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Clinical Characteristics and Treatment Outcomes of Patients with Pulmonary tuberculosis at a Private General Hospital (한 민간종합병원에서 진단된 폐결핵 환자의 특성과 치료성적)

  • Koh, Won-Jung;Kwon, O Jung;Kim, Cheol Hong;Ahn, Young Mee;Lim, Seong Yong;Yun, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Jung Wook;Suh, Jin Sook
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.154-164
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    • 2003
  • Background : Until the early 1990's in Korea, treatment outcomes of patients with pulmonary tuberculosis in the private sector were reported to be inferior to those of the public health center under the National Tuberculosis Programme. The purpose of this study was to analyze the clinical characteristics and the treatment efficacy of the patients with pulmonary tuberculosis recently diagnosed at a private general hospital. Materials and Methods : The study included all pulmonary tuberculosis patients diagnosed at Samsung Medical Center and notified to the public health center from August 2000 to January 2001. Results : Of the 232 patients included in the study during a 6-month period, 188 were (81.0%) initial treatment cases and 44 (19.0%) were re-treatment cases. Eighty-three (35.8%) patients had smear-positive sputa, and 27 (11.6%) had smear-negative, culture-positive sputa. Initial sputum examinations were not performed in 47 (20.3%) patients. A six-month, short-course treatment using isoniazid, rifampin, ethambutol and pyrazinamide was prescribed for 31.4% of the patients under the initial treatment. The success rate (cured plus treatment completed) of the initial treatment for the smear-positive patients was 69.1%. Eleven (13.3%) of the 83 patients with smear-positive pulmonary tuberculosis discontinued their treatment without notice. Conclusions : To improve the treatment efficacy and decrease the default rates of the patients with pulmonary tuberculosis in the private sector, further efforts are required in line with the Korean Academy of Tuberculosis and Respiratory Disease Treatment Guidelines and in the implementation of an appropriate model of public-private mix for tuberculosis control in Korea.

Analysis of Prognostic Factors in 1,435 Surgically Treated Patients with Gastric Cancer (위암 수술 1,435에의 예후 인자 분석)

  • Seo, Won-Hong;Seo, Byoung-Jo;Yu, Hang-Jong;Lee, Woo-Yong;Lee, Hea-Kyoung
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.143-151
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    • 2009
  • Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

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Clinicopathologic Characteristics of Stage IV Early Gastric Cancer (IV기 조기위암의 임상병리학적 특성)

  • Kim, Min Kuk;An, Ji Yeong;Choi, Min Gew;Noh, Jae Hyung;Sohn, Tae Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.136-140
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    • 2008
  • Purpose: Stage IV early gastric carcinoma (EGC) is a rare disease. We report here on 10 cases of EGC that showed metastasis in more than 15 lymph nodes. Materials and Methods: A total of 8354 cases of gastric carcinoma in patients who underwent surgical procedures between January 2001 and January 2007 at Samsung Medical Center were studied, and 10 cases were classified as stage IV EGC. We investigated their clinicopathologic characteristics. Results: There were 5 males and 5 females. Their ages at operation ranged from 46 to 76 years with a mean age of 61. All of the 10 patients had undergone curative resection for gastric cancer. The pathological diagnosis confirmed that all of the patients had tumor confined to the submucosa. The median size of the tumors was 5.3cm and the mean number of dissected nodes was 45.5 with a mean number of 22.2 involved nodes. Six cases were classified as the diffuse type and 4 were classified as the intestinal type by Lauren's classification. Histologically, 3 cases were signet ring cell carcinoma, 3 were poorly differentiated, 2 were moderately differentiated and 2 were well differentiated adenocarcinoma. Endolymphatic invasion was found in 9 cases. The median follow-up was 31 months. Adjuvant chemotherapy was done in 9 patients, and the patient who did not receive chemotherapy died by cerebrovascular accident. 2 patient had recurrence of gastric cancer and 7 survived without recurrence. Conclusion: More cases should be collected and further studies on the molecular and cellular tumor characteristics are required to characterize these tumors that show aggressive lymphatic spread.

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Antioxidant and Neuroprotective Effects of Green Tea Seed Shell Ethanol Extracts (녹차씨껍질 에탄올 추출물의 항산화 활성 및 신경세포 보호 효과)

  • Sung, Nak-Yun;Song, Hayeon;Ahn, Dong-Hyun;Yoo, Yung-Choon;Byun, Eui-Baek;Jang, Beom-Su;Park, Chulhwan;Park, Won-Jong;Byun, Eui-Hong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.7
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    • pp.958-965
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    • 2016
  • The objective of this study was to evaluate the antioxidant activity of green tea seed shell as an industrial byproduct. Green tea seed shell extract (GTSSE) was obtained by ethanol extraction, and the yield was $1.4{\pm}0.22%$. The radical scavenging activities [1,1-diphenyl-picrylhydrazyl and 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid)], xanthine oxidase inhibition activity, and reducing power of GTSSE dose-dependently increased. To estimate the neuroprotective effect of GTSSE, viability was tested in HT22 mouse hippocampal cells. GTSSE treatment induced cytotoxicity at a concentration higher than $100{\mu}g/mL$ but not at a concentration lower than $50{\mu}g/mL$. Using this optimal concentration range, GTSSE treatment significantly increased cell viability in $H_2O_2$-treated HT22 cells. Further, GTSSE treatment increased superoxide dismutase activity and decreased the malonaldehyde level, a product of lipid peroxidation, in HT22 cells. Therefore, these results indicate that green tea seed shell extract may be useful for the development of antioxidant materials and have potential activity to prevent and treat neuro-degenerative diseases such as Alzheimer's disease.

A Study on the Decisive Factors in Personal Health Maintenance Practice of Housewives Living in Younhi Area Apartments (연희지역 아파트주부의 건강관리실천의 결정요인분석에 관한 조사연구)

  • 김인숙
    • Journal of Korean Academy of Nursing
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    • v.8 no.2
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    • pp.89-102
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    • 1978
  • Owing to the development of modern science, prolonging man's life, the sudden increase of population and betterment of the standard of living has increased health needs. In order to fulfill these health needs, more active plans for developing health should be made. Health education is one of the methods at hand that can improve the health behavior of the community and the individual through the contact of individuals with their groups. Proper understanding of the characteristics of the sampled group and participation of individuals within the community for the development of their health plan are needed for efficient health education. This study was attempted for the purpose of presenting some data helpful for pre-paring the fundamentals of a health education plan that can improve personal health maintenance practice of a community through efficient health education by investigating the relationship between the response of subjects to personal health maintenance practice and selected decisive factors in personal health maintenance practice. The subjects for this study were a systematic sample of 120 housewives selected from 600 housewives from B Zone Apt. Younhi-3-Dong in Seoul. Data was collected for 4 days from May 16th to May 19th, 1578 through personal interviews with questionnaires by well trained interviewers. Percentage, t-test and stepwise multiple regression analysis by use of EDPS were employed for statistical analysis. Results of this study can be summarized : 1. General characteristics of subjects Subjects over 20 and below 40 years of age formed 62.5% of the toed and the rest were subjects of 40 years and upward. 76.7% of the subjects have less than 4 children. 51.3% of the subjects had completed at least the senior high school course. 2. The response of subjects to personal health maintenance practice. Ratios of personal health maintenance practice to the maximum score for each category are as follows; 84.1% in the category of population and family planning, which was the highest ratio; 82.4% in the prevention of accidents; 68.0% in control of communicable disease; 67.8% in personal health care and habits of daily life, 64.3% in mental health and 52.5% in control of parasites, which was the lowest. 3. The response of subjects to selected decisive factors. in personal health maintenance practice. The arithmetic mean of the score for each decisive factor was as follows: the mutual relation between family members marked 18.33, which is under 73,3% of the maximum score; the degree of interest in health marked 34.48, 70.0% of the maximum score: the degree of utilization and demand for health care facilities marked 25.79 or 64.5% of the maximum score and health maintenance of the family marked 11.58, 43.6% of the maximum score. 4. The relationship between personal health maintenance practice and general characteristics of subjects. 1) There was a significant difference in the numbers of children. (t = 1.83, d.f. =117, p< 0.1) 2) There was a significant difference in the contact rates with mass-media, (t = 5.02, d.f. = 118, p< 0,05) 5. The multiple correlation between personal health maintenance practice and their selected decisive factors. 1) The factor“the degree of interest in health”could account for personal health maintenance practice in 43.6% of the sample. (R = 0.6602, R²= 0,4359, F = 91.1678, p< 0.001) 2) When the factor,“health maintenance of family”is added to this, it accounts for 51.2% of personal health maintenance practice. (R = 0.7158, R²= 0.5124, F = 61.4653, p< 0.001) 3) When the factor,“mutual relations between family members”is also included, it accounts for 53.7% of personal health maintenance practice. (R = 0.7324, R²= 0.5365, F = 44.7509, p< 0.001) 4) When the factor, “the degree of utilization and demand for health care facilities”is included, it accounts for 55.1% of personal health maintenance practice. (R = 0.7421, R²= 0.5507, F = 35.2430, p< 0.001).

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Expression of Clusterin in the Salivary Gland under Restraint Stress (구속 스트레스에 의한 타액선 조직내의 Clusterin 발현)

  • Park, Hee-Kyung;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.33 no.3
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    • pp.247-256
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    • 2008
  • The belief that stress leads to illness has a long history. A number of the orofacial disease are also closely associated with stress. Despite research in the relationship of stress and the orofacial diseases leading to statistically significant correlations, the pathology remains vague. In the present study, the expression of clusterin, a stress protein responsible for antiapoptosis and cytoprotection, under restraint stress condition was observed in the submandibular gland, one of the major salivary glands. Sprague-Dawley rats were divided into 2 groups: normal group and restraint stress group. The rats of restraint stress group were placed in the stress cages and then sacrificed at day 0, 3 and 5 day of the experiment. After that, the submandibular glands of all the rats were excised immediately. The levels of clusterin proteins and mRNA in the tissues were measured by immunohistochemistry and Northern blot analyses, respectively. The results were as follows: 1. In the immunohistochemistry, clusterin protein was detected only immediately after the application of restraint stress. 2. In the restraint stress group, at day 3 and 5, histologically apoptosis was induced with karyorrhectic and pyknotic changes. 3. By the restraint stress, acinic cells were destructed earlier than ductal cells. 4. In the Northern blot, mRNA of clusterin was expressed only immediately after the application of restraint stress. The overall results suggest that as an early response to stress, clusterin is expressed in the glands to protect the glandular cells from the stress. But if stress is so strong and prolonged that it can exceed the stress adaptability of the cells, then the cells may undergo apoptosis instead of producing clusterin. An Epidemiologic Study of Symptoms of Temporomandibular Disorders in Korean College Students.

Value of Pulmonary Function Test as a Predicting Factor of Pneumothorax in CT-guided Needle Aspiration of the Lung (전산화단층촬영 유도하 경피적 폐침생검시 기흉발생 예측인자로써의 폐기능검사의 가치)

  • Kim, Yeon-Jae;Kim, Chang-Ho;Lee, Yeung-Suk;Park, Jae-Yong;Kang, Duk-Sik;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.259-266
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    • 1993
  • Background: To evaluate the risk factor of pneumothorax (PNX) which is the most common complication of CT-guided needle aspiration of the lung, we have examined the frequency of PNX according to the presence of obstructive ventilatory impairment determined by pulmonary function tests. Methods: A comparative study of analysis of forecd expiratory volume and folw-volume curves, and determinations of diffusing capacity taken before procedure were made between each 16 cases with PNX and controls with no PNX. Each of the control group was matched for sex, age, height, and size and depth of lesion with the former. Results: 1) In comparison of vital capacity and parameters derived from forced expiratory volume curve between two groups, VC and FVC were not significantly different, whereas $FEV_1$, $FEV_1$/FVC%, and FEF25-75% showed a significant decrease in the PNX gorup. Also, in the PNX group, all the observed values of parameters analyzed from flow-volune curve were siginificantly reduced in the PNX group compared with those in the control group. 2) The diffusing capacity tended to decrease along with varying individual differences in the PNX group. 3) Patients who had obstructive ventilatory impairment according to the results of pulmonary function tests experienced a twofold increase in the frequency of PNX and a sixfold increase in the frequency of chest tube drainage for treatment of PNX compared with those whose results were normal. Conclusion: These findings suggest that the exact evaluation of obstructive lung disease determined by pulmonary function test be considered assessing a pastient's risk for PNX in the patients who will take the CT-guided needle aspiration of the lung.

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Clinical Characteristics of Pulmonary Histiocytosis X (폐조직구증식증의 임상적 특징)

  • Hwang, Yong-Ii;Park, Gun-Min;Yim, Jae-Joon;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.346-353
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    • 2001
  • Background : Pulmonary Langerhans cell histiocytosis forms part of a spectrum of diseases that are characterized by a monoclonal proliferation and infiltration of organs by Langerhans cells. Several organ systems may be involved in Langerhans cell histiocytosis, including the lungs, bone, skin, pituitary gland, liver, lymph nodes and thyroid. Pulmonary histiocytosis X represents 2.8% of interstitial lung disease. Here we present the clinical, radiological, therapeutic aspects of pulmonary histiocytosis X. Method : Fourteen cases of biopsy-proven pulmonary histiocytosis X patients who were diagnosed in Seoul National University Hospital during the period from January 1990 to December 1998 were analyzed retrospectively. Result : There were 12 men and 2 women in this study. The initial presenting symptoms were dyspnea, cough, chest pain, which was associated with the pneumothorax, and chest radiography abnormalities. Only 8 patients (57%) were smokers. There were 5 patients with extra-pulmonary histiocytosis (pituitary, bone, skin). Eight patients had received the chemotherapy. There were no mortalities and only one patient experienced an aggravation of symptom during the follow-up period. Conclusion : In contrast to previous reports from other countries, the patients with pulmonary histiocytosis X in this study presented with several different clinical characteristics, such as a male predominance, relatively low smoker's rate, and a better prognosis.

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Attempted Suicides in South Korea : A Multi-Center Analysis of Causes, Methods, and Psychiatric Diagnoses of Suicidal Attempters in 2013 (응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석)

  • Kim, Hyeyoung;Kim, Bora;Kang, Seung-Gul;Kim, Moon-Doo;Kim, Min-Hyuk;Kim, Soo In;Kim, Jae Min;Moon, Eunsoo;Ahn, Joon-Ho;Lee, Kyung-Uk;Lee, Sang-Hyuk;Lee, Seung Jae;Jeong, Seong Hoon;Chung, Young-Chul;Jung, Hee Yeon;Ju, Gawon;Cha, Boseok;Ha, Tae Hyon;Ahn, Yong-Min
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.187-194
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    • 2015
  • Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

A Study on Degree of Daily Living Activities among Women with Osteoarthritis (여성 골관절염 환자의 일상생활 수행능력)

  • Yang, Kyeong-Ra;Rhee, Seon-Ja
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.57-71
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    • 1998
  • This study purports to examine sociodemographic characteristics and those factors associated with osteoarthritis in women experiencing the disease in order to make suggestions for the prevention and management of osteoarthritis in women. The subjects were 143 women who were diagnosed to have osteoarthritis and under follow-up care at an outpatient department of a university-affiliated hospital. The data were collected through personal interviews by using the structured questionnaire between October 6 and October 24, 1997. The degree of daily living activities was measured with 24 items, which were made based upon Katz Index, Barthel Index and Functional Status Index. Each item has 4 response categories : (1) being able to do alone with any difficulty, (2) being able to do alone with some difficulty, (3) being able to do alone with the help of a person or an instrument, (4) not being able to do at all. The data was analyzed with correlation analysis, t-test, ANOVA, and regression analysis. The results are summarized as follows : 1. As for the age of the subjects, 59.4% were between 45 and 64 years, while 28% were 65 years and above. The subjects having religion were 71.7% and 44.1% of the subjects were protestants. The educational level was low : 31.5% graduated from elementary school, while 30.1% had no formal education. Those married subjects were 72%. Fifty nine percent of the subjects evaluated their economic status as middle class. 2. Those people from whom the subjects currently receive some help were spouses in 35.8% of the subjects. Likewise, 50% of the subjects indicated spouse as the people from whom they want to receive help. 3. The score of the ability of daily living activities ranged between 48 and 96, with the mean of 78.94. Those means of physical activity, ADL(activities of daily living) and IADL(instrumental activities of daily living) were 14.89, 13.97 and 50.09, respectively. Except for the items of carrying heavy stuff and of washing clothes in the sitting position the subjects showed independence in more than 90% of the items, where Independence is defined as being able to do alone or with the help of a person or an instrument. 4. The increase in age was a significant predictor of the decrease in the ability of daily living activities. Those graduated from middle school and above showed a significantly higher degree in the ability of daily living activities than those with less educational level. The married women revealed significantly higher scores in physical activity, ADL, and IADL than the unmarried ones. The ability of daily living activities was not significantly related to having religion, economic status and living with family. 5. The average duration of experiencing osteoarthritis was 4 years and 7 months. Regarding the site of the onset, 65% of the subjects indicated knees. The women with osteoarthritis for less than 3 years were 65%. The ability of daily living activities was significantly different by the duration of illness : the longer the duration of illness, the less the ability of activities. The above findings suggest the need for developing those programs for prevention disabilities in performing daily living activities and for managing diseases targeting the women of middle and old age, with low educational level, and with unmarried status. In addition, there should be developed an instrument for measuring the ability of daily living activities which reflects daily lives of Korean women with osteoarthritis in order to examine comprehensive effects of osteoarthritis on women's daily lives in this country.

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