• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.23-29
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• 2005

Background : Chronic obstructive lung disease is characterized by smoke-related, gradually progressive, fixed airflow obstructions. However, some studies suggested that a reversible bronchial obstruction is common in chronic obstructive lung disease. Such reversibility persists despite the continued treatment with aerosolized bronchodilators and it appears to be related to the diminution in symptoms. The isolated volume response to a bronchodilator is defined as a remarkable increase in the FVC in response to the administration of a bronchodilator whereas the $FEV_1$ remains unchanged. This has been suggested in patients with severe emphysema. Therefore, the aim of this study was to determine the relationship between the response to a bronchodilator and the severity of an airflow obstruction in COPD patients using the GOLD classification. Methods : This study examined 124 patients with an airway obstruction. The patients underwent spirometry, and the severity of the airflow obstruction was classified by GOLD. The response groups were categorized by an improvement in the FVC or $FEV_1$ > 12%, and each group was analyzed. Results : Most subjects were men with a mean age of $65.9{\pm}8.5$ years. The mean smoking history was $41.26{\pm}20.1$ pack years. The isolated volume response group had relatively low $FEV_1$ and FVC values compared with the other groups. (p<0.001) Conclusion : In this study, an isolated volume response to a bronchodilator is a characteristic of a severe airway obstruction, which is observed in patient with a relatively poorer baseline lung function.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.277-284
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• 2006

Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

• Korean Journal of Biological Psychiatry
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• v.15 no.2
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• pp.83-91
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• 2008

Objectives : Neurological soft signs have been regarded as endophenotypes associated with the genetic basis of schizophrenia. This study was to investigate the intra-familial correlations of the neurological soft signs according to their genetic loading. Methods : Schizophrenic patients(N=14) were included, who had one parent with a family history of schizophrenia and the other without it. Genetic loading was determined by the patient's family history of schizophrenia using the Family Interview for Genetic Studies(FIGS). These parents were subdivided into two groups. The first group was designated as 'presumed carriers'(N=9) of genetic loading, who had one or more schizophreic firstor second-degree relatives. The second group was designated as 'presumed non-carriers'(N=11) of genetic loading, who had no schizophrenic first- or second-degree relatives. Normal controls(N=12) consisted of people without schizophrenic relatives. NSS were evaluated using the Neurological Evaluation Scale-Korean Version (NES-K), and the intra-familial correlations of NSS were tested using the Intra-Class Coefficients(ICC) method. Results : The scores of Motor Coordination subdimension of NES-K were significantly correlated between the patients and their presumed carriers(ICC=.804, p=.016), but not significantly correlated between the patients and their presumed noncarriers. In other subdimensions of NES-K, no significant correlation were found between the patients and their parents regardless of the genetic loading. But, there were no statistically significant differences in the scores of Motor Coordination subdimension of NES-K between the patients and controls. Conclusion : This study did not prove that the neurological soft signs might be an endophenotype of schizophrenia that cosegregate with the genetic loading. The future study using more subjects than this would be needed.

• Progress in Medical Physics
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• v.26 no.4
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• pp.294-303
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• 2015

American Association of Physicists in Medicine (AAPM) Published Task Group 40 report which includes recommendations for comprehensive quality assurance (QA) for medical linear accelerator in 1994 and TG-142 report for recommendation for QA which includes procedures such as intensity-modulated radiotherapy (IMRT), stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) in 2010. Recently, Nuclear Safety and Security Commission (NSSC) published NSSC notification no. 2015-005 which is "Technological standards for radiation safety of medical field". This notification regulate to establish guidelines for quality assurance which includes organization and job, devices, methods/frequency/tolerances and action levels for QA, and to implement quality assurance in each medical institution. For this reason, all of these facilities using medical machine for patient treatment should establish items, frequencies and tolerances for proper QA for medical treatment machine that use the techniques such as non-IMRT, IMRT and SRS/SBRT, and perform quality assurance. For domestic, however, there are lack of guidelines and reports of Korean Society of Medical Physicists (KSMP) for reference to establish systematic QA report in medical institutes. This report, therefore, suggested comprehensive quality assurance system such as the scheme of quality assurance system, which is considered for domestic conditions, based the notification of NSSC and AAPM TG-142 reports. We think that the quality assurance system suggested for medical linear accelerator also help establishing QA system for another high-precision radiation treatment machines.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.1-7
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• 2004

Purpose: Alvarado scoring system was evaluated regarding its usefulness for the early diagnosis of acute appendicitis in adult and in reduction of the incidence of negative appendicectomies. To evaluate the accuracy of diagnosing appendicitis using the Alvarado score in children. Methods: Prospectively, we surveyed 122 patients (male 67, female 55) suffering from abdominal pain, who had visited to the emergency department of Chosun University Hospital from June 2002 to May 2003. The Alvarado score has been computed from the white blood cell count, neutrophil count, body temperature, resistance in the right lower quadrant, length of symptoms, nausea and vomiting. Each patient was evaluated by a pediatric resident and then by a general surgeon independently. Results: Out of 170 total children who visited to the emergency department due to abdominal pain, 122 patients were associated with appendicitis. A total of 122 patients (67 male and 55 female) were visited to the emergency room with suspected appendicitis. From 105 operated patients, 92 (87.6%) were diagnosed acute appendicitis and erronous diagnostic rate was 12.4%, pathologically. Mean alvarado score of appendicitis group was $5.40{\pm}1.24$ whereas those of non-appendicitis group was $3.73{\pm}1.82$ (p<0.05). From 6 Alvarado score high sensitivity (86.4%) and high specificity (80.0%) were observed. Sensitivity of ultrasonography or computed tomography was 92.5%. Conclusion: We found that Alvarado score system is a noninvasive, safe diagnostic method, which is simple, reliable and repeatable. Alvarado score is useful system for a first, rapid and economic evaluation for the appendicitis in children.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.26-34
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• 2009

Purpose: The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Materials and Methods: Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Results: Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors ($5.8{\pm}3.1$ vs. $3.7{\pm}2.1$, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) ($5.7{\pm}3.2$ vs. $3.7{\pm}2.0$, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types ($5.4{\pm}2.8$ vs. $3.7{\pm}1.3$, p=0.003). SUVmax between p53 positive group and negative group was significantly different ($6.0{\pm}2.8$ vs. $4.4{\pm}3.0$, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. Conclusion: T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.76-79
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• 2013

Purpose: It is very important to establish the appropriate reference range in the laboratory for preventing mistakes like false positive or false negative. Because the reference range in the laboratory is standard of patient test results interpretation. Proinsulin is precursor hormone of insulin, and the importance is increasing for diagnosing diabetes or insulinoma. Proinsulin reagent used in our laboratory is produced in the USA, and the reference range provided by manufacturer was adapted to our reference range after the validation test. But, it is generally recommend for the every laboratory to establish the their own reference range. So, we decided to re-evaluate the reference range with our patients' test results. Materials and Methods: Among 737 patients who had been to health promotion center in our hospital between Dec. $8^{th}$ 2011 and Dec. $21^{st}$ 2011, 563 patients are chosen with exception of diabetics patients and patients showing abnormal test results in Fasting Glucose, HbA1c, Insulin, and C-peptide. The 563 test results (275 males and 288 females) were classified with three groups(entire, male, female), and analysis of normal distribution was performed with aid of SPSS(version 19.0). Because Each group didn't show normal distribution, the reference range was set from the lowest limit of 2.5% to the highest limit of 97.5% with Percentile method used in non-normal distribution. Results: When evaluation values are sorted in ascending order, the entire range is 4.5~52.0 pM and 5.3~51.9 pM for male and 4.5~52.0 pM for female. The calculated reference range with percentile method shows 6.7~26.5 pM for entire group, 6.8~26.5 pM for male and 6.7~26.5 pM for female, respectively. Conclusion: The reference range provided by reagent manufacturer is 6.4~9.4 pM and the one established in this study is 6.7~26.5 pM. This difference might be caused by racial characteristics between Western people and Koreans. So an ideal reference range can be gotten with normal population visiting to every hospital. Our hospital has been using the newly re-establishing reference range under consultation with the department of endocrinology since Aug. $1^{st}$ 2012.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.2
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• pp.105-110
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• 2004

Objectives: Despite severe oligospermia, males with Y chromosome microdeletion can achieve conception through ICSI (Intracytoplasmic Sperm Injection). However, ICSI may not only result in the transmission of microdeletions but also the expansion of deletion to the offspring. The purpose of this study was to screen vertical transmission, expansion of microdeletions and de novo deletion in male fetuses conceived by ICSI. Materials and Methods: A total of 32 ICSI treated patients with their 33 (a case of twin) male fetuses conceived by ICSI were used to make this study group. Sequence-tagged sites (STSs)-based PCR analyses were performed on genomic DNA isolated from peripheral blood of fathers and from the amniocytes of male fetuses. Ten primer pairs namely, sY134, sY138, MK5, sY152, sY147, sY254, sY255, SPGY1, sY269 and sY158 were used. The samples with deletions were verified at least three times. Results: We detected a frequency of 12.5% (4 of the 32 patients) of microdeletions in ICSI patients. In 4 patients with detected deletions, two patients have proven deletions on single STS marker and their male fetuses have the identical deletion in this region. Another two patients have two and three deletions, but their male fetuses have more than 3 deletions which include deletions to their father's. Meanwhile, seven male fetuses, whose fathers were analyzed to have all 10 STS markers present, have deletions present in at least one or more of the markers. Conclusions: Although the majority of deletions on the Y chromosome are believed to arise de novo, in some cases a deletion has been transmitted from the fertile father to the infertile patient. In other cases the deletion was transmitted through ICSI treatment, it is likely that one sperm cell is injected through the oocyte's cytoplasm and fertilization can be obtained from spermatozoa. Our tests for deletion were determined by PCR and our results show that the ICSI treatment may lead to vertical transmission, expansion and de novo Y chromosome microdeletions in male fetuses. Because the sample group was relatively small, one should be cautious in analyzing these data. However, it is important to counsel infertile couples contemplating ICSI if the male carries Y chromosomal microdeletions.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.129-136
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• 1987

To determine the hepatitis 8 virus infection rate of the medical school students and appropriate time for immunization with hepatitis B vaccine,355 students in the 1st, 2nd and 3rd grades of Medical School of Kyungpook National University who had not been vaccinated and volunteered to participate in this study were tested for HBsAg, anti-HBs and anti-HBc with radioimmunoassay method (Abbott Lab. kit). A questionnaire was administered to ask the history of transfusion, acupuncture and surgery. HBsAg positive students were retested 16 months after the initial test. Overall HBsAg positive rate was 6.8% and the age adjusted rate for male (7.2%) was higher than that for female (4.9%). Anti-HBs positive rate was 35.3% (36.1% for male, 37.9% for female) and anti-HBc positive rate was 45.5% (46.5% for male,44.7% for female). Overall hepatitis B virus (HBV) infection rate was 49.1% and the infection rate for male (50.3%) was slightly higher than that for female (46.5%). HBsAg positive rate and infection rate were increased as the grade increased but it was attributed to the age distribution of the students. HBaAg positive rate for 20 years old students was 1.7%; 21 years, 6.6%; 22 years, 6.1%; 23 years, 12.2%; and 24 years and older, 6.4%. HBV infection rate showed an increasing trend as age increased; 45.8% for 20 years,41.5% for 21 years, 49.5% for 22 years, 55.5% for 23 years and 59.6% for 24 years and older. The age differences in HBsAg positive rates and HBV infection rates did not reach the statistical significance level of 0.05. However, these findings and similar age differences in HBsAg positive rates and HBV infection rates observed in other study suggest that there is a significant age differences. Study of the same age group in other schools and different social classes is warranted to confirm the age difference. Clarification of the reason for such differences would provide a clue to identify the major route of HBV transmission in this age group. Among 26 HBsAg positive students in the initial test, only one student was active hepatitis patient. Out of 24 students who had follow-up test after 16 months 22 students were positive for HBaAg and two students became HBsAg negative and anti-HBs positive. It is obvious that nearly one-half of the medical school students were infected with HBV before 20 years of age and the HBV infection occurs in medical school. Thus, it is recommended to test all the students for HBV infection soon after the admission to the medical school and immunize all the susceptible students with hepatitis B vaccine and give booster as they start to practice at a hospital.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.362-368
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• 2007

Background: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. Material and Method: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax undewent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a blob larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant blob via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. Result: Multiple or single blob lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and blob was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of $30{\pm}3$ months, no recurrence occurred in both the operative group and the non-operative group. Conclusion: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.