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Peritonitis in Children Undergoing Peritoneal Dialysis: 10 Years' Experience in a Single Center (소아 복막 투석 환자에서 발생한 복막염: 단일기관에서 10년간의 경험)

  • Lee, Se-Eun;Han, Kyoung-Hee;Jung, Yun-Hye;Lee, Hyun-Kyung;Kang, Hee-Gyung;Cheong, Hae-Il;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.174-183
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    • 2010
  • Purpose : The organisms causing peritonitis and their antibiotic sensitivities vary in different regions and centers, and these data are necessary to establish regional treatment guidelines. The aim of this study was to investigate the changes in incidence and characteristics of the organisms that cause peritonitis in children undergoing peritoneal dialysis (PD) during recent 10 years. Methods : We retrospectively collected and analyzed the data from medical records of 110 children on PD during the period from 2000 to 2010. Results : One hundred and forty episodes of peritonitis have occurred in 57 patients. The overall incidence of peritonitis was 0.43 episodes/patient year, and similar incidence have been maintained since 2003. Sixty percent of the patients experienced peritonitis within 1 year of PD, and all patients commencing PD in infancy experienced peritonitis. Gram positive (G (+)), gram negative (G (-)) organisms and fungi were cultured in 58%, 38%, and 4.1% respectively and cultures were negative in 13.6%. Staphylococcus was the most common G (+) organism, and Pseudomonas and Acinetobacter were 2 most frequent G (-) organisms isolated. Fifty-six percent of the G (+) organisms were sensitive to first generation cephalosporin and 91% of G (-) pathogens were sensitive to ceftazidime. Methicillin-resistance rate was not higher in children less than 2 years of age than in those more than 2 years. Conclusion : An additional breakthrough has to be made to further reduce the incidence of peritonitis. Treatment guideline customized for peritonitis in Korean children on PD need to be established through a nationwide co-work.

Chromosome Aberration in Peripheral Lymphocyte of Radiation Workers in Hospital (병원내 방사선작업종사자들의 염색체이상빈도)

  • Yi, Chun-Ja;Ha, Sung-Whan;Jung, Hae-Won
    • Journal of Radiation Protection and Research
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    • v.22 no.4
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    • pp.227-235
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    • 1997
  • Cytogenetic studies were performed in peripheral blood lymphocytes from hospital workers occupationally exposed to low doses of radiation (0.30 - 40.07mSv). The workers were divided into three groups according to their job area : 18 diagnostic radiology, 17 therapeutic radiology, and 16 nuclear medicine. The control group consisted of 49 non-radiation workers with no history of exposure to radiation. A higher percentage of cells with aberration(1.275%) was observed in the workers compared to the controls(0.677%) and the difference was statistically significant(p<0.001). The frequency of chromosomal aberration was $0.706{\times}10^{-2}$/cell in the exposed and $0.344{\times}10^{-2}$/cell in the control(p<0.05). Chromosomal exchange frequency was $0.083{\times}10^{-2}$/cell in the control vs $0.245{\times}10^{-2}$/cell in the workers. There was no evidence of significant increase of chromosome aberration related to age or to the duration of employment. The frequency of chromosomal exchange in workers of nuclear medicine was $0.313{\times}10^{-2}$/cell, which was significantly higher than in the control($0.083{\times}10^{-2}$/cell) or other working groups: therapeutic radiology($0.265{\times}10^{-2}$/cell), and diagnostic radiology($0.167{\times}10^{-2}$/cell). No dose-effect relation was found between chromosome aberration and total cumulative doses, recent 5 yr, recent 2 yr cumulative dose. But in case of last 1 yr cumulative dose, dose-dependant increase was observed when controls were considered(p<0.05). The radiation dose which workers have received was much lower than the maximum permissible dose, but there was a significant difference in the frequency of chromosome aberration between occupationally exposed workers and control. So, it is clear that chromosome aberration is a quite sensitive indicator of radiation exposure and it can be detected at very low dose level of occupational exposure.

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Significance of brain magnetic resonance imaging(MRI) in the assessment of occupational manganese exposure (직업적 망간 폭로에 있어서 뇌자기공명영상의 의의)

  • 정해관
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.14-30
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    • 1998
  • Manganese is an essential element in the body. It is mainly deposited in the liver and to a lesser degree in the basal ganglia of the brain and eliminated through the bile duct. Rapid turnover of managanese in the body makes it difficult to evaluate the manganese exposure in workers, esecially in those with irregular or intermittent exposure, like welders. Therefore, conventional biomarkers, including blood and urine manganese can provide only a limited information about the long-tern or cumulative exposure to manganese. Introduction of magnetic resonance imaging (MRI) made a progress in the assessment of manganese exposure in the medical conditions related to manganese accumulation, e. g. hepatic failure and long-term total parenteral nutrition. Manganese shortens spin-lattice(T1) relaxation time on MRI due to its paramagnetic property, resulting in high signal intensity (HSI) on T1-weighted image(T1W1) of MRI. Manganese deposition in the brain, therefore, can be visualizedas an HSI in the globus pallidus, the substantia nigra, the putamen and the pituitary. clinical and epidemiologic studies regarding the MRI findings in the cases of occupational and non-occupational manganese exposure were reviewed. relationships between HSI on T1W1 of MRI and age, gender, occupational manganese exposure, and neurological dysfunction were analysed. Relationships betwen biological exposure indices and HSI on MRE werealso reviewed. Literatures were reviewed to establish the relationships between HSI, Manganese deposition in the brain, pathologic findings, and neurological dysfunction. HSI on T1W1 of MRI reflects regional manganese deposition in the brain. This relationship enables an estimation of regional manganese deposition in the brain by analysing MR signal intensity. Manganese deposition in the brain can induce a neuronal loss in the basal ganglia but functional abnormality is supposed to be related to the cumulative exposure of manganese in the brain, use of brain MRI for the assessment of exposure in a group of workers seems to be hardly rationalized, while ti can be a useful adjunct for the evaluation of manganese exposure int he cases with suspected manganese-related health problems.

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Development of nutrition quotient for elementary school children to evaluate dietary quality and eating behaviors (학령기 아동 대상 영양지수 개발과 타당도 검증)

  • Lee, Jung-Sug;Hwang, Ji-Yun;Kwon, Sehyug;Chung, Hae-Rang;Kwak, Tong-Kyung;Kang, Myung-Hee;Choi, Young-Sun;Kim, Hye-Young
    • Journal of Nutrition and Health
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    • v.53 no.6
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    • pp.629-647
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    • 2020
  • Purpose: This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. Methods: The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. Results: Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. Conclusion: Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.

A Study on Way to Revitalize the Service Delivery System in the Hinterland Villages in Non-Urbanized Area (비도시지역 배후마을 서비스전달체계 활성화방안 연구)

  • Haechun Jung;Heeseung Yang
    • Journal of Environmental Impact Assessment
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    • v.32 no.6
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    • pp.533-544
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    • 2023
  • The Ministry of Agriculture, Food and Rural Affairs has been promoting policies to strengthen the functions of rural centers (culture, welfare, economy, education, etc.) and to ensure that services from the centers are delivered to and connected to hinterland villages. For this policy purpose, the rural center revitalization project and the basic living base creation project within the rural development projects are being promoted. However, in the process of carrying out the actual project, as the focus is on strengthening the functions of rural centers, service delivery and connection with hinterland villages are not being actively promoted. therefore, in this study, we analyze the projects previously carried out in Jeoksang-myeon, Muju-gun and the regional status, analyze the reasons why hinterland village services were not connected and activated, and propose a direction for the second phase of the basic living base creation project to be carried out in the future. As a result of analyzing the reasons for the failure of hinterland village services to be activated, problems such as disadvantages in accessing services due to dispersed residence in rural areas and limitations in topographical structure, and the lack of a service delivery system to develop demand in hinterland areas were found to be problems. Improvement measures were derived as follows. First, it is a stepping stone construction plan proposed to overcome topographical limitations. Establish a stepping base that will function as a service intermediate terminal to ensure efficient service delivery. Second, for a rational decision-making structure, we proposed a plan for deploying communication channels that could closely collect local opinions by operating various small-scale communities along with the efficient composition of a resident committee that includes residents of the central and hinterland villages and various classes. Third, it is a virtuous cycle of local manpower training plans that train local residents into professional instructors. We aim to complete a sustainable, resident-led service supply system by nurturing the most important service deliverers, that is, activists, in service delivery.

Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon (직장풍선을 삽입한 전립선암 환자의 수술 후 방사선 치료 시 용적변조와 세기변조방사선치료계획 비교 평가)

  • Jung, hae youn;Seok, jin yong;Hong, joo wan;Chang, nam jun;Choi, byeong don;Park, jin hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.45-52
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    • 2015
  • Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

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