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Clinical Characteristics of Pulmonary Tuberculosis Presenting Prolonged Fever Despite Primary Short-Course Anti-tuberculosis Treatment (1차 항결핵약제 치료 후에도 지속적으로 발열을 보인 폐결핵 환자의 임상상)

  • Kim, Eun-Kyung;Hwang, Jung-Hwa;Song, Kun-Sick;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.169-178
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    • 2000
  • Background : Usually fever subsides within one week in over 90% of pulmonary tuberculosis (TBp) patients after the start of short-course anti-tuberculosis therapy, but occasionally it persists over two weeks after treatment. When the fever persists, drug resistance, combined infection, or drug fever, and so on, are considered as an etiology and, in some cases, drugs are changed. But inadvertent discontinuation of a short-course regimen inevitably will extend the duration of treatment, and the treatment completion may be delayed. This study was performed to investigate the causes of prolonged fever (PF) and to identify the predictors of PF in drug-susceptible TBp patients in Korea. Method : Five hundred-ninety-eight patients, who were admitted to Asan Medical Center from January 1996 to March 1999, diagnosed with TBp and prescribed short-course, anti-tuberculosis treatment, were reviewed. PF was defined as having fever over two weeks despite treatment. The causes of PF were analyzed. Drug-sus-ceptible TBp patients who presented no causes for PF, except turberculosis itself, were selected(n=22), and they were compared with those who had no fever at diagnosis (n=22) and those who had fever at diagnosis, which had subsided within two weeks after treatment (n=22). Clinical, laboratory, and radiological parameters were compared among the three groups. Results : Twenty-eight (4.8%) of 598 patients showed PF over two weeks despite short-course treatment. The causes of PF were drug fever (n=2), multi-drug resistant tuberculosis (n=3), disseminated Mycobacterium kansasii infection (n=1), and drug-susceptible tuberculosis itself (n=22). The patients with PF had more risk factors for tuberculosis, long duration of symptoms before treatment, night sweats, weight long, numerous acid fast bacilli on sputum smear, anemia, hyponatremia, hypoalbuminemia, over three lung cavity numbers and extensive infiltration, indicating that they had prolonged and extensive lung diseases. Conclusion : The main cause of PF in TBp despite short-course regimen seems to be drug-susceptible but extensive disease in Korea. Any changes to the drug regiment provided for TBp patients with prolonged fever despite treatment should be carefully considered.

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Comparing Photosynthesis, Growth, and Yield of Paprika (Capsicum annuum L. 'Cupra') under Supplemental Sulfur Plasma and High-Pressure Sodium Lamps in Growth Chambers and Greenhouses (황 플라즈마 및 고압나트륨 램프의 보광에 따른 생육상 및 온실에서의 파프리카 광합성 및 생산성 비교)

  • Park, Kyoung Sub;Kwon, Dae Young;Lee, Joon Woo;Son, Jung Eek
    • Journal of Bio-Environment Control
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    • v.27 no.4
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    • pp.332-340
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    • 2018
  • Supplemental lighting with artificial light sources is a practical method that enables normal growth and enhances the yield and quality of fruit vegetable in greenhouses. The objective of this study was to investigate the effect of sulfur plasma lamp (SP) and high-pressure sodium lamp (HPS) as supplemental lighting sources on the growth and yield of paprika. For investigating the effectiveness of SP and HPS lamps on paprika, the effects of primary lighting on plant growth were compared in growth chambers and those of supplemental lighting were also compared in greenhouses. In the growth chamber, plant height, leaf area, stem diameter, number of leaves, fresh weight, and dry weight were measured weekly at SP and HPS from 2 weeks after transplanting. In the greenhouse, no supplemental lighting (only sunlight) was considered as the control. The supplemental lights were turned on when outside radiation became below $100W{\cdot}m^{-2}$ from 07:00 to 21:00. From 3 weeks after supplemental lighting, the growth was measured weekly, while the number and weight of paprika fruits measured every two weeks. In the growth chamber, the growth of paprika at SP was better than at HPS due to the higher photosynthetic rate. In the greenhouse, the yield was higher under sunlight with either HPS or SP than sunlight only (control). No significant differences were observed in plant height, number of node, leaf length, and fresh and dry weights between SP and HPS. However, at harvest, the number of fruits rather than the weight of fruits were higher at SP due to the enhancement of fruiting numbers and photosynthesis. SP showed a light spectrum similar to sunlight, but higher PAR and photon flux sum of red and far-red wavelengths than HPS, which increased the photosynthesis and yield of paprika.

Computer Assisted EPID Analysis of Breast Intrafractional and Interfractional Positioning Error (유방암 방사선치료에 있어 치료도중 및 분할치료 간 위치오차에 대한 전자포탈영상의 컴퓨터를 이용한 자동 분석)

  • Sohn Jason W.;Mansur David B.;Monroe James I.;Drzymala Robert E.;Jin Ho-Sang;Suh Tae-Suk;Dempsey James F.;Klein Eric E.
    • Progress in Medical Physics
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    • v.17 no.1
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    • pp.24-31
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    • 2006
  • Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

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A Comparative Analysis of Blood and Urine Luteinizing Hormone Surge According to Different Regimens of Induced Ovulatory Agens in Superovulated Menstrual Cycles (배란유도방법에 의한 과배란주기에서 혈중및 요중 황체화호르몬 Surge에 관한 연구)

  • Park, Won-Jong;Suh, Byung-Hee;Lee, Jae-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.2
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    • pp.103-117
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    • 1988
  • Ovulation induction was done with 3 different regimens as clomid combined with HMG, HMG only, and FSH combined with HMG in 28 menstrual cycles for IVF-ET and GIFT program. The appearance of endogenous LH surge, estradiol plateau, atypical LH surge, and time from initiation to peak of LH surge in serum and urine were observed and compared in 3 groups. 1. The estradiol concentration of serum LH surge day was similar in three groups but 1st group (Clomiphene Citrate+Sequential HMG) was slightly higher at $1924.0{\pm}865.1\;pg/ml$. In regards to the existence of serum estradiol plateau, 3rd group (FSH+Sequential HMG) was highest at 60%, and 1st group and 2nd group (HMG only) were similar at 33% and 44% respectively. 2. The number of ovarian of ovarian follicle which was more than 18mm in diameter was $4.1{\pm}2.0$, $4.2{\pm}2.1$ respectibely for 2nd group and 3rd group. Although the numbers were slightly higher thean 1st group for each ovarian follicle, serum estradiol value per follicle was higher for 1st group at $583.0{\pm}261.2pg/ml$. 3. When measuring the urine LH surge according to Hi-Gonavi and according to the standard set by three different types of surge, simultameous satisfaction for 1st group, 2nd group, 3rd group was two cases, five cases, four cases respectively at 40%, and the remained cases were composed of numorous type combination which satisfied the two definition, simultaneously in this study, the LH surge starting time was determined only in the cases tow combination were satisfied simultaneously at first, but there are something to study more. In one case of the 3rd group. 4. The concentration of LH surge start in urine and serum of 2nd group was highest at306. $0{\pm}287.2IU/l$ and $34.0{\pm}9.9mIU/ml$ and 1st group was low at $116.6{\pm}66.1IU/l$ and 7.4mIU/ml. The urine and serum value of LH was highest at $1644.4{\pm}988.8IU/l$, $65.9{\pm}15.0mIU/ml$ for 2nd group, 1st group was low at urine, and 3rd group was low of serum. With pregnancy established, the LH concentration of urine was relatively high but on the contrary the LH concentration of serum was low compared to urine concentration. 5. Time from LH surge start to the maximun of urine and serum value was highest at 15. $7{\pm}9.1$ hrs and $10.8{\pm}4.9$ hrs for 1st group and 3rd group. With pregnancy established, time was shortened for urine but on the contrary serum showed an increase in time. 6. The concentration of LH which increases with time on urine was highest at 2nd group ($194.6{\pm}76.8\;IU/hour$). The lowest increase for serum was at 3rd group (2.1mIU/hour). With pregnancy established, urine showed more increase than control group ($266.5{\pm}47.4\;IU/hour$) and for serum there was similar increase ($3.4{\pm}0.8\;mIU/hour$). 7. There were two examples of non-typical surge from 1st group and 3rd group each. Among these three cases showed a reestablishment of LH surge after 10-24 hours. 8. Endogenous spontaneous Lh surge occurs once for each 2nd group and 3rd group.

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Evaluation on Management of Unified Health Subcenters (통합보건지소 운영 평가)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Hwang, Tae-Yoon;Kim, Chang-Yoon
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.67-77
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    • 2003
  • Objectives: This study is designed to suggest the health service goals necessary for providing the more efficient services relevant to the requests of the community, through the evaluation on the operating status of the unified health subcenters. Methods: We visited total 5 unified health subcenters comprising 3 ones located in Gyeongsangbuk-do and 2 ones located in Gyeongsangnam-do from December 2000 to January 2001, and interviewed about the pre- and post-unified status related to manpower, facilities, equipment, medical service and health service quality, and the problems and improvement plans of the unified management. Results: According to the evaluation on the manpower before and after the unification of the health subcenters, the total employees increased by 2.8 persons on average from 6.8 to 9.6 persons in the investigated subjects. The numbers of doctors, dentists and nurses were almost the same as before. There were no clinical pathologic technician and radiological technician before but they were appointed to duty in 3 unified health subcenters later. The unification of the health subcenters has produced slight increases in the frequency of the medical service and dental treatment and considerable increases in that of the physical therapy and laboratory tests. In relating to the changes of the health service, the cases of visiting health care and ambulatory medical service, and the total number of health education participants were greatly increased after the unification. The number of cases undergoing the vaccination and cervical cancer screening was similar to that of the pre-unification while the patient number of the registration to hypertension or diabetes showed a tendency to increase a little. Since the unification of the health subcenters, the frequency of laboratory tests has been increased, but the quality of health service has not been improved yet. Nevertheless, the unification seems to be positive according to the result of the great improvement in visiting health care, ambulatory medical service and health education service. The problems of the unification of the health subcenters were indicated in indefiniteness of the service details between the workers; excessively large building hard to be effectively managed; insufficient medical instruments, inappropriation of working expenses, lack of professional training for the health education, etc. Conclusions: For further active functions of the unified health subcenters, the minimal allocation basis to appoint doctors, nurses and administrative workers to do the duty should be differentiated from the basis for a health subcenter, and the fundamental instruments needs to be expanded to improve the quality of the medical service and visiting health care service. Moreover, the unified health subcenter needs to have definite service details between the workers, and should improve the working efficiency through the development of service-related guidelines.

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The Effect of Bamboo (Phyllostachys nigra var. henenis Strapf) Leaf Extract on Ultraviolet B-induced Skin Damages in Mouse (자외선 B 조사 마우스에서 피부손상에 대한 분죽 (Phyllostachys nigra var. henenis Strapf)잎 추출물의 효과)

  • Chae, Se-Lim;Lee, Hae-June;Moon, Chang-Jong;Kim, Jong-Choon;Bae, Chun-Sik;Kang, Seong-Soo;Jang, Jong-Sik;Jo, Sung-Kee;Kim, Sung-Ho
    • Journal of Radiation Protection and Research
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    • v.32 no.2
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    • pp.65-69
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    • 2007
  • The effects of bamboo (Phyllostachys nigra var. henenis Strapf) leaf extract (BLE) on the changes of ultraviolet (UV) light B radiation-induced apoptotic sunburn cell (SBC) and epidermal ATPase-positive dendritic cell (DC) in SKH1-hr or ICR mouse were investigated. The mice were treated with UVB ($200mJ/cm^2$) and were sacrificed 24 hours later. BLE (50 mg/kg of body weight) or vehicle (saline) was given i.p. at 36 and 12 hours before irradiation, and 30 minutes after irradiation. BLE cream (0.2%) or cream base (vehicle) was also topically treated at 24 hours and 15 minutes before irradiation, and immediately after irradiation. The skin of SKH1-hr mouse prepared from the back of untreated mice exhibited about 0.3 SBC/cm length of epidermis, and 24 hours after UV irradiation, the applied areas show an increased number of SBCs. But the frequency of UVB-induced SBC formation was significantly reduced by intraperitoneal injection (59.0%) and topical application (31.8%) of BLE extract. The numbers of DC in normal ICR mouse were $628.00{\pm}51.56\;or\;663.20{\pm}62.58\;per\;mm^2$ of ear epidermis. By 1 day after UVB treatment, the number of ATPase-positive $cells/mm^2$ were decreased by 39.0% or 27.1% in i.p. or topical application group with vehicle. The frequency of UVB ($200mJ/cm^2$)-induced DC decrease was reduced by treatment of BLE as 25.7% in i.p. group and 3.2% in topical application group compared with the irradiation control group. The results presented herein that BLE administration could reduce the extent of skin damages produced by UVB.

Pelvic microbial flora in the users versus the nonusers of intrauterine device determined by laparoscopic method (복강경을 이용한 자궁내장치 사용자의 복강세균학적 연구)

  • Hahn, Won-Bo;Kwak, Hyun-Mo
    • Clinical and Experimental Reproductive Medicine
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    • v.11 no.1
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    • pp.17-32
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    • 1984
  • There are numerous reports on the relative risk of pelvic inflammatory disease among the users versus the nonusers of intrauterine device. Reported relative risk varied from no difference between the two groups to 3-9 fold increase in the users. In an attempt to define this relative risk of pelvic inflammatory disease and related microorganisms ,pelvic organ observation and bacteriological study were done through laparoscopy. Specimens for microbiologic culture were obtained simultaneously from the fallopian tubes via laparoscopy and from the endocervix via regular pelvic examination method. The study population was consisted of 30 I.U.D.users and 35 J.U.D.nonusers who visited the Yonsei University Severance Hospital and the Sung-Ga Hospital for laparoscopic sterilization. The results obtained were as follows: 1. There was no difference in age distribution, economic status and numbers of parity and abortion between I.U.D. users and I.U.D. nonusers. 2. The pelvic inflammatory findings were noted on laparoscopy in 2 cases of I.U.D. users, with an incidence of 6.6%. And no pelvic inflammatory finding was noted in any of the nonusers,but this difference was not statistically significant (p>0.005). 3. All the bacteriologic culture of the specimens from the fallopian tubes of both groups yielded negative results. 4. The bacteriologic culture of the spec imens f rom the endocervix revealed more frequent isolation of possible pathogen such as Hem ophilus ,alpha-Streptococcus ,Corynebacteria, Bacteroides in the I.U.D.users than in the nonusers.But,this difference was also not statistically significant (p>0.005).

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Social Perception on Gifted Education (영재교육에 대한 사회적 인식 - 신문기사 분석을 중심으로 -)

  • Kim, In-Hye;Park, Jung-Ok;Choi, Moon-Kyung
    • Journal of Gifted/Talented Education
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    • v.16 no.1
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    • pp.21-42
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    • 2006
  • The object of this research is to analyze the contents and amount of articles on gifted education in major daily newspapers dated January 1990 to December 2003, and to review the trend of social perception of gifted education with the passage of time. Following are the research question : 1. How many articles belonging to the same category appeared in the newspapers within the period of time covered by the study? 2. What kinds of articles appeared in the newspapers within the period of time covered by the study? To arrive at the answers to the problems mentioned above, 714 articles on gifted education. The period from 1990 to 2003 were divided into time frames of 5 years to facilitate the analysis of social consciousness regarding gifted education before and after the enforcement of the Early School Entering Law in 1995 and the Law for Promotion of Gifted Education in 2000. The researcher defined Period I as the years from 1990 to 1994, Period II from 1995 to 1999, and Period III from 2000 to 2003. The articles were classified by content which were significance and trend of gilled education, current policies on gifted education, information on gifted education, and social environment of gifted education. The results of the analysis are as follows: (1) The articles from 1990 to 2003 totalled 714. 130 articles were found within Period I, 213 within Period II, and 371 within Period III. Since the year 2000, when the Law for Promotion of gifted education was enforced, the amount of articles considerably increased. The articles on the trend of gifted education numbered 42 within Period I, 49 within Period II, and 81 within Period III, showing a huge increase in the last period. The articles on current policies numbered 56 within Period I, 77 within Period II, and 143 within Period III, numbering the most in the last period. This means that, even before the Law for Promotion of gifted education was enforced, there has been much interest in and discussion of the appropriate educational system for gifted children in preparation for the legal and institutional foundation of such system. Since the enforcement of the law, many institutions were established and the problem became an important social issue. The articles that most frequently appeared were about current policies on and status of gifted education. This category showed the largest numbers through all the three periods and on all the subjects. This subject represented 43.1% of the articles on gifted children within Period I, 36.2% within Period II, and 38.6% within Period III. As to the significance and trend of gifted education, this subject showed a decrease from 32.3% within Period I, 23% within Period II, and 21.8% within Period III. However, the articles in the category of information on gifted education gradually increased from they represented 5.4% of the articles on brilliant children within Period I, 7.5% within Period II, and 8.4% within Period III. The social environment articles showed an increase from Period I to Period II-- from 19.2% to 33.3%, but it went down to 31.3% within Period III. (2) As to articles on the trend of gifted education, there were many such articles found, mainly on researches and trends in other countries. As greater importance is accorded to gifted children and as the recognition of the necessity of providing specific education for them grows, more related studies are conducted and people try to adopt new trends from other countries. For the articles on the current policies of gifted education, most of them were about institutions. This means that many educational institutions have been established since the Law for Promotion of Gifted Education was enforced. Informative articles on gilled education were mostly about distinctive features of gifted children and how to tell who the brilliant children are. This fact shows the importance of identifying gifted children in order to educate them systemically and effectively.

The Development of National Competency Standard(NCS) Regarding Casino Operations Management (카지노운영관리 직무에 관한 국가직무능력표준(NCS) 개발)

  • Kim, Dong-Yeon;Oh, Seung-Gyun;Koo, Ja-Gil;Kim, Jinsoo
    • 대한공업교육학회지
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    • v.39 no.1
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    • pp.143-163
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    • 2014
  • This study developed a National Competency Standard(NCS) regarding the casino operations management based on the manual for developing National Competency Standard of 13 years and a revised classification system chart of the National Competency Standard. For the research method, this study developed a national competency standard of relevant jobs after going through review, consultation, modification, supplementation, and reporting procedures 10 times with development experts of the National Competency Standard, the industrial setting professionals, education and training experts, qualification(job analysis) experts, facilitators, and a working group of job verification committee based on the phased range and DACUM procedure of study. The major development results of this study are as follows. First, this study selected and defined duties based on the revised classification system chart of the National Competency Standard, then drew and developed total 8 ability units based on the applicable duties. Secondly, based on the developed ability units, total 27 ability unit factors were deduced and developed. Thirdly, a standard system by ability unit factor was developed based on the level of the national competency standard and revised classification system chart, then this study deduced and developed a supra-domain of the standard system by competency units using the standard tranquility value by these competency unit factors. Based on such development contents and guidelines for the national competency standard ability unit classification number, this study deduced and developed category numbers by relevant competency unit. Fourthly, total 27 relevant performance standard by competency units and knowledge, skill, and attitude were deduced and developed. Fifthly, this study deduced and developed a scope of application, work situation, evaluation guide, core competency, and development history in reference to the total 8 relevant competency units based on the duties.

Effect of Ethane 1,2-Dimethane Sulfonate(EDS) on the Apoptosis in the Rat Epididymis (흰쥐 부정소에서의 세포자연사에 미치는 Ethane 1,2-Dimethane Sulfonate(EDS)의 효과)

  • Son, Hyeok-Jun;Lee, Sung-Ho
    • Development and Reproduction
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    • v.10 no.3
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    • pp.203-209
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    • 2006
  • Ethane 1,2-Dimethane sulfonate(EDS), a toxin which specifically kills Leydig cells(LC), has been widely used to prepare the reversible testosterone(T) depletion rat model. Previous studies including our own clearly demonstrated that the dramatic weight loss of the T-dependent accessory sex organs such as epididymis and seminal vesicle in this 'LC knock-out' rats. These weight loss could be derived from massive and abrupt death of the cells via apoptotic process. The present study was performed to test the effect of EDS administration on the expression of some apoptotic genes in the rat epididymis. Adult male Sprague-Dawley rats($300{\sim}350$ g B.W.) were injected with single dose of EDS(75 mg/kg, i.p.) and sacrificed on Weeks 0, 1, 2, 3, 4, 5, 6 and 7. Tissue weights and the numbers of the epididymal sperm were measured. The transcriptional activities of the bcl-2, bax, Fas and Fas ligand(Fas-L) were evaluated by semi-quantitative RT-PCR. As expected, the weights and the sperm counts of epididymis declined progressively after the EDS treatment during Week 1 and 2. These decrements were discontinued with a gradual return towards normal during Weeks $5{\sim}7$, although the maximal recoveries of the epididymal weights(71%) and sperm count(38%) were subnormal on Week 7. The initial level of bcl-2 transcripts persisted to Week 6 then elevated significantly on Week 7. The level of bax transcripts significantly decreased on Week 6, and no remarkable change was found in the rest of the experimental period. The transcripts for the Fas in epididymis elevated during Weeks $1{\sim}2$, returned to normal on Week 3, and the level persisted to the Week 7. Similarly, the level of Fas-L transcripts elevated during Weeks $1{\sim}3$ and returned to normal after Week 4. Our results demonstrated the transient T depletion by EDS administration could induce the changes in expression of the apoptotic genes in rat epididymis. The activation of Fas and Fas-L in the epididymis of EDS-treated rats might be responsible for the initial apototic process and consequently the tissue damage and the sperm loss. Future studies will attempt to determine the precise molecular mechanism(s) of apoptosis in the rat epididymis.

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