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Rifabutin Susceptibility and rpoB Gene Mutations in Multi-drug Resistant Mycobacterium Tuberculosis (다제내성 결핵균에서 Rifabutin감수성과 rpoB 유전자 돌연변이 양상의 비교 연구)

  • Shim, Tae-Sun;Kim, Jin-Sub;Park, Mi-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.853-869
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    • 2000
  • Background : Following several decades of decline, the incidence of tuberculosis has recent1y begun to increase in many countries of this the control of this disease has been impeded by the emergence of multi-drug resistant tuberculosis (MDR-TB). The development of rapid diagnostic methods and effective new drugs are needed to control MDR-TB. One of the new drugs for MDR-TB is rifabutin (RBU) which has been known to be effective in some patients with MDR-TB. A few reports showed that some types of mutations of the rpoB gene, which were known to be present in 96-98% of rifampicin-resistant M. tuberculosis, were associated with the rifampicin-resistant but RBU-susceptible phenotype. This study was performed to investigate the correlation between RBU susceptibility and the patterns of rpoB gene mutations in Korean MDR-TB. Methods : Sixty-five clinical isolates of multi-drug resistant Mycobacterium tuberculosis, gathered from patients who visited the Asan Medical Center from July 1997 to June 1999, were investigated. Clinical responses to rifabutin-containing regimen were evaluated. An RBU susceptibility test and sequencing analysis of rpoB gene were performed, and the results were analyzed to confirm which mutations correlated with RBU-susceptible MDR-TB. Results : Fifty-three of 56 (95%) clinical isolates of MDR-TB had 60 mutations of the rpoB gene. The most frequent mutations were found at codon 531 (43%), and two mutations were combined in seven clinical isolates. Five of 53 (10%) clinical isolates showed the RBU-susceptible phenotype, and in them the characteristic patterns of point mutations were found at codon 509, 516, and 526. Conclusion : The frequency and pattern of mutations of the rpoB gene of Korean MDR-TB isolates were similar to those in western countries, where the prevalence of tuberculosis is low, but some show RBU-susceptible phenotypes. RBU-susceptible MDR-TB isolates showed the characteristic pattern of mutations of the rpoB gene which could be used to rapidly diagnose RBU susceptibility.

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Predictors of Drug-resistance in Patients with Pulmonary Tuberculosis (폐결핵환자에서 약제내성의 예측인자)

  • Koh, Hyung-Ki;Kang, Yoon-Jung;Lim, Sung-Yong;Shin, Jong-Wook;Choi, Jae-Sun;Yoo, Ji-Hoon;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.311-316
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    • 1999
  • Background: The drug-resistant tuberculosis has recently decreased in Korea, but it is still one of the major obstacles in the treatment of pulmonary tuberculosis. Unfortunately there are no reliable ways to figure out the drug sensitivity pattern of the M. tuberculosis in the starting point of treatment. At least several months which is critical for the success of treatment have to be passed away before getting the report of drug-sensitivity test. The aim of this study was to find out the clinical and radiological parameters that make it possible to predict the drug-resistant pulmonary tuberculosis and to make a correct decision on the antituberculosis drug regimens. Method: We studied 253 pulmonary TB patients with sputum and/or bronchial washing fluid culture-positive diagnosed at the Chung-Ang University Young-San Hospital in the period of 1989-1994. The differences in the clinical and raiological variables between the drug-sensitive and the drug-resistant tuberculosis patients were evaluated. Results: In 66 out of 253 patients(26.1%), drug resistant tuberculosis to at least one antituberculosis drug were found. Patients with retreatment showed higher resistance rate than those with initial treatment(30/69, 43.5% vs 36/184, 19.5%, p<0.01). Patients with cavitary TB showed higher resistance rate than those with non-cavitary TB(24/54, 44.4% vs 42/199, 21.1%, p<0.05). Among patients with initial treatment, those with far-advanced TB showed a higher drug resistance rate than those with minimal lesion(9/23, 36.9% vs 10/82, 12.5%, p<0.05). Patients with culture positive only in the bronchial washing fluid showed lower resistance rate than those with sputum culture positive(7/63, 11.1 % vs 59/190, 31.1%, p<0.05). Conclusion: Prior treatment history for pulmonary tuberculosis, the presence of cavity & far advanced tuberculosis in the radiologic exam, sputum rather than solely bronchial washing culture positivity would be the related factors to the drug resistance. So in the patients with such characteristics, it is needed to try to find out the drug sensitivity pattern of the infecting tuberculosis organism as soon as possible.

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Development of Technology·Home Economics teaching-learning plans using ARCS strategies to improve character for middle school students: Focusing on the unit of 'Understanding families' (인성교육을 위해 기술·가정교과 '가족의 이해' 단원에 ARCS 동기유발 전략을 적용한 교수·학습 과정안 개발 및 평가)

  • Kang, Jimin;Yu, Nan Sook
    • Journal of Korean Home Economics Education Association
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    • v.30 no.1
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    • pp.29-42
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    • 2018
  • The purposes of this study were to develop and apply teaching-learning plans using ARCS strategies to improve character of middle school students and analyze whether a home economics class helps to give positive effects on youth character change. Nine-period classes were conducted for 110 male students in 4 classes of M middle school in Gwangju metropolitan city for 5 weeks from March 6 through April 7 in 2017. The effectiveness of classes were examined with learners' class assessment and pre- and post- character index test. The research steps and results in this study are as follows. First, the teaching-learning plans for 9 periods were developed for the character education class of the chapter 'Understanding families'. These teaching and learning course plans were designed to enhance learner's interests in learning using ARCS motivational strategy and improve character of middle school students in consideration of character elements. In the chapter 'Understanding families' of Technology Home Economics in middle school, the teaching-learning plans for 9 periods, 14 student activity sheets, and 2 powerpoint materials for teaching and learning were developed. Second, students who had the character education classes using ARCS motivational strategy showed significant differences in all character elements. Therefore, the character education class using ARCS shows positive effects to build up character of middle school students. Third, the character education classes using ARCS motivational strategy increased the class satisfaction of learners. The character education class teaching and learning course plans and learning materials in Technology Home Economics using ARCS motivational strategy will be used as a basic resource to build up students' character in the future.

Anti-inflammatory effects of Ishige sinicola ethanol extract in LPS-induced RAW 264.7 cell and mouse model (LPS로 유도된 RAW 264.7 Cell과 마우스 모델에 대한 넓패(Ishige sinicola) 에탄올 추출물의 항염증 효과)

  • Kim, Ji-Hye;Kim, Min-Ji;Kim, Koth-Bong-Woo-Ri;Park, Sun-Hee;Cho, Kwang-Su;Kim, Go-Eun;XU, Xiaotong;Lee, Da-Hye;Park, Ga-Ryeong;Ahn, Dong-Hyun
    • Food Science and Preservation
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    • v.24 no.8
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    • pp.1149-1157
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    • 2017
  • Inflammation is the first response of the immune system to infection or irritation in our body. The use of medicinal plants has been widely applied as an alternative source for drug development. One of marine natural resources, the anti-inflammatory effect of Ishige sinicola ethanol extract (ISEE), was evaluated by using LPS-induced RAW 264.7 cell and mice model. As a result, the production of nitric oxide (NO) and pro-inflammatory cytokines (IL-6, IL-$1{\beta}$, TNF-${\alpha}$) were inhibited with increasing concentration of ISEE without any cytotoxicity. Furthermore, ISEE suppressed the expression of not only inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear factor-kappa B (NF-${\kappa}B$) p65, and mitogen-activated protein kinases (MAPKs), including extracellular signal-regulated kinase (ERK) 1/2, p38, and c-Jun N-terminal kinase (JNK) in a dose-dependent manner. In mice ear edema test, the formation of edema was reduced at the highest dosage of ISEE and the reduction of the number of infiltrated mast cells was observed in histological analysis. These results indicate that ISEE has a potent anti-inflammatory activity and can be used as a pharmaceutical material for many kinds of inflammatory disease.

A Comparative Study of Physiological Activity and Ingredient Analysis of Glycyrrhiza uralensis Fischer Stems and Leaves Cultivated with Different Wavelength of LED Lights (LED광원에 따른 감초 지상부의 생리활성 및 성분 평가)

  • Bang, Keuk Soo;Chang, Young Nam;Jin, Jong Sik;Park, Sang A;Lim, Jae Soo;Park, Jeong Sub;Kim, Jong Sung;Lee, Jeong Ho
    • Korean Journal of Plant Resources
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    • v.28 no.1
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    • pp.126-134
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    • 2015
  • Glycyrrhiza uralensis Fischer is one of the most commonly used herbs. Recently, the stem and leave of the plant have been interested in physiological activities because the aerial parts have been thrown away. Finding out cultivation method of Glycyrrhiza uralensis Fischer to improve chemical ingredients and biological activities has been tried these days. In this study, different wavelengths of light emitting diode (LED) were used for a cultivation of Glycyrrhiza uralensis Fischer. Antioxidant activities and inhibitory effect on mutagenecity of samples were evaluated. The stem and leave cultivated under blue light (BL-0) showed the strongest antioxidant activities of $3.02{\pm}0.13{\mu}g/ml$ ($EC_{50}$) and $2.18{\pm}0.18{\mu}g/ml$ ($EC_{50}$) in DPPH and ABTS radical scavenging test, respectively. Total phenolic content of BL-0 was $2.93{\pm}0.11g/100g$, the highest value between cultivation conditions. However, antioxidant activities of the stem and leave cultivated under red light were the weakest between samples. All of the stem and leave used in this study showed inhibitory effect on mutagenecity of 1-nitropyrene. BL-0 showed stronger inhibitory effects on mutagenicity of Trp-P-1, Trp-P-2, and AFB1 than samples cultivated under other conditions. Only on mutagenecity of 2-aminoanthracene, the stem and leave cultivated at 1 m apart from red light (RL-1) showed the strongest inhibitory effect. These results indicate that blue LED might be the most effective condition for improvement of physiological activities for the aerial parts of Glycyrrhiza uralensis Fischer in cultivation. The components were identified with GC/MS. Cytidine was detected only in RL-1 at 25 min of retention time and 2-bromotrimethylene glycol was detected only in BL-0 at 37 min.

A Study of the Attitudes of Nonpsychiatric Registered Nurses towards Mental illness and Mental Patients (비정신과 간호원의 정신질환 및 정신질환자에 대한 태도 조사 연구)

  • 박예숙
    • Journal of Korean Academy of Nursing
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    • v.3 no.2
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    • pp.31-43
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    • 1973
  • The trend in modern nursing is toward the performance of comprehensive nursing care. Psychiatric nursing emphasizes education which enables the nurse to understand the underlying difficulties being expressed through a wide range of emotions and through practice to be more adept in her selection of a manner of approach which best meets the needs of a given situation. Presently, in Korea, there is nothing in the literature regarding evaluation of the effect of psychiatric nursing education on the attitudes of nurses towards mental illness and mentally ill patients. This stud!1 was attempted in order to understand 1) some of the problems in psychiatric nursing education 2) some of tile factors which affect the attitudes of nurses towards mental illness and mental patients. A questionnaire, a Korean translation of the "Opinions about Mental illness Scale" by Cohen and Stranding, 1962, was administered to 188 nonpsychiatric registered nurses employed in Yonsei University Hospital (Y. Hospital) and Seoul National University Hospital (S. Hospital) located in the city of Seoul. All of the nurses were directly involved with adult patient care. They graduated from various nursing schools. The data was collected during the period of October 2 to October 16,1972. The age, educational background , marital status, type of previous psychiatric experience, experience as a graduate nurse and close personal relationship with someone who was a psychiatric patient were compared with the O.M.I. scores. The mean and standard errors for each of the comparison groups were computed and tile relationships calculated by a t-test. The results of the study are summarized as follow: 1. There is no significant difference between the age of the nurses and their attitudes toward mental illness and mental patients. 2. There is no significant difference between the. educational backgrounds of the nurses and their attitudes toward mental illness and mental patients. 3. There is a significant difference in the nurses ′student psychiatric nursing experience and their attitudes towards mental illness and mental patients for the nurses in 5. Hospital only. The nurses who had 3-4 week of student psychiatric nursing experience had a significantly higher mean score for Benevolence (factor B) than nurses whose student psychiatric experience had been less than 1 Ivcek (P<0.05). The nurses who had 1-2 weeks, 3-4 weeks and more than 4 weeks of student psychiatric nursing experience had significantly higher mean scores for Interpersonal Ethology (factor E) than nurses whose student psychiatric had been less than 1 week (p<0.05), 4. There is a significant difference in the nurses′student psychiatric nursing experience by types of institution and their attitudes towards mental illness and mental patients for S. Hospital nurses only. The nurses who had their student psychiatric nursing experience in the government psychiatric hospitals recorded significantly higher mean score for Authoritarianism (factor A) than nurses who had their. experience in private psychiatric hospitals (p<0.05). 5. There is no significant difference in the nurses′psychiatric nursing experience as a graduate nurse and their attitudes toward mental illness and mental patients. 6. There is no significant difference in the nature and variety of the nurses′experience as a graduate nurse and their attitude toward mental illness and mental patients. 7. There is no significant difference in the presence or absence of a close personal relationship with a mentally ill person and the nurses′attitude toward mental illness and mental patients. 8. There is no significant difference in the nurses′ marital status and their attitude toward mental illness and mental patients. 9. There is no significant difference between the nurses who were employed ill S. and Y. hospitals and their attitudes towards mental illness and mental patients. Major suggestion for further study was to have more larger and wider scale research for establishing of the reliability and validity of the Korean translation of the O.H.I. Scale.

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The Role of Resectional Surgery for the Treatment of Localized Multi-drug Resistant Pulmonary Tuberculosis (국소 병변의 다제 내성 폐결핵 환자에서 폐절제술의 역할)

  • An, Chang-Hyeok;Ahn, Jong-Woon;Kang, Kyeong-Woo;Kang, Soo-Jung;Lim, Young-Hee;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.676-683
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    • 2000
  • Background : Surgery may have a role when medical treatment alone is not successful in patients with multidrug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. Methods : A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). Results : The thirteen patients were $37.5{\pm}12.4$ years old (mean${\pm}$S.D.)(M : F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods ($109.7{\pm}132.0$ months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative $FEV_1$ was $2.37{\pm}0.83$ L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After $41.5{\pm}58.9$ days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. Conclusion : When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.

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The Comorbidity of Periodic Limb Movements Disorder in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자에서의 수면중 주기성 사지운동장애의 동반이환율)

  • Yang, Chang-Kook;Son, Choon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1039-1046
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    • 1998
  • Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

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EFFECT OF FLUORIDE IN NATURAL POLYMER ON ENAMEL DEMINERALIZATION (천연고분자 화합물을 이용한 불소겔이 법랑질 탈회에 미치는 영향)

  • Kim, Ji-Yeon;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.35-43
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    • 2010
  • We have developed a sodium fluoride containing gelatin and methyl cellulose gel. Cariostatic abilities of those gel were investigated and compared with APF gel and fluoride varnish($Cavityshield^{TM}$). We prepared the bovine tooth samples and divided into two surface, control side and experimental side in same specimen for exclusion of difference between specimens. The experiment was consisted of 4 groups : (I) APF gel : (II) $Cavityshield^{TM}$ : (III) Gelatin F gel : (IV) Methyl cellulose F gel Decalcification were produced by placing each specimen into artificial acidic solution(pH 4.0) for 72 hours. Surface microhardness were measured and depth of demineralization lesion were measured by polarizing light microscope. The results were as follows: 1. The difference of VHN between control and experimental side is smallest in group I (p<0.05). 2. The largest difference was shown in group II (p<0.05). 3. There were no significant difference between group III and IV in microhardness test (p>0.05). 4. The difference of lesion depth is smallest in group I (p<0.05). 5. There were no significant difference between group II, III and IV in lesion depth (p>0.05). The result of the present study indicate that the fluoride containing gelatin and methyl cellulose gel is more effective than APF gel and is similar to fluoride varnish application for prevention of demineralization.

Effects of Dietary Quartz Porphyry and Feed Stimulants, BAISM Supplementation on Growth Performance and Disease Resistance of juvenile eel Anguilla japonica (사료내 맥반석과 BAISM 복합첨가가 치어기 뱀장어 Anguilla japonica의 성장과 내병성에 미치는 영향)

  • Bae, Jun-Young;Han, Kyung-Min;Lee, Jun-Ho;Kim, Sang-Eun;Lee, Jeong-Yeol;Bai, Sung-Chul C.
    • Journal of Aquaculture
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    • v.21 no.1
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    • pp.26-33
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    • 2008
  • This study investigated the synergistic effects of dietary supplementation of quartz porphyry(QP) and a laboratory developed feed stimulants, BAISM(BS) on growth performance and utilization as the additives for juvenile eel Anguilla japonica. Six isoenergetic experimental diets(18.2 kJ/g) were formulated to contain 50% crude protein, 15% lipid with or without dietary QP(Song-Gang stone, Davistone, Korea) and BS supplementation. QP and BS were provided at 0% in the control diet($Q_0B_0$) and at 0.7% QP+0% BS($Q_{0.7}B_0$), 0.7% QP+0.3% BS($Q_{0.7}B_{0.3}$), 0.7% QP+0.5% BS($Q_{0.7}B_{0.5}$), 0.7% QP+0.75% BS($Q_{0.7}B_{0.75}$) and 0.7% QP+1.0% BS($Q_{0.7}B_{1.0}$) in experimental diets on dry matter basis. After four weeks of adaptation, triplicate groups of 30 fish initially averaging $15{\pm}0.1g(mean{\pm}SD)$ were randomly distributed into each aquarium, and they were fed one of the experimental diets for 8 weeks. By the end of the feeding trial, weight gain(%), specific growth rate(%), feed efficiency(%) and protein efficiency ratio of fish fed diet $Q_{0.7}B_{0.5},\;Q_{0.7}B_{0.75}\;and\;Q_{0.7}B_{1.0}$, were significantly higher(P<0.05) than those of fish fed the other diets. But, $Q_{0.7}B_{0.5},\;Q_{0.7}B_{0.75}\;and\;Q_{0.7}B_{1.0}$ were no significant differences(P<0.05). In challenge test, fish were infected by intraperitoneal injection of 0.1 mL bacterial suspension with Edwardsiella tarda per fish after the feeding trial. As a result, fish fed QP and BS supplemented diets have a significantly higher cumulative survival rate than those of fish fed control diet(P<0.05). In conclusion, these results indicated that the optimum dietary supplementation level of QP and BS could be approximately 0.7% quartz porphyry+0.5% BAISM($Q_{0.7}B_{0.5}$) of diet based on WG, FER, SGR, PER, cumulative survival rate in juvenile eel A. japonica.