Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.
Park, Jin A;Park, Joo Young;Park, Ji Min;Park, Seat Byoul;Kim, Heung Sik;Jeon, Dong Seok
Clinical and Experimental Pediatrics
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v.45
no.8
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pp.1007-1015
/
2002
Purpose : The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination. Methods : We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells. Results : The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes. Conclusion : Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.
Purpose : Methylmalonic aciduria (MMA) and propionic aciduria (PA) are inborn errors in the catabolism of branched-chain amino acids. The study was undertaken to investigate the genotypes and clinical features of Korean patients with MMA and PA. Methods : This study examined 12 patients with MMA and eight with PA. We analyzed various clinical features, laboratory findings, treatments, and neuro-developmental outcomes. Diagnoses were based on the presence of characteristic compounds detected by amino acid analysis in serum and organic acid analysis in urine. Mutation analysis was performed in the genes of MUT, MMAA, MMAB, and MMACHC for MMA and PCCA and PCCB for PA. Results : Among the 20 patients, six patients were diagnosed before one month of age and nine patients were diagnosed after the newborn period. Five patients were diagnosed via a neonatal screening test. Patients with early-onset forms had more severe illness at presentation and generally poor outcomes. A favorable outcome was obtained in 55% patients; most of them were of a late-onset type or diagnosed by neonatal mass screening test without symptoms. Genotypes were confirmed in all patients with MMA. We detected 11 different mutations by MUT gene analysis in 10 patients, and three different mutations in MMACHC genes in two patients. PCCA and PCCB gene mutations were identified in 14 of the 16 alleles, in eight patients with PA. Conclusion : Organic aciduria is a fatal disease; however, better outcomes are expected whenever early diagnosis and prompt management are made possible. Mutation analysis is useful for confirming diagnoses and planning management strategies.
Some circadian rhythms can become disorgnized due to rotating shift work. This lack of organization, termed desynchronization, can produce a group of symptoms such as insomnia, GI disturbance and fatigue among many rotating shift workers. The magnitude of these symptoms are influenced by personal and environmental factors and the patterns of shift work. This study was carried out to investigate the subjective symptoms related to rotational schedules of shift work after personal and environmental factors adjusted. 182 male workers in rapidly rotating shift system and 86 male workers in weekly rotating shift system were conducted the questionnaire on personal factors and subjective sleep, GI and fatigue symptoms. Major findings obtained from this study are as follows: 1. The symptoms of 'feeling tired at work' and 'being irritable' were more frequent in weekly rotating shift workers (P<0.05), and the mean of symptom score was significantly higher in weekly rotating shift workers(P<0.01). 2. According to 6 hours of sleeping which is a definite elevation point of fatigue, there was not a significant difference between two groups in sleeping hours. Among workers in rapidly rotating shift system, the mean of symptom score was significatly higher in workers of less than 6 hours of sleeping(P<0.05), but it was not different among weekly rotating shift workers. 3. The symptoms of GI disturbance were more frequent in weekly rotating shift workers but statistically not significant. 4. The positive rate of mental and physical fatigue symptoms were significantly higher in weekly rotating shift workers(P<0.01) and mental and physical fatigue symptoms were more frequent in them (P<0.01). 5. After the effect of the factors that were significantly different between two groups by $X^2-test$ were controlled, the mean score of sleep disturbance was significantly higher in weekly rotating shift workers (P<0.01) and mental physical fatigue symptoms were more frequent in them (P<0.01). Based on these study results, subjective symptoms were more common in the weekly rotating shift workers. In future, medical examination and laboratory test will be also administered to evaluate a more accurate health outcomes and the review of current shift schedules will be required.
This paper describes a study on the permeability reduction of the riverbed ground during urban railway tunnel construction. The research is mainly concentrated on the study of the grouting or injection methods among permeability reduction methods which can be adapted in the riverbed ground. Firstly, the various grouting methods are theoretically reviewed and compared based on the previous research papers and case study results. It is also evaluated the grouting methods in view of a safe construction of the river crossing railway tunnel. Baced on the literature review and previous construction data, the design technology of grouting methods considering the long term hydro-geological behaviour in the riverbed, is suggested. Two injection methods namely, Natural Durable Stabilizer(N.D.S) and Space-Multi Injaction Grouting(S.M.I) methods, are introduced as new approach methods which can be adopted to modify the riverbed ground. In order to evaluate the ground that grouted and modified by the N.D.S and S.M.I method, the pilot test programmes including the field and laboratory permeability tests, are carried out in the river crossing tunnel construction sites. The results obtained from pilot test programme, are also reviewed. In conclusion, the grouting efficiency of the S.M.I method using the non-alcalimeter silica sol is better than that of NDS method using cement. In addition, it hopes that the research results are contributed to develop the grouting design technology.
Purpose : This study was to analyze serious bacterial infections in infants younger than three months of age and to review the direction of treatments for these patients. Methods : 378 febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ visited from Jan. 2001 through Dec. 2002 were retrospectively studied. Infants with the following criteria belonged to the low risk group. WBC $5,000{\sim}15,000/mm^3$, WBC negative in urine stick test and negative for nitirite test, CSF WBC < $10/mm^3$ and negative in CSF gram stain, negative chest X-ray, stool WBC <5/HFP(high power field), and focal infection. If any of the above criteria were not met, they belonged to the high risk group. SBI was defined as a positive culture of urine, blood or CSF. SI was defined as aseptic meningitis or pneumonia including above laboratory tests of SBI. SBI patients were separately compared with two groups, high risk and low risk. Results : Of the 378 infants that were tested 216(57.1%) were in the high risk group and 162(42.9%) in the low risk group. Among 105 SBI(27.8%) and 172 SI(45.5%), there were 98 urinary tract infection(25.2%), 10 bacteremia(2.6%), 2 bacterial meningitis(0.6%), and 77 aseptic meningitis(22.8%). There were 76 SBI(35.2%) from the high risk group and 29 SBI(17.9%) from the low risk group identified. The results of the sensitivity(72.4%), the specificity(48.7%), the negative predictive value(82.1%) and the positive predictive value (35.2%) were calculated. Conclusion : Even though the probability of SBI in the low risk group is insignificant, it should still be considered in febrile infants younger than 3 months of age. I believe the CSF study is necessary because of the moderate high incidence of abnormal finding in our study.
Kim, Young Kwang;Lee, Kyoung Hoon;Yun, Ki Wook;Lee, Mi Kyung;Lim, In Seok
Pediatric Infection and Vaccine
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v.23
no.3
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pp.194-201
/
2016
Purpose: Monitoring pneumococcal carriage rates is important. We developed and evaluated the accuracy of a real-time reverse transcription polymerase chain reaction (RT-PCR) protocol for the detection of Streptococcus pneumoniae. Methods: In October 2014, 157 nasopharyngeal aspirates were collected from patients aged <18 years admitted to Chung-Ang University Hospital. We developed and evaluated a real-time PCR method for detecting S. pneumoniae by comparing culture findings with the results of the real-time PCR using genomic DNA (gDNA). Of 157 samples, 20 specimens were analyzed in order to compare the results of cultures, real-time PCR, and real-time RT-PCR. Results: The concordance rate between culture findings and the results of real-time PCR was 0.922 (P<0.01, Fisher exact test). The 133 culture-negative samples were confirmed to be negative for S. pneumoniae using real-time PCR. Of the remaining 24 culture-positive samples, 21 were identified as S. pneumonia -positive using real-time PCR. The results of real-time RT-PCR and real-time PCR from 20 specimens were consistent with culture findings for all S. pneumoniae -positive samples except one. Culture and real-time RT-PCR required 26.5 and 4.5 hours to perform, respectively. Conclusions: This study established a real-time RT-PCR method for the detection of pneumococcal carriage in the nasopharynx. Real-time RT-PCR is an accurate, convenient, and time-saving method; therefore, it may be useful for collecting epidemiologic data regarding pneumococcal carriage in children.
Rahman, Siddiqur;Bhuiyan, Salauddin;Islam, Taohidul;Nahar, Azimun;Sarker, Roma Rani;Alam, Emtiaj;Chakrabarty, Amitavo;Sarker, Abu Sayed;Akhter, Laila;Chae, Joon-Seok
Journal of Veterinary Clinics
/
v.31
no.1
/
pp.1-5
/
2014
Feline leukemia virus (FeLV) is a retrovirus that represents one of the most common and important infectious diseases of cats worldwide and it is responsible for more deaths among cats than any other infectious diseases. Prevalence data are necessary to define prophylactic, management and therapeutic measures for stray, feral and owned cats which are lacking in Bangladesh. The study was carried out to determine the prevalence of FeLV infection in Mymensingh district of Bangladesh using RapiGEN$^{(R)}$ FeLV Ag Test Kit (RapiGEN$^{(R)}$ Inc., Republic of Korea), a rapid one-step immunochromatographic assay. Blood samples from total 130 cats (23 owned cats and 107 unowned cats) were collected and tested following the manufacturer's instruction. An overall prevalence of FeLV infection was 1.54% (2/130). Prevalence was found 1.79% (2/112) on Day 0-up to one year aged cats (young) but no positive case was found in above 1 year (Adult) aged group. In male and female cats, the prevalence was 1.72% (1/58) and 1.39% (1/72), respectively. In un-owned cats the prevalence was 1.87%. Positive cases to FeLV were found only in clinically sick cats. No significant relationship was found according to age, sex, ownership status and health status. To the best of our knowledge this is the first report of the prevalence of FeLV infection in Bangladesh using RapiGEN$^{(R)}$ FeLV test kits which is very much effective because it is easy to apply, less expensive and quick screening of such type of infection.
Soil testing for silicon (Si) in the upland soils has not been sufficiently investigated. The objective of this study was to identify a suitable Si extraction method for upland soils of oriental melon (Cucumis melo L.). Thirty-eight surface soil samples and matured leaf samples were collected from plastic film houses in Sungju, Gyeongbuk province. In the laboratory, six different methods were used for extracting Si from the soils. The methods included 0.5 N HCl extraction, 1 N sodium acetate buffer (PH 4.0) extraction, citric acid 1% extraction, water extraction, Tiis buffer pH 7.0 extraction, and extraction after incubation with water for 1 week. The concentration of dissolved Si in soil extracts from all methods was determined colorimetrically. With 1 N sodium acetate buffer extraction, as the available soil Si increased, the concentration ofSi in oriental melon leaf increased until around $14g\;SiO_2\;kg^{-1}$ was reached in the form of a saturation curve. Also, among the methods studied, extraction with 1 N sodium acetate buffer was the only method provided a significant linear correlation with oriental melon leaf Si content in the range of extractable soil Si lower than the level which inducing Si saturation in oriental melon leaf. These results indicate that 1 N sodium acetate buffer extraction procedure is the best soil Si test method for upland soils of oriental melon. This sodium acetate buffer extraction procedure is rapid and quite well acquainted with scientists and farmers, since the method has been used for routine paddy soil testing.
Laboratory dynamic tests are carried out to assess the liquefaction potential of saturated sands in most countries. However, simple results such as the maximum cyclic shear stress and the number of cycles at initial liquefaction are used in the experimental assessment of liquefaction potential, even though various results can be obtained from the dynamic test. In addition, it seemed to be inefficient because more than three dynamic tests with different stress ratio have to be carried out to draw a liquefaction resistance experimental curve. To improve the present assessment method fur liquefaction potential, a new critical resistible characteristic far soil liquefaction is proposed and verified through conventional cyclic triaxial tests with Jumunjin sand. In the proposed method, various experimental data such as effective stress path, stress-strain relationship, and the change of excess pore water pressure can be used in the determination of cumulative plastic shear strains at every 1/4 cycle. Especially, the critical cumulative plastic shear strain to initiate liquefaction can be defined in a specific point called a phase change point in the effective stress path and it can be calculated from a hysteric curve of stress-strain relationship up to this point. Through this research, it is found that the proposed cumulative plastic shear strain can express the dissipated energy to resist dynamic loads and consider the realistic soil dynamic behavior of saturated sands reasonably. It is also found that the critical plastic shear strain can be used as a registible index of soils to represent the critical soil dynamic state, because it seems to include no effect of large deformation.
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