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Molecular-epidemiologic study on outbreak of colonization by extended spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit (신생아 중환자실에서 extended spectrum β-lactamase를 생성하는 Klebsiella pneumoniae 집단 보균 발생의 분자 역학적 조사 및 추적관찰)

  • Jun, Nu-Lee;Kim, Mi-Na;Jeong, Jae-Sim;Kim, Yang-Soo;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.150-156
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    • 2006
  • Purpose : The aims of this study included assessment of molecular-epidemiologic features during an outbreak of colonization of extended spectrum ${\beta}$-lactamase producing Klebsiella pneumoniae(ESBL-KPN) and re-evaluation of their colonized status one year later. Methods : Rectal swab cultures for ESBL-KPN from all hospitalized infants and newly admitted infants were obtained during the outbreak of colonization from July to December, 2000. The pattern of XbaI-digested chromosomal DNA of isolates were analyzed by pulsed-field gel electrophoresis. Weekly rectal swab cultures were obtained during the outbreak until patients were either discharged or decolonized. Patients discharged after being colonized had follow up stool cultures a year later. Results : A total of 80 patients(28.5 percent) were colonized. Of those, 53 whose pulsed-field gel electrophoresis(PFGE) was possible only once, were ESBL-KPN grouped into six cluster clones and 10 single clones : 28 patients(52.8 percent) were colonized with type A, the most common clone, followed by type B in 11 patients(20.8 percent). Of those 12 patients in whom serial PFGE was done more than twice, type A was predominant. Narrowed-down in strains occurred from types A, B, C, D and three single clones at initiation of the study into types A and type B after three months of strict infection control. Among 75 patients(93.7 percent) who were sent home after being colonized, 30 patients were re-called for stool cultures a year later : All of them were decolonized. Conclusion : This study demonstrates the importance of infection control as the diversity of ESBL-KPN strains could be narrowed into fewer strains. Colonization of ESBL-KPN could be reversed upon return to the community.

The Effects of Vitamin C on Lipid Contents and Fatty Acid Compositions of Serum and Liver in Rats Treated with Radiation or Aflatoxin B1 (Vitamin C가 방사선과 Aflatoxin B1을 투여한 흰쥐의 혈청과 간장의 지질성분 및 지방산 조성에 미치는 영향)

  • Kang, Jin-Soon;Kim, So-Young;Kim, Hee-Suk;Cho, Heung-Lae;Chai, Gyu-Young;Chung, Duck-Hwa
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.2
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    • pp.163-173
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    • 2007
  • Lipid peroxidation is one of the main manifestations of oxidative damage and has been found to play an important role in the toxicity and carcinogenesis of many carcinogens. This study was carried out to determine the effects of vitamin C on lipid contents and fatty acid compositions of serum and liver in male rats treated with radiation or aflatoxin $B_1\;(AFB_1)$. Six week-old male Sprague-Dawley rats were randomly divided into 7 groups; control group, radiation exposed group, $AFB_1$ treated group, X-ray and $AFB_1$ co-treated group. Three groups, except control group, were each further divided into vitamin C administered group and not administered groups. For this study, vitamin C was injected with 10 mg/kg of body weight by intraperitoneal injection and 1 hr later, 0.4 mg/kg of $AFB_1$ was injected by the same method. These administrations were repeated every 3 days over a period of 15 days. Only one time, X-ray was irradiated on whole liver with 1,500 cGy. Then vitamin C and AFB1 were administered by the same level and same method described above. On the 16th day of treatments, the animals were sacrificed. From the analysis of the serum lipid patterns, significant decrease (p<0.01) in triglyceride (TG) and total cholesterol levels were observed in X-ray and $AFB_1$ co treated group administered with vitamin C (group 7). In liver lipids, the levels of free cholesterol and total cholesterol were also decreased in X-ray and $AFB_1$ co treated group administered with vitamin C (group 7). The levels of serum free cholesterol and hepatic TG were not significantly different among all groups according to vitamin C administrations. The high density lipoprotein (HDL)-cholesterol level of serum was significantly (p<0.01) increased while the low density lipoprotein (LDL)-cholesterol level was decreased in X-ray and $AFB_1$ co treated group administered with vitamin C (group 7). In the phospholipid fatty-acid compositions of serum and liver tissue, group 3, 5 and 7 showed an increase in polyunsaturated fatty-acid (PUFA) but a decrease in saturated fatty acid (SFA) when compared to the control group. The composition ratio of fatty acid varied according to vitamin C administration. These results suggested that vitamin C has partly suppressive effects on lipid contents and fatty acid composition of serum and liver in rats treated by radiation and $AFB_1$.

The Result of Bone Grafting for Fibrous Dysplasia (섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석)

  • Jeong, Won-Ju;Kim, Tae-Seong;Cho, Hwan-Seong;Yoon, Jong-Pil;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.74-79
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    • 2014
  • Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.

Age Estimation by Modified Johanson Method (Johanson 방법을 응용한 연령추정)

  • Lee, Won-Joon;Kim, Byung-Gook;Kim, Jae-Hyung;Lim, Hoi-Soon;Lee, Guem-Sug;Choi, Hong-Ran
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.201-214
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    • 2005
  • Age estimation is fundamental and important in personal identification with forensic medicine and dentistry. Recently, a lot of studies using various part of the body have been done for age estimation. Age estimation with teeth is the most significant method comparing ones with other part of the body. Gustafson method and Johanson method using postmortem teeth have been authorized in accuracy and systemization and used domestically and internationally. The verification of the accuracy in above methods had been tried many times but it is still rare in Korea. Fifty-nine teeth(incisors, canine, premolars and molars) which were extracted due to periodontal diseases or orthodontic problem were collected. Present study is to 1) compare the accuracy of estimated age in applying Gustafson method and Johanson method to the teeth in Korea, 2) compare and analyze the correlation with results using Gustafson method and Johanson method by age, gender, maxilla - mandible and anterior - premolar - molar. Teeth were embedded in resin and sliced and then examined each one using Gustafson method and Johanson method. The results are as follows: 1. Actual age was a significant difference in estimated age by Johanson method. Actual age was a significant correlation in estimated age by Gustafson method and modified Johanson method. Modified Johanson method was more significant than Gustafson method. 2. In estimated age by Gustafson method, Johanson method and modified Johanson method, there was no significance with actual age by location and gender. 3. In estimated age by Gustafson method, Johanson method and modified Johanson method, there was significance with actual age by age group. Finally, Gustafson method and Johanson method can be used in Korea. To make more accurate verification, however, it needs more specimen and postmortem teeth. Johanson equation proposed by himself has to be developed by further studies.

Prognostic Values of Preoperative Hematologic Parameters in Gastric Cancer (위암에서 수술 전 혈액학적 검사의 예후인자로서의 가치)

  • Kim Hyoung-Ju;Kwon Sung Joon
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.29-33
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    • 2005
  • Purpose: To determine the prognostic values of the hematologic parameters checked preoperatively in gastric cancer patients, we evaluated and compared the relationship between hematologic parameters and clinicopathologic factors of gastric cancer patient. Materials and Methods: The medical records of 357 consecutive patients who had undergone surgery for gastric cancer at the Department of Surgery, Hanyang University Hospital, between Dec. 2,000 and Dec. 2003 were reviewed. To exclude any adverse effect of invasive procedures to hematologic parameters, the samples taken immediately at outpatient department was used. The normal range of serum albumin was defined above 3.5 g/dl, serum hemoglobin above 12 g/dl, and serum platelet count under $400\times10^{3}{\mu}l$. Patients were defined as group 1 when any of these parameters was abnormal, and defined as group 2 when all parameters were normal. The relationships between hematologic parameters and survival rate were investigated. Results: The mean values of platelet count increased, but level of serum albumin and serum hemoglobin decreased significantly according to the advancement of the disease stage (P=0.000). The differences of depth of tumor invasion and lymph node metastasis between the group 1 and the group2 was statistically significant (P=0.001). Three-year survival difference between group 1 and group 2 was significant (P=0.037). Conclusion: The hematologic parameters checked preoperatively in patients of gastric cancer are simple and cheap, meanwhile reflect the general condition of the patients. Any presence of anemia, hypoalbuminemia, or thrombocytosis can predict the progression of the disease and poor survival rates.

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A MORPHOMETRIC STUDY ON THE PREFORMED STAINLESS STEEL CRORWNS OF SOME BRANDS (유치용 수종 기성금속관의 형태에 대한 계측학적 연구)

  • Han, Eun-Ok;Lee, Ji-Hyun;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.145-152
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    • 2012
  • Whenever pediatric dentists choose the preformed stainless steel crowns for restoration of primary molars, we usually prefer the crown forms that most fit to the abutment teeth. Despite some previous reports on significant ethnic difference in the size and shape of tooth crowns in primary dentition, only the imported products have been available to date, which might show some discrepancy with tooth anatomy of Korean. However, a domestic product of preformed stainless steel crown has been marketed recently that is expected to show more accurate fit to the primary tooth of Korean. To investigate the morphological characteristics of primary molars of Korean children, their mesiodistal and buccolingual diameters from the dental casts of 263 children in Pusan and Kyungsangnamdo province were measured by digital calipers. The measured data were compared with those of the three types of preformed stainless steel crowns(3M ESPE Stainless Steel Primary Molar Crown, Kids Crown, Sankin Anatom Primary Crown) by statistical processes with regression analysis. The results were as follows: 1. In every primary molar crown of three brands, the bucco-lingual width to mesio-distal width ratio (MD-BL ratio) showed higher values compared with those of natural teeth. 2. While the products of 3M ESPE and Shinhung showed similar features, those of Sankin showed some difference from both, and these difference was more marked in mandibular primary molars. 3. The nearer is the mesio-distal width of the crown to the average, the better was the adaptation of the preformed crown, and the reverse was true. 4. The teeth which revealed more discrepancy between preformed crown and natural tooth were upper and lower first primary molars.

The Comparison of ICSD and DSM-Ⅳ Diagnoses in Patients Referred for Sleep Disorders (정신과에 의뢰된 환자 중 수면장애에 대한 ICSD와 DSM-Ⅳ 진단 비교)

  • Lee, Bun-Hee;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.37-44
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    • 2001
  • Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

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A Study on the Conditions of Dental Caries on the First Molar in the Elementary School Students in H City (H시 초등학교 학동의 제 1대구치 치아우식 실태조사 연구)

  • Kim, Eung-Gwon;Im, Sun-Hwan
    • Journal of dental hygiene science
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    • v.2 no.2
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    • pp.89-94
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    • 2002
  • The present study attempts to find the ways to efficiently manage dental caries, one of the major causes of tooth loss, and to cope with oral diseases that deteriorate oral health. For this purpose, this study seeks to obtain fundamental data needed in planning the oral health projects. The study was conducted to the first-grade elementary school students in Hwa-Seong city, Gyeonggi-do, from April 1 - 30, 2002. The result was as follows: 1) Among a total of 2,710 subjects, 598 (274 boys and 324 girls) have more than 1 permanent tooth with a caries legion whether it was treated or not. 2) The number of permanent teeth examined is 6,029, in which girls' teeth are more (3,165) than boys' (2,864). 3) Out of a total of 6,029 teeth examined, 1,106 permanent teeth (508 boys' and 598 girls') have caries legions. 4) Out of 1,106 permanent teeth with caries legions, 170 (15.4%) were treated - 67 teeth for boys (13.2%) and 103 teeth for girls (17.2%). 5) 22.1% of the children have experienced dental caries in their permanent teeth. Among them, 20.1% are boys and 24.1% are girls. 6) The rate of the permanent teeth that once had, or now have caries legions are 21.2%, among which the rate for boy's teeth is 20.1% and that for girl's teeth is 22.1%. 7) The number of the permanent teeth that had caries legions is 0.5 for all the subjects. A boy has 0.4 and a girl has 0.5 teeth with caries legions regardless of whether it was treated or not. 8) The rate of the permanent teeth with caries legions is 86.7% for overall subjects - 88.3% for boys and 85.3% for girls. 9) The rate of treated permanent teeth is 13.3% for all the subjects - 11.7% for boys and 14.7% for girls. Based on the above result, the study draws a conclusion that in order to prevent dental caries in young students and to perform an early treatment for the dental caries that already occurred an oral health office should be installed at all the elementary schools so that elementary school students don't experience a loss of time and effort for learning and suffer nutritional imbalance or disorder. Besides, the oral health education concerning the importance of dental care should be conducted to the citizens, especially to the young people, in the community as an essential project of oral health centers in the community health offices, the public medical institutions.

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A Needs Analysis Oral Health Education Contents for Teachers and Parents Using Borich Priority Formula and The Locus for Focus Model (Borich 요구도와 The Locus for Focus Model을 활용한 교사와 학부모의 구강보건교육 내용 우선순위 요구분석)

  • Kim, Ji-Su;Kang, Yu-Min;Lee, Su-Young
    • Journal of dental hygiene science
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    • v.18 no.4
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    • pp.252-264
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    • 2018
  • The purpose of this study was to analyze the priorities of oral health education contents for preschool children by targeting teachers and parents using the Borich priority formula and The Locus for Focus Model. The survey was conducted in 212 teachers and 215 parents from December 26, 2017 to January 21, 2018. The priorities of oral health education contents were based on a 3-step analysis method, including the paired sample t-test, Borich priority formula, and The Locus for Focus Model. As a result of this study, the number of items about oral health education for preschool children that were prioritized by teachers was 7, while that by parents was 9. The top priorities that teachers and parents had in common were the following 5 items; "The progression of dental caries," "Symptoms of dental caries," "How to prevent dental caries," "Eruption sequence of permanent teeth," and "Method for emergency management of avulsed teeth." The teachers' priorities of the oral health education contents were the same between teachers and parents; "Eruption sequence of deciduous teeth" and "The function of the permanent teeth" were added. The parents' priorities of the oral health education contents were the same between teachers and parents; "The effect of fluoride application," "The number of permanent teeth," "How to prevent malocclusion," and "The appropriate timing of malocclusion treatment" were added. Based on the results of this study, when developing oral health education programs for teachers and parents, oral health education for teachers should include 7 items and oral health education for parents should include 9 items.

Health Lifestyle Patterns of Seoul Adults (서울 일부지역 성인의 건강생활양식 유형연구)

  • Lee, Hwa-Kyung;Lee, In-Young;Kim, Eun-Mi;Lee, Hun-Jae;Bae, Sang-Soo
    • Journal of agricultural medicine and community health
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    • v.31 no.2
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    • pp.145-156
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    • 2006
  • Objectives: Health behaviors are related to each other, or they may be essentially dependent upon each other. Hence the overall health behaviors of a given population could be better described in terms of health lifestyle patterns. This paper tried to classify such patterns in a sample population and suggest the socioeconomic and demographic characteristics of each groups. Methods: A sample population comprised of 2,775 adults who reported their health behaviors in a public health survey were classified according to their smoking, drinking, diet, and exercise related pattern of behaviors. Clustering analysis was used to classify them. Results: Six health lifestyle patterns were identified. Individuals in the passive lifestyle cluster (48.3%) had no active health promoting activities, but did avoid risk taking health behaviors. 24.8% of the sample (Health promoting lifestyle) had an overall healthy lifestyle. 13.5% of the sample were in the smoking cluster, and 8.4% were in the alcohol drinking cluster. The hedonic lifestyle (4.5%) was characterized by heavy smoking, alcohol drinking and poor diet and exercise. 0.7% of the sample (Smoking-Drinking lifestyle) had heavy smoking and drinking, but good diet and exercise. Each group could be characterized by sex, age, and income. Conclusions: A population sample of Seoul adults were successfully clustered into six health lifestyles. The socioeconomic and demographic characteristics were suggested for the characterization of the each health lifestyle groups. We can approach to a certain target population with specific strategy.

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