Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.
Purpose: This study aims to evaluate and prospect for current research trend and developmental perspectives via analyzing recent biomaterial coated-implants study. Materials and methods: To investigate each subject respectively, several biomaterials that are using for implant surface coating were set as 'keywords'. By these keywords, major research groups in each subject were chosen, and research trend of them was analyzed. Trend of In vivo studies that examined selected biomaterials were analyzed to evaluate commercial potential. Results: The collagen research accounted for 40% of total implant study, which was the highest, and fibronectin, BMPs (bone morphogenetic proteins) and RGD (Arg-Gly-Asp) peptides followed, which were ranked in descending order. Furthermore, figures of all four research subjects were also increased with time, especially a sharp increase in RGD research. According to the results of major research group, collagen that was combined with other organic and inorganic biomaterials was mostly examined, rather than using collagen only. Major research groups investigating BMPs mostly focused on rhBMP-2. In animal studies, collagen was used as resorbable membrane in guided bone regeneration (GBR) or drug carrier, while BMPs were used with bone graft materials or coating material for titanium implant surface. Conclusion: There is not consistency of results even in identical subjects research field. Many studies are ongoing to optimize combination between mechanical surface treatment and biomaterials such as extracellular matrix component and growth factors.
Seo, Cheon-Seok;Youn, Tak;Kim, Eui-Joong;Jeong, Do-Un
Sleep Medicine and Psychophysiology
/
v.7
no.1
/
pp.34-42
/
2000
Objectives: Periodic limb movements in sleep(PLMS) is a moderately prevalent disorder, of which pathophysiology remains largely unknown. PLMS has been reported to be common in patients with obstructive sleep apnea syndrome(OSAS), but reports on their relationship have been inconsistent in previous studies. Inconsistency of results may be attributable to insufficient number of the study subjects. We attempted to explore the influence of OSAS on PLMS in a large number of subjects. Methods: Three hundred and twenty subjects(M : F=192:128) with PLMS, as identified by the nocturnal polysomnography, were studied. Sample mean age was 53.1(SD=15.1) years and their mean periodic limb movement index(PLMI) is 25.2/hr (SD=24.8). PLMS subjects were divided into two groups, based on the presence or absence of OSAS. Periodic limb movement indices and sleep parameters between two groups were analyzed to evaluate the effects of OSAS on PLMS. Results: Each of PLMI and PLMI with arousal(PLMAI) correlated positively with age. PLMI of men was larger than that of women (p<0.01). The presence of comorbid OSAS independently had influence on PLMI(t=-2.20, p<0.05), but not PLMAI. There were no significant differences between the two groups in their PLMI, PLMAI and sleep parameters. However, the two groups differed in PLMI-correlated sleep parameters. In PLMS subjects with comorbid OSAS, PLMI was negatively correlated with each of slow wave sleep time and REM sleep time. In subjects without comorbid OSAS, PLMI was negatively correlated with sleep efficiency. Conclusion: PLMS patients with OSAS turned out to have increased PLMI than those without OSAS We suggest that OSAS patients may have subtle autonomic arousals and these arousals could, in part, express themselves as PLM.
Kim, Eun Kyung;Shim, Tae Sun;Lee, Jung Yeon;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Dong Soon;Kim, Won Dong;Kim, Woo Sung
Tuberculosis and Respiratory Diseases
/
v.57
no.3
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pp.226-233
/
2004
Background : Interferon-gamma (IFN-${\gamma}$) is a critical cytokine in the defense against a Mycobacterium tuberculosis infection. Even though IFN-${\gamma}$ has occasionally been used in the treatment of refractory multidrug-resistant tuberculosis (MDR-TB) with some promising results, there is still some controversy regarding the therapeutic efficacy of IFN-${\gamma}$. This study was performed to examine the effect of subcutaneous IFN-${\gamma}$ in the treatment of MDR-TB patients. Methods : Six patients with refractory MDR-TB were enrolled in this study. Two million IU of IFN-${\gamma}$ was administered subcutaneously three times a week with the concomitant administration of antituberculous drugs for at least for 28 weeks. During the IFN-${\gamma}$ therapy, the sputum smear and culture, radiological and clinical evaluations were performed every 4 weeks throughout the study period. Results : The mean age of the 6 patients was 37 years (ranges, 15-61 years). The drug susceptibility test to standard antituberculous drugs revealed resistance to an average of 6.8 (${\pm}1.2$) agents including isoniazid and rifampicin. An average of 10.8 (${\pm}1.3$) antituberculous drugs were prescribed before IFN-${\gamma}$ therapy. The culture became negative in 2 patients (33%) after initiating IFN-${\gamma}$ therapy; one at 8 weeks, and the other at 24 weeks. Finally, after stopping the IFN-${\gamma}$ therapy after 28 weeks, the culture became positive again in the two patients who were culture-negative. The other 4 patients who failed in the culture conversion are still on antituberculous treatment except for one who died of tuberculosis. Conclusion : Even though 28 weeks of subcutaneous IFN-${\gamma}$ therapy in combination with antituberculous drugs was successful in inducing the culture-negative conversion in some patients with refractory MDR-TB, the culture became positive again after stopping the IFN-${\gamma}$ therapy. This suggests that subcutaneous IFN-${\gamma}$ therapy may have suppressive effect on tuberculosis only during the IFN-${\gamma}$ therapy period in some patients. Further studies will be needed to determine the optimum dose, the administration route, the duration of therapy, and the predicting factors of the response to adjuvant IFN-${\gamma}$ therapy.
Kang, Min Joo;Shin, Hye Kyung;Yim, Hyung Eun;Je, Bo-Kyung;Eun, So Hee;Choi, Byung Min;Park, Jong-Tae;Eun, Baik Lin;Yoo, Kee Hwan
Clinical and Experimental Pediatrics
/
v.49
no.3
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pp.278-286
/
2006
Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.
The tortoise pedestal for the memorial monument of Choe Jin-rip(an army officer in the mid-Joseon Period) in Ijo-ri, Naenam-myeon, Gyeongju is known to have been made in 1740. As such, it was originally understood to be a Joseon imitation of a tortoise pedestal made in the Unified Silla Period. The style of the Ijori Tortoise Pedestal differs from other tortoise pedestals dating back to the same period, and bears no resemblance to the Unified Silla pedestals of which it is a copy. Mullu ilgi, a record of the production of the pedestal, explains that the monument was made before the pedestal. Traces show that the two sides of the bottom of the monument were cut off so that it would fit into the smaller space made on the pedestal. It is scarcely conceivable that they made the pedestal and the platform without considering the bottom size of the monument. The record only states that the monument was made at a temple site named Baegundae, without explaining the details of the production process. This leaves some doubt as to whether its production was undertaken systematically. The cloud patterns engraved on this pedestal look similar to the temporal seriation found on the Tortoise Pedestal of the Royal Tomb of King Muyeol and the Seoangni Tortoise Pedestal of Gyeongju. The lotus pattern decorating the square pedestal on the back of the tortoise is one of a number of patterns that were widely used on roof-tiles in the 8th century, the heyday of the Unified Silla Kingdom. The Ijori Tortoise Pedestal, which represents a tortoise moving forward, displays a liveliness the like of which is rarely found in its cousins remaining in Gyeongju. The layout of the patterns in a queue on the tortoise-shell looks much better schematized than those made at an earlier date. It also looks like a more developed form, with the use of space taken into account. Such factors as the style of the patterns, the incongruity between the monument and its pedestal, and what is stated in the historical record indicate that the Ijori Tortoise Pedestal of Gyeongju was made in the mid-8th century(i.e. during the Unified Silla Period), rather than in the Joseon Period(i.e. the 18th century), as an imitation of earlier ones, including changes in the style unique to the Silla Period.
Ahn, Hee Ju;Kang, Kyung Soo;Song, Yun Ha;Lee, Da Hae;Kim, Mun Ho;Lee, Jae Kyoung;Woo, Hee Chul
Clean Technology
/
v.28
no.1
/
pp.24-31
/
2022
Petroleum-based plastics are used for various purposes and pose a significant threat to the earth's environment and ecosystem. Many efforts have been taken globally in different areas to find alternatives. As part of these efforts, this study manufactured alginate-based polyvinyl alcohol (PVA) blended films by casting from an aqueous solution prepared by mixing 10 wt% petroleum-based PVA with biodegradable, marine biomass-derived alginate. Glutaraldehyde was used as a cross-linking agent, and cardanol, an alkyl phenol-based bio-oil extracted from cashew nut shell, was added in the range of 0.1 to 2.0 wt% to grant antibacterial activity to the films. FTIR and TGA were performed to characterize the manufactured blended films, and the tensile strength, degree of swelling, and antibacterial activity were measured. Results obtained from the FTIR, TGA, and tensile strength test showed that alginate, the main component, was well distributed in the PVA by forming a matrix phase. The brittleness of alginate, a known weakness as a single component, and the low thermal durability of PVA were improved by cross-linking and hydrogen bonding of the functional groups between alginate and PVA. Addition of cardanol to the alginate-based PVA blend significantly improved the antibacterial activity against S. aureus and E. coli. The antibacterial performance was excellent with a death rate of 98% or higher for S. aureus and about 70% for E. coli at a contact time of 60 minutes. The optimal antibacterial activity of the alginate-PVA blended films was found with a cardanol content range between 0.1 to 0.5 wt%. These results show that cardanol-containing alginate-PVA blended films are suitable for use as various antibacterial materials, including as food packaging.
Copper is one of the non-ferrous metals used in the electrical/electronic manufacturing industries due to its superior properties particularly the high conductivity and less resistivity. The effluent generated from the surface finishing process of these industries contains higher copper content which gets discharged in to water bodies directly or indirectly. This causes severe environmental pollution and also results in loss of an important valuable metal. To overcome this issue, continuous R & D activities are going on across the globe in adsorption area with the purpose of finding an efficient, low cost and ecofriendly adsorbent. In view of the above, present investigation was made to compare the performance of a plant root (Datura root powder) as a bio-adsorbent to that of the synthetic one (Tulsion T-42) for copper adsorption from such effluent. Experiments were carried out in batch studies to optimize parameters such as adsorbent dose, contact time, pH, feed concentration, etc. Results of the batch experiments indicate that 0.2 g of Datura root powder and 0.1 g of Tulsion T-42 showed 95% copper adsorption from an initial feed/solution of 100 ppm Cu at pH 4 in contact time of 15 and 30 min, respectively. Adsorption data for both the adsorbents were fitted well to the Freundlich isotherm. Experimental results were also validated with the kinetic model, which showed that the adsorption of copper followed pseudo-second order rate expression for the both adsorbents. Overall result demonstrates that the bio-adsorbent tested has a potential applicability for metal recovery from the waste solutions/effluents of metal finishing units. In view of the requirements of commercial viability and minimal environmental damage there from, Datura root powder being an effective material for metal uptake, may prove to be a feasible adsorbent for copper recovery after the necessary scale-up studies.
Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.
Kim Jin-Sun;Choi Jin-Ho;Yang Ji-Hyuk;Park Pyo-Won;Youm Wook;Jun Tae-Gook
Journal of Chest Surgery
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v.39
no.8
s.265
/
pp.588-597
/
2006
Background: The surgical repair of a tetralogy of Fallot (TOF) has been performed successfully with a favorable early and late outcome. However, the later development of pulmonary regurgitation and stenosis remains a problem. The development of pulmonary regurgitation and stenosis may be changed by the size of right ventricular outflow tract (RVOT) reconstruction at the initial total correction. Hence, it is necessary to investigate the ideal size of RVOT reconstruction. Material and Method: This prospective study was carried out to determine how a surgical strategy and the RVOT size affect the occurrence of pulmonary regurgitation and stenosis. From January 2002 to December 2004, 62 patients underwent the TOF total correction. The RVOT size (diameter of pulmonary valve annulus) of each case was measured after the RVOT reconstruction and converted to a Z value. A pre-scheduled follow up (at discharge, 6 months, 1 year, 2 years and 3 years) was carried out by echocardiography to evaluate the level of pulmonary regurgitation and stenosis. Result: The patients were divided to two groups (transannular group n=12, nontransannular group n=50) according to the method of a RVOT reconstruction. The Z value of RVOT=iameter of pulmonary valve annulus) (transannular group -1, $range\;-3.6{\sim}-0.8;$ nontransannular group -2.1, $range\;-5.2{\sim}-1.5)$ and the average pRV/LV after surgery ${(transannular group 0.44{\pm}0.09,\;nontransannular group\;0.42{\pm}0.09)}$ did not show any significant difference between two groups. The occurrence of pulmonary regurgitation above a moderate degree was more frequent in the transannular group (p<0.01). In nontransannular group, the development of pulmonary regurgitation more than moderate degree occurred to the patients with larger RVOT size (Z value>0, p<0.02) and the progressing pulmonary stenosis more than mild to moderate degree developed in the patients with smaller RVOT size (Z value<-1.5, p<0.05). A moderate degree of pulmonary stenosis developed for 4 nontransannular patients. Three underwent additional surgery and one underwent a balloon valvuloplasty. Their Z value of RVOT were -3.8, -3.8 -2.9, -1.8, respectively. Conclusion: When carring out a TOF total correction, transannular RVOT reconstruction group has significantly more pulmonary regurgitation. In the nontransannular RVOT reconstruction. the size of the RVOT should be maintained from Z value -1.5 to 0. If the Z value is less than -1.5, we should follow up carefully for the possibility of pulmonary stenosis.
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