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A Study on the Leakage Protection with Polypropylene Mat in Irrigation Canal (Polypropylene Mat에 의(依)한 용수로(用水路)의 누수방지(漏水防止)에 관(關)한 연구(硏究))

  • Kang, Sin-Up;Kang, Yea-Mook;Cho, Seung-Seup
    • Korean Journal of Agricultural Science
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    • v.6 no.2
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    • pp.166-184
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    • 1979
  • In order to prevent the water loss in the irrigation canal constructed on the sandy gravel layer or on the other highly permeable ground layer, lining has been practiced. Many studies have been done so far on the lining method to prevent the water loss in the irrigation canal and recently studies on the lining with plastic film or polyethylene film were also reported. However, the plastic film or polyethylene film has low strength and is liable to break, and water loss from pin hole caused by contacting with sand or gravel is highly predicted. This study was then conducted to find proper lining and buring method in canal construction of polypropylene mat after coated with vinyl, as one way to overcome the shortcoming frequently observed when plastic or usual polyehtylene film were used. Eventhough rather longer periods of experiments are needed to attain reliable and accurate results on the variation of durability, the durability of asphalt coated area, or on the damage due to freeze after burial or exposure of polypropylene mat, the experiemental results obtained during one year of period are summarized as follows: 1. The curvature at the area between canal bottom and side slope had increased stability and saved consruction cost. The relationship among the variation of curvature, the reduction of polypropylene mat and the reduced amount of soil cutting at each side slope was presented in Fig. 7 through 9. 2. The depth of covering material to protect polypropylene mat was desired to be over 30cm, considering the water depth, side slope, canal cleaning practices, traffic, or back pressure of irrigation period. 3. In order to increase the canal stability and to prevent slope erosion, sandy soil was required, to be placed under ground, and coarse gravel should cover the surface area of canal. 4. The studies on the stability of side slope in the canal should consider the passive area on the bottom and the slope should be about 1 to 2, considering the slope stability, allowable velocity and tractive force. 5. When compared with earth lining, the lining with polypropylene mat coated with vinyl was responsible to save 28% and 37% of canal lining cost, when the soil carrying distances were 500 and 700m. respectively. 6. The water interception was almost completely attained when the polypropylene mat coated with vinyl was used for lining. But further studies were assumed to be necessary for the use of asphalt since the strength of polypropylene mat connected with asphalt will vary with duration.

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Dosimetric Effect on Selectable Optimization Parameters of Volumatric Modulated Arc Therapy (선택적 최적화 변수(Selectable Optimization Parameters)에 따른 부피적조절회전방사선치료(VMAT)의 선량학적 영향)

  • Jung, Jae-Yong;Shin, Yong-Joo;Sohn, Seung-Chang;Kim, Yeon-Rae;Min, Jung-Wan;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.15-25
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    • 2012
  • The aim of this study is to evaluate plan quality and dose accuracy for Volumetric Modulated Arc Therapy (VMAT) on the TG-119 and is to investigate the effects on variation of the selectable optimization parameters of VMAT. VMAT treatment planning was implemented on a Varian iX linear accelerator with ARIA record and verify system (Varian Mecical System Palo Alto, CA) and Oncentra MasterPlan treatment planning system (Nucletron BV, Veenendaal, Netherlands). Plan quality and dosimetric accuracy were evaluated by effect of varying a number of arc, gantry spacing and delivery time for the test geometries provided in TG-119. Plan quality for the target and OAR was evaluated by the mean value and the standard deviation of the Dose Volume Histograms (DVHs). The ionization chamber and $Delta^{4PT}$ bi-planar diode array were used for the dose evaluation. For treatment planning evaluation, all structure sets closed to the goals in the case of single arc, except for the C-shape (hard), and all structure sets achieved the goals in the case of dual arc, except for C-shape (hard). For the variation of a number of arc, the simple structure such as a prostate did not have the difference between single arc and dual arc, whereas the complex structure such as a head and neck showed a superior result in the case of dual arc. The dose distribution with gantry spacing of $4^{\circ}$ was shown better plan quality than the gantry spacing of $6^{\circ}$, but was similar results compared with gantry spacing of $2^{\circ}$. For the verification of dose accuracy with single arc and dual arc, the mean value of a relative error between measured and calculated value were within 3% and 4% for point dose and confidence limit values, respectively. For the verification on dose accuracy with the gantry intervals of $2^{\circ}$, $4^{\circ}$ and $6^{\circ}$, the mean values of relative error were within 3% and 5% for point dose and confidence limit values, respectively. In the verification of dose distribution with $Delta^{4PT}$ bi-planar diode array, gamma passing rate was $98.72{\pm}1.52%$ and $98.3{\pm}1.5%$ for single arc and dual arc, respectively. The confidence limit values were within 4%. The smaller the gantry spacing, the more accuracy results were shown. In this study, we performed the VMAT QA based on TG-119 procedure, and demonstrated that all structure sets were satisfied with acceptance criteria. And also, the results for the selective optimization variables informed the importance of selection for the suitable variables according to the clinical cases.

Antioxidant Properties of the Lotus Leaf Powder Content of Cheongpomuk (연잎 분말 첨가량에 따른 청포묵의 항산화 특성)

  • Moon, Jong-Hee;Hong, Ki-Woon;Yoo, Seung Seok
    • Culinary science and hospitality research
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    • v.22 no.7
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    • pp.112-130
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    • 2016
  • In this study the moisture content and chromaticity of fresh made lotus leaf powder added Cheongpomuk to utilize various efficacy of lotus leaf for processed food, as well as chromaticity, moisture content change, texture, total phenolic compound content, DPPH radical scavenging ability and preference of lotus leaf powder added Cheongpomuk with different storage period have been measured and analyzed. From the texture of lotus leaf powder added mung bean as per the storage period, the hardness of fresh Cheongpomuk were $0.38g/cm^2$ from control group, $0.40g/cm^2$ from CCD 1% group, $0.42g/cm^2$ from CCD 3% group, $0.37g/cm^2$ from CCD 5% group, $0.42g/cm^2$ from GGD 1% group, $0.39g/cm^2$ from GGD 3% group, $0.35g/cm^2$ from GGD 5% group, $0.39g/cm^2$ from JLD 1% group, $0.33g/cm^2$ from JLD 3% group, and $0.32g/cm^2$ from JLD 5% group. It has shown that JLD 5% group was the lowest, while CCD 3% group and GGD 1% group were the highest, and there were significant differences among sample groups. For DPPH radical scavenging ability, that of GLD 5% group was 22 times higher than that of control group. In addition, the tendency was increasing by increasing the adding rate of lotus leaf powder though there was some tolerance among sample groups. For total phenolic compound content, that of control group was 6.65 mg CE/100 g, and others were 7.48 mg CE/100 g from CCD 1% group, 15.82 mg CE/100 g from CCD 3% group, 20.15 mg CE/100 g from CCD 5% group, 15.55mg CE/100 g from GGD 1% group, 23.02 mg CE/100 g from GGD 3%, 26.95 mg CE/100 g from GGD 5% group, 3.92 mg CE/100 g from JLD 1% group, 16.72 mg CE/100 g from JLD 3%, and 26.58 mg CE/100 from JLD 5% group. From the analyzing result of responses for color and scent, taste, elasticity, and total preference of lotus leaf powder added Cheongpomuk between two panel groups, there was significant difference for the color, higher from professional cooking instructor group, but there were no significant difference between two groups for all other factors among professional cooking instructors and cooking department students. According to the results, it is expected that various functional foods can be developed by utilizing lotus leaf powder, depending on the growth condition and cultural environment of each region by adding 3% of lotus leaf powder, would be the most suitable recipe for Cheongpomuk.

Antibiotic Resistance for Common Hospital Acquired-pneumonia Pathogens in the Intensive Care Unit of Newly Opened Hospital (새로 개원한 병원 중환자실에서 주요 원내획득 폐렴 감염균의 연도별 항생제 내성율 변화)

  • Lee, Jae-Hyung;Shin, Sung-Joon;Kim, Young-Chan;Oh, Seung-Il;Kim, Mi-Ok;Park, Eun-Joo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.207-218
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    • 2002
  • Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.

Comparison of Property Changes of Black Jujube and Zizyphus jujube Extracts during Lactic Acid Fermentation (흑대추와 일반 건조대추의 추출 및 유산발효과정 중 특성 변화)

  • Auh, Mi Sun;Kim, Yi Seul;Ahn, Seung Joon;Ahn, Jun Bae;Kim, Kwang Yup
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.10
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    • pp.1346-1355
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    • 2012
  • This study was carried out to investigate the characteristics of black jujube and Zizyphus jujube extracts during lactic acid fermentation. Both extracts were fermented using Lactobacillus fermentum YL-3. As a result, viable cell number rapidly increased until 24 hours, after which it gradually decreased. Before lactic acid fermentation, the $IC_{50}$ of black jujube, which was 0.014 mg/mL, was lower than that of Zizyphus jujube. Further, black jujube showed stronger antioxidant activity (374.21 mg AA eq/g) than Zizyphus jujube. Contents of total polyphenolics in both extracts were 15.46 mg/g and 13.61 mg/g, respectively, whereas contents of total flavonoids were 374.21 ${\mu}g/g$ and 64.25 ${\mu}g/g$. After lactic acid fermentation, there was no significant increase in DPPH or ABTS free radical scavenging activity. Total polyphenolic content of Zizyphus jujube decreased to 12.39 mg/g upon fermentation, whereas flavonoid content significantly increased to 291.58 ${\mu}g/g$. Further, polyphenolic and flavonoid contents of black jujube increased from 15.46 mg/g to 17.46 mg/g and from 374.21 ${\mu}g/g$ to 1,135.29 ${\mu}g/g$, respectively. These results demonstrate that 9-Times Steamed and Dried increased functional components. Especially, lactic acid fermented black jujube showed remarkably high antioxidant activity. These results confirm the potential use of lactic acid fermented black jujube as a valuable resource for the development of functional foods.

Clinical Characteristics and Prognosis of Gastrointestinal Stromal Tumors of Stomach (위의 위장관 간질 종양의 임상적 특징 및 예후)

  • Kim, Min-Hyung;Hur, Hoon;Kim, Sin-Sun;Kim, Sung-Keun;Jeon, Kyung-Hwa;Song, Kyo-Young;Kim, Jin-Jo;Jin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.146-153
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    • 2006
  • Purpose: Gastrointestinal stromal tumorsm (GISTs) are the most common mesenchymal tumors that arise anywhere in the tubular GI tract. The prognosis for GSTIs is important because f GISTs may metastasiwx in the liver or the abdominal cavity in an early stage. For the reason we examined the tumor size, the mitotic number, ki 67, p53, and c-kit mutation as independent prognostic factor for GISTs. Materials and Methods: A retrospective study was conducted in 76 patients who had been re-evaluated for confirmation of diagnosis between Jan 1998 and Dec. 2001. at Catholic University of medicine. Results: There were significant difference between the turner size, mitotic indices, ki 67, c-kit mutations and the 5-years survival rates. Tumor size (${\geq}5\;cm$) and mitotic index (${\geq}5/50\;HPF$) were statistically related to a significantly poor prognosis (P=0.017 and P=0.042, respectively). c-kit mutations in exon 11 were found in 7 cases c-kit mutation was observed more frequently in high risk patients, and there was a significant difference between c-kit mutation and survival (P=0.037). Elevated ki 67 was noted in 34 out of the 76 cases. High risk patients showed elevated ki67 index more frequently and there was significant relation with the survival rate (P=0.0417). Conclusion: We think that tumor size, mitotic index, Ki 67 and c-kit mutation are as independent prognostic factors for GISTs, but more research is needed.

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The Factors Influencing the Systemic Action of Dimethoate (O.O-dimethyl-S-(N-methylcarbamoylmethyl) phosphorodithioate) to the Rice Seeds and Phytotoxic Effects (수도종자에의 Dimethoate 침투력 및 발아저해에 관여하는 요인에 관한 연구)

  • Choi Seung Yoon
    • Korean journal of applied entomology
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    • v.9 no.2
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    • pp.57-74
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    • 1970
  • These experiments were conducted to investigate the :actors influencing the systemic action of Dimethoate (O,O-dimethyl-S-(N-methylcarhamoylmethyl) photphorodithioate) to rice seeds and the phytotoxic effects on the seed germination. Dimethoate $(Roxion^{(R)})$ $40\%$ emulsion was used. The varieties tested were Jinheung. Nongkwang,Suwon #82, Norm #6, Paltal, Shirogane, Suseong, Pungkwang, Shin #2, Fujisaka #5, Kwanok, and Jaekeun. The permeated Dimethoate was extracted from the treated seeds by chloroform and quantities were determined by Spectrophotometer. The phytotoxicity was evaluated from the effects on the germination of the treated seeds which were kept in an incubator. The oxygen consumption was measured by Warburg Manometer at $30^{\circ}C$ for 60 minutes. Indices of KOH disintegration of seeds and chemical composition of the seeds were also determined. The results obtained were as followings; 1) The amount of permeated Dimethoate in the seeds showed remarkable differences with varieties. The amount of Dimethoate per 100 grains was greater as in the ascending order of Suseong, Kwanok, Nongkwang, Jinheung, Paltal, Fujisaka #5, Suwon #82, Norm #6, Shirogane, Shin #2, Pungkwang and Jaekeun. 2) It was observed that the total amount of Dimethoate in the seeds(mg./100 grains) were greater among the varieties with large grain than those with small grains, while reverse cases were true in the amount of Dimethoate in a gramme of seeds, probably because of the greater surface areas In a small grains for a gramme weight. 3) There was no significant correlation between the permeated amount of Dimethoate and amount of absorbed water by the seeds when the seeds were treated with $0.1\%$ Dimethoate for 24 and 48 hours. 4) The permeability of Dimethoate to seeds significantly increased in the prolonged soaking periods, higher concentration, and higher temperature. 5) When the seeds were treated with $0.1\%$ Dimethoate for 24 and 48 hours at $15^{\circ},\;20^{\circ},\; 20^{\circ},\; and \;30^{\circ}C$, the permeated amount of Dimethoate were increased at higher temperature. It seems to be that the more active penetration of Dimethoate was involved at the higher temperature. 6) The phytotoxic effects of Dinethoate on the seed germination varied with the varieties. An descending order of varietal tolerance of seeds was as followings: Jinheung, Fujisaka #5, Suwon #82, Paltal, Nongkwang, Jaekeun, Shin #2, Kwanok, Shirogane, Pungkwang, Suseong, and Norm #6. 7) There was a positive correlation between the amount of Dimethoate permeated into the seeds (mg./gram. of seeds) and phytotoxicity of seeds. 8) The Phytotoxic effects of Dimethoate showed close correlation with the degree of KOH disintegration of seeds, average germination periods, and oxygen respiration of seeds. 9) It was observed that higher protein contents of the seeds decreased the phytotoxic effects of Dimethoate. 10) Relatively high negative correlation between the degree of KOH disintegration of seeds and crude protein content of the seeds was observed. 11) The average germination period was delayed for about 2 days when the seeds were treated with $0.2\%$ Dimethoate for 24 hours at $30^{\circ}C$. 12) The oxygen consumption of the seeds treated with $0.2\%$ Dimethoate for 24 hours at $30^{\circ}C$ was greatly decreased when compared with that of the normal seeds. 13) The amount of oxygen consumption of the seeds (in 24 hours after 24 hours water soaking) was negatively correlated with the average germination periods of the seeds.

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COMPARISON OF POLYMERIZATION SHRINKAGE AND STRAIN STRESS OF SEVERAL COMPOSITE RESINS USING STRAIN GUAGE (스트레인 게이지를 이용한 수종의 복합레진의 중합수축 및 수축응력의 비교)

  • Kim, Young-Kwang;Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.516-526
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    • 2004
  • Polymerization shrinkage of photoinitiation type composite resin cause several clinical problems. The purpose of this study was to evaluate the shrinkage strain stress, linear polymerization shrinkage, compressive strength and microhardness of recently developed composite resins. The composite resins were divided into four groups according to the contents of matrix and filler type. Group I : $Denfil^{TM}$(Vericom, Korea) with conventional matrix, Group II : $Charmfil^{(R)}$(Dentkist, Korea) with microfiller and nanofller mixture, Group III : $Filtek^{TM}$ Z250(3M-ESPE, USA) TEGDMA replaced by UDMA and Bis-EMA(6) in the matrix, and Group IV : $Filtek^{TM}$ Supreme(3M-ESPE, USA) using pure nanofiller. Preparation of acrylic molds were followed by filling and curing with light gun. Strain gauges were attached to each sample and the leads were connected to a strainmeter. With strainmeter shrinkage strain stress and linear polymerization shrinkage was measured for 10 minutes. The data detected at 1 minute and 10 minutes were analysed statistically with ONE-way ANOVA test. To evaluate the mechanical properties of tested materials, compressive hardness test and microhardness test were also rendered. The results can be summarized as follows : 1. Filling materials in acrylic molds showed initial temporary expansion in the early phase of polymerization. This was followed by contraction with the rapid increase in strain stress during the first 1 minute and gradually decreased during post-gel shrinkage phase. After 1 minute, there's no statistical differences of strain stress between groups. The highest strain stress was found in group IV and followed by group III, I, II at 10 minutes-measurement(p>.05). In regression analysis of strain stress, group III showed minimal inclination and followed by group II, I, IV during 1 minute. 2. In linear polymerization shrinkage test, the composite resins in every group showed initial increase of shrinkage velocity during the first 1 minute, followed by gradually decrease of shrinkage velocity. After 1 minute, group IV and group III showed statistical difference(p<.05). After 10 minutes, there were statistical differences between group IV and group I, III(p<.05) and between group II and group III(p<.05). In regression analysis of linear polymerization shrinkage, group II showed minimal inclination and followed by group IV, III, I during 1 minute. 3. In compressive strength test, group III showed the highest strength and followed by group II, IV, I. There were statistical differences between group III and group IV, I(p<.05). 4. In microhardness test, upper surfaces showed higher value than lower surfaces in every group(p<.05).

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Usefulness of Tuberculin Skin Test by Tuberculin PPD RT23 2 TU (Tuberculin PPD RT23 2 TU를 이용한 투베르쿨린 피부반응 검사의 의의)

  • Yang, Jong-Wuk;Jeon, Man-Jo;Kim, Sung-Jung;Lee, Hyang-Lim;Lee, Seung-Jun;Lee, Myoung-Goo;Kim, Dong-Gyu;Park, Myoung-Jae;Kang, Min-Jong;Hyoen, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.401-408
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    • 2002
  • Background : Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. Methods : From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. Results : In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60±16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. Conclusion : In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.

The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter Drainage in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study (소방이 형성된 결핵성 흉막염 환자에서 경피적 도관을 이용한 유로카나제 치료의 효과 ; 전향적 무작위연구)

  • Lee, Yong-Whan;Kwak, Seung-Min;Kwon, Mee-Young;Bae, In-Young;Park, Chan-Sup;Moon, Tae-Hun;Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Hyong-Lyeol;Roh, Hyung-Keun;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.601-608
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    • 1999
  • Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

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