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Predicting Oxygen Uptake for Men with Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD환자에서 6분 보행검사를 이용한 최대산소섭취량 예측)

  • Kim, Changhwan;Park, Yong Bum;Mo, Eun Kyung;Choi, Eun Hee;Nam, Hee Seung;Lee, Sung-Soon;Yoo, Young Won;Yang, Yun Jun;Moon, Joung Wha;Kim, Dong Soon;Lee, Hyang Yi;Jin, Young-Soo;Lee, Hye Young;Chun, Eun Mi
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.433-438
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    • 2008
  • Background: Measurement of the maximum oxygen uptake in patients with chronic obstructive pulmonary disease (COPD) has been used to determine the intensity of exercise and to estimate the patient's response to treatment during pulmonary rehabilitation. However, cardiopulmonary exercise testing is not widely available in Korea. The 6-minute walk test (6MWT) is a simple method of measuring the exercise capacity of a patient. It also provides high reliability data and it reflects the fluctuation in one' s exercise capacity relatively well with using the standardized protocol. The prime objective of the present study is to develop a regression equation for estimating the peak oxygen uptake ($VO_2$) for men with moderate to very severe COPD from the results of a 6MWT. Methods: A total of 33 male patients with moderate to very severe COPD agreed to participate in this study. Pulmonary function testing, cardiopulmonary exercise testing and a 6MWT were performed on their first visits. The index of work ($6M_{work}$, 6-minute walk distance [6MWD]${\times}$body weight) was calculated for each patient. Those variables that were closely related to the peak $VO_2$ were identified through correlation analysis. With including such variables, the equation to predict the peak $VO_2$ was generated by the multiple linear regression method. Results: The peak $VO_2$ averaged $1,015{\pm}392ml/min$, and the mean 6MWD was $516{\pm}195$ meters. The $6M_{work}$ (r=.597) was better correlated to the peak $VO_2$ than the 6MWD (r=.415). The other variables highly correlated with the peak $VO_2$ were the $FEV_1$ (r=.742), DLco (r=.734) and FVC (r=.679). The derived prediction equation was $VO_2$ (ml/min)=($274.306{\times}FEV_1$)+($36.242{\times}DLco$)+($0.007{\times}6M_{work}$)-84.867. Conclusion: Under the circumstances when measurement of the peak $VO_2$ is not possible, we consider the 6MWT to be a simple alternative to measuring the peak $VO_2$. Of course, it is necessary to perform a trial on much larger scale to validate our prediction equation.

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.

체질별(體質別) 식품표(食品表)에 근거한 태음인(太陰人), 소음인(少陰人), 소양인(少陽人) 당뇨식단(1800kcal)의 초보(初步)적 제시

  • Kim, Ji-Yeong;Go, Byeong-Hui
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.395-411
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    • 1996
  • 1. 연구배경 사상체질의학(四象體質醫學)을 창시하여 개인(個人)의 차별성(差別性)을 강조한 동무(東武) 이제마(李濟馬)는 양생(養生)의 방법(方法)에서도 체질별(體質別) 요법(療法)을 말하고 있는데 체질별(體質別)로 과소지장(過小之臟)의 기능(機能)이 정상적(正常的)으로 이루어지는 상황을 완실무병(完實無病)의 조건으로 제시(提示)하였고 이를 위한 수단(手段)으로 성정(性情)과 함께 약물(藥物), 식품(食品) 등을 이용하였다. 특히 식이요법(食餌療法)에 있어서도 체질(體質)에 따른 구별(區別)의 필요성(必要性)을 말하고 있는데 식품(食品)이라 하더라도 그 음식(飮食)을 섭취하여 과대(過大)한 장기(臟器)의 기능(機能)은 유제(柳制)하고 과소(過小)한 기능(機能)은 보완(補完)받음으로써 불균형(不均衡)을 조정(調整)한 것이다. 당뇨병의 식단 작성은 평생동안 열량(熱量)과 영양소(營養素) 필요치(必要置)을 맞출 것을 권장하고 당뇨병학회에서 편집한 식품교환표(食品交換表)를 사용(使用)하는 것이 일반적(一般的)인데 식품교환표(食品交換表)는 많은 식품(食品)들중에 같은 영양소를 가진 식품(食品)들을 한 그룹으로 묶어 환자(患者)의 기호(嗜好)에 따라 교환(交煥)해 가면서 먹을 수 있도록 고안(考案)한 것이니 이에 지시한 수량(數量)만 섭취해도 저(低)cal식(食)으로 관양(管養)의 균형(均衡)이 잘 이루어진다. 본 연구는 체질별로 이로운 식품표에 근거하여 식이요법(食餌療法)이 특히 강조되고 하루 섭취열량이 제한되는 성인병중의 하나인 당뇨병(糖尿病)의 식단(1800kcal)을 식단작성법에 따라 구성(構成)하여 몇가지 예를 제시해 보았다. 구체적으로 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 당뇨 환자 1800kcal에 대한 식단을 구성하여 제시했는데 즉, 태음인(太陰人)의 식단은 태음인(太陰人)에 유리(有利)한 식품(食品)들로 구성하고 해(害)로운 식품(食品)들은 제외시키는 방법(方法)을 이용하였다. 이 식단은 다분히 이론적(理論的)인 식단으로 임상(臨床)에 이용(利用)하여 본 바는 없으나 동량(同量)의 열량(熱量)을 섭취(攝取)하더라도 체질(體質)에 적합(適合)한 식품(食品)으로 구성된 식사(食事)가 각 체질의 섭생(攝生)에 더 유리(有利)하지 않올까 하는 단순(單純)한 사고(思考)에 바탕을 둔 것이다. 2. 연구방법 1) 후세가(後世家)가 주장(主張)한 체질별(體質別) 식품(食品) 분류(分類)를 종합, 정리한 체질별(體質別) 식품표(食品表)를 제시한다. 박석언의 동의사상대전, 박인상의 동의사상요결, 송일병의 알기 쉬운 사상의학, 홍순용의 사상진료보원, 홍순용, 이을호의 사상의학원론에서 체질별로 유익한 식풍을 조사하여 곡류, 과일류, 채소류, 어패류, 육류로 분류하여 살펴본다. 2) 당뇨병(糖尿病) 식이요법의 식단 작성법의 개요(槪要)를 제시한다. 3) 1)의 체질별(體質別) 식품표(食品表)로 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 당뇨 식단 1800kcal을 작성해 제시(提示)한다. 체질별(體質別)로 유익(有益)한 식품(食品)은 1)의 식품표에 근거(根據)하고 체질별(體質別)로 해(害)로운 식품(食品)은 노정우(盧正祐), 한동석(韓東錫)의 주장에 근거(根據)한다. 3. 결과 체질별(體質別) 식품표(食品表)는 후세가의 연구를 종합하여 제시(提示)하였고, 식품(食品)을 분류(分類)한 후(後) 약명(藥名)과 성미(性味), 귀경(歸經)을 찾아 도표화 하였다. 체질별 식품들은 대부분 소음인(少陰人)의 경우 신감(辛甘) 온열(溫熱)하며 비위(脾胃)로 귀경(歸經)하고 태음인(太陰人)의 경우 감신(甘辛) 온열(溫熱)하며 폐간(肺肝)으로 귀경(歸經)하고 소양인(少陽人)의 산고(酸苦) 양한(凉寒)하고 신(腎)으로 귀경(歸經)함이 우세(優勢)함을 알 수 있다. 즉, 체질적으로 양성(陽性)인 소양인(少陽人)은 식품의 성질이 음성(陰性)인 것이 유리(有利)하고 체질적으로 음성(陰性)인 태음인(太陰人), 소음인(少陰人)은 식품의 성질이 양성(陽性)인 것이 유리(有利)하다. 다양한 식품(食品)을 섭취하고자 하는 환자의 욕구(慾求)에 맞추면서도 식품교환의 범위를 체질별로 유익한 식품들로 제한하여 동일(同一)한 열량(熱量)의 식단이라도 체질에 맞는 식품으로 차별성(差別性)을 두었는데 식단의 작성은 전문 영양사의 의견을 거쳤다. 제시된 식단은 다소 이론적(理論的)으로 작성(作成)된 단계이고 임상적(臨床的) 검증을 거친 바 없으나 활용하기에 따라 실용성을 얻을 수 있으리라 본다. <식단예> 태음인의 식단: 곡류 : 콩, 율무, 밀가루, 밀, 수수, 들깨, 고구마, 땅콩, 기장, 옥수수, 두부, 설탕등 태음인에 유리한 식품으로 교환한다 어때류 : 우렁이, 대구, 조기, 민어, 청어, 오정어, 낙지, 미역, 김, 다시마등으로 교환한다 육류 : 소고기, 우유등으로 교환한다 과일류 : 밤, 배, 호도, 은행, 잣, 살구, 매실, 자두등으로 교환한다 채소류 : 무우, 도라지, 연근, 토란, 마, 고사리, 더덕, 목이버섯, 송이버섯, 석이버섯등으로 교환한다 해로운 음식 : 닭, 돼지, 모밀, 배추, 사과, 염소고기, 조개, 계란, 곳감, 커피등은 피한다 * 아침 ; 콩나물죽, 대구포묶음, 우령이무침, 갓김치, 우유, 자두 점심 ; 기장밥, 콩나물두부찌게, 장어양념구이, 도라지나물, 열무김치, 배 저녁 ; 수수밥, 두부명란, 더덕양념구이, 깍두기 * 아침 ; 비빔국수, 토란국, 알타리김치, 두유, 살구주스 점심 ; 율무밥, 낙지전골, 김무생채, 느타리나물무침, 동치미, 귤 저녁 ; 콩밥, 감자북어국, 두부묶음, 열무김치 소음인의 식단: 곡류 : 찹쌀, 좁쌀, 차조, 감자등 소음인에 유익한 식품으로 교환한다 어패류 : 명태, 미꾸라지, 뱀장어, 뱀, 메기등 육류 : 닭, 개, 꿩, 염소, 양, 참새고기등 과일류 : 사과, 귤, 복숭아, 대추등 채소류 : 미나리, 파, 마늘, 후추, 시금치, 양배추, 생강, 고추, 당근, 양파, 감자, 쑥갓등 해로운 음식 : 메밀, 호도, 계란, 고구마, 녹두, 돼지고기, 밤, 배, 배추, 보리, 쇠고기, 수박, 오이, 참외, 팥등은 피한다. * 아침 ; 찰밥, 닭찜, 감자전, 쑥갓나물, 부추김치, 사과 점심 ; 감자밥, 메기매운탕, 명태조림, 미나리, 고들빼기김치, 사과주스 저녁 ; 좁쌀밥, 양배추감자국, 병어양념구이, 연근양념조림, 귤, 인삼차.

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Study on 3D Printer Suitable for Character Merchandise Production Training (캐릭터 상품 제작 교육에 적합한 3D프린터 연구)

  • Kwon, Dong-Hyun
    • Cartoon and Animation Studies
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    • s.41
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    • pp.455-486
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    • 2015
  • The 3D printing technology, which started from the patent registration in 1986, was a technology that did not attract attention other than from some companies, due to the lack of awareness at the time. However, today, as expiring patents are appearing after the passage of 20 years, the price of 3D printers have decreased to the level of allowing purchase by individuals and the technology is attracting attention from industries, in addition to the general public, such as by naturally accepting 3D and to share 3D data, based on the generalization of online information exchange and improvement of computer performance. The production capability of 3D printers, which is based on digital data enabling digital transmission and revision and supplementation or production manufacturing not requiring molding, may provide a groundbreaking change to the process of manufacturing, and may attain the same effect in the character merchandise sector. Using a 3D printer is becoming a necessity in various figure merchandise productions which are in the forefront of the kidult culture that is recently gaining attention, and when predicting the demand by the industrial sites related to such character merchandise and when considering the more inexpensive price due to the expiration of patents and sharing of technology, expanding opportunities and sectors of employment and cultivating manpower that are able to engage in further creative work seems as a must, by introducing education courses cultivating manpower that can utilize 3D printers at the education field. However, there are limits in the information that can be obtained when seeking to introduce 3D printers in school education. Because the press or information media only mentions general information, such as the growth of the industrial size or prosperous future value of 3D printers, the research level of the academic world also remains at the level of organizing contents in an introductory level, such as by analyzing data on industrial size, analyzing the applicable scope in the industry, or introducing the printing technology. Such lack of information gives rise to problems at the education site. There would be no choice but to incur temporal and opportunity expenses, since the technology would only be able to be used after going through trials and errors, by first introducing the technology without examining the actual information, such as through comparing the strengths and weaknesses. In particular, if an expensive equipment introduced does not suit the features of school education, the loss costs would be significant. This research targeted general users without a technology-related basis, instead of specialists. By comparing the strengths and weaknesses and analyzing the problems and matters requiring notice upon use, pursuant to the representative technologies, instead of merely introducing the 3D printer technology as had been done previously, this research sought to explain the types of features that a 3D printer should have, in particular, when required in education relating to the development of figure merchandise as an optional cultural contents at cartoon-related departments, and sought to provide information that can be of practical help when seeking to provide education using 3D printers in the future. In the main body, the technologies were explained by making a classification based on a new perspective, such as the buttress method, types of materials, two-dimensional printing method, and three-dimensional printing method. The reason for selecting such different classification method was to easily allow mutual comparison of the practical problems upon use. In conclusion, the most suitable 3D printer was selected as the printer in the FDM method, which is comparatively cheap and requires low repair and maintenance cost and low materials expenses, although rather insufficient in the quality of outputs, and a recommendation was made, in addition, to select an entity that is supportive in providing technical support.

Comparison of Naphthalene Degradation Efficiency and OH Radical Production by the Change of Frequency and Reaction Conditions of Ultrasound (초음파 주파수 및 반응조건 변화에 따른 나프탈렌 분해효율과 OH 라디칼의 발생량 비교)

  • Park, Jong-Sung;Park, So-Young;Oh, Je-Ill;Jeong, Sang-Jo;Lee, Min-Ju;Her, Nam-Guk
    • Journal of Korean Society of Environmental Engineers
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    • v.31 no.2
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    • pp.79-89
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    • 2009
  • Naphthalene is a volatile, hydrophobic, and possibly carcinogenic compound that is known to have a severe detrimental effect to aquatic ecosystem. Our research examined the effects of various operating conditions (temperature, pH, initial concentration, and frequency and type of ultrasound) on the sonochemical degradation of naphthalene and OH radical production. The MDL (Method detection limit) determined by LC/FLD (1200 series, Agilient) using C-18 reversed column is measured up to 0.01 ppm. Naphthalene vapor produced from ultrasound irradiation was detected under 0.05 ppm. Comparison of naphthalene sonodegradion efficiency tested under open and closed reactor cover fell within less than 1% of difference. Increasing the reaction temperature from $15^{\circ}C$ to $40^{\circ}C$ resulted in reduction of naphthalene degradation efficiency ($15^{\circ}C$: 95% ${\rightarrow}$ $40^{\circ}C$: 85%), and altering pH from 12 to 3 increased the effect (pH 12: 84% ${\rightarrow}$pH 3: 95.6%). Pseudo first-order constants ($k_1$) of sonodegradation of naphthalene decreased as initial concentration of naphthalene increased (2.5 ppm: $27.3{\times}10^{-3}\;min^{-3}\;{\rightarrow}$ 10 ppm : $19.3{\times}10^{-3}\;min^{-3}$). Degradation efficiency of 2.5 ppm of naphthalene subjected to 28 kHz of ultrasonic irradiation was found to be 1.46 times as much as when exposed under 132 kHz (132 kHz: 56%, 28 kHz: 82.7%). Additionally, its $k_1$ constant was increased by 2.3 times (132 kHz: $2.4{\times}10^{-3}\;min^{-1}$, 28 kHz: $5.0{\times}10^{-3}\;min^{-1}$). $H_2O_2$ concentration measured 10 minutes after the exposure to 132 kHz of ultrasound, when compared with the measurement under frequency of 28 kHz, was 7.2 times as much. The concentration measured after 90 minutes, however, showed the difference of only 10%. (concentration of $H_2O_2$ under 28 kHz being 1.1 times greater than that under 132 kHz.) The $H_2O_2$ concentration resulting from 2.5 ppm naphthalene after 90 minutes of sonication at 24 kHz and 132 kHz were lower by 0.05 and 0.1 ppm, respectively, than the concentration measured from the irradiated M.Q. water (no naphthalene added.) Degradation efficiency of horn type (24 kHz) and bath type (28 kHz) ultrasound was found to be 87% and 82.7%, respectively, and $k_1$ was calculated into $22.8{\times}10^{-3}\;min^{-1}$ and $18.7{\times}10^{-3}\;min^{-1}$ respectively. Using the multi- frequency and mixed type of ultrasound system (28 kHz bath type + 24 kHz horn type) simultaneously resulted in combined efficiency of 88.1%, while $H_2O_2$ concentration increased 3.5 times (28 kHz + 24 kHz: 2.37 ppm, 24 kHz: 0.7 ppm.) Therefore, the multi-frequency and mixed type of ultrasound system procedure might be most effectively used for removing the substances that are easily oxidized by the OH radical.

A Comparison of Anthropomery and Nutrient Intakes of Rural Middle School Students Provided with and without National School Lunch Program (경상북도 의성군 농촌지역 급식교와 비급식교 중학생의 영양소 섭취 실태와 체조성과의 상관성에 관한 연구)

  • 장현숙;이옥이
    • Journal of the East Asian Society of Dietary Life
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    • v.10 no.2
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    • pp.116-128
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    • 2000
  • The purpose of this study is to analyze the nutrient intakes and growth development of rural middle school students provided with and without the national school lunch program(NSLP). The subjects consisted of 340 rural middle school students provided with(n=177) and without(n=163) NSLP. Anthropometric measurements were taken for body weight, height, triceps skinfold thickness and percentage of body fat, and nutrient intakes were assessed by food record method. The results of this study were summarized as follows: There was no significant difference in the height, body weight girls provided with (155.8cm 47.2kg) and without (156.0cm, 49.7kg) NSLP. Total energy intakes of boys were 2123kca1 in with NSLP and 1857kca1 in without NSLP. Total energy intakes of girls were 1913kca1 in with NSLP and 1814kca1 in without NSLP. Total daily energy was provided in the ratio of 19.1%, 39.8%, 32.4% and 8.7% by breakfast, lunch, dinner and snacks in the with NSLP and 17.5%, 32.0%, 34.8% and 15.7% in without NSLP, respectively. Phosphorus, vitamin A, vitamin E, ascorbic acid, thiamin, riboflavin, niacin intakes were above the RDA in with NSLP. In without NSLP, phosphorus, vitamin E, thiamin intakes were above the RDA. however, calcium. iron, vitamin A, vitamin B$_{6}$ were less than the RDA. The study showed that total daily energy and nutrient intakes were significantly higher in students provided with than without school-lunch. Thus, the school-lunch program is recommended and necessary to improve the nutritional status of middle school students.

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Factors Related with the Compliance and Treatment in Patients with Pulmonary Tuberculosis in Urban and Suburb Area (도시와 농촌지역의 폐결핵 환자 순응도 및 치료에 관련된 요인)

  • Kim, Sang-Soon;Kim, Yoon-Ock
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.69-79
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    • 1996
  • To investigate the factors related with the compliance and the treatment of the patients with pulmonary tuberculosis in urban and suburb area, we followed up all the 755 registered patients(at urban Public Health Office 544, at suburb 210) as follow from January 1,1992 to December 31, 1993. We describe the general characteristics and the characteristics related with the disease of the patients according to the area as follow. 150 patients(27.5%) were at their age of 20 to 29 years in the urban area, whereas 45 patients (21.4%) were 60 to 69 years and another 45 patients(21.4%) were 70 to 79 years in the suburb area. According to the first chest X -ray examination, 54.5% of all cases were proved to be mild in the urban area. But in the suburb area, moderate cases (44.3%) were more than mild cases(p<0.01). Follow-up X-ray's were performed more properly(p<0.05) in the urban area(94.3%) than in the suburb area(90.0%). Most cases were found in the chest X -ray examination performed by Public Health Office (p<0.01) : payable chest X-ray in the urban area (56.7%) and free chest X-ray in the suburb area(35.2%). More patients were cured in the urban area(90.8%) than in the suburb area(87.1%). The presence of supporting family member were significantly higher(p<0.05) in the urban area(79.1%) than in the suburb area(88.1%). In the analysis of the treatment efficacy, more cure ate were found in the patients cytologically confirmed to be culture (+). In the urban area, 201 culture (+) patients (93.5%) 294 culture (-) patients (89.1%) were cured. In the suburb area, 99 culture (+) patients(91.7%) and 84 culture (-) patients(82.4%) were cured. Age, the presence of supporting family member, and the socioeconomic status of the patient had significant association with the prescription compliance related with the general characteristics of the patients. Whereas, X-ray finding and AFB culture finding were the significant factors associated with the prescription compliance related with pulmonary tuberculosis (p<0.05). The cumulative compliance in the survival analysis was 92.5% in the urban area and 88.1% in suburb area, at sixth month of follow-up. Failure rate for regular drug receipt was highest at second month in the urban area(3.75%) and at fourth month in the suburb area(4.15%). In logistic regression of the factors related with the tratment result, first X-ray examination and prescription compliance were significantly associated in the urban area(p<0.05). However, there is no factor significantly associated with the treatment result in the suburb area. It could be explained by too small size of the sample. In logistic regression of the factors related with the prescription compliance, first chest X-ray, sputum culture outcome and the presence of supporting family member were significant variables in the urban area(p<0.05). Most patients with family member were proved to be compliant with the prescription. This shows that it is important for the patients with long-lasting ilnesses to have supporting family member. Therefore, to improve prescription compliance we should strengthen the health education before the initiation of treatment and take special interest in the patients without supporting family member.

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Lung Clearance of Inhaled $^{99m}Tc$-DTPA by Urine Excretion Ratio (소변내 방사능배설량비를 이용한 $^{99m}Tc$-DTPA 폐청소율에 관한 연구)

  • Suh, G.Y.;Park, K.Y.;Jung, M.P.;Yoo, C.G.;Lee, D.S.;Kim, Y.W.;Han, S.K.;Jung, J.K.;Lee, M.C.;Shim, Y.S.;Kim, K.Y.;Han, Y.C.
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.357-366
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    • 1993
  • Background: Lung clearance of inhaled $^{99m}Tc$-DTPA reflects alveolar epithelial permeability and it had been reported as more sensitive than conventional pulmonary function tests in detecting lung epithelial damage. However, measuring lung clearance of inhaled $^{99m}Tc$-DTPA by gamma camera may not always reflect alveolar epithelial permeability exactly because it is influenced by mucociliary clearance depending on the site of particle deposition. Moreover, this method takes much time and patient's effort because he has to sit or lie still in front of the camera for a prolonged period. Most of the absorbed DTPA is excreted in urine within 24 hours and the amount of excreted DTPA in urine during the first few hours after inhalation is influenced by absorption rate which is correlated with the alveolar-epithelial permeability suggesting that the urinary excretion, especially in first few hours, may be an alternate index for lung clearance. The purpose of this study was to evaluate the usefulness of ratio of excreted $^{99m}Tc$-DTPA in 2 hour and 24 hour urine as an index of alveolar-epithelial damage. Methods: Pulmonary function tests including diffusing capacity and lung clearance of $^{99m}Tc$-DTPA measured by gama camera ($T_{1/2}$) and 2hr/24hr urine excretion ratio (Ratio) of inhaled $^{99m}Tc$-DTPA in 8 normal subjects and 14 patients with diffuse interstitial lung disease were compared. Results: 1) In the normal control, there was significant negative correlation between the $T_{1/2}$ and the Ratio (r=-0.77, p<0.05). In patients with diffuse interstitial lung disease, there also was significant negative correlation between $T_{1/2}$ and Ratio(r=-0.63, p<0.05). 2) In diffuse interstitial lung disease patients, the $T_{1/2}$ was $38.65{\pm}11.63$ min which was significantly lower than that of normal control, $55.53{\pm}11.15$ min and the Ratio was $52.15{\pm}10.07%$ also signifantly higher than that of the normal control, $40.43{\pm}5.53%$ (p<0.05). 3) There was no significant correlations between $T_{1/2}$ or Ratio and diffusing capactiy of lung in both patients and controls (p>0.05). Conclusion: These results suggests that 2hr/24hr urine excretion ratio of inhaled $^{99m}Tc$-DTPA is a useful simple bedside test in assessing alveolar epithelial permeability and that it may be used as an additive follow-up test in patients with diffuse interstitial lung disease complementing conventional pulmonary function tests.

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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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TNF-$\alpha$ TGF-$\beta$ and Fibrinolytic Parameters in Tuberculous and Malignant Pleural Effusions (결핵성 및 악성 흉막염에서 TNF-$\alpha$, TGF-$\beta$ 및 섬유소용해계의 역할)

  • Shim, Tae-Sun;Yang, Sung-Eun;Chi, Hyun-Sook;Kim, Mi-Jung;Chung, Hun;JeGal, Yang-Jin;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.149-161
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    • 2000
  • Background : Residual pleural thickening (RPT) develops in about 50% of tuberculous pleurisy ($PL_{TB}$). Some reports have suggested that elevated TNF-$\alpha$ and impaired fibrinolysis could be the cause of RPT, but until now, the mechanism and predictors of RPT have not been well known. TGF-$\beta$ has been known to promote fibrogenesis and is increased in tuberculous pleural fluid (PF). $PL_{TB}$ and malignant pleurisy ($PL_{MAL}$) manifest lymphocyte-dominant exudative pleural effusion, and it has clinical implications in the differentiation of the two diseases based on the findings of pleural effusion. We performed this study to compare pleural fluid TNF-$\alpha$ TGF-$\beta$, and fibrinolytic parameters between $PL_{TB}$ and $PL_{MAL}$, and to find the predictors of RPT in $PL_{TB}$. Methods : Thirty-five $PL_{TB}$ and 14 $PL_{MAL}$ patients who were admitted to the Asan Medical Center from February 1997 to August 1999 were enrolled. All $PL_{TB}$ patients were prescribed a primary, short-course, anti-tuberculosis regimen. INF-$\alpha$ tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), plasminogen, $\alpha$2-antiplasmin, and D-dimer were measured in both PF and PB. TGF-$\beta$was measured only in PF. Clinical characteristics, TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters were compared between patients with RPT less than 2 mm and patients with more than 2 mm of the thirty patients who completed the anti-tuberculosis treatment. Results : The levels of TNF-$\alpha$ tPA, PAI-1, plasminogen, $\alpha$2-antiplasmin, and D-dimer in PF were higher than those in peripheral blood (PB) in $PL_{TB}$, whereas only plasminogen, $\alpha$2-antiplasmin, and D-dimer were higher in PF than in PB in $PL_{MAL}$. Pleural fluid TNF-$\alpha$ TGF-$\beta$, PAI-1, plasminogen, $\alpha$2-antiplasmin were increased in $PL_{TB}$ compared with $PL_{MAL}$, but these factors did not show any further advantages over ADA in differentiation between $PL_{TB}$ and $PL_{MAL}$. TNF-$\alpha$ TGF-$\beta$ and fibrinolytic parameters did not show any differences between patients with RPT less than 2 mm and patients with RPT more than 2 mm. Conclusion : Our data suggest that TNF-$\alpha$, TGF-$\beta$ and fibrinolytic parameters may play some role for the development of RPT in $PL_{TB}$, but they failed to predict the occurrence of RPT in $PL_{TB}$. Also these parameters did not seem to have any advantages over ADA in differentiating between two diseases.

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