• 제목/요약/키워드: Manifest

검색결과 603건 처리시간 0.024초

Pulmonary Resection in the Treatment of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵환자의 폐절제술에 관한 연구)

  • Kwon, Eun-Soo;Ha, Hyun-Cheol;Hwang, Su-Hee;Lee, Hung-Yol;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • 제45권6호
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    • pp.1143-1153
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    • 1998
  • Background : Recent outbreaks of pulmonary disease due to drug-resistant strains of Mycobacterium Tuberculosis have resulted in significant morbidity and mortality in patients worldwide. We reviewed our experience to evaluate the effects of pulmonary resection on the management of multidrug-resistant tuberculosis. Method : A retrospective review was performed of 41 patients undergoing pulmonary resection for multidrug-resistant tuberculosis between January 1993 and December 1997. We divided these into 3 groups according to the radiologic findings : (1) patients who have reasonably localized lesion (Localized Lesion Group ; LLG) (2) patients who have cavitary lesions after pulmonary resection on chest roentgenogram (Remained Cavity Group : RCG) (3) patients who have Remained infiltrative lesions postoperatively (Remained infiltrative group : RIG). We evaluated the negative conversion rate after resection and overall response rate of the groups. Then they were compared with the results of the chemotherapy on the multi drug-resistant tuberculosis which has been outcome by Goble et al. Goble et al reported that negative conversion rate was 65% and overall response rate, 56% over a mean period of 5.1 months. Results : Seventy five point six percent were men and 24.4% women with a median age of 31 years (range, 16 to 60 years). Although the patients were treated preoperatively with multidrug regimens in an effort to reduce the mycobacterial burden, 22 of 41 were still sputum culture positive at the time of surgery. 20 of 22 patients(90.9%, p<0.01) responded which is defined as negative sputum cultures within 2 months postoperative. Of 26 patients with the sufficient follow up data, 19 have Remained sputum culture negative for a mean duration of 25.7 months (73.1%, p<0.05). The bulk of the disease was manifest in one lung, but lesser amounts of contralateral disease were demonstrated in 15, consisted of 8 in RIG and 7 in RCG, of 41. 12 of 12 patients (100%, p<0.01) who were sputum positive at the time of surgery in LLG converted successfully. 14 of 15 patients (93.3%, p<0.05) with the follow up have completed treatment and not relapsed for a mean period of 25. 7 months. The mean length of postoperative drug therapy of LLG was 12.2 months. In RIG, postoperative negative conversion rate was 83.3% which was not significant statistically. There was a statistical significance in overall response rate (100%, p<0.05) of RIG for a mean period of 24.4 months with a mean length of postoperative chemotherapy, 11.8 months. In RCG a statistically lower overall response rate (14.3%, p<0.01) has been revealed for a mean duration of follow up, 24.2 months. A negative conversion rate of RCG was 75% which was not significant statistically. Conclusion : Surgery plays an important role in the management of patients with multidrug-resistant Mycobacterium tuberculosis infection. Aggressive pulmonary resection should be performed for resistant Mycobacterium tuberculosis infection to avoid treatment failure or relapse. Especially all cavitary lesions on preoperative chest roentgenogram should be resected completely. If all of them could not be resected perfectly, you should not open the thorax.

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A Study of Mac(脈)-Theory and Change of Mac(脈)-Diagnosis in Whang Di Nei Qing(黃帝內經) (황제내경(黃帝內經)의 맥(脈) 이론(理論)과 진맥법(診脈法)의 변화(變化)에 관(關)한 연구(硏究))

  • Ra, Kyoung-Chan;Park, Hyun Kook
    • The Journal of Dong Guk Oriental Medicine
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    • 제2권1호
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    • pp.73-105
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    • 1993
  • To say nothing of the orient and the west, the human beings discover the method of Jin Mac(診脈) by the way that observe disease. But oriental medicine devise special method of Jin Mac(診脈) in the study of Kyoung Mac(經脈). Although sip-ei Kyoung Mac Jin(十二經脈診), Sam Bu Gu Who Jin(三部九候診), In Young Mac Gu Jin(人迎脈口診), Chon Kwan Chuck Jin(寸關尺診) namely Yuk Bu Jung Wee Jin Mac (六部定位診脈) that is used today are devised, it has changed naturally by the changing treatment and the introduction of Yuin Yang(陰陽) and five element(五行). Many methods dg Jin Mac(診脈), it had not developped successing alternative, it had developped of declined by it's own way. 1. Results for the birth of Mac(脈) 1) Mac(脈), it means Kyoung Mac(經脈), at first entirelly Mac(脈), is seized a blood vessel that flows in the body. As presumed today, after finding many acupunture point, a general idea of Mac(脈) is not maked by the line that connect point and point, it connect between acupunture point and acupunture point. 2) Like blood flows in Hyul Mac(血脈), Gie(氣) flows in Kyoung Mac(經脈). The two things relate deeply each other. In a general idea or actrally Kyoung Rak(經洛), the two things sometimes accord, sometimes seperate, sometimes mix alternative. 3) Hyul Mac(血脈) and Kyoung Mac(經脈), we call it Mac(脈) entirely Kyoung Mac(經脈), is a way that manifest disease through Kyoung Mac(經脈) or a boundary that disease belongs to it method of Mac Jin(脈診) individual that disease of Kyoung Mac(經脈) is diagnosed by the jumping situation of Hyul Mac(血脈). 4) In method of Moxa, athough the pathology and the diagnostic of Mac(脈) are created by finding Mac(脈). Finding acupunture have opportunitty fot Mac Jin(脈診) and treatment. 2. Results of Kyoung Mac Mac Jin(經脈脈診) 1) In theory of kyoung Rak(經洛), disease are resumed for malfunction of Young Wee(榮衛) that flows in Kyung Rak(經洛). So to speak, in treatment of Kyoung Rak area, the purpose of diagnosis observe the situation of disease and cause. For fitting the purpose of diagnosis, the dead had esatablised four-diagnosis method mangMunMnnJeul(望聞問切), in four-diagnosis(四診法), the core is Mac Jin(脈診). 2) sip-ei Kyoung Mac Mac Jin(十二經脈診) had existed as Kyoung Mac Mac Jin(經脈脈診), it precedes Sam Bu Gu Who Jin(三部九候診). In Young Ki Gu Mac(人迎脈口診). 3) Although Bu Yang Mac(趺陽脈), So Um Mac(少陰脈) is a part of Sip-ei Kyoung Mac(十二經脈診), they developped especially because they located in the point of Won Hyul(原穴) and they are convenient for diagnose. 4) Sip-ei Kyoung Mac Mac Jin(十二經脈診), which belongs to Bu Yang Mac(趺陽脈) and So Urn Mac(少陰脈), is not important for the comming age medical books compared with Mac Kyoung(脈經). 3. Results gor Sam Bu Gu Who Jin(三部九候診) 1) Mac Jin(脈診) of Sam Bu Gu Who(三部九候), which is noted in the theory of Sam Bu Gu Who(三部九候診) of So Mun(素問), belongs to Kyoung Mac Mac Jin's(經脈脈診) geneology, Sip-ei Kyoung Mac Mac Jin(十二經脈診) is arranged, simplicated by the idealogy three talents(三才思想) in the heaven and the earth. 2) What Sam Bu Gu Jin(三部九候診) is regardded as very important in So Mun(素問), the editor of So Mun(素問) recognize the meaning that one discover disease early in this method of diagnosis. 3) After Young chu(靈樞), Nan Kyoung(難經) it is lacked the method of Sam Bu Gu Who Jin(三部九候診) in the books that treatment has changed. Sam Bu Gu Who Jin(三部九候診) based on actually clinic appropriate. 4. results for In Young Mac Gu Jin(人迎脈口診) 1) In Young Mac Gu Jin(人迎脈口診) is the method of comparative Mac Jin(脈診) according to the theory of Yin Yang(陰陽), it is presumed after Sam Bu Gu Who Jin(三部九候診), it had perished in parallel with the development of the theory of five elelment(五行). The development of the acupunture, the perishment of the treatment of negative(刺絡). 2) In Young Mac Gu Jin(人迎脈口診), Wang Suk Wha(王叔和) recreated that the left is In Young(人迎), the right is Kie Gu(氣口). In future generations by Jin Mu Taek(陳無擇) who is the writer of Sam In Bang(三因方). In Young Mac Gu Jin(人迎脈口診) is a measure for disease which classify it's inside and outside cause. 5. Results for Chon Gu Mac Jin(寸口脈診) 1) What we say Mac Jin(脈診) of Chon Gu(寸口) two means are used in commn. First case, we simply say the area of Chon Gu(寸口), second case, we say Chon Kwan Chuk Jin(寸口尺診) reducingly. Chon Gu(寸口) is the area which is the radial artery of wrist joint. What we attemp diagnose by only Chon Gu Mac(寸口脈), it is clearly shoued in the method of Nan Kyoung, five Nan(難經五難). 2) Because Jin Mac(診脈) is made in only Chon Gu(寸口), that is the area in which is concentated Kyoung Kee(經氣). That is the birth of Jin Kee(眞氣) and Jin Kee(眞氣) is related with disease. We can diagnose disease by taking Chon Gu(寸口). 3) Chuk Jin(尺診) in Nae Kyoung(難經) have two things. One is Il Chuk(一尺), the other is Chon Kwan Chu(寸關尺). 4) Chuk Chon Jin(尺寸診) is the method which diagnose the difference of point and the condition of Mac(脈) by dividing a part of Chuk(尺) in the area of Chon Gu(寸口). In Chon Gu Jin(寸口診), by introducing the theory of Yin Yang(陰陽), the method of Chon Gu Jin(寸口診) is developed by chon Gu Jin(寸口診). 5) What Chuk Kwan Chon Jin(寸關尺診) is that area of the Chon Gu(寸口) are divided fot three point, we can diagnose. By consulting Sam Bu Gu Who Jin(三部九候診), developping of the method of acupunture, utilzing the theory of five element(五行) it is devised by concentrating way of thinking of the method mac Jin(脈診) exiting. 6) Chon Kwan Chuk Jin MaC(寸關尺診脈) begin from Nae Kyoung(內徑) exiting. After Nan Kyoung(內徑), spread out widely from Mac Kyoung(脈診) of Wang Suk wha(王叔和), the future medicins followed it. Yang Hyun Jo(楊玄操) and established Chon Kwan Chuk Jin(寸關尺診) which is used widely today. This right and left Chon Kwan Chuk Jin(寸關尺診), we call it method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 7) We can think the base which presume the arrangement of the viscera for Chon Kwan Chuk(寸關尺) of the right and the left. 8) The origin, which seperate the right and the left of Mac(脈), is showed at the treory of Ji Jin Yo Dae(至眞要大論) in So Mun(素問) which Chon Chuk(寸尺) seperate the right and the left. But the method of diagnosis in Nan Kyoung(難經) have no seperation the fight and the left. Otherwise this. there is clearly writtened the seperation for the right origin of the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈) seek for Cang Gong(倉公). 9) Yang Hyun Jo(楊玄操) notice that the Chuk(尺) is mentioned for Sam Cho(三焦) in the method of Mac Kyuong(脈經), Sim Po Kyung(心包經) which put together with Sam Cho(三焦) allot on this, he had established the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 10) On the method of Paen Jak Yin Yang Mac(扁鵲陰陽脈) in Mac Kyoung(脈經), equal article exist with the theory of Pyung In Kee Sang(平人氣象論) in So Mun(素問). When Wang Suk Wha(王叔和) write Mac Kyung(脈經), we can presume that the book of Mac(脈) which Paen Jak(扁鵲) had experienced the origin have exited besides So Mun(素問), Young Chu(靈樞). If so he must be make Chon Kwan Chuk Jin(寸關尺診) very fairly standard. So Nae Kyoung(內經), which must be fllowed the method of Paen Jak Mac(扁鵲脈), do the method diagnosis of Chon Kwan Chuk(寸關尺), diagnise of disease and treat.

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Studies on the Varietal Difference in the Physiology of Ripening in Rice with Special Reference to Raising the Percentage of Ripened Grains (수도 등숙의 품종간차이와 그 향상에 관한 연구)

  • Su-Bong Ahn
    • KOREAN JOURNAL OF CROP SCIENCE
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    • 제14권
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    • pp.1-40
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    • 1973
  • There is a general tendency to increase nitrogen level in rice production to insure an increased yield. On the other hand, percentage of ripened grains is getting decreased with such an increased fertilizer level. Decreasing of the percentage is one of the important yield limiting factors. Especially the newly developed rice variety, 'Tongil' is characterized by a relatively low percentage of ripened grains as compared with the other leading varieties. Therefore, these studies were aimed to finding out of some measures for the improvement of ripening in rice. The studies had been carried out in the field and in the phytotron during the period of three years from 1970 to 1972 at the Crop Experiment Station in Suwon. The results obtained from the experiments could be summarized as follows: 1. The spikelet of Tongil was longer in length, more narrow in width, thinner in thickness, smaller in the volume of grains and lighter in grain weight than those of Jinheung. The specific gravity of grain was closely correlated with grain weight and the relationship with thickness, width and length was getting smaller in Jinheung. On the other hand, Tongil showed a different pattern from Jinheung. The relationship of the specific gravity with grain weight was the greatest and followed by that with the width, thickness and length, in order. 2. The distribution of grain weight selected by specific gravity was different from one variety to another. Most of grains of Jinheung were distributed over the specific gravity of 1.12 with its peak at 1.18, but many of grains of Tongil were distributed below 1.12 with its peak at 1.16. The brown/rough rice ratio was sharply declined below the specific gravity of 1.06 in Jinheung, but that of Tongil was not declined from the 1.20 to the 0.96. Accordingly, it seemed to be unfair to make the specific gravity criterion for ripened grains at 1.06 in the Tongil variety. 3. The increasing tendency of grain weight after flowering was different depending on varieties. Generally speaking, rice varieties originated from cold area showed a slow grain weight increase while Tongil was rapid except at lower temperature in late ripening stage. 4. In the late-tillered culms or weak culms, the number of spikelets was small and the percentage of ripened grains was low. Tongil produced more late-tillered culms and had a longer flowering duration especially at lower temperature, resulting in a lower percentage of ripened grains. 5. The leaf blade of Tongil was short, broad and errect, having light receiving status for photosynthesis was better. The photosynthetic activity of Tongil per unit leaf area was higher than that of Jinheung at higher temperature, but lower at lower temperature. 6. Tongil was highly resistant to lodging because of short culm length, and thick lower-internodes. Before flowering, Tongil had a relatively higher amount of sugars, phosphate, silicate, calcium, manganese and magnesium. 7. The number of spikelets of Tongil was much more than that of Jinheung. The negative correlation was observed between the number of spikelets and percentage of ripened grains in Jinheung, but no correlation was found in Tongil grown at higher temperature. Therefore, grain yield was increased with increased number of spikelets in Tongil. Anthesis was not occurred below 21$^{\circ}C$ in Tongil, so sterile spikelets were increased at lower temperature during flowering stage. 8. The root distribution of Jinheung was deeper than that of Tongil. The root activity of Tongil evaluated by $\alpha$-naphthylamine oxidation method, was higher than that of Jinheung at higher temperature, but lower at lower temperature. It is seemed to be related with discoloration of leaf blades. 9. Tongil had a better light receiving status for photosynthesis and a better productive structure with balance between photosynthesis and respiration, so it is seemed that tongil has more ideal plant type for getting of a higher grain yield as compared with Jinheung. 10. Solar radiation during the 10 days before to 30 days after flowering seemed enough for ripening in suwon, but the air temperature dropped down below 22$^{\circ}C$ beyond August 25. Therefore, it was believed that air temperature is one of ripening limiting factors in this case. 11. The optimum temperature for ripening in Jinheung was relatively lower than that of Tongil requriing more than $25^{\circ}C$. Air temperature below 21$^{\circ}C$ was one of limiting factors for ripening in Tongil. 12. It seemed that Jinheung has relatively high photosensitivity and moderate thermosensitivity, while Tongil has a low photosensitivity, high thermosensitivity and longer basic vegetative phase. 13. Under a condition of higher nitrogen application at late growing stage, the grain yield of Jinheung was increased with improvement of percentage of ripened grains, while grain yield of Tongil decreased due to decreasing the number of spikelets although photosynthetic activity after flowering was. increased. 14. The grain yield of Jinheung was decreased slightly in the late transplanting culture since its photosynthetic activity was relatively high at lower temperature, but that of Tonil was decreased due to its inactive photosynthetic activity at lower temperature. The highest yield of Tongil was obtained in the early transplanting culture. 15. Tongil was adapted to a higher fertilizer and dense transplanting, and the percentage of ripened grains was improved by shortening of the flowering duration with increased number of seedlings per hill. 16. The percentage of vigorous tillers was increased with a denser transplanting and increasing in number of seedlings per hill. 17. The possibility to improve percentage of ripened grains was shown with phosphate application at lower temperature. The above mentioned results are again summarized below. The Japonica type leading varieties should be flowered before August 20 to insure a satisfactory ripening of grains. Nitrogen applied should not be more than 7.5kg/10a as the basal-dressing and the remained nitrogen should be applied at the later growing stage to increase their photosynthetic activity. The morphological and physiological characteristics of Tongil, a semi-dwarf, Indica $\times$ Japonica hybrid variety, are very different from those of other leading rice varieties, requring changes in seed selection by specific gravity method, in milling and in the cultural practices. Considering the peculiar distribution of grains selected by the method and the brown/rough rice ratio, the specific gravity criterion for seed selection should be changed from the currently employed 1.06 to about 0.96 for Tongil. In milling process, it would be advisable to bear in mind the specific traits of Tongil grain appearance. Tongil is a variety with many weak tillers and under lower temperature condition flowering is delayed. Such characteristics result in inactivation of roots and leaf blades which affects substantially lowering of the percentage of ripened grains due to increased unfertilized spikelets. In addition, Tongil is adapted well to higher nitrogen application. Therefore, it would be recommended to transplant Tongil variety earlier in season under the condition of higer nitrogen, phosphate and silicate. A dense planting-space with three vigorous seedlings per hill should be practiced in this case. In order to manifest fully the capability of Tongil, several aspects such as the varietal improvement, culural practices and milling process should be more intensively considered in the future.he future.

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