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The Effects of Catheter Revision and Mupirocin on Exit Site Infection/Peritonitis in CAPD Patients (복막 투석 환자에서 도관 관련 감염 및 복막염에 대한 Mupirocin과 도관 전환술(Catheter revision)의 효과)

  • Park, Jun-Beom;Kim, Jung-Mee;Choi, Jun-Hyuk;Jo, Kyu-Hyang;Jung, Hang-Jae;Kim, Yeung-Jin;Do, Jun-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.347-356
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    • 1999
  • Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI. we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt. mon and 1 per 2l.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA. 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for refractory ESI/TI before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

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KOREAN CHILD AND ADOLESCENT PSYCHIATRY - A REVIEW OF THE PAST, THE PRESENT AND THE FUTURE - (한국 소아 ${\cdot}$ 청소년정신의학 - 과거 ${\cdot}$ 현재 ${\cdot}$ 미래 -)

  • Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.139-149
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    • 2003
  • Objectives:To review the history of the development and current status of Korean Child and Adolescent Psychiatry and to propose the future tasks at this 20th anniversary of Korean Academy of Child and Adolescent Psychiatry. Methods:Records and publications of Korean Academy, personal communications with senior members of the Academy, the author's recollections and memoirs. Results:Korean Child Psychiatry started with opening Child Psychiatry Clinic at Seoul National University Hospital in 1979 and establishing Division of Child and Adolescent Psychiatry at the same hospital in 1980. A Child Psychiatry Study Group was formed in 1983 and it transformed into Korean Academy of Child and Adolescent Psychiatry in 1986. In the past 20 years, Korean child and adolescent psychiatry made an impressive progress and contributed significantly to the development of Korean medicine as well as to the establishment of child mental health service. There are 77 board-certified and 48 board-eligible child psychiatrists, and 18 child psychiatry fellows are in training as of 2003. Main forces of this successful introduction of child psychiatry are 1) 7 child psychiatry training centers at major university hospitals, 2) publication of Korean Journal of Child and Adolescent Psychiatry in 1990, 3) the establishment child psychiatry board certification system in 1996. Korean child psychiatry has extended its role in the international child psychiatry and took leadership in establishing Asian Society of Child and Adolescent Psychiatry and Allied Professions(ASCAPAP). Conclusion:Korean child psychiatry has achieved a remarkable progress for the past 20 years and is currently producing 15 or more child psychiatry each year. However, there are needs of more active involvements in adolescent problems, more active consultation-liaison services at general hospitals as well as community mental health institutions. More school consultation and preventive educational services are desired. There is a urgent need of carrying out more empirical studies with strong scientific rigor. Korean Academy should pay attention and provide assistance to the development of child psychiatry service in other countries in Asia.

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A Study on the Impact of General Characteristics on Achievement Motivation in Dental Hygiene Students (치위생과 학생들의 일반적인 특성이 성취동기에 미치는 영향 연구)

  • Youn, Hye-Jeong;Lim, Sun-A;Kim, Soo-kyung
    • Journal of dental hygiene science
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    • v.11 no.5
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    • pp.389-395
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    • 2011
  • The purpose of this study was to examine dental hygiene students' achievement motivation and factors affecting dental hygiene students' achievement motivation by the general characteristics of subjects in this study. The subjects in this study were 450 who were selected by convenience sampling from three different three-year-course colleges. After a survey was conducted, the answer sheets from 421 respondents were analyzed. The collected data were analyzed, which made use of t-test, ANOVA and Kruscal-Wallis test. The findings of the study were as follows. 1. The dental hygiene students investigated got 3.34 in achievement motivation. They got the highest score of 3.78 in the item 'I perform what I have to do with a sense of responsibility.' and they got the lowest score of 2.67 in the item 'I like to do something risky.' 2. Concerning links between their general characteristics and achievement motivation, the students whose academic year was higher(p<0.001) and who had more clinical practice experiences (p<0.01) were better motivated than their counterparts. As to connections between achievement motivation and expected post-graduation length of service, those who replied that they planned to find another job after getting married were better motivated(p<0.05). Regarding relationship between achievement motivation and a will to work abroad, the students who had a stronger will to work abroad were better motivated. 3. As a result of checking the influence of their general characteristics on achievement motivation, stronger motivation was found among the students whose academic year was higher(p<0.01), who intended to work until marriage(p<0.01) and who didn't plan to keep working after marriage(p<0.05) when the other variables were controlled. Therefore dental hygiene students should be taught to look at things positively when they enter college, and they should also be educated to become progressive to keep working for their lifetime instead of just getting a temporary job after graduation.

Effect of Internal Marketing Activities on Motivating Dental Hygienists (내부마케팅 활동이 치과위생사의 동기부여에 미치는 영향)

  • Han, Ji-Hyoung;Ahn, Eunsuk
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.43-50
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    • 2014
  • The purpose of this study was to examine the influence of internal marketing activities on motivating dental hygienists in dental hospital in an effort to be of use for setting strategies geared toward boosting the productivity of dental hygienists. The findings of the study were as follows: Concerning internal marketing activities by general characteristics, the dental hygienists who received 4-year college or higher education received more education than the college graduates ($p{\leq}0.001$). As for the leave system, the dental hygienists who worked in general hospitals (p=0.011) and sited in Chungcheongnam-do ($p{\leq}0.001$) replied more leaves were provided. In terms of welfare benefits, there were significant differences in those regards according to the type of hospital (p=0.029) and service area ($p{\leq}0.001$). As to the reward system, their responses about this system were similar to their responses about education & training, leaves and welfare benefits. The motivating factors consisted of 6 motivation factors and 10 hygiene factors. The motivation factors included an opportunities to develop ability and appropriate training to their work. The hygiene factors involved implement of policies and procedures, work environments, relationship with colleagues. Regarding awareness of the motivation factors by general characteristics, there were differences in that aspect according to age (p=0.043), and their awareness of the hygiene factors was different according to service area (p=0.038). As a result of analyzing which factors affected motivating, the leave system (p=0.038) and communication (p=0.001) that belonged to the internal marketing activities were identified as the influential motivation factors. In terms of the hygiene factors, age and service area were influential among the general characteristics (p=0.047, p=0.045). Above findings of the study suggest that it will be possible for dental institutions to ensure successful management by conducting internal marketing activities tailored to the characteristics of their organizational members and by motivating dental hygienists especially through communication.

The Clinical Considerations of Serous Otitis Media and Ventilation Tube (삼출성중이염과 중이내 통기관 유치술의 임상적 고찰)

  • 김영명;박인용;장태영;심형보
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.14.2-15
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    • 1982
  • Serous otitis media (SOM) is one of the most common otologic diseases which was first discribed by Politzer in 1869. Currentely, among many methods introduced to treat SOM, ventilation tube insertion is considered to be the most popular and standard method being used. However due to complication of it, there remains many disputable various problems. In order to review the clinical aspect of SOM and search for the effects and safety of ventilation tube, we studied 97 SOM patients, who had performed V-tube from Jan. 1981 to Feb. 1982 at ENT dept. of Severance Hospital. Analizing the clinical symptoms, age distribution, associated disease, otoscopic findings of ear drum, degree of hearing loss, hearing gain after insertion of V-tube and complications, following results were obtained. 1) As a subjective symptom, among 29 cases all patients had hearing loss, 19 cases (65.6%) had tinnitus, 12 cases (44.4%) had autophony and 10 cases (34.5%) of the patients had sensation of ear fullness. 2) In age distribution, 6 to 10 year old group was most numerous up to 42 cases (43.3%) and 20 years and over was 23 cases (23.5%) 3) In adult group SOM tend to be involved unilaterally whereas young child group had tendency involving bilaterally. 4) 49 cases (50.05%) were associated with tonsillitis and adenoid vegetation, 15 cases (15.5%) were associated with sinusitis, 4 cases (4.1%) had nasal allergy. 5) In preoperative otoscopic findings, 62 ears (47.7%) had retraction, 37 ears (23.6%) had bulging, 34 ears (21.7%) had color change, and 29 ears (19.7%) had no significant findings. 6) In characteristics of middle ear fluid, child group was tend to have mucinous content (84.2%) while adult group had serous content (62.5%). 7) Average preoperative air-bone gap of pure tone was 25.3 dB. 8) 24 ears (72.7%) had over 10 dB of postoperative hearing gain and average hearing gain was 17.2 dB. 9) There were 44 ears (28.1%) of complications. Among them 37 ears (23.6%) had infection, 3 ears had atelectasis, 2 ears had granulation tissue, 2 ears had permanent perforations. 10) Among 37 ears suffered from post-op. infection, 19 ears (51.4%) had initial infection just after insertion of ventilation tube, 18 ears (48.6%) were infected during the course of post-ventilation tube. Of 37 infected ears, 26 ears (70.3%) responded to conservative care, while 11 ears (29.7%) was cured after removal of ventilation tube.

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Development of an Emergence Model for Overwintering Eggs of Metcalfa pruinosa (Hemiptera: Flatidae) (미국선녀벌레(Metcalfa pruinosa) (Hemiptera: Flatidae) 월동난 부화 예측 모델 개발)

  • Lee, Wonhoon;Park, Chang-Gyu;Seo, Bo Yoon;Lee, Sang-Ku
    • Korean journal of applied entomology
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    • v.55 no.1
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    • pp.35-43
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    • 2016
  • The temperature-dependent development of Metcalfa pruinosa overwintering eggs was investigated at ten constant temperatures (12.5, 15, 17.5, 20, 22.5, 25, 27.5, 30, 32.5, and $35{\pm}1^{\circ}C$, Relative Humidity 20~30%). All individuals collected before April 13, 2012 failed to develop into first instar larvae. In contrast, some individuals that were collected on April 11, 2013 successfully developed when reared under $20{\sim}32.5^{\circ}C$ temperature regimes. The developmental duration was shortest at $30^{\circ}C$ (13.3 days) and longest at $15^{\circ}C$ (49.6 days) in the fourth collected colony (April 26 2013). Developmental duration decreased with increasing temperature up to $30^{\circ}C$ and development was retarded at high-temperature regimes ($32.5^{\circ}C$). The lower developmental threshold was $10.1^{\circ}C$ and the thermal constant required to complete egg overwintering was 252DD. The Lactin 2 model provided the best statistical description of the relationship between temperature and the developmental rate of M. pruinosa overwintering eggs ($r^2=0.99$). The distribution of the developmental completion of overwintering eggs was well described by the 2-parameter Weibull function ($r^2=0.92$) based on the standardized development duration. However, the estimated cumulative 50% spring emergence dates of overwintering eggs were best predicted by poikilotherm rate model combined with the 2-parameter Weibull model (average difference of 1.7days between observed and estimated dates).

An Experimental Study on Dynamic Behavior Evaluation of Transitional Track (접속부 궤도의 동적거동분석을 위한 실험적 연구)

  • Cho, Sung-Jung;Choi, Jung-Youl;Chun, Dae-Sung;Kim, Man-Cheol;Park, Yong-Gul
    • Proceedings of the KSR Conference
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    • 2007.11a
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    • pp.1379-1385
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    • 2007
  • In domestic transitional zone design, there is regulation to prevent generation of irregular substructure behaviors that negatively influence in prevention of plasticity settlement on approach section and contact section as well as relieve overall track rigidity by reducing sectional foundation and track stiffness difference, but design guideline that considers dynamic behavior of transitional track in actual service line is very insignificant. Therefore in this study, characteristics of transitional track dynamic behaviors by substructure stiffness are researched and measured dynamic response of transitional track by substructure stiffness in order to prove correlation between substructure and track and calculate elasticity(stiffness) and track load of transitional track by using measurement and formula to provide basic information for developing design guideline considering dynamic behavior of service line transitional track.

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A Dynamic Behavior Evaluation of the Curved Rail according to Lateral Spring Stiffness of Track System (궤도시스템의 횡탄성에 따른 곡선부 레일의 동적거동평가)

  • Kim, Bag-Jin;Choi, Jung-Youl;Chun, Dae-Sung;Eom, Mac;Kang, Yun-Suk;Park, Yong-Gul
    • Proceedings of the KSR Conference
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    • 2007.11a
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    • pp.517-528
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    • 2007
  • Domestic or international existing researches regarding rail damage factors are focused on laying, vehicle conditions, driving speed and driving habits and overlook characteristics of track structure (elasticity, maintenance etc). Also in ballast track, as there is no special lateral spring stiffness of track also called as ballast lateral resistance in concrete track, generally, existing study shows concrete track has 2 time shorter life cycle for rail replacement than ballast track due to abrasion. As a result of domestic concrete track design and operation performance review, concrete track elasticity is lower than track elasticity of ballast track resulting higher damage on rail and tracks. Generally, concrete track has advantage in track elasticity adjustment than ballast track and in case of Europe, in concrete track design, it is recommended to have same or higher performance range of vertical elastic stiffness of ballast track but domestically or internationally review on lateral spring stiffness of track is very minimal. Therefore, through analysis of service line track on site measurement and analysis on performance of maintenance, in this research, dynamic characteristic behaviors of commonly used ballast and concrete track are studied to infer elasticity of service line track and experimentally prove effects of track lateral spring stiffness that influence curved rail damage as well as correlation between track elasticity by track system and rail damage to propose importance of appropriate elastic stiffness level for concrete and ballast track.

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A marine deep-towed DC resistivity survey in a methane hydrate area, Japan Sea (동해의 메탄 하이드레이트 매장 지역에서의 해양 심부 견인 전기비저항 탐사)

  • Goto, Tada-Nori;Kasaya, Takafumi;Machiyama, Hideaki;Takagi, Ryo;Matsumoto, Ryo;Okuda, Yoshihisa;Satoh, Mikio;Watanabe, Toshiki;Seama, Nobukazu;Mikada, Hitoshi;Sanada, Yoshinori;Kinoshita, Masataka
    • Geophysics and Geophysical Exploration
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    • v.11 no.1
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    • pp.52-59
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    • 2008
  • We have developed a new deep-towed marine DC resistivity survey system. It was designed to detect the top boundary of the methane hydrate zone, which is not imaged well by seismic reflection surveys. Our system, with a transmitter and a 160-m-long tail with eight source electrodes and a receiver dipole, is towed from a research vessel near the seafloor. Numerical calculations show that our marine DC resistivity survey system can effectively image the top surface of the methane hydrate layer. A survey was carried out off Joetsu, in the Japan Sea, where outcrops of methane hydrate are observed. We successfully obtained DC resistivity data along a profile ${\sim}3.5\;km$ long, and detected relatively high apparent resistivity values. Particularly in areas with methane hydrate exposure, anomalously high apparent resistivity was observed, and we interpret these high apparent resistivities to be due to the methane hydrate zone below the seafloor. Marine DC resistivity surveys will be a new tool to image sub-seafloor structures within methane hydrate zones.

문경지역에 분포하는 변성 염기성암과 변성 퇴적암에 대한 백악기 화강암의 열변성작용

  • 오창환;김성원;김종섭
    • The Journal of the Petrological Society of Korea
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    • v.2 no.2
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    • pp.74-94
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    • 1993
  • Metabasites and metapelites in the Mungyong area were intruded by Cretaceous granites with radius of 4-8 km. As the distance from granite body increases, the mineral assemblage of metabasite changes from amphibole + plagioclase through amphibole + plagioclase + epidote to amphibole + plagioclase + epidote + chlorite. The compositional variations of amphibole and plagioclase according to the change of metamorphic grade and bulk rock compositions are very complex. Towards the Mungyong Cretaceous granite body, the mineral assemblage of metapelite changes from chlorite+ muscovite(ch1orite zone) through biotite + chlorite + muscovite(biotite zone) to andalusite+biotite + muscovite${\pm}$chlorite or cordierite+ biotite+ muscovite${\pm}$chlorite(cordierite zone). The estimated metamorphic conditions of cordierite zone are 480~$580^{\circ}C$ 1.5-3.3 kb. The theoretical study on the thermal metamorphism caused by the Cretaceous granite with radius longer than 4 km in the Mungyong area suggests the followings: The degree of metamorphism is mainly determined not by the size of granite body but by the temperature of granite intrusion; The country rocks within 2 km from Cretaceous granite have undergone metamorphism with temperature higher than $500^{\circ}C$, which is consistent with the petrological study in the Mungyong area. Mungyong Cretaceous granite caused a low P/T thermal metamorphism to the country rocks; the amphibolite facies metamorphism to the country rocks within 1-2 km from the granite body and the epidote-amphibolite and greenschist facies metamorphism to the country rocks within 2-5 km.

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