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Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과)

  • Hong, Jae-Rak;Yoo, Min-Kyu;Jeong, Jae-Man;Kim, Young-Jun;Son, Mal-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.693-700
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    • 1996
  • Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

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Longitudinal flowcytometric measurement of respiratory burst activity of neutrophils in patients with pneumonia (폐렴경과 중 순환 호중구의 Respiratory Burst 활성도 변화)

  • Lee, Jae Myung;Lee, Jong Min;Kim, Dong Gyu;Choi, Jeong Eun;Mo, Eun Kyung;Park, Myung Jae;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki-Suck;Park, Chan Jeoung
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.728-735
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    • 1996
  • Background : Recognition and ingestion of opsonized microorganisms by neutrophils induces the burst of oxidative metabolic activity. Products of the respiratory burst activity provide powerful oxygen dependent killing mechanism. Measurement of respiratory burst activity has been a major indicator of the functional capacity of neutrophils. We determined the respiratory burst activity of neutrophils in patients with pneumonia and observed the changes during the clinical course of pneumonia. Methods: The EDTA blood was drawn from 24 normal controls and same numbers of pneumonia patients. The respiratory burst activity(with the production of $H_2O_2$ which changes nonfluorescent DCF-DA to green fluorescent DCF) in the non-stimulated state and the stimulated state with fMLP and PMA of neutrophils was measured by flowcytometry at day 1, 3, 5, 7 and 9 of admission. Results: The respiratory burst activity of neutrophils was mildly increased by stimulation with fMLP. But there was no statistical significance between normal control and patients with pneumonia. The respiratory burst activity of neutrophils was markedly increased by stimulation with PMA in both groups. There was a significant difference in response to PMA between normal control and patients with pneumonia. The production of hydrogen peroxide from neutrophils was decreased during early course of pneumonia and it was recuperated gradually to normal level in 9 days. Conclusion : Hydrogen peroxide production from neutrophils was suppressed during early course of pneumonia and restored after treatment. It is suggested that the production of oxygen radical in response to PMA stimulation from each neutrophils is decreased rather than increased during the early course of pneumonia.

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Efficacy of Transcervical Fallopian Tube Catheterization in Infertility Patients with Fallopian Tube Occlusion (난관 폐쇄에 기인한 불임 환자에서 난관 개통술의 효용성)

  • Park, Chan-Woo;Cha, Sun-Hwa;Yang, Kwang-Moon;Han, Ae-Ra;Yoo, Ji-Hee;Song, In-Ok;Kim, Hye-OK;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.321-327
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    • 2010
  • Objective: To evaluate the significance and efficacy of trans-cervical fallopian tube catheterization (TFTC) in diagnosis and optimal treatment modality for tubal blockage. Methods: The retrospective study was performed in those underwent TFTC from January 2005 to December 2009. A total of 342 fallopian tubes in 215 patients which showed tubal blockage in hysterosalpingography (HSG), were subjected to TFTC. Recanalization rate (RR) was compared according to portion of tubal blockage; proximal, isthmic and distal portion and blockage type; tapering, concave, and convex type. Results: In total, RR was 72.5% (248/342 tube). According to the portion of tubal blockage, RR was 83.8% in proximal, 45.6% in isthmic and 100% in distal portion. RR was 92.3% in tapering, 80.2% in concave and 25.5% in convex type, respectively. There were 98 pregnancies in 156 patients after successful recanalization, which shows 62.7% pregnancy rate. Conclusio: TFTC were capable of recanalizing tubal blockage in 248 of 342 tubes in 156 of 215 patients (72.5%). The RR was increased with proximal portion and tapering type tubal blockage.

Relationship between iron deficiency anemia and febrile convulsion in infants (영아에서 철결핍 빈혈과 열성경련과의 상관관계)

  • Jun, Youn Soo;Bang, Ho Il;Yu, Seung Taek;Shin, Sae Ron;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.392-396
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    • 2010
  • Purpose : The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. Methods : In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. Results : The mean ages of the febrile convulsion and control group were $16.3{\pm}7.4$ and $15.8{\pm}6.1$ months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb <10.5 gm/dL) was more frequent in the febrile convulsion group than in the control group, although there was no statistical significance. Unexpectably, the RDW (red blood cell distribution width) was significantly lower and the MCNC (mean corpuscular hemoglobin concentration) was significantly higher among seizure cases than among the controls (P <0.05). There is no statistical difference between simple and complex febrile groups in the clinical and laboratory profiles. On multiple logistic regression analysis, iron deficiency anemia was more frequent, but the RDW was lower, among the cases with febrile convulsion, compared with the controls. Conclusions : Our study suggests that the iron deficiency anemia is associated with febrile convulsion, and screening for iron deficiency anemia should be considered in children with febrile convulsions.

Life Style and Eating Behavior of Stroke Patients in Daegu and Gyeongbuk Province, Korea (대구.경북지역 뇌졸중 환자의 생활습관 및 식행동 특성)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.3
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    • pp.319-332
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    • 2009
  • The present study was performed to analyze the life style and eating behavior of stroke patients and to find the risk factors related to stroke incidence in Daegu and Gyeongbuk Province, Korea. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community inhabitants who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews using questionnaires on the general characteristics, life-style, eating behavior, food intake frequency and food preference. The high body mass index, preexisting diseases such as diabetes and hypertension, stroke family history, smoking, overeating habit and high preference for sweet, greasy and meat foods appeared to be the risk factors for stroke incidence. On the other hand, the results suggest that life style of regular exercise and nonsmoking, food habits of green tea drinking and enough chewing, preference for Korean meal type, high intake frequency for legumes, vegetables, mushrooms, seaweeds, fishes and shell fishes, soy milk and green tea might be the protective factors for the stroke. Therefore, maintenance of healthy weight, the prevention and management of the deteriorative chronic diseases, change of life style and improvement of eating behaviors are considered to be important for stroke prevention.

Prognostic Values of Preoperative Hematologic Parameters in Gastric Cancer (위암에서 수술 전 혈액학적 검사의 예후인자로서의 가치)

  • Kim Hyoung-Ju;Kwon Sung Joon
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.29-33
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    • 2005
  • Purpose: To determine the prognostic values of the hematologic parameters checked preoperatively in gastric cancer patients, we evaluated and compared the relationship between hematologic parameters and clinicopathologic factors of gastric cancer patient. Materials and Methods: The medical records of 357 consecutive patients who had undergone surgery for gastric cancer at the Department of Surgery, Hanyang University Hospital, between Dec. 2,000 and Dec. 2003 were reviewed. To exclude any adverse effect of invasive procedures to hematologic parameters, the samples taken immediately at outpatient department was used. The normal range of serum albumin was defined above 3.5 g/dl, serum hemoglobin above 12 g/dl, and serum platelet count under $400\times10^{3}{\mu}l$. Patients were defined as group 1 when any of these parameters was abnormal, and defined as group 2 when all parameters were normal. The relationships between hematologic parameters and survival rate were investigated. Results: The mean values of platelet count increased, but level of serum albumin and serum hemoglobin decreased significantly according to the advancement of the disease stage (P=0.000). The differences of depth of tumor invasion and lymph node metastasis between the group 1 and the group2 was statistically significant (P=0.001). Three-year survival difference between group 1 and group 2 was significant (P=0.037). Conclusion: The hematologic parameters checked preoperatively in patients of gastric cancer are simple and cheap, meanwhile reflect the general condition of the patients. Any presence of anemia, hypoalbuminemia, or thrombocytosis can predict the progression of the disease and poor survival rates.

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Diurnal Variation and Sleep Pattern in Depressive Patients (우울증 환자의 주간기분변동과 수면 양상)

  • Park, Young-Min;Kim, Leen;Suh, Kwang-Yoon;Joe, Sook-Haeng;Kang, Seung-Gul;Yoon, Ho-Kyung
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.30-36
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    • 2001
  • Object: Diurnal variation is included in the diagnostic criteria of the major depressive disorder, melancholic specifier. But there has been controversy over whether diurnal variation is an unique depressive symptoms or a symptom related to a change of sleep patterns, or that of another mechanism, when the previous studies are reviewed. We investigated the existence of diurnal variation according to the subtype of depression and whether diurnal variation is charateristic of melancholic depression or not. We also compared sleep variables according to the existence of diurnal variation. Method: We examined diurnal variation, sleep patterns, severity of depression using the Visual Analogue Mood Scale, Pittsburgh Sleep Quality Index, and Hamilton Depression Rating Scale. Patients recorded their mood state on the Visual Analogue Mood Scale twice a day, morning and evening, for diurnal variation. We divided depressive patients into two groups,-diurnal variation group and nondiurnal variation group,-and compared the mood and sleep variables using SPSS. Results: The frequency of diurnal variation is not significantly different among the subtypes of depression. Significant differences between the diurnal variation group and the nondiurnal variation group existed in middle insomnia and sleep time (p<0.05). In melancholic type, al significant difference between the diurnal variation group and the nondiurnal variation group was noticed in PSQI total, sleep latency, sleep disturbances, daytime dysfunction as well as middle insomnia and sleep time (p<0.05). Conclusions: Diurnal variation existed in other types of depression as well as melancholic type. The results showed that diurnal variation was not a specific symptom of melancholic type, and existence of diurnal variation might be related to sleep patterns.

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The Differences in Resting Pulmonary Function in Relation to the Nutritional status of Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자의 영양상태에 따른 안정시 폐기능 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Park, Jong-Won;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Kim, Jung-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.570-578
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    • 2001
  • Background: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigate the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. Method : 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. Result : Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure($P_{Imax}$) was also significantly lower in the depleted group(p<0.05). Conclusion : We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.

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Diagnostic Value of Serum Beta-hCG Measured by EIA in Suspected Ectopic Pregnancy (EIA로 측정한 혈청 ${\beta}$-hCG치의 자궁외 임신에 대한 진단적 가치)

  • Park, Yoon-Ki;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.221-227
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    • 1985
  • Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty-four patients with suspected ectopic pregnancy comprised twenty- eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and, one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21,980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100mIU/ml and high serum hCG level above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy, respectively. 4. Mean serum hCG levels (${\pm}SD$) of twelve patients with tubal pregnancy who had intra-abdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intra-abdominal free blood of more than 500ml were 4,131 (${\pm}7,801$) mIU/ml and 3,208 (${\pm}5,081$) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (${\pm}SD$) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (${\pm}5,448$) mIU/ml and 4,449 (${\pm}6,938$) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59-933 mIU/ml.

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Immunoglobin G Antibodies to Purified-Protein-Derivative and Lipoarabinomannan-B by Enzyme-Linked Immunosorbent Assay in the Diagnosis of Tuberculous Pleural Effusion (결핵성 흉막염 환자에 있어서 효소결합 면역분석법으로 측정한 Purified-Protein-Derivative와 Lipoarabinomannan-B에 대한 Immunoglobulin G 항체의 진단적 가치에 관한 연구)

  • Moon, Tai-Hoon;Cho, Chul-Ho;Kwak, Seung-Min;Kim, Jin-Ju;Cho, Sang-Nae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.455-464
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    • 1995
  • Background: Considering that both humoral and cell mediated immunities play an important role for human tuberculosis infection, enzyme-linked immunosorbent assay(ELISA) measurement of immunoglobulin G (IgG) antibody to mycobacterial antigens can be used for the serologic diagnosis of tuberculous pleural effusion. Method: We measured absorbance values of IgG antibodies to purified-protein-derivative (PPD) and lipoarabinomannan-B (LAM-B) in the pleural fluid (PF) and the serum in 40 tuberculous (TPE) and 19 nontuberculous pleural effusions (NTPE). Results: 1) The IgG antibodies to PPD and LAM-B were significantly (P<0.0005) higher in the PF and the serum of TPE compared to NTPE. 2) The IgG antibodies to PPD and LAM-B in the serum were higher than that in PF. 3) Significant correlations were found between pleural and serum IgG antibodies to PPD and LAM-B. 4) With a cutoff value for IgG antibody to PPD in the PF of 0.091, sensitivity was 55.0% and specificity 94.7% in the diagnosis of TPE. 5) With a cutoff value for IgG antibody to LAM-B in the PF of 0.337, sensitivity was 50.0% and specificity 94.7% in the diagnosis of TPE. 6) The seropositive rates in TPE were not related to PPD skin test status, the amount of PF and coexisting active pulmonary tuberculosis. Conclusion: The assay of IgG antibodies to PPD and LAM-B might be useful for the diagnosis of TPE. Our study suggests the mechanism of passive transfer of IgG antibodies to PPD and LAM-B from the serum to the PF through pleural tissue.

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