• Tuberculosis and Respiratory Diseases
• /
• v.58 no.4
• /
• pp.392-398
• /
• 2005

Background : The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. Method : A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. Results : In comparison with the data reported in 1995, the mean age was increased by 3.6 years ($44.1{\pm}14.6$ vs $47.7{\pm}16.4$, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from $2.0{\pm}1.7$ and $6.1{\pm}2.3$ to $1.7{\pm}1.8$ and $4.6{\pm}3.6$(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). Conclusion : The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.

• Journal of Chest Surgery
• /
• v.19 no.1
• /
• pp.35-42
• /
• 1986

Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

• Journal of Nutrition and Health
• /
• v.44 no.1
• /
• pp.61-73
• /
• 2011

The aim of this study was to develop a reliable dietary questionnaire to assess human exposure to food-borne hazards. Eleven food-borne hazards were chosen as a priority control list through a literature review and advisory committees. The 11 food-borne hazards were phthalate, aflatoxin, bisphenol A, polycyclic aromatic hydrocarbons, dioxin, polychlorinated biphenyls, mercury, lead, cadmium, arsenic, and acrylamide. The characteristics, exposure level, and paths of these hazards were reviewed, and questionnaire items were identified to assess human exposure from the literature. A questionnaire was developed for each selected food based on its characteristics. Based on the items in the individual questionnaires, a comprehensive questionnaire, which contained demographic characteristics, job information, socioeconomic factors, health related lifestyles, and dietary behaviors, was developed. A 99-item food frequency questionnaire (FFQ) to assess food-borne hazard exposure was also developed. The FFQ included frequency of food intake during the previous year, container type for purchasing and storing food, and cooking method. The questionnaire developed in this study could be applied to assess dietary factors during an exposure assessment of food-borne hazards in a large population. A validation study for the questionnaire is needed before applying it to surveys.

• Journal of the Korean Applied Science and Technology
• /
• v.36 no.3
• /
• pp.942-953
• /
• 2019

The objective of this study was to evaluate the effects of L-arginine supplementation on muscle damage and fatigue indices and athletic performance improvement of canoe athletes after conducting a high-intensity training program. To achieve the objective, this study applied a high-intensity training program to seven high school canoe athletes. The high-intensity training program is composed of aerobic exercise sessions (twice per week; Tuesday and Thursday), anaerobic exercise sessions (three times per week; Monday, Wednesday, and Friday), and flexibility exercise sessions (five times per week). During the 6 week high-intensity training program, drug ingestion (L-arginine or placebo) was conducted in the first two weeks, wash out (two weeks) followed it, and drug ingestion (L-arginine or placebo) was carried out again in the last two weeks. The crossover design was used for the experiment so all study subjects were assigned to either the L-arginine intake group (the treatment group) or the placebo group (the control group). Each subject ingested 3g per day. This study confirmed the significant effects of L-arginine supplementation on muscle damage indices, fatigue indices, and antioxidants using blood samples. Additionally, FMD was analyzed to evaluate vascular endothelial cell functions and canoe performance was examined using the canoe ergometer. The results of this study showed that L-arginine intake did not have direct effects on the levels of ammonia, IP, and CK. The level of LDH decreased significantly more in the ARG group than in the PLA group due to L-arginine supplementation. Moreover, L-arginine supplementation did not change total NO, d-ROMs, BAP, and FMD significantly. Lastly, the results of the 500m canoe ergometer, which was conducted to evaluate the canoe performance, revealed that L-arginine did not have direct effects on total time, stroke distance, and mean velocity. However, L-arginine supplementation significantly improved muscle damage indices, fatigue indices, antioxidants, FMD, and canoe performance. Therefore, it is believed that additional studies are needed for examining the potential effects of L-arginine supplementation athletic performance enhancement.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.33 no.1
• /
• pp.52-58
• /
• 2004

The active principle responsible for lipid lowering in Chinese cabbage kimchi, 3-(4-hydroxyl-3'5'-dimethoxyphenyl)propionic acid, of molecular weight 226, was chemically synthesized and then used for the treatment of hypercholesterolemia in male New Zealand white rabbit. Hypercholesterolemia in rabbits were induced by feeding 0.5% cholesterol added chow diet for 5 weeks. Each experimental group has four rabbits in it. for the 1st experiment,3-(4-hydroxyl-3'5'-dimethoxyphenyl)propionic acid or simvastatin was injected to the ear vein of rabbit every other day for 16 days (2 mg/3 kg/2 days) while normal chow diet was provided. Blood was drawn every 4th day. For the 2nd experiment, all the experimental condition was same as the 1st trial except 0.5% cholesterol diet was provided while 16 days. Plasma cholesterol level was decreased when cholesterol in the diet was removed. Decreased in cholesterol in kimchi and simvastatin groups were 18.65 and 29.67%, respectively compared to the control when the normal diet was given, and cholesterol increase was inhibited by 33.79 and 21.81% for kimchi and simvastatin groups, respectively, when 0.5% cholesterol diet was provided. The drop in LDL-C level by the active principle of kimchi and simvastatin was not significant when normal diet was given, however the changes was significant (p<0.05), approximately 130% decrease, when 0.5% cholesterol diet was given. The 105% and 62% decreased in triglyceride concentration were observed from 0.5% cholesterol diet fed kimchi and simvastatin groups respectively HDL cholesterol levels in experimental groups were not changed significantly from the both trials. The HMG-CoA reductase activity of kimchi and simvastatin groups were found to be higher than that of control to compensate the hypercholesterolemic condition induced by 0.5% cholesterol diet in these groups. In conclusion, diet is an important factor to control the hypercholesterolemia besides drug treatment. 3-(4-hydroxyl-3'5'-dimethoxyphenyl)propionic acid that is the active principle in Chinese cabbage kimchi seems a beneficial to the hypercholesterolemia and its effect is comparable to that of simvastatin.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.1
• /
• pp.72-81
• /
• 2000

Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

• Korean Journal of Veterinary Research
• /
• v.39 no.5
• /
• pp.878-895
• /
• 1999

Ischemic preconditioing (IPC), i.e., a preliminary brief episode of ischemia and reperfusion, has been shown to reduce the cell damage induced by long ischemia and reperfusion. Superoxide radical which is produced during reperfusion after ischemia was recognized as a factor of the ischemic injury and it is dismutated into $H_2O_2$ and $O_2$ by two types of intracellular superoxide dismutase (SOD), Cu,Zn-SOD in cytoplasm and Mn-SOD in mitochondria. Recently oxygen free radicals are suggested to induce the apoptosis, however mechanism of the reduced apoptosis by ischemic preconditioing was unknown, while many studies performed in mammalian heart indicated that ATP-sensitive $K^+$ ($K_{APT}$) channel activation related with the protective effects. The aim of present study is to investigate 1) whether IP upregulate the Cu,Zn-SOD and Mn-SOD activities, and 2) whether ischemic preconditioning decreases apoptosis via $K_{APT}$ channel activation in timely reperfused skeletal muscle after long ishemia. The experimental animals, Sprague-Dawley rats weighing 250~300g, were divided into 8 groups; 1) control group, 2) ischemic preconditioning only groups, 3) pinacidil, a $K_{APT}$ channel opener, treatment only groups, 4) glibenclamide, a $K_{APT}$ channel blocker, treatment only groups, 5) ischemia groups, 6) ischemia after IPC groups, 7) ischemia and pinacidil treatment groups, and 8) IP and ischemia after glibenclamide pretreatment groups. Animals of the control group were administered with the vehicle (DMSO) alone. Pinacidil (1mg/kg) was administered intravenously 5 minutes after initiation of ischemia, and glibenclamide (0.5mg/kg) was injected intravenously 20 minutes before IPC. In rats that were ischemic preconditioned, the left common iliac artery was occluded for 5 minutes followed by 5 minutes of reperfusion by three times using vascular clamp. Ischemia was done by occlusion of the same artery for 4 hours. The specimens of left rectus femoris muscle were obtained immediately (0 hour), 12 hours, 24 hours after drug administrations, IP or ischemia and reperfusion. The immunoreactivities of SOD and its alterations were observed by use of sheep antihuman Cu,Zn-SOD and Mn-SOD antibodies on the $10{\mu}m$ cryosections. The incidencies of apoptosis were observed by TUNEL methods with in situ apoptosis detection kit on $6{\mu}m$ paraffine section. The results obtained were as follows : 1. After IPC, immunoreactivities of Cu,Zn-SOD mainly in the small-sized fibers were increased by 24 hours, that of Mn-SOD at 0 hour and 24 hours. 2. No significant changes in immunoreactivities of SOD was observed in the pinacidil and in the glibenclamide treatment only groups, and in the ischemia only groups. 3. The immunoreactivities of the Cu,Zn-SOD were increased in the ischemia after IPC groups and the ischemia and pinacidil treatment groups. 4. The immunoreactivities of the Cu,Zn-SOD in the IPC and ischemia after glibenclamide pretreatment groups were not increased except for the 12 hours reperfusion group. But, Mn-SOD immunoreactivities were increased in the 0 hours, 12 hours and 24 hours after reperfusion. 5. In the control group, the IPC only groups, and the pinacidil treatment only groups, negative or trace apoptotic reactions were observed, but the positive apoptotic reaction occured in the glibenclamide treatment groups. 6. Moderate or many number of apoptosis were revealed in the ischemia groups, and also the IPC and ischemia after glibenclamide pretreatment group except for 12 hours and 24 hours after reperfusion. However, the incidence of apoptosis was decreased in the ischemia after IPC groups and in the ischemia and pinacidil treatment groups. 7. There is a coincidence between the increase of Cu,Zn-SOD immunoreactivities and the decrease of apoptosis in the presence of ischemia and reperfusion. These results suggest that the protective effects of ishemic preconditioing may related to the SOD activation, and the ischemic preconditioning decreases the apoptosis partially via $K_{APT}$ channel activation in timely reperfused rat skeletal muscle. It is also suggested that inhibition of apoptosis by IPC may related with the SOD activation.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.34 no.10
• /
• pp.1545-1552
• /
• 2005

Sanguisorba officinalis L. has been used as a traditional remedy for arthritis, neuralgia, diarrhea, vomiting, gastric ulcer and gastro-intestinal disorders. This study was performed to investigate the protective effects of ethylacetate fraction of Sanguisorba officinalis L. ethanol extract (SOE) on the gastric mucosal damage and gastric ulcer induced by HCI-ethanol, indomethacin, Shay-ligation method, restraint and water-immersion stress, and cysteamine in rats. The experiment animals were divided into four groups: a negative control group (CON), positive control group (cimetidine 100 mg/kg-CMT or omeprazol 100 mg/kg administrated group-OMT), SOE 200 mg/kg administrated group (SOL) and SOE 400 mg/kg administrated group (SOH), respectively. Rats were given an oral or intraduodenal administration of SOE, and all SOE treatment groups compared with the CON significantly inhibited HCI-ethanol-induced acute gastritis and indomethacin-induced gastric ulcers in dose-dependent manner, of which effects were lower in a positive control drug (CMT). The inhibition rates ($\%$) on the acute gastritis induced by HCI-ethanol and the gastric ulcers induced by indomethacin in rats, 17.66$\%$ and 48.28$\%$ in SOL, 21.71$\%$, and 51.08$\%$ in SOH, and 47.26$\%$ and 58.26$\%$ in CMT compared with CON, respectively, In pylorus ligated rats, the groups of SOE showed decreases in the volume of gastric secretion and acid output. However, no significant differences were observed in the pepsin activity between treated groups . In addition, SOH also depressed gastric ulcers induced by restraint and water-immersion stress and duodenal ulcers induced by cysteamine. These results suggest that Sanguisorba officinalis L. has remarkable antigastric ulcer effects and could be developed as a new antigastric ulcer agents.

• Journal of Chest Surgery
• /
• v.33 no.9
• /
• pp.697-706
• /
• 2000

Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

• The Korean Society of Law and Medicine
• /
• v.16 no.2
• /
• pp.55-84
• /
• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.