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Comparative Study on the Regimens with Pyrazinamide or Ofloxacin in the retreatment of pulmonary tuberculosis (폐결핵 재치료에서 Pyrazinamide 복합처방과 Ofloxacin 복합처방의 효과에 관한 비교 연구)

  • Choi, In Hwan;Park, Seung Kyu;Kim, Kyeong Ho;Kim, Jin Ho;Kim, Cheon Tae;Song, Sun Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.871-881
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    • 1996
  • Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

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Clinical Finding of MDR Tuberculosis and Frequency of MOTT (다제내성결핵의 임상적 특성과 비결핵항산균증의 빈도)

  • Bae, Mi-Hee;Kim, Hwa-Jung;Kwon, Eun-Soo;Kim, Cheol-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1123-1142
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    • 1998
  • Background : The frequency of MOTT has risen as the prevalence of tuberculosis has been declining. Our country has been also. The most of MOTT was resistant to the major anti-tuberculous drugs. Method : To compare clinical characteristics and frequencies of MDR tuberculosis with MOTT, the author studied 65 patients showing AFB culture positive with sputum. The data were collected from 176 patients who had been admitted at the National Masan Tuberculosis Hospital from May to June, 1997 to April, 1998. Result : The frequency of MDR tuberculosis was 43.1% and that of MOTT was 9.2%. Among 65 isolated mycobacteria, 3 cases were M. intracellulare. 2 cases were M. fortuitum, and 1 case was unidentified MOTT. The most frequent age group in 65 culture positive patients was 4th decade and the mean age was 44. The mean age was 61 in MOTT and 42 in M. tuberculosis and had significant difference(p<0.01). The numbers with past history of treatment were 2.3 in MDR tuberculosis and 1.7 in non-MDR tuberculosis and had significant difference(p<0.05). At the time of admission, the most frequent regimen for the treatment of MDR tuberculosis was 24 months regimen(85.7%) with the 2nd line anti-tuberculosis drugs. For non-MDR tuberculosis, 9 or 12 months regimen (72.9%) with the 1st line anti-tuberculosis drugs and had significant difference (p<0.01). At the time of admission, the symptom of weight loss was shown in 84.7% of M. tuberculosis and 50.0% in MOTT and there was significant difference(p<0.05) between them. All of the MOTT were identified to be resistant against INH and PAS. Drug resistance rates to INH, OFX(p<0.01) and PAS(p<0.05) in MOTT were higher than in MDR. All of three M. intracellulare strains were resistant to INH, RFP, PAS and OFX. All of two M. fortuitum strains were resistant to most anti-tuberculosis drugs. And the other MOTT was resistant to INH, EMB and PAS. Conclusion : MOTT was more common in elderly patients than M. tuberculosis. MOTT cases should be considered to be the probability of multiple drug resistance and treatment failure during the 1st treatment because they showed more resistance to anti-tuberculosis drugs than M. tuberculosis cases. Therefore, there should be more careful investigations for clinical characteristics, natural history of disease, and efficient management for MOTT.

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Utility of Routine Culture for Tuberculosis from Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in a Tuberculosis Endemic Country

  • Hong, Ji-Young;Jung, Ji-Ye;Kang, Young-Ae;Park, Byung-Hoon;Jung, Won-Jai;Lee, Su-Hwan;Kim, Song-Yee;Lee, Sang-Kook;Chung, Kyung-Soo;Park, Seon-Cheol;Kim, Eun-Young;Lim, Ju-Eun;Kim, Se-Kyu;Chang, Joon;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.408-416
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    • 2011
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a technique developed to allow mediastinal staging of lung cancer and also to evaluate intrathoracic lymphadenopathy. In a tuberculosis-endemic area, tuberculosis should be considered as an etiology of mediastinal lymphadenopathy. The aim of this study was to investigate the utility of the routine culture for tuberculosis from specimens of EBUS-TBNA. Methods: We prospectively performed routine culture for tuberculosis from aspiration or core biopsy specimens got from 86 patients who had undergone EBUS-TBNA due to mediastinal lymphadenopathy between March 2010 and March 2011. Results: A total of 135 lymph node aspiration and 118 core biopsy specimens were included in this analysis. We confirmed the malignancy in 62 (72.9%), tuberculosis in 7 (8.1%), sarcoidosis in 7 (8.1%), asperogillosis in 2 (2.3%) and pneumoconiosis in 2 (2.3%) patients. One lung cancer patient had pulmonary tuberculosis coincidentally and 5 patients had unknown lymphadenopathy. The number of positive culture for Mycobacterium tuberculsosis by EBUS-TBNA is 2 (1.5%) from 135 lymph node aspiration specimens and 2 (1.7%) from 118 core biopsy specimens. Out of eight patients confirmed with tuberculosis, only one patient had positive mycobacterial culture of aspiration specimen from EBUS-TBNA without histopathologic diagnosis. Conclusion: These results propose that routine culture for tuberculosis from EBUS-TBNA may not provide additional information for the diagnosis of coincident tuberculous lymphadenitis. However, if there is any possibility of tuberculous lymphadenopathy or pulmonary tuberculosis, it should be considered to perform EBUS-TBNA in patients who have negative sputum AFB smears or no sputum production.

Design of Over-sampled Channelized DRFM Structure in order to Remove Interference and Prevent Spurious Signal (간섭 제거 및 스퓨리어스 방지를 위한 오버샘플링 된 채널화 DRFM 구조 설계)

  • Kim, Yo-Han;Hong, Sang-Guen;Seo, Seung-Hun;Jo, Jung-Hun
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.8
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    • pp.1213-1221
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    • 2022
  • In Electronic Warfare, the need to develop a jamming system that protects our location information from enemy radar is constantly increasing. The jamming system normally uses wide-band DRFM(Digital Radio Frequency Memory) that processes the entire bandwidth at once. However, it is difficult to jam if there is a CW(Continuous Wave) interference signal in the band. Recently, instead of wide-band signal processing, a structure using a filter bank that divides the entire band into several sub-bands and processes each sub-band independently has been proposed. Although it is possible to handle interference signal through the filter bank structure, spurious signal occurs when the signal is received at a boundary frequency between sub-bands. Spurious signal makes a output power of jamming signal distributed, resulting in lower JSR(Jamming to Signal Ratio) and less jamming effect. This paper proposes an over-sampled channelized DRFM structure that enables interference response and prevents spurious signal for sub-band boundary frequency input.

Evaluation of the Effectiveness of a Re-decontaminating Process with Bacterial Contaminated Specimens Showing a Positive MGIT Signal for the Detection of Mycobacteria (마이코박테리아 검출을 위하여 MGIT 양성 신호를 보인 세균에 오염된 검체 재처리 과정의 효율성 평가)

  • Jung, Haeyong;Bang, Hae In;Choi, Tae Youn
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.171-176
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    • 2019
  • A comparative study between commercially available mycobacteria growth indicator tubes (MGIT) in the BACTEC MGIT 960 System and the conventional Ogawa media was carried out to assess the effectiveness of the re-decontaminating process for the recovery of mycobacteria. Processed specimens with 5% sodium hydroxide and 0.5% N-acetyl-L-cysteine were inoculated into MGIT and Ogawa media. The acid fast bacilli (AFB) recovered from the cultures were identified using a mycobacterium tuberculosis (TB) antigen kit. If contaminants were observed in the MGIT tubes within five days, a decontaminating process was repeated. A total of 1,190 out of 4,790 (24.8%) specimens showed positive results using the BACTEC MGIT 960 system. Among them, 278 specimens were reprocessed. When the MGIT and Ogawa results were compared, it showed discordant results (weighted kappa value: 0.283). One TB and 10 nontuberculous mycobacteria (NTM) were newly detected in MGIT only. The likely benefit of the re-decontaminating process is the detection of additional mycobacteria that could not be detected without a re-decontaminating process despite being small in number. In addition to the combination of MGIT and Ogawa, the re-decontaminating process is recommended in the case of contaminations to recover mycobacteria.

The Difference of History Associated with Occupation of Pulmonary Tuberculosis (폐결핵 환자의 직업에 따른 병력의 차이)

  • Song, Sun-Dae;Kim, Cheon-Tae;Koh, Seok-Shin
    • Journal of agricultural medicine and community health
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    • v.20 no.2
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    • pp.149-156
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    • 1995
  • This study was performed for 182 rural persons of patients who had admitted at National Masan Tuberculosis Hospital from 21th Feb to 18th Aug, 1994. We investigated diseased history based on the data according to the kind of occupation. The results were summarized as follows : The most common occupation was no occupation(35.2%). The most common age group was 5th decade(25.3%). By the age, the most common group in cases of no occupation was over 7th decade and under 5th decade, and agriculture was over 7th decade and 6th decade. Male(83.5%) were more than female, but wasn't significantly different. The most common group in the level of education was over the graduate of high school. The group that have ever drunken(p<0.05) and smoked(p<0.01) was significantly different in labour, service, agriculture, others. Family history, combined disease, symptom were no significantly different by occupation. Both lung fields on the chest X-ray was the most common site of invasion(82.4%). In the tests of AFB smear and culture, the differences according to the occupation were not. At the time of admission, the most common group in the state of treatment was initial treatment. The multi-drug resistance tuberculosis was no significantly different by occupation.

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A Clinical Effect of Retreatment by Prothionamide, Cycloserine, Para-Aminosalicylic Acid, Streptomycin (Kanamycin or Tuberactinomycin) on Pulmonary Tuberculosis (폐결핵 재치료의 Prothionamide, Cycloserine, Para-Aminosalicylic Acid, Streptomycin (Kanamycin or Tuberactinomycin) 4제 요법 임상 효과)

  • Shin, Cheol-Shick;Im, Young-Jae;Kim, Young-Jun;Koh, Seok-Shin;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.2
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    • pp.167-171
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    • 1992
  • Background:In the management of patients whose primary chemotherapy has failed, very careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow-up of 112 smear positive cases, who were treated by four-drug regimen between July 1985 and June 1990. Four drugs were, namely prothionamide, cycloserine, para-aminosalicylic acid, and streptomycin (kanamycin or tuber-actinomycin). The duration of follow-up was over one year. Results: 1) Out of 112 cases with positive sputum AFB smear, 72 (64%) achieved the negative conversion. 2) Among the 72 patients, 85% achieved negative conversion within 3 months after treatment. 3) When the duration of patient's illness was less than 2 years, 2 to 4 years and more than 5 years, the favourable response to retreatment was 86%, 62% and 54%, respectively. 4) When the number of sensitive drugs was 4,3,2 and 1, the favourable response rate was 74%, 68%, 39% and 0%, respectively. Conclusion: The shorter the duration of patient's illness was, the larger the number of sensitive drugs was. And the larger the number of sensitive drugs was, the better the result of treatment was. Thus it is very crucial to successfully treat newly discovered patients with adequate regimens and proper case-holding.

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Effect of Processing on the Antimutagenicity of Rice (쌀의 돌연변이 억제활성에 미치는 가공처리의 영향)

  • Kim, In-Ho;Chun, Hyang-Sook;Ha, Tae-Youl;Moon, Tae-Wha
    • Korean Journal of Food Science and Technology
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    • v.27 no.6
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    • pp.944-949
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    • 1995
  • To investigate the effect of processing on the antimutagenicity of rice, antimutagenic effect of rice products including cooked rice, plain steamed rice bread(baikseolgi) and parched rice powder were observed. They showed inhibitory effects of $46%{\sim}100%$ on the frameshift mutation, whereas they showed little inhibitory effect on the base substitution mutation in the Salmonella typhimurium reversion assay. No inhibitory effect was found in the SOS chromotest. Inhibitory effect was more clearly observed on the indirect-acting mutagen than on the direct-acting mutagen. In case of the S. typhimurium reversion assay, the range of inhibition rate against the frameshift and base substitution mutation was $75%{\sim}100%$ and $66%{\sim}87%$, respectively, and was $19%{\sim}67%$ in the SOS chromotest. Antimutagenic activity of raw rice was supposed to be maintained in processed rice products.

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Inhibitory Effect of Methanol Extracts and Solvent Fractions from Doenjang on Mutagenicity Using in vitro SOS Chromotest and in vivo Drosophila Mutagenic System (된장 메탄올 추출물 및 분획물에 의한 in vitro SOS Chromotest 실험계와 in vivo 초파리 돌연변이 검출계에서의 항돌연변이 효과)

  • Lim, Sun-Young;Lee, Sook-Hee;Park, Keun-Young;Yun, Hee-Sun;Lee, Won-Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.9
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    • pp.1432-1438
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    • 2004
  • This study investigated the inhibitory effect of methanol extracts and several solvent fractions from doen-jang on mutagenicity using in vitro SOS chromotest and in vivo Drosophila mutagenic system. In order to determine an antimutagenic effect of doenjang methanol extracts, other soybean fermented foods and original materials were compared. The treatment of doenjang methanol extracts (100 ${\mu}$/assay) to SOS chromotest system inhibited N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) induced mutagenicity by 87~97% and showed higher antimutagenic effect than other fermented foods. Among solvent fractions from doenjang methanol extracts, the ethylacetate and dichloromethane fractions showed the stronger antimutagenic effect (91% and 95%, respectively) in SOS chromotest. In Drosophila mutagenic system, the treatment of ethylacetate fraction (5%/bottle) significantly inhibited aflatoxin $B_1$ induced mutagenicity by 97%. These results demonstrated that doenjang had an inhibitory effect to mutagenic agents in both in vitro and in vivo mutagenic systems, suggesting that its antimutagenic effect may be due to active compounds in the ethylacetate fraction from doenjang methanol extracts.

The Telescopic Findings and Clinical Manifestations of Laryngeal Tuberculosis (후두 결핵의 후두 내시경 소견과 임상 양상 분석)

  • Lee, Sang-Hyuk;Lee, Seung-Suk;Lee, No-Hee;Ban, Jae-Ho;Lee, Kyung-Chul;Jin, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.1
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    • pp.38-42
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    • 2006
  • Background and Objectives: There has been a gradual decline in the incidence of laryngeal tuberculosis due to effective an-tituberculous chemotherapy and improvement in the standard of living. During the last decade, however, the disease has changed its clinical pattern. We aimed to study a clinical and telescopic evaluation of laryngeal tuberculosis. Materials and Method: A retrospective clinical analysis was done for 16 patients who diagnosed laryngeal tuberculosis from January 2000 through December 2004. All patients had a complete clinical and laboratory work-up including telescopy, chest X-rays, sputum cultures, Tbc PCR(polymerase chain reaction). Laryngeal biopsies were performed in some cases. All the patients received proper antituberculous chemotherapy. Results: The patients age ranged from 21 to 59 with a mean age 43. The male to female ratio was 10:6. The prominent presenting symptom was hoarseness. The various telescopic findings were categorized: 7 patients showed ulcerative, 4 patients granulomatous, 3 patients ulcerofungative, 2 patients had nonspecific inflammatory lesions. Involving sites were true vocal cord most commonly in 12 patients. Three of 16 patients had normal chest X-ray fmding. Among 16 patients, 4 patients showed positive response for AFB stain, 13 patients showed positive for Tbc PCR. Biopsy was done for 3 patients who were not confirmed in initial tuberculous test. All patients responded satisfactorily to antituberculous medication. Conclusion: The telescopic findings and clinical manifestations of laryngeal tuberculosis have changed and seemed to be different from those of classic reports. Thus, the clinicians who deal with the various symptoms and diseases should be aware of the existence of laryngeal tuberculosis and the changing patterns of the disease.

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