• Progress in Medical Physics
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• v.29 no.1
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• pp.1-7
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• 2018

The $TomoTherapy^{(R)}$ beam-delivery method creates helical beam-junctioning patterns in the dose distribution within the target. In addition, the dose discrepancy results in the particular region where the resonance by pattern of dose delivery occurs owing to the change in the position and shape of internal organs with a patient's respiration during long treatment times. In this study, we evaluated the dose pattern of the longitudinal profile with the change in respiration. The superior-inferior motion signal of the programmable respiratory motion phantom was obtained using AbChes as a four-dimensional computed tomography (4DCT) original moving signal. We delineated virtual targets in the phantom and planned to deliver the prescription dose of 300 cGy using field widths of 1.0 cm, 2.5 cm, and 5.0 cm. An original moving signal was fitted to reflecting the beam delivery time of the $TomoTherapy^{(R)}$. The EBT3 film was inserted into the phantom movement cassette, and static, without the movement and with the original movement, was measured with signal changes of 2.0 s, 4.0 s, and 5.0 s periods, and 2.0 mm and 4.0 mm amplitudes. It was found that a dose fluctuation within ${\pm}4.0%$ occurred in all longitudinal profiles. Compared with the original movement, the region of the gamma index above 1 partially appeared within the target and the border of the target when the period and amplitude were changed. Gamma passing rates were 95.00% or more. However, cases for a 5.0 s period and 4.0 mm amplitude at a field width of 2.5 cm and for 2.0 s and 5.0 s periods at a field width of 5.0 cm have gamma passing rates of 92.73%, 90.31%, 90.31%, and 93.60%. $TomoTherapy^{(R)}$ shows a small difference in dose distribution according to the changes of period and amplitude of respiration. Therefore, to treat a variable respiratory motion region, a margin reflecting the degree of change of respiration signal is required.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.309-313
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• 2009

There are several respiratory diseases that show chronic granulomatous inflammation for the histologic finding. Among them, sarcoidosis and tuberculosis are not easy to differentiate when the clinical and radiological features present similar patterns. The increasing incidence of nontuberculous mycobacteria pulmonary disease is making it more difficult for clinicians to arrive at a proper diagnosis. A 69 year old male patient visited our hospital with chronic cough as his chief compliant. His radiologic findings were multiple enlarged mediastinal lymphadenpathies with innumerable micronodules and multiple patch infiltrations. The spleen biopsy finding showed chronic granulomatous inflammation, and Mycobacterium avium was identified on the bronchoscopic culture. Because of these findings, we treated him with drugs for nontuberculous mycobacteria disease other than sarcoidosis. However, during the treatment, his symptoms and radiological features became aggravated. Thus, we reviewed the radiologic and pathologic findings and decided to treat him with steroid, which relieved his symptoms and improved the radiologic findings. We report here on a case of sarcoidosis that was initially misdiagnosed as nontuberculous mycobacteria pulmonary disease.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.1
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• pp.181-197
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• 2013

Objectives : This study aimed to assess the differences in treatment behavior by reviewing data of a medical institution that studies treatment behavior in URI and assessing the treatment efficacy in Korea. Methods : We analyzed the behavior of medical customers and providers of upper respiratory infection medications using the NPS published by the Health Insurance Review Assessment Service. We created an operational definition for complications, and confirmed the difference in complication distribution between medical specialties. We also performed a multivariate analysis using a mixed model to elucidate the factors influencing the occurrence of complications. Results : The outcomes of analyzing factors to influence the difference in practice patterns of the diagnosing URI between the physicians are as follows; (1) Analysis of antibiotics prescriptions rate showed significant difference from medical departments (pediatrics; 49.7%, internal medicine; 54.2%, otorhinolaryngology; 69.6%, family medicine; 61.6%, general surgery; 57.5%, p<0.001). Analysis of steroid prescriptions rate showed significant difference from medical departments (pediatrics; 3.8%, internal medicine; 4.5%, otorhinolaryngology; 5.4%, family medicine; 3.0%, general surgery; 11.2%, p<0.001). (2) In patients who visited medical institutes with the common cold, the complication distribution differed according to the medical specialty, which suggests that specific complications arise depending on the particular medical specialty (p<0.001). (3) Moreover, through multivariate analysis, we found that the complication rate is higher in clinics than in hospitals, depending on the institute's size. (p<0.001; odds ratio of 4.67 in clinics than in hospitals, 95% CI 2.66-8.21) Conclusions : We observe a deviation between the behavior of patients diagnosed with URI and medication providers. This may arise from the interaction between providers and consumers, wherein the complications are associated with the choice of outpatient department and the prevention of cutting incentives. These findings suggest that the health policies should be improved to prevent inappropriate medical practice in the treatment of pediatric URI.

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.479-483
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• 2006

Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of prominent intra-alveolar fibrin and organizing pneumonia, with out hyaline membranes or prominent eosinophilia. The clinical manifestations of AFOP resemble those of acute lung injury such as acute interstitial pneumonia (AIP). However, the classic histological patterns of AFOP differ from diffuse alveolar damage (DAD), bronchiolitis obliterans with organizing pneumonia (BOOP) or acute eosinophilic pneumonia (AEP). The characteristic intra-alveolar fibrin ball and lack of classic hyaline membrane are the predominant histological features of AFOP. Although some reports suggest that its clinical course is less catastrophic than DAD, the clinical entity that distinguishes AFOP from DAD has not been established. We present a case of pathologically demonstrated AFOP in a 79-year-old man. The radiological findings of our case were similar to those of DAD, presented with diffuse bilateral lung infiltrations. However, despite the rapid development of respiratory failure, the patient had a better response and outcome to steroid therapy than what would be expected for DAD.

• Journal of Animal Science and Technology
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• v.66 no.4
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• pp.663-681
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• 2024

Co-infection with porcine reproductive and respiratory syndrome virus (PRRSV) and Haemophilus parasuis (HPS) has severely restricted the healthy development of pig breeding. Exploring disease resistance of non-coding RNAs in pigs co-infected with PRRSV and HPS is therefore critical to complement and elucidate the molecular mechanisms of disease resistance in Kele piglets and to innovate the use of local pig germplasm resources in China. RNA-seq of lungs from Kele piglets with single-infection of PRRSV or HPS and co-infection of both pathogens was performed. Two hundred and twenty-five differentially expressed long non-coding RNAs (DElncRNAs) and 30 DEmicroRNAs (DEmiRNAs) were identified and characterized in the PRRSV and HPS co-infection (PRRSV-HPS) group. Compared with the single-infection groups, 146 unique DElncRNAs, 17 unique DEmiRNAs, and 206 target differentially expressed genes (DEGs) were identified in the PRRSV-HPS group. The expression patterns of 20 DEmiRNAs and DElncRNAs confirmed by real-time quantitative polymerase chain reaction (RT-qPCR) were consistent with those determined by high-throughput sequencing. In the PRRSV-HPS group, the target DEGs were enriched in eight immune Gene Ontology terms relating to two unique DEmiRNAs and 16 DElncRNAs, and the unique target DEGs participated the host immune response to pathogens infection by affecting 15 immune-related Kyoto Encyclopedia of Genes and Genomes enrichment pathways. Notably, competitive endogenous RNA (ceRNA) networks of different groups were constructed, and the ssc-miR-671-5p miRNA was validated as a potential regulatory factor to regulate DTX4 and AEBP1 genes to achieve innate antiviral effects and inhibit pulmonary fibrosis by dual-luciferase reporter assays. These results provided insight into further study on the molecular mechanisms of resistance to PRRSV and HPS co-infection in Kele piglets.

• Korean Journal of Veterinary Research
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• v.48 no.3
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• pp.267-274
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• 2008

This study was to evaluate the efficacy of single dose Mycoplasma hyopneumoniae (M. hyo)-vaccination in the swine farms which had different serological patterns of porcine reproductive and respiratory syndrome virus (PRRSV) and porcine circovirus type 2 (PCV2). A minimum of 240 pigs from each farm was applied, allocating M. hyo vaccinated and control groups. The PRRSV and PCV2 infections were analyzed by serological method (commercial ELISA kit). After administrating pigs a single dose of M. hyo vaccine or control saline at 3 weeks of age, serum antibodies to M. hyo, PRRSV and PCV2 were monitored at 4, 10, 16 and 22 weeks of age. Mortality, weight changes, feed conversion ratio (FCR) and lung score were also evaluated. A single-dose vaccination of M. hyo bacterin was efficacious to reduce mycoplasmal lung lesions and induce good humoral immune response. However, FCR was improved only in one of the three farms where showed seronegative status to both PRRSV and PCV2 in the period from 4 to 16 weeks of age. These results might imply that M. hyo vaccine alone could not overcome the PRRSV and PCV2 infection-associated wasting in the field condition. Therefore, the control of PRRSV and PCV2 should be considered to obtain the better effects of M. hyo vaccination.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.298-305
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• 2016

Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

• The Korean Journal of Physiology and Pharmacology
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• v.6 no.5
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• pp.247-253
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• 2002

Major pelvic ganglia (MPG) neurons are classified into sympathetic and parasympathetic neurons according to the electrophysiological properties; membrane capacitance (Cm), expression of T-type $Ca^{2+}$ channels, and the firing patterns during depolarization. In the present study, function and molecular expression of ATP-sensitive $K^+\;(K_{ATP})$ channels was investigated in MPG neurons of male rats. Only in parasympathetic MPG neurons showing phasic firing patterns, hyperpolarizing changes were elicited by the application of diazoxide, an activator of $K_{ATP}$ channels. Glibenclamide $(10{\mu}M),$ a $K_{ATP}$ channel blocker, completely abolished the diazoxide-induced hyperpolarization. Diazoxide increased inward currents at high $K^+$ (90 mM) external solution, which was also blocked by glibenclamide. The metabolic inhibition by the treatment with mitochondrial respiratory chain inhibitors (rotenone and antimycin) hyperpolarized the resting membrane potential of parasympathetic neurons, which was not observed in sympathetic neurons. The hyperpolarizing response to metabolic inhibition was partially blocked by glibenclamide. RT-PCR analysis revealed that MPG neurons mainly expressed the $K_{ATP}$ channel subunits of Kir6.2 and SUR1. Our results suggest that MPG neurons have $K_{ATP}$ channels, mainly formed by Kir6.2 and SUR1, with phenotype-specificity, and that the conductance through this channel in parasympathetic neurons may contribute to the changes in excitability during hypoxia and/or metabolic inhibition.

• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.134-143
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• 2022

Objectives: Many governments have imposed-and are still imposing-mobility restrictions to contain the coronavirus disease 2019 (COVID-19) pandemic. However, there is no consensus on whether policy-induced reductions of human mobility effectively reduce the effective reproduction number (Rt) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several studies based on country-restricted data reported conflicting trends in the change of the SARS-CoV-2 Rt following mobility restrictions. The objective of this study was to examine, at the global scale, the existence of regional specificities in the correlations between Rt and human mobility. Methods: We computed the Rt of SARS-CoV-2 using data on worldwide infection cases reported by the Johns Hopkins University, and analyzed the correlation between Rt and mobility indicators from the Google COVID-19 Community Mobility Reports in 125 countries, as well as states/regions within the United States, using the Pearson correlation test, linear modeling, and quadratic modeling. Results: The correlation analysis identified countries where Rt negatively correlated with residential mobility, as expected by policymakers, but also countries where Rt positively correlated with residential mobility and countries with more complex correlation patterns. The correlations between Rt and residential mobility were non-linear in many countries, indicating an optimal level above which increasing residential mobility is counterproductive. Conclusions: Our results indicate that, in order to effectively reduce viral circulation, mobility restriction measures must be tailored by region, considering local cultural determinants and social behaviors. We believe that our results have the potential to guide differential refinement of mobility restriction policies at a country/regional resolution.

• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.113-121
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• 2023

Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.