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A Clinical Review of Acute Respiratory Distress Syndrome (ARDS) Due to Miliary Tuberculosis (급성호흡곤란증후군으로 발현된 속립성 결핵의 임상적 고찰)

  • Ahn, Young-Soo;Lee, Sang-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.17-26
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    • 2002
  • Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.

A Polarization-based Frequency Scanning Interferometer and the Measurement Processing Acceleration based on Parallel Programing (편광 기반 주파수 스캐닝 간섭 시스템 및 병렬 프로그래밍 기반 측정 고속화)

  • Lee, Seung Hyun;Kim, Min Young
    • Journal of the Institute of Electronics and Information Engineers
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    • v.50 no.8
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    • pp.253-263
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    • 2013
  • Frequency Scanning Interferometry(FSI) system, one of the most promising optical surface measurement techniques, generally results in superior optical performance comparing with other 3-dimensional measuring methods as its hardware structure is fixed in operation and only the light frequency is scanned in a specific spectral band without vertical scanning of the target surface or the objective lens. FSI system collects a set of images of interference fringe by changing the frequency of light source. After that, it transforms intensity data of acquired image into frequency information, and calculates the height profile of target objects with the help of frequency analysis based on Fast Fourier Transform(FFT). However, it still suffers from optical noise on target surfaces and relatively long processing time due to the number of images acquired in frequency scanning phase. 1) a Polarization-based Frequency Scanning Interferometry(PFSI) is proposed for optical noise robustness. It consists of tunable laser for light source, ${\lambda}/4$ plate in front of reference mirror, ${\lambda}/4$ plate in front of target object, polarizing beam splitter, polarizer in front of image sensor, polarizer in front of the fiber coupled light source, ${\lambda}/2$ plate between PBS and polarizer of the light source. Using the proposed system, we can solve the problem of fringe image with low contrast by using polarization technique. Also, we can control light distribution of object beam and reference beam. 2) the signal processing acceleration method is proposed for PFSI, based on parallel processing architecture, which consists of parallel processing hardware and software such as Graphic Processing Unit(GPU) and Compute Unified Device Architecture(CUDA). As a result, the processing time reaches into tact time level of real-time processing. Finally, the proposed system is evaluated in terms of accuracy and processing speed through a series of experiment and the obtained results show the effectiveness of the proposed system and method.

Identification of Maysin and Related Flavonid Analogues in Corn Silks (옥수수 수염에서 Maysin 및 유사물질의 동정)

  • Kim, Sun-Lim;Snook, Maurice E.;Kim, E-Hun;Park, Cheol-Ho
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.45 no.3
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    • pp.151-157
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    • 2000
  • This study was carried out to isolate and identify the maysin and related flavonoid analogues in corn silks. Silks were covered with silk bag to prevent pollination and were sampled at 3-5 days after silking. The silks were filled with 100% MeOH and stored at $0^{\circ}C$ until analysis. The MeOH extracts of corn silks were filtered and concentrated at 35-4$0^{\circ}C$. The ${CH}_2$${Cl}_2$ was added on the concentrated aqueous solution to remove the chlorophyll and lipids. The Cis open column (25mm$\times$54 cm) was washed and activated with serial treatment of 500$m\ell$ of 100% MeOH(twice)longrightarrow75% MeOH longrightarrow50% MeOHlongrightarrow30% MeOHlongrightarrow100% $H_2$O(2 times). The concentrated aqueous solution was applied to the $C_{18}$ column and washed with $H_2O$ several times to remove the sugars and water soluble pigments. Neochlorogenic acid, chlorogenic acid and 4-caffeoylquinic acid were eluted with 10% MeOH, and rhamosyl isoorientin was eluted with 30% MeOH, but maysin was eluted with 50% MeOH from the $C_18$ open column. Collected fractions were analyzed with HPLC by using revers-phase Ultras-phere $C_{18}$ column (4.6$\times$250mm, 5$\mu\textrm{m}$) and $H_2$O (10% MeOH containing 0.1% $H_3$${PO}_4$)/MeOH (100% MeOH containing 0.1% H$_3$PO$_4$) linear gradient from 20% to 90% MeOH for 35 minutes, a flow rate of 1 $m\ell$/min and detection at 340nm. The selected fractions were concentrated and applied to the silicic acid column. Maysin was eluted with 500$m\ell$ of 100% ethyl acetate from the silicic acid column for the first purification, and the purity of collected fractions was about 75%, but the purity from the second purification with the Cis column (1/2 $\times$ 43") was greater than 95%. FAB-MS spectral data was obtained with VG7O-VSEQ VG analytical fast atom bombardment mass (UK). $^1$H-NMR and $^{13}$ C-NMR data were obtained with Bruker DPX 400 MHz NMR spectrometers (German) in DMSO-d$_{6}$ at 400 and 100 MHz, respectively.vely.

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A Study of Genetic Polymonhisms of HLA-class I and II Genes Using Polymerase Chain Reaction (중합효소연쇄반응을 이용한 HLA-class I, II 유전자군의 유전적 다형성에 관한 연구)

  • Kyung-Ok Lee
    • Biomedical Science Letters
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    • v.4 no.1
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    • pp.11-25
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    • 1998
  • The HLA genes located in the short arm of chromosome 6 specify heterodimeric glycoproteins involved in the regulation of the immune response. Recently, in the elucidation of HLA polymorphism, serological and cellular typing methods have been replaced by DNA typing using polymerase chain reaction (PCR). The purpose of this study was to establish the HLA DNA typing methods and determine gene frequencies of HLA molecules in Koreans. PCR-SSP (sequence specific primers) and PCR-RFLP (restriction fragment length polymorphism) techniques were used for the analysis of HLA-A, -B, -C, DRBl genes and HLA-DQAl, DQBl, DPBl genes, respectively. The results of B-lymphoblastoid cells used for control experiment were consistent with the previous data identified in the 11th International Histocompatibility Workshop. Seventeen, 23, 16, 8, 16, 13 and 37 types of HLA-A, B, C, DQAl, DQBl, DPBl and DRBl alleles were found, respectively, in a total of unrelated 120 Korean individuals. The most frequent HLA alleles were $A^*$02 (27.0%), B$^*$40 (17.6%), Cw$^*$01 (19.2%), DQAl$^*$0301 (32.1%), DQBl$^*$0303 (12.9%), DPBl$^*$0501 (31.3%) and DRBl$^*$1501 (9.2%) among Koreans. This study shows that DNA typing method using PCR technique is a relatively simple, fast and practical tool for the determination of the HLA-class I and II genes. Moreover, the data of HLA gene frequencies could be useful for the Korean database before clinical applications, including organ and unrelated bone marrow transplantation, anthropological study, disease association and individual identification.

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Pulmonary tuberculosis misdiagnosed as lung Metastasis in childhood cancer patients (소아암 환자에서 암의 전이로 오인된 폐결핵)

  • Lee, Hyun-Jae;Kim, Dong-Whan;Lee, Kang-Min;Park, Kyung-Duk;Lee, Jun-Ah;Cho, Soo-Yeon;Kook, Yoon-Hoh;Kim, Hee-Youn;Kim, Dong-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.904-909
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    • 2009
  • Purpose : The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. Methods : We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. Results : There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. Conclusion : It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.

Comparative Analysis of Absorption Doses between Exposed and Unexposed Area on Major Organs During CT Scan (전산화 단층촬영시 주선속내 외의 주요장기 흡수선량 비교분석)

  • 사정호;서태석;최보영;정규회
    • Progress in Medical Physics
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    • v.11 no.1
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    • pp.59-71
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    • 2000
  • It is possible to obtain a fast CT scan during breath holding with spiral technique. But the risk of radiation is increased due to detailed and repeated scans. However, the limitation of X-ray doses is not fully specified on CT, yet. Therefore, the purpose of the present study is to define the limitation of X-ray doses on CT The CT unit was somatom plus 4. Alderson Rando phantom, Solenoid water phantom, TLD, and reader were used. For determining adequate position and size of organs, the measurement of distance(${\pm}$2mm) from the midline of vertebral body was performed in 40 women(20~40 years). On the brain scan for 8:8(8mm slice thickness, 8mm/sec movement velocity of the table) and 10:10(10mm slice thickness, 10mm/sec movement velocity of the table) methods, the absorption doses of exposed area of the 10:10 were slightly higher than those of 8:8. The doses of unexposed uterus were negligible on the brain scan for both 8:8 and 10:10. On the chest scan for 8:8, 8:10(8mm slice thickness, 10mm/sec movement velocity of the table), 10:10, 10:12(10mm slice thickness, 12mm/sec movement velocity of the table) and 10:15(10mm slice thickness, 15mm/sec movement velocity of the table) methods, 8:8 method of the absorption doses of exposure area was the most highest and 10:15 method was the most lowest. The absorption doses of 8:10 method was relatively lower than those of the other methods. In conclusion, the 8:10 method is the most suitable to give a low radiation burden to patient without distorting image quality.

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Evaluation of Cerebral Aneurysm with High Resolution MR Angiography using Slice Interpolation Technique: Correlation wity Digital Subtraction Angiography(DSA) and MR Angiography(MRA) (Slice Interpolation기법의 고해상도 자기공명혈관조영술을 이용한 뇌동맥류의 진단 : 디지탈 감산 혈관조영술과 자기공명 혈관조영술의 비교)

  • ;;;Daisy Chien;Gerhard Laub
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.94-102
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    • 1997
  • Purpose: There have been some efforts to diagnose intracranial aneurysm through a non-invasive method using MRA, although the process may be difficult when the lesion is less than 3mm. The present study prospectively compares the results of high resolution, fast speed slice interpolation MRA and DSA thereby examing the potentiality of primary non-invasive screening test. Materials and Methods: A total of 26 cerebral aneurysm lesions from 14 patients with subarachnoid hemorrhage from ruptured aneurysm (RA) and 5 patients with unruptured aneurysm(UA). In all subjects, MRA was taken to confirm the vessel of origin, definition of aneurysm neck and the relationship of the aneurysm to nearby small vessels, and the results were compared with the results of DSA. The images were obtained with 1.5T superconductive machine (Vision, Siemens, Erlangen, Germany) on 4 slabs of MRA using slice interpolation. The settings include TR/TE/FA=30/6.4/25, matrix $160{\times}512$, FOV $150{\times}200$, 7minutes 42 seconds of scan time, effective thickness of 0.7 mm and an entire thickness of 102. 2mm. The images included structures from foramen magnum to A3 portion of anterior cerebral artery. MIP was used for the image analysis, and multiplanar reconstruction (MPR) technique was used in cases of intracranial aneurysm. Results: A total of 26 intracranial aneurysm lesions from 19 patients with 2 patients having 3 lesion, 3 patients having 2 lesions and the rest of 14 patients having 1 lesion each were examined. Among those, 14 were RA and 12 were UA. Eight lesions were less than 2mm in size, 9 lesions were 3-5mm, 7 were 6-9mm and 2 were larger than IOmm. On initial exams, 25 out of 26 aneurysm lesions were detected in either MRA or DSA showing 96% sensitivity. Specificity cannot be estimated since there was no true negative of false positive findings. When MRA and MPR were used concurrently for the confirmation of size and shape, the results were equivalent to those of DSA, while in the confirmation of aneurysm neck and parent vessels, the concurrent use of MRA and MPR was far superior to the sole use of either MRA or DSA. Conclusion: High resolution MRA using slice interpolation technique showed equal results as those of DSA for the detection of intracranial aneurysm, and may be used as a primary non-invasive screening test in the future.

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The effect of antagonists produced by Paenibacillus polymyxa CK-1 on the growth of Trichoderma sp. (Paenibacillus polymyxa CK-1이 생산한 길항물질이 Trichoderma sp. 생육에 미치는 영향)

  • Lee, Sang-Won;Choi, Jin-Sang;Kim, Chul-Ho
    • Journal of Mushroom
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    • v.12 no.3
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    • pp.201-208
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    • 2014
  • The separation of the bacteria inhibiting Trichoderma sp. mold, the strain causing blue mold disease that occurs frequently when cultivating mushroom while carrying out the efficient fermentation of mushroom medium, from the growth was done. In about 200 strains isolated primarily from fungus garden samples, 6 strains were secondly isolated, which had fast growth rates and a clear zone on the plate medium of SM, AM, and CM. Among the 6 strains isolated, the C-1 strain showed high enzymatic activity of cellulase, amylase, and protease, and strong antibacterial activity for the T. virens and T. harzianum, selected finally. The selected C-1 strain was identified as Paenibacillus polymyxaby the result of the identification by Bergey's Manual of Systematic Bacteriology and the analysis of the nucleotide sequence of 16S rRNA, and named as P. polymyxa CK-1. In reviewing the growth conditions of the P. polymyxa CK-1 strain, the optimum cultivation temperature was $45^{\circ}C$, and the optimum pH for growth was in the range of 6.0~7.0. Appropriate incubation time of P. polymyxa CK-1 for the growth inhibition of the fungus T. virens and T. harzianum was 22 to 36 hours. And the fungal growth was not observed, even when leaving two molds inoculated on each petri dishes, which were treated with 24 hour culture solution of P. polymyxa CK-1 strain for 10 days. As a result of studying the thermal stability of the antagonists produced by the P. polymyxa CK-1 strain, no mycelial growth of the two fungi was observed in the test group treated for 20 minutes at $60^{\circ}C$ and $100^{\circ}C$, but mycelial growth was slightly observed in the test group treated for 20 minutes at $121^{\circ}C$. As aresult of reviewing the impact of the P. polymyxa CK-1 culture medium on mushroom mycelial growth, it showed no effect on a variety of mushroom mycelial growth including enoki mushroom and shiitake mushroom.

The effects of stepping in place tempo and roundhouse kick types on response time in taekwondo (태권도에서 제자리딛기 템포와 돌려차기 유형이 응답시간에 미치는 영향)

  • Lee, Jong-Hwa;Song, Young-Hoon
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.4
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    • pp.870-877
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    • 2020
  • The purpose of this study is to compare and analyze the effects of stepping-in-place tempo and roundhouse kick types on response time. Fifteen males participated in this experiment. All have over ten years of experience and hold a forth dan(degree) black belt in taekwondo. The task is when the participants are doing stepping in place they respond to the light stimulus as fast as they can do roundhouse kick. Five different stepping in place tempos (100, 120, 140, 160, and 180 bpm) and four different types of roundhouse kick(front leg body roundhouse kick, front leg head roundhouse kick, back leg body roundhouse kick, and back leg head roundhouse kick) were used. Three measurements were taken for each of the different combinations of conditions for a total of 60 measurements. For data analysis, two-way ANOVA with repeated measures was used and pair-wise comparisons were performed using bonferroni statistics. The results show that there was significant difference interaction effect between stepping in place tempo and roundhouse kick type in the response time. And, there were significant difference in main effect of response time in accordance with stepping in place tempo and roundhouse kick type. The response time of roundhouse kick was the fastest at 160 bpm of stepping in place tempo, but there was no significant difference between 140 and 160 bpm. Front leg body roundhouse kick was the fastest. And, the response time was the fastest when front leg body roundhouse kicked at 140 bpm of stepping in place tempo. Stepping in place tempo between 140 and 160 bpm is the most effective to optimize the response time. And, More effective response time was front leg roundhouse kick as compared with back leg roundhouse kick and, body roundhouse kick as compared with head roundhouse kick. The findings in this study will provide useful information for performance improvement and will help with strategy for taekwondo competition.

Development of an Eating Habit Checklist for Screening Elementary School Children at High Risk of Energy Overintake (초등학생의 에너지 과잉섭취 위험 진단을 위한 식습관평가표 개발)

  • Yon, Mi-Yong;Hyun, Tai-Sun
    • Journal of Nutrition and Health
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    • v.41 no.5
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    • pp.414-427
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    • 2008
  • The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.