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Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals (국내 민간병원에서 치료한 다제내성결핵 환자의 치료 결과 및 예후 인자)

  • Park, Jin-Kyeong;Koh, Won-Jung;Kim, Deog-Kyeom;Kim, Eun-Kyung;Kim, Yu-Il;Kim, Hee-Jin;Kim, Tae-Hyung;Kim, Jae-Yeol;Park, Moo-Suk;Park, I-Nae;Park, Jae-Seuk;Lee, Ki-Man;Song, Sook-Hee;Lee, Jin-Hwa;Lee, Seung-Heon;Lee, Hyuk-Pyo;Yim, Jae-Joon;Lim, Jae-Min;JeGal, Yang-Jin;Jung, Ki-Hwan;Huh, Jin-Won;Choi, Jae-Chol;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.2
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    • pp.95-102
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    • 2010
  • Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75~80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000. Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals. We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors. Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean body-mass-index was $20.2kg/m^2$. None of the patients tested positive for HIV. Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation. Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159). Default rate was high, 21.8% (37/170). Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality. Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data. The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high. Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea.

Prevalence of Metabolic Syndrome and Related Risk Factors of Elderly Residents in Andong Rural Area 2. Based on the Biochemical Measurements and Nutrient Intakes (안동 농촌지역 중년 및 노인 주민의 대사증후군 유병율과 관련 위험요인 분석 2. 생화학 측정결과와 영양소 섭취를 중심으로)

  • Lee, Hye-Sang;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.10
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    • pp.1459-1466
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    • 2010
  • This study was performed to identify the association between the metabolic syndrome and the biochemical measurements and nutrient intakes. A total of 1,431 people (533 males, 898 females) aged over 45 years living in Andong rural area participated in this study in 2003. Plasma aspartate aminotransferase (AST), alanine aminotransferase (ALT), $\gamma$-glutamyl transferase ($\gamma$-GT) and thiobarbituric acid reactive substances (TBARS) levels in metabolic syndrome were significantly higher than those in normal group. In multiple logistic regression, those biochemical measurements were found to be positively associated with the metabolic syndrome as the adjusted odds ratios (OR) 1.839 (p<0.001) by AST, 2.302 (p<0.01) by ALT, 2.143 (p<0.001) by $\gamma$-GT, and 1.874 (p<0.001) by TBARS. We also found that the increased level of those measurements tended to be strongly associated with high triglyceride among the metabolic syndrome components. However, the nutrient intakes between the metabolic syndrome and the normal group were not significantly different. Also, we could not find any nutrient intakes significantly associated with the metabolic syndrome, except high carbohydrate intake (>70% of kcal) compared to normal intake (55~70% of kcal) showed OR 0.781 (p<0.05). In analyzing the association of nutrient intakes with metabolic syndrome components, we found that the calorie intake was negatively associated with abdominal obesity (OR 0.696, p<0.05) and high fat intake (>25% of kcal) was positively associated with low HDL-cholesterol (OR 1.864, p<0.05). This study revealed that the biochemical measurements, such as plasma AST, ALT, $\gamma$-GT, and TBARS, are associated with metabolic syndrome, but considering the nutrient intakes, we suggest that further studies are needed to identify the associations.

Effects of Thawing Temperature of Frozen rare Breed Hanwoo (Korean Native Cattle) Semen on Viability of Refrozen Spermatozoa (융해 온도가 유전자원 활용을 위한 희소한우(칡소, 흑우 및 백우) 동결 정액의 재 동결 후 정자의 생존성에 미치는 영향)

  • Kim, Min Su;Choi, Arum;Kim, Chan-Lan;Kim, Dongkyo;Seong, Hwan-Hoo;Kim, Sung Woo
    • Journal of Embryo Transfer
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    • v.32 no.1
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    • pp.1-8
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    • 2017
  • Cryopreservation of germ cells from genetically proven animals could be a source of restoration tools from the risk of extinction or disappearance of wanted characteristics. Using frozen semen, the genetic gains of Korean native cattle have been increased greatly for 70 years. The preservation of genetic resources as a form of frozen semen straw has limited availability due to the numbers. To circumvent this weakness of frozen semen, we tested two re-freezing methods with different initial thawing temperatures using frozen Korean proven semen and rare breed semen from albino, black and chikso breeders. It has been known that human sperm could resist to cryo-damages by repeated freeze-thaw cycles, but not for Korean proven bulls number (KPN) or for rare breeds. Total 7 frozen semem from brindled(2), black(1), Korean Albino(2) and KPN(1) bulls were used for our research. After thawing straws under $5^{\circ}C/2min$ or $37^{\circ}C/40sec$ with low temperature water bath and thermo jug, spermatozoa were re-diluted with triladyl diluents after first thawing and re-frozen. Sperm motilities were compared between animals and treated groups after re-thawing. Mean values of motility and viability of refrozen/thawed sperm for expansion of the number of straws were significantly higher in $5^{\circ}C$ than in $37^{\circ}C$ (P < 0.05). However, the activity of viable sperm thawed at $5^{\circ}C$ was significantly decreased before refreezing. It is estimated that re-freezing of frozen semen from rare Korean native cattle is possible with resistant properties of survived spermatozoa.

A study on dosimetric comparison of craniospinal irradiation using tomotherpy and reproducibility of position (토모테라피를 이용한 뇌척수조사의 선량적 비교와 자세 재현성에 대한 고찰)

  • Lee, Heejeong;Kim, Jooho;Lee, Sangkyu;Yoon, Jongwon;Cho, Jeonghee
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.69-76
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    • 2017
  • Purpose: The purpose of this study was to verify dosimetric results and reproducibility of position during craniospinal irradiation (CSI) using tomotherapy (Accuray Incorporated, USA). Also, by comparing with conventional CSI Technique, we confirmed the efficiency of using a Tomotherapy. Materials and Methods: 10 CSI patients who get tomotherapy participate. Patient-specific quality assurances (QA) for each patient are conducted before treatment. When treating, we took Megavoltage Computed Tomography (MVCT) that range of head and neck before treatment, L spine area after treatment. Also we conducted in-vivo dosimetry to check a scalp dose. Finally, we made a 3D conventional radiation therapy(3D-CRT) of those patients to compare dosimetric differences with tomotherapy treatment planning. Results: V107, V95 of brain is 0 %, 97.2 % in tomotherapy, and 0.3 %, 95.1 % in 3D-CRT. In spine, value of V107, V95 is 0.2 %, 18.6 % in tomotherapy and 89.6 %, 69.9 % in 3D-CRT. Except kidney and lung, tomotherapy reduced normal organ doses than 3D-CRT. The maximum positioning error value of X, Y, Z was 10.2 mm, -8.9 mm, -11.9 mm. Through in-vivo dosimetry, the average of scalp dose was 67.8 % of prescription dose. All patient-specific QA were passed by tolerance value. Conclusion: CSI using tomotherapy had a risk of parallel organ such as lung and kidney because of integral dose in low dose area. However, it demonstrated dosimetric superiority at a target and saved normal organ to reduce high dose. Also results of reproducibility were not exceeded margins that estimated treatment planning and invivo dosimetry showed to reduce scalp dose. Therefore, CSI using tomotherapy is considered to efficient method to make up for 3D-CRT.

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A Study on the Consciousness Survey for the Establishment of Safety Village in Disaster (재난안전마을 구축을 위한 의식조사 연구)

  • Koo, Wonhoi;Baek, Minho
    • Journal of the Society of Disaster Information
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    • v.14 no.3
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    • pp.238-246
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    • 2018
  • Purpose: The purpose of this study is to examine the directions for establishing a disaster safety village in rural areas where damage from a similar type of disaster occurs repeatedly by conducting the consciousness survey targeting at experts and disaster safety officials in a local government. Method: The risks of disaster in rural areas were examined and the concept and characteristics of disaster safety village which is a measure on the basis of Myeon (township) among the measures of village unit were examined in order to carry out this study. In addition, opinion polling targeting at officials-in-charge in the local government and survey targeting at experts in disaster safety and building village were conducted. Based on the findings, the directions for establishing a disaster safety village that fitted the characteristics of rural areas were examined. Result: The officials-in-charge in the local government answered that rural areas have a high risk of storm and flood such as heavy snowing, typhoon, drought, and heavy rain as well as forest fire, and it is difficult to draw voluntary participation of farmers for disaster management activities due to their main duties. They also replied that active support and participation of residents in rural areas are necessary for future improvement measures. The experts mostly replied that the problem of disaster safety village project is a temporary project which has low sustainability, and the lack of connections between the central government, local governments and residents was stressed out as the difficulties. They said that measures to secure the budget and the directions of project promotion system should be promoted by the central government, local governments and residents together. Conclusion: The results of this study are as follows. First, a disaster safety village should be established in consideration of the disaster types and characteristics. Second, measures to secure the budget for utilizing the central government fund as well as local government fund and village development fund should be prepared when establishing and operating a disaster safety village in rural areas. Third, measures to utilize a disaster safety village in rural areas for a long period of time such as the re-authorization system should be prepared in order to continuously operate and manage such villages after its establishment. Fourth, detailed measures that allow residents of rural areas to positively participate in the activities for establishing a disaster safety village in rural areas should be prepared.

Aquatic exercise for the treatment of knee osteoarthritis: a systematic review & meta analysis (무릎 골관절염 환자를 대상으로 한 수중 운동과 지상운동 비교: 체계적 문헌고찰 및 메타분석)

  • Kim, Young-il;Choi, Hyo-Shin;Han, Jung-haw;Kim, Juyoung;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6099-6111
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    • 2015
  • This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.

A Loan System of funding Research Projects for Starting Up Venture Business(A Research fund Management System Incorporating Business Concept) (벤처기업 육성을 위한 대여 연구비 관리제도(Business형 연구관리제도))

  • 강박광;황희융
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.1 no.1
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    • pp.73-82
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    • 2000
  • Conventional funding system for the university research projects is limited to a grant or subsidy type funding method which does not require an obligation of refund. Such a funding system is known as ideal one for the university research activities which in general is not a profit oriented activities. It is considered ideal in a sense that nonprofit oriented research activities gives more emphasis on creativity than on efficiency or practical value. A venture- business-start-up research activity can not be considered as a pure nonprofit oriented activities. It clearly gives more emphasis on efficiency and practical value than on creativity Recently a large portion of the venture-business-start-up research activities are carried out in the universities. When a conventional research funding system is applied to such a new type of research activities, it turned out that the success rate is much lower than expectancy. This is why a new and differentiated funding system is sought for such a new type of research activities. A funding system of loan type for a venture-business-start-up research activities is proposed herewith. A loan system naturally requires a pay back after the successful start up of the venture business. This loan system nay be considered that a business concept is grafted on a conventional funding system for the university research activities. This means that a rather loose or generous terms and conditions of the money loan case is introduced into this funding system to remedy the short comings of the intrinsic nonprofit nature of the university research activities. The point is how to improve the success rate and how to reduce the undesirable aspect of the conventional university research activities when it is practiced with the new type of research activities. After one and half year of practicing with the new funding system. it can not be asserted that a definitely positive results could be obtained. but a trend of desirable aspects could be observed such as low drop out rate. project selection efficiency, higher sense of responsibility. etc.

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Open Heart Surgery after Pulmonary Artery Banding in Children (소아에서 폐동맥밴딩술후의 개심술 치료)

  • 김근직;천종록;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.781-789
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    • 1999
  • Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

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Association of Lifestyle with Blood Pressure (생활양식과 혈압의 관련성)

  • Joo, Ree;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.497-507
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    • 1997
  • This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives (97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake (low, moderate, high), the frequency' of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total choles terol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.045, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).

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Effects of Medicinal Enzyme Powder on Intestinal Mobility, Lipid Level, and Blood Parameters of Loperamide-Induced Constipation in Rats (약선효소 분말식이가 Loperamide의 투여로 유발된 변비 쥐의 장 운동과 지질 함량 및 혈액학적 성분 변화에 미치는 영향)

  • Park, Chan Sung;Park, Kyung Soo;Kim, Mi Lim;Kong, Hyun Joo;Yang, Kyung Mi
    • Journal of Life Science
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    • v.23 no.2
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    • pp.228-236
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    • 2013
  • This study was aimed at investigating whether dietary therapy using medicinal enzyme powder is effective in reducing constipation caused by loperamide in rats. Nine-week-old male Sprague Dawley were subdivided into 4 groups: normal diet group (C), loperamide treatment and normal diet (CL), medicinal enzyme powder diet (E), and loperamide treatment and medicinal enzyme powder diet (EL). Constipation was induced by subcutaneous injection of loperamide (1.5 mg/kg) 3 days prior to sacrifice. The treatment with loperamide led to an increase in weight gain, a decrease in the number and wet weight of fecal pellets, and a decrease in intestinal motility. The administration of the medicinal enzyme powder significantly reduced weight gain but increased intestinal mobility compared with the loperamide-treated group. The treatment with loperamide in the normal diet group reduced the activities of both suggesting that constipation may be involved in the low level of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT). Additionally, the loperamide treatment in the medicinal enzyme powder diet group increased the level of GOT, but reduced the level of GPT. Loperamide treatment also reduced cholesterol and increased the atherogenic index (AI) and cardiac risk factors (CRFs). Interestingly, the treatment with the medicinal enzyme powder effectively attenuated both the increase in AI and the reduction in high density lipopretein (HDL)-cholesterol, caused by the treatment with loperamide. Although there were no significant differences in the blood protein level, including hemoglobin and hematocrit, between the normal diet group and the loperamide-treated group, the administration of the medicinal enzyme powder to the loperamide-treated group effectively increased the levels of both hemoglobin and hematocrit. Collectively, the results demonstrate that the medicinal enzyme powder can help to combat the negative events caused by constipation.