Pharmacokinetic Profiles of Isoniazid and Rifampicin in Korean Tuberculosis Patients (한국인 결핵환자에서 Isoniazid와 Rifampicin의 약동학)
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- Tuberculosis and Respiratory Diseases
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- v.47 no.4
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- pp.442-450
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- 1999
Background : Isoniazid(INH) and rifampicin(RFP) are the most effective anti-tuberculosis drugs which make the short-course chemotherapy possible. Although prescribed dosages of INH and RFP in Korea are different from those recommended by American Thoracic Society, there has been few study about pharmacokinetic profiles of INH and RFP in Korean patients who receive INH, RFP, ethambutol(EMB) and pyrazinamide(PZA) simultaneously. Methods : Among the patients with active tuberculosis from Dec. 1997 to July 1998, we selected 17 patients. After an overnight fast, patients were given INH 300mg, RFP 450mg, EMB 800mg and PZA 1500mg daily. Blood samples for the measurement of plasma INH(n=15) and RFP(n=17) level were drawn each at 0, 0.5, 1, 1.5, 2, 4, 6, 8 and 12hrs, and urine was also collected. INH and RFP level in the plasma and the urine were measured by high-performance liquid chromatography(HPLC). Pharmacokinetic parameters such as peak serum concentration(Cmax), time to reach to peak serum concentration(Tmax), half-life, elimination rate constant(Ke), total body clearance(CLtot), nonrenal clearance(CLnr), and renal clearance(CLr) were calculated. Results : 1) Pharmacokinetic parameters of INH were as follows: Cmax;
Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.
Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.
These studies were carried out to select somatic hybrid using selectable marker genes of Nicotiana glauca transformed by NPTII gene and Solanum tuberosum transformed by T- DNA, and to study characteristics of transformant. The results are summarized as follows. 1. Crown gall tumors and hairy roots were formed on potato tuber disc infected by A. tumefaciens Ach5 and A. rhizogenes ATCC15834. These tumors and roots could be grown on the phytohormone free media. 2. Callus formation from hairy root was prompted on the medium containing 2, 4 D 2mg/I with casein hydrolysate lg/l. 3. The survival ratio of crown gall tumor callus derived from potato increased on the medium containing the activated charcoal 0. 5-2. 0mg/I because of the preventions on the other hand, hairy roots were necrosis on the same medium. 4. Callus derived from hairy root were excellently grown for a short time by suspension culture on liquid medium containing 2, 4-D 2mg/I and casein hydrolysate lg/l. 5. The binary vector pGA643 was mobilized from E. coli MC1000 into wild type Agrobacteriurn tumefaciens Ach5, A. tumefaciens
During my stay in the Netherlands, I have studied the following, primarily in relation to the Mokpo Yong-san project which had been studied by the NEDECO for a feasibility report. 1. Unit hydrograph at Naju There are many ways to make unit hydrograph, but I want explain here to make unit hydrograph from the- actual run of curve at Naju. A discharge curve made from one rain storm depends on rainfall intensity per houre After finriing hydrograph every two hours, we will get two-hour unit hydrograph to devide each ordinate of the two-hour hydrograph by the rainfall intensity. I have used one storm from June 24 to June 26, 1963, recording a rainfall intensity of average 9. 4 mm per hour for 12 hours. If several rain gage stations had already been established in the catchment area. above Naju prior to this storm, I could have gathered accurate data on rainfall intensity throughout the catchment area. As it was, I used I the automatic rain gage record of the Mokpo I moteorological station to determine the rainfall lntensity. In order. to develop the unit ~Ydrograph at Naju, I subtracted the basic flow from the total runoff flow. I also tried to keed the difference between the calculated discharge amount and the measured discharge less than 1O~ The discharge period. of an unit graph depends on the length of the catchment area. 2. Determination of sluice dimension Acoording to principles of design presently used in our country, a one-day storm with a frequency of 20 years must be discharged in 8 hours. These design criteria are not adequate, and several dams have washed out in the past years. The design of the spillway and sluice dimensions must be based on the maximun peak discharge flowing into the reservoir to avoid crop and structure damages. The total flow into the reservoir is the summation of flow described by the Mokpo hydrograph, the basic flow from all the catchment areas and the rainfall on the reservoir area. To calculate the amount of water discharged through the sluiceCper half hour), the average head during that interval must be known. This can be calculated from the known water level outside the sluiceCdetermined by the tide) and from an estimated water level inside the reservoir at the end of each time interval. The total amount of water discharged through the sluice can be calculated from this average head, the time interval and the cross-sectional area of' the sluice. From the inflow into the .reservoir and the outflow through the sluice gates I calculated the change in the volume of water stored in the reservoir at half-hour intervals. From the stored volume of water and the known storage capacity of the reservoir, I was able to calculate the water level in the reservoir. The Calculated water level in the reservoir must be the same as the estimated water level. Mean stand tide will be adequate to use for determining the sluice dimension because spring tide is worse case and neap tide is best condition for the I result of the calculatio 3. Tidal computation for determination of the closure curve. During the construction of a dam, whether by building up of a succession of horizontael layers or by building in from both sides, the velocity of the water flowinii through the closing gapwill increase, because of the gradual decrease in the cross sectional area of the gap. 1 calculated the . velocities in the closing gap during flood and ebb for the first mentioned method of construction until the cross-sectional area has been reduced to about 25% of the original area, the change in tidal movement within the reservoir being negligible. Up to that point, the increase of the velocity is more or less hyperbolic. During the closing of the last 25 % of the gap, less water can flow out of the reservoir. This causes a rise of the mean water level of the reservoir. The difference in hydraulic head is then no longer negligible and must be taken into account. When, during the course of construction. the submerged weir become a free weir the critical flow occurs. The critical flow is that point, during either ebb or flood, at which the velocity reaches a maximum. When the dam is raised further. the velocity decreases because of the decrease\ulcorner in the height of the water above the weir. The calculation of the currents and velocities for a stage in the closure of the final gap is done in the following manner; Using an average tide with a neglible daily quantity, I estimated the water level on the pustream side of. the dam (inner water level). I determined the current through the gap for each hour by multiplying the storage area by the increment of the rise in water level. The velocity at a given moment can be determined from the calcalated current in m3/sec, and the cross-sectional area at that moment. At the same time from the difference between inner water level and tidal level (outer water level) the velocity can be calculated with the formula
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
Experiments and investigations were done basically and practically for the purpose of labor saving in paddy rice cultivation especially on Homizil i.e. hoeing and herbicide, 1969. 8 concrete tanks were established on the open base of Keon Kuk University for comparison of percolation, dissolved oxygen and yield test of rice in the paddy plot of tank. The dimension of the bottom of each tank is square meter. Each of the 4 of the 8 tanks is 21cm in height and each of the remaining 4 tanks is 36cm. Each tank has a system that comprises 2 sets of tubes, each of which has 20 holes of 5mm in diameter scattered every side and is covered with nylon cloth taking water in the tank. One set consists of 4 P.V.C tubes. The first set is situated 8cm below the top of the tank and the second set is located at bottom layer inside the tank. The 4 tubes of each set are combined together and led to the glass tube which protects from inside to outside. And this inside-outside glass tube is connected to the small rubber tube. Also a glass tube is set 4cm below the top of the tank. Paddy loam was filled on sand in each of the tanks in the soil depth of either 15cm or 30cm. The depth of sand was 5cm in the soil depth of 15cm and 10cm in the soil depth of 30cm. (Fig. 1, 2 and 3). The paddy rice was grown in the tank. The percolation of water, the dissolved oxygen and the yield of rice were observed in the tank. And the dissolved oxygen was detected by Winkler method. A sandy paddy field of heavy percolation was selected at the field of the National Agricultural Material Inspection Center in Seoul. It was divided into 9 plots. These plots were given 3 treatments: (A) not hoeing, (B) hoeing one time and (C) hoeing two times. These treatments were replicated 3 times along the latin square design. The paddy rice was grown and sprayed with Stam F-34 in the all plots for the purpose of killing weeds before hoeing. The two types of paddy of field i.e. one for normal percolation and the other for ill drainage were selected at Iri Crop Experiment Station, Jeonla-Bukdo. Each field was divided into 24 plots for 8 treatments. They are: (A) not hoeing; (B) hoeing one time; (C) hoeing two times; (D) not hoeing but treating with herbicide, Pamcon; (E) hoeing one time and weeding two times also treating with herbicide, Pamcon; (F) hoeing two times and weeding one time a], o treating with herbicide, Pamcon; (G) hoeing two times and weeding two times also treating with herbicide, Pamcon, ; (H) usual manner. The labor hours and expenses needed for weeding in the paddy by hoeing were investigated in a farmer at Suwon and the price of herbicide and the yield of rice were taken out at Iri, Jeonla-Bukdo. The results obtained from the above experiments and investigations are as follows: 1. The relationship between percolation and dissolved oxygen shows that a very small amount of oxygen is detected in the soil water under 2cm below surface of earth in the paddy even when percolation is over 4.0cm per 24 hours (Tab. 1). 2. The relationship between percolation and yield of rice shows that the yield of rice increases in the percolation of 0cm and 1.5cm per 24 hours and decreases in the percolation of 2.5cm and 3.4cm in the plot of the 15cm ploughing depth and increases in the percolation of 1.4cm and 3.0cm and decreases in the percolation of 0cm and 4.0cm in the plot of 30cm ploughing depth (Tab. 1 and Fig. 5). 3. The yield of paddy weeded with Stam F-34 in the sandy field of heavy percolation in Seoul was 3.02 tons in the plot of not hoeing, 2.99 tons in hoeing one time and 3.05 tons in hoeing two times per hectare (Tab. 5). 4.1). 4. 1) The yield of rice per 10 ares in the field of normal percolation at Iri was 338kg in not hoeing, 379kg in hoeing one time, 383kg in hoeing two times, 413kg in spraying herbicide, Pamcon, and not hoeing, 433kg in spraying herbicide, Pamcon, and hoeing one time and weeding two times, 399kg in spraying herbicide, Pamcon, and hoeing two times and weeding one time, 420kg in spraying herbicide, Pamcon, and hoeing two times and weeding two times and 418kg in usual manner (Tab. 6-1). 2) The yield of rice per 10 ares in the field of ill drainage at Iri was 323kg in not hoeing, 363kg in hoeing one time, 342kg in hoeing two times, 388kg in spraying herbicide, Pamcon, and not hoeing, 425kg in spraying herbicide, Pamcon, and hoeing one time and weeding two times, 427kg in spraying herbicide, Pamcon, and hoeing two times and weeding one time, 449kg in spraying herbicide, Pamcon, and hoeing two times and weeding two times and 412kg in usual manner (Tab. 6-2). 5. 1) The labor hours for weeding by hoeing was 37.1 hours but 53.5 hours if hours for meal, smoking and so on are included, and the expenses including labor cost needed for weeding by hoeing in the paddy rice was 2, 346 Won per 10 ares at Suwon (Tab. 7). 2) The labor hours for weeding by spraying herbicide with hand sprayer in the paddy rice was about 5 hours per 10 ares at Suwon and the expenses for weeding by spraying herbicide in the paddy rice was 750 Won but 1130 Won if the loss by decrement of rice in the paddy field of ill drainage per 10 ares is calculated in estimation at Iri (Tab. 8). From these observations and investigations it is known that using of some kinds of herbicides Saves labor and expenses of weeding, almost without giving damages to the rice itself, in the field of normal or heavy percolation comparing usual manner of hoeing.
From the beginning of the chosun dynasty, an agriculture-first policy was imposed by being written farming books, for instance, Nongsajiksul, matched with real conditions of local agriculture, which provided the grounds of new, intensive farming technologies. This farming book was the collection of good fanning technologies that were experienced in rural farm areas at that time. According to Nongsajiksul, rice culture systems were divided into "Musarmi"(Water-Seeded rice), /"Kunsarmi"(dry-seeded rice), /transplanted rice and mountainous rice (upland rice) culture. The characteristics of these rice cultures with high technologies were based of scientific weeding methods, improved fertilization, and cultivation works using cattle power and manpower tools systematically. Reclamation of coastal swampy and barren land was possible in virtue of fire cultivation farming(火耕) and a weeding tool called "Yoonmok"(輪木). Also, there was an improved hoe to do weeding works as well as thinning and heaping-up of soil at seeding stages of rice. Direct-seeded rice culture in flat paddy fields were expanded by constructing the irrigation reservoirs and ponds, and the valley paddy fields was reclaimed by constructing "Boh(洑)". These were possible due to weed control by irrigation waters, keeping soil fertility by inorganic fertilization during irrigation, and increased productivity of rice fields by supplying good physiological conditions for rice. Also, labor-saving culture of rice was feasible by transplanting but in national-wide, rice should not basically be transplanted because of the restriction of water use. Thus, direct-seeded rice in dry soils was established, in which rice was direct-seeded and grown in dry soils by seedling stages and was grown in flooded fields when rained, as in the book "Nongsajiksul". During the middle of the dynasty(AD 1495-1725), the excellent labor-saving farmings include check-rowing transplanting because of weeding efficiency and availability in rice("Hanjongrok"), and, nurserybed techniques (early transplanting of rice) were emphasized on the basis of rice transplanting ["Nongajibsung"]. The techniques for deep plowing with cattle powers and for putting more fertilizers were to improve the productivity of labor and land, The matters advanced in "Sanlimkyungje" more than in "Nongajibsung" were, development of "drybed of rice nursery stock", like "upland rice nursery" today, transplanting, establishment of "winter barly on drained paddy field, and improvement of labor and land-productivity in rice". This resulted in the community of large-scale farming by changing the pattern of small-farming into the production system of rice management. Woo-hayoung(1741-1812) in his book "Chonilrok" tried to reform from large-scale farmings into intensive farmings, of which as eminent view was to divide the land use into transplanting (paddy) and groove-seeding methods(dry field). Especially as insisted by Seo-yugo ("Sanlimkyungjeji"), the advantages of transplanting were curtailment of weeding labors, good growth of rice because of soil fertility of both nurserybed and paddy field, and newly active growth because rice plants were pulled out and replanted. Of course, there were reestimation of transplanting, limitation of two croppings a year, restriction of "paddy-upland alternation", and a ban for large-scale farming. At that period, Lee-jiyum had written on rice farming technologies in dry upland with consider of the land, water physiology of rice, and convenience for weeding, and it was a creative cropping system to secure the farm income most safely. As a integrated considerations, the followings must be introduced to practice the improved farming methods ; namely, improvement of farming tools, putting more fertilizers, introduction of cultural technologies more rational and efficient, management of labor power, improvement of cropping system to enhance use of irrigation water and land, introduction of new crops and new varieties.
The purposes of this thesis are to clarify experimentally the variation of ground water temperature in tube wells during the irrigation period of paddy rice, and the effect of ground water irrigation on the growth, grain yield and yield components of the rice plant, and, furthermore, when and why the plant is most liable to be damaged by ground water, and also to find out the effective ground water irrigation methods. The results obtained in this experiment are as follows; 1. The temperature of ground water in tube wells varies according to the location, year, and the depth of the well. The average temperatures of ground water in a tubewells, 6.3m, 8.0m deep are