates. For accurate diagnosis, the pleural biopsy is the first procedure and repeated pleural biopsy of nonspedcific inflammatory reaction is required.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.4
• /
• pp.432-440
• /
• 2000

Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.