• The Korean Journal of Physiology
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• v.9 no.2
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• pp.7-15
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• 1975

The maximum breathing capacity (MBC) and the maximum mid-expiratory flow rate (MMF) are widely used in evaluation of the ventilatory function, among various parameters of pulmonary function. The MBC volume is the amount of gas which can be exchanged per unit time during maximal voluntary hyperventilation. Performance of this test, unlike that of single breath maneuvers, is affected by the integrity of the respiratory bellows as a whole including such factors are respiratory muscle blood supply, fatigue, and progressive trapping of air. Because of this, the MBC and its relation to ventilatory requirement correlates more closely with subjective dyspnea than does any other test. The MMF is the average flow rate during expiration of the middle 50% of the vital capacity. The MMF is a measurement of a fast vital capacity related to the time required for the maneuver and the MMF relates much better to other dynamic tests of ventilatory function and to dyspnea than total vital capacity, because the MMF reflects the effective volume, or gas per unit of time. Therefore, it is important to have a prediction formula with one can compute the normal value for the subject and the compare with the measured value. However, the formulas for prediction of both MBC and MMF of the Korean children and adolescents are not yet available in the present. Hence, present investigation was attempt to derive the formulas for prediction of both MBC and MMF of the Korean children and adolescents. MBC and MMF were measured in 1,037 healthy Korean children and adolescents (1,035 male and 1,002 female) whose ages ranged from 8 to 18 years. A spirometer (9L, Collins) was used for the measurement of MBC and MMF. Both MBC and MMF were measured 3times in a standing position and the highest values were used. For measurement, the $CO_2$ absorber and sadd valve were removed from the spirometer in order to reduce the resistance in the breathing circuit and the subject was asked to breathe as fast and deeply as possible for 12 seconds in MBC and to exhale completely as fast as possible after maximum inspiration for MMF. During the measurement, investigator stood by the subject to give a constant encouragement. All the measured values were subsequently converted to values at BTPS. The formulas for MBC and MMF were derived by a manner similar to those for Baldwin et al (1949) and Im (1965) as function of age and BSA or age and height. The prediction formulas for MBC (L/min, BTPS) and MMF (L/min, BTPS) of the Korean children and adolescents as derived in this investigation are as follows: For male, MBC=[41.70+{$2.69{\times}Age(years)$}]${\times}BSA$ $(m^{2})$ MBC=[0.083+{$0.045{\times}Age(years)$}]${\times}Ht$ (cm) For female, MBC=[45.53+{$1.55{\times}Age(years)$}]${\times}BSA$ $(m^2)$ MBC=[0.189+{$0.029{\times}Age(years)$}]${\times}Ht$ (cm) For male, MMF= [0.544+{$0.066{\times}Age(years)$}]${\times}Ht$ (cm) For female, MMF=[0.416+{$0.064{\times}Age(years)$}]${\times}Ht$ (cm)

• Tuberculosis and Respiratory Diseases
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• v.50 no.6
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• pp.686-692
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• 2001

Background : Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. Methods : Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into two groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk factors for treatment failure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test. chi-square test and a Fisher's exact test. Results : The treatment failure rate of MDR-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatment regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). Conclusion : The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.600-605
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• 2005

Background : Primary multidrug-resistant tuberculosis is defined as Mycobacterium tuberculosis isolates that are resistant to at least isoniazid and rifampin in never-been-treated tuberculosis patients, and this malady is caused by the transmission of a resistant strain from one patient, who is infected with a resistant Mycobacterium tuberculosis strain, to another patient. The prevalence of primary multidrug-resistant tuberculosis could be a good indicator of the performance of tuberculosis control programs in recent years. We conducted a case-control study to identify the risk factors for primary multidrug-resistant tuberculosis. Methods : From January 1, 2001 to, June 30, 2003, by conducting prospective laboratory-based surveillance, we identified 29 hospitalized patients with P-MDRTB and these patients constituted a case group in this study. The controls were represented by all the patients with culture-confirmed drug susceptible tuberculosis who were admitted to National Masan Hospital during the same study period. The odds ratios for the patients with primary multidrug-resistant tuberculosis, as compared with those of the patients with drug susceptible tuberculosis, were calculated for each categorical variable with 95% confidence intervals. Results : Multivariate logistic regression showed that the presence of diabetes mellitus (odds ratio 2.68; 95% confidence interval, 1.05-6.86) was independently associated with having primary multidrug-resistant tuberculosis. Conclusion : This study has shown that diabetes mellitus might be one of the risk factors for primary multidrug-resistant tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.353-356
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• 2006

Acute transverse myelitis (TM) is a neurological syndrome caused by inflammation of the spinal cord. TM is rare but is frequently caused by viral or bacterial infections. TM caused by tuberculosis (TB) is extremely rare and there are no reports of TM caused by multidrug-resistant TB (MDR-TB). We report a case of acute TM due to MDR-TB in a 40-year-old man. The patient had been diagnosed with pulmonary TB and was started on the first-line anti-TB treatment. However, the chest radiographic findings were aggravated and neurological symptoms such as weakness in both lower extremities, sensory changes, and voiding difficulty were newly developed. The T2-weighted magnetic resonance image of the spine showed diffusely increased signal intensity in the spinal cord, particularly at the lower cervical and upper thoracic levels, without any definite evidence of myeloradicular compression, which is consistent with a diagnosis of TM. A drug susceptibility test revealed MDR and second-line anti-TB drugs were prescribed. The chest radiographic findings showed improvement after treatment, the mycobacterial culture converted to negative, the MRI findings improved, and there was partial improvement in the low extremity weakness. The patient has been prescribing second-line anti-TB medications for 14 months.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1457-1461
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• 2012

Purpose: Non small cell lung cancer (NSCLC) is the leading worldwide source of cancer-related deaths. Although some drugs targeting EGFR mutations have been developed, most advanced cases are still incurable. New targets for anticancer drugs are demanded. The kringle 1 domain of hepatocellular growth factor alpha chain (HGFK1) is a potent anti-angiogenesis factor. It has also emerged as a potential anticancer factor in hepatocellular carcinoma (HCC). The expression of HGFK1 protein in patients with NSCLC has not been reported to date. Method: Here, we assessed HGFK1 expression by Western blotting in 103 cases with advanced NSCLC to investigate the impact of HGFK1 on survival. Results: Results revealed 33 (30.1%) patients were classified as high expressors, this being significantly associated with less remote metastasis (P = 0.002) but not with lymph node metastasis (P = 0.062). There was also a significant association between HGFK1 expression and tumor size (P = 0.025) as well as clinical stage (P = 0.012). Kaplan-Meier survival analysis showed that both overall survival (OS) and progression free survival (PFS) of patients with HGFK1 expression were longer than those of patients without HGFK1 expression (P = 0.004 and P = 0.001 respectively). HGFK1 reversed gefitinib inhibition in the resistent NSCLC cell line A431/GR but did not inhibit the proliferation of NSCLC cells A431 and A431/GR directly. Reversion of gefitinib inhibition in A431/GR cells by HGFK1 was related to decreased phosphorylation of ERK and STAT5. Conclusions: HGFK1 may be a useful prognostic factor of advanced NSCLC patients and a potential drug for gefitinib resistant patients.

• Journal of Aquaculture
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• v.11 no.4
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• pp.495-503
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• 1998

The present study investigated the effects of Bisroot, that contains live bacteria (Bacillus polyfermenticus, Bacillus mesentericus, Streptococcus faecalis, & Bifidobacterium breve) and digestive enzymes (protease, lipase), on the growth, body composition and immune response of Nile tilapia fingerlings. One percent of the Bisroot was added to the experimenta feed. All exprimental fish were fed for 60 days. The weigh gains among the experimental fish were not significntly different (P>0.05). Hematocrit value, hemoglobin, total protein, glucose, GOT, and GPT were unaffected by Bisroot treatment. However, it was observed that glucose, GOT, and GPT value in the fish that were fed Bisroot, were lower than the control. The complement activity ($CH_50$) tended to be significantly increased by Bisroot treatment, but not lysozyme activity. Phagocytosis and respiratory burst activities of macrophages in the head kidney were enhanced by Bisroot. Therefore, the Bisroot diet enhances the cellular immune activities were enhanced by Bisroot. Therefore, the Bisroot diet enhances the cellular immune activities of non-specific immune responses. When fish were challenged with a virulent strain of Edwardsiella tarda, the Bisroot treated fish were more resistant than the control. The present results suggest that the introduction of Bisroot into the diet of Nile tilapia could increase their resistance against bacterial infection, reduce fish mortality, and offers economic benefits.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.440-448
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• 2003

Background : Development of rapid drug susceptibility testing provides the opportunity for rapid identification of individuals with drug resistant tubercle bacilli, allowing selection of appropriate therapeutic regimens. Methods : A total of 502 drug resistant isolates were subjected to reverse blot hybridization assay to detect mutations within genes (rpoB, katG, inhA, and ahpC) associated with rifampicin (RMP) and isoniazid (INH) resistance. Results : Among the 264 RMP resistant strains ($RMP^R$) tested, the most prevalent mutation was the Ser531Leu seen in 121 strains (46%). The second common mutation occurred in 84 strains (32%) at codon 526. And 27 strains (10%) showed the mutation at codon 516. Among all 469 INH resistant strains ($INH^R$), the katG mutation was responsible for INH. The inhA mutation was present in 88 strains (19%). In 11 isolates (2%), coexisting of the katG and inhA mutations were identified. Reverse hybridization assay successfully detected over 80% of $INH^R$ and over 92% of $RMP^R$ among Korean isolates. CONCLUSION: Reverse hybridization was useful for rapid detection of $INH^R$ and $RMP^R$.

• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.212-220
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• 2009

Background: Ventilator-associated pneumonia caused by multi-drug resistant Acinetobacter baumannii has been increasing and growing as a threat in intensive care units. Limited therapeutic options have forced clinicians to choose colistin with or without combination of other antibiotics. We tried to compare the effectiveness between colistin monotherapy and combination therapy based on in vitro synergistic tests. Methods: From January 2006 to December 2007 in medical ICU of a tertiary care hospital in Korea, We reviewed the medical records of patients treated with intravenous colistin due to ventilator-associated pneumonia caused by multi-drug resistant Acinetobacter baumannii. Results: A total of 41 patients were analyzed. 22 patients had been treated with colistin monotherapy and 19 patients with colistin and combination antibiotics that were found to have in vitro synergistic effects. Baseline characteristics were similar in both groups but the mean duration of colistin administration was significantly longer in the combination group (19.1${\pm}$11.2 days vs. 12.3${\pm}$6.8 days, p=0.042). There were no significant differences in outcome variables between the two groups. Conclusion: Combination treatment based on the in vitro antimicrobial synergy test did not show better outcomes compared with colistin monotherapy in VAP caused by multi-drug resistant A. baumannii.

• Tuberculosis and Respiratory Diseases
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• v.63 no.5
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• pp.417-422
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• 2007

Background: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. Methods: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). Results: Smear conversion of the study subjects was observed after $8.3{\pm}2.3$ months treatment, and the patients were culture negative after $2.0{\pm}0.8$ months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (P>0.05). Conclusion: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.

• Tuberculosis and Respiratory Diseases
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• v.73 no.1
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• pp.48-55
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• 2012

Background: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. Methods: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. Results: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). Conclusion: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.