• Tuberculosis and Respiratory Diseases
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• v.64 no.1
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• pp.8-14
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• 2008

Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.

• The korean journal of orthodontics
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• v.29 no.5 s.76
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• pp.551-562
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• 1999

This study was undertaken to investigate the relation between orthodontic force magnitude and the amount of tooth movement. And more light force application for reducing root resorption Twenty-four rats were divided into three experimental groups(A, B, C) based on force magnitude and application method. Springs of 50g force were applied to A group, springs of 100g force were applied to B group and springs of 25g force were applied to C group initially, and after 4 days springs of C group were changed to springs of 50g force. Two kinds of $sentally^{(R)}$(GAC U.S.A.) closed coil spring, 50g and 100g, were used. And we made 25g springs by heat treatment process of 50g springs. Each spring was inserted between the maxillary central incisor and the maxillary left first molar. Amounts of tooth movement were measured everyday by digital caliper($Digimatic^{(R)}$, Mitutoyo, Japan) under inhalation anesthesia for 15 days. After 15 days, all rats were sacrificed and histological samples were obtained with Hematoxyline-Eosin stain and Masson's trichrome stain. Following conclusion were made; 1. Group B showed the mean cumulative tooth movement of $2.19{\pm}0.41mm$ at 15th day, which was greatest among three groups, followed by group C($2.06{\pm}0.10mm$), group A($1.90{\pm}0.49mm$) respectively. however, there was no statistically difference among three groups. 2. All groups showed general tooth movement pattern and A, B, C group finished lag phase at 9th, 8th, 7th day, but there was no statistical significance. 3. Group A,B,C showed root resorption and especially group B showed the most severe root resorption and group C showed milder root resorption than other groups. According to the above results, large initial force with the development of a flirty widespread hyalinized zone may cause severe root resorption, so initial force should be applied lightly to reduce hyalinized area and eventually root resorption and then increased force will induce efficient tooth movement.

• Journal of Environmental Science International
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• v.3 no.3
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• pp.253-261
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• 1994

Chloroform present in the swimming water disinfected with sodium hypochlorite is released to the air of swimming pools. The air chloroform concentrations were measured in two swimming pools A and B which applied both sodium hypochlorite a:d ozone. Thew mean concentrations are 28.0 $\mu\textrm{g}$/m3 and 33.6 $\mu\textrm{g}$/m3in the swimming pools A and B, respectively. On the other hand, the mean water chloroform concentrations in the swimming pools A and B were 23.9 $\mu\textrm{g}$/l and 19.5 $\mu\textrm{g}$/l, respectively. The air chloroform concentrations were lower in the swimming Bools A and B than those reported by previous studies abroad employed the swimming pools which applied sodium hypochlorite only for water disinfection. The water chloroform concentrations were also lower in this study than in the previous studies. The relationship between the air and water chloroform concentrations measured in this study was significant with p=0.002 and Rz=0.42. At similar time to the indoor air sampling, outdoor air samples were collected at two sites near each of the swimming Pools A and B. The mean outdoor air chloroform concentrations near the swiminE Pools A and B were 0.41 $\mu\textrm{g}$/m3 and 0.16 $\mu\textrm{g}$/m3, respectively. The outdoor air chloroform concentrations measured in this study were equal to or lower than those reported by previous studies abroad. 'rho chloroform dose inhaled for a typical one-hour swim was estimated to be 25.9 $\mu\textrm{g}$ per person, corresponding to a specific 0.37 $\mu\textrm{g}$/kg body weight for a reference 70 Kg male adult, while the inhalation dose of chloroform from the outdoor air was estimated to be 5.6 $\mu\textrm{g}$ per person per day, corresponding to a specific 0.08 $\mu\textrm{g}$/Kg/day for the same reference male adult.

• Development and Reproduction
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• v.2 no.2
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• pp.213-221
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• 1998

Intracytoplasmic sperm injection (ICSI) has been widely used to treat couples with infertility due to severely impaired sperm charateristics and for whom conventional in-vitro fertilization (IVF) had failed. The extent to which the morphology of the oocyte at the light microscopy level is related to the results of ICSI vis controversial. In this study, oocytes from 44 patients were reviewed. The ICSI procedure was recorded through CCD camera. The oocytes were divided into five groups according to the presence of cytoplasmic inclusions, the width of perivitelline space (PVS), the presence of cell debris in PVS, the status of first polar body and the flexibility of oolemma. The results showed that the fertilization rate and embryonic development were not associated with the morphological criteria of oocyte. The degeneraton rate of oocytes after ICSI was significantly higher (P<0.001) in the oocytes whose membranes were broken at the moment of insertion (17.7%) than the oocytes whose membranes were broken by aspiration of cytoplasm (1.6%). More oocytes with cytoplasmic inclusions (48.4% vs. 25.1%, p<0.001), wide PVS (35.2% vs. 19.0%, p<0.001), or cell debris in PVS (53.3% vs. 38.4%, p<0.05) were observed in patients with female factor infertility compared to patients with male factor infertility. These results .suggest that the fertilization rate and embryonic development after ICSI are not correlated with oocyte morphology based on the presence of cytoplasmic inclusions, size of PVS, the presence of cell debris in PVS and the status of polar body. And the degeneration rate of oocytes after ICSI was associated with the flexibility of oolemma.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.613-622
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• 1996

Constrictive bronchiolitis, one of small airway diseases, is very rare and occupies one of the two arms of bronchiolitis obliterans together with proliferative bronchiolitis. Proliferative bronchiolitis, presenting the prototype with bronchiolitis obliterans with organizing pneumonia(BOOP), can be easily taken into diagnostic consideration in terms of relatively rapid clinical course and radiologic presentation as if atypical pneumonia with interstitial and alveolar infiltrations. Meanwhile constrictive bronchiolitis is not only very Tare but also easily overlooked as chronic obstructive pulmonary diseases such as emphysema, because it usually shows normal chest radiographic finding and obstructive pattern in pulmonary function test. In the aspects of the response to treatment, proliferative bronchiolitis showed dramatic response to the corticosteroid while constrictive bronchiolitis is intractable, which is easily explained on the basis of the pathologic characteristics of cicartrical replacement of bronchiolar walls. The bronchiolitis, both proliferative and constrictive, can be associated with diverse conditions such as inhalational injury, postinfectious process, drug of chemical induced reactions, connective tissue diseases, and organ trasplantation. And there is idiopathic type which has no associated condition. There is one explanation that both types of bronchiolitis lie on the same disease spectrum because the different disease pattern can be evoked from the same etiology. In contrast, another explanation is suggested that both types of bronchiolitis are one of nonspecific tissue reaction rather than a disease specific histologic finding because the various types of causes can provoke the same histologic findings. These dilemma remains for further investigation. With literature investigation, the authors report a case of constrictive bronchiolitis proven by open lung biopsy in 47 year old female who was diagnosed as non-Hodgkin's lymphoma and simultaneously had relatively rapid progression of airflow obstruction and showed negative radiographic finding without the rise factors for the development of chronic obstructive lung disease. We consider it as idiopathic because we could not find any relationship between constrictive bronchiolitis and non-Hodgkin's lymphoma on the literature search and it requires further investigation.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.419-424
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• 2004

Background : Although bronchodilator reversibility testing is widely performed to diagnose asthma or COPD, there is debate upon its usefulness and methods to differentiate asthma from COPD. The purpose of this study is to elucidate the role of bronchodilator reversibility testing in differentiating asthma from COPD and to confirm which method is better at evaluating bronchodilator reversibility. Methods : 26 asthma patients and 31 COPD patients were reviewed retrospectively. Spirometry was performed before and after bronchodilator inhalation to get $FEV_1$, FVC. To evaluate bronchodilator reversibility, the increase in $FEV_1$ or FVC was expressed as three methods, 'percentage of the baseline value', 'percentage of the predicted value', or 'absolute value'. Area under the ROC curve was measured to compare the three methods. In addition, the criteria of American Thoracic Society (ATS) for bronchodilator reversibility were compared to those of European Respiratory Society (ERS). Results : 1. In differentiating asthma from COPD, 'percentage of the predicted value', or 'absolute value' method was useful but 'percentage of the baseline value' was not. However, the ability to differentiate was weak because areas under the ROC curves by all methods were less than 0.75. 2. The criteria of ERS were superior to those of ATS for bronchodilator reversibility to differentiate asthma from COPD because likelihood ratio (LR) of a positive test by ERS criteria was greater than ATS criteria and because LR of a negative test by ERS criteria was less than ATS criteria. Conclusion : In differentiating asthma from COPD, bronchodilator reversibility testing has a weak role and should be considered as an adjunctive test.

• Neonatal Medicine
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• v.18 no.2
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• pp.240-247
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• 2011

Purpose: The rationale for skin surface cultures is that bacterial colonization precedes infection and, as a result, that identification of a potential pathogen is predictive of later systemic infection in preterm infants. We aimed to analyze results of surveillance surface cultures in extremely low birth weight (ELBW) infants and seek for effective ways of performing surveillance surface cultures. Methods: We analyzed the surveillance surface cultures of 113 ELBW infants over a 4-year period. Surveillance cultures were obtained routinely from five sites: axilla, external ear canal, nasopharynx, throat (or tracheal aspirate if intubated) and anus. Each surface culture obtained during the 13 days, prior to the date of the blood culture, was compared with the blood culture obtained when sepsis was suspected. The sensitivity, specificity and positive predictive value (PPV) of the surveillance cultures were calculated among 1894 blood-surface culture pairs by surface sites, recovered organisms and interval between surveillance samples and blood cultures. Results: The overall sensitivity, specificity and PPV of surface cultures were 45.9, 22.4 and 6.8%, respectively. The PPV was highest for the throat/tracheal cultures (11.0%) and lowest for the anal cultures (2.3%). As the time of culturing progressed toward the day of blood culturing, the sensitivity and specificity of the surface cultures significantly increased. Only axillary and throat/tracheal cultures were useful in predicting the microorganisms causing sepsis. Conclusion: Surface cultures could help to predict sepsis pathogens and infection surveillance in preterm infants could be continued with a reduced number of cultured sites focusing on the axilla and throat/trachea.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.2
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• pp.373-379
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• 2002

This paper was the design of aerosol generator for inhalation toxicology study of lead and evaluation with real time monitoring, and applied several engineering methodology to classical aerosol generator to cope with it's disadvantages. According to the testing conditions, source temperature 50℃ and inlet-duct band heater temperature 150℃, aerosol generation results for sodium chloride and lead acetate were as followings: CPM(Count Per Minute) for Sodium chloride that used for the testing material in aerosol generation and inhalation system was decreased in the 2nd and the 3rd hour's serial trials, but CVs(coefficient of variation) were maintained within 10%. CPMs for 5 and 2.5 gram of lead acetate that used for aerosol generation and inhalation exposure of lead showed similar results because of the sedimentation of lead acetate on piezoelectric crystal with time. For that reason, heating and mixing of nebulizing solution will be needed to generate lead aerosol with stable profile and maximum generation efficiency. Fluctuations of 10 and 5 gram lead acetate were low but 2.5gram was high. However, CVs for 10, 5, and 2.5gram lead acetate were within 10%. Considering the theoretical efficiencies for sodium chloride and lead acetate, 5gram sodium chloride and 2.5gram lead acetate were appropriate choice. Aerosol generation characteristics for two materials with 1 hour interval were different with respect to the fluctuation of CPM and the decrease to 10gram in it's material. For that reason, sodium chloride can not be used to estimate the aerosol generation and it's related parts for lead acetate. According to the testing conditions, source temperature 20, 50, 70℃, and inlet-duct band heater temperature 20, 50, 100, 150, 200℃, aerosol generation results for sodium chloride and lead acetate were as followings: Excluding inlet-duct band temperature 200℃, maximum CPM for sodium chloride was manifested in source temperature 70℃ with each inlet-duct band temperature conditions. We suggest that this condition was the optimum in the design of aerosol generator, inhalation system, and the testing. Maximum CPMs for 10, 5, and 2.5gram sodium chloride were from source temperature 70℃ and inlet-duct band temperature 20℃. Excluding inlet-duct band temperature 50, 200℃, maximum CPMs for lead acetate were indicated in source temperature 50℃ with each inlet-duct band temperature conditions. We suggest that this condition was the optimum in the design of aerosol generator, inhalation system, and the testing for lead inhalation study. Source and inlet-duct band temperatures for 10, 5, 2.5gram lead acetate were 50 and 100℃, 50 and 100℃, 50 and 150℃, respectively. In conclusion, considering above 2 paragraphs of results for aerosol generation, 5gram efficiencies for sodium chloride, lead acetate were higher than 2.5gram's. If inlet-duct band temperature was same, aerosol generation was increased with increase of source temperature. To get maximum aerosol generation will be the conditions that set the appropriate inlet-duel band temperature for each materials and increase the source temperature.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.57-65
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• 1999

Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

• Journal of Korea Game Society
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• v.4 no.4
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• pp.11-18
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• 2004

The on-line games in the past were played by only two persons exchanging data based on one-to-one connections, whereas recent ones (e.g. MMORPG: Massively Multi-player Online Role-playings Game) enable tens of thousands of people to be connected simultaneously. Specifically, Korea has established an excellent network infrastructure that can't be found anywhere in the world. Almost every household has a high-speed Internet access. What made this possible was, in part, high density of population that has accelerated the formation of good Internet infrastructure. However, this rapid increase in the use of on-line games may lead to surging traffics exceeding the limited Internet communication capacity so that the connection to the games is unstable or the server fails. expanding the servers though this measure is very costly could solve this problem. To deal with this problem, the present study proposes the load distribution technology that connects in the form of local clustering the game servers divided by their contents used in each on-line game reduces the loads of specific servers using the load balancer, and enhances performance of sewer for their efficient operation. In this paper, a cluster system is proposed where each Game server in the system has different contents service and loads are distributed efficiently using the game server resource information such as CPU utilization. Game sewers having different contents are mutually connected and managed with a network file system to maintain information consistency required to support resource information updates, deletions, and additions. Simulation studies show that our method performs better than other traditional methods. In terms of response time, our method shows shorter latency than RR (Round Robin) and LC (Least Connection) by about 12%, 10% respectively.