• 보건행정학회지
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• 제22권3호
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• pp.427-450
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• 2012

Objectives : This study examined the factors influencing variation by local areas of antibiotics prescription rate in upper respiratory infections (URI) according to the public reporting. Methods : We used the National Health Insurance Claims Data which the clinics claimed for URI (Korean Standard Classification of Disease, J00 ~ J06) in ambulatory care. The period of analysis was from the first quarter (from January to March) of 2005 to the first quarter of 2007. The number of samples was total 242 local areas that included all clinics (N = 7,942), which prescribed antibiotics for URI in ambulatory care. Results : None of the demographic and socioeconomic characteristic indicators was statistically significant. Among the provider factors, An increase in number of doctors and the average annual antibiotics prescription rate (from 2003 to 2004) for URI by local area were significantly related to an increase of antibiotics prescription rate according to the public reporting. And an increase in number of pediatric clinics, the proportion of clinics less than 5 years since has opened and the average annual fluctuation of antibiotics prescription rate (from 2003 to 2005) were significantly related to a decrease in antibiotics prescription rate by local area according to the disclosure of information. Conclusions : According to the public reporting, the antibiotics prescription rate in clinics had decreased sharply. However, the reduction of antibiotic prescription rate varied in different local areas. The factors influencing variation by local areas in antibiotics prescription rate can be used for establishing effective strategies to reduce variation by region in antibiotics prescription rate.

• Tuberculosis and Respiratory Diseases
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• 제53권3호
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• pp.325-331
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• 2002

전폐절제술후 증후군은 우측 전폐절제술 후 기도폐쇄가 발생하는 드문 합병증으로 기관지연화증이 동반되는 경우는 수술적인 치료로 교정이 어렵다. 저자 등은 기관지연화증을 동반한 전폐절제술후 증후군 환자를 기관지내 스텐트삽입으로 성공적으로 치료한 경험을 하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제46권1호
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• pp.136-141
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• 1999

저자 등은 만성적으로 반복되는 호흡기 감염 증상과 흉부 X-선 검사상 침윤 소견을 보여온 우폐중엽 증후군 환자에서 기관지경을 통해 기관지 폐쇄를 일으킨 이(泥)형질의 결석을 제거하였고, 여기에서 Aspergillus를 분리함으로써 확진된 Aspergillus에 의한 기관지 결석 1예를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.106-115
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• 2018

Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (${\leq}14F$) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity ("water seal") drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established.

• Safety and Health at Work
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• 제6권1호
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• pp.62-70
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• 2015

Background: Animal skin provides an ideal medium for the propagation of microorganisms and it is used like raw material in the tannery and footware industry. The aim of this study was to evaluate and identify the microbial load in oropharyngeal mucosa of tannery employees. Methods: The health risk was estimated based on the identification of microorganisms found in the oropharyngeal mucosa samples. The study was conducted in a tanners group and a control group. Samples were taken from oropharyngeal mucosa and inoculated on plates with selective medium. In the samples, bacteria were identified by 16S ribosomal DNA analysis and the yeasts through a presumptive method. In addition, the sensitivity of these microorganisms to antibiotics/antifungals was evaluated. Results: The identified bacteria belonged to the families Enterobacteriaceae, Pseudomonadaceae, Neisseriaceae, Alcaligenaceae, Moraxellaceae, and Xanthomonadaceae, of which some species are considered as pathogenic or opportunistic microorganisms; these bacteria were not present in the control group. Forty-two percent of bacteria identified in the tanners group are correlated with respiratory diseases. Yeasts were also identified, including the following species: Candida glabrata, Candida tropicalis, Candida albicans, and Candida krusei. Regarding the sensitivity test of bacteria identified in the tanners group, 90% showed sensitivity to piperacillin/tazobactam, 87% showed sensitivity to ticarcillin/clavulanic acid, 74% showed sensitivity to ampicillin/sulbactam, and 58% showed sensitivity to amoxicillin/clavulanic acid. Conclusion: Several of the bacteria and yeast identified in the oropharyngeal mucosa of tanners have been correlated with infections in humans and have already been reported as airborne microorganisms in this working environment, representing a health risk for workers.

• Safety and Health at Work
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• 제11권2호
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• pp.173-177
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• 2020

Background: Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome). Methods: We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity. Results: The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called "brain fog", was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively. Conclusion: The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• Tuberculosis and Respiratory Diseases
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• 제45권1호
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• pp.191-196
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• 1998

Follicular bronchitis/bronchiolitis is pathologically characterized by peribronchiolar lymphoid follicles, which is one of reactive pulmonary lymphoid disorders. It is associated with 1) the result of infections such as mycoplasma, chlamydia etc., 2) immunodeficiency syndromes, 3) connective tissue diseases such as rheumatoid arthritis and Sjogren's syndrome and 4) local or systemic hypersensitivity reaction. And it can be also developed without obvious causes and associated diseases(idiopathic). Radiologically it represents as bilateral interstitial patterns of pulmonary infiltrates. In this case, a 49 year-old woman was presented with intermittent cough and sputum. On chest X-ray and CT, $5\times4$ cm sized mass in right upper lobe and paratracheal lymphadenopathies were detected, by which lung malignancy was suspected. Bronchoscopy, trans bronchial lung biopsy and transthoracic needle aspiration showed non-specific findings only. After right upper lobectomy, we could confirm a case of follicular bronchiolitis which presented as an unusual mass-like radiologic finding.

• Tuberculosis and Respiratory Diseases
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• 제57권1호
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• pp.61-65
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• 2004

노카르디아증은 기회감염성질환의 일종이지만 쿠싱병 환자에서는 아주 드물게 보고되고 있다. 저자들은 쿠싱병을 가진 52세 여자환자에서 폐결절로 발현하고, 이후 경피적 폐생검후 농흉 및 유방 농양이 발생한 노카르디아증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제64권5호
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• pp.387-391
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• 2008

폐트리코모나스증은 인체에 기생하는 3가지 종류의 편모충류(구강편모충, 질편모충, 장세포편모충)에 의해 유발되는 매우 드문 기회 감염성 질환으로 대부분 만성 폐질환이나 화농성 또는 괴사성 폐질환을 앓고 있는 환자 및 면역저하를 동반하는 전신질환을 앓고 있는 사람에서 흡입 또는 직접 전파에 의해 발생된다. 일반적으로 질편모충을 제외한 구강 및 장세포편모충은 병원성이 없는 것으로 고려되어 치료가 필요하지 않지만, 정상적으로 분포하지 않는 장기에서 기회감염을 일으키는 경우 적극적인 치료가 고려되어야 한다. 저자들은 폐 및 전신적인 기저 질환이 없는 무증상의 건강한 남성에서 우연히 발견된 흉부 방사선 검사상 이상 소견에 대해 폐트리코모나스증을 진단하여 항균제 치료로 호전된 드문 예를 경험하여 보고하는 바이다.