• Title/Summary/Keyword: Multiple failure

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Clinical Finding of MDR Tuberculosis and Frequency of MOTT (다제내성결핵의 임상적 특성과 비결핵항산균증의 빈도)

  • Bae, Mi-Hee;Kim, Hwa-Jung;Kwon, Eun-Soo;Kim, Cheol-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1123-1142
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    • 1998
  • Background : The frequency of MOTT has risen as the prevalence of tuberculosis has been declining. Our country has been also. The most of MOTT was resistant to the major anti-tuberculous drugs. Method : To compare clinical characteristics and frequencies of MDR tuberculosis with MOTT, the author studied 65 patients showing AFB culture positive with sputum. The data were collected from 176 patients who had been admitted at the National Masan Tuberculosis Hospital from May to June, 1997 to April, 1998. Result : The frequency of MDR tuberculosis was 43.1% and that of MOTT was 9.2%. Among 65 isolated mycobacteria, 3 cases were M. intracellulare. 2 cases were M. fortuitum, and 1 case was unidentified MOTT. The most frequent age group in 65 culture positive patients was 4th decade and the mean age was 44. The mean age was 61 in MOTT and 42 in M. tuberculosis and had significant difference(p<0.01). The numbers with past history of treatment were 2.3 in MDR tuberculosis and 1.7 in non-MDR tuberculosis and had significant difference(p<0.05). At the time of admission, the most frequent regimen for the treatment of MDR tuberculosis was 24 months regimen(85.7%) with the 2nd line anti-tuberculosis drugs. For non-MDR tuberculosis, 9 or 12 months regimen (72.9%) with the 1st line anti-tuberculosis drugs and had significant difference (p<0.01). At the time of admission, the symptom of weight loss was shown in 84.7% of M. tuberculosis and 50.0% in MOTT and there was significant difference(p<0.05) between them. All of the MOTT were identified to be resistant against INH and PAS. Drug resistance rates to INH, OFX(p<0.01) and PAS(p<0.05) in MOTT were higher than in MDR. All of three M. intracellulare strains were resistant to INH, RFP, PAS and OFX. All of two M. fortuitum strains were resistant to most anti-tuberculosis drugs. And the other MOTT was resistant to INH, EMB and PAS. Conclusion : MOTT was more common in elderly patients than M. tuberculosis. MOTT cases should be considered to be the probability of multiple drug resistance and treatment failure during the 1st treatment because they showed more resistance to anti-tuberculosis drugs than M. tuberculosis cases. Therefore, there should be more careful investigations for clinical characteristics, natural history of disease, and efficient management for MOTT.

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The Studies on the Development of Human Blastocyst Embryos in IVF -ET Program - II. The Development of Human Blastocyst Embryos by co-culture with Cumulus Cells (IVF-ET Program에서 Blastocyst 배아의 발생에 관한 연구 - II. 난구세포 공동배양에 의한 Blastocyst 배아의 발생)

  • Lee, Suk-Won;Yoon, San-Hyun;Yoon, Hye-Gyun;Cho, Hyon-Jin;Heo, Yong-Soo;Yoon, Hye-Jin;Park, Se-Pill;Lee, Won-Don;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.1
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    • pp.35-41
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    • 1998
  • This study was carried out to investigate the development rates of human embryos co-cultured with cumulus cells to each blastocyst stage. Human zygotes were co-cultured on cumulus cell monolayer in YS medium supplemented with 20% hFF. On day 2, if patient had four or more "good" embryos (regular blastomeres without fragmentation), embryos were further cultured for 72hrs. Blastocysts on day 5 were classified into early blastocyst (ErB), early expanding blastocyst (EEB), middle expanding Blastocyst (MEB), and expanded blastocyst (EdB) on the basis of their morphological aspects of trophectoderm cells and blastocoele. Subsequently, maximum 3 of best blastocysts were transferred in 486 cycles. The results in this study were as follows: Patients who had four or more "good" embryos on day 2 were 498 persons, but patients whose embryos could not be transferred due to failure in development to the blastocyst stage on day 5 were 12 persons (2.4%). The development rate of embryos to the blastocyst stage was 58.2% (2,885/4,957) on day 5, and the rates that developed to the ErB, EEB, MEB, and EdB stage were 15.0% (743/4,957), 14.9% (739/4,957), 14.4% (714/ 4,957), and 13.9% (689/4,957), respectively. Total 1366 blastocysts were transferred in 486 cycles (mean number=2.81). The implantation rate and the ongoing implantation rate obtained by observing the number of G-sac and FHB were 29.9% (409/1,366) and 22.5% (308/1,366), respectively. The clinical pregnancy rate was 51.2% (249/486), and the ongoing pregnancy rate' was 39.1% (190/486). Among women showing ongoing pregnancy, women with singleton were 50% (95/190), women with twin were 37.9% (72/190), and women with triplet were 12.1% (23/190). Although triplet pregnancy rate in this study was high such as 12.1%, because many blastocysts with high viability were produced in our co-culture system using cumulus cells on day 5, we really believe that a multiple pregnancy except twin should not occur by selecting good embryos for maximum two blastocyst transfer. These results demonstrate that autologous cumulus cells may be used for the production of blastocysts with high developmental competence, and the use of autologous cumulus cells to be collected easily, and to be treated conveniently at OPU must be an effective means for obtaining high implantation and pregnancy rate.

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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Flexure and tension tests of newly developed ceramic woven fabric/ceramic matrix composites (새로 개발된 세라믹 직포 보강 세라믹 기지 복합체의 인장 및 곡강도 시험)

  • Dong-Woo Shin;Jin-Sung Lee;Chang-Sung Lim
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.6 no.1
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    • pp.73-87
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    • 1996
  • The mechanical properties of 2D ceramic composites fabricated bythe newly developed powder infiltration and subsequent multiple impregnation process were characterised by both 3-point flexure and tensile tests. These tests were performed with strain gauge and acoustic emission instrument. The woven fabric composites used for the test have the basic combinations of $Al_{2}$$O_{3}$ fabric/$Al_{2}$$O_{3}$ and SiC fabric (Tyranno)/SiC. Uniaxially aligned SiC fibre(Textron SCS-6)/SiC composites were also tested for comparison, The ultimate flexural strength and first-matrix cracking stress of SiC fabric/SiC composite with 73% of theoretical density were about 300 MPa and 77 MPa respectively. However, the ultimate tensile strengths of composite were generally one third of flexural strengths, and first-matrix cracking stress in a tension test was also much lower than the value obtained from flexure test. The lower mechanical properties measured by tension test were analysed quantitatively bythe differences in stressed volume using Weibull statistics. This showed that the ultimate strength and the firs-tmatrix cracking stress of woven laminate composites were mainly determined bythe gauge length of fibres and the stressed volume of matrix respectively. Incorporation of SiC whiskers into the matrix increased first-matrix cracking stress by increasing the matrix failure strain of composites.

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DENTAL TREATMENT IN A PATIENT WITH METACHROMATIC LEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT (이염성 백질 이영양증 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.96-100
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    • 2016
  • Metachromatic leukodystrophy (MLD) is a progressive and degenerative neurological disease caused by a deficiency of the catabolic enzyme arylsulfatase A. Deficiency of arylsulfatase A results in accumulation of sulfatide in the white matter of the peripheral and central nervous system and it occurs demyelination as a result. The patient gradually goes through mental and motor failure. General symptoms of MLD include gait disturbance, mental deterioration, muscle rigidity and impaired swallowing. Inheritance of the disease is autosomal recessive. We report a dental caries treatment of a 3-year old boy with MLD. The patient underwent hematopoietic stem cell transplantation (HSCT) to slow the progression of the disease. He was suffered from difficulties of mastication and swallowing from the degenerative neurological symptom. He was ingesting food by both oral feeding and tubal feeding after he took percutaneous endoscopic gastrostomy (PEG). The cause of multiple caries was mainly presumed as patient's prolonged time of meal. The treatment was performed under general anesthesia considering patient's incompliance. Severely affected lower primary molars were treated with pulp treatment and restored with stainless steel crown. Others were restored with composite resin. There were no postoperative complications. MLD is life threatening progressive disease and also has an impact on unfavorable condition for oral health. Routine home oral care and periodic professional dental care should be emphasized to the caregiver of patient considering the susceptibility of dental caries. Not only the medical care, but periodic dental office visit would benefit the quality of life of the patient.

Development of a Scalable Clustering A/V Server for the Internet Personal-Live Broadcasting (인터넷 개인 생방송을 위한 Scalable Clustering A/V Server 개발)

  • Lee, Sang-Moon;Kang, Sin-Jun;Min, Byung-Seok;Kim, Hag-Bae;Park, Jin-Bae
    • The KIPS Transactions:PartC
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    • v.9C no.1
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    • pp.107-114
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    • 2002
  • In these days, rapid advances of the computer system and the high speed network have made the multimedia services popularized among various applications and services in the internet. Internet live broadcasting, a part of multimedia services, makes it possible to provide not only existing broadcasting services including audio and video but also interactive communications which also expand application scopes by freeing from both temporal and spatial limitation. In the Paper, an interned Personal-live broadcasting server system is developed by allowing individual users to actively create or join live-broadcasting services with such basic multimedia devices as a PC camera and a sound card. As the number of broadcasters and participants increases, concurrent multiple channels are established and groups are to be expanded. The system should also guarantee High Availability (HA) for continuous services even in the presence of partial failure of the cluster. Furthermore, a transmission mode switching is supported to consider network environments in the user system.

Prediction Model of Endurance Time to Isotonic Contraction Exercise for Biceps Brachii using Multiple Regression Analysis with Personal Factors and Anthropometric Data (신체측정치수를 적용하여 다중회귀 분석을 통한 위팔두갈래근 등장성 운동의 근지구력시간 예측모델 연구)

  • Jeong, Ju-Young;Lee, Sang-Sik
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.8 no.2
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    • pp.178-186
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    • 2015
  • Endurance time is very important indicator to estimate muscle fatigue. In the case of measuring endurance time directly, it is dangerous for subject to perform a test until the point of failure to main time force. Therefore, this paper presents the model to estimate endirance time using indirect measurements such as personal factors and anthropometrical data. Previous studies had shown that personal factors such as gender and age were not related to endurance time, but recently studies have shown that it is estimated by using independent variable or predictor such as GTA (Gravitational Torque of the horizontal, stretched arm) and MVC (Maximum Voluntary Contraction). The present study investigated variables to estimate endurance time using personal factors and anthrometrical data during isotonic contractions. Twenty five healthy subject volunteered for this study, and performed three test sessions of isotonic contraction exercises at 10~50% respectively. Afterward the correlation coefficient and p-values were compared among regression models using personal factors and anthropometrical data. The results demonstrated that multi-regression model had significant coefficient of correlation, and was useful estimate endurance time.

Evaluation of Corporate Distress Prediction Power using the Discriminant Analysis: The Case of First-Class Hotels in Seoul (판별분석에 의한 기업부실예측력 평가: 서울지역 특1급 호텔 사례 분석)

  • Kim, Si-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.520-526
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    • 2016
  • This study aims to develop a distress prediction model, in order to evaluate the distress prediction power for first-class hotels and to calculate the average financial ratio in the Seoul area by using the financial ratios of hotels in 2015. The sample data was collected from 19 first-class hotels in Seoul and the financial ratios extracted from 14 of these 19 hotels. The results show firstly that the seven financial ratios, viz. the current ratio, total borrowings and bonds payable to total assets, interest coverage ratio to operating income, operating income to sales, net income to stockholders' equity, ratio of cash flows from operating activities to sales and total assets turnover, enable the top-level corporations to be discriminated from the failed corporations and, secondly, by using these seven financial ratios, a discriminant function which classifies the corporations into top-level and failed ones is estimated by linear multiple discriminant analysis. The accuracy of prediction of this discriminant capability turned out to be 87.9%. The accuracy of the estimates obtained by discriminant analysis indicates that the distress prediction model's distress prediction power is 78.95%. According to the analysis results, hotel management groups which administrate low level corporations need to focus on the classification of these seven financial ratios. Furthermore, hotel corporations have very different financial structures and failure prediction indicators from other industries. In accordance with this finding, for the development of credit evaluation systems for such hotel corporations, there is a need for systems to be developed that reflect hotel corporations' financial features.

Effect of Recipient's Age on the Pregnancy Outcomes in Oocyte Donation Program (난자공여 프로그램에서 난자수혜자의 연령이 임신율에 미치는 영향에 관한 연구)

  • Suh, C.S.;Oh, S.K.;Kim, S.H.;Choi, Y.M.;Kim, J.G.;Moon, S.Y.;Lee, J.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.167-177
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    • 1997
  • Oocyte donation program developed to reach the pregnancy in those patients suffering from premature ovarian failure or surgery induced menopause, particularly in their reproductive age. With technical advances and popularity of ART (assisted reproductive technology), the indication of oocyte donation program extended to low responders, and even to naturally menopaused patients that has led them quite successfully to getting in pregnancy. The purpose of this study was to evaluate which one is involved in the decline of fertility between the oocyte and uterine factor. One hundred five cycles of oocyte donation program were performed in 84 patients from Jan., 1993 to Dec., 1996. Oocytes were donated from healthy, young, fertile anonymous donors or relatives or infertile patients with supernumerary oocytes. The study population was divided into 3 groups according to the age of recipients. Group 1 was less than 35 years old, Group 2 was between 35 to 39 years old, and Group 3 was more than 39 years old. The results were as follows: The mean age of oocyte donor was $31.5{\pm}3.3$ (range; 25-36). The mean concentration of basal serum FSH and peak serum estradiol were not different among groups. The mean number of oocytes retrieved from donors, embryos transferred to recipients, and fertilization rate were not different among groups. The clinical pregnancy rate was 37.3% in Group 1, 31.6% in Group 2, and 31.6% in Group 3, respectively. The spontaneous abortion rate was 16.0% in Group 1, 16.7% in Group 2, and 16.7 in Group 3, respectively. The multiple pregnancy rate was 20.0% in Group 1, 16.7% in Group 2, 16,7% in Group 3, respectively, The implantation rate was 11.3% in Group 1, 10.3% in Group 2 and 10.0% in Group 3, respectively. All of the pregnancy outcomes were not different statistically among groups. In conclusion, endometrial receptivity does not seem to be impaired as age increases with transfer of good quality embryos and adequate endometrial preparation.

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Enterprise Competitiveness and Corporate Performance Creation Strategies by Stage of Growth on Firm (벤처기업의 성장단계별 기업경쟁력 및 기업 성과 창출 전략)

  • Park, DaIn;Park, ChanHi
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.6
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    • pp.177-189
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    • 2018
  • Business environment is always full of challenges. Despite various strategic efforts, there are so many failure cases of misfit. With the weaker resource base and institutional foundation, startup firms find it more difficult to find the right spot in the stiff competition. In the middle of evolutionary process, the startup firms need proper strategies meeting the differential challenges along the multiple stages of growth. Following the idea of product life cycle, this study applies the four stages of growth-startup, initial growth, accelerated growth, matured, and decliing. The next step for the startup manager is meeting each stage of growth with proper strategic efforts, including strategy, structure, decision-making pattern, and control method. When the knowledge factor is introduced, there is a potential for higher performance. Based on the 'Detailed Survey on Startup Ventures in 2017,' this study explores the impact of the government subsidy program on the firm competitiveness and performance-along the four stages of growth. In each stage, the strategy factors showed differential impact.