• Tuberculosis and Respiratory Diseases
• /
• v.59 no.5
• /
• pp.473-479
• /
• 2005

Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.4
• /
• pp.406-412
• /
• 2005

Background : Recently, two commercialized whole-blood assays, $QuantiFERON^{(R)}-TB$ Gold (QFT) and T $SPOT-TB^{(R)}$ (SPOT), which measure the $IFN-{\gamma}$ released in the whole blood after being incubation with mycobacterial antigens, were approved for the diagnosis of a latent tuberculosis infection (LTBI). However, there is data on whether or not the previously used PPD skin tests (TST) have any influence on the diagnostic ability of these ex-vivo $IFN-{\gamma}$ assays. Methods : Forty-six 15 year-old students who did not appear to be infected with Mycobacterium tuberculosis were enrolled in this study. The peripheral blood was collected and used for two $IFN-{\gamma}$ assays. The $IFN-{\gamma}$ assays and TST were performed at the baseline ($1^{st}$). The TST was repeated two months later ($2^{nd}$), and the $IFN-{\gamma}$ assays were repeated two ($2^{nd}$) and four months ($3^{rd}$) later only in those subjects who had negative results at the baseline in both the $IFN-{\gamma}$ assays and TST. An induration size > 10 mm was considered to be positive in the TST. Results : The mean TST value was $3.1{\pm}5.4mm$ (range: 0-20). Of the 46 subjects examined, 13 subjects (28.3%) showed positive results in the two-step TST. Nine (19.6%) were SPOT-positive and only one (2.2%) was QFT-positive. The $2^{nd}$ and $3^{rd}$ QFT were carried out in 23 and 25 all-negative subjects, respectively, and all showed negative results. The $2^{nd}$ SPOT was performed in 23 subjects and only one (4.3%) showed a weak-positive result. Conclusion : Even though there were some discrepancies in the results of the two ex-vivo $IFN-{\gamma}$ assays, it appears that their results were not influenced by a previous TST carried out in two or four months earlier.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.1
• /
• pp.44-48
• /
• 2006

Background : Isoniazid (INH) is one of the most effective anti-tuberculosis (TB) drugs. In Korea, the dose of INH normally used in patients over 50 kg is 400 mg/day, which differs from the dose recommended by other countries. Indeed, the metabolism of INH shows ethnic variations, and Koreans are predominantly rapid acetylators. However, two reports suggested 300 mg of INH might be sufficient to reach an ideal peak level in Korean patients over 50 kg. Therefore, the aim of this study was to compare the effectiveness and adverse reactions between INH 300 mg and 400 mg in Korean TB patients. Method : Patients who were culture-positive, susceptible to all 1st-line drugs, initially on HREZ, and weighed over 50 kg were selected from patients with pulmonary TB between April 2003 and March 2005. The treatment results and adverse reactions in the INH 300 mg and 400 mg group were compared. Since April 2004, most TB patients at Asan Medical Center were administered INH 300 mg irrespective of the body weight. Results : The study included 123 patients in the 300 mg INH group and 128 in the 400 mg INH group. There were no significant differences between the groups in terms of age, gender, weight, history of TB treatment, initial smear strength, and frequency of cavitary lesions. There was no difference in the treatment duration between the groups. One hundred eleven (90%) patients in the INH 300 mg group and 102 (80%) in the INH 400 mg group completed treatment (p>0.05). There were no differences in the frequency of modification of the initial regimen between groups due to any adverse reactions (300 mg : 9.0%, 400 mg : 13.7%) and hepatotoxicity (300 mg : 2.7% ; 400 mg : 7.8%). Conclusion : Considering treatment results and adverse reactions of two groups, 300mg of INH may be sufficient for treating Korean TB patients. Further studies comparing the frequency of relapse will be needed.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.1
• /
• pp.38-43
• /
• 2006

Background : Even though two-month rifampicin (RMP, R) and pyrazinamide (PZA, P) treatment has some advantages over isoniazid (INH, H) treatment for latent tuberculosis infection (LTBI), it was withdrawn from the list of treatment regimens for LTBI because of reported cases of severe hepatotoxicity. The purpose of this study was to estimate the frequency of hepatotoxicity of RMP and PZA treatment excluding INH in a Korean population. Method : TIn order to recruit patients who were prescribed RMP and PZA excluding INH, 256 INH-resistant tuberculosis patients were investigated through retrospective medical record analysis. A standard four-drug regimen was changed to a RMP/PZA-containing regimen excluding INH in 64 patients (RZ+ group). In the same study period, 146 patients who were prescribed an INH/RMP/PZA-containing standard regimen were randomly selected as a control (HRZ+ group). Clinical characteristics including liver diseases and the frequency of drug-induced hepatitis were compared between the RZ+ and HRZ+ groups. Result : The mean age of patients in the RZ+ group was 50.2 (${\pm}16.2$) and the male-to-female ratio was 36:28. The frequency of underlying liver diseases was 10.9% (7/64), which was not significantly different from that of the HRZ+ group (4.1%, 6/146). Even though the treatment duration of RZ+ ($5.5{\pm}4.8months$) was longer that than that of HRZ+ ($2.7{\pm}2.3months$), the frequency of toxic hepatitis was not significantly different between RZ+ and HRZ+ groups, 3.5% (2/57) and 7.1% (10/140), respectively. Conclusion : Hepatotoxicity was mild and occurred in a minor proportion of patients in a Korean population prescribed an RMP/PZA-containing regimen. A future prospective study including more patients is needed.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.1
• /
• pp.91-103
• /
• 2003

Background : Histamine is widely distributed in the lung. It increases capillary permeability and the P-selectin expression on vascular endothelial cell surfaces. We studied the role of endogenous histamine on the pathogenesis of endotoxin-induced acute lung injury (ALI) in rats. Methods: We instilled either normal saline (control group) or lipopolysaccharide (3 mg/Kg, LPS group) to tracheas of Sprague-Dawley rats. H1-receptor blocker (mepyramine, 10 mg/Kg, H1RB group), H2-receptor blocker (ranitidine, 10 mg/Kg, H2RB group), and H3-receptor blocker (thioperamide, 2 mg/Kg, H3RB group) were administered through vein or peritoneum along with intratracheal LPS administration. Statistical significance was accepted at p<0.05. Results : LPS increases the histamine level in BAL fluid significantly at 2 h after the treatment compared with control group. LPS significantly increases protein concentration, PMN cell count in bronchoalveolar lavage (BAL) fluid, and myeloperoxidase (MPO) activity in the lung tissue at 6 h compared to control group. PMN cell count in BAL fluid and MPO activity in lung tissue were significantly lower in H2RB-group compared to LPS-group. However, protein concentration in BAL fluid showed no significant differences between the LPS alone and LPS with histamine receptor blockade. Conclusions : Endogenous histamine might be involved in the recruitment of PMNs in LPS-induced ALI via H2 receptor. However, its role in ALI would not be significant in this model.

• Tuberculosis and Respiratory Diseases
• /
• v.65 no.4
• /
• pp.292-300
• /
• 2008

Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.

• Journal of Veterinary Clinics
• /
• v.27 no.4
• /
• pp.330-335
• /
• 2010

This study was performed to compare the anesthetic and cardiorespiratory effects of the tiletamine/zolazepam/xylazine (TZX) combination and tiletamine/zolazepam/midazolam (TZM) combination. Eight healthy Landrace $\times$ Yorkshire pigs were randomly assigned to two groups. Each group was composed of four pigs. The pigs in group 1 (TZX) received tiletamine/zolazepam (2 mg/kg, IM) and xylazine (2 mg/kg, IM). The pigs in group 2 (TZM) received tiletamine/zolazepam (2 mg/kg, IM) and midazolam (0.5 mg/kg, IV). Induction time, anesthesia time and standing time were recorded for each pig. The scores of anesthetic effects were subjectively evaluated every 15 minutes during anesthesia. Cardiopulmonary parameters (heart rate, arterial blood pressure, respiratory rate and rectal temperature) were monitored and recorded 0, 5, 15, 30, 45 and 60 minutes after administration of drugs. Arterial blood gases ($pH_a$, $P_aCO_2$ and $P_aO_2$) and oxygen saturation ($SO_2$) were analyzed at same times. The scores of anesthetic effects decreased in the TZX group compare with the TZM group. From 5 to 85 minutes the mean heart rate in the TZX group was significantly lower than those in the TZM group. Mean arterial blood pressure in the TZX group was significantly higher than those in the TZM group at 5, 15 and 30 minutes. Both drug combinations provided a smooth induction and good immobilization. Scores of anesthetic effects in the TZM group were better than those in the TZX group. The effects to the cardiorespiratory function and temperature were lesser in the TZM group than those in the TZX group. In conclusion, when the two drug combinations were compared, the TZM group showed better anesthetic effects and less cardiorespiratory effects.

• Journal of Veterinary Clinics
• /
• v.26 no.6
• /
• pp.568-573
• /
• 2009

The purpose of this study is to evaluate the analgesic effects on the oral cavity in dogs which are treated with xylazine and electroacupuncture (EA). Furthermore, this study aims to find out its effects on glucose (GLU), serum alanine aminotransferase (ALT), and blood urea nitrogen (BUN) variation values, vital signs (rectal temperature, heart rate, respiratory rate) and pain responses to the noxious stimuli. Eight healthy dogs were randomly assigned to receive either xylazine or EA. Xylazine group dogs with weight of 3.6${\pm}$1.0 kg received 1.5 mg/kg of xylazine intramuscularly. EA group dogs with weight of 3.9${\pm}$1.0 kg received 1 volt (10-15 hz) for 5 minutes, and then 1-9 Volts (25-30 hz) for 60 minutes totally. The acupoints used were LI-3 (San Jian), LI-4 (He Gu) and ST-7 (Xia Guan). All dogs were examined before and 10, 25, 40, 55 and 120 minutes after administration of xylazine or EA. The mean rectal temperatures of the EA group were significantly higher than those of xylazine group after 25, 40 and 55 minutes (p < 0.05). The mean heart rates of the EA group were significantly higher than those of xylazine group after 10, 25, 40 and 55 minutes (p < 0.05). The mean respiratory rates of the EA group were significantly higher than those of xylazine group after 55 and 120 minutes (p < 0.05). The mean GLU concentration of the EA group were significantly lower than those of xylazine group after 55 and 120 minutes (p < 0.05). The sum of mean pain scores (SMPS) of the EA group were significantly higher than those of xylazine group after 10, 25 40 and 55 minutes (p < 0.05). In this study, the pain control of the EA group was shown to be better than that of the xylazine group. Also, there do not appear to be any negative physiologic effects associated with acupuncture-induced surgical analgesia. So, it was considered that these acupoints of EA analgesia might be useful for minor oral surgery in weak patients.

• Food Science and Preservation
• /
• v.21 no.5
• /
• pp.676-687
• /
• 2014

This study investigated the quality changes in cabbage brined with deep sea water salt and in a commercial brined cabbage product. The subject cabbages were separated into two groups: those manufactured in the Lab (ML) and the commercial brined cabbage product (CP). Each group had three brining treatments: with sun-dried salt (S, CS), refined salt (R, CR), and deep sea water salt (D, CD). The salinity level of the ML group was 2.1~2.3%, higher than that of the CP group (1.1~1.5%). The total plate count (TPC) was detected as 5.0 log CFU/g with the S, R, and D treatments at Day 7, but the growth rate of the TPC with the CS, CR, and CD treatments was faster than that with the S, R, and D treatments (6.9~7.7 log CFU/g). A lactic acid bacteria (LAB) level of 5.0~6.6 log CFU/g was also detected in the S, R, and D samples, but only 7.0~7.6 log CFU/g was detected in the CP groups at Day 14. The instrumental hardness levels of the cabbage brined with the deep sea water salts (D and CD) were 3,971 g and 3,932.4 g, respectively, which were significantly higher than those of the samples that were salted with sun-dried salt and refined salt (p<0.05). As for the sensory attributes, S, D, and CD maintained their marketability scores until the end of the storage period for all the properties. CD presented the highest total free amino acid (478.9 mg%), glutamic acid (107.0 mg%), citric acid (428 mg%), and sodium (189 ppm) contents.

• Journal of Veterinary Clinics
• /
• v.20 no.1
• /
• pp.22-25
• /
• 2003

The aims of this study were to investigate the efficacy of acupuncture on myoelectrical activity of inflamed or normal colon in the rat, and whether the effect of acupuncture on colonic motility was related to endogenous opioids. Twenty-two male Sprague-Dawley rats were divided into three groups. Experimental groups were normal group (n = 8), colitis group (n = 6) and naloxone group (n = 8). Stainless steel bipolar electrodes were implanted on the serosal layer of the proximal colon of rats. Colitis was induced 7 days after electrode implantation using trinitrobenzene sulphonic acid (TNBS) and ethanol. Electromyograms (EMG) were recorded by using polygraph 11 days after implantation of electrodes. In normal group, normal colonic motility was recorded for 60 min, and then traditional acupuncture at GV-1 was applied for 20 min and EMG was recorded for further 60 min in untreated rats. In colitis group, after recording of basal colonic motility for 60 min, 20 min of acupuncture treatment and further EMG recording was performed for 60 min in TNBS/ethanol treated rats. In naloxone group, following subcutaneous administration of naloxone (3 mg/kg), recording of EMG and acupuncture treatment were performed in TNBS/ethanol treated rats. In the normal group, acupuncture at GV-1 did not induce significant changes in colonic motility. TNBS/ethanol treatment had no significant effect on the frequency of colonic motility. And in colitis group, GV-1 acupuncture significantly decreased colonic motility (p < 0.01). In naloxone group, after injection of naloxone, acupuncture at GV-1 did not change colonic motility in TNBS/ethanol treated rats. On the inflamed colon, naloxone blocked the effect of acupuncture. The present results suggested that endogenous opioids released by acupuncture at GV-1 decrease the motility of inflamed colon in rats, but not normal colon.