• Pediatric Infection and Vaccine
• /
• v.18 no.2
• /
• pp.135-142
• /
• 2011

Purpose : Hospital associated infection (HAI) caused by multidrug-resistant (MDR) microorganisms has been recognized as an important issue in the world, especially in critically ill patients such as the patients admitted in the intensive care unit. There are fewer papers about MDR-HAI in pediatric patients compared to adult patients. In this study, we investigated the incidence and associated factors of MDR-HAI in children admitted to the intensive care unit (ICU) of a university hospital. Methods : We retrospectively evaluated 135 children who were admitted in ICU for at least 3 days between January 2009 and December 2010. HAI cases were divided into MDR-HAI group and non-MDR-HAI group. Clinical characteristics and various associated factors were compared between those groups. Results : In 39 patients, 45 cases of ICU-related HAI were developed. ICU-related HAI incidence was 47.7 per 1000 patientdays. Thirty-six cases (80.0%) were MDR-HAI. Acinetobacter baumannii was isolated more commonly in MDR-HAI group. And the followings were found more frequently in MDR-HAI group than non-MDR-HAI group: medical condition as an indication for ICU admission, mechanical ventilation, urinary catheterization and previous use of broad-spectrum antibiotics. Among the risk factors, previous use of broad-spectrum antibiotics was the independent risk factor for MDR-HAI. Conclusion : ICU-related HAI incidence was higher than previously reported. Previous use of broad-spectrum antibiotics was the independent risk factor for MDR-HAI. To investigate the characteristics of MDR-HAI in children admitted in ICU, further studies with a larger sample size over a longer period of time are warranted.

• Pediatric Infection and Vaccine
• /
• v.18 no.2
• /
• pp.154-162
• /
• 2011

Purpose : The aim of this study was to identify the clinical characteristics of lower respiratory tract infection due to respiratory syncytial virus (RSV) in young children and to provide information for an effective guideline for palivizumab administration in Korea. Methods : We reviewed medical charts of 167 patients under 3 years of age who were hospitalized in Dongguk University Ilsan Hospital for lower respiratory tract infection between January 2007 and February 2011. Diagnosis of the virus was made based on the multiplex real time polymerase chain reaction. Results : There were 113 patients who were infected by respiratory syncytial virus. 90 patients were term infants and 23 patients were preterm infants. No difference was shown between term and preterm infants except the days of admission which was 9.0${\pm}$6.0 days and 12.6${\pm}$21.0 days respectively. In the preterm group their mean age at the time of admission was 5.21${\pm}$4.9 months and the mean gestational age was 33.1${\pm}$4.3 weeks, and the mean birth weight was 2,152${\pm}$950 g. Only 4 patients were born under 28 weeks gestational age and were candidates for palivizumab administration. Conclusion : Most of the patients with severe RSV lower respiratory tract infection were term or near term infants who were not candidates for palivizumab prophylaxis. A nationwide study is needed to make a new risk stratified guideline for RSV prophylaxis for our country.

• Childhood Kidney Diseases
• /
• v.9 no.1
• /
• pp.38-45
• /
• 2005

Purpose : The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. Methods : Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number an[;. method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. Results : The patients' ages ranged from 26 mont]Is to 16 years of age, and the mean age was 9.9 years. There were S males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic svndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly Progressive glomerulonephritis(RPGN), 1 case of focal segmental glomorulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemoIThage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. Conclusion : Although it is presumptuous to generalize the therapeutic effects of plasma pheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.

• Childhood Kidney Diseases
• /
• v.17 no.2
• /
• pp.57-64
• /
• 2013

Purpose: In children, 24-hour urine collections are unreliable for evaluating glomerular filtration rate (GFR) because of the difficulty of regulating voiding and the daily variation of urinary creatinine up to 25%. Additionally, creatinine clearance (Ccr) based on urinary creatinine is considered inaccurate. The purpose of this study was to compare estimated GFR determined using Ccr, formulas with serum cystatin C and creatinine, and $^{99m}Tc$-mercaptoacetyltriglycine (MAG3) dynamic renal scintigraphy. Methods: This retrospective study included 101 patients (age, <18 years) who visited Chung-Ang University Hospital between July 2011 and August 2012. GFR was estimated using 24-hour urinary creatinine, five formulas with serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan. Results: Of the 101 patients, glomerular renal diseases were present in 60 patients (59.4%) and non-glomerular diseases were present in 41 patients (40.6%). There was a significant correlation between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and Ccr (r=0.389, P <0.001). The correlation values between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and each formula of Schwartz, Counahan-Barratt, Cockcroft-Gault, Filler and Lepage, and Bokencamp were 0.265 (P=0.007), 0.128 (P=0.044), 0.230 (P=0.021), 0.356 (P<0.001), and 0.355 (P <0.001), respectively. $^{99m}Tc$-MAG3 renal scan was correlated with estimated-GFR by all formulas in decreased renal function. Conclusion: Estimated GFRs determined using serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan correlated well with estimated GFR determined using Ccr. $^{99m}Tc$-MAG3 renal scan may be replaced for evaluation of renal function with convenience in patients with renal disease and decreased renal function in childhood.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
• /
• v.8 no.2
• /
• pp.111-120
• /
• 2003

To describe dinoflagellate cysts from Gwangyang Bay, surface sediment samples were collected at 20 sites by the TFO core sampler on 24 August 2001, in coupled with a phytoplankton investigation by surface seawater sampling. More than 17 genera, 36 species of dinoflagellate cysts were Identified from the sediment samples of Gwangyang Bay, consisting of 14 species of gonyaulacoid, 14 species of protoperidinioid, 3 species of diplopsalid, 2 species of gymnodinioid, 1 species of tuberculodinioid and calciodinellid, respectively. Cyst concentrations in Gwangyang Bay varied from 115 to 2,188 cysts/g, and generally increased toward a western part of the study area. The highest cyst concentration was observed at St. 11 located in the northwestern region with 11 genera and 19 species(2,188 cysts/g), while the lowest value with 6 genera and 9 species(115 cysts/g) was observed at St. 3 located in the center of the study area. The predominant dinoflagellate cyst was Spiniferites bulloideus, followed by Alexandrium sp., Brigantedinium simplex and S. delicatus. The motile forms of eight dinoflagellate cysts recorded in the sediment samples were also observed in the seawater: Polykrikos swartzii/kofoidii complex, Scripssiella trochoidea, Protoperidinium claudicans(cyst name: Votadinium spinosum), P. pentagonum(: Trinovantedinium capitatum capitatum), P. conicum(: Selenopemphix quanta), P. leonis(: Quinquecuspis concretum), P. conicoides(: Brigantedinium simplex), Gonyaulax spp.(: Spiniferites spp.). In this study, heterotrophic dinoflagellate cysts show the highest concentration at St. 6 where the highest density of diatoms simultaneously observed from surface water sample. This result suggests that the grazing of heterotrophic dinoflagellates on the diatoms in high concentration caused the higher concentration of heterotrophic dinoflagellate cysts.

• Journal of Food Hygiene and Safety
• /
• v.29 no.2
• /
• pp.79-84
• /
• 2014

This study has been performed for about 270 days at analyzing biologically hazardous factors in order to develop HACCP system for the non heat-frozen carrot juice. A process chart was prepared by manufacturing process of raw agricultural products of non heat-frozen carrot juice, which was contained water and packing material, storage, washing, cutting, extraction of the juice, internal packing, metal detection, external packing, storage and consignment (delivery). As a result of measuring Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, Enterohemorrhagic E. coli before and after washing raw carrot, Standard plate count was $4.7{\times}10^4CFU/g$ before washing but it was $1.2{\times}10^2CFU/g$ detected after washing. As a result of testing airborne bacteria (Standard plate count, Coliform group, Yeast and Fungal) depending on each workplace, number of microorganism of in packaging room, shower room and juice extraction room was detected to be 10 CFU/Plate, 60 CFU/Plate, 20 CFU/Plate, respectively. As a result of testing palm condition of workers, as number of Standard plate count, Coliform group and Staphylococcus aureus was represented to be high as $6{\times}10^4CFU/cm^2$, $0CFU/cm^2$ and $0CFU/cm^2$, respectively, an education and training for individual sanitation control was considered to be required. As a result of inspecting surface pollution level of manufacturing facility and devices, Coliform group was not detected in all the specimen but Standard plate count was most dominantly detected in scouring kier, scouring kier tray, cooling tank, grinding extractor, storage tank and packaging machine-nozzle as $8.00{\times}10CFU/cm^2$, $3.0{\times}10CFU/cm^2$, $4.3{\times}10^2CFU/cm^2$, $7.5{\times}10^2CFU/cm^2$, $6.0{\times}10CFU/cm^2$, $8.5{\times}10^2CFU/cm^2$ respectively. As a result of analyzing above hazardous factors, processing process of ultraviolet ray sterilizing where pathogenic bacteria may be prevented, reduced or removed is required to be controlled by CCP-B (Biological) and critical level (critical control point) was set at flow speed is 4L/min. Therefore, it is considered that thorough HACCP control plan including control criteria (point) of seasoning fluid processing process, countermeasures in case of its deviation, its verification method, education/training and record control would be required.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.30 no.5
• /
• pp.986-992
• /
• 2001

To assess the food intake and diet quality of middle school students who live in Kangneung area, a dietary survey using 3-day food record was conducted with 226 subjects. Seventy five percent of total food intake was in the form of plant foods and the rest in the form of animal food. Diet qualify was assessed by food group pattern, dietary diversity score (DDS), and dietary variety score (DVS). When counting the major food groups consumed, 53% of subjects had a DDS of 3 and 35% of subjects had a DDS of 4. When investigating the consumption pattern of the major five food groups, only 10.2% of subjects consumed foods from all five groups. The groups most frequently missed were dairy products (73.0%) and fruits (71.7%). On average, subjects habitually consumed 22.6 different foods daily, with the mean score of diet variety for males (22.1) being significantly lower than for females (22.9). Correlation coefficients between nutrient adequacy ratio (NAR) and DVS ranged from r=0.40 for vitamin B$_1$to r=0.61 for phosphorus. NAR also improved as the number of foods or food groups consumed increased (p<0.001). Associations between the NAR and high level of DVS was more positive than those between the NAR with DDS. When assessing the dietary quality of subjects using DDS and DVS, many people appeared not to have a desirable food intake. Therefore, to lead them to have nutritionally balanced diet, educating students and their parents on nutrients and suggesting guidelines for a desirable diet is considered to be essential so that they can intake from all of major food groups and have various foods in their diet.

• Journal of Yeungnam Medical Science
• /
• v.22 no.2
• /
• pp.211-220
• /
• 2005

Background: The purpose of this study was to determine the effectiveness of a percutaneously placed self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral selfexpanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cases of Bismuth type II, 21 cases of Bismuth type IIIa, 8 cases of Bismuth type IIIb and 15 cases of Bismuth type IV. Stent placement was technically successful in all patients. All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage rate of 91.1%. There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method for palliation of patients with hilar cholangiocarcinoma.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.4
• /
• pp.342-349
• /
• 2019

Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

• Korean Journal of Heritage: History & Science
• /
• v.47 no.1
• /
• pp.164-179
• /
• 2014

The Buddhas of the Three Words in a form of arranging Bhaiṣajyaguru and $Amit{\bar{a}}bha$ at its side based on ${\acute{S}}{\bar{a}}kyamuni$ at the center is enshrined in Daeungbojeon Hall of Daeheungsa Temple located at Haenam. So far, this Buddhas of the Three Words has been known as a wooden Buddha statue. However, as a result of X-ray screening, in left/right Buddha statues excepting main Buddha, wood and molding clay layer were observed at the same time. Therefore, this study intended to observe its internal structure, grafting method and to clarify making technique of Buddha statue during Joseon era based on image information being obtained through X-ray screening of The Buddhas of the Three Words of Daeheungsa Temple. As its result, it was revealed that form of ${\acute{S}}{\bar{a}}kyamuni$ was completed by mainly grafting 5 pieces of timber and this statue shows a typical wood grafted Buddha statue during Joseon era. Form of Bhaiṣajyaguru and $Amit{\bar{a}}bha$ were completed based on molding technique by applying clay on sculpture similar to its appearance after sculpturing more than 10 pieces of timber through its grafting. In other words, internal timber is considered to play a role of its core and grafting method of timber is more close to a technique of molding Buddha statue than to that of wooden Buddha statue during Joseon era. However, clay was directly applied on timber thinly, not applying clay thickly on it after winding straw rope on wooden core and its characteristic is that its facial area was completely composed of wooden construction only. Therefore, it is hard to rule out a possibility that the original sculpturing intention of an artist might be a wooden Buddha statue but in view of the fact that a word, 'molding' was used in a record of relics buried in statue, it could be seen that this Buddha statue might have been recognized as a molding statue at the time when creation of this statue was completed. It is considered that number of case of making statue based on this technique would be more increased when more results of X-ray screening should be accumulated and if more data should be collected, it would provide a significant evidence for identifying chronological, regional aspects of making technique of Buddha statue.