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Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과)

  • Hong, Jae-Rak;Yoo, Min-Kyu;Jeong, Jae-Man;Kim, Young-Jun;Son, Mal-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.693-700
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    • 1996
  • Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

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Effect of Knee Joint Stimulation on the Activity of Phrenic Nerve and Inspiratory Nuron in the Cat (슬관절 자극이 횡격신경 및 흡식중추신경에 미치는 영향)

  • Cho, Dong-Ill;Han, Hee-Chul;Nahm, Sook-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.683-693
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    • 1993
  • Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

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A Study on Real-Time Defect Detection Using Ultrasound Excited Thermography (초음파 서모그라피를 이용한 실시간 결함 검출에 대한 연구)

  • Cho, Jai-Wan;Seo, Yong-Chil;Jung, Seung-Ho;Jung, Hyun-Kyu;Kim, Seung-Ho
    • Journal of the Korean Society for Nondestructive Testing
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    • v.26 no.4
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    • pp.211-219
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    • 2006
  • The UET(ultrasound excited thermography) for the ,eat-time diagnostics of the object employs an infrared camera to image defects of the surface and subsurface which are locally heated using high-frequency putted ultrasonic excitation. The dissipation of high-power ultrasonic energy around the feces of the defects causes an increase In temperature. The defect's image appears as a hot spot (bright IR source) within a dark background field. The UET for nondestructive diagnostic and evaluation is based on the image analysis of the hot spot as a local response to ultrasonic excited heat deposition. In this paper the applicability of VET for fast imaging of defect is described. The ultrasonic energy is injected into the sample through a transducer in the vertical and horizontal directions respectively. The voltage applied to the transducer is measured by digital oscilloscope, and the waveform are compared. Measurements were performed on four kinds of materials: SUS fatigue crack specimen(thickness 14mm), PCB plate(1.8 mm), CFRP plate(3 mm) and Inconel 600 plate (1 mm). A high power ultrasonic energy with pulse durations of 250ms Is injected into the samples in the horizontal and vertical directions respectively The obtained experimental result reveals that the dissipation loss of the ultrasonic energy In the vertical injection is less than that in the horizontal direction. In the cafe or PCB, CFRP, the size of hot spot in the vortical injection if larger than that in horizontal direction. Duration time of the hot spot in the vertical direction is three times as long as that in the horizontal direction. In the case of Inconel 600 plate and SUS sample, the hot spot in the horizontal injection was detected faster than that in the vertical direction

Pregnancy Outcome According to In vitro Fertilization of Supernumerary Oocytes in Gamete Intrafallopian Transfer (생식세포 난관내이식시 잉여난자의 체외수정 결과에 따른 임신 예측도)

  • Kim, Seok-Hyun;Jun, Jong-Kwan;Shin, Chang-Jae;Kim, Jung-Gu;Moon, Shin-Yong;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.1
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    • pp.31-39
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    • 1992
  • By means of the results of In vitro fertilization(IVF) of supernumerary oocytes, the possibility of predicting a pregnancy outcome following gamete intrafallopian transfer(GIFT) and the prognostic implications for future pregnancy were evaluated in 46 GIFT cycles excluding simultaneous program of GIFT and IVF from February, 1989 to July, 1991. IVF of supernumerary oocytes were identified in 21 cycles, but not in remaining 25 cycles. There was no significant difference in age, duration and etiologic factors of infertility, and serum levels of FSH, LH and $E_2$ on MCD #3 and $E_2$ on the day of hCG injection between fertilized(N=21) and unfertilized group(N=25). The number of oocytes retrieved was similar in both groups. The number of supernumerary oocytes available for IVF after transfer was $5.43{pm}2.95$ ranging from 2 to 12. The prenancy rate in fertilized group, 33.3%(7/21), was higher without statistical significance, compared with 8.0%(2/25) in unfertilized group. Using IVF of supernumerary oocytes as a test of pregnancy following GIFT, sensitivity was 77.8 %; specificity, 61.2%; positive predictive value(PPV), 33.3%; negative predictive value(NPV), 92%. The fertilization rate of supernumerary oocytes in pregnant group, $86.4{\pm}22.8%$ was significantly higher compared with $56.1{\pm}20.2%$ in nonpregnant group. In cases with fertilization rate ${\geq}80%$, pregnancy was expected with PPV of 85.7%. In conclusion, IVF of supernumerary oocytes in GIFT program can be a profitable method as a prognostic indicator of pregnancy following GIFT. More aggressive diagnostic and therapeutic measures should be performed in cases with failure in IVF of supernumerary oocytes.

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Effects of Ultrasound and High-Voltage Pulsed Current on Adjuvant-Induced Arthritis in Rats (Adjuvant로 유발된 관절염의 흰쥐에서 초음파와 고전압 맥동 전류 치료의 효과)

  • Lee, Dong-Jin;Lee, Dong-Yeop;Hwang, Don-Young
    • Physical Therapy Korea
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    • v.13 no.3
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    • pp.33-40
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    • 2006
  • The purpose of this study was to assess the effects of High-Voltage Pulsed Current (HVPC) and ultrasound on adjuvant-induced arthritis in rats. Adjuvant arthritis was induced in female Sprauge-Dawley rats by the subcutaneous injection of a single dose of $.1m{\ell}$ of Complete Freund's Adjuvant (CFA) (1 mg of Mycobacterium Butyricum suspended in $.1m{\ell}$ paraffin oil) into the right hind paw. A randomized, parallel-groups design of 24 subjects was used. All rats were randomly assigned to control (n=8), ultrasound (n=8), and HVPC (n=8) were compared with those of injured rats. The rats in the pulsed ultrasound group were treated at 1 MHz frequency with $.5W/cm^2$ intensity in 1:4 mode for 5 minutes per day. The rats in the HVPC group were treated at 120 pulses per second and $50{\mu}s$ phase duration, 20 mA intensity for 30 min per day. Treatment was done in the left and right hind limb for 2 weeks. We evaluated clinical, radiographic, hematologic and histopathologic findings before and after treatment and obtained the following results. 1. Edema of the right hind paw was more significantly reduced in the ultrasound and HVPC groups than the control group on days 9, 12, and 14 (p<.05). Edema of the left hind paw was more significantly reduced in ultrasound and HVPC groups than the control group on days 12, 14 (p<.05). 2. WBC counts of the ultrasound and HVPC groups as compared with the control group were becoming remarkably decreased after the treatment. 3. In radiologic findings, arthritis formation was seen according to the score of arthritis, which was the highest in the control group, upon the observation of radiographs of the left and right hind paws. However, no statistically significant difference was present in the score within three groups. 4. In the histopathologic findings, ultrasound and HVPC groups had effectively suppressed erosions of articular cartilage and inflammatory cell infiltrations. Therefore, the results of the study show that rats that were treated with the ultrasound and HVPC effectively suppressed adjuvant arthritis. However, no statistically significant difference was present between the ultrasound group and the HVPC group.

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Pathologic Fracture of Unicameral Bone Cyst (단순 골낭종에서 발생한 병적 골절)

  • Choo, Suk-Kyu;Lee, Hee-Du;Oh, Hyoung-Keun
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.58-64
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    • 2011
  • Purpose: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. Materials and Methods: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. Results: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). Conclusion: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.

Neurolysis for Megalgia Paresthetica

  • Son, Byung-Chul;Kim, Deok-Ryeong;Kim, Il-Sup;Hong, Jae-Taek;Sung, Jae-Hoon;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.363-366
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    • 2012
  • Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

Effect of Carbamazepine on the Ouabain-Induced Arrhythmia in Rabbits (가토의 Quabain-Induced Arrhythmia에 미치는 Carbamzepine의 효과)

  • Kim, Eui-Hong;Ha, Jeoung-Hee;Lee, Kwang-Youn;Kim, Won-Joon
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.279-285
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    • 1986
  • Carbamazepine is a derivative of iminostilbene with carbamyl group and related chemically to the tricyclic antidepressants. Carbamazepine has been introduced for treatment of trigeminal neuralgia. Recently it is used as an antiepileptic agent such as diphenylhydantoin. Antiepileptic drugs are known to affect experimentally induced cardiac arrhythmia and are now widely used clinically for treatment of ventricular tachyarrhythmias, particularly those produced by digitalis intoxication. Steiner et al.(1970) reported that carbamazepine was found to be very effective in converting ventricular tachycardia due to digitalis toxicity to normal sinus rhythm. Clinically bradycardia, complete heart block, ventricular standstill and Adams-stokes attack were reported in the course of carbamazepine treatment. The purpose of this study was to investigate the effects of carbamazepine on the ouabain-induced arrhythmia in vivo. The rabbits of either sex, weighing from 1.6 to 3.2kg were anesthesized by urethane. After the trachea was cannulated, the rabbits were ventilated with room air using a respirator. Drugs were given into polyethylene cannula in the femoral vein. Blood pressure were recorded by physiograph via pressure tranducer connected with the cannula in the femoral artery. EKG were recorded by Physiograph via electrode implanted in both fore leg and left hind leg. The results are summarized as follows; 1. Arrhythmia was induced by continuous infusion of ouabain.($64{\pm}8.8{\mu}g/kg$) 2. Single administration of ouabain($64{\mu}g/kg$) induced arrhythmia which was persisted for 7-8 min. 3. Ouabain induced arrhythmia was restored to normal sinus rhythm by administration of carbamazepine.(The more dosage, the less frequent and the longer duration) 4. Severe bradycardia, A-V block, atrial fibrillation were seen on the EKG after injection of carbamazepine alone. By the above results, it may be concluded that carbamazepine inhibits the ouabain-induced arrhythmia by dose-dependent.

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Laminotomy with Continuous Irrigation in Patients with Pyogenic Spondylitis in Thoracic and Lumbar Spine

  • Kim, Sung-Hyun;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Tae-Sun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.332-340
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    • 2011
  • Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

Clinical Results after Arthroscopic Treatment in Acute Pyogenic Arthritis of the Knee (급성 화농성 슬관절염에서 관절경적 치료 후 결과)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.53-57
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    • 2008
  • Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

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