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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.

Detection of Multidrug Resistance Using Molecular Nuclear Technique (분자핵의학 기법을 이용한 다약제내성 진단)

  • Lee, Jae-Tae;Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.2
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    • pp.180-189
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    • 2004
  • Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. $^{99m}Tc$-MIBI and other $^{99m}Tc$-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of PgP-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with $^{11}C$ have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and $N-[^{11}C]acetyl-leukotriene$ E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo.

Research Direction for Functional Foods Safety (건강기능식품 안전관리 연구방향)

  • Jung, Ki-Hwa
    • Journal of Food Hygiene and Safety
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    • v.25 no.4
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    • pp.410-417
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    • 2010
  • Various functional foods, marketing health and functional effects, have been distributed in the market. These products, being in forms of foods, tablets, and capsules, are likely to be mistaken as drugs. In addition, non-experts may sell these as foods, or use these for therapy. Efforts for creating health food regulations or building regulatory system for improving the current status of functional foods have been made, but these have not been communicated to consumers yet. As a result, problems of circulating functional foods for therapy or adding illegal medical to such products have persisted, which has become worse by internet media. The cause of this problem can be categorized into (1) product itself and (2) its use, but in either case, one possible cause is lack of communications with consumers. Potential problems that can be caused by functional foods include illegal substances, hazardous substances, allergic reactions, considerations when administered to patients, drug interactions, ingredients with purity or concentrations too low to be detected, products with metabolic activations, health risks from over- or under-dose of vitamin and minerals, and products with alkaloids. (Journal of Health Science, 56, Supplement (2010)). The reason why side effects related to functional foods have been increasing is that under-qualified functional food companies are exaggerating the functionality for marketing purposes. KFDA has been informing consumers, through its web pages, to address the above mentioned issues related to functional foods, but there still is room for improvement, to promote proper use of functional foods and avoid drug interactions. Specifically, to address these issues, institutionalizing to collect information on approved products and their side effects, settling reevaluation systems, and standardizing preclinical tests and clinical tests are becoming urgent. Also to provide crucial information, unified database systems, seamlessly aggregating heterogeneous data in different domains, with user interfaces enabling effective one-stop search, are crucial.

Clinical Characteristics in Panic Disorder Patients in Emergency Department (공황발작으로 응급실에 내원한 공황장애 환자들의 임상 특징)

  • Lee, Chang-Ju;Nam, Beom-Woo;Sohn, In-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.26-33
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    • 2021
  • Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

A Case of Glycogen Storage Disease Type Ia Confirmed by Biopsy and Enzyme Assay (제Ia형 당원병 1례 (Glycogen Storage Disease , Type Ia))

  • Meen Sang-Ae;Rho Kwang-Sik;Kim Pyung-Kil;Jeong Hyeon-Joo;Park Young-Nyeon;Kim Myung-Joon;Kim Ji-Hong
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.77-81
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    • 1998
  • The author exprienced a case of glycogen storage disease type Ia(GSD-I) in an 18-year-old male patient who was admitted to our hospital due to proteinuria and hypertension. he was suspected to have GSD when 12 years old because of his family history of short stature and hepatomegaly. On admission, physical examination revealed short stature, heparomegaly, and The diagnosis of GSD-I was confirmed by compatible liver biopsy finding and enzyme assay which erealeddeficiency of glcose-6-phosphatase if hepatocyte. Sympromatic treatment was done using antihypertensive drugs and allopurinol with diet control. The authors report a case of glycogen storage disease type Ia completely confirmed by typical clinical manifestation, pathologic findings of the liver and the kidney, and the result of enzyme assay which revealed deficiency of glucose-6-phosphatase in hepatocytes with brief review fo related literatures.

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Antioxidant and Anti-Inflammatory Activities of Eugenol and Its Derivatives from Clove (Eugenia caryophyllata Thunb.) (정향(Eugenia caryophyllata Thunb.) Eugenol 및 그 유도체의 항산화 및 항염증활성)

  • Leem, Hyun-Hee;Kim, Eun-Ok;Seo, Mi-Jae;Choi, Sang-Won
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.10
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    • pp.1361-1370
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    • 2011
  • Antioxidant and anti-inflammatory activities of eugenol and its derivatives from clove (Eugenia caryophyllata Thunb.) were evaluated using in vitro assay systems by measuring 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical, cyclooxygenase-2 (COX-2), and 15-lipoxygenase (15-LOX). Among eight different crude medicinal drugs tested, volatile extracts of clove extracted by steam distillation extraction (SDE) showed potent DPPH radical scavenging activity ($IC_{50}$=8.85 ${\mu}g/mL$) as well as strong inhibitory activity against COX-2 (58.15%) and 15-LOX (86.15%) at 10 ${\mu}g/mL$ and 25 ${\mu}g/mL$, respectively. Major volatile components of clove were identified as eugenol, trans-caryophyllene, and acetyleugenol by GC-MS analysis. Out of three eugenol derivatives, eugenol, methyl eugenol, and acetyl eugenol, eugenol showed the strongest DPPH radical scavenging activity and COX-2 inhibitory activity, whereas methyl eugenol exhibited the strongest 15-LOX inhibitory activity. Finally, the contents of the three eugenol derivatives in clove were quantified by analytical HPLC. Contents of eugenol and acetyl eugenol in clove were 6.95% and 1.85% per dry weight, respectively. These results suggest that eugenol and its derivatives in steam distilled extract of clove may be useful as potential antioxidant and anti-inflammatory agents.

Health Medical Center Utilization Pattern and Its Related Factors among the Rural Inhabitants (농촌지역(農村地域) 주민(住民)들의 보건의료원(保健醫療院) 이용양상(利用樣相)과 관련요인(關聯要因))

  • Hwang, Byung-Deog;Park, Jae-Yong
    • Journal of agricultural medicine and community health
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    • v.18 no.1
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    • pp.77-91
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    • 1993
  • This study was conducted to assess health medical center utilization pattern and its related factors among the rural inhabitants for the purpose of contribution to establishment of health medical center institutions. A questionnaire survey was carried out for object of 3,754 population of three primary school and three middle school student's parents (total 832 household) in Kyungbook Ulchin Gun rural area from 24 to 28 September, 1990. The summarized result are as follows, Respondents are 60.3% in male, 39.7% in female and 30-40s 81.3% in age, high school graduates 40.3% in education level and a regional medical insurance scheme in 44.1% in forms of health insurance. Recognition for health medical center was showed higher according to high educational, high income level, and short distance for location of health medical center of respondents (p < 0.01). Recognition for health medical center services was showed higher about care of medicaid in medical treatment services and higher preventive vaccination in health prevention services by respondents. Utilization rates of health medical center by out-patient care and preventive care service were 11.1 and 4.5 per 100 persons by year, but admission utilization rate was 34.6 per 10.000 persons by year. Motivations of health medical center utilization were showed a good care(45.7%), a good drugs(45.2%), and nearby health medical center(42.9%). In comparison health service levels of health medical center with general clinic was better (16.3%), similar(38.7%), 7(19.0%), and worse(19.0%) in view of health medical center utilizators. Inconvinience about health medical center utilized was the most higher longtime waiting, the next was limited utilization times. Transportation utilited were on foot(55%), by bus(35.5%), and so on. As mentioned above, there are many inhabitants who less understanding and less acknowledgement about health medical center and even mistake health center for health medical center. Therefore, there must be more information about health medical center. For higher utilization of health medical center, there must be considered expansion of health equipment, facilities, accomplishment with reinforcement of health staffs and efficiency management.

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Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: Protocol for a Randomized Controlled Pilot Trial (폐경 후 여성의 전단계 및 1기 고혈압에 대한 침 치료: 다기관 무작위 대조 예비연구)

  • Kim, Jung-Eun;Choi, Jin-Bong;Kim, Hyeong-Jun;Kang, Kyung-Won;Liu, Yan;Jung, Hee-Jung;Lee, Min-Hee;Shin, Mi-Suk;Kim, Jae-Hong;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.5-13
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    • 2014
  • Objectives : This study aims to evaluate the effectiveness and safety of acupuncture and explore the appropriate number of treatment for postmenopausal women diagnosed with prehypertension and stage 1 hypertension. Methods : A 4-arm randomized open label pilot trial will be performed at 2 centers. Sixty participants will be divided into 2 treatment groups and 2 control groups. Treatment groups will receive acupuncture at 8 points(bilateral GB20, LI11, ST36, SP6) for 4 weeks(treatment group A, 10 total sessions) or 8 weeks(treatment group B, 20 total sessions), while maintaining usual care. Control groups will not receive acupuncture but will be under usual care for 16 weeks(control group C) or 20 weeks(control group D). Each patient's living habits will be corrected and drugs that may affect blood pressure(BP) will be prohibited. Treatment group A and control group C will be evaluated at 4, 8, 12, and 16 weeks after randomization, while treatment group B and control group D will be evaluated at 4, 8, 12, 16, and 20 weeks after randomization. The major outcome variable is the magnitude of change in diastolic BP levels at 4 weeks after randomization; auxiliary outcome variables are (1) diastolic BP change at 8, 16, and 20 weeks, (2) systolic BP change, (3) BP control rate, (4) lipid profiles, and (5) high-sensitivity C-reactive protein. Patient safety will be assessed at every visit. Results and Conclusions : The study findings may help develop evidence for the effectiveness and safety of acupuncture for BP control.

Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

Incidence of Escherichia coli and Its Susceptibility to Antimicrobials in Childhood Urinary Tract Infection (소아 요로감염에서 Escherichia coli의 빈도와 항생제 감수성에 대한 연구)

  • Chi Hye-Mi;Kwahk Jae-Hyok;Lee Jun-Ho;Park Hye-Won
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.18-26
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    • 2006
  • Purpose : Empirical antimicrobial treatment is indicated before bacteriological results are available for young children with febrile UTI to minimize renal scarring. To ensure appropriate therapy, knowledge of the prevalence of causative organisms and their susceptibility patterns to antimicrobials is mandatory. We performed a retrospective analysis investigating the local prevalence and resistance patterns of uropathogens, primarily E. coli, isolated from community-acquired UTIs. Methods : A total of 103 positive urine cultures from children with febrile UTI collected at Bundang CHA General Hospital from February 2004 to February 2005 were analyzed. Inclusion criteria were fever higher than $37.5^{\circ}C$, significant bacteriuria with single strain growth of at least 10s colony forming units/mL urine, and leukocyturia >5/HPF. Results : E. coli(89.3%) was the leading uropathogen followed by Enterococcus spp.(3.9%) Klebsiella spp.(2.9%), Citrobctcter spp.(1.9%) and Enterobacter spp.(1.9%). E. coli strains revealed a low proportion of antimicrobial susceptibility to ampicillin(AMP; 27.2%) ampicillinsulbactam(AMS; 34.8%) and trimethoprim-sulfamethoxazole(SXT; 65.2%). Susceptibility patterns to cephalosporins were as follows; cefazolin(1st generation; 91.3%), cefoxitin(2nd; 100%), ceftriaxone(3rd; 97.8%) and cefepime(4th; 97.8%). Three E. coli isolates produced ex tended - spectrum beta-lactamase(ESBL). Conclusion : Empirical treatment with AMP, AMS and SXT, which are commonly used in pediatric clinics, is not recommended for childhood UTI due to high incidence of resistance. The high level of susceptibility to cephalosporins makes these drugs reasonable alternatives. However the emergence of ESBL-producers, even though they are quite few, may have an impact on cephalosporin treatment in the future. (J Korean Soc Pediatr Nephrol 2006;10:18-26)

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