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Fluconazole prophylaxis in high-risk, very low birth weight infants (고위험 극소저체중 출생아에서 fluconazole 예방요법)

  • Kim, Soo Young;Lee, Soon Joo;Kim, Mi Jeong;Song, Eun Song;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.636-642
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    • 2007
  • Purpose : Fluconazole prophylaxis for very low birth weight (VLBW) infants has been shown to reduce invasive fungal infection and its mortality. This study aims to evaluate the effect of fluconazole prophylaxis in VLBW infants on the incidence and mortality of fungal infection. Methods : VLBW infants with endotracheal intubation and central vascular access admitted to the Neonatal Intensive Care Unit (NICU) at Chonnam University Hospital were enrolled. Twenty eight infants of 7-month baseline period from January to July 2005 ('non-fluconazole group') were compared with 29 infants of a 7-month fluconazole period from January to July 2006 ('fluconazole group'). Results : Gestational age, birth weight, sex, mode of delivery, frequency of twin pregnancy, chorioamnionitis, antenatal steroid and rupture of membranes were similar between the fluconazole and non-fluconazole groups. The rate of extremely low birth weight (ELBW) infants, frequency and duration of prophylactic antibiotics, total parenteral nutrition and umbilical catheters, duration of intralipid, mechanical ventilation and nasal continuous positive airway pressure (CPAP) were also not significant. However, frequency of percutaneous central venous catheterization (PCVC) and intralipid administration, and duration of PCVC were significant between the two groups. The overall incidence and mortality of fungal infection were not different between the two groups. Although the Malassezia infection was increased in the fluconazole group (P<0.05), candida was significantly decreased compared to the non-fluconazole group (P<0.05). Conclusion : Fluconazole prophylaxis in high risk VLBW infants decreased the candida infection significantly. Antifungal prophylaxis is recommended in terms of cost effectiveness, but further study is needed to clarify the reason for the increase of Malassezia infection.

Serum Lmmunoglobulin G and M Level after Xenograft Valve or Valved Conduit Implantation (이종 조직판막 도관 혹은 판막 이식술 직후 면역 글로불린 항체 G, M의 혈중 농도 변화)

  • Kwak, Jae-Gun;Yoo, Jae-Suk;Yoon, Sun-Hee;Kim, Woong-Han;Kim, Kyung-Hwan;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.223-228
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    • 2008
  • Background: The aim of this study is to confirm that peripheral blood sampling for measuring of serum immunoglobulin can predict immunological changes after xenograft implantation. Material and Method: Between March 2006 and January 2007, 19 patients were enrolled (10 xenograft implantation group, 9 control group). Through 3 peripheral blood samples, we measured changes in serum immunoglobulin G and M levels preoperatively, and 2 and 10 days postoperatively. Result: In both groups, serum immunoglobulin levels showed similar changes-they decreased 2 days postoperatively, then increased up to the baseline levels 10 days postoperatively. However, this postoperative change of immunoglobulin G and M was not significantly different in absolute value or pattern between the 2 groups (Ig G; p-value=0.393, Ig M; p-value=0.193). Conclusion: We could not predict immunological changes after xenograft implantation by measuring serum immunoglobulin levels by simple blood sampling. Direct checking of ${\alpha}$-Galactose antibody may confirm an immunological reaction after xenograft implantation.

The Usefulness of Noninvasive Positive Pressure Ventilation as a New Weaning Method (새로운 이탈방법으로서 비침습적 양압환기법의 유용성)

  • Shim, Tae-Sun;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lim, Chae-Man
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.500-511
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    • 1999
  • Background: Noninvasive positive pressure ventilation (NPPV) using facial or nasal mask have been widely used for several years in stable patients with chronic neuromuscular disease or central alveolar hypoventilation, and recently have been tried in patients with acute respiratory failure. In a few studies, NPPV was also used to rescue the patients with post-extubation respiratory failure. However, yet it has not been adopted as a weaning method in patients on long-term mechanical ventilation. So we performed this prospective clinical study to evaluate the usefulness of NPPV as a weaning method after removing endotracheal tube intentionally in patients on long-term mechanical ventilation. Method: Twelve patients who had been on invasive mechanical ventilation over 10 days were enrolled and 14 trials of NPPV were done. All had failed at least one weaning trial and showed ventilator dependence(pressure support requirement between 8-15cm $H_2O$, and PEEP requirement between 5-10cm $H_2O$), so tracheostomy was being considered. After removing the endotracheal tube, NPPV was applied using facial mask. Respiratory rate, arterial blood gas, pressure support level, and PEEP level were monitored just before intended extubation, at 30 minutes, 1 to 6, 6 to 12, 12 to 24 hours, 2nd day, and 3rd day following initiation of NPPV, and just before weaning from NPPV. The successful weaning was defined as spontaneous breathing off the ventilator for 48 hours or longer without respiratory distress. Results: The weaning through NPPV after intended extubation was successful in 7(50%) of 14 trials, and tracheostomy could be avoided in them. There were no differences in age, sex, APACHE III score, duration of invasive mechanical ventilation, baseline respiratory rate, $PaCO_2$ $PaO_2/FiO_2$, and ventilatory requirement(PS and PEEP) between the success and failure groups. In the success group, respiratory rate, pH, $PaCO_2$, and $PaO_2/FiO_2$ were not different between invasive MV and NPPV period. But in the failure group, pH decreased after 30 minutes of NPPV initiation compared with that of invasive MV($7.40\pm0.08$ vs. $7.34\pm0.06$, p<0.05). The causes of failure were worsening of ABG(n=3), retained tracheal secretion(n=2), mask intolerance(n=1), and flail chest(n=1). Conclusion: NPPV may be worth trying as a bridge method in weaning patients on long-term invasive mechanical ventilation.

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Analysis of Sleep Questionnaires of Patients who Performed Overnight Polysomnography at the University Hospital (한 대학병원에서 철야 수면다원검사를 시행한 환자들의 수면설문조사 결과 분석)

  • Kang, Ji Ho;Lee, Sang Haak;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik;Park, Yong Moon
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.76-82
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    • 2006
  • Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

Change of Spherical Aberration with Aspheric Soft Contact Lens Wear (비구면 소프트콘택트렌즈 착용에 의한 눈의 구면수차 변화)

  • Kim, Jeong Mee;Mun, Mi-Young;Kim, Young Chul;Lee, Koon-Ja
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.4
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    • pp.365-372
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    • 2012
  • Purpose: To investigate ocular higher order aberrations (HOA) and spherical aberration changes caused by an aspheric soft contact lens designed to reduce spherical aberration (SA) of the eye. Methods: Fifty subjects who have successfully experienced soft contact lenses were refitted with aspheric design (Soflens Daily Disposable: SDD, Bausch+Lomb) soft contact lens. Ocular higher order aberrations (HOA) and stand alone SA were measured and analyzed for a 4-mm pupil size using Wave-Scan Wavefront$^{TM}$ aberrometer (VISX, Santa Clara, CA, USA). High and low contrast log MAR visual acuity and contrast sensitivity function (CSF) were also measured under photopic and mesopic conditions (OPTEC 6500 Vision Tester$^{(R)}$). All measurements were conducted monocularly with an undilated pupil. Results: The RMS mean values for total HOA with SDD contact lenses were significantly lower than those at with unaided eyes (p<0.001) and a reduction for SA in the SDD was close to the baseline SA (zero ${\mu}m$) (p<0.001). For the SDD lens, there was a statistically significant correlation between the changes in the total HOA and the contact lens power (r=0.237, p=0.018) as well as between the changes in SA and the lens power (r=0.324, p=0.001). High contrast visual acuity (HCVA) and low contrast visual acuity (LCVA) with SDD lenses were $-0.063{\pm}0.062$ and $0.119{\pm}0.060$, respectively under photopic and $-0.003{\pm}0.063$ and $0.198{\pm}0.067$, respectively under mesopic condition. Contrast Sensitivity Function (CSF) with SDD lenses under both photopic and mesopic conditions was $3.095{\pm}0.068$ and $3.087{\pm}0.074$, respectively. Conclusions: The SDD contact lens designed to control SA reduced the total ocular HOA and SA of the eye, resulting in compensating for positive SA of the eyes. Thus, the optical benefits of the lens with SA control would be adopted for improving the quality of vision.

Nocturnal Bruxism and Botulinum Toxin Effect on the Subjects with Masseteric Hypertrophy (야간 이갈이와 교근비대 환자의 보툴리눔 독소 주사 효과)

  • Sohn, Seung-Mahn;Chung, Gi-Chung;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.337-346
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    • 2007
  • This study aimed to evaluate a relation of bruxism with clinical effects of botulinum toxin type A(BTX-A) injection. 5 bruxers and 5 nonbruxers with bilateral masseter hypertrophy were participated in this study. After injecting 25 unit of BTX-A(Allergen Inc, $Botox^{(R)}$) into each masseter muscle, the thickness of masseter(Mm) and anterior temporalis(Ta) muscles was measured by ultrasonography and the maximum bite force was evaluated during a 9-month period. Self-estimation on the recovery of occlusal force during mastication was done as well. Regardless of presence of bruxsim, all subjects showed significantly reduced Ms thickness(p<0.001) and maximum bite force at $1^{st}$ molars(p=0.027) with their peak at 3 months after injection, which then started to return. No significant difference was observed in Ta thickness and the bite force at the central incisors. While self-estimated occlusal force was the least at 2 weeks after injection and then rapidly returned to the baseline level with full recovery at the time of 6 to 9 months after injection, the maximum bite force measured by bite force recorder did not recover the original value, particularly in the nonbruxer group. It is assumed that nocturnal bruxism can influence recovery of atrophic masseter and decreased occlusal force due to BTX-A injection. These findings suggest a need of occlusal appliance to control bruxism or clenching habit for longer clinical effect of BTX-A injection.

Early Bronchoconstriction After Allergen Challenge of Nonanesthetized Guinea Pigs (Ovalbumin으로 감작된 기니픽에서 Allergen 흡입으로 인한 즉시형 기관지 수축반응에 대한 비침습적 측정)

  • Kim, Je-Hyeong;Shim, Jae-Jeong;Lee, Sung-Yong;Kwon, Young-Hwan;Lee, So-Ra;Lee, Sang-Youb;Cho, Jae-Youn;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.99-106
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    • 1998
  • Background: Bronchial asthma is a complex disease, which is characterized by spontaneous exacerbations of airway obstruction and persistent bronchial hyperresponsiveness. Animal models have fallen short of reproducing the human disease, particularly in mimicking the spontaneous and persistent airflow obstruction that characterized in asthma. In animals, airflow obstruction is usually assessed by measuring airflow resistance during tidal breathing under such invasive technique as tracheostomy and anesthesia. A noninvasive technique for measuring pulmonary function in small animals is needed to evaluate long-term changes in lung function during the course of experimentally produced disease without sacrificing the animal. Purpose: The purpose of this study was to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness (AR) to inhaled methacholine in nonanethetized, unrestrained guinea pigs. Method: Guinea pig model of asthma was sensitized by subcutaneous injection with ovalbumin and challenged by inhalation of aerosolized ovalbumin(1% wt/vol ovlabumin). Airflow obstruction of conscious guinea pig was measured as specific airway resistance (airway resistance $\times$ thoracic gas volume). Airway resistance and thoracic gas volume of conscious guinea pig were assessed by body plethysmography before challenge and at regular intervals for as long as 30 minutes after challenge. AR to aerosolized methacholine of asthma group was compared with that of control group in body plethysmography. Result: Asthma model<> developed in 13 (65%) among 20 guinea pigs, in which early responses occurred in the airways after the exposure to inhalation with ovalbumin. Airway challenge with ovalbumin caused increase in specific airway resistance, which peaked at 6 minutes and amounted to a $231.5{\pm}30.4%$ increase from baseline. AR to aerosolized methacholine of asthma model increased significantly compared with control group. Conclusion: These results have showed a useful animal model to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness in nonanethetized, unrestrained guinea pigs.

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Study on Climate Change Impacts on Hydrological Response using a SWAT model in the Xe Bang Fai River Basin, Lao People's Democratic Republic (기후변화에 따른 라오스인민공화국의 시방파이 유역의 수문현상 예측에 대한 연구: SWAT 모델을 이용하여)

  • Phomsouvanh, Virasith;Phetpaseuth, Vannaphone;Park, Soo Jin
    • Journal of the Korean Geographical Society
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    • v.51 no.6
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    • pp.779-797
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    • 2016
  • A calibrated hydrological model is a useful tool for quantifying the impacts of the climate variations and land use/land cover changes on sediment load, water quality and runoff. In the rainy season each year, the Xe Bang Fai river basin is provisionally flooded because of typhoons, the frequency and intensity of which are sensitive to ongoing climate change. Severe heavy rainfall has continuously occurred in this basin area, often causing severe floods at downstream of the Xe Bang Fai river basin. The main purpose of this study is to investigate the climate change impact on river discharge using a Soil and Water Assessment Tool (SWAT) model based on future climate change scenarios. In this study, the simulation of hydrological river discharge is used by SWAT model, covering a total area of $10,064km^2$ in the central part of country. The hydrological model (baseline) is calibrated and validated for two periods: 2001-2005 and 2006-2010, respectively. The monthly simulation outcomes during the calibration and validation model are good results with $R^2$ > 0.9 and ENS > 0.9. Because of ongoing climate change, three climate models (IPSL CM5A-MR 2030, GISS E2-R-CC 2030 and GFDL CM3 2030) indicate that the rainfall in this area is likely to increase up to 10% during the summer monsoon season in the near future, year 2030. As a result of these precipitation increases, the SWAT model predicts rainy season (Jul-Aug-Sep) river discharge at the Xebangfai@bridge station will be about $800m^3/s$ larger than the present. This calibrated model is expected to contribute for preventing flood disaster risk and sustainable development of Laos

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Comparison of the Effectiveness of Dietary Intervention between Calorie Restriction Diet and Food Selective Method according to Yin and Yang Constitution in Obese Woman (열량제한식과 체질식에 따른 비만 여성의 체중감량 효과)

  • Sim, Seon-Ha;Hur, Bons-Soo;Hong, Kyung Hee
    • The Korean Journal of Food And Nutrition
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    • v.28 no.2
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    • pp.302-312
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    • 2015
  • This study was conducted to evaluate the effects of constitutional diets in comparison with general low calorie diets in obese women. The subjects were 52 adult obese women that participated in a calorie restriction diet program (control group, n=16) or a constitutional diet program (experimental group, n=36) for 8 weeks. The subjects in the experimental group were classified as negative (Yin) or positive (Yang) constitution. The obesity management program focused on the calorie restriction diet (300~400 kcal reduction per day) for the control group, whereas, for a constitutional diet without calorie restrictions was allowed for the experimental group. Daily intakes of nutrient and food were assessed using a 24 hr recall method. Body measurements and blood biochemical parameters were measured at baseline and after 8 weeks. After the intervention, weight, body fat, BMI, waist circumference and hip circumference decreased significantly in both the control and experimental group. Energy intake increased from 1,679.6 kcal to 1,810.6 kcal along with significant increase in protein, carbohydrate, fiber, calcium, phosphorus, iron, zinc, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin and vitamin C in the experimental group. Calcium intake increased from 54.0% to 72.4% of DRI in the experimental group. Hemoglobin concentrations were significantly decreased in the control group, but were increased in the experimental group. In addition, blood glucose, serum total cholesterol and triglyceride were significantly decreased in the experimental group. In conclusion, consumption of a constitutional diet without calorie restrictions for 8 weeks was effective for weight reduction with improvement of blood glucose, serum cholesterol and triglyceride.

The Validation Study of Beck Depression Scale 2 in Korean Version (한국판 벡 우울 척도 2판의 타당화 연구)

  • Lim, Sun-Young;Lee, Eun-Jeong;Jeong, Seong-Won;Kim, Hee-Chul;Jeong, Cheol-Ho;Jeon, Tae-Yeon;Yi, Min-Soo;Kim, Jae-Min;Jo, Hyeon-Ju;Kim, Jeong-Beom
    • Anxiety and mood
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    • v.7 no.1
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    • pp.48-53
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    • 2011
  • Objective : Korean Version of Beck-II Depression Inventory to verify the reliability and validity of the proposed standards are practical and standardized, cut-off score by establishing a baseline indicating the presence of depression and depression On in the evaluation was to evaluate the clinical usefulness. Methods : 739 patients with major depression using the SCID and normal controls were 302 study subjects. Of patients with clinically significant medical condition, or psychotic disorders, organic mental disorder, epilepsy or seizure disorder, eating disorders are associated with patients taking anti-convulsants experienced in the past, patients were excluded from the study. Results : The main findings of this study were as follows. First, with respect to the KBDI-II items, the correlation between them ranged from 0.51 to 0.74, and was 0.60 over all questions. Further, the overall correlation of the KBDI-II plates showing confidence 'normal' than it was verified that. Second, the BDIII was used in each group to examine internal consistency and thus, whether Cronbach's alpha values were greater than 0.94. Third, the principal component analysis sought to extract factors in a way consistent with the results inspected last 3 factors were extracted and the total variance explained was 47.3%. Fourth, the Cutting calculated the score on the KBDI-II for ROC (Receiver operator characteristic) analysis yielding 18 dot, with the highest sensitivity and specificity was seen. Conclusion : Based on the results of this Study, the KBDI-II cut-off point should be valid as prescribed in 18 is considered.