• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.277-294
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• 1995

Background: The prevalence of tuberculosis in Korea decreased remarkably for the past 30 years, while the incidence of disease caused by mycobacteria other than tuberculosis is unknown. Korean Academy of Tuberculosis and Respiratory Diseases performed national survey to estimate the incidence of mycobacterial diseases other than tuberculosis in Korea. We analyzed the clinical data of confirmed cases for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1981 to October 1994. We collected the data retrospectively by correspondence with physicians in the hospitals that referred the specimens to Korean Institute of Tuberculosis, The Korean National Tuberculosis Association for the detection of mycobacteria other than tuberculosis. In confirmed cases, we obtained the records for clinical, laboratory and radiological findings in detail using protocols. Results: 1) Mycobacterial diseases other than tuberculosis were confirmed that 1 case was in 1981, 2 cases in 1982, 4 cases in 1983, 2 cases in 1984, 5 cases in 1985, 1 case in 1986, 3 cases in 1987, 1 case in 1988, 6 cases in 1989, 9 cases in 1990, 14 cases in 1990, 10 cases in 1992, 4 cases in 1993, and 96 cases in 1994. Cases since 1990 were 133 cases(84.2%) of a total. 2) Fifty seven percent of patients were in the age group of over 60 years. The ratio of male to female patients was 2.6:1. 3) The distribution of hospitals in Korea showed that 61 cases(38.6%) were referred from Double Cross Clinic, 42 cases(26.6%) from health centers, 21 cases(13.3%) from tertiary referral hospitals, 15 cases(9.5%) from secondary referral hospitals, and 10 cases(6.3%) from primary care hospitals. The area distribution in Korea revealed that 98 cases(62%) were in Seoul, 17 cases(10.8%) in Gyeongsangbuk-do, 12 cases(7.6%) in Kyongki-do, 8 cases(5.1%) in Chungchongnam-do, each 5 cases(3.2%) in Gyeongsangnam-do and Chungchongbuk-do, 6 cases(3.8%) in other areas. 4) In the species of isolated mycobacteria other than tuberculosis, M. avium-intracellulare was found in 104 cases(65.2%), M. fortuitum in 20 cases(12.7%), M. chelonae in 15 cases(9.5%), M. gordonae in 7 cases(4.4%), M. terrae in 5 cases(3.2%), M. scrofulaceum in 3 cases(1.9%), M. kansasii and M. szulgai in each 2 cases(1.3%), and M. avium-intracellulare coexisting with M. terrae in 1 case(0.6%). 5) In pre-existing pulmonary diseases, pulmonary tuberculosis was 113 cases(71.5%), bronchiectasis 6 cases(3.8%), chronic bronchitis 10 cases(6.3%), and pulmonary fibrosis 6 cases(3.8%). The timing of diagnosis as having pulmonary tuberculosis was within 1 year in 7 cases(6.2%), 2~5 years ago in 32 cases(28.3%), 6~10 years ago in 29 cases(25.7%), 11~15 years ago in 16 cases(14.2%), 16~20 years ago in 15 cases (13.3%), and 20 years ago in 14 cases(12.4%). Duration of anti-tuberculous treatment was within 3 months in 6 cases(5.3%), 4~6 months in 17 cases(15%), 7~9 months in 16 cases(14.2%), 10~12 months in 11 cases(9.7%), 1~2 years in 21 cases(18.6%), and over 2 years in 8 cases(7.1%). The results of treatment were cure in 44 cases(27.9%) and failure in 25 cases(15.8%). 6) Associated extra-pulmonary diseases were chronic liver disease coexisting with chronic renal failure in 1 case(0.6%), diabetes mellitus in 9 cases(5.7%), cardiovascular diseases in 2 cases(1.3%), long-term therapy with steroid in 2 cases(1.3%) and chronic liver disease, chronic renal failure, colitis and pneumoconiosis in each 1 case(0.6%). 7) The clinical presentations of mycobacterial diseases other than tuberculosis were 86 cases (54.4%) of chronic pulmonary infections, 1 case(0.6%) of cervical or other site lymphadenitis, 3 cases(1.9%) of endobronchial tuberculosis, and 1 case(0.6%) of intestinal tuberculosis. 8) The symptoms of patients were cough(62%), sputum(61.4%), dyspnea(30.4%), hemoptysis or blood-tinged sputum(20.9%), weight loss(13.3%), fever(6.3%), and others(4.4%). 9) Smear negative with culture negative cases were 24 cases(15.2%) in first examination, 27 cases(17.1%) in second one, 22 cases(13.9%) in third one, and 17 cases(10.8%) in fourth one. Smear negative with culture positive cases were 59 cases(37.3%) in first examination, 36 cases (22.8%) in second one, 24 cases(15.2%) in third one, and 23 cases(14.6%) in fourth one. Smear positive with culture negative cases were 1 case(0.6%) in first examination, 4 cases(2.5%) in second one, 1 case (0.6%) in third one, and 2 cases(1.3%) in fourth one. Smear positive with culture positive cases were 48 cases(30.4%) in first examination, 34 cases(21.5%) in second one, 34 cases(21.5%) in third one, and 22 cases(13.9%) in fourth one. 10) The specimens isolated mycobacteria other than tuberculosis were sputum in 143 cases (90.5%), sputum and bronchial washing in 4 cases(2.5%), bronchial washing in 1 case(0.6%). 11) Drug resistance against all species of mycobacteria other than tuberculosis were that INH was 62%, EMB 55.7%, RMP 52.5%, PZA 34.8%, OFX 29.1%, SM 36.7%, KM 27.2%, TUM 24.1%, CS 23.4%, TH 34.2%, and PAS 44.9%. Drug resistance against M. avium-intracellulare were that INH was 62.5%, EMB 59.6%, RMP 51.9%, PZA 29.8%, OFX 33.7%, SM 30.8%, KM 20.2%, TUM 17.3%, CS 14.4%, TH 31.7%, and PAS 38.5%. Drug resistance against M. chelonae were that INH was 66.7%, EMB 66.7%, RMP 66.7%, PZA 40%, OFX 26.7%, SM 66.7%, KM 53.3%, TUM 53.3%, CS 60%, TH 53.3%, and PAS 66.7%. Drug resistance against M. fortuitum were that INH was 65%, EMB 55%, RMP 65%, PZA 50%, OFX 25%, SM 55%, KM 45%, TUM 55%, CS 65%, TH 45%, and PAS 60%. 12) The activities of disease on chest roentgenogram showed that no active disease was 7 cases(4.4%), mild 20 cases(12.7%), moderate 67 cases(42.4%), and severe 47 cases(29.8%). Cavities were found in 43 cases(27.2%) and pleurisy in 18 cases(11.4%). 13) Treatment of mycobacterial diseases other than tuberculosis was done in 129 cases(81.7%). In cases treated with the first line anti-tuberculous drugs, combination chemotherapy including INH and RMP was done in 86 cases(66.7%), INH or RMP in 30 cases(23.3%), and not including INH and RMP in 9 cases(7%). In 65 cases treated with the second line anti-tuberculous drugs, combination chemotherapy including below 2 drugs were in 2 cases(3.1%), 3 drugs in 15 cases(23.1%), 4 drugs in 20 cases(30.8%), 5 drugs in 9 cases(13.8%), and over 6 drugs in 19 cases (29.2%). The results of treatment were improvement in 36 cases(27.9%), no interval changes in 65 cases(50.4%), aggravation in 4 cases(3.1%), and death in 4 cases(3.1%). In improved 36 cases, 34 cases(94.4%) attained negative conversion of mycobacteria other than tuberculosis on cultures. The timing in attaining negative conversion on cultures was within 1 month in 2 cases(1.3%), within 3 months in 11 cases(7%), within 6 months in 14 eases(8.9%), within 1 year in 2 cases(1.3%) and over 1 year in 1 case(0.6%). Conclusion: Clinical, laboratory and radiological findings of mycobacterial diseases other than tuberculosis were summarized. This collected datas will assist in the more detection of mycobacterial diseases other than tuberculosis in Korea in near future.

• Journal of Biosystems Engineering
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• v.6 no.1
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• pp.28-38
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• 1981

A survey has been conducted to investigate the presents of breaks down and repair of power tiller for efficient use. Eight provinces were covered for this study. The results are summarized as follows. A. Frequency of breaks down. 1) Power tiller was breaken down 9.05 times a year and it represents a break down every 39.1 hours of use. High frequency of breaks down was found from the fuel and ignition system. For only these system, the number of breaks down were 2.02 and it represents 23.3% among total breaks down. It was followed by attachments, cylinder system, and traction device. 2) For the power tiller which was more than six years old, breaks down accured 37.7 hours of use and every 38.6 hours for the power tiller which was purchased in less than 2 years. 3) For the kerosene engine power tiller, breaks down occured every 36.8 hours of use, which is a higher value compared with diesel engine power tiller which break down every 42.8 hours of use. The 8HP kerosene engine power tiller showed higher frequency of break down compared with any other horse power tiller. 4) In October, the lowest frequency of break down was found with the value of once for every 51.5 hours of use, and it was followed by the frequency of break down in June. The more hours of use, the less breaks down was found. E. Repair place 1) 45.3% among total breaks down of power tiller was repaired by the owner, and 54.7% was repaired at repair shop. More power tiller were repaired at repair shop than by owner of power tiller. 2) The older the power tiller is, the higher percentage of repairing at the repair shop was found compared with the repairing by the owner. 3) Higher percentage of repairing by the owner was found for the diesel engine power tiller compared with the kerosene engine power tiller. It was 10 HP power tiller for the kerosene power tiller and 8 HP for the diesel engine power tiller. 4) 66.7% among total breaks down of steering device was repaired by the owner. It was the highest value compared with the percentage of repairing of any other parts of power tiller. The lowest percentage of repairing by owner was found for the attachments to the power tiller with the value of 26.5%. C. Cause of break down 1) Among the total breaks down of power tiller, 57.2% is caused by the old parts of power tiller with the value of 5.18 times break down a year and 34.7% was caused by the poor maintenance and over loading. 2) For the power tiller which was purchased in less than two years, more breaks down were caused by poor maintenance in comparison to the old parts of power tiller. 3) For the both 8-10 HP kerosene and diesel engine power tiller, the aspects of breaks down was almost the same. But for the 5 HP power tiller, more breaks down was caused by over loading in comparison to the old parts of power tiller. 4) For the cylinder system and traction device, most of the breaks down was caused by the old parts and for the fuel and ignition system, breaks down was caused mainly by the poor maintenance. D. Repair Cost 1) For each power tiller, repair cost was 34,509 won a year and it was 97 won for one hoar operation. 2) Repair cost of kerosene engine power tiller was 40,697 won a year, and it use 28,320 won for a diesel engine power tiller. 3) Average repair cost for one hour operation of kerosene engine power tiller was 103 won, and 86 won for a diesel engine power tiller. No differences were found between the horse power of engines. 4) Annual repair cost of cylinder system was 13,036 won which is the highest one compared with the repair cost of any other parts 362 won a year was required to repair the steering device, and it was the least among repair cost of parts. 5) Average cost for repairing the power tiller one time was 3,183 won. It was 10,598 won for a cylinder system and 1,006 won for a steering device of power tiller. E. Time requirement for repairing by owner. 1) Average time requirements for repairing the break down of a power tiller by owner himself was 8.36 hours, power tiller could not be used for operation for 93.58 hours a year due to the break down. 2) 21.3 hours were required for repairing by owner himself the break down of a power tiller which was more than 6 years old. This value is the highest one compared with the repairing time of power tiller which were purchased in different years. Due to the break down of the power tiller, it could not be used for operation annually 127.13 hours. 3) 10.66 hours were required for repairing by the owner himself a break down of a diesel engine power tiller and 6.48 hours for kerosene engine power tiller could not be used annually 99.14 hours for operation due to the break down and it was 88.67 hour for the diesel engine power tiller. 4) For both diesel and kerosene engine power tiller 8 HP power tiller required the least time for repairing by owner himself a break down compared with any other horse power tiller. It was 2.78 hours for kerosene engine power tiller and 8.25 hours fur diesel engine power tiller. 5) For the cylinder system of power tiller 32.02 hours were required for repairing a break down by the owner himself. Power tiller could not be used 39.30 hours a year due to the break down of the cylinder system.