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Field Control of Paulownia Witches' Broom with Oxytetracycline Hydrochloride (옥시테트라사이클린에 의(依)한 오동나무·빗자루병(病) 방제(防除))

  • La, Yong Joon;Shin, Hyeon Dong
    • Journal of Korean Society of Forest Science
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    • v.49 no.1
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    • pp.6-10
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    • 1980
  • The witches' broom disease of Paulownia tomentosa (Thunb.) Steud with which mycoplasmalike organisms are associated is widespread throughout Korea and poses serious threat to the cultivation of paulownia. Attempt was made to investigate the feasibility of field control of the disease with oxytetracycline hydrochloride (OTC). A total of 84 paulownia trees (6 year-old, DBH: 10-15cm) exhibiting severe symptoms of witches' broom were selected and treated during March to September. Solution of 1-10g of OTC dissolved in 0.1­2.0 of water was transfused into infected trees with gravity flow method from a dark-brown colored plastic reservoir (11 volume) through plastic tubes (1.2m long) connected to 2-4 holes (5 mm in diameter and 4-5cm in depth) bored in the basal part of the tree trunks (Fig. 1 and 2). Of 60 diseased paulownia trees injected with 2g of OTC in 0.1-2.0l of water during May to September, 1979, 58 trees resulted in complete remission of symptom development and resumption of healthy new growth at least up to September, 1980 when the last observation of the effect of OTC treatment for this experiment was made. The rest of two trees were dead probably due to too severe infection. Of 24 paulownia trees treated in March and April, 1979 complete remission of symptom development was obtained with 8 trees, and nine trees were partially prevented from symptom development in the following season. The remaining 7 trees were dead due to failure in uptake of OTC and partly because the trees were in too far advanced stage of infection. Application of highly concentrated solution of 2g of OTC dissolved in 0.1-0.2l of water per tree was just as effective as the 2g/1-2l treatment. Injection of 2g/1-2l required 3-4 days while treatment of 2g/0.1-0.2l reduced the time for injecting one tree down to less than 24 hrs. The result of this experiment demonstrates that basal trunk injection of 2g OTC/0.1-0.2l/tree is feasible for field control of paulownia witches' broom, provided that tree injection is performed in actively growing season (May-September) and at the initial stage of disease development.

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The First 20 Cases of Cardiac Surgery Using the da $Vinci^{TM}$ Surgical System: A Single Center Experience (다빈치 수술로봇을 이용한 심장수술 20예 보고 - 단일 기관 보고 -)

  • Je, Hyoung-Gon;Lee, Yong-Jik;Jung, Sung-Ho;Jung, Jae-Seung;Kang, Pil-Je;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.423-429
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    • 2008
  • Background: The interest in robotic cardiac surgery has recently grown but there has not been much clinical research reported on this. The aim of this study is to examine our initial experience, since August 2007, with robotic cardiac surgery using the da $Vince^{TM}$ surgical system and to evaluate the feasibility and safety of it. Material and Method: Between August and December 2007, a total of 20 patients underwent robotic cardiac surgery using the da Vinci surgical system. For mitral valve repair (n=11), tricuspid valve repair (n=1), and ASD repair (n=1), cannulation, antegrade cardioplegia and transthoracic aortic cross-clamping were conducted for the right femoral vessels and the right internal jugular vein. For minimally invasive direct CABG (MIDCAB) (n=7), the internal thoracic artery (ITA) was harvested with the da Vinci surgical system. Result: The mean age of the patients was 50.1 (range: $26{\sim}78$) years. Three concomitant Maze procedures and one tricuspid annuloplasty were combined with mitral valve repair. The mean cardiopulmonary bypass time was $208.0{\pm}61.3$ minutes and the aortic cross clamp time was $158.8{\pm}40.6$ minutes. No patients showed more than mild mitral regurgitation after repair and the median hospital stay was 4 days. The robotic-harvested ITA was used for either left ITA (n=6) or bilateral ITA (n=1). The mean harvest time was $43.2{\pm}12.0$ minutes. The harvested ITA showed good flow and it was anastomosed under direct vision after left anterolateral thoracotomy. The patency of all the grafts was 100% (18/18) in MIDCAB. Conclusion: Robotic cardiac surgery using the da Vinci surgical system was variously adapted to areas such as mitral and tricuspid valve repair, ASD repair and ITA harvest for MIDCAB. The early results of the robotic cardiac surgery showed its safety and feasibility. With this primary report, we anticipate that clinical applications and further studies on robotic cardiac surgery using the da Vinci surgical system will be actively conducted in Korea.

GROWTH OF SOUTH AND WEST COAST PACIFIC OYSTER SPATS(CRASSOSTREA GIGAS) AFTER CROSS-TRANSPLANTATION (남해산 및 서해산 참굴(Crassostrea gigas)종패의 상호 이식 후의 성장)

  • CHUNG Jong Rak;KWAK Hi-Sang
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.3 no.2
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    • pp.129-136
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    • 1970
  • As an attempt to determine if the morphological differences between the southern and western oysters are due simply to the local ecological factors or are based on their fundamental genetic nature, oyster seeds produced in 1968 at Tong-Young, Ye-Chun, and Ko-Hung on the south coast and at Kan-Wol-Do on the west coast were cross-transplanted during May of 1969 to compare their growth. The spats were placed in plastic baskets which permitted free water flow through and the baskets hung from a wooden rack located at a tidal zone of less than I hour exposure at a depth chosen to keep the baskets submerged in water at all times. Twice a month the growth of the spats were measured along with the air and water temperature and salinity. The early summer spats, which were $17-240\%$ larger, in size, than the late summer spats at the time of cross-transplantation, grew more slowly than the late summer spats when exposed to identical environmental conditions, shortening the initial gap to a $5-20\%$ level as the first year of the growth phase came to an end in December. The growth of the Kan-Wol-Do spats lagged considerably behind the southern spats at all localities tested, whereas there were no significant differences among the latter groups. This suggests that the morphological differences between southern and western Pacific oysters in Korea are a manifestation of genetic variety and that Pacific oysters cultured along the south coast are of an identical variety as they are commonly believed to be. The seasonal changes in temperature and salinity even during rainy season in both the southern and western coastal areas are well within the range suitable for successful spawning, and spat fall. However, since the results were based on twice-a-month measurements with no data covering the critical period before and after spawning, they can only serve to indicate at best the general pattern of changes in the environmental conditions of each growing area.

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Geochemical and Nd-Sr Isotope Studies for Foliated Granitoids and Mylonitized Gneisses from the Myeongho Area in Northeast Yecheon Shear Zone (예천전단대 북동부 명호지역 엽리상 화강암류와 압쇄 편마암류에 대한 지구화학 및 Nd-Sr 동위원소 연구)

  • Kim, Sung-Won;Lee, Chang-Yun;Ryu, In-Chang
    • Economic and Environmental Geology
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    • v.41 no.3
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    • pp.299-314
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    • 2008
  • The NE-trending Honam shear zone is a broad, dextral strike-slip fault zone between the southern margin of the Okcheon Belt and the Precambrian Yeongnam Massif in South Korea and is parallel to the trend of Sinian deformation that is conspicuous in Far East Asia. In this paper, we report geochemical and isotopic(Sr and Nd) data of mylonitic quartz-muscovite Precambrian gneisses and surrounding foliated hornblende-biotite granitoids near the Myeongho area in the Yecheon Shear Zone, a representative segment of the Honam Shear Zone. Foliated hornblende-biotite granitoids commonly plot in the granodiorite field($SiO_2=61.9-67.1\;wt%$ and $Na_2O+K_2O=5.21-6.99\;wt%$) on $SiO_2$ vs. $Na_2O+K_2O$ discrimination diagram, whereas quartz-muscovite Precambrian orthogneisses plot in the granite field. The foliated hornblende-biotite granitoids are mostly calcic and calc-alkalic and are dominantly magnesian in a modified alkali-lime index(MALI) and Fe# [$=FeO_{total}(FeO_{total}+MgO)$] versus $SiO_2$ diagrams, which correspond with geochemical characteristics of Cordilleran Mesozoic batholiths. The foliated hornblende-biotite granitoids have molar ratios of $Al_2O_3/(CaO+Na_2O+K_2O)$ ranging from 0.89 to 1.10 and are metaluminous to weakly peraluminous, indicating I type. In contrast, Paleoproterozoic orthogneisses have peraluminous compositions, with molar ratios of $Al_2O_3/(CaO+Na_2O+K_2O)$ ranging from 1.11 to 1.22. On trace element spider diagrams normalized to the primitive mantle, the large ion lithophile element(LILE) enrichments(Rb, Ba, Th and U) and negative Ta-Nb-P-Ti anomalies of foliated hornblende-biotite granitoids and mylonitized quartz-muscovite gneisses in the Yecheon Shear Zone are features common to subduction-related granitoids and are also found in granitoids from a crustal source derived from the arc crust of active continental margin. ${\varepsilon}_{Nd}(T)$ and initial Sr-ratio ratios of foliated hornblende-biotite granitoids with suggest the involvement of upper crust-derived melts in granitoid petrogenesis. Foliated hornblende-biotite granitoids in the study area, together with the Yeongju Batholith, show not changing contents of specific elements(Ti, P, Zr, V and Y) from shear zone to the area near the shear zone. These results suggest that no volume changes and geochemical alterations in fluid-rich foliated hornblende-biotite granitoids may occur during deformation, which mass transfer by fluid flow into the shear zone is equal to the mass transfer out of the shear zone.

Improvement of Fontan Circulatory Failure after Conversion to Total Cavopulmonary Connection (완전 대정맥-폐동맥 연결수술로 전환 후의 폰탄순환장애 개선)

  • Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.559-565
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    • 2003
  • By improving the flow pattern in Fontan circuit, total cavopulmonary connection (TCPC) could result in a better outcome than atriopulmonary connection Fontan operation. For the patients with impaired hemodynamics after atriopulmonary Fontan connection, conversion to TCPC can be expected to bring hemodynamic and functional improvement. We studied the results of the revision of the previous Fontan connection to TCPC in patients with failed Fontan circulation. Material and method: From October1979 to June 2002, eight patients who had failed Fontan circulation, underwent revision of previous Fontan operation to TCPC at Yonsei University Hospital. Intracardiac anomalies of the patients were tricuspid atresia (n=4) and other functional single ventricles (n=4). Mean age at TCPC conversion was 14.0$\pm$7.0 years (range, 4.6~26.2 years) and median interval between initial Fontan operation and TCPC was 7.5 years (range, 2.4~14.3 years). All patients had various degree of symptoms and signs of right heart failure. NYHA functional class was 111 or IV in six patients. Paroxysmal atrial fibrillation (n:f), cyanosis (n=2), intraatrial thrombi (n=2), and protein losing enteropathy (PLE) (n=3) were also combined. The previous Fontan operation was revised to extracardiac conduit placement (n=7) and intraatrial lateral tunnel (n=1). Result: There was no operative death. Major morbidities included deep sternal infection (n=1), prolonged pleural effusion over two weeks (n=1), and temporary junctional lachyarrhythrnia (n=1). Postoperative central venous Pressure was lower than the preoperative value (17.9$\pm$3.5 vs. 14.9$\pm$1.0, p=0.049). Follow-up was complete in all patients and extended to 50,1 months (mean, 30.3$\pm$ 12.8 months). There was no late death. All patients were in NYHA class 1 or 11. Paroxysmal supraventricular tachycardia developed in a patient who underwent conversion to intraatrial lateral tunnel procedure, PLE was recurred in two patients among three patients who had had PLE before the convertsion. There was no newly developed PLE. Conclusion: Hemodynamic and functional improvement could be expected for the patients with Fontan circulatory failure after atriopulmonary connection by revision of their previous circulation to TCPC. The conversion could be performed with low risk of morbidity and mortality.

A Study on the Development of a Simulation Model for Predicting Soil Moisture Content and Scheduling Irrigation (토양수분함량 예측 및 계획관개 모의 모형 개발에 관한 연구(I))

  • 김철회;고재군
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.19 no.1
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    • pp.4279-4295
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    • 1977
  • Two types of model were established in order to product the soil moisture content by which information on irrigation could be obtained. Model-I was to represent the soil moisture depletion and was established based on the concept of water balance in a given soil profile. Model-II was a mathematical model derived from the analysis of soil moisture variation curves which were drawn from the observed data. In establishing the Model-I, the method and procedure to estimate parameters for the determination of the variables such as evapotranspirations, effective rainfalls, and drainage amounts were discussed. Empirical equations representing soil moisture variation curves were derived from the observed data as the Model-II. The procedure for forecasting timing and amounts of irrigation under the given soil moisture content was discussed. The established models were checked by comparing the observed data with those predicted by the model. Obtained results are summarized as follows: 1. As a water balance model of a given soil profile, the soil moisture depletion D, could be represented as the equation(2). 2. Among the various empirical formulae for potential evapotranspiration (Etp), Penman's formula was best fit to the data observed with the evaporation pans and tanks in Suweon area. High degree of positive correlation between Penman's predicted data and observed data with a large evaporation pan was confirmed. and the regression enquation was Y=0.7436X+17.2918, where Y represents evaporation rate from large evaporation pan, in mm/10days, and X represents potential evapotranspiration rate estimated by use of Penman's formula. 3. Evapotranspiration, Et, could be estimated from the potential evapotranspiration, Etp, by introducing the consumptive use coefficient, Kc, which was repre sensed by the following relationship: Kc=Kco$.$Ka+Ks‥‥‥(Eq. 6) where Kco : crop coefficient Ka : coefficient depending on the soil moisture content Ks : correction coefficient a. Crop coefficient. Kco. Crop coefficients of barley, bean, and wheat for each growth stage were found to be dependent on the crop. b. Coefficient depending on the soil moisture content, Ka. The values of Ka for clay loam, sandy loam, and loamy sand revealed a similar tendency to those of Pierce type. c. Correction coefficent, Ks. Following relationships were established to estimate Ks values: Ks=Kc-Kco$.$Ka, where Ks=0 if Kc,=Kco$.$K0$\geq$1.0, otherwise Ks=1-Kco$.$Ka 4. Effective rainfall, Re, was estimated by using following relationships : Re=D, if R-D$\geq$0, otherwise, Re=R 5. The difference between rainfall, R, and the soil moisture depletion D, was taken as drainage amount, Wd. {{{{D= SUM from { {i }=1} to n (Et-Re-I+Wd)}}}} if Wd=0, otherwise, {{{{D= SUM from { {i }=tf} to n (Et-Re-I+Wd)}}}} where tf=2∼3 days. 6. The curves and their corresponding empirical equations for the variation of soil moisture depending on the soil types, soil depths are shown on Fig. 8 (a,b.c,d). The general mathematical model on soil moisture variation depending on seasons, weather, and soil types were as follow: {{{{SMC= SUM ( { C}_{i }Exp( { - lambda }_{i } { t}_{i } )+ { Re}_{i } - { Excess}_{i } )}}}} where SMC : soil moisture content C : constant depending on an initial soil moisture content $\lambda$ : constant depending on season t : time Re : effective rainfall Excess : drainage and excess soil moisture other than drainage. The values of $\lambda$ are shown on Table 1. 7. The timing and amount of irrigation could be predicted by the equation (9-a) and (9-b,c), respectively. 8. Under the given conditions, the model for scheduling irrigation was completed. Fig. 9 show computer flow charts of the model. a. To estimate a potential evapotranspiration, Penman's equation was used if a complete observed meteorological data were available, and Jensen-Haise's equation was used if a forecasted meteorological data were available, However none of the observed or forecasted data were available, the equation (15) was used. b. As an input time data, a crop carlender was used, which was made based on the time when the growth stage of the crop shows it's maximum effective leaf coverage. 9. For the purpose of validation of the models, observed data of soil moiture content under various conditions from May, 1975 to July, 1975 were compared to the data predicted by Model-I and Model-II. Model-I shows the relative error of 4.6 to 14.3 percent which is an acceptable range of error in view of engineering purpose. Model-II shows 3 to 16.7 percent of relative error which is a little larger than the one from the Model-I. 10. Comparing two models, the followings are concluded: Model-I established on the theoretical background can predict with a satisfiable reliability far practical use provided that forecasted meteorological data are available. On the other hand, Model-II was superior to Model-I in it's simplicity, but it needs long period and wide scope of observed data to predict acceptable soil moisture content. Further studies are needed on the Model-II to make it acceptable in practical use.

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Effects of Dissolved Oxygen and Depth on the Survival and Filtering Rate and Pseudofeces Production of a Filter-feeding Bivalve (Unio douglasiae) in the Cyanobacterial Bloom (남조류 대발생 환경에서 수심과 용존산소 변화에 따른 담수산 이매패(말조개)의 생존율, 여과율 및 배설물 생산)

  • Park, Ku-Sung;Kim, Baik-Ho;Um, Han-Yong;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
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    • v.41 no.spc
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    • pp.50-60
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    • 2008
  • We performed the experiment to evaluate the effect of different DO concentrations (0.5, 4.5 and 9.0 $mgO_2L^{-1}$) and water depths (20, 50 and 80 cm) on the filtering rate, mortality, and pseudifeces production of Unio douglasiae against the cyanobacterial bloom (mainly Microcystis aeruginosa). A solitary-living bivalve U. douglasiae was collected in the upstream region of the North Han River (Korea). The harvested mussels were carefully transferred to the laboratory artificial management system, which was controlled temperature $(18{\pm}2^{\circ}C)$, flow rate (10L $h^{-1}$), food $(Chlorella^{TM})$, sediment (pebble and clay), light intensity (ca. $20{\mu}mol$ photons), and photocycle (12 L : 12 D). In the field observation, the mussel mortality was significantly correlated with water temperature, pH and DO concentration (P<0.05). The mortality was decreased with water depth; 65, 90, 80% of mortality at 20, 50, 80 cm water-depth, respectively. Filtering rate (FR) showed the highest value at 50 cm water depth, and thereby the concentration of chlorophyll-${\alpha}$ decreased continuously by 94% of the control at the end of the experiment. In contrast, FR decreased by 34% of the initial concentration at 20 cm water depth. Over the given water-depth range, the mussel FR ranged from $0.15{\sim}0.20L\;gAFDW^{-1}hr^{-1}$ during the 18hrs of experiment, and thereafter, they appeared to be approximately 0.11, 0.26 and 0.30 L $gAFDW^{-1}hr^{-1}$ at 20, 50 and 80cm water depth, respectively. FR was highest with the value of 0.46L $gAFDW^{-1}hr^{-1}\;at\;0.5mgO_2 L^{-1}$ at the early stage of the experiment, while it increased with DO concentration. Maximum pseudofaeces production was 11.2 mg $gAFDW^{-1}hr^{-1}\;at\;9.0mgO_2L^{-1}$. Our results conclude that U. douglasiae has a potential to enhance water quality in eutrophic lake by removing dominant cyanobacteria, but their effects vary with environmental parameters and the water depth at which they are located.

Design of a Bit-Serial Divider in GF(2$^{m}$ ) for Elliptic Curve Cryptosystem (타원곡선 암호시스템을 위한 GF(2$^{m}$ )상의 비트-시리얼 나눗셈기 설계)

  • 김창훈;홍춘표;김남식;권순학
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.27 no.12C
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    • pp.1288-1298
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    • 2002
  • To implement elliptic curve cryptosystem in GF(2$\^$m/) at high speed, a fast divider is required. Although bit-parallel architecture is well suited for high speed division operations, elliptic curve cryptosystem requires large m(at least 163) to support a sufficient security. In other words, since the bit-parallel architecture has an area complexity of 0(m$\^$m/), it is not suited for this application. In this paper, we propose a new serial-in serial-out systolic array for computing division operations in GF(2$\^$m/) using the standard basis representation. Based on a modified version of tile binary extended greatest common divisor algorithm, we obtain a new data dependence graph and design an efficient bit-serial systolic divider. The proposed divider has 0(m) time complexity and 0(m) area complexity. If input data come in continuously, the proposed divider can produce division results at a rate of one per m clock cycles, after an initial delay of 5m-2 cycles. Analysis shows that the proposed divider provides a significant reduction in both chip area and computational delay time compared to previously proposed systolic dividers with the same I/O format. Since the proposed divider can perform division operations at high speed with the reduced chip area, it is well suited for division circuit of elliptic curve cryptosystem. Furthermore, since the proposed architecture does not restrict the choice of irreducible polynomial, and has a unidirectional data flow and regularity, it provides a high flexibility and scalability with respect to the field size m.

Changes of CGRP immunoreactivity in rat trigeminal ganglion neurons during tooth movement (백서 삼차신경절내 신경세포체의 치아이동에 따른 CGRP 면역염색성의 변화)

  • Park, Chyo-Sang;Park, Guk-Phil;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.607-621
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    • 1997
  • GRP was known as the modulator of Pain transmission in central nervous system and local effector to peripheral tissue causing vasodilation, increased blood flow, modulation of immune sysem, stimulation of endothelial cell proliferation, and stimulation of bone formation. Numerous study, therefore, were done to elucidate involvement of CGRP to tooth movement. To investgate the response of CGRP immunoreactive nerve cells according to cell size in trigeminal ganglion during tooth movement, immunohistochemical study was performed using rat. Experimental rats(9 weeks old, 210 gm) were divided as six groups(normal(n=6), 3 hour group(n=5), 12 hour group(n=4), 1 day group(n=5), 3 day group(n=5), 7 day group(n=5)), and were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. After frozen sections of trigeminal ganglions were immunostained using rabbit antisera, the changes of CGRP immunoreactive cells in regard to cell size distribution(small cell(upto $20{\mu}m$), medium cell($20-35{\mu}m$), large cell(above $35{\mu}m$)) were observed. The results were as follows 1. The percentage of CGRP immunoreactive cells to all nerve cells in trigeminal ganglion was 33.0% in normal control group, was decreased to 24.5% in 1 day group, and was increased to 41.8% in 7 day group. 2. The percentage of small, medium, and large cells expressing CGRP immunoreactivity in normal trigeminal ganglion to all CGRP immunoreactive cells were 51.3%, 44.0%, 4.7%, respectively. 3. The percentage of small cells with CGRP immunoreactivity to all CGRP immunopositive cells was increased in 3 hour and 12 hour groups. 4. The percentage of medium cells with CGRP immunoreactivity was increaed in 3 day and 7 day groups. 5. The percentage of large cells with CGRP immunoreactivity was increaed in 7 day group. Conclusively, the small cells with CGRP immunoreactivity in trigeminal ganglion respond to orthodontic force during initial phase of tooth movement, and later the medium and large cells with CGRP immunoreactivity respond

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Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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