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Serotype Distribution of Pneumococcus Isolated from the Ear Discharge in Children with Otitis Media in 2001-2006 (중이염 환아의 이루에서 분리된 폐구균의 혈청형 분포(2001-2006))

  • Lee, Teak Jin;Chun, Jin-Kyong;Kim, Ki Hwan;Kim, Khi Joo;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.45-51
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    • 2008
  • Purpose : Better understanding of the epidemiology of Streptococcus pneumoniae affects preventive and therapeutic strategies for children with otitis media. This study was undertaken to examine the prevalence of pneumococcal serotypes causing otitis media in children. Methods : Pneumococcal isolates obtained from the ear discharge of children with otitis media between January 2001 and December 2006 were characterized by serotyping and antibiotic susceptibility testing. Results : There were 54 pneumococcal isolates from 54 children with otitis media. The median age of patients was 13 months, and the proportion of children <5 years old was 81%. The predominant serotypes, in order of decreasing frequency, were 19A (44%), 19F(28%), 6B (7%), 6A (4%), 9V (4%), and 1 (4%); 23 isolates (43%) belonged to types included in the heptavalent pneumococcal conjugate vaccine (PCV7). The proportion of serotype 19A and 19F accounted for 72% of overall pneumococcal isolates, which accounted for 84% of pneumococcal isolates from otorrhea of children <5 years old (vs 20% in children ${\geq}5$ years old, P<0.001). All serotypes isolated from 3 vaccinees of PCV7 were 19A. There was no significant diminution in otitis media caused by pneumococcal vaccine serotypes after the introduction of PCV7. The frequency of nonsusceptibility to penicillin, erythromycin, and trimethoprim-sulfamethoxazole was higher in serotype 19A than in other non-vaccine serotypes, respectively. The frequency of multiple drug resistance was 96% in serotype 19A, compared with 29% in other non-vaccine serotypes (P=0.001). Conclusion : 19A was the most common pneumococcal serotype causing otitis media and represented a large proportion of strains with multiple drug resistance in children younger than 5 years of age.

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Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer (조기유방암환자의 이차원치료계획과 삼차원치료계획의 방사선조사범위의 차이)

  • Jo, Sun-Mi;Chun, Mi-Son;Kim, Mi-Hwa;Oh, Young-Taek;Kang, Seung-Hee;Noh, O-Kyu
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.177-183
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    • 2010
  • Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

Quantitative Conductivity Estimation Error due to Statistical Noise in Complex $B_1{^+}$ Map (정량적 도전율측정의 오차와 $B_1{^+}$ map의 노이즈에 관한 분석)

  • Shin, Jaewook;Lee, Joonsung;Kim, Min-Oh;Choi, Narae;Seo, Jin Keun;Kim, Dong-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.303-313
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    • 2014
  • Purpose : In-vivo conductivity reconstruction using transmit field ($B_1{^+}$) information of MRI was proposed. We assessed the accuracy of conductivity reconstruction in the presence of statistical noise in complex $B_1{^+}$ map and provided a parametric model of the conductivity-to-noise ratio value. Materials and Methods: The $B_1{^+}$ distribution was simulated for a cylindrical phantom model. By adding complex Gaussian noise to the simulated $B_1{^+}$ map, quantitative conductivity estimation error was evaluated. The quantitative evaluation process was repeated over several different parameters such as Larmor frequency, object radius and SNR of $B_1{^+}$ map. A parametric model for the conductivity-to-noise ratio was developed according to these various parameters. Results: According to the simulation results, conductivity estimation is more sensitive to statistical noise in $B_1{^+}$ phase than to noise in $B_1{^+}$ magnitude. The conductivity estimate of the object of interest does not depend on the external object surrounding it. The conductivity-to-noise ratio is proportional to the signal-to-noise ratio of the $B_1{^+}$ map, Larmor frequency, the conductivity value itself and the number of averaged pixels. To estimate accurate conductivity value of the targeted tissue, SNR of $B_1{^+}$ map and adequate filtering size have to be taken into account for conductivity reconstruction process. In addition, the simulation result was verified at 3T conventional MRI scanner. Conclusion: Through all these relationships, quantitative conductivity estimation error due to statistical noise in $B_1{^+}$ map is modeled. By using this model, further issues regarding filtering and reconstruction algorithms can be investigated for MREPT.

Changes of Blood Gases, Plasma Catecholamine Concentrations and Hemodynamic Data in Anesthetized Dogs during Graded Hypoxia Induced by Nitrous Oxide (아산화질소에 의한 점진적 저산소가스 흡입이 혈중 가스치와 Catecholamine치 및 혈역학에 미치는 영향)

  • Kim, Sae-Yeon;Song, Sun-Ok;Bae, Jung-In;Cheun, Jae-Kyu;Bae, Jae-Hoon
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.97-113
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    • 1998
  • The sympathoadrenal system plays an important role in homeostasis in widely varing external environments. Conflicting findings, however, have been reported on its response to hypoxia. We investigated the effect of hypoxia on the sympathoadrenal system in dogs under halothane anesthesia by measuring levels of circulating catecholamines in response to graded hypoxia. Ten healthy mongreal dogs were mechanically ventilated with different hypoxic gas mixtures. Graded hypoxia and reoxygenation were induced by progressively decreasing the oxygen fraction in the inhalation gas mixture from 21%(control) to 15%, 10% and 5% at every 5 minutes, and then reoxygenated with 60% oxygen. Mean arterial pressure, central venous pressure and mean pulmonary arterial pressure were measured directly using pressure transducers. Cardiac output was measured by the thermodilutional method. For analysis of blood gas, saturation and content, arterial and mixed venous blood were sampled via the femoral and pulmonary artery at the end of each hypoxic condition. The concentration of plasma catecholamines was determined by radioenzymatic assay. According to the exposure of graded hypoxia, not only did arterial and mixed venous oxygen tension decreased markedly at 10% and 5% oxygen, but also arterial and mixed venous oxygen saturation decreased significantly. An increased trend of the oxygen extraction ratio was seen during graded hypoxia. Cardiac output, mean arterial pressure and systemic vascular resistance were unchanged or increased slightly. Pulmonary arterial pressure(PAP) and pulmonary vascular resistance(PVR) were increased by 55%, 76% in 10% oxygen and by 82%, 95% in 5% oxygen, respectively(p<0.01). The concentrations of plasma norepinephrine, epinephrine and dopamine increased by 75%, 29%, 24% in 15% oxygen and by 382%, 350%, 49% in 5% oxygen. These data suggest that the sympathetic nervous system was activated to maintain homeostasis by modifying blood flow distribution to improve oxygen delivery to tissues by hypoxia, but hemodynamic changes might be blunted by high concentration of nitrous oxide except PAP and PVR. It would be suggested that hemodynamic changes might not be sensitive index during hypoxia induced by high concentration of nitrous oxide exposure.

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Trace Components and Functional Saccharides in Marine Algae -2. Dietary Fiber Contents and Distribution of the Algal Polysaccharides- (식용해조류중의 미량요소와 특수기능성 당질 -2. 산지와 채취시기별 식이성섬유질 함량의 변화와 해조다당류의 분포-)

  • KIM Doo-Sang;LEE Dong-Soo;CHO Deuk-Moon;KIM Hyeung-Rak;PYEUN Jae-Hyeung
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.28 no.3
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    • pp.270-278
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    • 1995
  • This report described on the soluble, insoluble, and total dietary fiber level depending on the harvesting seasons and habitats in 9 species of marine algae. Total dietary fiber contents were comprised $25.4-38.1\%$ (dry basis) in green laver and $35.4-43.8\%$in sea staghorn of green algae, $34.2-48.8\%$ in sea mustard, $37.5-47.8\%$ in seaweed fusiforme, $42.9-71.3\%$ in gulf weed, and $37.1-45.1\%$ in sea tangle of brown algae, and $31.3-40.5\%$ in laver, $51.5-60.4\%$ in seaweed dilatata, and $57.1-65.8\%$ in seaweed furcata of red algae. Relatively high levels of both soluble and insoluble dietary fibers were found in seaweed furcata and gulf weed. The ratio of soluble dietary fiber to total dietary fiber was the highest in green laver $(43.7-64.8\%)$, sea mustard $(17.5-31.3\%)$, and seaweed furcata $(44.7-63.2\%)$ in their respective groups. The highest level of algal polysaccharides was confirmed to be an alkali-soluble alginic acid $(9.0-15.1\%)$ in whole brown algae, porphyran$(5.8\%)$ in laver, agar $(20.0\%)$ in seaweed furcata, and carrageenan $(23.8\%)$ in seaweed dilatata of red algae.

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First-pass Stress Perfusion MR Imaging Findings of Apical Hypertrophic Cardiomyopathy: with Relation to LV Wall Thickness and Late Gadolinium-enhancement (심첨형 비후성 심근병증에서의 스트레스 부하 관류 자기공명영상 소견: 좌심실 벽 비후 정도와 지연 조영 증강 간의 관련성)

  • Yoo, Jin Young;Chun, Eun Ju;Kim, Yeo-Koon;Choi, Sang Il;Choi, Dong-Ju
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.1
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    • pp.7-16
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    • 2014
  • Purpose : To evaluate the prevalence and pattern of perfusion defect (PD) on first-pass stress perfusion MR imaging in relation with the degree of left ventricular hypertrophy (LVH) and late gadolinium-enhancement (LGE) in patients with apical hypertrophic cardiomyopathy (APH). Materials and Methods: Cardiac MR imaging with first-pass stress perfusion, cine, and LGE sequence was performed in 26 patients with APH from January 2008 to December 2012. We analyzed a total of 416 segments for LV wall thickness on end-diastolic phase of cine images, and evaluated the number of hypertrophied segment and number of consecutive hypertrophied segment (NCH). We assessed the presence or absence of PD and LGE from all patients. If there was PD, we subdivided the pattern into sporadic (sporadic-PD) or ring (ring-PD). Using univariate logistic method, we obtained the independent predictor for presence of overall PD and ring-PD. Results: PD on stress perfusion MRI was observed in 20 patients (76.9%), 12 of them (60%) showed ring-PD. Maximal LV wall thickness and number of hypertrophied segment were independent predictors for overall PD (all, p < 0.05). NCH with more than 3 segments was an additional independent factor for ring-PD. However, LGE was not statistically related with PD in patients with APH. Conclusion: About three quarters of the patients with APH showed PD, most of them represented as ring-PD. LVH degree or distribution was related with pattern of PD, however, LGE was not related with PD. Therefore, the clinical significance of PD in the patients with APH seems to be different from those with non-APH, and further comparison study between the two groups should be carried out.

Distribution of CD4+CD25+ T cells and graft-versus-host disease in human hematopoietic stem cell transplantation (사람의 동종 조혈모세포이식에서 CD4+CD25+ T세포의 분포와 이식편대숙주병)

  • Lee, Dae Hyoung;Chung, Nak Gyun;Jeong, Dae Chul;Cho, Bin;Kim, Hack Ki
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1336-1341
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    • 2008
  • Purpose : This study aimed to determine the frequencies of $CD4^+CD25^+$ T cells in donor graft and peripheral blood $CD4^+CD25^+$ T cells in recipients after hematopoietic stem cell transplantation (HSCT) and their association with graft-versus-host disease (GVHD). Methods : Seventeen children who underwent HSCT were investigated. $CD4^+CD25^+$ T cells in samples from donor grafts and recipient peripheral blood were assessed by flow cytometry at 1 and 3 months after transplantation. Results : $CD4^+CD25^+$ T cell frequencies in the grafts showed no significant difference between patients with and without acute GVHD (0.90% vs. 1.06%, P=0.62). Absolute $CD4^+CD25^+$ T cell number in grafts were lower in patients with acute GVHD than in those without acute GVHD ($6.18{\times}10^5/kg$ vs. $25.85{\times}10^5/kg$, P=0.09). Patients without acute GVHD showed a significant decrease in peripheral blood $CD4^+CD25^+$ T cell percentage at 3 months compared to those at 1 month after HSCT (2.11% vs. 1.43%, P=0.028). However, in patients with acute GVHD, $CD4^+CD25^+$ T cell percentage at 3 months was not different from the corresponding percentage at 1 month after HSCT (2.47% vs. 2.30%, P=0.5). Conclusion : The effect of frequencies of $CD4^+CD25^+$ T cells in donor grafts on acute GVHD after HSCT could not be identified, and the majority of peripheral blood $CD4^+CD25^+$ T cells in patients who underwent HSCT may be activated T cells related to acute GVHD rather than regulatory T cells. Further studies with additional markers for regulatory T cells are needed to validate our results.

Evaluation of Dose and Position Compensation of Parotid Gland Using CT On-rail System in Head-and-Neck Cancer (두경부 암환자 치료 시 CT On-rail System을 이용한 이하선의 위치 보정 및 선량 평가)

  • Jang, Hyeong-Jun;Im, Chung-Geun;Chun, Geum-Sung;Jeong, Il-Seon;Kim, Hoi-Nam
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.2
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    • pp.83-89
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    • 2008
  • Purpose: The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H&N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H&N cancer patient of CT On-rail System. Materials and Methods: The object of H&N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. Results: The changes of target coordinate by the parotid gland movement are X: -0.4~0.4 cm, Y: -0.4~0.3 cm, Z: -0.3~0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Conclusion: Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivary time.

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Colony Size Distributions according to in vitro Aging in Human Skin Fibroblasts (피부 섬유모세포 노화에 따른 세포집락 크기의 분포)

  • Kim, Jun-Sang;Kim, Jae-Sung;Cho, Moon-June;Park, Jeong-Kyu;Park, Tae-Hyun
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.158-165
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    • 1999
  • Purpose : To investigate the percentage of colonies wi1h16or more cells distribution of human skin fibroblast according to in vitro aging, and to evaluate the relationship between percentage of colonies with 10 or more cells and in vivo donor age in human skin fibroblast culture. Material and Method : C1, C2, C3a, and C3b human skin fibroblast samples from three breast cancer patients were used as subjects. The C1, C2, and C3a donor were 44, 54, and 55 years old, respectively. C3a and C3b cells were isolated from the same person. Single cell suspension of skin fibroblasts was prepared with primary explant technique. One hundred cells are plated into 100m1 tissue culture flask and cultured for two weeks. The colony size was defined as colonies with 16 or more cells. The cultured cell was stained with crystal violet, and number of cells in each colony was determined with stereo microscope at $\times$10 magnification. Passage number of C1, C2, C3a and C3b skin fibroblast were 12th, 17th, and 14th, respectively. Results : Percentage of colonies with 16 or more cells of skin fibroblast samples decreased with increasing in vitro passage number. In contrast, cumulative population doublings of skin fibroblast sample increased with increasing in vitro passage number. Percentage of colonies with 16 or more cells also decreased with increasing population doublings in human skin fibroblast culture. There was strong correlation with percentage of colonies with 16 or more cells and population doublings En C3a skin fibroblast sampie. At the same point of population doublings, the percentage of colonies with 16 or more cells of the young C1 donor was higher level than the old C3a donor. Conclusion : The population doublings increased with increasing in vitro passage number but percentage of colonies with 16 or more cells decreased. The results of this study imply that percentage of colonies with 16 or more cell is useful as a indicator of in vitro human skin fibroblast aging and may estimate the in vivo donor age.

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Ehrlichia and Borrelia spp. Infection in German Shepherd Dogs in Korea (독일 셰퍼드 개에서 Ehrlichia와 Borrelia spp.의 감염)

  • Hwang, Cheol-Yong;Seo, Sang-Ho;Kang, Jun-Gu;Youn, Hwa-Young;Chae, Joon-Seok
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.204-210
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    • 2011
  • The presence of the tick-borne pathogens Ehrlichia and Borrelia in German Shepherd dogs in Korea was determined by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). A total of 291 dogs were randomly selected from five Korean provinces from October 2005 through September 2006. The seroprevalence of antibodies to canine Ehrlichia and Borrelia agents detected by ELISA (Snap$^{(R)}$ 3Dx$^{(R)}$ Test, IDEXX Laboratories) was 7.56% (22 dogs) and 1.72% (5 dogs) respectively, throughout the country. Positive antibodies against both pathogens were detected in two dogs (0.69%). The provincial distribution of seroprevalence against Ehrlichia was 1.28% (1 of 78) in Gyeonggi-do, 12.64% (11 of 87) in Gangwon-do, 9.76% (4 of 41) in Chungcheong-do, 8.93% (5 of 56) in Gyeongsang-do, and 3.45% (1 of 29) in Jeolla-do. According to PCR analysis, Ehrlichia chaffeensis target DNA was amplified in 3.09% (9 of 291 dogs) of blood samples, 2.41% (7 of 291) from Gangwon-do and 0.69% (2 of 291) from Chungcheong-do. The oligonucleotide sequences (SNU-EC3 and SNU-EC5) from the PCR fragment examined in Korea were closely related to E. chaffeensis isolated from the tick Haemaphysalis longicornis, in China and the state of Arkansas in the US. Based on these results, the presence of E. chaffeensis infection was identified in German Shepherds being bred in Korea. These results bring to light the importance of paying close attention to tick-borne infections such as Lyme disease during clinical diagnosis. This infectious disease should be included as a differential diagnosis for patients who participate in outdoor activity from spring to fall or who have thrombocytopenia or leucopenia.