• Title/Summary/Keyword: resistance management

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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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Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2009 (설비공학 분야의 최근 연구 동향 : 2009년 학회지 논문에 대한 종합적 고찰)

  • Han, Hwa-Taik;Lee, Dae-Young;Kim, Seo Young;Choi, Jong-Min;Baik, Yong-Kyu;Kwon, Young-Chul
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.22 no.7
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    • pp.492-507
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    • 2010
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2009. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) Research trends of thermal and fluid engineering have been surveyed as groups of general thermal and fluid flow, fluid machinery and piping, and new and renewable energy. Various topics were covered in the field of general thermal and fluid flow such as an expander, a capillary tube, the flow of micro-channel water blocks, the friction and anti-wear characteristics of nano oils with mixtures of refrigerant oils, etc. Research issues mainly focused on the design of micro-pumps and fans, the heat resistance reliability of axial smoke exhaust fans, and hood systems in the field of fluid machinery and piping. Studies on ground water sources were executed concerning two well type geothermal heat pumps and multi-heat pumps in the field of new and renewable energy. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics and industrial heat exchangers. Researches on heat transfer characteristics included the heat transfer in thermoelectric cooling systems, refrigerants, evaporators, dryers, desiccant rotors. In the area of industrial heat exchangers, researches on high temperature ceramic heat exchangers, plate heat exchangers, frosting on fins of heat exchangers were performed. (3) In the field of refrigeration, papers were presented on alternative refrigerants, system improvements, and the utilization of various energy sources. Refrigeration systems with alternative refrigerants such as hydrocarbons, mixed refrigerants, and $CO_2$ were studied. Efforts to improve the performance of refrigeration systems were made applying various ideas of suction line heat exchangers, subcooling bypass lines and gas injection systems. Studies on heat pump systems using unutilized energy sources such as river water, underground water, and waste heat were also reported. (4) Research trend in the field of mechanical building facilities has been found to be mainly focused on field applications rather than performance improvements. In the area of cogeneration systems, papers on energy and economic analysis, LCC analysis and cost estimating were reported. Studies on ventilation and heat recovery systems introduced the effect on fire and smoke control, and energy reduction. Papers on district cooling and heating systems dealt with design capacity evaluation, application plan and field application. Also, the maintenance and management of building service equipments were presented for HVAC systems. (5) In the field of architectural environment, various studies were carried to improve indoor air quality and to analyze the heat load characteristics of buildings by energy simulation. These studies helped to understand the physics related to building load characteristics and to improve the quality of architectural environment where human beings reside in.

A Comparative Study of Effect of Secondary Anti-tuberculosis Drugs in the Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 이차항결핵제 복합처방의 효과에 관한 비교 연구)

  • Ha, Hyun-Cheol;Kwon, Eun-Soo;Choi, In-Hwan;Hwang, Su-Hee;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1154-1166
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    • 1998
  • Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

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Toxicological Effects of Some Insecticides against Welsh Onion Beet Armyworm (Spodoptera exigua) (Metaflumizone을 포함한 몇 가지 약제의 파밤나방(Spodoptera exigua)에 대한 독성검정)

  • Kang, E.J.;Kang, M.G.;Seo, M.J.;Park, S.N.;Kim, C.U.;Yu, Y.M.;Youn, Y.N.
    • Korean journal of applied entomology
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    • v.47 no.2
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    • pp.155-162
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    • 2008
  • The Welsh onion beet armyworm, Spodoptera exigua (Hubner), has attacked Welsh onion and is now the most important pest of Welsh onion in southwestern Korea. The beet armyworm has a wide host range, occurring as a serious pest of vegetable and fields. The relatively high abundance of beet armyworm has stimulated frequent application of insecticides to foliage. Insecticide resistance is a major problem in management of this insect. Accordingly, pesticide application for the control of beet armyworm was tried in both the open field and in laboratory, using 4 synthetic compounds such as metaflumizone and chlorfenapyr, indoxacarb, flufenoxuron, emamectin benzoate. In the laboratory, each developmental stages from eggs, larva to pupa was tested against 4 insecticides. Against the eggs of welsh onion beet armyworm, there was no significantly different with each other. These tested chemicals no killing effect to eggs. However, the population of 1st larva hatched from eggs were reduced because they eaten the egg shell with residual insecticides. The tested insecticides were taken very high mortalities to 1st to 3rd larva of Welsh onion beet armyworm. Otherwise, there were decreased the death rate from 4th to 6th larva. On the other hand, their value of control effects were relatively good against Welsh onion beet armyworms in the field between 87.2 and 90.5% on 10 days after insecticide application.

The Comorbidity of Periodic Limb Movements Disorder in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자에서의 수면중 주기성 사지운동장애의 동반이환율)

  • Yang, Chang-Kook;Son, Choon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1039-1046
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    • 1998
  • Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

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Assessment of Growth Conditions and Maintenance of Law-Protected Trees in Je-cheon City (제천시 보호수의 생육환경 및 관리현황 평가)

  • Yoon, Young-Han;Ju, Jin-Hee
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.2
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    • pp.67-74
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    • 2010
  • Law-protected trees are our precious asset as natural resources with history and tradition and natural heritage which should be protected and maintained well to bequeath next generation. Law-protected trees have not only thremmatologic and genetic meaning but also environmental and emotional meaning for their value to be high. This study investigated location, vitality, wrapping condition of root area and status of maintenance of the trees to figure out their growth environment and status of maintenance in a small-middle city through survey on those of law-protected trees in Je-cheon. There showed 300 more year old trees in Je-cheon mostly and the number of trees located in flat fields was the highest. For location type, village, hill and road types were presented in the order and for degree of development, land for building was found most frequently. The average electric resistance of the formative layer was measured to be $8.4k{\Omega}$ and four trees showed bark separation. Most law-protected trees underwent tree surgery, and complete bareness of root area was observed in a tree. The root area of two trees was covered with concrete. pH of soil was recorded to be 5.0~8.4 with its average of 7.1 and electric conductivity(EC) was less than 0.5 dS/m. For status of maintenance rearing facilities were placed for 16 trees out of totally 48 ones and stone fence was done for three ones. Tree surgery was conducted for 33 trees to prevent and to treat decomposed parts of holes. Direction boards were installed for 23 trees. Based on these results, measures to manage systematically law-protected trees in Jecheon could be suggested as follows. First, a sufficient space for growth of low part of trees should be secured. Second, a voluntary management should be induced by advertising them to residents in a community. Third, rearing facilities and direction boards of law-protected trees should be placed and related education should be conducted. Fourth, through operation of the department for law-protected trees consisting of related professions and cooperation among related departments the trees should be maintained continuously.

Correlation Analysis between Damage of Expansion Joints and Response of Deck in RC Slab Bridges (RC 슬래브교의 신축이음 손상과 바닥판 응답과의 상관관계 분석)

  • Jung, Hyun-Jin;An, Hyo-Joon;Park, Ki-Tae;Jung, Kyu-San;Kim, Yu-Hee;Lee, Jong-Han
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.25 no.6
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    • pp.245-253
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    • 2021
  • RC slab bridges account for the largest portion of deteriorated bridges in Korea. However, most RC slabs are not included in the first and second classes of bridges, which are subject to bridge safety management and maintenance. The highest damaged components in highway bridges are the subsidiary facilities including expansion joints and bearings. In particular, leakage through expansion joints causes deterioration and cracks of concrete and exposure of reinforced bars. Therefore, this study analyzed the effect of adhesion damage at expansion joints on the response of the deck in RC slab bridges. When the spacing between the expansion joints at both ends was closely adhered, cracks occurred in the concrete at both ends of the deck due to the resistance rigidity at the expansion joints. Based on the response results, the correlation analysis between displacements in the longitudinal direction of the expansion joint and concrete stress at both ends of the deck for each damage scenario was performed to investigate the effect of the occurrence of damage on the bridge behavior. When expansion joint devices at both sides were damaged, the correlation between displacement and stress showed a low correlation of 0.18 when the vehicles proceeded along all the lanes. Compared with those in the intact state, the deflections of the deck in the damaged case at both sides showed a low correlation of 0.34 to 0.53 while the vehicle passed and 0.17 to 0.43 after the vehicle passed. This means that the occurrence of cracks in the ends of concrete changed the behavior of the deck. Therefore, data-deriven damage detection could be developed to manage the damage to expansion joints that cause damage and deterioration of the deck.

The Morphologic Characteristics of Step-pool Structures in a Steep Mountain Stream, Chuncheon, Gangwon-do (강원도 춘천시 근교의 산지계류에 형성된 계단상 하상구조의 특징)

  • Kim, Suk Woo;Chun, Kun Woo;Park, Chong Min;Nam, Soo Youn;Lim, Young Hyup;Kim, Young Seol
    • Journal of Korean Society of Forest Science
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    • v.100 no.2
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    • pp.202-211
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    • 2011
  • The geometric characteristics of step-pool structures and how they are influenced by channel characteristics were investigated in a steep mountain stream in the Experimental Forests of Kangwon National University in Chuncheon, Gangwon-do. Average values of steps for the study reaches were as follows: step spacing, 4.69 m; step height, 0.47 m; step drop, 0.71 m; step-forming particle sizes, 0.68 m; number, 21steps/ 100 m; the ratio of step spacing to channel width, 0.5; and step steepness, 0.13. Relationships between spacing and height of steps and channel gradient showed a negative- and positive correlation, respectively, whereas all geometric variables of steps manifested poor correlation with channel width. Therefore, step steepness, expressed as the ratio of step height to step spacing, increased as channel gradient increased. The ratio of step steepness to channel gradient representing the criterion of maximum flow resistance was 1.2, indicating the channel bed's stable condition. In particular, the relationship between the ratio of step drop to step height and channel gradient showed a significant negative correlation, suggesting the influence of step-pool geometry in trapping sediment and providing an aquatic habitat. Positive correlations also exist between spacing and drop of steps and step particles. Our findings suggest that the dynamics of step-pool structures may strongly control physical and ecological environments in steep mountain streams, so understanding them is essential for stream management.

Analysis of Foodborne Pathogens in Food and Environmental Samples from Foodservice Establishments at Schools in Gyeonggi Province (경기지역 학교 단체급식소 식품 및 환경 중 식중독균 분석)

  • Oh, Tae Young;Baek, Seung-Youb;Koo, Minseon;Lee, Jong-Kyung;Kim, Seung Min;Park, Kyung-Min;Hwang, Daekeun;Kim, Hyun Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.44 no.12
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    • pp.1895-1904
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    • 2015
  • Foodborne illness associated with food service establishments is an important food safety issue in Korea. In this study, foodborne pathogens (Bacillus cereus, Clostridium perfringens, Escherichia coli, pathogenic Escherichia coli, Listeria monocytogenes, Salmonella spp., Staphylococcus aureus, and Vibrio parahaemolyticus) and hygiene indicator organisms [total viable cell counts (TVC), coliforms] were analyzed for food and environmental samples from foodservice establishments at schools in Gyeonggi province. Virulence factors and antimicrobial resistance of detected foodborne pathogens were also characterized. A total of 179 samples, including food (n=66), utensil (n=68), and environmental samples (n=45), were collected from eight food service establishments at schools in Gyeonggi province. Average contamination levels of TVC for foods (including raw materials) and environmental samples were 4.7 and 4.0 log CFU/g, respectively. Average contamination levels of coliforms were 2.7 and 4.0 log CFU/g for foods and environmental swab samples, respectively. B. cereus contamination was detected in food samples with an average of 2.1 log CFU/g. E. coli was detected only in raw materials, and S. aureus was positive in raw materials as well as environmental swab samples. Other foodborne pathogens were not detected in all samples. The entire B. cereus isolates possessed at least one of the diarrheal toxin genes (hblACD, nheABC, entFM, and cytK enterotoxin gene). However, ces gene encoding emetic toxin was not detected in B. cereus isolates. S. aureus isolates (n=16) contained at least one or more of the tested enterotoxin genes, except for tst gene. For E. coli and S. aureus, 92.7% and 37.5% of the isolates were susceptible against 16 and 19 antimicrobials, respectively. The analyzed microbial hazards could provide useful information for quantitative microbial risk assessment and food safety management system to control foodborne illness outbreaks in food service establishments.

The Clinical Application and Results of Palliative Damus-Kaye-Stansel Procedure (고식적 Damus-Kaye-Stansel 술식의 임상적 적용 및 결과)

  • Lim, Hong-Gook;Kim, Soo-Jin;Kim, Woong-Han;Hwang, Seong-Wook;Lee, Cheul;Shinn, Sung-Ho;Yie, Kil-Soo;Lee, Jae-Woong;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.1-11
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    • 2008
  • Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.