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Clinical Meaning of INNO-LiPA Test in the Diagnosis of Rifampin Resistant Tuberculosis (Rifampin 내성 결핵의 진단에서 INNO-LiPA 검사법의 임상적 의미)

  • Chang, Yoon Soo;Kim, Young;Lee, Chang Youl;Choi, Jong Rak;Kim, Hyung Jung;Ahn, Chul Min;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.344-352
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    • 2003
  • Background : The prevalence of multidrug resistant tuberculosis (MDR-TB), resistant to isoniazid (INH) and rifampin (RFP), was 5.3% worldwide in 1995 and its increment has raised important public health problems. Resistance to RFP, one of the key drugs in the treatment of tuberculosis, results in grim clinical outcome. Recently rapid detection of RFP-resistant mutations in rpoB gene based on PCR method has become available. This study evaluated the prevalence of RFP resistance in first diagnosed, treatment failure, and recurred patients using INNO-LiPA test, and compared the results of INNO-LiPA with those of conventional mycobacterial drug susceptibility test. Methods : Forty-six patients, who were diagnosed of pulmonary tuberculosis and had revealed positive sputum AFB smear, were enrolled in this study from 1998 to 2002. The cases were classified as one three groups; first diagnosed, treatment failure, or recurred. RFP resistance was studied using an INNO-LiPA Rif. TB kit and compared with that obtained from drug susceptibility based on M. tuberculosis culture study. Results : Twenty-one out of 46 patients were enrolled under first diagnosis of pulmonary tuberculosis, 17 under treatment failure with first line drugs, and 8 under recurrence. The positive and negative predictive values of INNO-LiPA test in diagnosis in RFP resistant tuberculosis compared with conventional mycobacterial drug susceptibility test were 85.7% and 76.0%, respectively. INNO-LiPA result revealed rpoB gene mutation in 20 (80.0%) out of 25 patients who were diagnosed as treatment failure or recurrence, but in only 4 (19.0%) out of 21 patients who were first diagnosed as pulmonary tuberculosis. Conclusion : This study showed that RFP resistance could be diagnosed rapidly and accurately using INNO-LiPA test and that this test might be helpful for choosing second line anti-mycobacterial drugs. It might be of great help in clinical diagnosis and decision when used in complimentarily with drug susceptibility test based on M. tuberculosis culture.

Multiplex PCR of Endotracheal Aspirate for the Detection of Pathogens in Ventilator Associated Pneumonia (기계환기폐렴의 원인균 진단에서 인공기도 흡인액을 이용한 Multiplex PCR과 세균배양 결과의 비교)

  • Song, Ju Han;Myung, Soon Chul;Choi, Song Ho;Jeon, Eun Ju;Kang, Hyung Gu;Lee, Hye Min;Cho, Sung Keun;Choi, Jae Chol;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.194-199
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    • 2008
  • Background: Early identification of pathogens can improve the prognosis of patients with ventilator associated pneumonia (VAP). In the present study, we evaluated the feasibility of performing multiplex PCR for endotracheal aspirates to detect three important pathogens (P. aeruginosa, K. pneumoniae and MRSA) in patients with VAP. Methods: The endotracheal aspirates of 24 patients were collected within 24 hours of the diagnosis of VAP for performing multiplex PCR. Forward and reverse primers were designed to target the specific site of each pathogen (the oprL gene for P. aeruginosa, 16S rRNA for K. pneumoniae and the mec gene for MRSA). We analyzed the clinical data of the VAP patients, including the culture reports for the endotracheal aspirates. Results: Twenty-four patients (M:F=18:6, mean age=$70{\pm}11$) with VAP were enrolled. Pathogens were isolated from 11 patients (P. aeruginosa in 2, K. pneumoniae in 1, MRSA in 2, other enteric Gram negative bacilli in 3, S. pneumoniae in 2 and mixed infection in 1). Multiplex PCR detected three cases of P.aeruginosa (2 cases coincided with the culture reports) and four cases of K. pneumoniae (1 matched with the culture report). PCR detected two MRSA cases, which did not coincide with the culture reports. Conclusion: Multiplex PCR of the endotracheal aspirate showed some ability to detect Gram negative bacilli, although caution is required when interpreting the results.

Change Detection of land-surface Environment in Gongju Areas Using Spatial Relationships between Land-surface Change and Geo-spatial Information (지표변화와 지리공간정보의 연관성 분석을 통한 공주지역 지표환경 변화 분석)

  • Jang Dong-Ho
    • Journal of the Korean Geographical Society
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    • v.40 no.3 s.108
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    • pp.296-309
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    • 2005
  • In this study, we investigated the change of future land-surface and relationships of land-surface change with geo-spatial information, using a Bayesian prediction model based on a likelihood ratio function, for analysing the land-surface change of the Gongju area. We classified the land-surface satellite images, and then extracted the changing area using a way of post classification comparison. land-surface information related to the land-surface change is constructed in a GIS environment, and the map of land-surface change prediction is made using the likelihood ratio function. As the results of this study, the thematic maps which definitely influence land-surface change of rural or urban areas are elevation, water system, population density, roads, population moving, the number of establishments, land price, etc. Also, thematic maps which definitely influence the land-surface change of forests areas are elevation, slope, population density, population moving, land price, etc. As a result of land-surface change analysis, center proliferation of old and new downtown is composed near Gum-river, and the downtown area will spread around the local roads and interchange areas in the urban area. In case of agricultural areas, a small tributary of Gum-river or an area of local roads which are attached with adjacent areas showed the high probability of change. Most of the forest areas are located in southeast and from this result we can guess why the wide chestnut-tree cultivation complex is located in these areas and the capability of forest damage is very high. As a result of validation using a prediction rate curve, a capability of prediction of urban area is $80\%$, agriculture area is $55\%$, forest area is $40\%$ in higher $10\%$ of possibility which the land-surface change would occur. This integration model is unsatisfactory to Predict the forest area in the study area and thus as a future work, it is necessary to apply new thematic maps or prediction models In conclusion, we can expect that this way can be one of the most essential land-surface change studies in a few years.

A Study of Hydrodynamics and Reaction Characteristics in Relation to the Desulfurization Temperatures of Zn-Based Solid Sorbent in the Lab-scale High Pressure and High Temperature Desulfurization Process (실험실규모 고온고압건식탈황공정의 수력학적 특성 및 탈황온도에 따른 아연계 탈황제의 반응특성 연구)

  • Kyung, Dae-Hyun;Kim, Jae-Young;Jo, Sung-Ho;Park, Young Cheol;Moon, Jong-Ho;Yi, Chang-Keun;Baek, Jeom-In
    • Korean Chemical Engineering Research
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    • v.50 no.3
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    • pp.492-498
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    • 2012
  • In this study, hydrodynamics such as solid circulation rate and voidage in the desulfurizer and the reaction characteristics of Zn-based solid sorbents were investigated using lab-scale high pressure and high temperature desulfurization process. The continuous HGD (Hot Gas Desulfurization) process consist of a fast fluidized bed type desulfurizer (6.2 m tall pipe of 0.015 m i.d), a bubbling fluidized bed type regenerator (1.6 m tall bed of 0.053 m i.d), a loop-seal and the pressure control valves. The solid circulation rate was measured by varying the slide-gate opening positions, the gas velocities and temperatures of the desulfurizer and the voidage in the desulfurizer was derived by the same way. At the same gas velocities and the same opening positions of the slide gate, the solid circulation rate, which was similar at the temperature of $300^{\circ}C$ and $550^{\circ}C$, was low at those temperatures compared with a room temperature. The voidage in the desulfurizer showed a fast fluidized bed type when the opening positions of the slide gate were 10~20% while that showed a turbulent fluidized bed type when those of slide gate were 30~40%. The reaction characteristics of Zn-based solid sorbent were investigated by different desulfurization temperatures at 20 atm in the continuous operation. The $H_2S$ removal efficiency tended to decrease below the desulfurization temperature of $450^{\circ}C$. Thus, the 10 hour continuous operation has been performed at the desulfurization temperature of $500^{\circ}C$ in order to maintain the high $H_2S$ removal efficiency. During 10 hour continuous operation, the $H_2S$ removal efficiency was above 99.99% because the $H_2S$ concentration after desulfurization was not detected at the inlet $H_2S$ concentration of 5,000 ppmv condition using UV analyzers (Radas2) and the detector tube (GASTEC) which lower detection limit is 1 ppmv.

Discrimination of Hanwoo from Holstein and Mixed Beef by DHPLC (변성 고성능 액체 크로마토그래피를 이용한 한우, 젖소 그리고 혼입육의 구분)

  • Ahn, Young-Chang;Cho, Min-Ho;Seo, Jae-Won;Yoon, Il-Kyu;Jung, Duck-Hyun;Lee, Eun-Young;Nam, Youn-Hyoung;Park, Su-Min;Jang, Won-Cheoul
    • Journal of the Korean Chemical Society
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    • v.53 no.6
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    • pp.742-748
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    • 2009
  • In the meat industry, correct breed information in food labeling is required to assure meat quality. Genetic markers provide corroborating evidence to identify breed. We described the development of DNA markers to discriminate between Korean beef cattle (Hanwoo), Holstein, and mixed cow beefs. As most breeds are standardized for coat colour, the melanocortin 1 receptor (MC1R) gene, involved in the regulation of eu/pheomelanins synthesis, has been suggested as marker for breed traceability of products of animal origin. We also designed sex-determining region Y (SRY) gene specific primers for Y chromosome detection. In this study, fragments of MC1R gene and SRY gene were amplified by multiplex-PCR and subjected to digestion by MspA1I restriction endonuclease. Reaction products were analysised by denaturing high performance liquid chromatography (DHPLC). As a result, we identified 6 DHPLC peak types from MC1R gene and SRY gene analysis. DHPLC method showed more sensitive than RFLP method for DNA fragments analysis. Therefore, DHPLC method can apply to identify for Hanwoo, Holstein and mixed beef.

Environmental Pollutants in Streams of Andong District and Insect Immune Biomarker (안동지역 하천의 환경오염물질과 곤충면역 생체지표 분석)

  • Ryoo Keon Sang;Ko Seong-Oon;Cho Sunghwan;Lee Hwasung;Kim Yonggyun
    • Korean journal of applied entomology
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    • v.44 no.2
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    • pp.97-108
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    • 2005
  • Samples of water, soil, and sediment were taken from 10 streams near Andong, Korea in May 2004. To assess the degree of environmental pollution of each stream, chemical pollutants such as total notrogen (T-N), total phosphorus (T-P), chemical oxygen demand (COD), heavy metals, organophosphorus pesticides, organochlorine pesticides, and dioxin-like PCB congeners were analyzed by standard process tests or U.S. EPA methods. In addition, biomarkers originated from insect immune systems of beet armyworm, Spodoptera exigua, were used to analysis of the environmental samples. Except Waya-chun stream showing T-N content of 9.12 mg/L, most streams were contaminated with relatively low levels of overall pollutants in terms of T-N, T-P, and COD, compared to their acceptable environmental levels designated by the Ministry of Environment. Contents of Pb and Cd in samples of each stream were much lower than environmentally permissible levels. However, several times higherconcentrations of Pb and Cd were found in locations at Mi-chun, Kilan-chun, and Hyunha-chun streams, in comparison with other streams. Diazinon, parathion, and phenthoate compounds among organophosphorus pesticides were detected as concentrations of 0.19, 0.40, and $1.13\;{\mu}g/g$, respectively, from soil sample collected in the vicinity of Mi-chun stream. On the other hand, 16 organochlorine pesticides and 12 dioxin-like PCB congeners, known as endocrine disrupting chemicals, selected in this study were not found above the limit of detection. Biomarker analyses using insect immune responses indicated that Waya-chun stream was suspected as exposure to environmental pollutants. Limitation and compensation of both environmental analysis techniques are discussed.

Polymorphisms in Glutamate Receptor, Ionotropic, N-methyl-D-aspartate 2B(GRIN2B) Genes of Autism Spectrum Disorders in Korean Population : Family-based Association Study (한국인 자폐스펙트럼장애에서 Glutamate Receptor, Ionotropic, N-methyl-D-Aspartate 2B(GRIN2B) 유전자 다형성-가족기반연구)

  • Yoo, Hee Jeong;Cho, In Hee;Park, Mira;Yoo, Hanik K.;Kim, Jin Hee;Kim, Soon Ae
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.289-298
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    • 2006
  • Objectives : Autism is a complex neurodevelopmental spectrum disorder with a strong genetic component. Previous neurochemical and genetic studies suggested the possible involvement of glutamate N-methyl-D-aspartate(NMDA) receptor in autism. The aim of study was to investigate the association between the NMDA2B receptor gene(GRIN2B) and autism spectrum disorders(ASD) in the Korean population. Methods : The patients with ASD were diagnosed with Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule based on DSM-IV diagnostic classification. The present study was conducted with the detection of four single nucleotide polymorphisms(SNPs) in GRIK2 and family-based association analysis of the single nucleotide polymorphisms in Korean ASD trios using transmission disequilibrium test (TDT). Results : One hundred twenty six patients with ASD and their biological parents were analyzed. 86.5% were male and 85.1% were diagnosed as autistic disorder. The mean age was $71.9{\pm}31.6$ months(range : 26-185 months). We found that rs1805247 showed significantly preferential transmission(TDT ${\chi}^2$=12.8, p<0.001) in ASD. Conclusion : One SNP in GRIN2B gene was significantly associated with ASD in the Korean population. This result suggests the possible involvement of glutamate NMDA receptor gene in the development of ASD.

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A study on the location of fire fighting appliances in cargo ships (화물선 소화설비 비치에 대한 연구)

  • Ha, Weon-Jae
    • Journal of Advanced Marine Engineering and Technology
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    • v.40 no.9
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    • pp.852-858
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    • 2016
  • To safeguard the accommodation spaces on cargo ships from fire, structural fire protection provisions introduced by SOLAS and these measures retard the propagation of flames and smoke. SOLAS also specifies provisions for fire fighting drills. These provisions are a combination of regulations regarding structure and equipment and those dealing with the human element for the fire protection and effective responses in the event of fire. Requirements related to the human element play a supporting role to the requirements for structure and equipment because the present accommodation structure and equipment are insufficient for extinguishing a fire, therefore, fire-extinguishing activity performed by crew members is essential. To reduce human error and ensure effective fire fighting, it is necessary to install a fire-fighting system and improve the fire fighting process. The fundamental concept of fire fighting exercises is to commence fire fighting before the fire grows too big to extinguish. It is essential to relocate the storage place of fire fighting equipment to expedite the fire-fighting exercise. This study was carried out to reduce human risk for this purpose, the fire control station was relocated to a site that could be accessed from the open deck. Further, two sets of a fire fighter's outfit were stored at the same site. This relocation eliminated the risk of the crew reentering to operate the fire fighting system in the fire control station and allowed the crew to pick up the fire fighters' outfits quickly in the event of a fire. In addition, it was proposed that the IIC method be made mandatory. This method is combination of automatic fire detection system and sprinkler system which can reduce the risk of the fire fighting exercises for the crew and to suppress fire in the initial stage. This study was carried out to provide a foundation to the possible amendment of the relevant SOLAS regulations and national legislation.

Computer Assisted EPID Analysis of Breast Intrafractional and Interfractional Positioning Error (유방암 방사선치료에 있어 치료도중 및 분할치료 간 위치오차에 대한 전자포탈영상의 컴퓨터를 이용한 자동 분석)

  • Sohn Jason W.;Mansur David B.;Monroe James I.;Drzymala Robert E.;Jin Ho-Sang;Suh Tae-Suk;Dempsey James F.;Klein Eric E.
    • Progress in Medical Physics
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    • v.17 no.1
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    • pp.24-31
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    • 2006
  • Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

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Radiotherapy Incidents Analysis Based on ROSIS: Tendency and Frequency (ROSIS 자료 기반 방사선 사고 사례 분석 : 경향과 빈도)

  • Koo, Jihye;Yoon, MyongGeun;Chung, Won Kuu;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.298-303
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    • 2014
  • In this study, we examine the trends and types of incidents frequently occur during radiation therapy by using the data from the radiation oncology safety information system (ROSIS), according to discovery method explores the development direction of future research accident cause factor control method. This study was carried out analysis of incident data in ROSIS nearly 1163 cases in last 11 years from 2003 to 2013. We categorized into treatment methods, found the time, discoverer of occupations and finding ways to analyze the data. Then, we calculate the percentage and the classification for each item. About 1163 cases of incident cases including the near miss cases, external radiation therapy, brachytherapy and other were 97%, 2% and 1%. In the case was improperly planned dose delivery was 44% (497 cases) which 429 cases (86%) was found before 3 fractions and 13 cases were found after 11 fractions. The investigation was found to be distributed in various a found times. Approximately 42% of found time was during treatment and 29% of patients were found the problem during inspection chart. Occupation to discover the most radiation accidents was the radiation therapist (53%) who works in treatment room. Among 1163 incidence cases, 24% cases were found the accident before the treatment, therefore most of accident were found after of during the treatment (70%, 813 cases). This trend is acquired through ROSIS analysis, is expected to be not significantly different in the case of Korea, so it is necessary more diverse and systematic research for the prevention and early detection by using the ROSIS data.