• Title/Summary/Keyword: History taking

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Implication of embB Gene Mutation in Ethambutol-Susceptible Clinical Isolates of Mycobacterium tuberculosis (임상에서 분리된 에탐부톨 감수성균에서의 embB 유전자 돌연변이에 대한 고찰)

  • Park, Young Kil;Shin, Sonya;Kim, Sang Jae;Koh, Won-Jung;Kwon, O Jung;Kim, Bum Jun;Kook, Yoon Ho;Cho, Sang Nae;Lew, Woo Jin;Bai, Gill Han
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.266-271
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    • 2005
  • Background : Ethambutol(EMB) is one of the first-line drugs included in short-course anti-tuberculosis therapy. The point mutations in embB gene have been speculated to be associated EMB resistance. However, detection of embB mutations at these positions have been observed in both EMB-susceptible isolates; thus, it remains controversial whether these mutations are associated with EMB resistance Methods : The 36 M. tuberculosis isolates were selected from clinical isolates which tested susceptible to EMB and resistant to at least one drug. DNA extracted from the isolates was analyzed by amplifying embB gene. The PCR products were purified and directly sequenced. We reviewed the history of past drug susceptibility test results. Results : Out of 36 EMB-susceptible strains, 3 strains (8.3%) had a mutation in codon 306 or 406 of the embB gene. These three strains had at least isoniazid resistance. They grew at 1.0 mcg/ml of EMB in Lowenstein-Jensen media. The patients of the strains were continuously smear-positive for over 3 years despite taking TB therapy. One strain had been EMB-resistant in past drug susceptibility tests. Conclusion : EMB-susceptible strains containing embB mutation may be caused by decreased viability in vitro test not by itself.

An Exploration of the Development of School-based Curriculum Model for the Gifted in Elementary School (초등학교 영재들을 위한 학교교육과정 개발 모형 탐색)

  • Kang, Choong-Youl
    • Journal of Gifted/Talented Education
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    • v.17 no.2
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    • pp.223-250
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    • 2007
  • Since 1992, the sixth national curriculum introduced the policy of school based curriculum development(SBCD) and required all the public elementary schools to develop their own curriculum for the gifted children in their schools. However, in spite of the fact that this curriculum policy for the gifted children has the history of 15 years until now, the current state of its implementation seems to be unsatisfactory. The major reason for that seems to be due to the reality that the schools have not had the theoretical basis for the curriculum development for the gifted children. In this vein, the researcher presented the theoretical SBCD model for the gifted children in elementary schools under the assumption that the model should suit the identity of elementary education, so that the gifted education in the elementary school can be implemented in its own form and adequacy. Based on the identity of elementary education, the model was developed by reformulating three component models of VanTassel-Baska's ICM: content model, process-product model, and epistemological model. The major feature of the researcher's model is to adapt and adjust the three component models differently according to the age level from the first to sixth graders in the elementary school. The model can be used not only as a general model for the talent pool of the school but also as an individual model for a specific gifted child by taking his special needs and characteristics into account. The model is a theoretical one based on the curriculum models for the gifted which were presented by several scholars in the area of G/T education, and it needs to be validated empirically in the future.

Numerical Analysis of Added Resistance and Vertical Ship Motions in Waves for KVLCC2 (KVLCC2에 대한 파랑 중 부가저항과 수직운동에 대한 수치해석)

  • Kim, Mingyu;Park, Dong-Woo
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.22 no.5
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    • pp.564-575
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    • 2016
  • The present study provides numerical simulations to predict the added resistance and ship motion of the KVLCC2 in regular waves using the unsteady Reynolds-Averaged Navier-Stokes (URANS) and 3-D potential methods. This numerical analysis is focused on added resistance and vertical ship motions (heave and pitch) under a wide range of wave conditions at three ship speeds (design, operating and zero speeds). Firstly, the characteristics of the CFD and 3-D potential flow methods are presented to predict added resistance and ship motions in regular waves taking into account various wave conditions at design speed to provide a validation study as well as at operating and zero speeds. Secondly, analyses of added resistance and ship motion with unsteady wave patterns and time history results as simulated by CFD were performed at each ship speed. Systematic validation and verifications of the numerical computations in this study were made against available Experimental Fluid Dynamics (EFD) data including grid convergence tests to demonstrate that reliable numerical results were obtained for the prediction of added resistance and ship motion in waves. Relationships between added resistance, vertical motion and changes in ship speeds were also found.

A study on critical strain based damage-controlled test for the evaluation of rock tunnel stability (암반터널 안정성 평가를 위한 손상제어실험 기반의 한계변형률에 관한 연구)

  • Lee, Kang-Hyun;Kim, Do-Hoon;Park, Jeong-Jun;Lee, In-Mo
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.13 no.6
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    • pp.501-517
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    • 2011
  • In general, the tunnel stability during excavation is assessed by comparing measured displacements at roof and sidewall to control criteria. The control criteria were established based on the past experience that considered ground conditions, size of the tunnel cross section, construction method, supports, etc. Therefore, a number of researches on the control criteria using the critical strain have been conducted. However, the critical strain obtained from uniaxial compression tests have drawbacks of not taking damage in rock mass due to increase of stress level and longitudinal arching into account. In this paper, damage-controlled tests simulating stress level and longitudinal arching during tunnel excavation were carried out in addition to uniaxial compression tests to investigate the critical strain characteristics of granite and gneiss that are most abundant rock types in Korean peninsula. Then, the critical strains obtained from damage-controlled tests were compared to those from uniaxial compression tests; the former showed less values than the latter. These results show that the critical strain obtained from uniaxial compression tests has to be reduced a little bit to take stress history during tunnel excavation into account. Moreover, the damage critical strain was proposed to be used for assessment of the brittle failure that usually occurs in deep tunnels.

Unresolving Pneumonia (치료에 대한 반응이 없는 폐렴)

  • Bang, Do Seok;Jung, In Sung;Kang, Ki Man;Park, Bum Chul;Yoon, Young Gul;Kim, Jae Su;Park, Yol;Lee, Sung Hoon;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.604-608
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    • 2004
  • A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of $39^{\circ}C$, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still $39^{\circ}C$ despite the aggressive therapy of community-acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.

A Case of Churg-Strauss Syndrome with Multiple Tracheobronchial Mucosal Lesions (기관과 기관지내 다발성 점막 병변을 동반한 Churg-Strauss 증후군 1예)

  • Boo, Sun-Jin;Lee, Kwangha;Ra, Seung Won;Jin, Young-Joo;Park, Gyung-Min;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.405-409
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    • 2008
  • Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.

EARLY DETECTION OF BEHCET'S DISEASE (베체트병의 조기 진단)

  • Kim, Seung-Hye;Song, Je-Seon;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.575-579
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    • 2009
  • Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

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A Study on the Entrepreneurship Curriculum Development Model to Systemize Entrepreneurship Education in Entrepreneurial Graduate School (AHP를 활용한 창업대학원 교과목 선호도 평가요인별 중요도에 관한 연구: 창업대학원 재학생을 대상으로)

  • Lee, Il han;Kim, Hyun sook
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.6
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    • pp.131-142
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    • 2016
  • Since global circumstances have become competitive, entrepreneurship has been regarded as the most important factors in economic revitalization not only in korea but also internationally. According to these changes, public entrepreneurship education has been started from the year of 2004 establishing Entrepreneurial Graduate School as a part of governmental plan. Although entrepreneurship education history is not long enough in korea, but the need for entrepreneurship education in social is now going ahead of the public education systems such as universities and graduate schools. Therefore, this study is conducted for the purpose of drawing the subject frame for systematized integration curriculum of entrepreneurship education through evaluating the importance of the subjects by Analytic Hierarchy Process analysis after being composed of 6 modularity in the Entrepreneurship subjects. This was structured based on studying the current status for entrepreneurship education in domestic universities and graduate schools. The research findings under the condition of Judgement consistency ratio 0.1 are as follows. The most important factors are in order as following; "Entrepreneurial Issues for Fund"(.242), "Entrepreneurship Plan"(.195), "Entrepreneurship & Entrepreneurship mindset"(.161), "Entrepreneurial Issues for Growth & Development"(.160), "Management Skill & Strategy"(.150), and "Special Entrepreneurship"(.093). Then, these findings also represent subfactors as well. The results of this study provide the practical guidelines where the curriculums needed for the entrepreneurship education at graduate schools by suggesting consistency for the systematic and comprehensive curriculum design. It was reflected the survey result from the graduate students taking the entrepreneurship subjects. Therefore, it will contribute the foundation of the present curriculum of Entrepreneurial Graduate School.

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J. M. W. Turner's The Shipwreck and the Romantic Semiotics of Maritime Disaster (터너의 <난파선>과 낭만주의적 해양재난)

  • Chun, Dongho
    • The Journal of Art Theory & Practice
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    • no.14
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    • pp.33-51
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    • 2012
  • Joseph Mallord William Turner (1775-1851) has been widely regarded as the most original and brilliant English landscape painter in the 19th century. Admitted to the Royal Academy Schools in 1789, Turner was a precocious artist and gained the full membership of the prestigious Royal Academy in 1802 at the age of 27. Already in the 1800s he was recognised as a pioneer in taking a new and revolutionary approach to the art of landscape painting. Among his early works made in this period, The Shipwreck, painted in 1805, epitomizes the sense of sublime Romanticism in terms of its dramatic subject-matter and the masterly display of technical innovations. Of course, the subject of shipwreck has a long standing history. Ever since human beings first began seafaring, they have been fascinated as much as haunted by shipwrecks. For maritime societies, such as England, shipwreck has been the source of endless nightmares, representing a constant threat not only to individual sailors but also to the nation as a whole. Unsurprisingly, therefore, shipwreck is one of the most popular motifs in art and literature, particularly during the 18th and 19th centuries. Yet accounts, images and metaphors of shipwreck have taken diverse forms and served different purposes, varying significantly across time and between authors. As such, Turner's painting registers a panoply of diverse but interconnected contemporary discourses. First of all, since shipwreck was an everyday occurrence in this period, it is more than likely that Turner's painting depicted the actual sinking in 1805 of the East India Company's ship 'The Earl of Abergavenny' off the coast of Weymouth. 263 souls were lost and the news of the wreck made headlines in major English newspapers at the time. Turner's painting may well have been his visual response to this tragedy, eyewitness accounts of which were given in great quantity in every contemporary newspaper. But the painting is not a documentary visual record of the incident as Turner was not present at the site and newspaper reports were not detailed enough for him to pictorially reconstruct the entire scene. Rather, Turner's painting is indebted to the iconographical tradition of depicting tempest and shipwreck, bearing a strong visual resemblance to some 17th-century Dutch marine paintings with which he was familiar through gallery visits and engravings. Lastly, Turner's Shipwreck is to be located in the contexts of burgeoning contemporary travel literature, especially shipwreck narratives. The late 18th and early 19th century saw a drastic increase in the publication of shipwreck narratives and Turner's painting was inspired by the re-publication in 1804 of William Falconer's enormously successful epic poem of the same title. Thus, in the final analysis, Turner's painting is a splendid signifier leading the beholder to the heart of Romantic abyss conjoing nightmarish everyday experience, high art, and popular literature.

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Study on The explanation of channel disease in "Tai Su(太素)". ("태소(太素) . 경맥병해(經脈病解)"에 대한 연구)

  • Lee, Yong-Bum
    • Journal of Korean Medical classics
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    • v.20 no.4
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    • pp.151-169
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    • 2007
  • The "Tai Su(太素)" which was published by Yang Shang Shan(楊上善) during the Tang(唐) dynasty does not follow complicating hand down procedures allowing it to be preserved in a relatively satisfactory state, and the book is evaluated as a major article in the study of the "Yellow Emperor's Internal Classic(黃帝內經)" in the modern age. The book of "Tai Su explanation of channel diseases(太素 經脈病解)" offers the detailed description of disease symptoms found in the book of "Miraculous Pivot channels(靈樞 經脈)", and Yang Shang Shan(楊上善) provided relatively complete explanations from the perspective of the wane and wax of shadow and sunshine powers(陰陽消長). The present writing was projected to acknowledge the relationship between the books of "Tai Su explanation of channel diseases(太素 經脈病解)" and "Miraculous Pivot channels(靈樞 經脈)" and substantially attempted to understand the original text of the "Tai Su(太素)" by adopting the perspectives of Yang Shang Shan(楊上善) in explaining the disease symptoms as he attempted in the book of "Miraculous Pivot channels(靈樞 經脈)". Total 50 disease symptoms were explained in the book of "Tai Su explanation of channel diseases(太素 經脈病解)", and 33 of them are common to the symptoms described in the book of "Miraculous Pivot channels(靈樞 經脈)" by taking up about 66% of the book. The monthly attachment(月別配屬) of three shadow and three sunshine power(三陰三陽), which is described in the book of "Tai Su explanation of channel diseases(太素 經脈病解)" provides an important clue in understanding the exterior and interior(表裏) relationship, and the crucial perspective lies on the mutual intensity change of shadow and sunshine powers. Therefore, the monthly attachment of three shadow and three sunshine power provided by the present article helps to understand the meaning of the three shadow and three sunshine power along with the time attachment(時間配屬) described in the other chapter of the "Yellow Emperor's Internal Classic(黃帝內經)". In the method of explaining pathogenesis, the explanation was made by understanding the perspective of mutual intensity change of shadow and sunshine powers, and exterior and interior relationship along with the channel Path(經脈流注) have been used simultaneously. In the comment of the main article, Yang Shang Shan(楊上善) stated the channels of hands and feet(手足經脈) as the scope of the three shadow and three sunshine power, but the symptoms and signs are mainly focused on the channels of feet as in the book of "Miraculous Pivot channels(靈樞 經脈)".

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