• Title/Summary/Keyword: A University Hospital

Search Result 43,972, Processing Time 0.094 seconds

Urinary Tract Infection in Febrile Infants with Pyuria (발열과 농뇨가 있는 영아에서 요로감염에 관한 연구)

  • Lee, Sue Young;Cho, Sung Hee;Kim, Sun Mi;Jeong, Dae Chul;Chung, Seung Yeon;Lee, Kyung Yil;Kang, Jin Han
    • Pediatric Infection and Vaccine
    • /
    • v.11 no.1
    • /
    • pp.90-100
    • /
    • 2004
  • Objective : Urinary tract infection(UTI) is a frequent serious bacterial infection in young infants. The clinical presentation may be non-specific and variable, depends on factors such as the age and the level of infection. Children with renal involvement may be at risk of permanent renal damage. Experimental studies have shown that renal lesions caused by acute febrile UTI may be prevented or diminished by early diagnosis and treatment. Therefore, it is important to find a method that can permit early diagnosis and identification of patients who are at risk for progressive renal damage. We designed this study to identify related factors in culture positive UTI infants, and also to identify related factors in culture negative UTI infants, who are febrile with pyuria, by using renal imaging and functional studies including renal sonography, DMSA scan and VCUG. Methods : Retrospectively analyzed the medical records of 136 febrile infants with pyuria over 2 years(from January 2001 to February 2003). Urine culture was done in all cases, and regardless of urine culture findings, renal imaging study was done if symptomatic UTI suspected. Results : Total 57 organisms were isolated in 53 patients. E. coli was the most common organism(86%), followed by E. faecalis, M. morganii, Proteus species, P. aeruginosa, S. aureus and E. fergusonii. Most of the isolates had high sensitivity on cephalosporins or amikacin and had low sensitivities on aminopenicillins. Abnormal acute phase DMSA scan or VCUG findings were seen in both urine culture positive and negative group without statistical differences(P>0.05). In febrile infants with pyuria, fever over 48 hours, older age and high CRP related to abnormal acute phase DMSA scan findings regardless urine culture results. Conclusion : 1st or 3rd generation cephalosporins with amikacin could be the first choice of treatment for UTI. Febrile infants with positive urine culture dose mean urinary tract infection but not acute pyelonephritis which directly relates to cortical damage which could be confirmed by acute phase DMSA scan. Even cases with negative urine culture findings, acute pyelonephritis should be concerned in febrile infants with pyuria who are older than 3 months of age, has fever over 48 hours or high CRP level. And in such cases, acute phase DMSA scan and VCUG should be evaluated for early treatment and long term prognosis.

  • PDF

Early Hemodynamic Changes and Short-term Outcomes of Mitral Valvuloplasty versus Replacement with Chordal Preservation for Patients with Mitral Regurgitation (승모판막폐쇄부전 환자에서 판막성형술과 판막대치술이 수술 후 혈역학과 단기 예후에 미치는 영향 비교)

  • Choi, Yong-Seon;Kwak, Young-Lan;Chang, Byung-Chul;Kim, Ji-Ho;Hong, Yong-Woo;Bang, Sou-Ouk
    • Journal of Chest Surgery
    • /
    • v.40 no.10
    • /
    • pp.659-666
    • /
    • 2007
  • Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.

Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography (산전 초음파로 진단된 태아 수신증의 생후 경과 관찰)

  • Park, Youn Jin;Mun, Soon Jung;Bae, Chong Woo;Lee, Bum Ha;Kim, Jin Il
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.10
    • /
    • pp.1213-1218
    • /
    • 2002
  • Purpose : Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. Methods : The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). Results : The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. Conclusion : Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.

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
    • /
    • v.36 no.2
    • /
    • pp.163-173
    • /
    • 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 $AFB_1$.

Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea (일개 도농복합시 영유아 예방접종 수첩의 정확도 평가)

  • Lee, Moo-Sik;Kim, Jee-Hee;Kim, Kwang-Hwan;Hong, Jee-Young;Lee, Jin-Yong;Kim, Keon-Yeop
    • Journal of agricultural medicine and community health
    • /
    • v.36 no.2
    • /
    • pp.113-119
    • /
    • 2011
  • The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 months old children was carried out in Nonsan, Korea. We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data. Accuracy of the child's vaccination card by type of National Immunization Program vaccine in whole medical institutions were from 41.8% to 83.2%. Accuracy for the date of vaccination of vaccination card in National Immunization Programme vaccine were from 55.3% to 89.7%. In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.

Blood Pressure of Healthy Newborns in the First Week of Life (분당 차병원에서 출생한 신생아 혈압치 비교)

  • Lee Jung-Sun;Park Shin-I;Park Hye-Won;Kim Se-Hyun;Hah Tae-Sun;Lee Jun-Ho
    • Childhood Kidney Diseases
    • /
    • v.9 no.1
    • /
    • pp.8-14
    • /
    • 2005
  • Purpose : This study was peformed to study normative blood pressure data in full-term neonates that may be used to facilitate Identification of neonatal hypertension.Methods : 383 newborns born in our hospital from May 2003 to January 2004 were enrolled in this study Using an oscillometric device(BP-88 NEXT, COLIN Corp.), their blood pressures were measured more than one time within a week after birth. According to each clinical variable such as sex, delivery mode, birth weight, gestational age and presence of maternal disease or perinatal problems, we divided the population into groups and calculated the mean blood pressures of each group. We compared mean blood pressures between the divided groups according to each clinical variable statistically.Results : Mean systolic and diastolic blood pressure of the Population was 70.8$\pm$ 10.9 mmHg and 43.4 $\pm$ 8.0 mmHg, respectively. There was no satistically significant difference in blood pressure according to clinical variables. Mean systolic pressure showed positive correlation with birth weight and gestational age(r=0.1420, 0.03130).Conclusion : Our results are almost in agreement with Zubrow's data from 695 newborns in U.S.A, 1995. Our data may be helpful for early detection and management of neonatal hypertension, thereby maintaining renal function ,and preventing possible complications of renal disease.

  • PDF

Verification of Indicator Rotation Correction Function of a Treatment Planning Program for Stereotactic Radiosurgery (방사선수술치료계획 프로그램의 지시자 회전 오차 교정 기능 점검)

  • Chung, Hyun-Tai;Lee, Re-Na
    • Journal of Radiation Protection and Research
    • /
    • v.33 no.2
    • /
    • pp.47-51
    • /
    • 2008
  • Objective: This study analyzed errors due to rotation or tilt of the magnetic resonance (MR) imaging indicator during image acquisition for a stereotactic radiosurgery. The error correction procedure of a commercially available stereotactic neurosurgery treatment planning program has been verified. Materials and Methods: Software virtual phantoms were built with stereotactic images generated by a commercial programming language, Interactive Data Language (version 5.5). The thickness of an image slice was 0.5 mm, pixel size was $0.5{\times}0.5mm$, field of view was 256 mm, and image resolution was $512{\times}512$. The images were generated under the DICOM 3.0 standard in order to be used with Leksell GammaPlan$^{(R)}$. For the verification of the rotation error correction function of Leksell GammaPlan$^{(R)}$, 45 measurement points were arranged in five axial planes. On each axial plane, there were nine measurement points along a square of length 100 mm. The center of the square was located on the z-axis and a measurement point was on the z-axis, too. Five axial planes were placed at z=-50.0, -30.0, 0.0, 30.0, 50.0 mm, respectively. The virtual phantom was rotated by $3^{\circ}$ around one of x, y, and z-axis. It was also rotated by $3^{\circ}$ around two axes of x, y, and z-axis, and rotated by $3^{\circ}$ along all three axes. The errors in the position of rotated measurement points were measured with Leksell GammaPlan$^{(R)}$ and the correction function was verified. Results: The image registration errors of the virtual phantom images was $0.1{\pm}0.1mm$ and it was within the requirement of stereotactic images. The maximum theoretical errors in position of measurement points were 2.6 mm for a rotation around one axis, 3.7 mm for a rotation around two axes, and 4.5 mm for a rotation around three axes. The measured errors in position was $0.1{\pm}0.1mm$ for a rotation around single axis, $0.2{\pm}0.2mm$ for double and triple axes. These small errors verified that the rotation error correction function of Leksell GammaPlan$^{(R)}$ is working fine. Conclusion: A virtual phantom was built to verify software functions of stereotactic neurosurgery treatment planning program. The error correction function of a commercial treatment planning program worked within nominal error range. The virtual phantom of this study can be applied in many other fields to verify various functions of treatment planning programs.

Role of Invasive Procedures in the Diagnosis and Management of Pulmonary Infiltrates in Patients with Leukemia (백혈병 환자에서 발생한 폐침윤의 진단 및 치료에 있어 침습적 검사의 역할)

  • Kang, Soo-Jung;Park, Sang-Joon;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.48 no.4
    • /
    • pp.448-463
    • /
    • 2000
  • Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

  • PDF

A Study of Serum HBV Markers in Term Pregnant Women and Their Neonates (만삭임부 및 신생아의 혈청 B형간염 바이러스 표식자에 관한 연구)

  • Lee, Tae-Hyung;Park, Wan-Seok;Kim, Sung-Rim;Lee, Kang-Wan;Lee, Sung-Ho;Chung, Wun-Young
    • Journal of Yeungnam Medical Science
    • /
    • v.4 no.2
    • /
    • pp.121-129
    • /
    • 1987
  • To evealuate the status of hepatitis B virus infection in the mothers and neonates and to determine the maternal-neonatal transmission of hepatitis B virus, 2,276 term pregnant women were screened for the presence of serum HBsAg, at the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during the period of 18 months from Jan. 1986 to Jun. 1987, and the sera of sixty-six HBsAg carrier mothers and their neonates were tested for HBV markers and liver enzymes. The results were as follows : 1. The prevalence rate of asymptomatic HBsAg carrier in the term pregnant women was 4.7%(53/1,279). 2. Positive rates of HBsAg and anti-HBs 10 the sera of sixty-six neonates born to asymptomatic HBsAg carrier mothers were 12.1% and 9.1%, respectively. Transient elevation of SGOT(three to four times of upper normal limit) was detected in one of eight HBsAg-positive neonates and one of six anti-HBs positive neonates. 3. Positive rates of anti-HBc, HBeAg and anti-HBe to the sera of sixty-six asymptomatic HBsAg carrier term pregant women were 93.9%, 45.5% and 50%, respectively. The rates of transmission of maternal anti-HBc, HBeAg and anti-HBe to the neonates were 85.5%(53/62), 90%(27/30) and 87.9%(29/33). respectively. 4. Serum HBsAg was detected in four of thirty neonates born to HBeAg positive HBsAg carrier mother, three of thirty-three neonates born to anti-HBe positive HBsAg carrier mothers, and one of three neonates born to both HBeAg and anti-HBe negative HBsAg carrier mothers.

  • PDF

A Study on the Patient Exposure Doses from the Panoramic Radiography using Dentistry (치과 파노라마 촬영에서 환자의 피폭선량에 관한 연구)

  • Park, Ilwoo;Jeung, Wonkyo;Hwang, Hyungsuk;Lim, Sunghwan;Lee, Daenam;Im, Inchul;Lee, Jaeseung;Park, Hyonghu;Kwak, Byungjoon;Yu, Yunsik
    • Journal of the Korean Society of Radiology
    • /
    • v.7 no.1
    • /
    • pp.17-24
    • /
    • 2013
  • This study estimate radiation biological danger factor by measuring patient's exposed dose and propose the low way of patient's exposed dose in panoramic radiography. We seek correcting constant of OSL dosimeter for minimize the error of exposed dose's measurement and measure the Left, Right crystalline lens, thyroid, directly included upper, lower lips, the maxillary bone and the center of photographing that indirect included in panoramic radiography by using the human body model standard phantom advised in ICRP. In result, the center of photographing's level of radiation maximum value is $413.67{\pm}6.53{\mu}Gy$ and each upper, lower lips is $217.80{\pm}2.98{\mu}Gy$, $215.33{\pm}2.61{\mu}Gy$. Also in panoramic radiography, indirect included Left, Right crystalline lens's level of radiation are $30.73{\pm}2.34{\mu}Gy$, $31.87{\pm}2.50{\mu}Gy$, and thyroid's level of measured exposed dose can cause effect of radiation biological and we need justifiable analysis about radiation defense rule and substantiation advised international organization for the low way of patient's exposed dose in panoramic radiography of dental clinic and we judge need the additional study about radiation defense organization for protect the systematize protocol's finance and around internal organs for minimize until accepted by many people that is technological, economical and social fact by using panoramic measurement.