• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.683-692
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• 1996

Background: Although most of the patients with tuberculous pleural effusions completely reabsorbed their effusions and became asymptomatic within 2 to 4 months, later surgical procedures such as decortication is needed in some patients because of dyspnea caused by pleural loculations and thickening despite anti-tuberculous chemotherapy. It is obligatory to secure adequate drainage to prevent the development of complications. But, the best methods for treating loculated tuberculous pleural effusions remain debatable. Recent several reports revealed that intrapleural instillation of fibrinolytic agents is an effective adjunct in the management of complicated empyema and may reduce the need of surgery. Purpose : The effects of catheterization with intrapleural urokinase instillation were prospectively evaluated in the patients with septated tuberculous pleural effusion, and compared with other therapeutic effects of different modalities of therapy such as repeated thoracentesis and small-bored catheterization. Methods : Forty-eight patients diagnosed with tuberculous pleurisy were randomly separated into three groups; control group(n=13), catheter group(n=12), urokinase group(n=22). In urokinase group, dose of 100.000U urokinase was instilled into the pleural cavity via a percutaneous drainage catheter for complete drainage or total dose of 700,000U of urokinase. After two hours clamping, the catheter was opened and intermittently irrigated. The early and late effectiveness of therapies was assessed by radiographically and by measuring the volume of fluid drained from the catheter. Results : There was statistically significantly better result in the urokinase group in respect of frequency of catheterization, frequency of catheter obstruction and the duration of catheterization in early effectiveness(p < 0.05). There were no difference in radiologic improvement of follow-up in later phase chest X-ray between urokinase group and catheter group in later phase(p > 0.05). But there were more failure rates in control group especially honeycomb septa in pleural effusion sonographically than former two groups. And there were no complications of urokinase such as fever or hemorrhage. Conclusion : In the treatment of septated tuberculous pleurisy, there were better results in urokinase than those of catheterization alone in early effectiveness. And there was no difference in radiographic improvement between urokinase group and catheter group. Intrapleural instillation of urokinase is an effective and safe mode of treatment for septated tuberculous pleural effusions and alleviates the need for thoracotomy.

• Journal of the Korean Geographical Society
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• v.30 no.4
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• pp.389-410
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• 1995

Large metropolitan areas in the US are distinguished by highly fragmented fiscally independent suburban municipalities and special districts. The suburban fragmentation implies the congregation of similar socio-economic groups escaped from central cities and the disparity of geographical resources among local government jurisdictions. This study examines St.Louis County suburbs as a case study for the implictions of suburban governmental fragmentation and the fiscal disparities across local governmental boundaries by analyzing their relationship with public service provision using police and public school services as examples. The distribution of fiscal resources across political boundaries, the processes which created them, and public service inequalities reproduced from the disparity of fiscal resources reveal the causes and consequences of suburban governmental fragmentation. The central part of suburban fragmentation is the segregation of public goods consumption reproduced from the disparity of local fiscal resources, and it acts as a basic geographical segregating force in the suburban spatial organization.

• Fire Science and Engineering
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• v.28 no.6
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• pp.82-89
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• 2014

Disasters that destroy homes and infrastructure and cause significant financial damage are becoming more common as population centers grow. In addition, several natural disasters have resulted in a major loss of life and created countless refugees due to damage to housing. After major catastrophic disasters, it is very important that the government agencies respond to post-disaster housing issues and provide resources such as temporary housing before the full rehabilitation and reconstruction of destroyed and damaged housing. To provide affordable temporary housing for residents who may lose their homes as the result of a catastrophic disaster including storms, government agencies must develop a post-disaster housing prototype. In general, government agencies should explore several different forms of factory-built single-story, single family housing, such as modular homes, panelized homes, and precut homes. In urban cities including New York and Seoul, it is very important to provide housing which supports the demand for higher-density living spaces than single-family homes or trailers typically available due to the high population density and the desire to resettle as many residents as possible in their former neighborhoods. This study identified the urban post-disaster housing prototypes that may provide higher density housing with high quality living spaces, high air quality, and energy efficiency as well as rapid deployment. A case study of "Urban Post-Disaster Housing Prototype Program in New York" was conducted through a detailed interview process with a designer, engineer, contractor, the Office of Emergency Management (OEM) in New York, the U.S. Army Corps of Engineers (USACE), and temporary occupants. An appropriate disaster housing program that can provide living spaces for victims of disasters that keeps residents in their community and allows them to live and work in their neighborhoods was developed.