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Prediction of High Grade Vesicoureteral Reflux in Infants Less than 3 Months with Urinary Tract Infection (3개월 미만 요로감염 영아에서 중증 방광 요관 역류의 예측인자)

  • Yi, Dae-Yong;Kim, Na-Yeon;Cho, Hee-Yeon;Kim, Ji-Eun;Sim, So-Yeon;Son, Dong-Woo;Jeon, In-Sang;Cha, Han
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.178-185
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    • 2008
  • Purpose : Our aim was to investigate the predictive factors for detecting grade III-V vesicoureteral reflux(VUR) in young infants less than 3 months with urinary tract infections (UTI). Methods : Data of infants who underwent ultrasonography and VCUG between January 2004 and September 2007 were reviewed. Age, gender, incidence of bacteremia, C-reactive protein(CRP) and imaging studies were compared between group I(grade III-V VUR) and group II (normal or grade I and II VUR) retrospectively. Sensitivity, specificity, positive and negative predictive values, odds ratio, and likelihood ratio of ultrasonography for high grade VUR were evaluated. Results : Among 54 enrolled infants(41 males, 13 females), 14 infants were group I and 40 infants were group II. In the group I, CRP level was significantly higher(6.11$\pm$5.18 vs. 3.27$\pm$3.45, P=0.025), and there were more ultrasonographic abnormal findings(71.4%, vs. 22.5%, P=0.002) compared with group II. However, ultrasonography was the only significant factor after adjusting with logistic regression(P=0.002). Incidence of bacteremia and abnormal DMSA findings were not significantly different in two groups. Sensitivity, specificity, and odds ratio of ultrasonography was 71.4%, 77.5%, 6.9 respectively. Negative predictive value was 88.6% and negative likelihood ratio was 0.37. Ultrasonography had significant negative likelihood ratio for grade III-V VUR, but missed 4 infants with grade III VUR. Conclusion : We could not find any alternative predictive factors to reduce VCUG in detecting high grade VUR. Therefore, VCUG must be considered in young infants less than 3 months with UTI.

TGF-${\beta}1$ Protein Expression in Bullae of Patients with Spontaneous Pneumothorax (자연기흉환자의 폐기포에서 TGF-${\beta}1$ 단백질 발현에 대한 연구)

  • Kim, Kwang-Ho;Cho, Jung-Soo;Kim, Young-Sam;Yoon, Yong-Han;Kim, Joung-Taek;Baek, Wan-Ki;Kim, Lucia;Song, Sun-U.
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.805-809
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    • 2006
  • Background: In our previous study, we demonstrated that transforming growth factor-beta 1 receptor II(TGF-${\beta}1RII$) may have a role in the formation of bullae. In this study, we investigated if expression of transforming growth factor-beta 1 (TGF-${\beta}1$) ligand was altered in a bullous lung tissue by immunohistochemical staining of bullous tissues from patients with primary spontaneous pneumothorax. Material and Method: Bullous lung tissues were obtained from 36 patients with primary spontaneous pneumothorax, including 34 males and 2 females aged 14 to 38 years old. Result: Of the 36 patients, 19 were TGF-${\beta}1$ positive and 24 were transforming growth factor-beta 1 receptor II(TGF-${\beta}1RII$) positive. Among the 19 TGF-${\beta}1$ positives, 15 were also TGF-${\beta}1RII$ positive, observation at high magnification showed that strong immunohistochemical stain was detected in the boundary region between the bullous and normal lung tissues. Conclusion: These results suggest that overexpression of TGF-${\beta}1$ may be involved in the formation of a bulla as well as the alteration of TGF-${\beta}1RII$ expression. Further molecular studies are needed to elucidate the more detailed molecular mechanisms of the bulla formation.

Systemic Candida Infection in Very Low Birth Weight Infants : Epidemiological Features Over 5 Years (극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성)

  • Lee, Seung-Woo;Lee, Jeong-Eun;Lee, Ju-Young;Lee, Hyun-Seung;Lee, Jung-Hyun;Sung, In-Kyung
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.190-196
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    • 2009
  • Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

Predictors of Failed Closure of Patent Ductus Arteriosus with the First Course of Indomethacin in Preterm Infants (미숙아 동맥관 개존에서 인도메타신 1차 투여 후 폐쇄 실패의 예측 인자)

  • Lee, Mong-Young;Lim, Dong-Hee;Park, Kyu-Hee;Ha, Gi-Su;Lee, Jang-Hoon;Choi, Byung-Min;Hong, Young-Sook;Yoo, Kee-Hwan;Lee, Joo-Won
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.75-83
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    • 2010
  • Purpose : This study was performed to determine the predictors of failed closure of a patent ductus arteriosus (PDA) following the first course of indomethacin in symptomatic preterm infants. Methods : Forty three of 43 preterm infants, admitted to the neonatal intensive care unit diagnosed with PDA and treated with indomethacin at the Korea University Medical Center between January 1990 and October 2007, ware studied. The perinatal risk factors affecting the failed closure of PDA were retrospectively assessed. Results : The failed PDA closure group included 16 (37%) out of 43 infants three of whom underwent surgery. The closure group included 27 (63%) out of 43 infants. In the failed closure group, the Apgar scores (1 min, 5 min) were significantly higher (P<0.05) and antenatal steroid administration was significantly lower (P<0.05). In addition, dopamine administration was significantly lower (P<0.05) and the mean postnatal age at diagnosis was significantly lower (P<0.05). Multiple logistic regression for the prediction of failed PDA closure found only antenatal steroid administration (OR 0.092, CI 0,010-0.826, P=0.0331) as an associated factor. Conclusion : In patients with antenatal steroid administration the failed PDA closure rate was significantly lower. Therefore, antenatal steroid administration can be considered as an important factor for the closure of PDA in preterm pregnancies.

Pathogens and Prognotic Factors for Early Onset Sepsis in Very Low Birth Weight Infants (극소 저체중 출생아에서 조기 패혈증의 원인균과 예후인자)

  • Kim, Yi-Sun;Kim, Jin-Kyu;Yoo, Hye-Soo;Ahn, So-Yoon;Seo, Hyun-Ju;Choi, Seo-Heui;Park, Soo-Kyung;Jung, Yu-Jin;Kim, Myo-Jing;Jeon, Ga-Won;Koo, Soo-Hyun;Lee, Kyung-Hoon;Chang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.163-171
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    • 2009
  • Purpose: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants. Methods: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated. Results: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants. Conclusion: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.

Characteristics of stormwter runoff from highways with unit traffic volume (고속도로 자동차 통행량에 따른 강우유출수 유출 특성 분석)

  • Choi, Jiyeon;Hong, Jungsun;Kang, Heeman;Kim, Lee-Hyung
    • Journal of Wetlands Research
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    • v.18 no.3
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    • pp.275-281
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    • 2016
  • This study was conducted to analyze the runoff characteristics of the highway depending on the number of vehicles and to provide the installation proposal of an NPS pollution reduction facility. There were a total of 5 monitoring sites used for the study namely, Gyeongbu, Seohaean, Honam and Tongyeoung Dageon highway. Monitoring events started from 2006 until 2015 having a total of 44 storm events. According to monitoring statistics, the average antecedent dry days (ADD) and rainfall was 6.2 days and 19.2 mm, respectively. The Gyeongbu Highway (H-4) was recorded having the highest Average Daily Traffic and Catchment Area (ADT/CA) with $49.4car/day{\cdot}m^2$ while other site were less than $10car/day{\cdot}m^2$. The average concentration of the NPS pollutants generated from monitoring sites were 63.5 mg/L(TSS), 24.9 mg/L(BOD), 3.35 mg/L(TN), 0.63 mg/L(TP) and 298 ug/L(Total Zn). This exhibited lower values in comparison to the remarks of highway related runoff EMC values published in Korea. Moreover, through the results of the correlation analysis between the contaminant concentration and ADT/CA, $R^2$ value of SS showed the highest correlation with 585. Through the correlation equation between ADT/CA and EMC of TSS, when there is 73.7 mg/L of TSS EMC found from a domestic highway, ADT/CA ratio is normally $13car/day{\cdot}m^2$. Therefore, in a case of more than 13 cars passing through a certain area, the area can be considered and present as the point of generation of nonpoint source pollutants. Also, in this study, since it considered a unit area ADT indicated in previous studies, it was determined that it has a high applicability and utilization in generalized units than conventional study which were conventionally done.

Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children (소아 만성 기능성 변비의 치료 성적과 장기적 예후)

  • Ahn, Yoon Jin;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.200-209
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    • 2006
  • Purpose: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. Methods: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. Results: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was $21.1{\pm}23.5$ (1.9~84.0) months and $47.1{\pm}34.2$ (6.9~138.0) months, respectively. The mean defecation frequency before treatment was $3.2{\pm}2.3$ (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was $34.2{\pm}14.6$ (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was $4.3{\pm}2.4$ (1.0~36.0), $5.0{\pm}1.4$ (0.8~36.0) and $5.0{\pm}3.1$ (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was $2.9{\pm}1.9$ (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. Conclusion: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.

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The Prevalence of Elevated Serum Liver Enzymes in Obese Children (인천 지역내 비만아에서 혈청 간효소치 상승의 유병률)

  • Oh, Yun Jung;Lee, Ji Eun;Son, Byong Kwan;Kim, Soon Ki
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.218-225
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    • 2006
  • Purpose: With a remarkable increase in the prevalence of childhood obesity, the prevalence of nonalcoholic fatty liver disease is assumed to be increasing. The aim of this study is to evaluate the prevalence of nonalcoholic fatty liver disease, hyperlipidemia, and glucose intolerance in normal and obese children. Methods: A total of 2,206 elementary students (boys: 1340, girls: 866) were grouped according to obesity index; normal group and obesity group (mild, moderate, severe). Aspartate aminotransferase (AST, SGOT) and alanine aminotransferase (ALT, SGPT) were measured with total cholesterol, triglyceride, and fasting blood glucose. Results: Compared with the 4.6% of elevated aminotransferases in normal group, obese groups showed significantly higher prevalence; 12.1% in mild obesity group, 19.4% in moderate group, and 21.6% in severe group (p<0.0001). The prevalence of hypertriglyceremia was 16.9% in normal weight group, which was significantly lower than obesity group (mild obesity group 30.3%, moderate and severe 37.6%, 38.2% each). In boys, the prevalences of elevated aminotransferases in normal weight and obese groups (mild, moderate, severe) were 6.8%, 18.0%, 23.0%, and 26.0%, respectively (p<0.0001). In girls, those were 2.1%, 5.1%, 12.0%, and 12.6%, respectively (p< 0.0001). The prevalence of hypertriglyceremia was relative to severity of obesity in boys and girls (p<0.0001). Conclusion: The prevalence of elevated serum liver enzymes increased with severity of obesity. For the prevention and treatment of fatty liver and hypertriglycemia, it is important to lower the obesity degree and enforce the education for a weight loss in the student and the parents.

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Functional analysis of seaR protein identified from Saccharopolyspora erythraea (희소방선균의 seaR 단백질 발현을 통한 기능 분석)

  • Ryu, Jae Ki;Kwon, Pil-Seung;Lee, Hyeong Seon
    • Korean Journal of Microbiology
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    • v.51 no.1
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    • pp.39-47
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    • 2015
  • Secondary metabolism in actinomycetes has been known to be controlled by a small molecule, ${\gamma}$-butyrolactone autoregulator, the binding of which to each corresponding receptor leads to the regulation of the transcriptional expression of the secondary metabolites. We expected that expression of an autoregulator receptor or a pleiotropic regulator in a non-host was to be gained insight of effective production of new metabolic materials. In order to study the function of the receptor protein (seaR), which is isolated from Saccharopolyspora erythraea, we introduced the seaR gene to Streptomyces coelicolor A3(2) as host strains. An effective transformation procedure for S. coelicolor A3(2) was established based on transconjugation by Escherichia coli ET12567/pUZ8002 with a ${\varphi}C31$-derived integration vector, pSET152, which contained int, oriT, attP and $ermEp^*$ (erythromycin promotor). Therefore, the pEV615 was introduced into S. coelicolor A3(2) by conjugation and integrated at the attB locus in the chromosome of the recipients by the ${\varphi}C31$ integrase (int) function. Exconjugant of S. coelicolor A3(2) containing the seaR gene was confirmed by PCR and transcriptional expression of the seaR gene in the transformant was analyzed by RT-PCR. In case of S. coelicolor A3(2), a phenotype microarray was used to analyze the phenotype of transformant compared with wild type by seaR expression. After that, in order to confirm the accuracy of the results obtained from the phenotype microarray, an antimicrobial susceptibility test was carried out. This test indicated that sensitivity of the transformant was higher than wild type in tetracycline case. These results indicated that some biosynthesis genes or resistance genes for tetracycline biosynthesis in transformant might be repressed by seaR expression. Therefore, subsequent experiments, analysis of transcriptional pattern of genes for tetracycline production or resistance, are needed to confirm whether biosynthesis genes or resistance genes for tetracycline are repressed or not.

Agro-Climatic Indices Changes over the Korean Peninsula in CO2 Doubled Climate Induced by Atmosphere-Ocean-Land-Ice Coupled General Circulation Model (대기-해양-지면-해빙 접합 대순환 모형으로 모의된 이산화탄소 배증시 한반도 농업기후지수 변화 분석)

  • Ahn, Joong-Bae;Hong, Ja-Young;Shim, Kyo-Moon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.12 no.1
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    • pp.11-22
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    • 2010
  • According to IPCC 4th Assessment Report, concentration of carbon dioxide has been increasing by 30% since Industrial Revolution. Most of IPCC $CO_2$ emission scenarios estimate that the concentration will reach up to double of its present level within 100-year if the current tendency continues. The global warming has resulted in the agro-climate change over the Korean Peninsula as well. Accordingly, it is necessary to understand the future agro-climate induced by the increase of greenhouse gases in terms of the agro-climatic indices in the Korean peninsula. In this study, the future climate is simulated by an atmosphere/ocean/land surface/sea ice coupled general circulation climate model, Pusan National University Coupled General Circulation Model(hereafter, PNU CGCM), and by a regional weather prediction model, Weather Research and Forecasting Model(hereafter, WRF) for the purpose of a dynamical downscaling. The changes of the vegetable period and the crop growth period, defined as the total number of days of a year exceeding daily mean temperature of 5 and 10, respectively, have been analyzed. Our results estimate that the beginning date of vegetable and crop growth periods get earlier by 3.7 and 17 days, respectively, in spring under the $CO_2$-doubled climate. In most of the Korean peninsula, the predicted frost days in spring decrease by 10 days. Climatic production index (CPI), which closely represent the productivity of rice, tends to increase in the double $CO_2$ climate. Thus, it is suggested that the future $CO_2$ doubled climate might be favorable for crops due to the decrease of frost days in spring, and increased temperature and insolation during the heading date as we expect from the increased CPI.