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The Efficacy of ZD1839 ($Iressa^{TM}$) in Patients with Advanced Non-small Cell Lung Cancer which has Progressed After Previous Chemotherapy (표준 항암화학요법에 실패한 진행성 비소세포폐암에서 ZD1839 ($Iressa^{TM}$)의 효과)

  • Lee, Seung Whan;Kim, Duck Ryung;Lee, Sang Dae;Lee, Jong Sin;Park, Yeon Hee;Ryoo, Baek-Yeol;Kim, Heung Tae;Park, Sunhoo;Kim, Bong Seog;Kim, Cheol Hyeon;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.160-168
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    • 2004
  • Background : The role of second-line chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) is known to be limited. Recently, ZD1839, the small molecule epidermal growth factor receptor-tyrosine kinase inhibitor, has been developed and has shown anti-tumor activity in patients with solid malignant tumors including lung cancer. We evaluated the response rate and toxicities of ZD1839 in patients with advanced NSCLC which has progressed after previous chemotherapy. Patients and Methods : We examined 83 patients with advanced NSCLC treated with ZD1839 for more than 1 month in Korea Cancer Center Hospital during the period from January 2002 to September 2003. All the patients were enrolled in the international expanded access program (EAP) with ZD1839 by AstraZeneca. The administered dose of ZD1839 was 250 mg once daily. Chest radiography and laboratory tests were followed-up. We evaluated the response rate, median survival, and toxicity after treatment. Results : Median age of the patients was 59 years (range 33-76). The most predominant cell type was adenocarcinoma and the most stage of the patients was IV. ECOG performance status was as follows; grade 0-1 in 10, grade 2 in 42, and grade 3 in 31 patients. Partial response was achieved in 12 patients (14.5%). Median overall survival was 9.2 (range 1.3-21.6+) months and median time to progression was 3.1 (range 1-21.2+) months. The most common adverse effect of ZD1839 was skin eruption which developed in 25 patients (25.8%). Significantly higher response rate and survival was found in patients with adenocarcinoma or good performance status. Conclusion : ZD1839 showed modest activity and tolerable toxicity in the treatment for patients with NSCLC which has progressed after previous chemotherapy.

Cross-resistance Between Rifampicin and Rifabutin and Its Relationship with rpoB Gene Mutations in Clinically Isolated MDR-TB Strains (다제내성 결핵 균주에서 리팜핀과 리파부틴간의 교차내성률 및 rpoB 유전자 돌연변이와의 연관성)

  • Kim, Byoung Ju;Oh, Seung Hwan;Cho, Eun Jin;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.171-179
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    • 2006
  • Background : Despite the emerging danger of MDR-TB to human beings, there have only been a limited number of drugs developed to treat MDR-TB since 1970. This study investigated the cross-resistance rate between rifampicin (RFP) and rifabutin (RBU) in order to determine the efficacy of rifabutin in treating MDR-TB. In addition, the results of rifabutin were correlated with the rpoB mutations, which are believed to be markers for MDR-TB and RFP resistance. Methods : The MICs of RBU were tested against 126 clinical isolates of MDR-TB submitted to the clinical laboratory of National Masan TB Hospital in 2004. Five different concentrations ($10-160{\mu}g/ml$) were used for the MICs. The detection of the rpoB mutations was performed using a RFP resistance detection kit with a line probe assay(LiPA), which contains the oligonucleotide probes for 5 wide type and 3 specific mutations (513CCA, 516GTC, and 531TTG) The rpoB mutation was determined by direct sequencing. Results : The rate of cross-resistance between RFP and RBU was 70.5%(74/105) at $20{\mu}g/ml$ RBU(ed note: How much RFP?) Most mutations (86.3%) occurred in the 524~534 codons. The His526Gln, His526Leu, Leu533Pro, Gln513Glu, and Leu511Pro mutations(Ed note: Is this correct?) were associated with the susceptibilty to RBU. Conclusion : Based on the cross-resistance rate between RFP and RBU, RBU may be used effectively in some MDR-TB patients. Therefore, a conventional drug susceptibility test for RBU and a determination of the critical concentration are needed. However, rpoB gene mutation test may be have limited clinical applications in detecting RBU resistance.

Pathogenic Classification and Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Disease in a National Tuberculosis Hospital (일개 국립결핵병원에서 경험한 비결핵성 마이코박테리아 폐질환의 원인균과 임상상)

  • Choi, Sun-Pil;Lee, Bong-Keun;Min, Jin-Hong;Kim, Jin-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.606-612
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    • 2005
  • Background : It has been reported that nontuberculosis mycobacterium(NTM) isolates account for approximately 10% of patients with a positive Acid-Fast Bacilli(AFB) smear. Therefore, it is necessary to consider NTM pulmonary disease when such a positive test is encountered. The aim of this study was to evaluate the etiologies and clinical characteristics of patients with NTM pulmonary disease who had been treated at a national tuberculosis hospital. Methods : The NTM isolates were recovered from the sputum or bronchial washing specimens submitted to a clinical laboratory of National Masan TB Hospital from August 2002 to July 2003. All samples were identified using a polymerase chain reaction-restriction fragment length polymorphism analysis method, which amplifies the rpoB gene. The patients were diagnosed with NTM disease according to the American Thoracic Society diagnostic criteria. Results : One hundred NTM isolates were recovered from 57 patients. Of the 100 isolates, M. avium complex(MAC) was the most common species, which was found 55%(n=55) of patients, followed by M. abscessus(n=25), and M. fortuitum( n=9). 26(45.6%) patients had NTM disease. Twenty-six (45.6%) patients had NTM disease according to The American Thoracic Society classification. The main organisms involved in NTM disease were MAC(n=19, 73.1%) and M. abscessus(n=5, 19.2%). The pathogenic potential was 67.9% in M. intracellulare and 41.7% in M. abscessus. The predictive factors related to NTM disease were a positive sputum smear (OR 6.4, p=0.02) and the isolation of either MAC or M. abscessus(OR 6.9, p=0.007). Fifteen patients(57.7%) were cured. There were no significant factors associated with the treatment success. Conclusion : There was a relatively high proportion of NTM disease in NTM isolates and the common species were MAC and M. abscessus. The predictive factors for NTM disease were a positive sputum smear and the isolation of either MAC or M. abscessus.

The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005~2009 (일개 부산지역 3차 병원에서 관찰한 다제내성 결핵의 실태, 2005~2009)

  • Yoon, Neul-Bom;Lee, Sung-Woo;Park, Su-Min;Jeong, Il-Hwan;Park, So-Young;Han, Song-Yee;Lee, Yu-Rim;Jung, Jin-Kyu;Kim, Joon-Mo;Kim, Su-Young;Um, Soo-Jung;Lee, Soo-Keol;Son, Choon-Hee;Hong, Young-Hee;Lee, Ki-Nam;Roh, Mee-Sook;Kim, Kyeong-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.2
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    • pp.120-125
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    • 2011
  • Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.

IGRINS Design and Performance Report

  • Park, Chan;Jaffe, Daniel T.;Yuk, In-Soo;Chun, Moo-Young;Pak, Soojong;Kim, Kang-Min;Pavel, Michael;Lee, Hanshin;Oh, Heeyoung;Jeong, Ueejeong;Sim, Chae Kyung;Lee, Hye-In;Le, Huynh Anh Nguyen;Strubhar, Joseph;Gully-Santiago, Michael;Oh, Jae Sok;Cha, Sang-Mok;Moon, Bongkon;Park, Kwijong;Brooks, Cynthia;Ko, Kyeongyeon;Han, Jeong-Yeol;Nah, Jakyuong;Hill, Peter C.;Lee, Sungho;Barnes, Stuart;Yu, Young Sam;Kaplan, Kyle;Mace, Gregory;Kim, Hwihyun;Lee, Jae-Joon;Hwang, Narae;Kang, Wonseok;Park, Byeong-Gon
    • The Bulletin of The Korean Astronomical Society
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    • v.39 no.2
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    • pp.90-90
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    • 2014
  • The Immersion Grating Infrared Spectrometer (IGRINS) is the first astronomical spectrograph that uses a silicon immersion grating as its dispersive element. IGRINS fully covers the H and K band atmospheric transmission windows in a single exposure. It is a compact high-resolution cross-dispersion spectrometer whose resolving power R is 40,000. An individual volume phase holographic grating serves as a secondary dispersing element for each of the H and K spectrograph arms. On the 2.7m Harlan J. Smith telescope at the McDonald Observatory, the slit size is $1^{{\prime}{\prime}}{\times}15^{{\prime}{\prime}}$. IGRINS has a plate scale of 0.27" pixel-1 on a $2048{\times}2048$ pixel Teledyne Scientific & Imaging HAWAII-2RG detector with a SIDECAR ASIC cryogenic controller. The instrument includes four subsystems; a calibration unit, an input relay optics module, a slit-viewing camera, and nearly identical H and K spectrograph modules. The use of a silicon immersion grating and a compact white pupil design allows the spectrograph collimated beam size to be 25mm, which permits the entire cryogenic system to be contained in a moderately sized ($0.96m{\times}0.6m{\times}0.38m$) rectangular Dewar. The fabrication and assembly of the optical and mechanical components were completed in 2013. From January to July of this year, we completed the system optical alignment and carried out commissioning observations on three runs to improve the efficiency of the instrument software and hardware. We describe the major design characteristics of the instrument including the system requirements and the technical strategy to meet them. We also present the instrumental performance test results derived from the commissioning runs at the McDonald Observatory.

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Jejunal Pouch Interposition (JPI) after Distal Gastrectomy in Patients with Gastric Cancer (위암 환자에서 원위부 위절제 후 공장낭 간치술)

  • Jeon, Hae-Myung;Kim, Wook;Hur, Hoon;Lee, Joon-Hyun;Won, Jong-Man
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.242-251
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    • 2004
  • Purpose: Recently, because of the increasing numbers of early gastric cancer patients and improvements in their survivals, greater attention has been directed towards the quality of life and nutritional status of gastric cancer patients after surgery. However, conventional reconstructions, Billroth- I, -II (B-I and B-II) or Roux-en-Y, have proven to have certain limitations, such as a small reservoir, and a malabsorption for iron, fat, calcium, and carotene. To overcome these limitations, we used a jejunal pouch interposition(JPI) after a distal gastrectomy not only to substitute for the small reservoir but also to maintain a physiologic pathway for ingested foods. Materials and Methods: A total of 196 gastric cancer patients who underwent a distal gastrectomy between March 2001 and February 2004 were divided into 3 groups: JPI group (n=100), B-I group (n=29), and B-II group (n=67). We assessed the patient's nutritional status, gastric emptying time, and gastrofiberscopic findings. Results: The percents of body weight loss at 6 months, 1 year, and 2 years postoperatively in the JPI group ($5.14\%,\;3.01\%,\;2.37\%$) were significantly less than those of the conventional B-I ($8.41\%,\;6.69\%,\;5.90\%$) and B-II groups ($7.50\%,\;7.65\%,\;5.86\%$) (P=0.011, 0.000, 0.013). The laboratory findings showed no significant differences between the 3 groups, except for a higher total protein level in the JPI group after 6 months postoperatively. Especially, stage I and II cancers in the JPI group showed much higher total protein levels after 1 year postoperatively. The gastric emptying times in the $\^{99m}$Tc- semisolid scans at 6 months, 1 year, and 2 years postoperatively were 102.5, 83.1, and 58.1 minutes in the JPI group, 95.5, 92.0, and 58.5 minutes in the B-I group, and 53.9, 69.1, and 50.2 minutes in the B-II group, respectively. Also, the symptomatic gastric stasis detected with a gastrofiberscope during the early postoperative period (6 months) was gradually improved. Conclusion: From a nutritional aspect, a jejunal pouch interposition after a distal gastrectomy could be an alternative reconstruction method, especially in stage I and II gastric cancer patients, in spite of the longer operation time and the probable delayed gastric emptying.

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A Comparison of Segmental Gastrectomy and Distal Gastrectomy with Billroth I Reconstruction for Early Gastric Cancer That's Developed on the Gastric Body (위체부에 발생한 조기위암에서 위구획절제술과 Billroth I 재건술식의 비교)

  • Song, Min-Sang;Lee, Sang-Il;Sul, Ji-Young;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.207-214
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    • 2009
  • Purpose: Subtotal distal gastrectomy has been accepted as the standard treatment for early gastric cancer that's developed on the gastric body. EMR and ESD have been introduced to minimize the incidence of postgastrectomy syndrome, but these procedures can not detect lymph node metastasis and they have a risk for gastric perforation. Segmental gastrectomy has recently been applied for treating early gastric cancer, but its usefulness has not been clarified. The aim of this study was to compare segmental gastrectomy and distal gastrectomy with Billroth I reconstruction for treating early gastric cancer that's developed on the gastric body. Materials and Methods: We performed a retrospective review of all the patients who were diagnosed as having early gastric cancer that developed on the gastric body at Chungnam National University Hospital from January 2004 through July 2007. During this period, 41 patients received segmental gastrectomy and 40 patients underwent subtotal distal gastrectomy. All the patients were studied via a biannual review of the body systems, a physical examination, endoscopy, computed tomography and the laboratory findings. Results: There were no significantly differences of the clinicopathologic characteristics between the two groups. The changes of the nutritional status (Hb, TP, Alb and TC) and the body weight change were not significantly different between the 2 groups. There were significantly more residual food in the SG group than that in the SDG group (RGB classification, Residual>Grade 2), but there were no differences for epigastric discomfort (P>0.05). Esophagitis developed at a similar rate for both two groups (LA classification, >Grade A), and bile reflux was found in only one patient of each group. Conclusion: We expected the reduction of esophagitis and gastritis and the improvement of nutritional status according to the type of procedure. Yet the results of our study showed no significant differences between the two study groups. More patients and a longer follow up time are needed for determining the advantage sand disadvantages of segmental gastrectomy.

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A Study on Laboratory Treatment of Metalworking Wastewater Using Ultrafiltration Membrane System and Its Field Application (한외여과막시스템을 이용한 금속가공폐수의 실험실적 처리 및 현장 적용 연구)

  • Bae, Jae Heum;Hwang, In-Gook;Jeon, Sung Duk
    • Korean Chemical Engineering Research
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    • v.43 no.4
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    • pp.487-494
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    • 2005
  • Nowadays a large amount of wastewater containing metal working fluids and cleaning agents is generated during the cleaning process of parts working in various industries of automobile, machine and metal, and electronics etc. In this study, aqueous or semi-aqueous cleaning wastewater contaminated with soluble or nonsoluble oils was treated using ultrafiltration system. And the membrane permeability flux and performance of oil-water separation (or COD removal efficiency) of the ultrafiltration system employing PAN as its membrane material were measured at various operating conditions with change of membrane pore sizes and soil concentrations of wastewater and examined their suitability for wastewater treatment contaminated with soluble or insoluble oil. As a result, in case of wastewater contaminated with soluble oil and aqueous or semi-aqueous cleaning agent, the membrane permeability increased rapidly even though COD removal efficiency was almost constant as 90 or 95% as the membrane pore size increased from 10 kDa to 100 kDa. However, in case of the wastewater contaminated with nonsoluble oil and aqueous or semi-aqueous cleaning agent, as the membrane pore size increased from 10 kDa to 100 kDa and the soil concentration of wastewater increased, the membrane permeability was reduced rapidly while COD removal efficiency was almost constant. These phenomena explain that since the membrane material is hydrophilic PAN material, it blocks nonsoluble oil and reduces membrane permeability. Thus, it can be concluded that the aqueous or semi-aqueous cleaning solution contaminated with soluble oil can be treated by ultrafiltration system with the membrane of PAN material and its pore size of 100 kDa. Based on these basic experimental results, a pilot plant facility of ultrafiltration system with PAN material and 100 kDa pore size was designed, installed and operated in order to treat and recycle alkaline cleaning solution contaminated with deep drawing oil. As a result of its field application, the ultrafiltration system was able to separate aqueous cleaning solution and soluble oil effectively, and recycle them. Further more, it can increase life span of aqueous cleaning solution 12 times compared with the previous process.

Ecological Characteristics of Cotesia glomerata L. (Hymenoptera: Braconidae) and Its Parasitism Rates for Diamondback Moth (Plutella xylostella L.) in a Kimchi Cabbage Field in The Korean Highland Area (배추나비고치벌(Cotesia glomerata L.)의 생태적 특성 및 고랭지 배추밭에서 배추좀나방(Plutella xylostella L.)에 대한 기생률)

  • Kwon, Min;Kim, Juil;Hong, Eunju;Lee, Yeonggyu
    • Korean journal of applied entomology
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    • v.58 no.4
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    • pp.355-362
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    • 2019
  • Cotesia glomerata L., an internal parasitoid wasp, attacks the larvae of both the cabbage white butterfly (Artogeia rapae L.) and the diamondback moth (Plutella xylostella L.). It can be utilized as a natural biological enemy to control these two insect pests in the summer cabbage fields of the Korean highland areas. The developmental response and sex ratio of C. glomerata to various temperatures and its longevity were examined in the laboratory. The egg-to-larva and pupa stages of C. glomerata were 12.1 ± 2.1 and 6.4 ± 1.8 days, respectively, at 20℃, The developmental threshold for egg-to-larva and pupa stages were 7.7 and 8.5℃, respectively. The sex ratios of C. glomerata when reared under various temperatures were 61.0 ± 4.5% at 15℃, 44.2 ± 1.0% at 20℃, and 39.0 ± 2.3% at 25℃, and the incidence of females increased as the temperature decreased. The longevity of C. glomerata when fed a 10% sugar solution was 20.4 ± 0.2 days, while in adults without any feed, the longevity was 3.6 ± 0.1 days. Indoor reared C. glomerata adults were released into cabbage fields from 2007 to 2018, in early August of each year, and the outdoor parasitism rates were surveyed. The parasitism rates were found to increase gradually as the year passed (Y = 0.2696X + 2.8633, R2 = 0.3994). The highest parasitism rate was observed in 2013 at 7.6%, and the lowest was in 2018 at 6.5 %. These results could be used as basic information for biological control of kimchi cabbage pests at highland fields.