• Title/Summary/Keyword: respiratory drugs

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Clinical Observational study of Pulmonary Tuberculosis for admitted patients at a National Tuberculosis Hospital - Comparison with the previous results in 1995 - (일개 국립결핵병원에 입원치료를 받은 폐결핵환자의 임상양태에 관한 연구 - 1995년과 2002년 비교연구 -)

  • Park, Seung-Kyu;Lee, In-Hee;Kim, Byoung-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.392-398
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    • 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.

Postoperative Clinical Courses According to the Length of Preoperative Drug Therapy in Pulmonary Tuberculosis (폐결핵 환자의 수술전 항결핵제 투여기간에 따른 수술후 임상경과)

  • Kwon, Eun-Su;Kim, Dae-Yun;Park, Seung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.775-785
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    • 1999
  • Background : Though surgery plays an important role in the management of patients with Mycobacterium tuberculosis infection, there is little information regarding the timing of resection. We tried to find out the ideal timing of operation. Method: A retrospective review was performed in 69 patients underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1997. They were categorized into various groups according to the length of preoperative specific drug therapy. The rates of treatment failure, realpse and complication in each group were compared statistically by $x^2$-test. Results: Eighty one point two percent were men and 18.8 % women with a median age of 33 years(range, 16 to 63 years). The mean number of resistant drugs was 3.l(range, 0 to 9). Patients were treated preoperatively with multidrug regimens, which mean number of preoperative specific drugs was 4.6, in an effort to reduce the mycobacterial burden with the mean length of preoperative drug therapy, 5.0 months. Postoperative treatment was conducted for a mean period of 13.0 months with a mean number of postoperative specific drugs, 4.4. Postoperative treatment failures were confirmed in 8 among 69 patients(11.6%). 2 of these 8 patients were showed up in the preoperative 3 to 4 months medication group and each of the rest was occurred in the preoperative 2 to 3, 5 to 6, 6 to 7, 12 to 13, 17 to 18 months, less than one month medication group, respectively. 59 of 69 patients were available for evaluation of the relapse rate with the mean duration of the postoperative follow-up, 19.8 months. In 4 patients bacterial relapse was confirmed(6.8%). Each of these 4 was in the preoperative 1 to 2, 2 to 3, 3 to 4, 5 to 6 months medication group. Categorized into various groups according to the length of preoperative specific therapy, there were no statistical significances of the treatment failure rate, relapse rate and complication rate in the groups. There were seven treatment failures of 28 who were AFB culture positive until the time of operation(25%, p<0.01). Categorized the preoperative AFB culture positive group into various groups according to the length of preoperative drug therapy, there were no statistical significances, either. Conclusion: We believe that operation plays an important ancillary role in the treatment of pulmonary tuberculosis. Our results indicate that the timing of resection according to the length of preoperative drug therapy may not cause trouble.

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Objectives and Contents of Basic Medical Sciences in Nursing Education (간호학 교육에서 기초의과학 교과목별 목표와 내용에 대한 연구)

  • 최명애;신기수
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1455-1468
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    • 1999
  • The purpose of this study was to investigate the objectives and contents of basic medical sciences at department of nursing in college of nursing, and junior college of nursing, thus ultimately providing the basic data to standardize the curriculum of the basic medical sciences in nursing education. Seventy eight professors who were in charge of teaching basic medical sciences to at 22 colleges of nursing/ department of nursing, and 20 junior colleges of nursing responded to the questionnaires that consisted of the questions regarding objectives and contents, of basic medical sciences. Based on the description of objectives, the description related to nursing, nurse, nursing science was cathegorized as on objective applicable to nursing science, the description related to medicine or clinical medicine as medical model, the description without description related to medicine was cathegorized as knowledge acquisition. The number of schools corresponding to each category were summerized in descending order. The objectives of basic medical sciences were categorized by concepts and number of schools corresponding to the categorized concept. The findings of the study are as follows ; 1. The subjects of basic medical science identified were physiology, anatomy, biochemistry, pathology, microbiology, and pharmacology in most colleges of nursing and junior colleges. Two colleges of nursing/department of nursing (9.1%) and 19 junior colleges of nursing(95%) did not offer biochemistry, 1 college of nursing /department of nursing(5%) did not offer pathology & pharmacology. 2 junior colleges of nursing (10%) did not offer pharmacology, 1 junior college of nursing(5%) did not offer pathology. The other 1 junior college of nursing did not offer microbiology. 2. Objectives of physiology were to acquire knowledge and understanding on human function in both 6 (50%) colleges and 5 junior colleges. Objectives of anatomy were to acquire knowledge on human structure in both 4 (57%) colleges and 2 (50%) junior colleges; knowledge applicable to nursing sciences in both 3 (42.8%) colleges and 2 (50%) junior colleges. Objectives of biochemistry was to obtain knowledge and understanding on biochemistry, and understanding of basic concepts about biochemistry. Objectives of pathology were to obtain knowledge and understanding on pathology in both 4 (57.1%) colleges and 5(62.5%) junior colleges. Objectives of microbiology were to acquire knowledge and understanding on microbiology in both 5(83.8%) colleges and 6(85.7%) junior colleges. Objectives of pharmacology were to acquire knowledge on pharmacology in both 7(100%) colleges and 8(100%) junior colleges. 3. Contents of physiology in 19 (100%) schools were membrane transport, digestion, circulation, nervous system and respiration. In 16(84.2%) were kidney and muscle, that in 13(68.4%) were endocrine physiology. In 11(57.9%) were introduction and that in 9(47.4%) were structure and function of cells. Contents of anatomy in 11(100%) schools were skeletal system, muscle system, digestive system, circulatory system, concepts regarding human structure. In 10(90.9%) schools were endocrine system and nervous system, and in 5(45.5%) schools were blood, urinary system and cell. Contents of biochemistry in 6(100%) schools were history of biochemistry, body regulating factor, bioenergy, health and nutrition, nutrition of cell, energy production system. In 5(83.3%) schools were metabolism of protein and carbohydrate and enzyme, and in 3(50%) schools were metabolism of energy and fat. Contents of microbiology in 13(100%) schools were environment and influenc of bacteria, virus, G(-) rods, purulent cocci, G(+) rods. In 10 (76.9%) were immunity, diphtheria, enterobacteria, and in 9(69.2%) were spirochete, rickettsia and clamydia, and that in 6(46.2%) were sterilization and disinfection. Contents of pathology in 14(100%) schools were cell injury and adaptation, inflammation, respiratory diseases, circulatory diseases. In 10(71.4%) were neurological disorders, in 8(57.1%) were immunity and disease, and in 7 (50%) were tumor and progressive changes. Contents of pharmacology in 15(100%) were cardivascular drugs, introduction to pharmacology, hypnotics, analgesics, local anesthetics, an ticonvulsants. In 12(80%) were drugs activity on sympathetic and parasympathetic nervous system, and in 11(73%) were sulfa drugs, antibiotics, drug abuse and addiction.

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Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Etiologies of Bacterial Pneumonia with Implications for Therapy (세균성 폐렴의 원인균과 그 치료)

  • Woo, Jun-Hee;Lee, Jae-Seok;Kwon, Kwang-Ho;Kim, Kyung-Ho;Choi, Chang-Hyun;Park, Choon-Sik;Lee, Wee-Gyo;Choi, Tae-Youn
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.67-75
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    • 1995
  • Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

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Nontuberculous Mycobacterial pulmonary Infection in Immunocompetent Patients (면역적격자에서 비결핵마이코박테리아의 폐감염)

  • Lee, Hyo-Won;Kim, Mi-Na;Shim, Tae-Sun;Bai, Gill-Han;Pai, Chik-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.173-182
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    • 2002
  • Background : Nontuberculous mycobacteria (NTM) have usually been considered to be contaminants of colonizers when isolated from respiratory specimens in Korea, where there is a high prevalence of tuberculosis and a low rate of HIV infections. Therefore, there has been few studies on the clinical significance of NTM species in immunocompetent patients were investigated. Methods : Thirty-five NTM isolates, for which species identification was requested by the treating physicians during 1999 at the Asan Medical Center, were retrospectively analyzed. They were identified to the species level by mycolic acid analysis using high-performance liquid chromatography. The medical records of the patients with the NTM isolates were reviewed to identify those patients who met the American Thoracic Society (ATS)'s criteria for mycobacterial pulmonary infection. Their antimicrobial susceptibility data were compared with the clinical outcomes. Results : The NTM were identified as M. intracellulare (6 isolates), M. avium (5), M. abscessus (5), M. gordonae (5), M. terrae complex (4), M. szulgai (2), M. kansasii (2), M. fortuitum (2), M. peregrinum (1), M. mucogenicum (1), M. celatum (1), and M. chelonae (1). All 35 patients showed clinical symptoms and signs of chronic lung disease, but none had a HIV infections; 16 (45.7%) patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria, 5 and 4 cases were affected with M. intracellulare and M. abscessus, respectively; 8 patients had a history of pulmonary tuberculosis. 13 patients received antimycobacterial therapy for an average of 21 months and 9 patients were treated with second-line drugs. Only 4 patients had improved radiologically. Conclusion : A NTM should be considered a potential pathogen of pulmonary infections in immunocompetent patients with chronic pulmonary diseases. Most NTM infections were left untreated for a prolonged period and showed a poor outcome as a result, M. intracellulare and M. abscessus were the two most frequent causes of NTM pulmonary infections in this study. Species identification and antimycobacterial susceptibility tests based on the species are needed for the optimum management of a NTM pulmonary infection in patients.

Studies on Isolation of Pasteurella multocida from Slaughtered Pigs, Microbiological and Serological Properties, Antibiotic Susceptibility of the Isolates and Pathological Observation of Their Lungs (도축돈에서 Pasteurella multocida의 분리, 분리주에 대한 미생물학적, 혈청학적성상 및 항생물질의 감수성조사와 돈폐에 대한 병리학적 관찰에 관하여)

  • Lee Hak-Cheol;Ham Tai-Soo;Chung Yoo-Yeol;Cho Seong-Lyong;Lee Jag-Hyeon
    • Journal of Veterinary Clinics
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    • v.6 no.2
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    • pp.307-318
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    • 1989
  • In recent years much attention has been paid to swine respiratory infection caused by Pasteurella(P) multocida with rapid expansion of pork Industry in Korea. The present study was performed to observe the etiologic situation of P. multocida infection by bacteriological, serological(serotyping) and pathological examinations with the lungs respectively. In addition antibiotic susceptibility test was carried out against the isolated strains of P. multocida. The results obtained are as follows : 1. Eighteen strains(12.8%) wert isolated from the 140 cases of swine lungs examined, and biological and biochemical characteristics of the isolates were the sam as those in the references of other workers, whereas some differences were observed in sugar fermentation and enzyme activity according to the strain of isolates. 2. Capsular serotyping performed on 18 P. multocida revealed that 13 strains(72.2%) were A type and 5 strains(27.8%) were D type, respectively. 3. When serotyping was performed against somatic antigen on 18 strains capsular types of which were identified as described above 9(50%), 3(16.7%) and 4(22.2%) strains belong to 1:A, 3:A and 2:D, respectively, but untypable 2 strains(11.1%) were observed. 4. Antibiotic susceptibility test by employing disc method for 24 kinds of drugs revealed that 15 kinds of antibiotics were sensitive to 18 strains of P. multocida isolated such as ampicillin(l00%), penicillin(100%), cloxacillin(56%), piperacillin(70%), cefotaxime(30%), minocycline(60%), chloramphenicol(95%), erythromycin(39%), kanamycin(17%), gentamicin(70%), amikasin(30%), colistin(78%) and nalidixic acid(5%), respectively, but resistant to 9 kinds of antibiotics such as sulpenicillin, cefazolin, cephalothin, cefametazol, cefoperazone, kitasamycin, oleandomycin. lincomycin and bacitracin. 5. Pathological features of 60 cases of swine lungs indicated that pneumonic .lesions were observed in 38 cases(63.3%) examined by macroscopic finding, in which lesions of 8 cases(13.4%) would correspond to those of mycoplasmal infection, and 30 cases(50%) were similar to viral infection by histopathological finding, whereas 22 cases(36.7%) were considered to be normal by ecropsy or histopathological finding.

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Colchicine Derivatives Allows Prolonged Survival of Cardiac Allograft in the Rat (백서에서의 동종이형의 심장이식후 Colchicine 변형 물질 투여군의 장기 변존)

  • Kim Young-Hak;Lee Hyung-Chang;Chung Won-Sang;Kang Jung-Ho;Kim Hyuck;Chon Sun-Ho;Shin Sung-Ho
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.595-600
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    • 2005
  • Background: Colchicine with its immunosupressive properties has been used with benefcial effects in autoimmune disease, such as Gout, etc. Whether colchicine, by virtue of the above property, could attenuate the process of cardiac allograft rejection in the rats is investigated in this report. Material and Method: We compared the untreated group (Control, n=6), Cyclosporin A group (10 mg/kg, daily, n=20), and Colchicine derivative group (Colchicine 40 ${\mu}g$/kg, n=20) of cardiac allografts in the rats. Result: In the untreated control group (n=6), all of 6 rats showed rejection within 3 weeks after cardiac allograft. In the cyclosporin A group (n=20), cyclosporin A (10 mg daily oral dose) was administered at a 10 mg daily oral dose and promoted long-term survival (over 100 days). The cyclosporin A group had one mortality at the 18th post-operative day due to infection. Furthermore, in the Colchicine derivatives group (n=20) with a daily IP (Intra Peritoneum) dose (40 ug/kg/day), we observed long-term survival.(> 100 days), except for one rat that died of an anesthetic problem (respiratory failure) at the 9th post-operative day. Conclusion: Experiments have also been performed to evaluate whether the effect of colchicine derivatives allowed prolonged survival of cardiac allografts compared with the cyclosporin A administration group in the rats.

Simple, Rapid and Sensitive Portable Molecular Diagnosis of SFTS Virus Using Reverse Transcriptional Loop-Mediated Isothermal Amplification (RT-LAMP)

  • Baek, Yun Hee;Cheon, Hyo-Soon;Park, Su-Jin;Lloren, Khristine Kaith S.;Ahn, Su Jeong;Jeong, Ju Hwan;Choi, Won-Suk;Yu, Min-Ah;Kwon, Hyeok-il;Kwon, Jin-Jung;Kim, Eun-Ha;Kim, Young-il;Antigua, Khristine Joy C.;Kim, Seok-Yong;Jeong, Hye Won;Choi, Young Ki;Song, Min-Suk
    • Journal of Microbiology and Biotechnology
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    • v.28 no.11
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    • pp.1928-1936
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    • 2018
  • Recently, human infections caused by severe fever with thrombocytopenia syndrome virus (SFTSV), which can lead to fatality, have dramatically increased in East Asia. With the unavailability of vaccines or antiviral drugs to prevent and/or treat SFTSV infection, early rapid diagnosis is critical for prevention and control of the disease. Here, we report the development of a simple, rapid and sensitive portable detection method for SFTSV infection applying reverse transcription-loop mediated isothermal amplification (RT-LAMP) combined with one-pot colorimetric visualization and electro-free reaction platform. This method utilizes a pocket warmer to facilitate diagnosis in a resource-limited setting. Specific primers were designed to target the highly-conserved region of L gene of SFTSV. The detection limit of the RT-LAMP assay was approximately $10^0$ viral genome copies from three different SFTSV strains. This assay exhibited comparable sensitivity to qRT-PCR and 10-fold more sensitivity than conventional RT-PCR, with a rapid detection time of 30 to 60 minutes. The RT-LAMP assay using SFTSV clinical specimens has demonstrated a similar detection rate to qRT-PCR and a higher detection rate compared to conventional RT-PCR. Moreover, there was no observed cross-reactive amplification of other human infectious viruses including Japanese Encephalitis Virus (JEV), Dengue, Enterovirus, Zika, Influenza and Middle East Respiratory Syndrome Coronavirus (MERS-CoV). This highly sensitive, electro- and equipment-free rapid colorimetric visualization method is feasible for resource-limited SFTSV field diagnosis.

Diagnostic Techniques for SARS-CoV-2 Detection (SARS-CoV-2의 진단기술)

  • Kim, Jong-Sik;Kang, Na-Kyung;Park, Seon-Mi;Lee, Eun-Joo;Chung, Kyung Tae
    • Journal of Life Science
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    • v.30 no.8
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    • pp.731-741
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    • 2020
  • Coronavirus disease 19 (COVID-19) is caused by SARS-CoV-2 (Severe Acute Respiratory SyndromeCoronavirus 2). To date, seven coronaviruses that can infect humans were reported. Among them, infections with four coronavirus strains (HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1) resulted in mild symptoms such as common cold, whereas SARS-CoV and MERS-CoV caused severe symptoms and epidemics in 2002 and 2012, respectively. In the most recent, SARS-CoV-2 was first reported in Wuhan, China in December 2019 and became a notorious cause of the ongoing global pandemics. To diagnose, treat, and prevent COVID-19, the development of rapid and accurate diagnostic tools, specific therapeutic drugs, and safe vaccines essentially are required. In order to develop these powerful tools, it is prerequisite to understand a phenotype, a genotype, and life cycle of SARS-CoV-2. Diagnostic techniques have been developing rapidly around world and many countries take the fast track system to accelerate approval. Approved diagnostic devices are rapidly growing facing to urgent demand to identify carriers. Currently developed commercial diagnostic devices are divided into mainly two categories: molecular assay and serological & immunological assay. Molecular assays begins the reverse transcription step following polymerase chain reaction or isothermal amplification. Immunological assay targets SARS-CoV-2 antigen or anti-SARS-CoV-2 antibody of samples. In this review, we summarize the phenotype, genome structure and gene expression of SARS-CoV-2 and provide the knowledge on various diagnostic techniques for SARS-CoV-2.