• Title/Summary/Keyword: KM12

Search Result 1,347, Processing Time 0.026 seconds

Clinical Outcome after Treatment with the First-line Drugs in Patients with Persistent Positive Sputum Smear and Negative Sputum Culture Results (지속적인 객담 도말양성 및 배양음성인 폐결핵환자에서 일차항결핵제로 치료종결한 후의 임상성적)

  • Kwon, Eun-Su;Lee, Jong-Youk
    • Tuberculosis and Respiratory Diseases
    • /
    • v.51 no.4
    • /
    • pp.325-333
    • /
    • 2001
  • Background : This study aimed to estimate the clinical outcome and identify the characteristics of a group of patients with pulmonary tuberculosis who completed anti-tuberculosis therapy with the First-line drugs in spite of having positive smear results with negative sputum culture results over the previous six months. Method : A retrospective chart review of 21 patients who fulfilled the above criteria between 1995 and 1999 was performed. The laboratory data as well as the clinical data of the patients with positive smear results and negative culture results over a six months period were reviewed. Results : The negative conversion of sputum culture results was achieved within $1.3{\pm}1.2$ months and the negative conversion of the sputum smear results was accomplished during $9.5{\pm}3.3$ months. Chest X-rays at 5 months following the institution of anti-tuberculosis therapy from all patients revealed improvements. Four out of 21 patients(19%) relapsed during the follow up, $15.2{\pm}13.4$ months after administering anti-tuberculosis therapy for $13.3{\pm}3.1$ months. Relapses were confirmed from between 3 months and 4 months after the treatment completion. Only one of the four relapses had no past history of anti-tuberculosis therapy and the others had prior treatment twice (p<0.01). The period of anti-tuberculosis treatment was extended to a mean of $4.6{\pm}2.6$ months in 12 patients. However, prolongation of anti-tuberculosis therapy had no affect on the relapse rate (odds ratio, 95% CI 0.18, 2.15). Conclusion : Prolongation of therapy with the First-line drugs is not necessary for patients with persistently positive smear results over 6 months and negative culture results. A patient who has had prior anti-tuberculosis therapy more than twice should be paid the closest attention.

  • PDF

Hydrogeochemical Characteristics and Contamination of Dissolved Major ions and Heavy Metals in Waters and Sediments from the Tancheon River (탄천의 하상퇴적물과 하천수내 주요 용존 이온과 중금속의 수리지구화학적 특성과 오염)

  • 이성은;김규한;이진수;전효택
    • Economic and Environmental Geology
    • /
    • v.35 no.1
    • /
    • pp.25-41
    • /
    • 2002
  • In order to investigate the hydrogeochemical characteristics and contamination of dissolved major ions and heavy metals in the Tancheon River, river water and sediment samples were collected at 18 locations, along a distance of 69 km, between Yongin-si in Kyunggi-do and Samsung-dong in Seoul on October in 2000 and April in 2001. After appropriate sample preparation, waters were analyzed for the dissolved constituents and sediments. The pH values of river waters were in the range of 7.0 to 9.3 and could be plotted in the area of surface environment. The level of $Ca^{2+}$, , CI-, sol-, N0$_{3}$ and HC0$_{3}$ in the Tancheon River were higher than those in world average river water. Most of dissolved constituents in the river waters increased toward downstream from upstream. In particular, high concentrations of Zn2+, Na$_{+}$, CI$^{-}$, SO$_{4}^{2-}$ and N03- were found near densely residential areas and the Sungnam waste water treatment plant. The relative ion enrichment was caused by the inflow of local domestic and industrial sewages. Also, Ca2+ and HC03- concentrations were enriched in the middle of the Tancheon River due to the dissolution of cements. This indicates that the apartment complexes were built on a large scale in the upriver since these ten years and large amounts of construction materials such as cements were flowed into the Tancheon River. Concentrations of heavy metals (Mn, Cd, Cu, Pb, Zn) in sediments from the Tancheon River exceeded the lower limit of tolerence level in bottom sediment established by the Ontario Ministry of the Environment (OME) of Canada. In particular, these metals were highly elevated in sediment (TSM-12) collected from near the Sungnam waste water treatment plant. Heavy metals were higher enriched in sediments collected from dry period rather than wet period.

Pressure-load Calibration of Multi-anvil Press and the Thermal Gradient within the Sample Chamber (멀티 앤빌 프레스의 압력-부하 보정 작업과 시료 내의 온도구배 연구)

  • Kim, Eun Jeong;Lee, Sung Keun
    • Journal of the Mineralogical Society of Korea
    • /
    • v.31 no.3
    • /
    • pp.161-172
    • /
    • 2018
  • Multi-anvil press (MAP) is one of the high pressure apparatuses and often generates the pressure-conditions ranging from 5 to 25 GPa and temperature-conditions up to $2,300^{\circ}C$. The MAP is, therefore, suitable to explore the pressure-induced structural changes in diverse earth materials from Earth's mantle and the bottom of the mantle transition zone (~660 km). In this study, we present the experimental results for pressure-load calibration of the 1,100-ton multi-anvil press equipped in the authors' laboratory. The pressure-load calibration experiments were performed for the 14/8 step, 14/8 G2, 14/8 HT, and 18/12 assembly sets. The high pressure experiments using ${\alpha}$-quartz, wollastonitestructure of $CaGeO_3$, and forsterite as starting materials were analyzed by powder X-ray diffraction spectroscopy. The phase transition of each mineral indicates the specific pressure that is loaded to a sample at $1,200^{\circ}C$: a transition of ${\alpha}$-quartz to coesite at 3.1 GPa, that of garnet-structure of $CaGeO_3$ to perovskite-structure at 5.9 GPa, that of coesite to stishovite at 9.2 GPa, and that of forsterite to wadsleyite at 13.6 GPa. While the estimated pressure-load calibration curve is generally consistent with those obtained in other laboratories, the deviation up to 50 tons is observed at high pressure above 10 GPa. This is partly because of the loss of oil pressure at high pressure resulting from the differences in a sample chamber, and the frictional force between pressure medium and second anvil. We also report the ${\sim}200^{\circ}C/mm$ of thermal gradient in the vertical direction of the sample chamber of 14/8 HT assembly. The pressure-load calibration curve and the observed thermal gradient within the sample chamber can be applied to explain the structural changes and the relevant macroscopic properties of diverse crystalline and amorphous earth materials in the mantle.

Identification of Quaternary Faults and shallow gas pockets through high-resolution reprocessing in the East Sea, Korea (탄성파 자료 고해상도 재처리를 통한 동해해역의 제4기 단층 및 천부 가스 인지)

  • Jeong, Mi Suk;Kim, Gi Yeong;Heo, Sik;Kim, Han Jun
    • Journal of the Korean Geophysical Society
    • /
    • v.2 no.1
    • /
    • pp.39-44
    • /
    • 1999
  • High-resolution images are drawn from existing seismic data which were originally obtained by Korea Ocean Research & Development Institute (KORDI) during 1994-1997 for deep seismic studies on the East Sea of Korea. These images are analyzed for mapping Quaternary faults and near-bottom gas pockets. First 12 channels are selected from shot gathers for reprocessing. The processing sequence adopted for high-resolution seismic images comprises data copy, trace editing, true amplitude recovery, common-midpoint sorting, initial muting, prestack deconvolution, bandpass filtering, stacking, highpass filtering, poststack deconvolution, f-x migration, and automatic gain control (AGC). Among these processing steps, predictive deconvolution, highpass filtering, and short window AGC are the most significant in enhancement of resolution. More than 200 Quaternanry faults are interpreted on the migrated sections in the shallow depths beneath the seafloor. Although numerous faults are found mostly at the western continental slope and boundaries of the Ulleung Basin, significant amount of the faults are also indicated within the basin. Many of these faults are believed to be formed with reactivation of basement, from geotectonic activities including volcanism, and often originated in Tertiary, indicating that the tectonic regime of the East Sea might be unstable. Existence of shallow gas pockets casts real hazardous warnings to deep-sea drillings and/or to underwater constructions such as inter-island cables and gas pipelines. On the other hand, discovery of these gas pockets heightens the interests in developing natural resources in the East Sea. Reprocessed seismic sections, however, show no typical seismic characteristics for gas hydrates such as bottom-simulating reflectors in the western continental slope and ocean floor.

  • PDF

Decomposition Characteristics of Non-Degradable Liquid Waste under High Temperature and High Pressure Conditions (고온 고압 조건에서의 난분해성 액상폐기물 분해 특성)

  • Lee, Gang-Woo;Shon, Byung-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.8 no.6
    • /
    • pp.1572-1578
    • /
    • 2007
  • The specified wastes consist of waste acid, waste alkali, waste oil, waste organic solvent, waste resin, dust, sludge, infectious waste, and others. Among these specified wastes, a great portion is liquid phase wastes. The purpose of this study is to develop the high temperature and high pressure (HTHP) treatment system for decomposition of the liquid phase specified waste (LPSW). For this, we analyzed the physical and chemical properties of the LPSW such as density, proximate analysis, ultimate analysis, heating values, and designed 0.3 ton/day HTHP treatment system. The LPSW tested in this experiment were prepared by adding TCE(trichloroethylene) and toluene to liquid phase waste which was brought into the commercial waste treatment company. The average density of waste oil (25 samples), waste resin (5 samples), and waste solvent (12 samples) was 0.99 g/mL, 0.91 g/mL, and 0.93 g/mL, respectively. And the average lower heating value of waste oil, waste resin, and waste solvent was 8,294 kcal/kg, 5,809 kcal/kg, and 7,462 kcal/kg, respectively. The DRE (Destruction & Removal Efficiency) of TCE and toluene were 99.95% and 99.73% at atmospheric pressure conditions and that were 99.99% and 99.82% at pressurized conditions, respectively. These results showed that TCE/toluene mixtures were properly decomposed over about 99.73% of DRE by the HTHP treatment system and pressurized conditions were more effective to destroy those pollutants than atmospheric pressure conditions. Also these systems could be directly applied to industries which try to treat the liquid phase specified waste within the regulation limit.

  • PDF

W-Sn-Bi-Mo Mineralization of Shizhuyuan deposit, Hunan Province, China (중국 호남성 시죽원 광상의 W-Sn-Bi-Mo광화작용)

  • 윤경무;김상중;이현구;이찬희
    • Economic and Environmental Geology
    • /
    • v.35 no.3
    • /
    • pp.179-189
    • /
    • 2002
  • The Geology of the Shizhuyuan W-Sn-Bi-Mo deposits, situated 16 Ian southeast of Chengzhou City, Hunan Province, China, consist of Proterozoic metasedimentary rocks, Devonian carbonate rocks, Jurassic granitic rocks, Cretaceous granite porphyry and ultramafic dykes. The Shizhuyuan polymetallic deposits were associated with medium- to coarse-grained biotite granite of stage I. According to occurrences of ore body, ore minerals and assemblages, they might be classified into three stages such as skarn, greisen and hydrothernlal stages. The skarn is mainly calcic skarn, which develops around the Qianlishan granite, and consists of garnet, pyroxene, vesuvianite, wollastonite, amphibolite, fluorite, epidote, calcite, scheelite, wolframite, bismuthinite, molybdenite, cassiterite, native bismuth, unidetified Bi- Te-S system mineral, magnetite, and hematite. The greisen was related to residual fluid of medium- to coarse-grained biotite granite, and is classified into planar and vein types. It is composed of quartz, feldspar, muscovite, chlorite, tourmaline, topaz, apatite, beryl, scheelite, wolframite, bismuthinite, molybdenite, cassiterite, native bismuth, unknown uranium mineral, unknown REE mineral, pyrite, magnetite, and chalcopyrite with minor hematite. The hydrothermal stage was related to Cretaceous porphyry, and consist of quartz, pyrite and chalcopyrite. Scheelite shows a zonal texture, and higher MoO) content as 9.17% in central part. Wolframite is WO); 71.20 to 77.37 wt.%, FeO; 9.37 to 18.40 wt.%, MnO; 8.17 to 15.31 wt.% and CaO; 0.01 to 4.82 wt.%. FeO contents of cassiterite are 0.49 to 4.75 wt.%, and show higher contents (4.]7 to 4.75 wt.%) in skarn stage (Stage I). Te and Se contents of native bismuth range from 0.00 to 1.06 wt.% and from 0.00 to 0.57 wt.%, respectively. Unidentified Bi-Te-S system mineral is Bi; 78.62 to 80.75 wt.%, Te; 12.26 to 14.76 wt.%, Cu; 0.00 to 0.42 wt.%, S; 5.68 to 6.84 wt.%, Se; 0.44 to 0.78 wt.%.

Characteristic on the Layout and Semantic Interpretation of Chungryu-Gugok, Dongaksan Mountain, Gokseong (곡성 동악산 청류구곡(淸流九曲)의 형태 및 의미론적 특성)

  • Rho, Jae-Hyun;Shin, Sang-Sup;Huh, Joon;Lee, Jung-Han;Han, Sang-Yub
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.32 no.4
    • /
    • pp.24-36
    • /
    • 2014
  • The result of the research conducted for the purpose of investigating the semantic value and the layout of the Cheongryu Gugok of Dorimsa Valley, which exhibits a high level of completeness and scenic preservation value among the three gugoks distributed in the area around Mt. Dongak of Gogseong is as follows.4) The area around Cheongryu Gugok shows a case where the gugok culture, which has been enjoyed as a model of the Neo-Confucianism culture and bedrock scenery, such as waterfall, riverside, pond, and flatland, following the beautiful valley, has been actually substituted, and is an outstanding scenery site as stated in a local map of Gokseong-hyeon in 1872 as "Samnam Jeil Amban Gyeryu Cheongryu-dong(三南第一巖盤溪流 淸流洞: Cheongryu-dong, the best rock mooring in the Samnam area)." Cheongryu Gugok, which is differentiated through the seasonal scenery and epigrams established on both land route and waterway, was probably established by the lead of Sun-tae Jeong(丁舜泰, ?~1916) and Byeong-sun Cho(曺秉順, 1876~1921) before 1916 during the Japanese colonization period. However, based on the fact that a number of Janggugiso of ancient sages, such as political activists, Buddhist leaders, and Neo-Confucian scholars, have been established, it is presumed to have been utilized as a hermit site and scenery site visited by masters from long ago. Cheongryu Gugok, which is formed on the rock floor of the bed rock of Dorimsa Valley, is formed in a total length of 1.2km and average gok(曲) length of 149m on a mountain type stream, which appears to be shorter compared to other gugoks in Korea. The rock writings of the three gugoks in Mt. Dongak, such as Cheongryu Gugok, which was the only one verified in the Jeonnam area, total 165 in number, which is determined to be the assembly place for the highest number of rock writings in the nation. In particular, a result of analyzing the rock writings in Cheongryu Gugok totaling 112 places showed 49pieces(43.8%) with the meaning of 'moral training' in epigram, 21pieces (18.8%) of human life, 16pieces(14.2%) of seasonal scenery, and 12pieces(10.6%) of Janggugiso such as Jangguchur, and the ratio occupied by poem verses appeared to be six cases(3.6%). Sweyeonmun(鎖烟門), which was the first gok of land route, and Jesiinganbyeolyucheon(除是人間別有天) which was the ninth gok of the waterway, corresponds to the Hongdanyeonse(虹斷烟鎖) of the first gok and Jesiinganbyeolyucheon of the ninth gok established in Jaecheon, Chungbuk by Se-hwa Park(朴世和, 1834~1910), which is inferred to be the name of Gugok having the same origin. In addition, the Daeeunbyeong(大隱屛) of the sixth gok. of land route corresponds to the Chu Hsi's Wuyi-Gugok of the seventh gok, which is acknowledged as the basis for Gugok Wollim, and the rock writings and stonework of 'Amseojae(巖棲齋)' and 'Pogyeongjae(抱經齋)' between the seventh gok and eighth gok is a trace comparable with Wuyi Jeongsa(武夷精舍) placed below Wuyi Gugok Eunbyeon-bong, which is understood to be the activity base of Cheongryu-dong of the Giho Sarim(畿湖士林). The rock writings in the Mt. Dongak area, including famous sayings by masters such as Sunsaeuhje(鮮史御帝, Emperor Gojong), Bogahyowoo(保家孝友, Emperor Gojong), Manchunmungywol(萬川明月, King Joengjo), Biryeobudong(非禮不動, Chongzhen Emperor of the Ming Dynasty)', Samusa(思無邪, Euijong of the Ming Dynasty), Baksechungpwoong(百世淸風, Chu Hsi), and Chungryususuk-Dongakpungkyung(淸流水石 動樂風景, Heungseon Daewongun) can be said to be a repository of semantic symbolic cultural scenery, instead of only expressing Confucian aesthetics. In addition, Cheongryu Gugok is noticeable with its feature as a cluster of cultural scenery of the three religions of Confucian-Buddhism-Taoism, where the Confucianism value system, Buddhist concept, and Taoist concept co-exists for mind training and cultivation. Cheongryu Gugok has a semantic feature and spatial character as a basis for history and cultural struggle for the Anti-Japan spirit that has been conceived during the process of establishing and utilizing the spirit of the learning, loyalty for the Emperor and expulsion of barbarians, and inspiration of Anti-Japan force, by inheriting the sense of Dotong(道統) of Neo-Confucianism by the Confucian scholar class at the end of the Joseon era that is represented by Ik-hyun Choi(崔益鉉, 1833~1906), Woo Jeon(田愚, 1841~1922), Woo-man Gi(奇宇萬, 1846~1916), Byung-sun Song(宋秉璿, 1836~1905), and Hyeon Hwang(黃玹, 1855~1910).

Recent Research for the Seismic Activities and Crustal Velocity Structure (국내 지진활동 및 지각구조 연구동향)

  • Kim, Sung-Kyun;Jun, Myung-Soon;Jeon, Jeong-Soo
    • Economic and Environmental Geology
    • /
    • v.39 no.4 s.179
    • /
    • pp.369-384
    • /
    • 2006
  • Korean Peninsula, located on the southeastern part of Eurasian plate, belongs to the intraplate region. The characteristics of intraplate earthquake show the low and rare seismicity and the sparse and irregular distribution of epicenters comparing to interplate earthquake. To evaluate the exact seismic activity in intraplate region, long-term seismic data including historical earthquake data should be archived. Fortunately the long-term historical earthquake records about 2,000 years are available in Korea Peninsula. By the analysis of this historical and instrumental earthquake data, seismic activity was very high in 16-18 centuries and is more active at the Yellow sea area than East sea area. Comparing to the high seismic activity of the north-eastern China in 16-18 centuries, it is inferred that seismic activity in two regions shows close relationship. Also general trend of epicenter distribution shows the SE-NW direction. In Korea Peninsula, the first seismic station was installed at Incheon in 1905 and 5 additional seismic stations were installed till 1943. There was no seismic station from 1945 to 1962, but a World Wide Standardized Seismograph was installed at Seoul in 1963. In 1990, Korean Meteorological Adminstration(KMA) had established centralized modem seismic network in real-time, consisted of 12 stations. After that time, many institutes tried to expand their own seismic networks in Korea Peninsula. Now KMA operates 35 velocity-type seismic stations and 75 accelerometers and Korea Institute of Geoscience and Mineral Resources operates 32 and 16 stations, respectively. Korea Institute of Nuclear Safety and Korea Electric Power Research Institute operate 4 and 13 stations, consisted of velocity-type and accelerometer. In and around the Korean Peninsula, 27 intraplate earthquake mechanisms since 1936 were analyzed to understand the regional stress orientation and tectonics. These earthquakes are largest ones in this century and may represent the characteristics of earthquake in this region. Focal mechanism of these earthquakes show predominant strike-slip faulting with small amount of thrust components. The average P-axis is almost horizontal ENE-WSW. In north-eastern China, strike-slip faulting is dominant and nearly horizontal average P-axis in ENE-WSW is very similar with the Korean Peninsula. On the other hand, in the eastern part of East Sea, thrust faulting is dominant and average P-axis is horizontal with ESE-WNW. This indicate that not only the subducting Pacific Plate in east but also the indenting Indian Plate controls earthquake mechanism in the far east of the Eurasian Plate. Crustal velocity model is very important to determine the hypocenters of the local earthquakes. But the crust model in and around Korean Peninsula is not clear till now, because the sufficient seismic data could not accumulated. To solve this problem, reflection and refraction seismic survey and seismic wave analysis method were simultaneously applied to two long cross-section traversing the southern Korean Peninsula since 2002. This survey should be continuously conducted.

The Role of the Soft Law for Space Debris Mitigation in International Law (국제법상 우주폐기물감축 연성법의 역할에 관한 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.30 no.2
    • /
    • pp.469-497
    • /
    • 2015
  • In 2009 Iridium 33, a satellite owned by the American Iridium Communications Inc. and Kosmos-2251, a satellite owned by the Russian Space Forces, collided at a speed of 42,120 km/h and an altitude of 789 kilometers above the Taymyr Peninsula in Siberia. NASA estimated that the satellite collision had created approximately 1,000 pieces of debris larger than 10 centimeters, in addition to many smaller ones. By July 2011, the U.S. Space Surveillance Network(SSN) had catalogued over 2,000 large debris fragments. On January 11, 2007 China conducted a test on its anti-satellite missile. A Chinese weather satellite, the FY-1C polar orbit satellite, was destroyed by the missile that was launched using a multistage solid-fuel. The test was unprecedented for having created a record amount of debris. At least 2,317 pieces of trackable size (i.e. of golf ball size or larger) and an estimated 150,000 particles were generated as a result. As far as the Space Treaties such as 1967 Outer Space Treaty, 1968 Rescue Agreement, 1972 Liability Convention, 1975 Registration Convention and 1979 Moon Agreement are concerned, few provisions addressing the space environment and debris in space can be found. In the early years of space exploration dating back to the late 1950s, the focus of international law was on the establishment of a basic set of rules on the activities undertaken by various states in outer space.. Consequently environmental issues, including those of space debris, did not receive the priority they deserve when international space law was originally drafted. As shown in the case of the 1978 "Cosmos 954 Incident" between Canada and USSR, the two parties settled it by the memorandum between two nations not by the Space Treaties to which they are parties. In 1994 the 66th conference of International Law Association(ILA) adopted "International Instrument on the Protection of the Environment from Damage Caused by Space Debris". The Inter-Agency Space Debris Coordination Committee(IADC) issued some guidelines for the space debris which were the basis of "the UN Space Debris Mitigation Guidelines" which had been approved by the Committee on the Peaceful Uses of Outer Space(COPUOS) in its 527th meeting. On December 21 2007 this guideline was approved by UNGA Resolution 62/217. The EU has proposed an "International Code of Conduct for Outer Space Activities" as a transparency and confidence-building measure. It was only in 2010 that the Scientific and Technical Subcommittee began considering as an agenda item the long-term sustainability of outer space. A Working Group on the Long-term Sustainability of Outer Space Activities was established, the objectives of which include identifying areas of concern for the long-term sustainability of outer space activities, proposing measures that could enhance sustainability, and producing voluntary guidelines to reduce risks to long-term sustainability. By this effort "Guidelines on the Long-term Sustainability of Outer Space Activities" are being under consideration. In the case of "Declaration of Legal Principles Governing the Activities of States in the Exp1oration and Use of Outer Space" adopted by UNGA Resolution 1962(XVIII), December 13 1963, the 9 principles proclaimed in that Declaration, although all of them incorporated in the Space Treaties, could be regarded as customary international law binding all states considering the time and opinio juris by the responses of the world. Although the soft law such as resolutions, guidelines are not binding law, there are some provisions which have a fundamentally norm-creating character and customary international law. In November 12 1974 UN General Assembly recalled through a Resolution 3232(XXIX) "Review of the role of International Court of Justice" that the development of international law may be reflected, inter alia, by the declarations and resolutions of the General Assembly which may to that extend be taken into consideration by the judgements of the International Court of Justice. We are expecting COPUOS which gave birth 5 Space Treaties that it could give us binding space debris mitigation measures to be implemented based on space debris mitigation soft law in the near future.

Prevalence of Drug-resistances in Patients with Pulmonary Tuberculosis and Its Association with Clinical Characteristics at One Tertiary Referral Hospital in Pusan, Korea (부산지역 한 3차 병원으로 내원한 폐결핵 환자에서 약제 내성률과 예측인자간의 연관성)

  • Son, Choon-Hee;Yang, Doo-Kyung;Rho, Mee-Sook;Jeong, Jin-Sook;Lee, Hyuck;Lee, Ki-Nam;Choi, Pil-Jo;Lee, Soo-Keol;Chang, Kwang-Yul;Choi, Ik-Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.51 no.5
    • /
    • pp.416-425
    • /
    • 2001
  • Background : The incidence of drug-resistant tuberculosis has recently decreased in Korea. However, it is still one of the major obstacles in treating pulmonary tuberculosis. This study was performed to determine the prevalence and clinical characteristics associated with drug-resistance in pulmonary tuberculosis at the tertiary referral hospital in Pusan, Korea. Methods : The medical records of 138 patients, who had been diagnosed as active pulmonary tuberculosis were retrospectively reviewed, and results of drug susceptibility from May 1997 to June 2000. The relationships among those with a history of previous tuberculosis treatment, the extent of lung involvement, the presence of cavities on the initial chest X-ray films and patterns of drug resistance were analyzed. Results : The total number of patients who had drug resistance to at least one drug was 55(39.9%). Among them 34(24.6%) had resistance to isoniazid(INH) and rifampin(RFP). There was drug resistance in 20(22%) of 91 patients without previous tuberculosis therapy, and among them 9(9.9%) were multi-drug resistant. Thirty-two(74.5%) out of 47 patients with previous therapy were drug-resistant and 25(53.2%) were multidrug resistant. For all 138 patients, resistance to INH was the most common(34.1%), followed by RFP(26.1%) and ethambutol(EMB)(14.5%). Drug resistance to INH, RFP, PZA and streptomycin(SM) were independently associated with a history of previous treatment(odds ratio; 9.43, 9.09, 8.93 and 21.6 respectively, p<0.01). The extent of lung involvement on the chest films was significantly associated with the drug resistance to INH and RFP(odds ratio; 2.12 and 2.40 respectively, p<0.01). The prevalence of drug resistance to RFP, INH and RFP was significantly more common in patients with a cavitary lesion on the chest films by multivariate analysis(odds ratio; 4.17 and 4.81 respectively, p<0.05). Conclusion : This study revealed that patients with a prior treatment history for pulmonary tuberculosis, and the presence of a cavitary lesion on chest films had a higher prevalence of anti-tuberculosis drug resistance. A very careful clinical and microbiological examination is needed for patients with such characteristics.

  • PDF