• Tuberculosis and Respiratory Diseases
• /
• v.55 no.1
• /
• pp.59-68
• /
• 2003

Background : In intubated patients, cultures of endotracheal aspirates (EA) are apt to contamination throughout the endotracheal tube. Therefore, the identification of etiologic agents via conventional EA cultures is not always reliable. In order to differentiate a pulmonary infection from a non-infectious disease, and to identify the true etiologic agent of acute pulmonary infection, blinded protected specimen brushing (PSB) was used, and its efficacy evaluated. Methods : In 51 intubated patients, with suspected pneumonia, blind PSB were performed, and the results compared with blood and EA cultures. A protected specimen brush was introduced through the endotracheal tube, and settled at the affected large bronchus. A specimen brush was introduced to the expected region using the blind method. The tip of the brush was introduced with an aseptic technique after vigorously mixed for 1 minute in $1cm^3$ of Ringer's lactate solution. The specimens were submitted for quantitative culture within 15 minutes, with a culture being regarded as positive if the colony forming units were above $10^3/ml$. Results : Of the 51 patients, 15 (29.4%) had community-acquired pneumonia (CAP), 27 (52.9%) hospital-acquired pneumonia (HAP) and 9 (17.6%) non-infectious diseases. The sensitivity and specificity of the quantitative PSB culture for the diagnosis of pneumonia were 52.4 and 88.9%, respectively. The sensitivity and specificity of EA were 78.6 and 77.8%, respectively. The blind PSB was superior to the EA for the identification of true etiologic agents. Of 53 episodes of 27 HAP patients, MRSA (Methicillin-resistant staphylococcus aureus) (41.5%) was the most common causative agent followed by Pseudomonas aeruginosa (15.1%), Klebsiella sp. (7.5%) and Acinetobacter sp. (7.5%). Conclusions : As a simple, non-invasive diagnostic modality, the blind PSB is a useful method for the differentiation of a pulmonary infection from non-infectious diseases and to identify the etiologic agents in intubated patients. A blind PSB can be performed without bronchoscopy, so is safer, more convenient and cost-effectiveness for patients where bronchoscopy can not be performed.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.3
• /
• pp.295-303
• /
• 2003

Backgroung : The incidence of penicillin-resistant streptococcus pneumoniae(PRSP) accounts for almost 70% of all pneumococcal pneumonia cases in Korea. It is still unclear as to whether the efficacy of penicillin or equally active beta-lactam agents is compromised in PRSP pneumonia. This study investigated the prevalence of PRSP in community-acquired pneumonia and its clinical course. Methods : A total of 42 patients with community-acquired pneumococcal pneumonia were evaluated from July 1999 to May 2001. The cultured strains of Streptococcus pneumoniae were divided into susceptible, intermediately resistant, and resistant strains by an E-test, and the effect of the clinical course was investigated. Results : From a total of 42 patients, 22 (52.4%) patients had an intermediate resistance (MIC $0.1-1{\mu}g/m{\ell}$) and six (14.3%) showed a high resistance ($MIC{\geq}2.0{\mu}g/m{\ell}$) with current penicillin susceptibility categories. However, according to the classification of the DRSPTWG (Drug Resistant Streptococcus pneumoniae Therapeutic Working Group), there were 11 cases (26.2%) of intermediate resistance and no case of high resistance. Under empirical antimicrobial treatment, there was no difference in the clinical outcome between the penicillin susceptible and resistant group. Conclusion : The clinical outcome of PRSP pneumonia with empirical therapy was acceptable. These results suggest that the current MIC breakpoint for penicillin resistance in Streptococcus pneumoniae has been set at a very low level and penicillin resistance according to the NCCLS classification does not significantly influence the outcome of the empirical treatment for pneumococcal pneumonia.

• Tuberculosis and Respiratory Diseases
• /
• v.58 no.5
• /
• pp.473-479
• /
• 2005

Background : Gefitinib targets the epidermal growth factor receptor r(EGFR), and Gefitinib has antitumor activity in patient with non-small cell lung cancer (NSCLC). However, only 10 to 20 percent of patients show a clinical response to this drug, and the molecular mechanisms underlying patient sensitivity to gefitinib are unknown. PTEN (Phosphatase and tensin homolog deleted on chromosome Ten) plays a role for the modulation of the phosphatidylinositol 3-kinase pathway (PI3K), which is involved in cell proliferation and survival, so that it can inhibit cell cycle progression and induce G1 arrest. Therefore, we analyzed the relationship between PTEN expression and gefitinib's responsiveness in patients having advanced non small cell lung cancer that had progressed after previous chemotherapy. Methods : The expression of PTEN was studied by immunohistochemistry in paraffin-embedded tumor blocks that were obtained from 22 patients who had been treated with gefitinib from JAN, 2001 to AUG. 2004. For the evaluation of the relationships between the PTEN expression, the clinical stage and the basal characteristics, those cases that showed the respective antigen expression in >50% of the tumor cells were considered positive. Results : The positive rate of PTEN staining was 55% of the total of 22 patients. There was a significant relationship between the increased expression of PTEN and the response group (p=0.039). However, there was no significant relationship between the expression of PTEN and other clinicopathologic characteristics. Conclusion: The expression of PTEN in patients with advanced non small cell lung cancer that has progressed after previous chemotherapy may play a role in gefitinib's responsiveness.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.6
• /
• pp.437-443
• /
• 2009

Background: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). Methods: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. Results: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA ($\geq$40 IU/L). When we considered ADA $\geq$40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and posttest posttest probability 74.5%. However, when we considered ADA $\geq$40 IU/L combined with the L/N ratio $\geq$0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. Conclusion: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.6
• /
• pp.451-456
• /
• 2009

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.

• Biomedical Science Letters
• /
• v.4 no.2
• /
• pp.143-151
• /
• 1998

To study the incidence and epidemiological factors of uterine cervical cancer in medical underserved area females, the questionnaire survey and Pap. smear for uterine cervical cancer was done on total 330 women who lived in Ullungdo from 5th to 12th August, 1998. The results were summarized as follows： The age distribution of subjects was 50s (24.5%), 60s (24.5%) and their educational level was “no schooling” (14.2%) and “elementary school” (42.7%). The first coital age of subjects was 19∼21yrs (30.0%), 16∼18yrs (13.9%) and the first pregnancy age was 22∼24yrs (36.7%) and 19∼21yrs (30.0%). The frequency of total pregnancy of subjects was over 5 times (52.1%). The frequency of total delivery was “3∼4 times” (35.5％) and “5∼6 times” (15.2％). 68.8% of subjects had experience of abortion and 80.0% of their husband were on the phimosis. 172 (52.1%) subjects had gynecological symptoms, their symptoms were leukorrhea (48.3%), pruritus (21.5%) and leukorrhea with pruritus (20.3%). 63.9% of total subjects have been received Pap. smear and the frequency of their Pap. smear was “only 1 time” (44.1 ％), “irregularly” (30.3%) and the reason of respondents who have not been received Pap. smea. was “no specific symptom” (51.3%). Among the 330 women screened there were negative (45.8%), inflammation (47.3%), trichomoniasis and candidiasis (1.8%), atypical cells (4.5%) and dysplasia (0.6%).

• Biomedical Science Letters
• /
• v.2 no.2
• /
• pp.187-198
• /
• 1996

The cut-off values and related factors for total cholesterol of serum in normal Korean adults were studied from March to October, 1995, based on the data of 1,818 healthy adults of human involved the male and female. The comparisons of the serum total cholesterol levels were analyzed by sex, age, systolic blood pressure, diastolic blood pressure, body weight, height, PIBW, BMI and other biochemical tests. 1. The serum total cholesterol level were 194.4 mg/dl in total group, 186.9 mg/dl for male, and 197.6 mg/dl for female. 2. There was no significant differences by sex among the 21 to 50 ages group, but significantly higher in women than in men over 51 years old. 3. In general, the levels of serum total cholesterol were increased with age, the highest level in men was 192.7 mg/ dl in 51 to 60 years old, and 210.5 mg/dl in more than 60 years old in women. 4. The cut-off values of serum total cholesterol for moderate risk were 191 mg/dl in 21 to 30 years group, 195 mg/dl in 31 to 40 years,214 mg/dl in 41 to 50 years, 227 mg/dl in 51 to 60 years, and 222 mg/dl in more than 61 years. The cut-off values of serum total cholesterol for high risk were 214 mg/dl dl in 21 to 30 years group, 214 mg/dll in 31 to 40 years, 239 mg/dl in 41 to 50 years, 213 mg/dl in 51 to 60 years, and 248 mg/dl in more than 61 years. 5. The mean values of serum total cholesterol were showed positive correlation with age, PIBW, BMI, systolic blood pressure and diastolic blood pressure. 6. Serum total cholesterol level of drinking group(188.9$\pm$34.85mg/dl) was showed love. than those of non-drinking group(196.0$\pm$36.0 mg/dl). 7. Serum total cholesterol levels of regular excercise group(192.1$\pm$33.3 mg/dl) was significantly lower than those of non regular excercise group(195.8$\pm$37.0 mg/dl).

• Progress in Medical Physics
• /
• v.22 no.3
• /
• pp.131-139
• /
• 2011

A method to get a size of the radiation isocenter of linear accelerators using star-shot images was presented and a computer program was developed to automate the method. Accuracy of the method was verified. The developed program was used to measure sizes of the radiation isocenters for a Clinac 21EX (Varian, USA) using data of quality assurance (QA) performed from June 2008 to December 2010. To calculated the size of radiation isocenter, positions of two points on each central ray of the star-shot image were found and the equation of the central ray was determined using the positions of two points. Using the equations of central rays the radius of the minimum circle intersecting all the central rays, which is one half of the size of radiation isocenter, was calculated. The program measured x-intercepts and y-intercepts of the central rays within errors of 0.084 mm and sizes of radiation isocenters within 0.053 mm. All the errors were less than the spatial resolution of star-shot images 0.085 mm. The radiation isocenter sizes of Clinac 21EX were $0.33{\pm}0.27mm$, $0.71{\pm}0.36mm$, $0.50{\pm}0.16mm$ for collimator, gantry and couch respectively. During the measurement period all the measured sizes were less than 2.0 mm and within tolerance. The developed program could calculate the size of radiation isocenters and it would be helpful to routine QA.

• Progress in Medical Physics
• /
• v.19 no.2
• /
• pp.131-138
• /
• 2008

We evaluated on the calculation accuracy of treatment planning system (TPS) with phantom having convex and concave surface. The TPS is Eclipse (Varian, USA) using both algorithms AAA and PBC for photon dose calculations. PBC algorithms have three corrections of Batho, modified Batho (M-Batho), and equivalent TAR (E-TAR). The field sizes were $10{\times}10\;cm^2$ and $20{\times}20\;cm^2$, and MLC-shaped fields for these fields. We measured doses at three depths 5, 10 and 15cm in phantom of SSD=90cm in the condition of inserted farmer chamber. For given conditions, we have calculated dose with these algorithms and compared them with measured doses. In AAA the calculated doses (dose/MU) were agreed to measured doses within ${\pm}1%$ in flat and convex surface and were under estimated with -1.9% maximum in concave surface. In PBC the calculated doses were over estimated with +1.7% and +4.1% respectively in flat and convex surface and the differences were from -3.1% to +2.1% in concave surface. In comparison of criteria from AAPM and IAEA reports, and statistical analysis for these results, it is found that the AAA's results are in good agreement with measured values and the M-Batho's results are generally good agreed with measured values among PBC algorithms.

• Journal of Mushroom
• /
• v.2 no.2
• /
• pp.88-96
• /
• 2004

This study was executed to decide the physiological characteristics of Ferule mushroom. Four strains of Ferule mushroom were tested to select a superior strain in its mycelial growth. The pertinent substrates, temperature and pH ranges for the growth of selected strain were determined. And then, the wood rotting ability and type of the Ferule mushroom were determined. The superior strain F-2 among four strains was selected, on the basis of its vegetative mycelial growth and density on agar media. Mycelial growth of F-2 was the best on MYPA among other tested synthetic or semi-synthetic media. The temperature range for pertinent mycelial growth was about $25{\sim}34^{\circ}C$ and best at $30^{\circ}C$. The optimum pH range on MYPA was 5.0~6.0. The mycelial growth was mostly stimulated by soluble starch at cont. 1% (w/w) and secondly, maltose among several carabon sources and by mixed solution of YE(0.25%) and ME(0.25%) but not by ME alone. Cell thining and erosion of Pinus rigida wood by the mycelia of Ferule mushroom were found only on a few cell but largely at wood block test, indicating that the softwood rotting ability of Ferule mushroom mycelia was not so good. The result of polarized light microscopy appeared that cellulose of some tracheides showing the S3 layer lost brifringence was degraded by Ferule mushroom. But only part of cellulose of P. rigida wood was degraded by Ferule mushroom, because most of wood cells continued to showing briefingence. A largely degraded ray parenchyma and longitudinal parenchyma cell and partly thinning and erosion of hardwood(Quercus serrata) cell was found and it indicates that the rotting ability of Ferule mushroom mycelia on hardwood was higher than on softwood. It could be concluded that the difference in the wood rot by Ferule mushroom between the hardwood and softwood was made by the difference of chemical constitutions between them, especially in the contents and the types of lignin. Ferule mushroom was considered as white rotter as a result of bavendam test, although more research should be required.