• Tuberculosis and Respiratory Diseases
• /
• 제44권2호
• /
• pp.251-263
• /
• 1997

Background : The emergence of multidrug-resistant strains of Mycobacterium tuberculosis presents a significant challange to the treatment and control of tuberculosis, and there is an urgent need to understand the mechanisms by which strains acquire multidrug resistance. Recent advances in molecular methods for the detection of M. tuberculosis genetic targets have approached the sensitivity of culture. Furthermore the prospect of determining resistance in mycobacteria at the nucleic acid level particulary to first-line drugs like rifampin, isoniazid has provided a glimps of the next generation of sensitivity test for M. tuberculosis. Previous studies in RMP resistant M. tuberculosis have shown that mutation in $\beta$subunit of RNA polymerase is main mechanism of resistance. Method : In this study, rpoB gene for the $\beta$subunit of RNA polymerase from M. tuberculosis of 42 cultured samples (32 were RMP resistant and 10 were sensitive cases) were isolated and characterised the mutations. Direct sequencing data were compared with the results of INNO-LiPA Line Probe Assay (LiPA, Innogenetics, Belgium), commercial RMP resistance detecting kit using reverse hybridization method. Results : All of the RMP resistant samples were revealed the presence of mutation by LiPA. In 22 samples (68.8%) out of 32 RMP resistant cases, the mutation types were confirmed by the positive signal at one of 4 mutation bands in the strip. The most frequent type was R5 (S531L) which were 17 cases (77.3%). Results of direct sequencing were identified the exact characteristics of 8 mutations which were not confirmed by LiPA. S522W type point mutation and 9 base pair deletion at codon 513~515 were new identified mutations for the first time. Conclusion : Mutations in rpoB gene is the main mechanism of RMP resistance in M. tuberculosis and LiPA is a very useful diagnostic tool for the early diagnosis of RMP resistance in M. tuberculosis.

• Tuberculosis and Respiratory Diseases
• /
• 제45권6호
• /
• pp.1154-1166
• /
• 1998

Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

• Tuberculosis and Respiratory Diseases
• /
• 제42권6호
• /
• pp.831-837
• /
• 1995

Background: We conducted a study to determine the factors associated with, patterns of, and proportion of cases of pulmonary tuberculosis with multiple drug-resistance at Kosin medical center in Pusan. Methods: We abstracted data from 141 patients, who had active pulmonary tuberculosis and report forms of drug susceptibility between 1986 and 1994, and related the previous treatment history, the extent of lung involvement and the presence of cavities on chest X-ray films to the drug resistance. Results: Overall, 59(41.8%) of the 141 cases of tuberculosis were resistant to at least one drug and 29(20.9%) of the 139 cases were resistant to isoniazid(INH) and rifampin(RIF). Among the 63 patients with previous tuberculosis therapy, 40(63.5%) had isolates that were drug-resistant and 24(38.1%) were multi-drug resistant. Among the 78 without previous therapy, 19(24.4%) had isolates that were drug-resistant and 5(7.5%) were multi-drug resistant. For all 141, resistance to INH was most common(39.0%) followed by RIF(21.6%), ethambutol(EMB, 16.3%), $\rho$- aminosalicylic acid(10.8%), streptomycin(SM, 8.7%), and pyrazinamide(PZA, 8.0%). INH, RIF and PZA resistances were independently associated with a history of previous tuberculosis therapy (odds ratio; 3.3, 7.2 and 10.8 respectively), and RIF and SM resistance were significantly high according to the extent of lung involvement on the chest films(odds ratio; 2.9 and 2.8 respectively). Conclusions: We conclude, (1) that all persons in whom pulmonary tuberculosis is diagnosed should initially receive at least four-drug therapy(INH, RIF, PZA, and EMB or SM), (2) that susceptibility testing be done in all culture-positive patient, and (3) that those with a history of previous tuberculosis therapy or those who have advanced pulmonary tuberculosis need very careful clinical and microbiological follow-up.

• Tuberculosis and Respiratory Diseases
• /
• 제49권6호
• /
• pp.676-683
• /
• 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.

• Journal of Korea Port Economic Association
• /
• 제25권1호
• /
• pp.15-28
• /
• 2009

The purpose of this paper is to show the empirical extraction way of benchmarking ports for overcoming the shortcoming which the traditional DEA method has by using 20 Korean ports in 2003 for 2 inputs (birthing capacity, cargo handling capacity) and 2 outputs(Export and Import Quantity, Number of Ship Calls). Because DEA method has produced the limited set of efficient units which are reference to inefficient units respective of their differences in efficiency scores, it is necessary to adopt the more feasible benchmarking information according to the path analysis(tier or stratification). The core empirical results of this paper are as follows. Benchmarking ports against inefficient ports according to the tier analysis are that Masan Port(Janghang$\rightarrow$Jeju$\rightarrow$Seogoipo$\rightarrow$Yeosu), Jinhae Port(Janghang$\rightarrow$Mogpo$\rightarrow$Seogoipo$\rightarrow$Wando), Pohang&DonghaePort(Janghang$\rightarrow$Samcheonpo$\rightarrow$Pyungtag$\rightarrow$Samcheog), and Sogcho Port(Janghang$\rightarrow$Mogpo$\rightarrow$Seogoipo$\rightarrow$Wando). The policy implication to the Korean seaports and planners is that Korean seaports should introduce the new methods like Tier analysis of this paper for evaluating the port performance and enhancing the efficiency in short term, mid term, and long term according to the tier 3 stage, the tier 2 stage, and the tier 1 stage with original DEA stage.

• Journal of the Korean Society of Food Science and Nutrition
• /
• 제38권4호
• /
• pp.415-422
• /
• 2009

We previously demonstrated that zinc plus arachidonic acid (ZA) treatment lowered blood glucose levels in streptozotocin-induced diabetic rats, genetically diabetic obese (ob/ob) mice, and genetically diabetic, non-obese Goto-Kakizaki rats. However, plasma insulin levels did not increase with ZA treatment, suggesting that ZA lowers blood glucose levels not by stimulating pancreatic insulin secretion. However, it is unclear whether these agents lower blood glucose levels by decreasing hepatic glucose output (HGO) or by increasing glucose utilization in peripheral tissues, or both. In order to determine ZA target organ of insulin action, we divided 18 Sprague-Dawley rats weighing ${\sim}130g$ into 3 groups (6 rats per group) and treated them for four weeks with: (1) Control diet (regular rat chow), (2) High fructose (60.0%) diet only, and (3) the same fructose diet plus zinc (10 mg/L) and arachidonic acid (50 mg/L) containing drinking water. After 4 weeks, insulin action was assessed using the hyperinsulinemic euglycemic clamp technique. Food intake and body weights were comparable in all three groups of rats throughout the study period. Plasma glucose and insulin concentrations, glucose uptake, and HGO in the basal state were all the same in these three rat groups. During the clamp study, fructose-treated and fructose+ZA treated rat groups did not exhibit any detectable change on insulin-mediated glucose uptake compared to controls. High fructose feeding impaired insulin mediated suppression of HGO, compared to controls during clamp (4.39 vs. 2.35 mg/kg/min; p<0.05). However, ZA treatment in high fructose-fed rats showed a remarkable increase in hepatic insulin sensitivity compared to high fructose-fed rats, reflected by a complete recovery in suppression of HGO during the clamp (4.39 vs. 2.18 mg/kg/min; p<0.05). This data suggests that ZA increases insulin sensitivity in liver but not glucose utilization of peripheral tissues in high fructose-fed rats.

• The Journal of Korean Physical Therapy
• /
• 제16권1호
• /
• pp.140-156
• /
• 2004

This study, to find whether a sports activity and a speciality aptitude activity in school-childhood can affect in forming E.Q, has been done in Gyoung-Nam area and Busan wide city with asked 222 of men and women being in their school-childhood and a group of 85 people who had not joined in such activity, using a E.Q testing paper provided by Dae-Gyo Education Corp,. and Seoul National University Educational Research Institute. Following is the results after analyzing the compiled datas. 1. The E.Q. level difference between people who joined, and who not joined in a sports action activity was reported existing, the total E.Q average of those who joined was resulted 212.6, a point 29.6 higher than those not joined of 183.0 ( p< .05). As for the E.Q causing points, it resulted that the points of the joined group is generally up than that of the non-joined group, especially this difference was remarkable in terms of feeling recognition or feeling control, a finding that deserves an attention ( p<.05) 2. Joining periods of sports activity did also have relation to develping E.Q. of school-childhood according to this research, the total E.Q points of a group joined in the activity more than 2 years was 215.5 points, which was 17.4 points higher than those not joined of 186.5 points ( p< .05). Backing again to E.Q causing points in this case, it resulted without exeption of all main causes that those who joined in more than 2 years are generally higher than that of those joined less than 2 years, especially the difference was regarded as big in terms of feeling recognition or feeling control, a finding that deserves an attention ( p<.01). 3. The E.Q. differnce between those joined in a specialty aptitude activity and not joined was studied existing, the total E.Q average points of those joined in a specialty aptitude activity was 207.8, a higher figure by 21.3 points than those not joined group of 186.5 ( p< .05). As for the E.Q causing points, it resulted without exeption of all main causes that those who joined are generally higher than that of those not joined, especially for feeling recognition or feeling control, this difference was more clear, a finding that deserves an attention ( p<.01). 4. It also resulted that E.Q growth depends on the periods to have joined in a speciality aptitude activity, for example, the total E.Q points of those joined in the activity more than 2 years was 217.1, a total more higher by 13.5 points than 203.6 of those not joined ( p< .05). For the E.Q. causing points, it, with the exception of empathy was resulted that those who joined in the speciality aptitude activity more than 2 years are generally higher than those joined less than 2 years, especially the difference is remarkable in terms of feeling recognition or feeling control, a finding that is also remarkable ( p<.05). 5. The E.Q difference between the men and women who joined in both activities of sports & speciality aptitude was found existing, the total E.Q. average for women was resulted 214.2 points, which was 9.2 points higher than men of 205.0. As for the E.Q. causing points, which, without exeption of main causes, women's was reported being high than that of men, in special is more remarkable in terms of feeling control, a finding that deserves an attention. ( p<.05).

• Clinical and Experimental Pediatrics
• /
• 제49권7호
• /
• pp.777-783
• /
• 2006

Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

• Journal of Preventive Medicine and Public Health
• /
• 제42권6호
• /
• pp.386-391
• /
• 2009

Objectives : This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. Methods : The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. Results : The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT ($p_{trend}$<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. Conclusions : Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was highnormal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.

• Journal of Korean Society of Forest Science
• /
• 제79권4호
• /
• pp.352-358
• /
• 1990

This study was performed to analyze the pollutants contaminated in the soils and leaves of ornamental trees along the Namhae Express way. The results obtained were as follow ; 1. The contents of total sulfur in soils were generally high in site 8 with slope way and site 9 having more traffic volume, as 87 ppm and 74 ppm, respectively, 2. The contents of heavy metals in soils were lower than those of industrial areas and urban roads, and Fe and Pb contents were higher in sites having much traffic volume. 3. The contents of soluble sulfur in leaves were in the range of 0.08%-0.25%. and those of Pinus strobus and Cedrus deodara were the highest as 0.25% and 0.23%, respectively, and that of Euonymus japonica was 0.08%, the lowest. 4. In the case of heavy metals concentration in leaves, the contents of Fe, Mn, Pb, Zn and Cu were in the range of 68-340 ppm, 101-463 ppm, 2.4-4.9ppm, 33-60 ppm and 1.8-5.1 ppm, respectively. Except Fe, there was not a wide difference between sites and species. 5. In the contents of soluble S, Pb and Zn in leaves, the sites between Jinju and Masan having generally much traffic showed more contents than between Jinju and Hadong. Therefore, it is inferred that contents of S, Pb, and Zn are positive related to the traffic volume. 6. Only for Pb, there was significant correlation between the heavy metals in soils and the leaves at 1% level.