• Title/Summary/Keyword: 과도 분류

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The effects of adjuvant therapy and prognostic factors in completely resected stage IIIa non-small cell lung cancer (비소세포 폐암의 근치적 절제술 후 예후 인자 분석 및 IIIa 병기에서의 보조 요법의 효과에 대한 연구)

  • Cho, Se Haeng;Chung, Kyung Young;Kim, Joo Hang;Kim, Byung Soo;Chang, Joon;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.709-719
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    • 1996
  • Background: Surgical resection is the only way to cure non-small cell lung cancer(NSCLC) and the prognosis of NSCLC in patients who undergo a complete resection is largely influenced by the pathologic stage. After surgical resection, recurrences in distant sites is more common than local recurrences. An effective postoperative adjuvant therapy which can prevent recurrences is necessary to improve long tenn survival Although chemotherapy and radiotherapy are still the mainstay in adjuvant therapy, the benefits of such therapies are still controversial. We initiated this retrospective study to evaluate the effects of adjuvant therapies and analyze the prognostic factors for survival after curative resection. Method: From 1990 to 1995, curative resection was perfomled in 282 NSCLC patients with stage I, II, IIIa, Survival analysis of 282 patients was perfonned by Kaplan-Meier method. The prognostic factors, affecting survival of patients were analyzed by Cox regression model. Results: Squamous cell carcinoma was present in 166 patients(59%) ; adenocarcinoma in 86 pmients(30%) ; adenosquamous carcinoma in II parients(3.9%); and large cell undifferentiated carcinoma in 19 patients(7.1%). By TNM staging system, 93 patients were in stage I; 58 patients in stage II ; and 131 patients in stage rna. There were 139 postoperative recurrences which include 28 local and 111 distant failures(20.1% vs 79.9%). The five year survival rate was 50.1% in stage I ; 31.3% in stage II ; and 24.1% in stage IIIa(p <0.0001). The median survival duration was 55 months in stage I ; 27 months in stage II ; and 16 months in stage rna. Among 131 patients with stage rna, the median survival duration was 19 months for 81 patients who received postoperative adjuvant chemotherapy only or cherne-radiotherapy and 14 months for the other 50 patients who received surgery only or surgery with adjuvant radiotherapy(p=0.2982). Among 131 patients with stage IIIa, the median disease free survival duration was 16 months for 21 patients who received postop. adjuvant chemotherapy only and 4 months for 11 patients who received surgery only(p=0.0494). In 131 patients with stage IIIa, 92 cases were in N2 stage. The five year survival rate of the 92 patients with N2 was 25% and their median survival duration was 15 months. The median survival duration in patients with N2 stage was 18 months for those 62 patients who received adjuvant chemotherapy and 14 months for the other 30 patients who did not(p=0.3988). The median survival duration was 16 months for those 66 patients who received irradiation and 14 months for the other 26 patients who did not(p=0.6588). We performed multivariate analysis to identify the factors affecting prognosis after complete surgical resection, using the Cox multiple regression model. Only age(p=0.0093) and the pathologic stage(p<0.0001) were significam prognostic indicators. Conclusion: The age and pathologic stage of the NSCLC parients are the significant prognostic factors in our study. Disease free survival duration was prolonged with statistical significance in patients who received postoperative adjuvant chemotherapy but overall survival duration was not affected according to adjuvant therapy after surgical resection.

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Biodiversity and Community Composition of Benthic Macroinvertebrates from Upo Wetlands in Korea (우포습지의 저서성 대형무척추동물 다양성과 군집 특성)

  • 배연재;조신일;황득휘;이황구;나국본
    • Korean Journal of Environment and Ecology
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    • v.18 no.1
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    • pp.75-91
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    • 2004
  • Biodiversity and seasonal community composition of benthic macroinvertebrates were studied from Upo wetlands in Gyeongsangnam-do, Korea, comprising Upo (4 sites), Mokpo (2 sites), Sajipo (1 site), Jjokjibeol (1 site), Yeobeol (1 site), and Topyeongcheon (2 sites) areas from October 2002 to August 2003. As a result, it was known that Upo wetlands retained relatively well-preserved littoral zones which may provide good habitats for benthic macroinvertebrates; however, frequent disturbances of littoral zones caused by flood were the major factor affecting on the survival and distribution of benthic macroinvertebrates in the areas. During the study period, a total of 135 species of benthic macroinvertebrates in 10 genera, 59 families, 16 orders, 7 classes, and 3 phyla were collected those of which are the highest degree of diversity of the taxa ever known in Korean wetlands: aquatic insects 103 spp. (Diptera 27 spp., Odonata 24 spp., Coleoptera 19 spp., Hemiptera 16 spp., Ephemeroptera 9 spp., Trichoptera 7 spp., and Collembola 1 sp.), Crustacea 2 spp., Mollusca 19 spp. (Gastropoda 12 spp. and Bivalvia 7 spp.), and Annelids 11 spp. (Oligocaeta 1 sp. and Hirudinea 10 spp.). Sajipo (St.G) and Jjokjibeol (St.H) areas yielded relatively larger numbers of species, 54 spp. and 53 spp., respectively, while more than 40 species occurred at most other sites. Based on quantitative sampling (0.5m${\times}$2m), aquatic insects (88.0%), particularly chironomids in Diptera (61.0%), occupied major proportion of the total individuals of benthic macroinvertebrates, while Mollusca (5.3%), Annelida (3.5%), and Crustacea (3.2%) occupied minor proportions. In standing water areas, diverse groups of benthic macroinvertebrates such as chironomids, demselflies, aquatic bugs, aquatic beetles, crustaceans, and gastropods were dominant in terms of individual number; in the running water areas, on the other hand, chironomids and baetid mayflies were dominant. However, gastropods, i.e. viviparids, were the dominant group of benthic macroinvertebrates in most study areas in terms of biomass. Dominance indices were 0.22-0.51 (mean$\pm$sd 0.42$\pm$0.09) in autumn, 0.31-0.96 (0.02$\pm$0.23) in winter, and 0.30-0.89 (0.57$\pm$0.18) in summer; diversity indices were 3.50-4.26 (3.80$\pm$0.24) in autumn,1.55-4.50 (3.10$\pm$1.01) in winter, and 1.35-3.77 (2.55$\pm$0.09) in summer. Highly movable or true aquatic benthic macroinvertebyates such as aquatic bugs, aquatic beetles, and gastropods recovered earlier after flood. In the study sites of Upo wetlands, Upo and Sajipo areas showed relatively higher values of average diversity index which may indicate a good habitat condition for benthic macroinvertebrates.

A Study on the Traumatic Teeth Damage of Children (어린이의 외상성 치아손상에 관한 연구)

  • Yoo, Su-Min;Park, Ho-won
    • Journal of dental hygiene science
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    • v.4 no.1
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    • pp.21-25
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    • 2004
  • In modern times, children's trauma is increasing every year because of car accidents and life environment changes. There is a limit to prevent traumatic damage for oral cavity organization. The fundamental data of trauma treatment and prevention will be presented through the survey and analysis of traumatic teeth damage. I examined 113 patients from Oct. 4th, 2000 to Feb. 27th, 2004 at Dept. of Children's Dental Clinic, Kangnung National University. The results are as follows. (1) The trauma frequency of male subjects is higher than that of female at a rate of 2.05:1. The average age is 5.27 for men and 5.27 for women. The highest percentage of trauma patients is among 2 year old children. It is 21.2%. (2) A patient survey was taken at a trauma treatment hospital. On the first day 34.4% of the patients had come to receive treatment of their first set of teeth. However, after a week, 38.8% of the patients had received treatment on their permanent teeth. (3) As a result of falling, 59% of patients needing treatment on their first set of teeth. 55.1% of patients is permanent teeth. As a result of bump against physical solid, 26.6% of patients is the first set of teeth and 26.5% of patients is permanent teeth. (4) Teeth damage happened at home. 42.1% were male. 35.1% were female. According to trauma, 59.4% of teeth damage happened at home. 28.6% of permanent teeth damage happened at school or kindergarten. (5) According to trauma, the number of teeth damaged was in the first set of teeth are as follows: 56.3%, one-31.3%, three or four-6.3% each. For permanent teeth: two-46.9%, one-28.6%, four over-16.3% and three-8.2%. Over four teeth is larger number for permanent teeth. (6) 56% of first set of teeth patients and 43.4% of permanent teeth patients were male. 56.8% of first set of teeth patients and 43.2% of permanent teeth were female. Trauma happened to both male and female frequently in the first set of teeth. (7) Most of the tooth damage which was in the first set of teeth and permanent teeth was done to the upper jaw. 75% of patients are the first set of teeth. 63.8% of patients are permanent teeth. Trauma is very high in the two mid teeth of the upper jaw. (8) According to trauma survey, 30.2% is from impulse. 28.0% is from crown fracture, 14.7% is from depression. 8.9% is from concussion. 7.1% is from full dislocation of a joint. 2.2% of patients are extrusion. 1.8% is from displacement. According to teeth damage trauma, 35.8% is pulse in the first set of teeth. The breaking of the crown of a tooth happened a lot in permanent teeth. (9) According to data, 43.2% of teeth damage in the first set of teeth goes without treatment. In permanent teeth, it is 38.9%. After treatment, 22.0% of first set of teeth treatment requires a dental pulp treatment. In permanent teeth, which is used for temporary acid etching resin restoration.

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The Effects of Preoperative Radiation Therapy in Resectable Rectal Cancer - in view of pathologic aspects - (절제 가능한 직장암에서 수술전 방사선 치료의 효과 -병리 조직학적인 연구를 중심으로-)

  • Choi, Ihl-Bong;Jang-Ji-Young;Kim, In-Ah;Shinn-Kyung-Sub;Lee, Jong-Suh;Chang-Suk-Kyun;Choi, Kyu-Young;Kim, Young-Ha;Kim, Jun-Gi;Chun-Chung-Soo;Kay-Chul-Seung
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.49-56
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    • 1997
  • Purpose : To evaluate the pathologic effects of preoperative radiotherapy o the resectable distal rectal cancer, we analyzed the results of postoperative pathologic findings for the patients with preoperative radiotherapy ant surgery Materials and Methods: From July 1995 to April 1996, we treated sixteen patients of resectable rectal cancer with preoperative radiation therapy and curative surgery At diagnosis, Thomas Jefferson (TJ) system was used for the clinical stage of the Patients. We treated the patients with conventional radiation therapy of 4500~5000cGy before surgery. The surgery was carried out 4 weeks after completion of radiation therapy. Modified Astler Coller (MAC) system was used for the postoperative pathologic stage. We analyzed the pathologic stages and findings according to preoperative clinical stage and compared with those of the control group in similar clinical stages. Result : All patients were treated with sphincter preservation surgery after Preoperative radiation therapy. Pathoiogic complete response (CR) was shown in 1 case $(6.3\%)$. We compared the results between preoperative radiation therapy group (Preop.RT group) and surgery only group (control group). In TJ stage II, among nine patients of Preop.RT group, 8 patients $(88.9\%)$ were in MAC stage 8 except 1 CR patient, but among 17 patients of control group. 11 patients$(64.7\%)$ were in MAC stage B and 6 Patients $(35.3\%)$ in MAC stage C. In TJ stage III, among 7 patients of Preop.RT group, 4 patients $(57.1\%)$ were in MAC stage B and 3 patients$(42.9\%)$ in MAC stage C. Among 14 Patients of control group, 4 patients $(28.6\%)$ were in MAC stage B and 10 Patients $(71.4\%)$ in MAC stage C. Above results showed that postoperative Pathologic stage was decreased in Preop.RT group with statistical significance (P=0.049). The postoperative Pathologic findings (blood vessel invasion. Iymphatic vessel invasion, perineural invasion) were decreased in the Preop.RT group compared with those of control group. But statistical significance was found only in Iymphatic vessel invasion (p=0.019). Conclusion : The Postoperative pathologic stages and adverse Prognostic pathologic findings were decreased in preoperative radiation therapy group. The Iymphatic vessel invasion and MAC stage C findings were abruptly decreased in Preoperative radiation therapy group. The preoperative radiation therapy was found to be effective in resectable rectal cancer. The patients group in our study was very small and long term follow up was not done. Therefore, further study about this issues is needed.

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Analysis of Critical Control Points through Field Assessment of Sanitation Management Practices in Foodservice Establishments (현장실사를 통한 급식유헝별 위생관리실태 분석)

  • Kwak Tong-Kyung;Lee Kyung-Mi;Chang Hye-Ja;Kang Yong-Jae;Hong Wan-Soo;Moon Hye-Kyung
    • Korean journal of food and cookery science
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    • v.21 no.3 s.87
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    • pp.290-300
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    • 2005
  • Increased sanitation management of foodservice establishments is required because most of the reported foodborne-disease outbreaks were in the foodservice industry. The purpose of this study was to determine the important control points for good sanitation. In this study, we inspected twenty foodservice establishments in Seoul, Kyunggi, Kyungnam with a self-developed monitoring tool. These foodservice establishments included secondary schools, universities, and industries. Six of them had appointed as the HACCP-certified establishments from the Korea Food and Drug Administration. The inspection was conducted from June to August in 2002. The inspection tool consisted of nine dimensions and sixty-five items. The dimensions were 'personal sanitation', 'supply of raw food', 'food storage', 'handling of raw food and ready-to-eat', 'cleaning and sterilization', 'waste control', 'pest control', and 'control of establishment and equipment' The highest possible score of this inspection tool is 105 points. Statistical data analysis was completed using the SPSS Package(11.0) for descriptive analysis Kruskal-Wallis. The score for the secondary schools (83.6 points) was higher than for the others and number of in compliance item was 50.9 on average. Therefore, we concluded that the secondary schools' sanitation condition was good. The foodservice establishments acquired HACCP certification was 89.7 points, which was significantly higher than that of establishments not applying foodservices in total score. Instituting the HACCP system in a foodservice is very effective for sanitation management. Many out of the compliance observations were found in the dimensions of 'waste control', 'control of establishment and equipment', and 'supply of raw food' 'Clean condition of refrigerator' item was $65\%$ out of the compliance that was the highest percent in this study. 'Notify and observance of heating/reheating temperature' was $45\%$ out of compliance. Items which were over $30\%$ out of compliance were 'sterilization of knifes and chopping boards in cooking', 'education of workers', 'maintain refrigerator temperature blow $5^{\circ}C$', and 'countermeasure of infection workers' In the results, most of the foodservice establishments were poorly managed in temperature control and cross-contamination. The important control points revealed in this study were preventing contamination, cooking temperature compliance, management of raw food and refrigerator. Therefore foodservice establishments should pay attention to education and training about important control points. The systematic sanitation management monitoring tool developed in this study can be effectively applied for conducting self-inspection and improving the sanitary conditions of their own foodservice operations.

The Studies on the Physiological Active Substances of Mugwort Components for the Utilization to the Foods of Animal Husbandry (축산식품에 이용하기 위한 쑥 성분중의 생리활성에 관한 연구)

  • Lee, Chi-Ho
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1998.05a
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    • pp.37-54
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    • 1998
  • This study was conducted to investigate the effects of mugwort extracts on the blood ethanol concentration, liver function and low level of cadmuim(Cd) in rats. The effects of mugwort extracts on the blood ethanol concentration was studied in Sprague-Dawley rats (10 weeks old) administered p.o. with 25% ethanol (5g/1kg body weight) and then injected with mugwort extracts (at the 2% levels of daily feed consumption compared with the concentration of catechins level in mugwort extracts) in caudal vein. SD rats were divided into five groups : control group (CON-E, only ethanol and 0.85% saline sol'n treated instead of each extracts), water extracts of mugwort treated to the control (MDW-E), ethanol extracts of mugwort treated to the control (POH-E). And then rat plasma of each time (0hr, 1hr, 2hr, 3hr) was investigated ethanol concentration by gas chromatography. Another rats were measured at the time of 0 and 5hr for the test of GOD(Glutamic Oxaloacetic Transaminase) and GPT(Glutamic Pyruvic Transaminase). Components of each extracts were analyzed by using high performance liquid chromatography. The effects of mugwort extracts on the liver function were studied in culture of rat hepatocyte composed of three groups : Control group and two groups treated with each extracts (1% & 2% MDW, 1% & 2% MOH). Condition of rat hepatocytes cultured for 36hr at $37^{\circ}C$(5% $CO_2$ incubator), number of cells, GOT and GPT activity were investigated. The results obtained were summarized as follows ; 1. Catechins level of mugwort extracts was $8{\sim}10mg/100g(MDW)$, $3{\sim}4mg/100g(MOH)$ 2. The contents of (-)-Epigallocatechin was high in MDW 3. The effects of mugwort extracts on the blood ethanol concentration were as follows; 1) The order in ethanol degradation efficiency was MDW-E > MOH-E > CON-E. 2) Ethanol concentration significantly decreased (p<0.05) in MDW-E and MOH-E. 4. The effects of mugwort extracts on the liver function were as follows; (rat hepatocytes cultured for 36hr at $37^{\circ}C$) 1) Cells condition of MDW-L was better than other groups. 2) The order in number of cells (rat hepatocytes) was 2% MDW-L >1% MDW-L >1% MOH-L > Con-L > 2% MOH-L 5. Cd treatment increased concentrations of hepatic GSH level, and decreased GOT activity in plasma. Therefore, this results suggest that the effects of mugwort extracts may an important rols in degradation ethanol and recovery liver function in body. Also, Mugwort extracts may modify the toxicities of Cd in Cd-treated rats and play an important roles in preventing the liver from various toxicants including Cd in Cd treated rats.

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Compare to Evaluate the Imaging dose of MVCT and CBCT (Tomotherapy MVCT와 Linac CBCT의 Imaging dose 비교평가)

  • Yoon, Bo Reum;Hong, Mi Lan;Ahn, Jong Ho;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.83-89
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    • 2014
  • Purpose : In case of the intensity modulated radiation therapy (IMRT) using Tomotherapy and linear accelerator (Linac), it was to compare and to evaluate the imaging dose of MVCT and CBCT that were performed daily for the correct set up of the patient. Materials and Methods : The human body model Phantom (Anderson rando Phantom, USA) was divided into the three parts as Head, Thorax, pelvis, and after GafChromic EBT3 film cut to the size of $0.5{\times}0.5cm2$.in the center of the recording area were situated on the ant, post, left, and right surface of the phantom and 2cm in depth from the ant, post, left, right, and center surface of the phantom, the surface dose and inner dose were measured repeatedly three times, respectively, using the tomotherapy (Hi Art) and the OBI of NovalisTx. The measured film calculated the output value by RIP version6.0 and then the average value of the dose was calculated by the one-way analysis of variance. Results : Using the human body model phantom, the results of MVCT and CBCT performance were that measurements of MVCT inner dose were showed $15.43cGy{\pm}6.05$ in the head, $16.62cGy{\pm}3.08$ in the thorax, $16.81cGy{\pm}5.24$ in the pelvis, and measurements of CBCT inner dose were showed $13.28{\pm}3.68$ in the head, from $13.66{\pm}4.04$ in the thorax, $15.52{\pm}3.52$ in the pelvis. The measurements of surface dose were showed in case of MVCT performance, $11.64{\pm}4.05$ in the head, $12.16{\pm}4.38$ in the thorax, $12.05{\pm}2.71$ in the pelvis, and in case of CBCT performance, $14.59{\pm}3.51$ in the head, $15.82{\pm}2.89$ in the thorax, $17.48{\pm}2.80$ in the pelvis, respectively. Conclusion : In case of Inner dose, the MVCT using MV energy showed higher than the CBCT using kV energy at 1.16 times in the head, at 1.22 times in the thorax, at 1.08 times in the pelvis, and in case of surface dose, the CBCT was higher than MVCT, at 1.25 times in the head, at 1.30 times in the thorax, at 1.45 times in the pelvis. Imaging dose was a small amount compared to the therapeutic dose but it was thought to affect partially to normal tissue because it was done in daily schedule. However, IMRT treatment was necessarily parallel with the IGRT treatment through the image-guide to minimize errors between planned and actual treatment. Thus, to minimize imaging dose that the patients receive, when planning the treatment, it should be set up a treatment plan considering imaging dose, or it must be performed by minimizing the scan range when shooting MVCT.

Comparative Evaluation of Dietary Intakes of Calcium, Phosphorus, Iron, and Zinc in Rural, Coastal, and Urban District (농촌, 어촌, 도시 지역별 칼슘, 인, 철, 아연의 섭취상태 비교평가)

  • Choi, Mi-Kyeong;Kim, Hyun-Sook;Lee, Won-Young;Lee, Hyomin;Ze, Keum-Ryon;Park, Jung-Duck
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.5
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    • pp.659-666
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    • 2005
  • The purpose of this study was to compare the intake status of calcium, phosphorus, iron, and zinc of Korean adults residing in different regions. Subjects were recruited and divided into three groups according to the districts where they lived, which included rural (n=137), coastal (n=100), and urban district (n=117). Subjects were interviewed using a general questionnaire and 24-hour recall method for dietary intake. The average age of the subjects were 58.1 years for rural district, 57.7 years for coastal district, and 48.6 years for urban district. There was no significance in total food intake by regions. The food intakes from cereals, mushrooms, vegetables of rural district, that from fishes of coastal district, and those from sugars, milks, oils of urban area were the highest among three districts. The calcium, phosphorus, iron, and zinc intakes were $60.1\%,\;123.9\%,\;95.2\%,\;and\;73.1\%$ of RDAs, respectively. The calcium intakes as percentage of RDA in rural and coastal district were significantly (p<0.01) lower than that in urban district. A larger number of subjects from coastal or urban district ate under $75\%$ of zinc RDA compared to those from rural village. Major sources of dietary calcium in total subjects were anchovy, kimchi, milk, soybean curd, rice, ice cream, sea mustard, yogurt, loach, and welsh onion. Rice supplied $15.5\%$ for phosphorus, $22.1\%$ for iron, and $35.9\%$ for zinc of total intake. Except for rice, major sources of dietary zinc were pork, beef, small red bean, dog meat, chicken, jacopever, soybean curd, glutinous millet, and kimchi. In conclusion, the food and mineral intakes of adults differed according to the regions in which they resided. The food and nutrient intakes of coastal district were not satisfactory, and calcium and zinc intakes of three regions did not meet RDAs. Therefore, it is required unique and discriminatory nutritional education with each region for increasing intakes of calcium and zinc.

Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Chul-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.241-250
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    • 1997
  • Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

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An Appreciation of Functional Role of Macrophage in the Acute Lung Injury in the Neutropenic Rat. (호중구 감소증을 보이는 백서의 급성폐손상에서 대식세포의 기능적 역할)

  • Kim, Yong-Hoon;Ki, Sin-Young;Im, Keon-Il;Moon, Seung-Hyug;Cheong, Seung-Whan;Kim, Hyeon-Tae;Uh, Soo-Taek;Park, Choon-Sik;Jin, Byung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.379-390
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    • 1997
  • Background : It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pulmonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutropenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. Method : The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cells was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. Results : The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA : More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells : In the ETX-group, the number of total cells (p < 0.01) and of macrophage and neutrophil (p < 0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC-group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and it took part in less than 0.1% of total BAL cells (p < 0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF : In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p < 0.05 and < 0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p < 0.05 vs NC-group), but the value was statistically not different from that of ETX-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p < 0.05), but showed still a higher value compared to that of NC-group (p < 0.05). A change of cytokine concentration in the BALF : TNF -alpha and IL-6 were elevated in the ETX - and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells : There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p < 0.0008 vs NC-group), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion : Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveolar macrophages.

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