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The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009 (최근 6년간 소아청소년기 급성 화농성 골관절염의 원인균과 임상 양상; 2003-2009)

  • Choi, Jin Hyoung;Choe, Young June;Hong, Ki Bae;Lee, Jina;Yoo, Won Joon;Kim, Han Soo;Park, Moon Seok;Cho, Tae Joon;Chung, Chin Youb;Lee, Hoan Jong;Choi, In Ho;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.31-39
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    • 2011
  • Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

The Clinical Experiences of "New Duromedics Valve" Replacement (새로운 Duromedics 인공판막 치환의 임상고찰)

  • Gang, Myeon-Sik;Yu, Gyeong-Jong;Yun, Chi-Sun;Park, Han-Gi
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.979-985
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    • 1997
  • Between October 1991 and May 1995, 256 "New Duromedics Valve"(Edward TEKNA Bileaflet Valve) were implanted in 208 adult patients(171 mitral, 82 aortic and 3 tricuspid) with age ranging from 18 years to 70 years(mean 48.2$\pm$ 11.6 years). Postoperative complication rates were 12.2%, but there was none valve related one. Overall early mortality rate were 1.4%(1.6% for MVR, 2.1% for DVR, and none for AVR or TVR) respectively. Follow-up was 99% completed ranging in duration from 2 months to 46 months. There were 6 valve-related late complications(2.9%) with 2 patients with upper gastrointestinal bleeding, 2 with cerebral thxomtioembolism, 1 with valve thrombosis and 1 with valve endocarditis. Freedom from these valve-related major complications were 89.9% at 40 months. There were 5 late deaths(2.4%). one of these late deaths was considered valve-related. Overall actuarial survival rates at 40 months were 95.5%, 96.8% for mitral, 97.1% for aortic, 100% for tricuspid, and 92.0% for double valve replacement respectively. Preoperative New York Heart Association functional class were 2.9, and 1.3 in post-operative state. We have been trying to keep the international normalized ratio(INR) with range of 2.5 to 3.0. The INR of 4 patients of 5 with anticoagulant ralated complications was beyond the range. To reduce the rate of anticoagulant related complications, we felt very strongly that the INR should be kept between 2.5 and 3.0. In our cases, there was no structural failure or significant hemolysis in the absence of periprosthetic leak. This experience encourages us to continue using the "New Duromedics Valve".omedics Valve".uot;.

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An Exploratory Study of REID Benefits for Apparel Retailing (의류소매업에서의 RFID 이점에 대한 탐색적 연구)

  • Kim, Hae-Jung;Kim, Eun-Young
    • Journal of the Korean Society of Clothing and Textiles
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    • v.30 no.12 s.159
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    • pp.1697-1707
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    • 2006
  • Relentless advances in information technology are constantly transforming market dynamics of the retail industry. RFID is an emerging innovative technology that can reduce labor costs, improve inventory control and increase sales by effective business processes. Apparel retailers need to recognize the benefits of RFID and identify critical success factors. By focusing on apparel retailers, this study attempts (1) to identify the reality of RFID associated with benefits; and (2) to prospect the implementation of RFID in apparel retailing. We conducted a focus group interview with selected six panels who were experts of retail industry in the United States to obtain data regarding RFID attributes. Content analysis was used to generate related excerpts and classify 31 attributes of RFID benefits from the meaningful 173 responses. For experience of RFID, retailers were familiar with RFID technology and expressed the belief that RFID basically would support an existing retail system for speed to markets. However, retailers addressed the level of experience with RFID technology that they were still in the early adoption stage among few innovative companies. The content analysis identified five dimensions of RFID benefits for apparel retailing: Visibility and Velocity, Revenue Enhancement, Customer Service, Security, and Employee Productivity. This result lends support to the belief that RFID has a significant potential to streamline supply chain management, store operation and customer service for apparel retailing. This study provides intellectual and managerial implications far practitioners and researchers by postulating the effective use of RFID in the apparel retail industry.

Effect on Myopia Progression Wearing Eye-glasses for School Children (학령기 아동의 안경착용이 근시진행에 미치는 영향)

  • Lee, Seok-Ju;Park, Seong-Jong;Chun, Young-Yun
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.2
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    • pp.195-200
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    • 2011
  • Purpose: We analyzed the influence of myopic's eye-glasses wearing on myopia progress after cycloplegic refraction. Methods: The 33 people (66 eyes) were school children from 8 years to 12 years having no experience eye-glasses wearing, they were taken cycloplegic refraction at the 100th, the 200th and 300th days in order to evaluate myopia progression. We investigated the eye-glasses wearing group (experimental group, 32 eyes) and the non-eye-glasses wearing group (control group, 34 eyes). The eye-glasses power of the experimental group were -0.50 D, -0.75 D, -1.00 D, -1.25 D and -1.50 D. We compared experimental group with control group for myopia progress according to period, age, and refraction error and investigated the myopia progress according to the eye-glasses power of experimental group. Results: At the 300th day from the first cycloplegic refaction, spherical equivalent for the experimental group increased as -1.03${\pm}$0.43 D (t=13.36, p<0.001) and for the control group increase as -0.61${\pm}$0.35 D (t=10.05, p<0.001) and two groups were statistical difference. Myopia power for experimental group increased 60.75%, for control group increased 56.66% at the 300 days. According to eye-glasses power increased 41.19${\pm}$15.25% at -1.50 D, 36.74${\pm}$19.29% at -1.25 D, 56.57${\pm}$20.21% at -1.00 D, 87.26${\pm}$49.38% at -0.75 D and 106.69${\pm}$59.60% at -0.50 D. Conclusions: The myopia power for the eye-glasses wearing group was 0.46 D faster than the non-eye-glasses wearing group at the 300th day from the first cycloplegic refraction. We will consider the effect of non-eye-glasses wearing to protect the progressing myopia and prescribe the under correction for school children having no experience eye-glasses wearing.

Clinical Study of Acute Pyogenic Osteomyelitis in Children (소아 급성 화농성 골수염의 임상적 고찰)

  • Park, Ji Sook;Yeom, Jeong Suk;Hwang, Sun Chul;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.731-736
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    • 2005
  • Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

Clinical Outcome and Prognostic Factors of Acute Respiratory Distress Syndrome in Children (소아 급성 호흡곤란 증후군의 치료 성적 및 예후 인자)

  • Ko, Jung-Min;Ha, Eun-Ju;Lee, Eun-Hee;Lee, So-Youn;Kim, Hyo-Bin;Hong, Soo-Jong;Park, Seong-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.599-605
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    • 2005
  • Purpose : The purpose of this study was to examine the causes, clinical courses and outcomes in children with acute respiratory distress syndrome(ARDS), and evaluate the physiologic variables as prognostic factors in the patients. Methods : Retrograde medical chart review was carried out in 24 patients who were diagnosed with ARDS at the pediatric intensive care unit(PICU) during 20-month period. Results : The incidence of ARDS among all PICU admission was 3.7 percent and the mortality rate was 37.5 percent, which was 14.8 percent of overall deaths in PICU. The most common causes of ARDS were pneumonia and sepsis. We found significant differences between survivors and nonsurvivors in $PaO_2/FiO_2$ ratio(P/F ratio), alveolar arterial oxygen gradient and oxygenation index(OI) on the second day from the onset of ARDS. Therapies for ARDS such as high frequency oscillator ventilation(HFOV), recruitment maneuver and low dose corticosteroid improved the P/F ratio and OI, especially in survivors. Conclusion : The mortality rate of children with ARDS was 37.5 percent; an important cause of death in PICU. HFOV, recruitment maneuver and low dose corticosteroid seemed to be effective in pediatric ARDS. The P/F ratio, alveolar arterial oxygen gradient and OI on the second day from the onset of ARDS may be useful as prognostic factors.

A clinical study on the etiology of parapneumonic effusion in children (소아 감염성 흉막삼출의 원인 분석)

  • Yeom, Jung-Sook;Bae, Won-Tae;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.56-63
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    • 2006
  • Purpose : This study was designed to document the etiologies and the characteristics of parapneumonic effusion in children. Methods : During a 17-year period from 1987 to 2004, parapneumonic effusion was confirmed in 86 children at Gyeongsang National University Hospital. The clinical records of these children were reviewed and radiological findings and laboratory data, especially results of thoracentesis, were analyzed retrospectively. Results : M. pneumoniae(34 subjects) was the most common pathogen at all over age, especially above 1-years-old. There were diagnosed with clinical characteristics and serologic tests. The $2^{nd}$ most common pathogen revealed non tuberculous bacteria(14 subjects). A species of bacteria at no tuberculous bacteria revealed S. aureus(5), S. pneumoniae(3), P. aeroginosa(3), other staphylococcus (2), and K. pneumoniae(1). There were confirmed with sputum culture or pleural fluid culture or blood culture. S. aureus was most common pathogen in infants. The $3^{rd}$ common pathogen was M. tuberculosis(7). There were confirmed with skin tuberculin tests and AFB stains. Another that was classified as a non bacteria was adenovirus(2). Complications of parapneumonic effusion such as pleural thickness occurred on M. tuberculosis(1). Non tuberculous bacteria, especially S. aureus revealed a serious predominance of polymorphocyte at pleural fluid, and lowest pleural pH and glucose, and highest pleural protein and LDH. Tuberculosis revealed high pleural protein and LDH. Conclusion : Age and chemistries of pleural fluid might be helpful in differentiating various etiologies of parapneumonic effusion. If there were suspicious of tuberculosis and non-tuberculous bacteria, more aggressive approaches were needed to prevent complication.

Epidemic acute interstitial pneumonia in children occurred during the early 2006s (2006년 초에 유행한 소아 급성 간질성폐렴)

  • Cheon, Chong Kun;Jin, Hyun-Seung;Kang, Eun Kyeong;Kim, Hyo Bin;Kim, Byoung-Joo;Yu, Jinho;Park, Seong Jong;Hong, Soo-Jong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.383-390
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    • 2008
  • Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

Counter-terrorism Safety Measures in Public Facilities (다중이용시설의 대테러 안전대책)

  • Kim, Du-Hyun;Ahn, Kwang-Ho
    • Korean Security Journal
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    • no.22
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    • pp.37-64
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    • 2010
  • Since the September 11, 2001, the motives and objectives of terrorism that have been targeted at hard targets such as key national facilities have now shifted towards soft targets such as subways, department stores, and tourist hotels; the attacks on these soft targets are steadily increasing. Simultaneous, unconventional, and indiscriminate terrorist attacks on civilians has also increased. In November, 2010, nearly forty states of the G20 and B20 (Business 20) will join in international summits to be hosted in Seoul. This coming July, an additional 350 troops will be deployed to Afghanistan for the sustainment of public security. Such events are sensitive topics, and there is the possibility of terrorist movement. Korea has successfully hosted various international events such as the APEC and ASEM Summits, and the 2002 Korea-Japan World Cup. The experiences from these events must be applied to ensure the safety of public facilities against the dangers of terrorism. First, counter-terrorism center must be established for the long-term, above the General Officer level to ensure the safety and efficiency of multilateral, international summits, as well as promoting policies and legislation aimed at preventing terrorism. Second, a terrorist threat management system must be secured and safety measures must be emphasized. Third, a fundamental structure must be established for the prevention of terrorism on public facilities, as well as legal and government action against the new threat of IED. Fourth, the police and fire fighting networks' must have a firm rapid response posture on the scene of an attack. Fifth, the state of mentality on the recognition of terrorist threats must be changed and restructured by promoting to and educating the population. Sixth, prevention measures must be established via research and academia. Seventh, for the guarantee of security in public facilities, safety management should employ cutting edge technology such as the 3D SICS and further develop and apply such technology. All methods and resources must be fully utilized for the establishment and strengthening terrorism prevention measures.

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Exploring the Patterns of Group model Development about Blood Flow in the Heart and Reasoning Process by Small Group Interaction (소집단 상호작용에 따른 심장 내 혈액 흐름에 대한 소집단 모델 발달 유형과 추론 과정 탐색)

  • Lee, Shinyoung;Kim, Chan-Jong;Choe, Seung-Urn;Yoo, Junehee;Park, HyunJu;Kang, Eunhee;Kim, Heui-Baik
    • Journal of The Korean Association For Science Education
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    • v.32 no.5
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    • pp.805-822
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    • 2012
  • The purpose of this study was to explore the patterns of group model development about blood flow in the heart and reasoning process by small group interaction. The subjects were 14, 8th graders in a Science Gifted Center. The group discussion was made possible by using triggering questions that can be answered based on experiences of hands-on activities such as a siphon pump analogy model activity and a dissection of pigs' hearts. Despite participating in same activities, the groups showed different model development patterns: unchanged, persuasive, and elaborated. Due to the critical revising, the group's explanatory model was elaborated and developed in the added and elaborated pattern. As critical revising is a core element of the developing model, it is important to promote a group interaction so that students become critical and receptive. The pedagogical analogy model and conflict situation enabled students to present elaborated reasoning. The Inquiry activity with the pedagogical analogy model promote students' spontaneous reasoning in relation to direct experience. Therefore offering a pedagogical analogy model will help students evaluate, revise and develop their models of concerned phenomena in science classroom. Conflict situation by rebuttal enable students to justify more solid and elaborate a model close to the target model. Therefore, teachers need to facilitate a group atmosphere for spontaneous conflict situation.