• Title/Summary/Keyword: RIF

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Drug-Resistant Pulmonary Tuberculosis In Kosin Medical Center (부산지역의 한 3차 진료기관을 방문한 폐결핵 환자의 약제내성률)

  • Kim, Ji-Ho;Kim, Ji-Hong;Jang, Tae-Won;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.831-837
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    • 1995
  • Background: We conducted a study to determine the factors associated with, patterns of, and proportion of cases of pulmonary tuberculosis with multiple drug-resistance at Kosin medical center in Pusan. Methods: We abstracted data from 141 patients, who had active pulmonary tuberculosis and report forms of drug susceptibility between 1986 and 1994, and related the previous treatment history, the extent of lung involvement and the presence of cavities on chest X-ray films to the drug resistance. Results: Overall, 59(41.8%) of the 141 cases of tuberculosis were resistant to at least one drug and 29(20.9%) of the 139 cases were resistant to isoniazid(INH) and rifampin(RIF). Among the 63 patients with previous tuberculosis therapy, 40(63.5%) had isolates that were drug-resistant and 24(38.1%) were multi-drug resistant. Among the 78 without previous therapy, 19(24.4%) had isolates that were drug-resistant and 5(7.5%) were multi-drug resistant. For all 141, resistance to INH was most common(39.0%) followed by RIF(21.6%), ethambutol(EMB, 16.3%), $\rho$- aminosalicylic acid(10.8%), streptomycin(SM, 8.7%), and pyrazinamide(PZA, 8.0%). INH, RIF and PZA resistances were independently associated with a history of previous tuberculosis therapy (odds ratio; 3.3, 7.2 and 10.8 respectively), and RIF and SM resistance were significantly high according to the extent of lung involvement on the chest films(odds ratio; 2.9 and 2.8 respectively). Conclusions: We conclude, (1) that all persons in whom pulmonary tuberculosis is diagnosed should initially receive at least four-drug therapy(INH, RIF, PZA, and EMB or SM), (2) that susceptibility testing be done in all culture-positive patient, and (3) that those with a history of previous tuberculosis therapy or those who have advanced pulmonary tuberculosis need very careful clinical and microbiological follow-up.

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The Patterns of Acquiring Anti-Mycobacterial Drug Resistance by Susceptible Strains of Mycobacterium tuberculosis (항결핵제 감수성 결핵에서의 내성 변화 추이)

  • Lee, Kyutaeg;Chong, Moo-Sang
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.137-142
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    • 2021
  • This study investigated the patterns of acquiring anti-mycobacterial resistance in individuals who were susceptible to all anti-mycobacterial drugs in their initial treatment. From 2010 to 2019, anti-mycobacterial drug susceptibility tests were conducted on patients who were referred to the Green Cross Laboratories. The test results of 594 anti-mycobacterial drug sensitivity tests were collected at 111 medical institutions. The first test results had 594 cases in which all anti-mycobacterial drugs were susceptible. Isoniazid (INH), rifampin (RIF), streptomycin (SM), and quinolone (QUI) showed the highest single-resistant conversion rates. Out of 56 patients, 17 patients (30.4%) showed a high conversion rate of resistance to both INH and RIF. The tracking period was analyzed from a minimum of 98 days to 1,862 days, and an average of 435.6 days for INH, and a minimum of 108 days to 1,673 days, with an average of 457.7 days for RIF. In the case of tuberculosis patients who are susceptible to all anti-mycobacterial drugs, it is considered that the conversion to resistant and multi-drug resistant tuberculosis (MDR-TB) must be confirmed through an anti-mycobacterial susceptibility test after 3 months. It is hoped that this study will help the national tuberculosis management project to improve public health.

The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis

  • Yang, Soo Yeon;Chon, Seung-Joo;Lee, Seon Heui
    • Women's Health Nursing
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    • v.26 no.4
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    • pp.300-317
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    • 2020
  • Purpose: Hysteroscopy can be used both to diagnose and to treat intrauterine pathologies. It is well known that hysteroscopy helps to improve reproductive outcomes by treating intrauterine pathologies. However, it is uncertain whether hysteroscopy is helpful in the absence of intrauterine pathologies. This study aimed to confirm whether hysteroscopy improves the reproductive outcomes of infertile women without intrauterine pathologies. Methods: We conducted a systematic review of 11 studies retrieved from Ovid-MEDLINE, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data and used risk-of-bias tools (RoB 2.0 and ROBINS-I) to assess their quality. Results: Diagnostic hysteroscopy prior to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) than non-hysteroscopy in patients with recurrent implantation failure (RIF) (odds ratio, 1.79 and 1.46; 95% confidence interval, 1.40-2.30 and 1.08-1.97 for CPR and LBR, respectively) while hysteroscopy prior to first IVF was ineffective. The overall meta-analysis of LBR showed statistically significant findings for RIF, but a subgroup analysis showed effects only in prospective cohorts (odds ratio, 1.40 and 1.47; 95% confidence interval, 0.62-3.16 and 1.04-2.07 for randomized controlled trials and prospective cohorts, respectively). Therefore, the LBR should be interpreted carefully and further research is needed. Conclusion: Although further research is warranted, hysteroscopy may be considered as a diagnostic and treatment option for infertile women who have experienced RIF regardless of intrauterine pathologies. This finding enables nurses to educate and support infertile women with RIF prior to IVF/ICSI.

Performance of the BD MAX MDR-TB assay in a clinical setting and its impact on the clinical course of patients with pulmonary tuberculosis: a retrospective before-after study

  • Sung Jun Ko;Kui Hyun Yoon;Sang Hee Lee
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.113-119
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    • 2024
  • Background: Missing isoniazid (INH) resistance during tuberculosis (TB) diagnosis can worsen the outcomes of INH-resistant TB. The BD MAX MDR-TB assay (BD MAX) facilitates the rapid detection of TB and INH and rifampin (RIF) resistance; however, data related to its performance in clinical setting remain limited. Moreover, its effect on treatment outcomes has not yet been studied. Methods: We compared the performance of BD MAX for the detection of INH/RIF resistances to that of the line probe assay (LPA) in patients with pulmonary TB (PTB), using the results of a phenotypic drug sensitivity test as a reference standard. The treatment outcomes of patients who used BD MAX were compared with those of patients who did not. Results: Of the 83 patients included in the study, the BD MAX was used for an initial PTB diagnosis in 39 patients. The sensitivity of BD MAX for detecting PTB was 79.5%. The sensitivity and specificity of BD MAX for INH resistance were both 100%, whereas these were 50.0% and 95.8%, respectively, for RIF resistance. The sensitivity and specificity of BD MAX were comparable to those of LPA. The BD MAX group had a shorter time interval from specimen request to the initiation of anti-TB drugs (2.0 days vs. 5.5 days, p=0.001). Conclusion: BD MAX showed comparable performance to conventional tests for detecting PTB and INH/RIF resistances. The implementation of BD MAX as a diagnostic tool for PTB resulted in a shorter turnaround time for the initiation of PTB treatment.

Prevalence and confounders of chronic endometritis diagnosed using CD138 in patients with recurrent implantation failure

  • Hye Jeong Hue;Hyunji Choi;Hyun Kyoung Lee;Jung Ryeol Lee;Byung Chul Jee;Chang Woo Choo;Seul Ki Kim
    • Clinical and Experimental Reproductive Medicine
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    • v.51 no.2
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    • pp.163-169
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    • 2024
  • Objective: This retrospective study aimed to investigate the prevalence of chronic endometritis, diagnosed using CD138 immunohistochemistry, among infertile women and to assess the association between chronic endometritis and recurrent implantation failure (RIF). Methods: In total, 266 patients who underwent hysteroscopy due to infertility between 2019 and 2020 were included in the analysis. Of these, 136 patients with RIF and 130 non-RIF patients were included in the study. CD138 immunohistochemistry test results, blood biomarkers (including natural killer cells, white blood cells, and the lymphocyte-to-neutrophil ratio), and data on pregnancy outcomes were obtained. If the CD138 test yielded a positive result, the patients received antibiotic treatment. Results: The overall proportion of CD138-positive patients was 32.7% (87/266). The CD138 positivity rate was not related to the number of cycles with implantation failure. In the RIF patient group, no significant associations were found between CD138 positivity and peripheral blood markers. The clinical pregnancy rates were similar between infertile women treated with antibiotics for chronic endometritis and those without chronic endometritis. Conclusion: To improve the pregnancy rate in infertile patients, it may be helpful to combine CD138 testing with other laboratory tests and administer antibiotic treatment if the result is positive.

Eulerian Particle Flamelet Modeling for Combustion Processes of Bluff-Body Stabilized Methanol-Air Turbulent Nonpremixed Flames

  • Kim, Seong-Ku;Kang, Sung-Mo;Kim, Yong-Mo
    • Journal of Mechanical Science and Technology
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    • v.20 no.9
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    • pp.1459-1474
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    • 2006
  • The present study is focused on the development of the RIF (Representative Interactive Flamelet) model which can overcome the shortcomings of conventional approach based on the steady flamelet library. Due to the ability for interactively describing the transient behaviors of local flame structures with CFD solver, the RIF model can effectively account for the detailed mechanisms of $NO_x$ formation including thermal NO path, prompt and nitrous $NO_x$ formation, and reburning process by hydrocarbon radical without any ad-hoc procedure. The flamelet time of RIFs within a stationary turbulent flame may be thought to be Lagrangian flight time. In context with the RIF approach, this study adopts the Eulerian Particle Flamelet Model (EPFM) with mutiple flamelets which can realistically account for the spatial inhomogeneity of scalar dissipation rate. In order to systematically evaluate the capability of Eulerian particle flamelet model to predict the precise flame structure and NO formation in the multi-dimensional elliptic flames, two methanol bluffbody flames with two different injection velocities are chosen as the validation cases. Numerical results suggest that the present EPFM model has the predicative capability to realistically capture the essential features of flame structure and $NO_x$ formation in the bluff-body stabilized flames.

Live birth in a woman with recurrent implantation failure and adenomyosis following transfer of refrozen-warmed embryos

  • Safari, Somayyeh;Faramarzi, Azita;Agha-Rahimi, Azam;Khalili, Mohammad Ali
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.3
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    • pp.181-184
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    • 2016
  • The aim was to report a healthy live birth using re-vitrified-warmed cleavage-stage embryos derived from supernumerary warmed embryos after frozen embryo transfer (ET) in a patient with recurrent implantation failure (RIF). The case was a 39-year-old female with a history of polycystic ovarian syndrome and adenomyosis, along with RIF. After ovarian hyperstimulation, 33 cumulus-oocyte complexes were retrieved and fertilized with conventional in vitro fertilization and intracytoplasmic sperm injection. Because of the risk of ovarian hyperstimulation syndrome, 16 grade B and C embryos were vitrified. After 3 and 6 months, 3 and 4 B-C warmed embryos were transferred to the uterus, respectively. However, implantation did not take place. Ten months later, four embryos were warmed, two grade B 8-cell embryos were transferred, and two embryos were re-vitrified. One year later, the two re-vitrified cleavage-stage embryos were warmed, which resulted in a successful live birth. This finding showed that following first warming, it is feasible to refreeze supernumerary warmed embryos for subsequent ET in patients with a history of RIF.

Mixed double-embryo transfer: A promising approach for patients with repeated implantation failure

  • Stamenov, Georgi Stamenov;Parvanov, Dimitar Angelov;Chaushev, Todor Angelov
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.2
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    • pp.105-110
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    • 2017
  • Objective: The purpose of this study was to evaluate the efficacy of frozen mixed double-embryo transfer (MDET; the simultaneous transfer of day 3 and day 5 embryos) in comparison with frozen blastocyst double-embryo transfer (BDET; transfer of two day 5 blastocysts) in patients with repeated implantation failure (RIF). Methods: A total of 104 women with RIF who underwent frozen MDET (n = 48) or BDET (n = 56) with excellent-quality embryos were included in this retrospective analysis. All frozen embryo transfers were performed in natural cycles. The main outcome measures were the implantation rate, clinical pregnancy rate, multiple pregnancy rate, and miscarriage rate. These measures were compared between the patients who underwent MDET or BDET using the chi-square test or the Fisher exact test, as appropriate. Results: The implantation and clinical pregnancy rates were significantly higher in patients who underwent MDET than in those who underwent BDET (60.4% vs. 39.3%, p=0.03 and 52.1% vs. 30.4%, p=0.05, respectively). A significantly lower miscarriage rate was observed in the MDET group (6.9% vs. 10.7%, p=0.05). In addition, the multiple pregnancy rate was slightly, but not significantly, higher in the MDET group (27.1% vs. 25.0%). Conclusion: MDET was found to be significantly superior to double blastocyst transfer. It could be regarded as an appropriate approach to improve in vitro fertilization success rates in RIF patients.

Stability Analysis of Bacillus stearothermopilus L1 Lipase Fused with a Cellulose-binding Domain

  • Hwang Sangpill;Ahn Ik-Sung
    • Biotechnology and Bioprocess Engineering:BBE
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    • v.10 no.4
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    • pp.329-333
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    • 2005
  • This study was designed to investigate the stability of a lipase fused with a cellulose­binding domain (CBD) to cellulase. The fusion protein was derived from a gene cluster of a CBD fragment of a cellulase gene in Trichoderma hazianum and a lipase gene in Bacillus stearother­mophilus L1. Due to the CBD, this lipase can be immobilized to a cellulose material. Factors affecting the lipase stability were divided into the reaction-independent factors (RIF), and the re­action-dependent factors (RDF). RIF includes the reaction conditions such as pH and tempera­ture, whereas substrate limitation and product inhibition are examples of RDF. As pH 10 and $50^{\circ}C$ were found to be optimum reaction conditions for oil hydrolysis by this lipase, the stability of the free and the immobilized lipase was studied under these conditions. Avicel (microcrystal­line cellulose) was used as a support for lipase immobilization. The effects of both RIF and RDF on the enzyme activity were less for the immobilized lipase than for the free lipase. Due to the irreversible binding of CBD to Avicel and the high stability of the immobilized lipase, the enzyme activity after five times of use was over $70\%$ of the initial activity.

Diverse Mutations of rpoB in Rifampin-Resistant Mycobacteria (Rifampin에 대한 내성 마이코박테리아에서 rpoB의 다양한 변이)

  • Kweon, Tae-Dong;Sa, Young-Hee;Hong, Seong-Karp
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2012.10a
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    • pp.991-993
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    • 2012
  • We analyzed RNA polymerase beta subunit gene (rpoB) mutation of rifampin-resistant Mycobacteria through analysis of nucleotide sequence of rpoB DNA (351 bp) containing rifampin resistant region, $rif^r$. For this study, we collected rifampin-resistant Mycobacteria that were identified by conventional culture methods from Masan National Hospital and The Korean Institute of Tuberculosis. We performed sequencing of DNA nucleotides and analyzed rpoB gene of those rifampin-resistant Mycobacteria. From this analysis, we invcestigated diverse mutations of rpoB gene included rifampin-resistant gene, which were not reported, from those rifampin-resistant Mycobacteria.

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