• Title/Summary/Keyword: Negative-resistance

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Mono-Rifampicin-Resistant Pulmonary Tuberculosis (Rifampicin단독내성 폐결핵)

  • Shim, Tae-Sun;Lee, Ki-Man;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.618-627
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    • 1999
  • Background : Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy. Usually the RFP resistant M.tuberculosis is also resistant to isoniazid (INH), so the RFP resistance is the marker of multi-drug resistant (MDR) tuberculosis. But unusual cases of mono-RFP-resistant tuberculosis have been recently reported with increasing frequency, especially associated with HIV infection in western countries. Therefore, we conducted a retrospective study to investigate the frequency, causes, and the clinical characteristics of mono-RFP-resistant tuberculosis in Korea. Methods : Of the bacteriologically confirmed and susceptibility-proven 699 pulmonary tuberculosis patients (921 isolates) who visited Asan Medical Center from January 1990 to August 1997, eighteen patients with INH-susceptible and RFP-resistant tuberculosis were evaluated. Previous history of tuberculosis, antituberculous drug compliances, associated systemic illness, drug susceptibility patterns, and clinical outcomes were analysed. And rpoB gene sequencing was done in 6 clinical isolates of M. tuberculosis. Results : The mean age of 18 patients was $43{\pm}14$ years, and the sex ratio is 12:6 (M : F). Sixteen (89%) patients had previous history of tuberculosis. None had diagnosed gastrointestinal disorders, and 2 HIV tests that were performed came out negative. Susceptibility tests were done repeatedly in eleven patients, and six (55%) were mono-RFP resistant repeatedly while five (45%) evolved to MDR tuberculosis. Eight (44%) patients were cured, six (33%) failed, three (17%) were lost to follow-up, and the other one is now on treatment. rpoB gene sequencing showed 5 mutations, codon 531 TCG to TIG mutation in 4 isolates and 526 CAC to TAC in 1 isolate. Conclusion : The clinical characteristics of mono-RFP resistant tuberculosis were similar to that of MDR tuberculosis in Korea where the HIV infection rate is lower than western countries. But some patients with mono-RFP-resistant tuberculous could be cured by primary drug regimens including RFP, suggesting that mono-RFP-resistant tuberculous is a different entity from MDR tuberculosis.

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Improvement of Tomato Seedling Quality under Low Temperature by Application of Silicate Fertilizer (저온 저장 시 규산 처리에 의한 토마토 묘소질 향상)

  • Vu, Ngoc-Thang;Tran, Anh-Tuan;Le, Thi-Tuyet-Cham;Na, Jong-Kuk;Kim, Si-Hong;Park, Jong-Man;Jang, Dong-Cheol;Kim, Il-Seop
    • Journal of Bio-Environment Control
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    • v.26 no.3
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    • pp.158-166
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    • 2017
  • The object of this study was to improve tomato seedling quality in low temperature(below 7, $10^{\circ}C$ during night time or daily mean air temperature was $18^{\circ}C$) by application of silicate fertilizer. Six different silicate fertilizer concentrations (8, 16, 32, 64, 128, and 256mM) or water as the control were applied to tomato seedlings twice a week for 20 days. Positive effects were observed in the growth parameters of the seedlings treated with 16 and 32mM silicate fertilizer; the most effective concentration of silicate at which seedlings showed the best performance was 16mM. However, a high concentration of silicate (256mM) caused negative effects on the growth. The transpiration rate decreased alongside with the increase of silicate concentration up to 32mM, possibly due to the increased stomatal diffusive resistance. Silicate stimulated the growth and development of tomato seedlings, resulting in increased growth parameters and root morphology. However, no significant differences were observed among treatment numbers of soil-drenching wuth the silicate (6, 10, or 20 times with 16mM) for 20 days, suggesting that silicate treatment with 6 times may be sufficient to induce the silicate effects. The application of 16mM of silicate fertilizer reduced relative ion leakage and chilling injury during low temperature storage. In addition, the seedlings treated with silicate fertilizer recovered faster than those without silicate treatment after low temperature storage.

Growth Rate of Bacillus cereus and Heat Resistance of its Spores (Bacillus cereus균(菌)의 증식속도(增殖速度)와 포자(胞子)의 내열성(耐熱性)에 관(關)한 연구(硏究))

  • Lee, Myeong-Sook;Chang, Dong-Suck
    • Korean Journal of Food Science and Technology
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    • v.14 no.1
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    • pp.11-15
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    • 1982
  • The growth rate and heat resistance of two types of Bacillus cereus isolated from cooked rice were observed. The FB-1 strain showed positive to haemolysis and negative to starch hydrolysis, but FB-2 strain positive to both reaction. The cell number of B. cereus FB-1 reached to more than $10^7\;cells/ml$ within 6 to 12 hours at $25{\sim}35^{\circ}C$ when cultured on the medium of cooked rice homogenate (cooked rice 30g-phosphate buffer solution 80 ml), but the numbers at its maximum growth were only $10^4{\sim}10^6\;cells/ml$ at $45{\sim}55^{\circ}C$. The specific growth rate of FB-1 strain were $0.82hr^{-1}\;at\;20^{\circ}C$, $1.76hr^{-1}\;at\;30^{\circ}C$, $2.21hr^{-1}\;at\;35^{\circ}C$ and $1.84hr^{-1}\;at\;40^{\circ}C$, respectively. D-values of FB-1 and FB-2 spores at $70{\sim}100^{\circ}C$ were in the range from 18 to 3.1 min and 23.5 to 3.7 min, respectively.

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THE EFFECT OF ND:YAG LASER IRRADIATION ON THE FORMATION OF CALCIUM FLUORIDE AND ACID RESISTANCE OF TOOTH ENAMEL (Nd:YAG 레이저 조사가 Calcium Fluoride 형성 및 치아 내산성에 미치는 영향)

  • Lee, Jae-Ho;Sohn, Heung-Kyu;Kim, Seong-Oh;Park, Kwang-Kyun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.377-398
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    • 1999
  • Calcium fluoride, created by topical fluoride application, is the reservoir for fluoride ion regulated by pH in the oral environment. Therefore, the amount and the maintenance of calcium fluoride have an important role in preventing dental caries. The aim of this study is to evaluate the effect of Nd:YAG laser irradiation on the generation of calcium fluoride and the acid resistance of tooth enamel. The bovine anterior permanent teeth were prepared (n=276), and divided into following groups : no treatment (control) fluoride application alone, laser irradiation alone, laser irradiation after fluoride application, and fluoride application after laser irradiation. And each group was subdivided based on the application time of 1.23% acidulated phosphate fluoride (APF) (5 min and 30 min) and the irradiation energy of Nd:YAG laser ($20J/cm^2\;and\;40J/cm^2$). In case of fluoride application, each group was divided according to KOH treatment. Twenty three treatment conditions were made for this experiment and twelve specimens were assigned to each treatment condition. In each treatment condition, ten specimens were used for chemical analysis and two specimens were observed under SEM. In groups without treating KOH, fluoride content and the depth of enamel dissolved were measured using enamel biopsy technique. In groups with treating KOH, the amount of calcium fluoride was measured by the treatment with 1 M KOH for 24 hours and enamel biopsy was performed after KOH treatment. The results were analyzed by the fluoride content and the depth of enamel dissolved by enamel biopsy, amount and thickness of calcium fluoride, and the surface structures of enamel. The results are as follows: 1. In groups without treating KOH, the fluoride content of removed enamel showed a positive relationship with the energy density of laser when the laser irradiated before fluoride application 2. In groups without treating KOH, the depth of enamel dissolved decreased more with the combined laser and fluoride treatment than with laser or fluoride treatment, except for the case of $20J/cm^2$ laser irradiation after 5 minute fluoride application (p<0.05). 3. The amount of calcium fluoride did not increased by laser treatment with no statistical significance(p>0.05). 4. The particle size of calcium fluoride increased in case of fluoride treatment after laser irradiation, compared with fluoride application alone. In case of laser treatment after fluoride application, the particle size of calcium fluoride increased and some of the particles fused as well. 5. There were no significant differences in the fluoride content of dissolved enamel between groups without treating KOH and control group, except for the case of laser irradiation after treatment of APF for 30 minutes (p>0.05). 6. In groups with treating KOH, depth of removed enamel in the groups of combined treatment with laser and fluoride was shallower than that in fluoride application groups (p<0.05). 7. In groups without treating KOH, the relationship between fluoride content and the depth of enamel dissolved showed more negative (Spearman correlation coefficient: -0.6281) than in groups with treating KOH (Spearman correlation coefficient: -0.3792). The greater amount of calcium fluoride could be found in case where there was a significant differences of the depth of enamel dissolved between groups with and without treating KOH. From these results, it can be concluded that laser seems to be a little effects on the amount of calcium fluoride formation, but has some effect on the lowering the solubility of calcium fluoride. As the combined treatment of laser and fluoride application showed more effective acid-resistant property, more extended recall period for fluoride application can be achieved with this combined treatment in the clinic.

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Comparative Study on the Regimens with Pyrazinamide or Ofloxacin in the retreatment of pulmonary tuberculosis (폐결핵 재치료에서 Pyrazinamide 복합처방과 Ofloxacin 복합처방의 효과에 관한 비교 연구)

  • Choi, In Hwan;Park, Seung Kyu;Kim, Kyeong Ho;Kim, Jin Ho;Kim, Cheon Tae;Song, Sun Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.871-881
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    • 1996
  • Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

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Reversal of Multidrug Resistance with KR-30035: Evaluated with Biodistribution of Tc-99m MIBI in Nude Mice Bearing Human Tumor Xenografts (이종이식된 인체종양에서 KR-30035가 Tc-99m MIBI체내 분포에 미치는 영향으로 평가한 다약제내성 역전가능성)

  • Kim, Jung-Kyun;Lee, Byung-Ho;Choi, Sang-Woon;Yoo, Sung-Eun;Lee, Sang-Woo;Chun, Kyung-Ah;Ahn, Byeong-Cheol;Park, Jae-Young;Suh, Jang-Soo;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.168-184
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    • 2001
  • Purpose: KR-30035 (KR), a new MDR reversing agent, has been found to produce a similar degree of increased Tc-99m MIBI uptake in cultured tumor cells over-expressing mdr1 mRNA compared to verapamil (VP), with less cardiovascular effects. We assessed the MDR-reversing ability of KR in vivo, and effects of various doses of KR on MIBI uptake un nude mice hearing P-glycoprotein (P-gp) positive (+) and P-gp negative (-) human tumor xenografts. Methods: P-gp (+) HCT15/CL02 colorectal and P-gp (-) A549 non-small cell cancer cells were inoculated in each flank of 120 nude mice (20 mice ${\times}$ 6 groups). Group 1 (Gr1) mice received 10mg/kg KR i.p. 3 times $({\times}3)$; Gr2, 10mg/kg VP i.p. ${\times}3$; Gr3, 10mg/kg KR i.p. ${\times}2$ + 25mg/kg KR i.p. ${\times}1$; Gr4, 10mg/kg KR i.p. ${\times}2$ + 50mg/kg i.p. ${\times}1$; Gr5, 10mg/kg KR i.p. ${\times}2$ + 25mg/kg KR i.v. ${\times}1$, GrC, controls. The mice were then injected with Tc-99m MIBI and sacrificed after 10 min, 30 min, 90 min and 240 min. Tumor uptake of MIBI (TU) in each group was compared. Results: TU in P-gp (+) and (-) tumors were both higher in Gr1 than Gr2. Washout rate between the 10 min and 4 hours was lower in Gr5 of P-gp (+) cell(0.93) than the control. Percentage increases in TU were higher in P-gp (+) than P-gp (-) tumors with all KR doses. Pgp (+) TU were highest at 10 mon (173% of GrC) and persisted up to 240 min (144%) in Gr3. Larger doses of KR resulted in a lesser degree of increase in P-gp (+) TU at 10 min (130% in Gr4 and 117% un Gr5) and 30 min (178%, 129%), but TU increased by time up to 240 min (177%, 196%). Heart and lung uptakes were markedly increased in Gr4 and Gr5 at 10 and 30 min, likely due to cardiovascular effects. No mice died. Conclusion: These data further suggest that KR that has significantly lower cardiovascular toxicity than verapamil can be used as an active inhibitor of MDR. Even a relatively low dose of KR significantly increased Tc-99m MIBI uptake in P-gp (+) tumors in vivo.

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The Effects of Silicate Nitrogen, Phosphorus and Potassium Fertilizers on the Chemical Components of Rice Plants and on the Incidence of Blast Disease of Rice Caused by Pyricularia oryzae Cavara (규산 및 삼요소 시비수준이 도체내 성분함량과 도열병 발생에 미치는 영향)

  • Paik Soo Bong
    • Korean journal of applied entomology
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    • v.14 no.3 s.24
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    • pp.97-109
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    • 1975
  • In an attempt to develop an effective integrated system of controlling blast disease of rice caused by Pyricularia oryzae Cav., the possibility of minimizing the disease incidence by proper application of fertilizers has been investigated. Thus the effect of silicate, nitrogen, phosphorus and potassium fertilizers on the development of blast disease as well as the correlation between the rice varieties an4 strains of P. oryzae were studied. The experiments were made in 1971 and 1973 by artificial inoculation and under natural development of the blast disease on rice plants. The results obtained are summarized as follows. 1. Application of silicate fertilizer resulted in the increase of silicate as well as total sugar and potassium content but decrease of total nitrogen and phosphorus in tile leaf blades of rice plants. 2. The ratios of total C/total N. $ SiO_2/total$ N, and $K_2O/total$ N in leaf blades of rice plants increased by the application of silicate fertilizers. There was high level of negative correlation between the ratios mentioned above and the incidence of rice blast disease. 3. Application of silicate fertilizer reduced the incidence of rice blast disease. 4. The over dressing of nitrogen fertilizer resulted in the increase of total nitrogen and decrease of silicate and total sugar content in leaf blades, thus disposing the rice plants more susceptible to blast disease. 5. Over dressing of phosphorus fertilizer resulted in the increase of both total nitrogen and Phosphorus, and decrease of silicate content in the leaf blades inducing the rice plants to become more susceptible to blast disease. 6. Increased dressing of potash resulted in the increase of silicate content and $K_2O/total$ N ratio but decrease of total nitrogen content in leaf blades. When potassium content is low in the leaf blades of rice plants, the additional dressing of potash to rice plant contributed to the increase of resistance to blast disease. However, there was no significant correlation between additional potassium application and the resistance to blast disease when the potassium content is already high in the leaf blades. 7. When four rice varieties were artificially inoculated with three strains of P. oryzae, the incidence of blast disease was most severe on Pungok, least severe on Jinheung and moderate on Pungkwang and Paltal varieties. 8. Disease incidence was most severe on the second leaf from top and less sever on top and there leaf regardless of the fertilizer application when 5-6 leaf stage rice seedlings of four rice varieties were artificially inoculated with three strains of P. oryzae. 9. The pathogenicity of three strains of P. oryzae was in the order of $P_1,\;P_2,\;and\;P_3$ in their virulence when inoculated to Jinheung, Paltal, Pungkwang varieties but not with Pungok. The interaction between strains of P. oryzae and rice varieties was significant.

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A Study on the Individual Issue and Organizational Issue of Organizational Innovation (개인혁신과 조직혁신의 이슈에 관한 연구)

  • Song Kyung-Soo;Kim Hye-Jung
    • Management & Information Systems Review
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    • v.16
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    • pp.59-76
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    • 2005
  • The inner and outer environment surrounding companies becomes more insecure and unpredictable due to sudden changes. Because the change of environment surrounding companies can deeply affect the existence of companies, continuous innovation of organization is required to develope management ability. Also, to conquer insecure present and future of companies effectively, organizations of companies have voluntarily coped with insecurities and intense competitions through endless organization innovation. Externally, globalization, openness, and relaxed regulation intensify competitions; consumers' requests get varied; consciousness of members of organizations have changed. Due to those factors, companies are placed in a situation that they should practice endless inner innovation. Internally, competitive power has weakened due to decline in productivity and inefficiency of indirect parts of company has increased. From those factors, managers increasingly request inner innovation and pursue organization innovation for the purpose of effective usage of extra resources and being prepared for the future. The managers who operate organization innovation think that systematized approach to organization innovation is the most practical, and actually operate the thought. However, the negative side of the thought is not neglectable. To minimize inner and outer resistance and to operate organization innovation successfully, some innovation strategies that properly reflect several issues related to organization innovation should be prepared. Another words, organization innovation should be operated differently by cases that if it focuses on personal perspective or on organization's. For many cases of our country, several techniques of organization innovation have been adopted in a short time and operated without making its original use. Therefore, this study looks into major Issues that should be considered for more successful operation of organization innovation, from both personal aspect and organizational aspect. When considering such aspects and operate organization innovation, there is more possibility to succeed on organization innovation. Now, Korean companies have overcame trial period and reborn as global companies. Take warnings by the ordeal under IMF administration, this is time to secure international competitive power by using developed innovation techniques and transform to superior company. Managers need to recognize that to try successful organization innovation is the shortcut to reborn as competitive company, and should take a continuous and profound search for decisive factors to succeed on organization innovation. To operate successful organization innovation, first, at the step of planning organization. innovation, the company should understand the company's capability, position in market and relationship with competitors. Then, the company should establish a distinguished innovation strategy which is of the whole company's aspect, so that the company can freely choose various technique of organization innovation that suits for the company's capability and needs, and unfold the organization innovation movement. Establishing strategy in the aspect of the total company is very important because it offers clear focus of the purpose of adopt, priority and distribution of resources. Second, at the step of operating organization innovation, the company should define concrete purpose and method to evaluate the results that are expected to obtain by adopting organization innovation in advance. While pushing forward, the company should set proper time of examination(milestone) and inspect if expected results are shown. Third, at the step of afterward management of operating organization innovation, the company requires a thorough afterwards verification if targeted results are obtained and of confirmation of successful or failure factors. Also, the company should cultivate specialists in the company who can accumulate and continuously spread the know-how learned during organization innovation promotion, so the know-how don't remain only in certain departments or to a few people in charge. The company should also give effort to maintain the accumulated innovation techniques to be continued.

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Effects of Aerosol Colistin Treatment of Pneumonia Caused by Multi-drug Resistant Acinetobacter baumannii (다약제 내성 Acinetobacter baumannii 에 의한 폐렴에서 Colistin 분무치료의 효과)

  • Choi, Hye Sook;Hwang, Yeon Hee;Park, Myung Jae;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.1
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    • pp.8-14
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    • 2008
  • Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.

The Adjunctive Role of Resectional Surgery for the Treatment of Multidrug-Resistant Pulmonary Tuberculosis (다제내성 폐결핵의 치료에서 폐절제술의 보조적인 역할)

  • Koh, Won-Jung;Lee, Jae-Ho;Yoo, Chul-Gyu;Kim, Young-Whan;Chung, Hee-Soon;Sung, Sook-Whan;Im, Jung-Gi;Kim, Joo-Hyun;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.975-991
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    • 1997
  • Background : Many patients with isoniazid and rifampin-resistant pulmonary tuberculosis have organisms that are also resistant to other first-line drugs. Despite of aggressive retreatment chemotherapy, the results are often unsuccessful, with a failure rate approaching 40%. Recently, there has been a revival of resectional surgery for the treatment of multidrug-resistant pulmonary tuberculosis. Methods : A retrospective analyses of the case records and radiographic findings were done. Between January 1991 and December 1995, 14 human immunodeficiency virus (HIV)-seronegative patients with multidrug-resistant pulmonary tuberculosis were selected for resection to supplement chemotherapy. All patients had organisms resistant to many of the first-line drugs, including both isoniazid and rifampin. Results : Despite of aggressive therapy for median duration of 9.5 months, 12 of the 14 patients (86%) were still sputum smear and/or culture positive at the time of surgery. The disease was generally extensive. Although main lesions of the disease including thick-walled cavities were localized in one lung, lesser amounts of contralateral disease were demonstrated in 10 of 14 (71%). Types of surgery performed were pneumonectomy including extrapleural pneumonectomy in six patients, lobectomy or lobectomy plus in six patients, and segmentectomy in two patients. The resected lung appeared to have poor function ; preoperative perfusion lung scan showed only 4.8% of the total perfusion to the resected portion of the lung. There were no operative deaths. Two patients had major postoperative complications including empyema with bronchopleural fistula and prolonged air leak, respectively. Of the 14 patients, 13 (93%) remained sputum-culture-negative for M. tuberculosis for a median duration of 23 months and one remained continuously sputum smear and culture positive for M. tuberculosis. Conclusion : On the basis of comparison with historical controls, adjunctive resectional surgery appears to play a significant beneficial role in the management of patients with multidrug-resistant pulmonary tuberculosis if the disease is localized and there are adequate reserve in pulmonary function.

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