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Factors Influencing Compliance with Anti-Tuberculosis Therapy (폐결핵 환자의 치료 순응과 관련된 요인)

  • Kim, Cheon-Tae;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.79-90
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    • 1996
  • The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-City, Dalseong-Gun in Teagu and Kumi-City. Data were collected between September and October 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication (p<0.05) wis a predictor of improvement and knowledge about anti-tuberculosis therapy(p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075) were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.

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Chronic Renal Failure in Children: A Nationwide Survey in Korea (소아 만성 신부전증의 전국적인 조사연구)

  • Kim, KyoSun;Jeon, Jeong-Sik;Lee, Ik-Jun;Go, Dae-Gyun;Lee, Gyeong-Il;Yun, Hui-Sang;Gu, Ja-Hun;Go, Cheol-U;Jo, Byeong-Su;Kim, Jun-Sik;Son, Chang-Seong;Yu, Gi-Hwan;An, Yeong-Ho
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.92-101
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    • 2000
  • Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

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The Decision of Voiding Cystourethrography in Children with Urinary Tract Infection (소아 요로감염에서 배뇨성 방광 요도 조영술의 결정)

  • Kim, Dong-Woon;Choi, Eung-Sang;Lim, In-Seok
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.203-211
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    • 2007
  • Purpose : We attempted to compare the independent factors such as age, sex, C-reactive protein(CRP), and white blood cell count(WBC) in children with radiologic studies and assess the necessity of performing voiding cystourethrography(VCUG). Method : 98 children who have been diagnosed their first time febrile urinary tract infection from Janurary 2002 to Januray 2005 were enrolled. In all patient, the duration of fever which occurred before and after treatment was recorded, and CRP, WBC, $^{99m}Tc$-2,3-dimercaptosuccinic acid($^{99m}Tc$-DMSA) renal scans, renal ultrasound and VCUG were analyzed. Results : Of the 98 children diagnosed with urinary tract infection(UTI), 52 were male and 46 were female. 18 had abnormalities in VCUG, 17 had abnormalities in kidney ultrasound, and 20 had partial defects or diffuse uptake decrease in $^{99m}Tc$-DMSA renal scans. There were no significant relationship between incidence of radiologic abnormalities and age. The risk of renal scar was significantly higher in children who had a longer febrile period before treatment than in those with shorter period. Both CRP and WBC were significantly elevated in children with the radiological abnormalities. A positive of $^{99m}Tc$-DMSA renal scans and renal ultrasound were highly associated with vesicoureteral reflux(VUR). Conclusion : If there are abnormalities in the kidney ultrasound and $^{99m}Tc$-DMSA renal scan of a child with initial UTI, a VCUG is recommended. Even in cases without abnormal findings in $^{99m}Tc$-DMSA renal scan and renal ultrasound, clinical data such as CRP and WBC should be assessed, and VCUG should be Performed for the undetected VUR.

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Utility of $^{99m}Tc$-MAG3 Perfusion Indices in the Evaluation of Renal Transplant Function During Early Post-transplantation Period (이식 초기 이식신 기능 평가에서 $^{99m}Tc$-MAG3 신관류 지표의 유용성)

  • Kim, Sung-Hoon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.497-507
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    • 2000
  • Purpose: We have examined the utility of $^{99m}Tc$-MAG3 perfusion indices for assessing renal graft function in early post-transplantation period. Materials and Methods: Our study included 80 renal transplant recipients (48 men and 32 women, mean age: 40.3 years). Diagnosis was based on biopsy, laboratory data and clinical course. Renal scintigraphy (RS) was obtained using 100 MBq of $^{99m}Tc$-MAG3 from 11 days to 23 days of kidney transplantation. We measured 5 indices in whole-kidney (WK) and cortical (C) renograms; Hilson's perfusion index (PI), transplant perfusion index (TP) and transplant function index (TF) as perfusion parameter, and the time to peak activity (Tmax) and the ratio of renal counts at 20 min to that at 3 min (K20/3) as functional parameter. Results: The diagnoses at the day of RS were normal graft (NG) in 44, acute rejection (AR) in 14, acute tubular necrosis (ATN) in 10, and Cyclosporine A nephrotoxicity (CsA) in 12. TP and TF were significantly decreased in AR, ATN and CsA, compared to those in NG. K20/3 of AR and ATN wore significantly greater than that of NG. WK-Tmax of AR was significantly longer than that of NG. K20/3 of AR and C-K20/3 of ATN were significantly prolonged relative to those of CsA. There were no statistically significant perfusion indices among complication groups. Conclusion: TP and TF reflecting microperfusion and initial tubular extraction are reliable in assessing graft function. However, it is required to correlate perfusion indices with functional indices and clinical course in differentiating from one another among complication groups.

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Microwave Vacuum Drying of Germinated Colored Rice as an Enzymic Health Food (효소식품으로서 발아유색미의 마이크로파 진공건조)

  • Kim, Suk-Shin;Kim, Sang-Yong;Noh, Bong-Soo;Chang, Kyu-Seob
    • Korean Journal of Food Science and Technology
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    • v.31 no.3
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    • pp.619-624
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    • 1999
  • This work was to study the potential health food use of germinated colored rice after germinating and drying using microwave under vacuum. Colored rice was soaked in water at $15^{\circ}C$ for 2 days and then germinated at $25^{\circ}C$ for $3{\sim}4\;days$. The germinated colored rice was dried by different drying methods: microwave vacuum drying 1, microwave vacuum drying $2\;(drying{\rightarrow}crushing{\rightarrow}drying)$, hot air drying, vacuum drying and freeze drying. Each drier except freeze drier was set to maintain the sample temperature at $60^{\circ}C$. During microwave vacuum drying 1 or 2, the sample reached $60^{\circ}C$ much faster (within 5 min) and was dried much faster ($2{\sim}3\;hrs$ than the other drying methods. The initial drying rate of microwave vacuum drying was ten times faster than that of hot air drying. The microwave vacuum drying 2 retained the highest ${\alpha}-amylase$ activity, followed by microwave vacuum drying 1, freeze drying, vacuum drying, and hot air drying.

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Fermentation Property of Chinese Cabbage Kimchi by Fermentation Temperature and Salt Concentration (발효온도 및 소금농도에 따른 배추김치의 발효 특성)

  • Chang, Moon-Jeong;Kim, Myung-Hwan
    • Applied Biological Chemistry
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    • v.43 no.1
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    • pp.7-11
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    • 2000
  • The effects of fermentation temperature$(0{\sim}l5^{\circ}C)$ and salt concentration$(1.5{\sim}4.0%)$ on the fermentation property of Chinese cabbage Kimchi were analyzed by response surface methodology. The pH decreased and acidity increased with increasing fermentation time. The reduction and increment velocities of pH and acidity were increased by increasing fermentation temperature and decreasing salt concentration. The optimum pH 4.2 was reached within $14{\sim}24$ days at $5{\sim}15^{\circ}C$, while pHs of 24 days at $0{\sim}5^{\circ}C$ were still lower value than 4.2. The effect of salt concentration more affected terminal fermentation period than initial fermentation period. The maximum edible acidity, 0.75%, was reached within 8 days at $15^{\circ}C$, while acidifies of 24 days at $0^{\circ}C$ were $0.35{\sim}0.43%$. The effects of salt concentration at $0^{\circ}C$ was higher than those at $15^{\circ}C$. The fermentation time, fermentation temperature and salt concentration were the first, second and third affecting factors on the pH and acidity of Kimchi. Based on the coefficients of determination, pH and acidity were highly fitted to the experimental data$(r^2>0.9276)$. For the suitable acidity range, $0.40{\sim}0.75%$, the edible period of Kimchi at $15^{\circ}C,\;10^{\circ}C\;and\;5^{\circ}C$ were 4 days, 10 days and 18 days at the 2.75% of salt concentration, respectively. The edible period increased from 14 days to 19 days with increased salt concentration from 1.50% to 4.00% at $5^{\circ}C$ of fermentation temperature.

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Clinical Significance of Follow-up CT after Ultrasonography for Acute Appendicitis in Children (소아 급성 충수염에서 복부초음파 이후 전산화단층촬영 추적 검사의 임상적 의의)

  • Yu, Seong-Keun;Moon, Jin-Soo;Kim, Nam-Hee;Hwang, Jong-Hee;Nam, Seung-Yeon;Kim, Dong-Wook;Lee, Chong-Guk;Seo, Jung-Wook;Heo, Tae-Gil
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.36-43
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    • 2007
  • Purpose: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children. Methods: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed. Results: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together. Conclusion: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.

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Peritoneal Dialysis Associated Peritonitis and Empirical Antibiotics Therapy in Korean Children with Chronic Renal Failure (소아 복막 투석 환자에서 발생한 복막염의 경험적 항생제 치료에 관한 연구)

  • Lee, Sang-Goo;Cho, Joong-Bum;Sohn, Young-Bae;Park, Sung-Won;Kim, Su-Jin;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.213-220
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    • 2008
  • Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.

Multiple Linear Analysis for Generating Parametric Images of Irreversible Radiotracer (비가역 방사성추적자 파라메터 영상을 위한 다중선형분석법)

  • Kim, Su-Jin;Lee, Jae-Sung;Lee, Won-Woo;Kim, Yu-Kyeong;Jang, Sung-June;Son, Kyu-Ri;Kim, Hyo-Cheol;Chung, Jin-Wook;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.317-325
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    • 2007
  • Purpose: Biological parameters can be quantified using dynamic PET data with compartment modeling and Nonlinear Least Square (NLS) estimation. However, the generation of parametric images using the NLS is not appropriate because of the initial value problem and excessive computation time. In irreversible model, Patlak graphical analysis (PGA) has been commonly used as an alternative to the NLS method. In PGA, however, the start time ($t^*$, time where linear phase starts) has to be determined. In this study, we suggest a new Multiple Linear Analysis for irreversible radiotracer (MLAIR) to estimate fluoride bone influx rate (Ki). Methods: $[^{18}F]Fluoride$ dynamic PET scans was acquired for 60 min in three normal mini-pigs. The plasma input curve was derived using blood sampling from the femoral artery. Tissue time-activity curves were measured by drawing region of interests (ROls) on the femur head, vertebra, and muscle. Parametric images of Ki were generated using MLAIR and PGA methods. Result: In ROI analysis, estimated Ki values using MLAIR and PGA method was slightly higher than those of NLS, but the results of MLAIR and PGA were equivalent. Patlak slopes (Ki) were changed with different $t^*$ in low uptake region. Compared with PGA, the quality of parametric image was considerably improved using new method. Conclusion: The results showed that the MLAIR was efficient and robust method for the generation of Ki parametric image from $[^{18}F]Fluoride$ PET. It will be also a good alternative to PGA for the radiotracers with irreversible three compartment model.

A Simulation of Agro-Climate Index over the Korean Peninsula Using Dynamical Downscaling with a Numerical Weather Prediction Model (수치예보모형을 이용한 역학적 규모축소 기법을 통한 농업기후지수 모사)

  • Ahn, Joong-Bae;Hur, Ji-Na;Shim, Kyo-Moon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.12 no.1
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    • pp.1-10
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    • 2010
  • A regional climate model (RCM) can be a powerful tool to enhance spatial resolution of climate and weather information (IPCC, 2001). In this study we conducted dynamical downscaling using Weather Research and Forecasting Model (WRF) as a RCM in order to obtain high resolution regional agroclimate indices over the Korean Peninsula. For the purpose of obtaining detailed high resolution agroclimate indices, we first reproduced regional weather for the period of March to June, 2002-2008 with dynamic downscaling method under given lateral boundary conditions from NCEP/NCAR (National Centers for Environmental Prediction/National Center for Atmospheric Research) reanalysis data. Normally, numerical model results have shown biases against observational results due to the uncertainties in the modelis initial conditions, physical parameterizations and our physical understanding on nature. Hence in this study, by employing a statistical method, the systematic bias in the modelis results was estimated and corrected for better reproduction of climate on high resolution. As a result of the correction, the systematic bias of the model was properly corrected and the overall spatial patterns in the simulation were well reproduced, resulting in more fine-resolution climatic structures. Based on these results, the fine-resolution agro-climate indices were estimated and presented. Compared with the indices derived from observation, the simulated indices reproduced the major and detailed spatial distributions. Our research shows a possibility to simulate regional climate on high resolution and agro-climate indices by using a proper downscaling method with a dynamical weather forecast model and a statistical correction method to minimize the model bias.