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Clinical Significance of PCR-Based Rapid Detection of Mycobacterium tuberculosis DNA in Peripheral Blood (결핵 환자에서 말초혈액 결핵균 중합효소 연쇄반응 양성의 임상적 의의)

  • Kim, Gyu-Won;Lee, Jae-Myung;Kang, Min-Jong;Son, Jee-Woong;Lee, Seung-Joon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Young-Kyung;Lee, Kyung-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.599-606
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    • 2001
  • Background : Since the advent of AIDS, tuberculosis has become a major public health problem in the western society. Therefore, it is essential that pulmonary tuberculosis be rapidly diagnosed. Light microscopic detection of acid-fast organisms in sputum has traditionally been used for rapidly diagnosing tuberculosis. However positive smears are only observed in about one-half to three-quarters of cases. Studies using PCR for diagnosing pulmonary tuberculosis disclosed several shortcomings suggesting an inability to distinguish between active and treated or inactive tuberculosis. In this study, the clinical significance of a PCR-based rapid technique for detecting Mycobacterium tuberculosis DNA in peripheral blood was investigated. Materials and Methods : From July 1, 1998 through to August 30, 1999, 59 patients with presumed tuberculosis, who had no previous history of anti-tuberculosis medication use within one year prior to this study were recruited and followed up for more than 3 months. AFB stain and culture in the sputum and/or pleural fluids and biopsies when needed were performed. Blood samples from each of the 59 patients were obtained in order to identify Mycobacterium Tuberculosis DNA by a PCR test. Results : 1) Forty five out of 59 patients had a final diagnosis of tuberculosis ; Twenty eight were confirmed as having active pulmonary tuberculosis by culture or biopsy. Four were clinically diagnosed with pulmonary tuberculosis. The other 13 patients were diagnosed as having tuberculous pleurisy (9) and extrapulmonary tuberculosis (4). 2) Fourteen patients showed a positive blood PCR test. The PCR assay correctly identified active tuberculosis in 13 out of 14 patients. The overall sensitivity and specificity of this blood peR assay for diagnosing tuberculosis were 29% and 93%, respectively. The positive predictive value was 93%, the negative predictive value was 29% and the diagnostic accuracy was 44%.3) Six out of 14(43%) patients with blood PCR positive tuberculosis were immunologically compromised hosts. 4) A simple chest radiograph in blood PCR positive tuberculosis patients showed variable and inconsistent findings. Conclusion : A peripheral blood PCR assay for Mycobacterium tuberculosis is not recommended as a screening method for diagnosing active tuberculosis. However, it was suggested that the blood PCR assay could contribute to an early diagnostic rate due to its high positive predictive value.

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Clinical Utility of Amplified Mycobacterium Tuberculosis Direct Test in the Diagnosis of Pulmonary Tuberculosis (폐결핵 잔단에서 Amplified Mycobacterium Tuberculosis Direct Test의 임상적 유용성)

  • Park, Sam-Seok;Kwak, Kyung-Rok;Hwang, Ji-Yun;Yun, Sang-Myeong;Ryue, Chi-Chan;Chang, Chul-Hun;Lee, Min-Gi;Park, Sun-Gue
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.747-756
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    • 1999
  • Background: Acid-fast stain and cultures for diagnosis of pulmonary tuberculosis are primary and essential method, but have their limitation : low sensitivity and time consuming. The objective of this study is comparison of amplified Mycobacterium tuberculosis direct test(MTD) by the conventional AFB smears and cultures in the detection of Mycobacterium tuberculosis in respiratory specimens. Methods: During the period between November, 1997 and May, 1998 a total of 267 respiratory specimens (sputum 173, bronchial washing 94) from 187 patients suspected pulmonary tuberculosis were subjected to AFB smears, cultures and MID test. MID is based on nucleic acid amplification. We compared the MID with 3% Ogawa culture method. In positive AFB smear and negative MID specimen, positive culture identification between nontuberculous mycobacterium and M.tuberculosis was assesed by using Accuprobe M.tuberculosis complex probe. In negative AFB smear and negative AFB culture, MTD results are assessed by clinical follow-up. Results : 1) Compared with culture in sputum and bronchial fluid specimens, sensitivity and specificity of MTD in positive AFB smear is 79.7% and 20.0%, sensitivity and specificity of MTD in negative AFB smear specimens is 75.0% and 79.7%. 2) Discrepant analysis is assessed by clinical follow-up and other specimen results beyond study. Culture negative but MTD positive specimens were proved to be true positive and gave MTD sensitivity 79.2%, specificity of 84.4%, positive predictive value 80.5% and negative predictive value 83.2%. 3) 14 out of 31 specimens in negative AFB smear, negative AFB culture and positive MTD showed pulmonary tuberculosis diagnosed on clinical follow-up and sensitivity is 45.2%. 4) 2 out of 13 specimens in positive AFB smear, positive AFB culture and negative MID diagnosed as non tuberculous mycobacterium by Accuprobe culture. Conclusion: This study suggested that MID in respiratory specimens is simple and rapid diagnostic method, but considered adjuvant method rather than replace the conventional AFB smear and culture.

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TIMP-2 Gene Transfer Via Adenovirus Inhibits the Invasion of Lung Cancer Cell (TIMP-2 유전자 재조합 아데노바이러스의 폐암세포 침윤 억제 효과)

  • Oh, Yeon-Mok;Lee, Jae-Ho;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.189-197
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    • 2000
  • Background : Tissue inhibitor of metalloproteinase is a natural inhibitor that counteracts pro teolytic enzymes essential to the invasion of cancer cell. Whether or not TIMP-2 gene transfer via adenovirus could inhibit the invasion of lung cancer cell iη vitro was evaluated for the future purpose of gene therapy against lung cancer. Methods : Recombinant adenovirus-TIMP-2(Ad-TIMP-2) was generated by homologous recombination after pACCMV-TIMP-2 and pJM17 were cotransfected into 293 cell by standard calcium phosphate coprecipitate method. Calu-6, one of the most invasive lung cancer cells, was transduced with Ad-TIMP-2 or Ad-$\beta$gal. Anchorage-independent growth and invasiveness were assessed by soft agar clonogenicity assay and invasion assay using two-chamber, well divided by matrigel. Results : Ad-TIMP-2 transduced calu-6 cells produced biologically active TIMP-2 more than 50 times more than parental calu-6. TIMP-2 gene transfer did not suppress the in vitro tumorigenicity. However, two chamber well assay revealed that Ad-TIMP-2 transduction reduced the invasiveness of calu-6 efficiently (12% compared with parental cell) even at low 10moi. Conclusion : Even though TIMP-2 gene transfer did not inhibit in vitro tumorigenicity, it did inhibit invasion of lung cancer cell in vitro. The inhibition of invasion by Ad-TIMP-2 may be a useful strategy for the treatment of lung cancer.

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Assessment of the Specificity of A Hybridization of Surfactant Protein A by Addition of Non-specific Rat Spleen RNA (Surfactant Protein A mRNA을 이용한 유전자 재결합 반응에서 비특이성 RNA의 첨가에 의한 특이성 검정)

  • Kim, Byeong Cheol;Kim, Mi Ok;Kim, Tae-Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.393-404
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    • 2004
  • Background : Nucleic acid hybridization has become an essential technique in the development of our understanding of gene structure and function. The quantitative analysis of hybridization has been used in the measurement of genome complexity and gene copy number. The filter hybridization assay is rapid, sensitive and can be used to measure RNAs complementary to any cloned DNA sequence. Methods : The authors assessed the accuracy, linearity, correlation coefficient and specificity of the hybridization depending on the added dose(0, 1, 5, and $10{\mu}g$) of non-specific rat spleen RNA to hybridization of surfactant protein A mRNA. Filter hybridization assays were used to obtain the equation of standard curve and thereby to quantitate the mRNA quantitation. Results : 1. Standard curve equation of filter hybridization assay between counts per minute (X) and spleen RNA input (Y) was Y=0.13X-19.35. Correlation coefficient was 0.98. 2. Standard curve equation of filter hybridization assay between counts per minute (X) and surfactant protein A mRNA transcript input (Y) was Y=0.00066X-0.046. Correlation coefficient was 0.99. 3. Standard curve equation of filter hybridization assay between counts per minute (X) and surfactant protein A mRNA transcript input (Y) after the addition of $1{\mu}g$ spleen RNA was Y=0.00056X-0.051. Correlation coefficient was 0.99. 4. Standard curve equation of filter hybridization assay between counts per minute (X) and surfactant protein A mRNA transcript input (Y) after the addition of $5{\mu}g$ spleen RNA was Y=0.00065X-0.088. Correlation coefficient was 0.99. 5. Standard curve equation of filter hybridization assay between counts per minute (X) and surfactant protein A mRNA transcript input (Y) after the addition of $10{\mu}g$ spleen RNA was Y=0.00051X-0.10. Correlation coefficient was 0.99. Conclusions : Comparison of cpm/filter in a linear range allowed accurate and reproducible estimation of surfactant protein A mRNA copy number irrespective of the addition dosage of non-specific rat spleen RNA over the range $0-10{\mu}g$.

Improved Preservation Methods for Big and Old Tress in South Korea (우리 나라의 노거수자원(老巨樹資源) 보호관리실태(保護管理室態) 및 개선방안(改善方案))

  • Park, Chong-Min;Seo, Byun-Soo;Lee, Cheong-Taek
    • Journal of Korean Society of Forest Science
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    • v.89 no.3
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    • pp.440-451
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    • 2000
  • This study was conducted in order to provide essential data and relevant management proposal to conserve and maintain big and old trees in a rational way. For the field survey, 77 big and old trees preserved by the laws in Chollabuk-do, Korea were investigated. The study results are summarized as follows : 1. To conserve and manage big and old trees, the valuable trees have been designated as natural monument trees and protection-needed trees. There are 141 individuals of 37 species designated as natural monuments and 10,049 individuals of 102 species designated as protection-needed trees. 2. Management budget for natural monument trees was devoted at 70% from the national expenditure, but that for protection-needed trees was devoted at 98% from the local expenditure. 3. Standardized sign boards and sign stones for natural monument trees were well placed and other protection facilities such as fences, branch supports and branch holdings were established. On the other hand, management of protection-needed trees was deficient overall. 4. Problems for designation process and management of protection-needed trees could include items such as insufficient management budget, various development activities, land ownership, misjudgement of tree age and species identification, unsatisfaction of sign board placement, insufficient surgery for damaged trees, pavement around tree root system and environmental pollution around the trees. 5. In order to improve the existing management methods of big and old trees, the following schemes were suggested : the development of practical criteria for natural monument and protection-needed trees, nationwide surveys of big and old tree resources, the security of national budget, securing sufficient spaces for the tree growth, specialization of management systems, extended practices of tree form management, establishment of permanent standard signs and consideration of opinions of village residents.

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Effect of Conidial Number and Nutrition on the Germination of Conidia in Colletotrichum dematium f. sp. capsicum Causing Red Pepper Anthracnose (분생포자수(分生胞子數) 및 영양상태(營養狀態)가 고추 탄저병균(炭疽病菌)(Colletotrichum dematium f. sp. capsicum)의 분생포자(分生胞子) 발아(發芽)에 미치는 영향(影響))

  • Chung, Bong-Koo;Lee, Sang-Bum
    • Korean journal of applied entomology
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    • v.25 no.1 s.66
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    • pp.41-46
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    • 1986
  • Exogenous factor and nutrients affecting for conidial germination of Colletetrichum dematium f. sp. capsicum causing red pepper anthracnose were studied by slide germination test. Optimum temperature of conidial germination was at $28^{\circ}C$, ranging 15 to $35^{\circ}C$. Optimum pH was at 5.5, ranging 4.5 to 8.0, and more than 90% of relative humidity (RH) was optimum. Poor conidial germination of the fungus was observed on sterile distilled water, but potato sucrose broth (PSB), red pepper fruit broth (RPFB), green pepper fruit broth (GPFB) and pepper leaf broth (PLB) furnished a satisfactory nutrients for conidial germination. Exogenous supply of carbon and nitrogen sources were essential for conidial germination, while potassium, phosphorous and sulfur were not evident as that for carbon and nitrogen. Soluble starch was the most suitable as a carbon source for conidial germination and followed by D-glucose, D-galactose and lactose in that order. Maximum germination was attained in the $1{\times}10^4$ conidia per ml. Germination was decreased with increment of conidial concentration, and in the density of $5{\times}10^4$ conida per ml, germination was nearly supipressed. It suggested existing a self-inhibitor. Non-washed conidia germinated more than washed conidia, and conidial germination was also gradually decreased by increasing conidial density.

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Change Detection of land-surface Environment in Gongju Areas Using Spatial Relationships between Land-surface Change and Geo-spatial Information (지표변화와 지리공간정보의 연관성 분석을 통한 공주지역 지표환경 변화 분석)

  • Jang Dong-Ho
    • Journal of the Korean Geographical Society
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    • v.40 no.3 s.108
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    • pp.296-309
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    • 2005
  • In this study, we investigated the change of future land-surface and relationships of land-surface change with geo-spatial information, using a Bayesian prediction model based on a likelihood ratio function, for analysing the land-surface change of the Gongju area. We classified the land-surface satellite images, and then extracted the changing area using a way of post classification comparison. land-surface information related to the land-surface change is constructed in a GIS environment, and the map of land-surface change prediction is made using the likelihood ratio function. As the results of this study, the thematic maps which definitely influence land-surface change of rural or urban areas are elevation, water system, population density, roads, population moving, the number of establishments, land price, etc. Also, thematic maps which definitely influence the land-surface change of forests areas are elevation, slope, population density, population moving, land price, etc. As a result of land-surface change analysis, center proliferation of old and new downtown is composed near Gum-river, and the downtown area will spread around the local roads and interchange areas in the urban area. In case of agricultural areas, a small tributary of Gum-river or an area of local roads which are attached with adjacent areas showed the high probability of change. Most of the forest areas are located in southeast and from this result we can guess why the wide chestnut-tree cultivation complex is located in these areas and the capability of forest damage is very high. As a result of validation using a prediction rate curve, a capability of prediction of urban area is $80\%$, agriculture area is $55\%$, forest area is $40\%$ in higher $10\%$ of possibility which the land-surface change would occur. This integration model is unsatisfactory to Predict the forest area in the study area and thus as a future work, it is necessary to apply new thematic maps or prediction models In conclusion, we can expect that this way can be one of the most essential land-surface change studies in a few years.

Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants (저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구)

  • Han, Kyung-Ja
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.5-24
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    • 2001
  • The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

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Analysis of Knowledge Community for Knowledge Creation and Use (지식 생성 및 활용을 위한 지식 커뮤니티 효과 분석)

  • Huh, Jun-Hyuk;Lee, Jung-Seung
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.85-97
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    • 2010
  • Internet communities are a typical space for knowledge creation and use on the Internet as people discuss their common interests within the internet communities. When we define 'Knowledge Communities' as internet communities that are related to knowledge creation and use, they are categorized into 4 different types such as 'Search Engine,' 'Open Communities,' 'Specialty Communities,' and 'Activity Communities.' Each type of knowledge community does not remain the same, for example. Rather, it changes with time and is also affected by the external business environment. Therefore, it is critical to develop processes for practical use of such changeable knowledge communities. Yet there is little research regarding a strategic framework for knowledge communities as a source of knowledge creation and use. The purposes of this study are (1) to find factors that can affect knowledge creation and use for each type of knowledge community and (2) to develop a strategic framework for practical use of the knowledge communities. Based on previous research, we found 7 factors that have considerable impacts on knowledge creation and use. They were 'Fitness,' 'Reliability,' 'Systemicity,' 'Richness,' 'Similarity,' 'Feedback,' and 'Understanding.' We created 30 different questions from each type of knowledge community. The questions included common sense, IT, business and hobbies, and were uniformly selected from various knowledge communities. Instead of using survey, we used these questions to ask users of the 4 representative web sites such as Google from Search Engine, NAVER Knowledge iN from Open Communities, SLRClub from Specialty Communities, and Wikipedia from Activity Communities. These 4 representative web sites were selected based on popularity (i.e., the 4 most popular sites in Korea). They were also among the 4 most frequently mentioned sitesin previous research. The answers of the 30 knowledge questions were collected and evaluated by the 11 IT experts who have been working for IT companies more than 3 years. When evaluating, the 11 experts used the above 7 knowledge factors as criteria. Using a stepwise linear regression for the evaluation of the 7 knowledge factors, we found that each factors affects differently knowledge creation and use for each type of knowledge community. The results of the stepwise linear regression analysis showed the relationship between 'Understanding' and other knowledge factors. The relationship was different regarding the type of knowledge community. The results indicated that 'Understanding' was significantly related to 'Reliability' at 'Search Engine type', to 'Fitness' at 'Open Community type', to 'Reliability' and 'Similarity' at 'Specialty Community type', and to 'Richness' and 'Similarity' at 'Activity Community type'. A strategic framework was created from the results of this study and such framework can be useful for knowledge communities that are not stable with time. For the success of knowledge community, the results of this study suggest that it is essential to ensure there are factors that can influence knowledge communities. It is also vital to reinforce each factor has its unique influence on related knowledge community. Thus, these changeable knowledge communities should be transformed into an adequate type with proper business strategies and objectives. They also should be progressed into a type that covers varioustypes of knowledge communities. For example, DCInside started from a small specialty community focusing on digital camera hardware and camerawork and then was transformed to an open community focusing on social issues through well-known photo galleries. NAVER started from a typical search engine and now covers an open community and a special community through additional web services such as NAVER knowledge iN, NAVER Cafe, and NAVER Blog. NAVER is currently competing withan activity community such as Wikipedia through the NAVER encyclopedia that provides similar services with NAVER encyclopedia's users as Wikipedia does. Finally, the results of this study provide meaningfully practical guidance for practitioners in that which type of knowledge community is most appropriate to the fluctuated business environment as knowledge community itself evolves with time.

Ontology-based Course Mentoring System (온톨로지 기반의 수강지도 시스템)

  • Oh, Kyeong-Jin;Yoon, Ui-Nyoung;Jo, Geun-Sik
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.149-162
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    • 2014
  • Course guidance is a mentoring process which is performed before students register for coming classes. The course guidance plays a very important role to students in checking degree audits of students and mentoring classes which will be taken in coming semester. Also, it is intimately involved with a graduation assessment or a completion of ABEEK certification. Currently, course guidance is manually performed by some advisers at most of universities in Korea because they have no electronic systems for the course guidance. By the lack of the systems, the advisers should analyze each degree audit of students and curriculum information of their own departments. This process often causes the human error during the course guidance process due to the complexity of the process. The electronic system thus is essential to avoid the human error for the course guidance. If the relation data model-based system is applied to the mentoring process, then the problems in manual way can be solved. However, the relational data model-based systems have some limitations. Curriculums of a department and certification systems can be changed depending on a new policy of a university or surrounding environments. If the curriculums and the systems are changed, a scheme of the existing system should be changed in accordance with the variations. It is also not sufficient to provide semantic search due to the difficulty of extracting semantic relationships between subjects. In this paper, we model a course mentoring ontology based on the analysis of a curriculum of computer science department, a structure of degree audit, and ABEEK certification. Ontology-based course guidance system is also proposed to overcome the limitation of the existing methods and to provide the effectiveness of course mentoring process for both of advisors and students. In the proposed system, all data of the system consists of ontology instances. To create ontology instances, ontology population module is developed by using JENA framework which is for building semantic web and linked data applications. In the ontology population module, the mapping rules to connect parts of degree audit to certain parts of course mentoring ontology are designed. All ontology instances are generated based on degree audits of students who participate in course mentoring test. The generated instances are saved to JENA TDB as a triple repository after an inference process using JENA inference engine. A user interface for course guidance is implemented by using Java and JENA framework. Once a advisor or a student input student's information such as student name and student number at an information request form in user interface, the proposed system provides mentoring results based on a degree audit of current student and rules to check scores for each part of a curriculum such as special cultural subject, major subject, and MSC subject containing math and basic science. Recall and precision are used to evaluate the performance of the proposed system. The recall is used to check that the proposed system retrieves all relevant subjects. The precision is used to check whether the retrieved subjects are relevant to the mentoring results. An officer of computer science department attends the verification on the results derived from the proposed system. Experimental results using real data of the participating students show that the proposed course guidance system based on course mentoring ontology provides correct course mentoring results to students at all times. Advisors can also reduce their time cost to analyze a degree audit of corresponding student and to calculate each score for the each part. As a result, the proposed system based on ontology techniques solves the difficulty of mentoring methods in manual way and the proposed system derive correct mentoring results as human conduct.