• Title/Summary/Keyword: 고려대학교

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Variation on Estimated Values of Radioactivity Concentration According to the Change of the Acquisition Time of SPECT/CT (SPECT/CT의 획득시간 증감에 따른 방사능농도 추정치의 변화)

  • Kim, Ji-Hyeon;Lee, Jooyoung;Son, Hyeon-Soo;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.2
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    • pp.15-24
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    • 2021
  • Purpose SPECT/CT was noted for its excellent correction method and qualitative functions based on fusion images in the early stages of dissemination, and interest in and utilization of quantitative functions has been increasing with the recent introduction of companion diagnostic therapy(Theranostics). Unlike PET/CT, various conditions like the type of collimator and detector rotation are a challenging factor for image acquisition and reconstruction methods at absolute quantification of SPECT/CT. Therefore, in this study, We want to find out the effect on the radioactivity concentration estimate by the increase or decrease of the total acquisition time according to the number of projections and the acquisition time per projection among SPECT/CT imaging conditions. Materials and Methods After filling the 9,293 ml cylindrical phantom with sterile water and diluting 99mTc 91.76 MBq, the standard image was taken with a total acquisition time of 600 sec (10 sec/frame × 120 frames, matrix size 128 × 128) and also volume sensitivity and the calibration factor was verified. Based on the standard image, the comparative images were obtained by increasing or decreasing the total acquisition time. namely 60 (-90%), 150 (-75%), 300 (-50%), 450 (-25%), 900 (+50%), and 1200 (+100%) sec. For each image detail, the acquisition time(sec/frame) per projection was set to 1.0, 2.5, 5.0, 7.5, 15.0 and 20.0 sec (fixed number of projections: 120 frame) and the number of projection images was set to 12, 30, 60, 90, 180 and 240 frames(fixed time per projection:10 sec). Based on the coefficients measured through the volume of interest in each acquired image, the percentage of variation about the contrast to noise ratio (CNR) was determined as a qualitative assessment, and the quantitative assessment was conducted through the percentage of variation of the radioactivity concentration estimate. At this time, the relationship between the radioactivity concentration estimate (cps/ml) and the actual radioactivity concentration (Bq/ml) was compared and analyzed using the recovery coefficient (RC_Recovery Coefficients) as an indicator. Results The results [CNR, radioactivity Concentration, RC] by the change in the number of projections for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.5%, +3.90%, 1.04] at -90%, [-77.9%, +2.71%, 1.03] at -75%, [-55.6%, +1.85%, 1.02] at -50%, [-33.6%, +1.37%, 1.01] at -25%, [-33.7%, +0.71%, 1.01] at +50%, [+93.2%, +0.32%, 1.00] at +100%. and also The results [CNR, radioactivity Concentration, RC] by the acquisition time change for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.3%, -3.55%, 0.96] at - 90%, [-73.4%, -0.17%, 1.00] at -75%, [-49.6%, -0.34%, 1.00] at -50%, [-24.9%, 0.03%, 1.00] at -25%, [+49.3%, -0.04%, 1.00] at +50%, [+99.0%, +0.11%, 1.00] at +100%. Conclusion In SPECT/CT, the total coefficient obtained according to the increase or decrease of the total acquisition time and the resulting image quality (CNR) showed a pattern that changed proportionally. On the other hand, quantitative evaluations through absolute quantification showed a change of less than 5% (-3.55 to +3.90%) under all experimental conditions, maintaining quantitative accuracy (RC 0.96 to 1.04). Considering the reduction of the total acquisition time rather than the increasing of the image acquiring time, The reduction in total acquisition time is applicable to quantitative analysis without significant loss and is judged to be clinically effective. This study shows that when increasing or decreasing of total acquisition time, changes in acquisition time per projection have fewer fluctuations that occur in qualitative and quantitative condition changes than the change in the number of projections under the same scanning time conditions.

A Study on the Evaluation of Fertilizer Loss in the Drainage(Waste) Water of Hydroponic Cultivation, Korea (수경재배 유출 배액(폐양액)의 비료 손실량 평가 연구)

  • Jinkwan Son;Sungwook Yun;Jinkyung Kwon;Jihoon Shin;Donghyeon Kang;Minjung Park;Ryugap Lim
    • Journal of Wetlands Research
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    • v.25 no.1
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    • pp.35-47
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    • 2023
  • Korean facility horticulture and hydroponic cultivation methods increase, requiring the management of waste water generated. In this study, the amount of fertilizer contained in the discharged waste liquid was determined. By evaluating this as a price, it was suggested to reduce water treatment costs and recycle fertilizer components. It was evaluated based on the results of major water quality analysis of waste liquid by crop, such as tomatoes, paprika, cucumbers, and strawberries, and in the case of P component, it was analyzed by converting it to the amount of phosphoric acid (P2O5). The amount of nitrogen (N) can be calculated by discharging 1,145.90kg·ha-1 of tomatoes, 920.43kg·ha-1 of paprika, 804.16kg·ha-1 of cucumbers, 405.83kg·ha-1 of strawberries, and the fertilizer content of P2O5 is 830.65kg·ha-1 of paprika, 622.32kg·ha-1 of tomatoes, 477.67kg·ha-1 of cucumbers. In addition, trace elements such as potassium (K), calcium (Ca), magnesium (Mg), iron (Fe), and manganese (Mn) were also analyzed to be emitted. The price per kg of each item calculated by averaging the price of fertilizer sold on the market can be evaluated as KRW, N 860.7, P 2,378.2, K 2,121.7, Ca 981.2, Mg 1,036.3, Fe 126,076.9, Mn 62,322.1, Zn 15,825.0, Cu 31,362.0, B 4,238.0, Mo 149,041.7. The annual fertilizer loss amount for each crop was calculated by comprehensively considering the price per kg calculated based on the market price of fertilizer, the concentration of waste by crop analyzed earlier, and the average annual emission of hydroponic cultivation. As a result of the analysis, the average of the four hydroponic crops was 5,475,361.1 won in fertilizer ingredients, with tomatoes valued at 6,995,622.3 won, paprika valued at 7,384,923.8 won, cucumbers valued at 5,091,607.9 won, and strawberries valued at 2,429,290.6 won. It was expected that if hydroponic drainage is managed through self-treatment or threshing before discharge rather than by leaking it into a river and treating it as a pollutant, it can be a valuable reusable fertilizer ingredient along with reducing water treatment costs.

A Study on the Characteristics and Management Plan of Old Big Trees in the Sacred Natural Sites of Handan City, China (중국 한단시 자연성지 내 노거수의 특성과 관리방안)

  • Xi, Su-Ting;Shin, Hyun-Sil
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.2
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    • pp.35-45
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    • 2023
  • First, The spatial distribution characteristics of old big trees were analyzed using ArcGIS figures by combining basic information such as species and ages of old big trees in Handan City, which were compiled by the local bureau of landscaping. The types of species, distribution by ages of trees, ownership status, growth status, and diversity status were comprehensively analyzed. Statistically, Styphnolobium, Acacia, Gleditsia, and Albizia of Fabaceae accounted for the majority, of which Sophora japonica accounted for the highest proportion. Sophora japonica is widely and intensively distributed to each prefecture and district in Handan city. According to the age and distribution, the old big trees over 1000 years old were mainly Sophora japonica, Zelkova serrata, Juniperus chinensis, Morus australis Koidz., Dalbergia hupeana Hance, Ceratonia siliqua L., and Pistacia chinensis, and Platycladus orientalis. Second, as found in each type of old big tree status, various types of old big tree status were investigated, the protection management system, protection management process, and protection management benefits were studied, and the protection of old big tree was closely related to the growth environment. Currently, the main driving force behind the protection of old big trees is the worship of old big trees. By depositing its sacredness to the old big tree and sublimating the natural character that nature gave to the old big tree into a guiding consciousness of social activities, nature's "beauty" and personality's "goodness" are well combined. The protection state of the old big tree is closely related to the degree of interaction with the surrounding environment and the participation of various cultures and subjects. In the process of continuously interacting with the surrounding environment during the long-term growth of old big trees, it seems that a natural sanctuary was formed around old big trees in the process of voluntarily establishing a "natural-cultural-scape" system involving bottom-up and top-down cross-regions, multicultural and multi-subjects. Third, China focused on protecting and recovering old big trees, but the protection management system is poor due to a lack of comprehensive consideration of historical and cultural values, plant diversity significance, and social values of old big trees in the management process. Three indicators of space's regional characteristics, property and protection characteristics, and value characteristics can be found in the evaluation of the natural characteristics of old giant trees, which are highly valuable in terms of traditional consciousness management, resource protection practice, faith system construction, and realization of life community values. A systematic management system should be supported as to whether they can be protected and developed for a long time. Fourth, as the perception of protected areas is not yet mature in China, "natural sanctuary" should be treated as an important research content in the process of establishing a nature reserve system. The form of natural sanctuary management, which focuses on bottom-up community participation, is a strong supplement to the current type of top-down nature reserve management in China. Based on this, the protection of old giant trees should be included in the form of a nature reserve called a natural monument in the nature reserve system. In addition, residents of the area around the nature reserve should be one of the main agents of biodiversity conservation.

The Effect of Service Failure on the Desire for Betrayal and Retaliatory Behavior - Based on the Moderating Role of the Customer-Service Firm Relationship Quality (서비스 실패요인이 보복행위에 미치는 영향과 관계품질의 조절효과)

  • Kim, Mo Ran;Ahn, Kwang Ho
    • Asia Marketing Journal
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    • v.14 no.1
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    • pp.99-130
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    • 2012
  • Service failure and a poor service recovery may lead loyal customers to try to aggressively punish the service firm. We use perceived betrayal and desire for vengeance as the key constructs to understand customer retaliation. Perceived betrayal is defined as a customer's belief that a firm has intentionally violated what is normative in the context of their relationship. And the desire for vengeance is defined as the retaliatory feelings that consumers feel toward a firm, such as the desire to exert harm on the firm. The perceived betrayal and the desire for vengeance are key antecedents of retaliatory behaviors such as vindictive complaining, negative WOM and third-party complaining for publicity. The empirical results suggest that betrayal is a key motivational factor that lead customers to restore fairness by making use of all means, including retaliation. We also find that relationship quality has effect on a customer's response to a failure in service recovery. As the levels of relationship increases, a violation of the proper fairness has a stronger effect on the sense of betrayal experienced by customers. Considerable research has investigated consumer responses to dissatisfaction. But our study examine the response of outraged and highly frustrated consumers. We focus on emotional and behavioral processes that have not been covered by previous dissatisfaction researches and which are unique to outraged consumers caused by extremely dissatisfied purchase experience. It has recently been pointed out by various mass media that the customers not only have positive effects on the company performance but also put the company in crisis. It has often been reported that one customer's dissatisfaction, for example, never ends as it is, and it tends to grow for retaliating upon the company, depending on the level of seriousness of the dissatisfaction. This sometimes leads to a lawsuit against the company. Our study focuses on the customers' emotional and behavioral responses induced by their extreme dissatisfactions. We divided the customer groups into the customers with high relationship quality and the customers with low relationship quality, and the difference between two groups is examined. The objective of this study is to comprehend the causal relationship between the feeling of betrayal caused by the service failure and the retaliatory behavior triggered by the desire of revenge. Our study is divided into three parts. First, a causal relationship between perceived unfairness and the perceived betrayal and desire for revenge. Second, the effect of the perceived betrayal and desire for revenge on the retaliatory behavior is investigated. Finally, the moderating role of relationship quality in the causal relationship between the unfairness in service recovery and the perceived betrayal is analyzed. This study finds the following empirical results. The distributive unfairness, procedural unfairness and interactional unfairness had significant effects on the perceived betrayal. Especially, the perceived distributive unfairness results in the highest perceived betrayal. When the service company does not provide customers proper and sufficient compensation for the failure, they feel the strong sense of betrayal. And in the causal relationship between the perceived betrayal, desire for revenge and retaliatory behavior, the perceived betrayal has significant effects on e desire for revenge. In addition desire for revenge has significant effects on negative word of mouth, retaliatory complaining behavior and publicity of complaints through third group. Therefore the perceived unfairness has effects on retaliatory behavior through the mediation of the perceived betrayal and desire for revenge. Finally the moderating role of relationship quality was examined in the relationship between the unfairness and perceived betrayal. If the customers experienced the perceived unfairness in the process of service recovery, the customers with high relationship quality feel the stronger perceived betrayal than the customers with low relationship quality do. When they experience the double service failure, the customer group with high relationship quality accumulating the sense of trust feel the more perceived betrayal than the customer with low relationship quality who do not have strong trust. The contribution of this study is to find the effect of the service failure on the retaliatory behavior with the moderating roles of relationship quality. The dimensions of unfairness in service recovery is found to have differential effects on the perceived betrayal, desire for revenge. And these differential effect is moderated by the level of relationship quality.

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Effects of Reward Programs on Brand Loyalty in Online Shopping Contexts (인터넷쇼핑 상황에서 보상프로그램이 브랜드충성도에 미치는 영향에 관한 연구)

  • Kim, Ji-Hern;Kang, Hyunmo;Munkhbazar, M.
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.39-63
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    • 2012
  • Previous studies of reward programs have generally focused on designing the best programs for consumers and suggested that consumers' perception of the value of reward programs can vary according to the type of reward program (e.g., hedonic vs. utilitarian and direct vs. indirect) and its timing (e.g., immediate vs. delayed). These studies have typically assumed that consumers' preference for reward programs has a positive effect on brand loyalty. However, Dowling and Uncles (1997) pointed out that this preference does not necessarily foster brand loyalty. In this regard, the present study verifies this assumption by examining the effects of consumers' perception of the value of reward programs on their brand loyalty. Although reward programs are widely used by online shopping malls, most studies have examined the conditions under which consumers are most likely to value loyalty programs in the context of offline shopping. In the context of online shopping, however, consumers' preferences may have little effect on their brand loyalty because they have more opportunities for comparing diverse reward programs offered by many online shopping malls. That is, in online shopping, finding attractive reward programs may require little effort on the part of consumers, who are likely to switch to other online shopping malls. Accordingly, this study empirically examines whether consumers' perception of the value of reward programs influences their brand loyalty in the context of online shopping. Meanwhile, consumers seek utilitarian and/or hedonic value from their online shopping activity(Jones et al., 2006; Barbin et al., 1994). They visit online shopping malls to buy something necessary (utilitarian value) and/or enjoy the process of shopping itself (hedonic value). In this sense, reward programs may reinforce utilitarian as well as hedonic value, and their effect may vary according to the type of reward (utilitarian vs. hedonic). According to Chaudhuri and Holbrook (2001), consumers' perception of the value of a brand can influence their brand loyalty through brand trust and affect. Utilitarian value influences brand loyalty through brand trust, whereas hedonic value influences it through brand affect. This indicates that the effect of this perception on brand trust or affect may be moderated by the type of reward program. Specifically, this perception may have a greater effect on brand trust for utilitarian reward programs than for hedonic ones, whereas the opposite may be true for brand affect. Given the above discussion, the present study is conducted with three objectives in order to provide practical implications for online shopping malls to strategically use reward program for establishing profitable relationship with customers. First, the present study examines whether reward programs can be an effective marketing tool for increasing brand loyalty in the context of online shopping. Second, it investigates the paths through which consumers' perception of the value of reward programs influences their brand loyalty. Third, it analyzes the effects of this perception on brand trust and affect by considering the type of reward program as a moderator. This study suggests and empirically analyzes a new research model for examining how consumers' perception of the value of reward programs influences their brand loyalty in the context of online shopping. The model postulates the following 10 hypotheses about the structural relationships between five constructs: (H1) Consumers' perception of the value of reward programs has a positive effect on their program loyalty; (H2) Program loyalty has a positive effect on brand loyalty; (H3) Consumers' perception of the value of reward programs has a positive effect on their brand trust; (H4) Consumers' perception of the value of reward programs has a positive effect on their brand affect; (H5) Brand trust has a positive effect on program loyalty; (H6) Brand affect has a positive effect on program loyalty; (H7) Brand trust has a positive effect on brand loyalty; (H8) Brand affect has a positive effect on brand loyalty; (H9) Consumers' perception of the value of reward programs is more likely to influence their brand trust for utilitarian reward programs than for hedonic ones; and (H10) Consumers' perception of the value of reward programs is more likely to influence their brand affect for hedonic reward programs than for utilitarian ones. To test the hypotheses, we considered a sample of 220 undergraduate students in Korea (male:113). We randomly assigned these participants to one of two groups based on the type of reward program (utilitarian: transportation card, hedonic: movie ticket). We instructed the participants to imagine that they were offered these reward programs while visiting an online shopping mall. We then asked them to answer some questions about their perception of the value of the reward programs, program loyalty, brand loyalty, brand trust, and brand affect, in that order. We also asked some questions about their demographic backgrounds and then debriefed them. We employed the structural equation modeling (SEM) method with AMOS 18.0. The results provide support for some hypotheses (H1, H3, H4, H7, H8, and H9) while providing no support for others (H2, H5, H6, H10) (see Figure 1). Noteworthy is that the path proposed by previous studies, "value perception → program loyalty → brand loyalty," was not significant in the context of online shopping, whereas this study's proposed path, "value perception → brand trust/brand affect → brand loyalty," was significant. In addition, the results indicate that the type of reward program moderated the relationship between consumers' value perception and brand trust but not the relationship between their value perception and brand affect. These results have some important implications. First, this study is one of the first to examine how consumers' perception of the value of reward programs influences their brand loyalty in the context of online shopping. In particular, the results indicate that the proposed path, "value perception → brand trust/brand affect → brand loyalty," can better explain the effects of reward programs on brand loyalty than existing paths. Furthermore, these results suggest that online shopping malls should place greater emphasis on the type of reward program when devising reward programs. To foster brand loyalty, they should reinforce the type of shopping value that consumers emphasize by providing them with appropriate reward programs. If consumers prefer utilitarian value to hedonic value, then online shopping malls should offer utilitarian reward programs and vice versa.

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Reevaluation of the Neonatal Screening Test for Congenital Hypothyroidism (선천성 갑상선기능저하증에 대한 신생아 선별검사의 재평가)

  • Kang, So Young;Chang, Young Pyo;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.387-394
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    • 2005
  • Purpose : We performed this study to compare the TSH and free $T_4$ levels according to gestational age and birth weight, and to reevaluate the cut-off values in the neonatal screening test for congenital hypothyroidism. Methods : Total 2,133 neonates(1,749 healthy newborns and 384 sick neonates) were screened in Dankook University Hospital from May 2000 to January 2003. Neonates with abnormal TSH values (higher than $20{\mu}IU/mL$) or abnormal free $T_4$ levels(lower than 1 ng/dL) were recalled to recheck the thyroid function test. At that time, physical examinations and history-taking regarding perinatal problem, medication history, and mother's illness were undertaken. Results : Serum TSH and free $T_4$ values revealed no significant difference according to sex, delivery type, and Apgar score. The free $T_4$ levels showed statistically significant differences, with gestational age or birth weight(P<0.01). The recall rate of neonates due to abnormal screening test was 7.48 percent. Compared with original cut-off values, the recall rate of the new cut-off values setted to TSH higher than $20{\mu}IU/mL$ or free $T_4$ lower than 0.64 ng/dL decreased from 7.48 percent to 4.8 percent in the healthy group. But, it compromised sensitivity when applied to the sick group. Conclusion : In this study, neonatal free $T_4$ levels were significantly different according to birth weight, gestational age, and the presence of compromised condition. Although the recall rate by TSH > $20{\mu}IU/mL$ or free $T_4$ <1 ng/dL was relatively high, it was impossible to set up new cut-off values without compromising sensitivity. We think studies including a larger study population will be required to change the cut-off values.

Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants (미숙아의 장천공에서 복막 배액술의 치료효과에 관한 임상적 경험)

  • Lee, Jun Seok;Koo, Kyo Yeon;Lee, Soon Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul;Choi, Seung Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1216-1220
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    • 2009
  • Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

The influence of some intrauterine growth variables on neonatal blood pressure (태아기 자궁내 성장지표와 신생아 혈압과의 관련성)

  • Min, Jungwon;Park, Eun Ae;Kong, Kyoungae;Park, Bohyun;Hong, Juhee;Kim, Young Ju;Lee, Hwayoung;Ha, EunHee;Park, Hyesook
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.966-971
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    • 2006
  • Purpose : 'Programming' describes the process that stimulus at a critical period of development has lifelong effects. The fact that low birth weight links to the risk of elevated blood pressures in adult life is well known. This study aims to examine whether this link is evident in the newborn by investigating the relationship of the intrauterine growth indices and neonatal blood pressure(BP). Methods : We studied 127 neonates who were born at Ewha Womans' Hospital and their mothers enrolled our cohort study during pregnancy. Data on the mothers and details of the birth records were tracked and collected from medical charts. Neonatal BP was measured within 24 hours after birth. Results : Neonatal SBP was positively correlated to intrauterine growth indices; birth weight(BW)(r=0.4), head circumference(HC)(r=0.4), and birth height(r=0.3). However, an inverse relationship existed, between HC/BW ratio and neonatal SBP(r=-0.4). After adjusting for the baby's sex, maternal BP, and gestational age, neonatal SBP still associated with intrauterine growth indices. SBP was 7 mmHg higher in the highest BW group(${\geq}90percentiles$) compared to the lowest group(<10 percentiles). On the other hand, SBP was 17 mmHg lower in the highest HC/BW group(${\geq}90percentiles$) compared in the lowest group(<10 percentiles). Conclusion : This study could not find the evidence that intrauterine growth retardation affect on elevated neonatal BP. It suggests that the initiating events of BP programming may occur during postnatal growth period. To identify the critical starting period that intrauterine growth retardation leads to elevated BP, a study tracking BP changes from birth to childhood is required.

Etiological agents isolated from blood in children with hemato-oncologic disease (2002-2005) (소아 혈액 종양 환자에서 발생한 균혈증의 원인균(2002-2005년))

  • Kim, So-Hee;Lee, Young-Ah;Eun, Byung-Wook;Kim, Nam-Hee;Lee, Jin-A;Kang, Hyoung Jin;Choi, Eun-Hwa;Shin, Hee Young;Lee, Hoan-Jong;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.56-64
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    • 2007
  • Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. Methods : One hundred and ninety-seven episodes of bloodstream infections that developed in 128 pediatric cancer patients were analyzed, which were identified at the Seoul National University Children's Hospital during a 4 year-period from 2002 to 2005. Results : A total of 214 pathogens was isolated, of which 64.0 percent were gram-negative, 31.3 percent were gram-positive bacteria, and 4.7 percent were fungi. The most common pathogens were Klebsiella spp. (21 percent) and Escherichia coli (16.8 percent), and coagulase-negative staphylococci (CNS, 7.9 percent) and viridans streptococci (7.5 percent) emerged as important pathogens. Neutropenic patients were more often associated with gram-negative bacteria than non-neutropenic patients (67.5 percent vs. 51.1%, P=0.018) and patients with central venous catheters were more often associated with CNS and viridans streptococci than those without. Resistance rates of gram-positive bacteria to penicillin, oxacillin and vancomycin were 83.3 percent, 48.5 percent and 0.5 percent, respectively, and those of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin and amikacin were 24.1 percent, 17.2 percent, 6.6 percent, 21.6 percent, and 14.2 percent, respectively. Gram-negative bacteremias were more often associated with intensive care than gram-positive bacteremias (26.5 percent vs. 10.3 percent, P=0.016), and patients with catheters were more often associated with intensive care (34.4 percent vs. 10.8 percent, P<0.001) and higher fatality rate (16.7 percent vs. 4.8 percent, P=0.012) than those without. Conclusion : This study revealed that gram-negative bacteria are still a dominant organism in bloodstream infections, especially in neutropenic patients, and confirmed that gram-positive bacteria are emerging as important etiological agents in bloodstream infections of pediatric hemato-oncologic patients.

Factors affecting the final adult height in survivors of childhood brain tumors (소아 뇌종양 환자의 최종 성인키에 영향을 미치는 인자)

  • Yun, Kyong-Ah;Lee, Young Ah;Shin, Choong Ho;Yang, Sei Won;Shin, Hee Young;Ahn, Hyo Seop;Kim, Il Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.65-73
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    • 2007
  • Purpose : Short stature is an important complication that impairs the quality of life in survivors of childhood brain tumors. We studied their final adult height (FAH) to evaluate risk factors for short stature. Methods : We reviewed the medical data of 95 survivors of childhood brain tumors (64 males and 31 females) who had been followed up from 1982 to 2006, reached FAH, and had a more than five year-disease-free survival. Results : Final adult height standard deviation score (FAHTSDS: $mean{\pm}SD$) of the patients was lower than those of general population ($-1.15{\pm}1.72$), HTSDS at diagnosis ($-0.13{\pm}1.57$), and target HTSDS ($-0.49{\pm}0.69$). FAHTSDS of craniopharyngioma patients did not decrease ($0.57{\pm}1.17$), but those of germ cell tumor and medulloblastoma patients were significantly reduced ($-1.20{\pm}1.45$, $-2.70{\pm}1.46$; P<0.05). The patients treated with craniospinal radiation or chemotherapy had lower FAHTSDS ($-1.93{\pm}1.58$, $-2.27{\pm}1.44$; P<0.01). In the spinal irradiation group, the younger the age at diagnosis was, the more the loss of FAH (r=0.442, P<0.01). Growth hormone replacement (GHR) didn't improve FAHTSDS, but starting GHR under 12 years was an independent factor for improving FAH once treatment methods were taken into account (P=0.01). Conclusion : The younger age at diagnosis, spinal radiation and chemotherapy were all important risk factors of height loss, and height gain was expected in patients who received GHR under the age of 12 years. Therefore, regular check-ups of growth and early intervention with growth hormones are needed for high risk groups to improve FAH.