• Title/Summary/Keyword: multiple-resistance

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Integrated Algorithm for Identification of Long Range Artillery Type and Impact Point Prediction With IMM Filter (IMM 필터를 이용한 장사정포의 탄종 분리 및 탄착점 예측 통합 알고리즘)

  • Jung, Cheol-Goo;Lee, Chang-Hun;Tahk, Min-Jea;Yoo, Dong-Gil;Sohn, Sung-Hwan
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.50 no.8
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    • pp.531-540
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    • 2022
  • In this paper, we present an algorithm that identifies artillery type and rapidly predicts the impact point based on the IMM filter. The ballistic trajectory equation is used as a system model, and three models with different ballistic coefficient values are used. Acceleration was divided into three components of gravity, air resistance, and lift. And lift acceleration was added as a new state variable. The kinematic condition that the velocity vector and lift acceleration are perpendicular was used as a pseudo-measurement value. The impact point was predicted based on the state variable estimated through the IMM filter and the ballistic coefficient of the model with the highest mode probability. Instead of the commonly used Runge-Kutta numerical integration for impact point prediction, a semi-analytic method was used to predict impact point with a small amount of calculation. Finally, a state variable initialization method using the least-square method was proposed. An integrated algorithm including artillery type identification, impact point prediction and initialization was presented, and the validity of the proposed method was verified through simulation.

Treatment of Multidrug-resistant Pseudomonas aeruginosa Bacteremia in a Immunocompromised Child With Ceftolozane-tazobactam (면역저하 소아에서 발생한 다제내성 녹농균 균혈증을 ceftolozane-tazobactam으로 성공적으로 치료한 증례보고)

  • Hyesun Yu;Areum Shin;Doo Ri Kim;Jaeyoung Choi;Hee Young Ju;Joongbum Cho;Cheol-In Kang;Yae-Jean Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.47-54
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    • 2023
  • With the widespread use of broad-spectrum antibiotics in clinical practice, the emergence of multidrug-resistant (MDR) gram-negative bacteria has become a global problem. The MDR Pseudomonas aeruginosa infection is especially difficult to treat and increases mortality in critically ill patients. Ceftolozane-tazobactam (ZerbaxaTM) is a fifth-generation cephalosporin and beta-lactamase inhibitor that has proved to be effective for treating complicated urinary tract infections and complicated intra-abdominal infections caused by MDR P. aeruginosa. Herein, we report the first case of pediatric hematologic cancer in Korea that was successfully treated for MDR P. aeruginosa bacteremia with Ceftolozane-tazobactam.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure

  • Sang Min Park;Soo Youn Lee;Mi-Hyang Jung;Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Seok-Min Kang;Byung-Su Yoo;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • v.53 no.7
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    • pp.425-451
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    • 2023
  • Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

Treatment of Dysphagia in a Cardiac Transplantation Patient: A Case Study (심장 이식 수술 환자의 연하장애 재활치료: 단일 사례 연구)

  • Lee, Su-Jung;Kim, Tu-Kyu;Seo, Sang-Min
    • Therapeutic Science for Rehabilitation
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    • v.13 no.3
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    • pp.85-100
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    • 2024
  • Objective : This case study aimed to explore dysphagia symptoms in post-cardiac transplantation patients and evaluate the effectiveness of dysphagia rehabilitation therapy in an occupational therapy clinic. Methods : A patient with post-cardiac transplant dysphagia underwent videofluoroscopic swallowing studies to assess the Functional Dysphagia Scale (FDS), Penetration-Aspiration Scale (PAS), and Dysphagia Outcome and Severity Scale (DOSS). Assessments were performed three times at two-week intervals. The treatment, administered from July 19 to August 21, 2023, included eight sessions of 30 minutes each. Treatments included corrective techniques (tongue-hold maneuver, chin tuck against resistance, mendelsohn maneuver, effortful swallowing, and respiratory muscle exercise) and compensatory strategies (chin-tuck position, multiple swallowing, modification of volume, and viscosity), alongside caregiver education. Results : The FDS scores decreased from 50 to 30, PAS scores improved from 5 to 3, and DOSS scores improved from Stage 2 to Stage 4. Conclusion : Dysphagia rehabilitation therapy improved swallowing function in a post-cardiac transplantation patient. However, further studies are required to confirm these findings.

Developing a Model for Crime Prevention Hardware Performance Test and Certification System (방범하드웨어의 침입범죄 저항성능 시험·인증 체계에 관한 모형 연구)

  • Park, Hyeon-ho
    • Korean Security Journal
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    • no.36
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    • pp.255-292
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    • 2013
  • Burglary (also called breaking and entering and sometimes housebreaking) is a crime, the essence of which is illegal entry into a building for the purposes of committing an offence. It is one of the most common types of crime and also a serious issue for every society. A house that is left insecure is an accessible and attractive target for burglars and therefore burglary resistance test & certification system for doors and windows has been developed in many countries. This paper explores several advanced foreign burglary resistance test/certifcation cases (the British SBD, the Dutch KOMO SKH/SKG, the Japanese CP mark, the Australian Standard Certification) for security products and domestic test/certification systems for fire safety products as a comparative study so that any improvement points can be gained for South Korea in the field of security product performance. The comparative analysis results show that South Korea is far behind the security product certification system and needs a lot of improvement in the system by benchmarking foreign cases. The domestic test/certification systems for fire safety products also give some insights for burglary-related security products' performance certification system in Korea. Overall, the need for relevant rules and regulations, the establishment of standards regarding testing and certification, including certified security +hardware product in building security certification system, performance testing as well as production testing (i.e. quality management system evaluation), the basic competency of testers, incentive system for certified/high quality security products were suggested in order to make an optimal model for the security production performance testing and certification system in Korea.

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The Adjuvant Effect of Subcutaneous Interferon-gamma in the Treatment of Refractory Multidrug-resistant Pulmonary Tuberculosis (난치성 다제내성 폐결핵에서 피하주사 Interferon-gamma 치료의 효과: 예비연구)

  • Kim, Eun Kyung;Shim, Tae Sun;Lee, Jung Yeon;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Dong Soon;Kim, Won Dong;Kim, Woo Sung
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.226-233
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    • 2004
  • Background : Interferon-gamma (IFN-${\gamma}$) is a critical cytokine in the defense against a Mycobacterium tuberculosis infection. Even though IFN-${\gamma}$ has occasionally been used in the treatment of refractory multidrug-resistant tuberculosis (MDR-TB) with some promising results, there is still some controversy regarding the therapeutic efficacy of IFN-${\gamma}$. This study was performed to examine the effect of subcutaneous IFN-${\gamma}$ in the treatment of MDR-TB patients. Methods : Six patients with refractory MDR-TB were enrolled in this study. Two million IU of IFN-${\gamma}$ was administered subcutaneously three times a week with the concomitant administration of antituberculous drugs for at least for 28 weeks. During the IFN-${\gamma}$ therapy, the sputum smear and culture, radiological and clinical evaluations were performed every 4 weeks throughout the study period. Results : The mean age of the 6 patients was 37 years (ranges, 15-61 years). The drug susceptibility test to standard antituberculous drugs revealed resistance to an average of 6.8 (${\pm}1.2$) agents including isoniazid and rifampicin. An average of 10.8 (${\pm}1.3$) antituberculous drugs were prescribed before IFN-${\gamma}$ therapy. The culture became negative in 2 patients (33%) after initiating IFN-${\gamma}$ therapy; one at 8 weeks, and the other at 24 weeks. Finally, after stopping the IFN-${\gamma}$ therapy after 28 weeks, the culture became positive again in the two patients who were culture-negative. The other 4 patients who failed in the culture conversion are still on antituberculous treatment except for one who died of tuberculosis. Conclusion : Even though 28 weeks of subcutaneous IFN-${\gamma}$ therapy in combination with antituberculous drugs was successful in inducing the culture-negative conversion in some patients with refractory MDR-TB, the culture became positive again after stopping the IFN-${\gamma}$ therapy. This suggests that subcutaneous IFN-${\gamma}$ therapy may have suppressive effect on tuberculosis only during the IFN-${\gamma}$ therapy period in some patients. Further studies will be needed to determine the optimum dose, the administration route, the duration of therapy, and the predicting factors of the response to adjuvant IFN-${\gamma}$ therapy.

The Etiologic Agents and Clinical Outcomes of Adult Community-acquired Pneumonia in Jeju (제주지역 성인 지역사회획득 폐렴의 원인균 및 임상양상)

  • Jeon, Bong-Hee;Kim, Miok;Kim, Jeong Hong;Shin, Sang Yop;Lee, Jaechun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.358-364
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    • 2009
  • Background: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. Methods: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. Results: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. Conclusion: S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.

Relationship among Body Composition, Biochemical Measurements and Serum Leptin Level in Obese Children (비만아의 체성분 및 생화학적 측정치와 혈중 Leptin 농도와의 관계)

  • 최봉순;손수진;이희자;박명희;이은주
    • Journal of Nutrition and Health
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    • v.35 no.4
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    • pp.454-463
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    • 2002
  • The purpose of this study was to investigate the relationship among the anthropometric measurements, body composition indices, biochemical indices and serum leptin level of obese school children. The study was conducted on 97 elementary school children from 4-5th grade residing in Daegu and Kyungbuk area. Obesity was defined as fat percentage that exceed 25% of body fat mass. The prevalence of obesity of subject was 58.3% for male and 54.1% for female. The mean value of height, weight, body composition indices and biochemical indices of obese group were significantly higher than those of control group. The leptin level was significantly different in obese group but showed no difference by gender. The differences of leptin level were according to adiposity and BMI in obese subjects. Multiple regression analysis data showed that the BMI and body fat mass may influence on the leptin level of subject. Also, these data revealed the leptin resistance in obese children and relationship between leptin level and various factors including anthropometric measurements, body composition and biochemical indices. Additional research should be necessary to assess the mechanism of leptin resistance in obese children.

Plasma Levels of High Molecular Weight Adiponectin are Associated with Cardiometabolic Risks in Patients with Hypertension (고혈압 환자에서 혈장 고분자량 아디포넥틴 농도와 심장-대사위험인자와의 관련성 연구)

  • Chung, Hye-Kyung;Shin, Min-Jeong
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.733-741
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    • 2008
  • In the present study, we comprehensively examined the associations of plasma levels of total adiponectin and high molecular weight (HMW) adiponectin with the features of cardiometabolic risks including body fat distribution, dyslipidemia, insulin resistance and inflammatory markers in a cross-sectional study of 110 treated hypertensive patients. Blood lipid profiles, high sensitivity C-reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA- IR) derived from fasting glucose and insulin concentrations were determined. Plasma levels of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) were analyzed using ELISA. The results showed that plasma levels of HMW-adiponectin were negatively associated with body mass index (BMI, r = - 0.203, p < 0.05) and waist circumference (r = -0.307, p < 0.01), which was not shown in total adiponectin. Plasma levels of HMW-adiponectin were negatively associated with triglyceride (r = -0.223, p < 0.05) and positively associated with HDL-cholesterol (r = 0.228, p < 0.05). Plasma levels of adiponectin were positively associated with HDL-cholesterol (r = 0.224, p < 0.05). Plasma levels of HMW-adiponectin were negatively associated with hsCRP (r = -0.276, p < 0.01) and IL-6 (r = -0.272, p < 0.01). In addition, there were weak associations between plasma levels of HMWadiponectin and TNF-${\alpha}$ (r = -0.163, p = 0.07) and ICAM-1 (r = -0.158, p = 0.09). However, there were no significant associations of total adiponectin with inflammatory markers except hsCRP (r = -0.203, p < 0.05). Stepwise multiple linear regression analysis showed that only plasma levels of HMW-adiponectin was an independent factor influencing serum levels of hsCRP, a marker of systemic low grade inflammation, after adjusting for age, gender, BMI, waist circumference, alcohol intake, smoking status, blood lipids, total adiponectin and drug use (p < 0.01). These results suggest that HMW-adiponectin, rather than total adiponectin, is likely to be closely associated with the features of cardiometabolic risks in treated hypertensive patients and might be effective biomarker for the prediction of cardiovascular disease.

Anti-diabetic effect and mechanism of Korean red ginseng extract in C57BL/KsJ db/db mice

  • Yuan, Hai-Dan;Shin, Eun-Jung;Chung, Sung-Hyun
    • Proceedings of the Ginseng society Conference
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    • 2007.12a
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    • pp.57-58
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    • 2007
  • Purpose: Ginseng is a well-known medical plant used in traditional Oriental medicine. Korean red ginseng (KRG) has been known to have potent biological activities such as radical scavenging, vasodilating, anti-tumor and anti-diabetic activities. However, the mechanism of the beneficial effects of KRG on diabetes is yet to be elucidated. The present study was designed to investigate the anti-diabetic effect and mechanism of KRG extract in C57BL/KsJ db/db mice. Methods: The db/db mice were randomly divided into six groups: diabetic control group (DC), red ginseng extract low dose group (RGL, 100 mg/kg), red ginseng extract high dose group (RGH, 200 mg/kg), metformin group (MET, 300 mg/kg), glipizide group (GPZ, 15 mg/kg) and pioglitazone group (PIO, 30 mg/kg), and treated with drugs once per day for 10 weeks. During the experiment, body weight and blood glucose levels were measured once every week. At the end of treatment, we measured Hemoglobin A1c (HbA1c), blood glucose, insulin, triglyceride (TG), adiponectin, leptin, non-esterified fatty acid (NEFA). Morphological analyses of liver, pancreas and white adipose tissue were done by histological observation through hematoxylin-eosin staining. Pancreatic islet insulin and glucagon levels were detected by double-immunofluorescence staining. To elucidate an action of mechanism of KRG, DNA microarray analyses were performed, and western blot and RT-PCR were conducted for validation. Results: Compared to the DC group mice, body weight gain of PIO treated group mice showed 15.2% increase, but the other group mice did not showed significant differences. Compared to the DC group, fasting blood glucose levels were decreased by 19.8% in RGL, 18.3% in RGH, 67.7% in MET, 52.3% in GPZ, 56.9% in PIO-treated group. With decreased plasma glucose levels, the insulin resistance index of the RGL-treated group was reduced by 27.7% compared to the DC group. Insulin resistance values for positive drugs were all markedly decreased by 80.8%, 41.1% and 68.9%, compared to that of DC group. HbA1c levels in RGL, RGH, MET, GPZ and PIO-treated groups were also decreased by 11.0%, 6.4%, 18.9%, 16.1% and 27.9% compared to that of DC group, and these figure revealed a similar trend shown in plasma glucose levels. Plasma TG and NEFA levels were decreased by 18.8% and 16.8%, respectively, and plasma adiponectin and leptin levels were increased by 20.6% and 12.1%, respectively, in the RGL-treated group compared to those in DC group. Histological analysis of the liver of mice treated with KRG revealed a significantly decreased number of lipid droplets compared to the DC group. The control mice exhibited definitive loss and degeneration of islet, whereas mice treated with KRG preserved islet architecture. Compared to the DC group mice, KRG resulted in significant reduction of adipocytes. From the pancreatic islet double-immunofluorescence staining, we observed KRG has increased insulin production, but decreased glucagon production. KRG treatment resulted in stimulation of AMP-activated protein kinase (AMPK) phosphorylation in the db/db mice liver. To elucidate mechanism of action of KRG extract, microarray analysis was conducted in the liver tissue of mice treated with KRG extract, and results suggest that red ginseng affects on hepatic expression of genes responsible for glycolysis, gluconeogenesis and fatty acid oxidation. In summary, multiple administration of KRG showed the hypoglycemic activity and improved glucose tolerance. In addition, KRG increased glucose utilization and improved insulin sensitivity through inhibition of lipogenesis and activation of fatty acid $\beta$-oxidation in the liver tissue. In view of our present data, we may suggest that KRG could provide a solid basis for the development of new anti-diabetic drug.

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