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Clinical Usefulness of Rapid Antigen Test on the Diagnosis of Influenza (인플루엔자 진단을 위한 신속 항원검사의 유용성)

  • Kim, Jae Seon;Choi, Hyon Joo;Ahn, Young Min;Hwang, Young Ok
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1348-1353
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    • 2005
  • Purpose : Influenza is a respiratory disease which prevails widely every year and shows high morbidity and mortality among not only chronic invalids and the old, but also among infants and young children. To prevent community-acquired influenza infection, to facilitate prompt antiviral therapy and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for the influenza virus is needed. We evaluated a lateral-flow immunoassay(QuickVue Influenza Test), compared to viral culture. Methods : During two consecutive years from Jan. 2004 to June 2004 and from Feb. 2005 to Jan. 2005, 408 patients who were suffering from fever, cough and/or sore throat and myalgia were enrolled in our study. A total of 408 patients were tested with $QuickVue^{(R)}$(Quidel Co., San Diego, USA) influenza rapid antigen test and virus cultures at the same time. Results : Of the 408 patients tested, children who showed positive results at the virus culture numbered 77; among them, 55(71.4 percent) were type A/H3N2 and 22(28.5 percent) were type B. QuickVue influenza test had a sensitivity of 71.4 percent and a specificity of 95.8 percent. The positive and negative predictive values were 79.7 percent and 93.5 percent, respectively. Conclusion : In our study, this test had comparable high sensitivity and high specificity and many advantages, such as being easy to perform and simple to interpret, and showing rapid results. If rapid influenza antigen tests are widely applied in the clinic, we can begin treatment more rapidly and reduce influenza complications and the abuse of antibiotics.

The Effect of Hyperthermic Pretreatment in a Neonatal Rat Model of Hypoxic-ischemic Brain Injury (열 전처지가 신생쥐의 허혈성 저산소성 뇌손상에 미치는 영향)

  • Kwak, Su-Hee;Lim, Hae-Ri;Kim, Heng-Mi;Choe, Byung-Ho;Kwon, Soon-Hak;Lee, Kyung-Hee;Oh, Ki-Won;Shon, Yoon-Kyung
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.32-37
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    • 2008
  • Purpose : Perinatal asphyxia is an important cause of neonatal mortality and subsequent lifelong neurodevelopmental handicaps. Although many treatment strategies have been tested, there is currently no clinically effective treatment to prevent or reduce the harmful effects of hypoxia and ischemia in humans. In the clinical setting, maternal hyperthermia induces adverse effects on the neonatal brain, but recent studies have shown that hyperthermic pretreatment (PT) plays some role in hypoxic-ischemic (HI) injuries of the developing brain. The present study investigated the effect of hyperthermic PT on HI brain injuries in newborn rats. Methods : HI was produced in 7-day-old neonatal rats by unilateral common carotid artery ligation, followed by hypoxia with 8% oxygen at $38^{\circ}C$ for 2 hours. Twenty-four hours before HI, one-half of the pups were exposed to a $40^{\circ}C$ environment for 2 hours. The severity of the brain injury was assessed 7 days after the HI. Results : Hyperthermic PT reduced the gross and histopathologic findings of brain injury from 64.7 to 31.2% (P<0.05). There were no differences in location and severity of injury between the pretreated and control brains. Conclusion : These findings indicate that hyperthermic PT provides neuroprotective benefits on HI in the developing brain. Also, these findings suggest maternal hyperthermia may have protective effect on perinatal HI brain injuries.

Swelling and Mechanical Property Change of Shale and Sandstone in Supercritical CO2 (초임계 CO2에 의한 셰일 및 사암의 물성변화 및 스웰링에 관한 연구)

  • Choi, Chae-Soon;Song, Jae-Joon
    • Tunnel and Underground Space
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    • v.22 no.4
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    • pp.266-275
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    • 2012
  • In this study, a method is devised to implement a supercritical $CO_2$ ($scCO_2$) injection environment on a laboratory scale and to investigate the effects of $scCO_2$ on the properties of rock specimens. Specimens of shale and sandstone normally constituting the cap rock and reservoir rock, respectively, were kept in a laboratory reactor chamber with $scCO_2$ for two weeks. From this stage, a chemical reaction between rock surface and the $scCO_2$ was induced. The effect of saline water was also investigated by comparing three conditions ($scCO_2$-rock, $scCO_2-H_2O$-rock and $scCO_2$-brine(1M)-rock). Finally, we checked the changes in the properties before and after the reaction by destructive and nondestructive testing procedures. The swelling of shale was a main concern in this case. The experimental results suggested that $scCO_2$ has a greater effect on the swelling of the shale than pure water and brine. It was also observed that the largest swelling displacement of shale occurred after a reaction with the $H_2O-scCO_2$ solution. The results of a series of the destructive and nondestructive tests indicate that although each of the property changes of the rock differed depending on the reaction conditions, the $H_2O-scCO_2$ solution had the greatest effect. In this study, shale was highly sensitive to the reaction conditions. These results provide fundamental information pertaining to the stability of $CO_2$ storage sites due to physical and chemical reactions between the rocks in these sites and $scCO_2$.

Convenient Nucleic Acid Detection for Tomato spotted wilt virus: Virion Captured/RT-PCR (VC/RT-PCR) (Tomato spotted wilt virus를 위한 간편한 식물바이러스 핵산진단법: Virion Captured/RT-PCR (VC/RT-PCR))

  • Cho Jeom-Deog;Kim Jeong-Soo;Kim Hyun-Ran;Chung Bong-Nam;Ryu Ki-Hyun
    • Research in Plant Disease
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    • v.12 no.2
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    • pp.139-143
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    • 2006
  • Virion captured reverse transcription polymerase chain reaction (VC/RT-PCR) could detect plant virus quickly and accurately. In the VC/RT-PCR, no antibody is needed unlike immuno-captured RT-PCR (IC/RT-PCR) which had been improved method of RT-PCR for plant viruses, and virus nucleic acids can be obtained easily within 30minutes by property of polypropylene PCR tube which is hold and immobilized viral particles on its surface. For the virion capture of Tomato spotted wilt virus (TSWV), the extraction buffer was tested. The optimum macerating buffer for TSWV was 0.01M potassium phosphate buffer, pH 7.0, containing 0.5% sodium sulfite. The viral crude sap was incubated for 30 min at $4^{\circ}C$. The virions in the PCR tubes were washed two times with 0.01M PBS containing 0.05% Tween-20. The washed virions were treated at $95^{\circ}C$ immediately for 1 min containing RNase free water and chilled quickly in the ice. Disclosed virions' RNAs by heat treatment were used for RT-PCR. Dilution end point of $10^{-5}$ from plant's crude sap infected with TSWV showed relatively higher detection sensitivity for VC/RT-PCR. During multiple detection using two or more primers, interference was arisen by interactions between primer-primer and plant species. The result of multiplex RT-PCR was influenced by combinations of primers and the kind of plant, and the optimum extraction buffer for the multiplex detection by VC/RT-PCR should be developed.

Development of Dose Planning System for Brachytherapy with High Dose Rate Using Ir-192 Source (고선량률 강내조사선원을 이용한 근접조사선량계획전산화 개발)

  • Choi Tae Jin;Yei Ji Won;Kim Jin Hee;Kim OK;Lee Ho Joon;Han Hyun Soo
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.283-293
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    • 2002
  • Purpose : A PC based brachytherapy planning system was developed to display dose distributions on simulation images by 2D isodose curve including the dose profiles, dose-volume histogram and 30 dose distributions. Materials and Methods : Brachytherapy dose planning software was developed especially for the Ir-192 source, which had been developed by KAERI as a substitute for the Co-60 source. The dose computation was achieved by searching for a pre-computed dose matrix which was tabulated as a function of radial and axial distance from a source. In the computation process, the effects of the tissue scattering correction factor and anisotropic dose distributions were included. The computed dose distributions were displayed in 2D film image including the profile dose, 3D isodose curves with wire frame forms and dosevolume histogram. Results : The brachytherapy dose plan was initiated by obtaining source positions on the principal plane of the source axis. The dose distributions in tissue were computed on a $200\times200\;(mm^2)$ plane on which the source axis was located at the center of the plane. The point doses along the longitudinal axis of the source were $4.5\~9.0\%$ smaller than those on the radial axis of the plane, due to the anisotropy created by the cylindrical shape of the source. When compared to manual calculation, the point doses showed $1\~5\%$ discrepancies from the benchmarking plan. The 2D dose distributions of different planes were matched to the same administered isodose level in order to analyze the shape of the optimized dose level. The accumulated dose-volume histogram, displayed as a function of the percentage volume of administered minimum dose level, was used to guide the volume analysis. Conclusion : This study evaluated the developed computerized dose planning system of brachytherapy. The dose distribution was displayed on the coronal, sagittal and axial planes with the dose histogram. The accumulated DVH and 3D dose distributions provided by the developed system may be useful tools for dose analysis in comparison with orthogonal dose planning.

Intraluminal High-Dose-Rate Brachytherapy for the Tumors of Gastrointestinal Tract (위장관 종양의 고선량율 강내 방사선치료)

  • Choi Byung Ock;Choi Ihl Bhong;Chung Su Mi;Kim In Ah;Choi Myoung Gyu;Chang Suk Kyun;Shinn Kyeong Sub
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.243-252
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    • 1995
  • Purpose : Intraluminal high dose rate brachytherapy is an accepted treatment for the tumors of GI tract. However, there is only some limited clinical data for intraluminal high dose rate brachytherapy for the tumors of GI tract. Materials and Methods : Between February 1991 and July 1993, 18 Patients who have the tumors of GI tract (esophageal cancer-8 cases, rectal cancer-10 cases) were treated with high dose rate Iridium-192 afterloading system (Microselectron-HDR, Nucletron CO, Netherland) at the department of therapeutic radiology, St. Mary's hospital, Catholic university medical college. Age range was 47-87 years with a mean a9e 71 years. All patients were treated with intraluminal high dose rate brachytherapy within two weeks after conventional external radiation therapy and received 3-5 Gy/fraction 3-4 times per week to a total dose 12-20 Gy (mean 17 Gy). Standard fractionation and conventional dose were delivered for external radiation therapy. Total dose of external radiation therapy ranged 41.4-59.4 Gy (mean 49.6 Gy). Median follow up was 19 months Results : The analysis was based on 18 patients, The complete response and partial response in esophageal cancer was similar (38%). Two year rates for survival and median survival were 13% and 10 months, respectively. Among 10 patients of rectal cancers, partial response was obtained in 6 patients (60%). There was no complete response in the patients with rectal cancer, but good palliative results were achieved in all patients. Conclusion : Although the number of patients was not large and the follow-up period was relatively short, these findings suggested that intraluminal high dose rate brachytherapy could be useful in the treatment of the patients with advanced tumors of GI tract.

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Studies on the Characteristics of Phosphorus in the Upland Soil -III. Yield Responses of Added Phosphorus for Soybean in Soils with Different Capacities of Phosphorus Sorbed (경작지(耕作地) 전토양(田土壤)의 인산특성(燐酸特性)에 관(關)한 연구(硏究) -III. 인산(燐酸) 흡수력(吸收力)이 상이(相異)한 밭토양(土壤)에서 대두(大豆)에 대(對)한 시용인산(施用燐酸)의 비효(肥效))

  • Shin, Cheol-Woo;Kim, Jeong-Je;Yoon, Jung-Hui
    • Korean Journal of Soil Science and Fertilizer
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    • v.21 no.3
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    • pp.272-279
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    • 1988
  • A pot experiment was conducted to define the effect of various soil phosphorus fractions for soybean yield and the relations of between various soil phosphorus fraction and each other in 11 upland soils with different capacities of phosphorus fixation and physico-chemical properties of soils. The effect of phosphorus fertilization was high in soils with high capacities of phosphorus fixation and low available phosphorus, and soybean yield was showed significant relationship with available phosphorus and inorganic soil phosphorus fractions. Fractional recovery of added phosphorus in soils were showed various range of 2.5-91.7%, and mean value of soils was 48.5%. In the relationships among the soybean yield, plant phosphorus content, phosphorus uptake and available phosphorus, inoganic phosphorus at flowering stage, soybean yield were showed significant relationship with available phosphorus content, phosphorus uptake were all showed significant correlation without Fe-P, but Fe-P was showed except Jeju soil. Al-P/Fe-P ratio was increased by phosphorus fertilization in soils at flowering stage, and in the relationships between Al-P/Fe-P ratio and soybean yield, phosphorus uptake, soil and plant phosphorus were showed high significant correlation, but Fe-P was not showed at flowering stage. P sorbed by soils from P 20ppm solution was decreased by phosphorus fertilization, and then decreasing rate was higher in soils with low capacity of phosphorus fixation then high phosphorus fixing soils. Also P sorbed was showed negatively high significant correlation with available phosphorus, plant phosphorus, phosphorus uptake and soil inorganic phosphours except Fe-P, and soybean yield was not showed.

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The Study of Effectiveness of MERS on the Law and Remaining Task (국내 메르스(MERS) 사태가 남긴 과제와 법률에 미친 영향에 대한 소고(小考))

  • Yoon, Jong Tae
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.263-291
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    • 2015
  • In May, 2015, a 68 years old man, who has been Middle East Saudi Arabia and the United Arab Emirates, had high fever, muscle aches, cough and shortness of breath. he went two local hospital near his house and the S Medical Center emergency center. He was diagnosed MERS(Middle East respiratory syndrome) and the diseases had put South Korea the fear of epidemics for three months. Especially, this disease has firstly reported in Middle East Asia in September 2012 and spreaded to twenty-six countries. In 21, July, 2015, European Center for disease prevention and control reported 533 people were died and in South Korea, 186 people were infected, 36 people were died and 16,693 people were isolated from MERS. South Korea government were faced into epidemic control and blamed from public. Especially, hospital acquired infection, disease control chain, opening of information, ventilation, lack of isolation bed, the problem of function of local health center, the issue of reparation for hospital and insurance cover rate, the classification of disease, the role of Korea Centers for disease control and prevention, the culture of visiting hospital to see sick people, the issue of hospital multiple room and other related social support policy. it is time to study and discuss to solve these problems. South Korea citizens felt fear and fright from MERS. What is wore, they thought the dieses were out of their government control. It was unusual case for word except Middle East Asia. numerous tourists canceled visiting korea. South korea economic were severly damaged especially, tourism industry. South korea government should admit that they had failed initial action against MERS and take full reasonability from any damages. The government have to open information to public in terms of epidemic diseases and try to prevent any other epidemic diseases and try to work with local governments.

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The Implementation and limits of Involuntary Detention of the Tuberculosis Prevention Act (결핵예방법의 격리명령의 실행과 한계에 관하여)

  • Kim, Jang Han
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.55-84
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    • 2015
  • The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

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Review of 2011 Major Medical Decisions (2011년 주요 의료 판결 분석)

  • Yoo, Hyun-Jung;Seo, Young-Hyun;Lee, Jung-Sun;Lee, Dong-Pil
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.199-247
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    • 2012
  • According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

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