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Stenotrophomonas maltophilia and Ventilator-Associated Pneumonia in Critically Ill Pediatric Patients: a Retrospective Analysis at a Single Center (소아 환자에서 Stenotrophomonas maltophilia와 인공 환기요법 관련 폐렴에 관한 연구)

  • Lee, Byung-Kee;Choi, Soo-Han;Kim, Soo Jin;Cho, Joong Bum;Ae, Hong;Yoo, So-young;Kim, Ji Hye;Lee, Nam Young;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.75-80
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    • 2015
  • Purpose: Ventilator-associated pneumonia (VAP) is a serious threat in critically ill pediatric patients. Data regarding Stenotrophomonas maltophilia VAP in pediatric population is limited. We evaluated the clinical data of S. maltophilia associated VAP in critically ill pediatric patients. Methods: A retrospective chart review was performed in pediatric patients 18 years old or younger who developed S. maltophilia associated VAP at Samsung Medical Center, Seoul Korea from January 2008 to December 2012. Results: A total of 31 patients were identified S. maltophilia associated VAP. Median age was 8 months (range, 0.5 month to 16.6 years) and 13 patients were male (40.6%). Underlying illnesses were cardiologic diseases (n=11, 34.4%), hematologic oncologic malignancies (n=7, 25%), neurologic diseases (n=4, 12.5%), pulmonary diseases (n=3, 9.4%), and others (n=4, 12.5%). The median duration of ventilator use before S. maltophilia VAP diagnosis was 14 days (range, 4-256 days). Overall mortality at 30 days was 12.5% (4/32). Conclusions: S. maltophilia should be also considered as a possible pathogen for VAP in critically ill pediatric patients. Empiric antibiotic choice should include agents that are active against S. maltophilia in patients who are deteriorating on broad spectrum beta-lactam antimicrobial agents.

Effectiveness of Varicella Zoster Immune Globulin Administration within 96 Hours versus more than 96 Hours after Exposure to the Varicella-Zoster Virus (수두 바이러스에 노출 후 96시간 이내와 96시간 이후에 수두 면역 글로불린 투여시 수두 예방 효과에 관한 연구)

  • Kim, Sun-Ja;Lee, Byung-Kee;Kim, Yang-Hyun;Kim, Soo-Jin;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.55-62
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    • 2015
  • Purpose: Varicella Zoster Immune Globulin (VZIG) is available in Korea for post-exposure prophylaxis of the Varicella-zoster virus (VZV) in high-risk patients. In July 2013, the United States Centers for Disease Control and Prevention (US CDC) recommended extending the time for administration of VariZIG$^{(R)}$ from within 96 hours up to 10 days after VZV exposure. This study was performed to analyze the effectiveness of VZIG prophylaxis between the two groups of patients who received VZIG within 96 hours and more than 96 hours of exposure to varicella. Methods: A retrospective chart review was performed in pediatric patients who received VZIG at Samsung Medical Center, Seoul, Korea from January 2001 to December 2012. Results: A total of 91 patients were identified. Fifty-seven patients were male (62.6%) and the median age was 5.91 years. Thirty-nine patients (42.9%) were exposed to VZV in the hospital. Underlying diseases were solid tumors (41.8%), hematologic malignancies (40.7%), and others (17.5%). Forty-five patients (49.5%) were hematopoietic cell transplant recipients. Seventy-four patients (81.3%) received VZIG within 96 hours after VZV exposure. There was no significant difference in the development of chickenpox between the two groups (2.7% vs. 5.9%, P=0.4664). In 22 seronegative patients, we also observed no significant difference between the groups in terms of the development of chickenpox (6.6% vs. 0%, P=0.667). Conclusions: This study showed that the effectiveness of VZIG for the prevention of chickenpox was comparable between patients who received VZIG within 96 hours and those who received VZIG more than 96 hours after exposure to VZV.

Fusaric Acid Production in Fusarium oxysporum Transformants Generated by Restriction Enzyme-Mediated Integration Procedure (Restriction Enzyme-Mediated Integration 방법으로 확보한 Fusarium oxysporum 형질전환체의 후자리산 생성능 분석)

  • Lee, Theresa;Shin, Jean Young;Son, Seung Wan;Lee, Soohyung;Ryu, Jae-Gee
    • Research in Plant Disease
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    • v.19 no.4
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    • pp.254-258
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    • 2013
  • Fusaric acid (FA) is a mycotoxin produced by Fusarium species. Its toxicity is relatively low but often associated with other mycotoxins, thus enhancing total toxicity. To date, biosynthetic genes or enzymes for FA have not been identified in F. oxysporum. In order to explore the genetic element(s) for FA biosynthesis, restriction enzyme mediated integration (REMI) procedure as an insertional mutagenesis was employed using FA producing-F. oxysporum strains. Genetic transformation of two F. oxysporum strains by REMI yielded more than 7,100 transformants with efficiency of average 3.2 transformants/${\mu}g$ DNA. To develop a screening system using phytotoxicity of FA, eleven various grains and vegetable seeds were tested for germination in cultures containing FA: Kimchi cabbage seed was selected as the most sensitive host. Screening for FA non-producer of F. oxysporum was done by growing each fungal REMI transformant in Czapek-Dox broth for 3 weeks at $25^{\circ}C$ then observing if the Kimchi cabbage seeds germinated in the culture filtrate. Of more than 5,000 REMI transformants screened, fifty-three made the seeds germinated, indicating that they produced little or fewer FA. Among them, twenty-six were analyzed for FA production by HPLC and two turned out to produce less than 1% of FA produced by a wild type strain. Sequencing of genomic DNA regions (252 bp) flanking the vector insertion site revealed an uncharacterized genomic region homologous (93%) to the F. fujikuroi genome. Further study is necessary to determine if the vector insertion sites in FA-deficient mutants are associated with FA production.

Analysis of characteristics affecting the score-groups by supervisor and subordinate rating (하향평가와 상향평가 결과에 영향을 미치는 특성 분석)

  • Shin Ki Soo;Cho Woo Hyun;Park Young Yo;Jung Sang Huyk;Lee Hye Jean
    • Health Policy and Management
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    • v.15 no.1
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    • pp.97-117
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    • 2005
  • This study was designed to compare the differences m results of supervisor and subordinate rating. Data was collected from personnel evaluation and subordinate rating results for middle managers(n=68) in hospital from 3rd January to 20th March in 2004. Supervisor rating consisted of performance, ability and attitude evaluation. Subordinate rating consisted of leadership, ability and attitude evaluation. Collected data included sociodemographic characteristics, work department, work level, years of work, years at present level and whether working in a patient serving department. The difference of standardized supervisor and subordinate rating score was used to define groups as 'higher in supervisor rating group'. Groups were defined in total score, ability score and attitude score. Main results were as follows: 1. In total score, sectional chiefs were apt to be 'higher in subordinate rating group' while chief clerks were apt to be 'similar group' or 'higher in supervisor rating group'. Staffs in patient serving department were likely to be 'higher in supervisor rating group' and staffs in non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 2. In ability score, there were no statistically significant differences in age, sex, years of education, work department, work level, years of work and whether working in a patient serving department among 'higher in supervisor rating group', 'similar group' and 'higher in subordinate rating group'. 3. In attitude score, staffs in the department of medical affairs and the department of administration were apt to be 'higher in subordinate rating group'. Staffs in the department of nursing were apt to be 'higher in supervisor rating group'. Staffs in a patient serving department were likely to be 'higher in supervisor rating group' and staffs in a non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 4. Logistic analysis about total score showed that sectional chiefs had higher Odds Ratio(OR) to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. Both these results were statistically significant. 5. Logistic analysis about ability score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. These results were not statistically significant. 6. Logistic analysis about total score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group', but the difference was not statistically significant. Staffs in a non-patient serving department had significantly higher OR to be in 'higher in subordinate rating group'. In conclusion, there is no clear superiority between supervisor and subordinate rating in personnel evaluation. It would be better to use a mixed model. It's also suggested to use an intervening rate of application or scores considering work levels and work department in personnel evaluation. These results would be helpful for hospitals planning a supervisor and subordinate rating system for personnel evaluation.

Playing with Rauschenberg: Re-reading Rebus (라우센버그와 게임하기-<리버스> 다시읽기)

  • Rhee, Ji-Eun
    • The Journal of Art Theory & Practice
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    • no.2
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    • pp.27-48
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    • 2004
  • Robert Rauschenberg's artistic career has often been regarded as having reached its culmination when the artist won the first prize at the 1964 Venice Biennale. With this victory, Rauschenberg triumphantly entered the pantheon of all-American artists and firmly secured his position in the history of American art. On the other hand, despite the artist's ongoing new experiments in his art, the seemingly precocious ripeness in his career has led the critical discourses on Rauschenberg's art to the artist's early works, most of which were done in the mid-1950s and the 1960s. The crux of Rauschenberg criticism lies not only in focusing on the artist's 50's and 60's works, but also in its large dismissal of the significance of the imagery that the artist employed in his works. As art historians Roger Cranshaw and Adrian Lewis point out, the critical discourse of Rauschenberg either focuses on the formalist concerns on the picture plane, or relies on the "culturalist" interpretation of Rauschenberg's imagery which emphasizes the artist's "Americanness." Recently, a group of art historians centered around October has applied Charles Sanders Peirce's semiotics as art historical methodology and illuminated the indexical aspects of Rauschenberg's work. The semantic inquiry into Rauschenberg's imagery has also been launched by some art historians who seek the clues in the artist's personal context. The first half of this essay will examine the previous criticism on Rauschenberg's art and the other half will discuss the artist's 1955 work Rebus, which I think intersects various critical concerns of Rauschenberg's work, and yet defies the closure of discourses in one direction. The categories of signs in the semiotics of Charles Sanders Peirce and the discourse of Jean-Francois Lyotard will be used in discussing the meanings of Rebus, not to search for the semantic readings of the work, hut to make an analogy in terms of the paradoxical structures of both the work and the theory. The definitions of rebus is as follows: Rebus 1. a representation or words or syllables by pictures of object or by symbols whose names resemble the intended words or syllables in sound; also: a riddle made up wholly or in part of such pictures or symbols. 2. a badge that suggests the name of the person to whom it belongs. Webster's Third New International Dictionary of the English Language Unabridged. Since its creation in 1955, Robert Rauschenberg's Rebus has been one of the most intriguing works in the artist's oeuvre. This monumental 'combine' painting($6feet{\times}10feet$ 10.5 inches) consists of three panels covered with fabric, paper, newspaper, and printed reproductions. On top of these, oil paints, pencil and crayon drawings connect each section into a whole. The layout of the images is overall horizontal. Starting from a torn election poster, which is partially read as "THAT REPRE," on the far left side of the painting. Rebus leads us to proceed from the left to the right, the typical direction of reading in a Western context. Along with its seemingly proper title. Rebus, the painting has triggered many art historians to seek some semantic readings of it. These art historians painstakingly reconstruct the iconography based on the artist's interviews, (auto)biography, and artistic context of his works. The interpretation of Rebus varies from a 'image-by-image' collation with a word to a more general commentary on Rauschenberg's work overall, such as a work that "bridges between art and life." Despite the title's allusion to the legitimate purpose of the painting as a decoding of the imagery into sound, Rebus, I argue, actually hinders a reading of it. By reading through Peirce to Rauschenberg, I will delve into the subtle anxiety between words and images in their works. And on this basis, I suggest Rauschenberg's strategy in playing Rebus is to hide the meaning of the imagery rather than to disclose it.

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A study on the literatherapy effects of Sijo - Focused on the 16th-17th century Gangho Sijo - (시조의 문학 치료적 기능에 관한 고찰 -16.17세기 강호시조를 대상으로-)

  • Kim, Sang-Jean
    • Sijohaknonchong
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    • v.26
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    • pp.25-54
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    • 2007
  • This paper examines the literatherapy effects of Korea's oldest form of literature, Sijo, and its role in the future of literatherapy. Since literature is the expression of human emotions, and therapy is related to medicine, the two seem to have little in common, but they share the function of resolving conflicts. The effectiveness of literatherapy has only recently become a matter of discussion. However, literatherapy is greatly involved with the utility value of literature, and should be taken seriously. This research focused on the literatherapy function of the 16th-17th century Gangho-Sijo. Gangho-Sijo was created by literary men from the Sarim-school, who were removed from their posts in the government due to a massacre(Sawha) and rianly(Dangjaing), and spent most of their time away from politics. Their Sijo were mostly about life in retreat, and their mental state at that time. In relation to literatherapy, the mentality and attitudes of these scholars can be divided into three stages. The first is anxiety and depression, the second tranquility and harmony. and the third serenity. At the final stage, the scholars are liberated from worldly desires. Each of these phases hold the effect of literatherapy. The first stage can relate to 'theory of purgation', ISO-Prinsip, which is based on 'like cures like' which means to treat something with its own kind Fight fire with fire. The second step involves 'theory of purification', and by balancing his emotions, the scholar can achieve mental stability. In the final stage, literatherapy is acquired when the scholar expresses his emotions in a clarification(theory of clarification). At this phase, literatherapy finally has an effect, while the phase itself functions as literatherapy as well. The study of literatherapy is still at its early stages, thus has many limitations. However, literatherapy has bright prospects, and it is my hope that this report will be used as a reference for its further research.

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Nano-mechanical Properties of Nanocrystal of HfO2 Thin Films for Various Oxygen Gas Flows and Annealing Temperatures (RF Sputtering의 증착 조건에 따른 HfO2 박막의 Nanocrystal에 의한 Nano-Mechanics 특성 연구)

  • Kim, Joo-Young;Kim, Soo-In;Lee, Kyu-Young;Kwon, Ku-Eun;Kim, Min-Suk;Eum, Seoung-Hyun;Jung, Hyun-Jean;Jo, Yong-Seok;Park, Seung-Ho;Lee, Chang-Woo
    • Journal of the Korean Vacuum Society
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    • v.21 no.5
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    • pp.273-278
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    • 2012
  • Over the last decade, the hafnium-based gate dielectric materials have been studied for many application fields. Because these materials had excellent behaviors for suppressing the quantum-mechanical tunneling through the thinner dielectric layer with higher dielectric constant (high-K) than $SiO_2$ gate oxides. Although high-K materials compensated the deterioration of electrical properties for decreasing the thickness of dielectric layer in MOSFET structure, their nano-mechanical properties of $HfO_2$ thin film features were hardly known. Thus, we examined nano-mechanical properties of the Hafnium oxide ($HfO_2$) thin film in order to optimize the gate dielectric layer. The $HfO_2$ thin films were deposited by rf magnetron sputter using hafnium (99.99%) target according to various oxygen gas flows. After deposition, the $HfO_2$ thin films were annealed after annealing at $400^{\circ}C$, $600^{\circ}C$ and $800^{\circ}C$ for 20 min in nitrogen ambient. From the results, the current density of $HfO_2$ thin film for 8 sccm oxygen gas flow became better performance with increasing annealing temperature. The nano-indenter and Weibull distribution were measured by a quantitative calculation of the thin film stress. The $HfO_2$ thin film after annealing at $400^{\circ}C$ had tensile stress. However, the $HfO_2$ thin film with increasing the annealing temperature up to $800^{\circ}C$ had changed compressive stress. This could be due to the nanocrystal of the $HfO_2$ thin film. In particular, the $HfO_2$ thin film after annealing at $400^{\circ}C$ had lower tensile stress, such as 5.35 GPa for the oxygen gas flow of 4 sccm and 5.54 GPa for the oxygen gas flow of 8 sccm. While the $HfO_2$ thin film after annealing at $800^{\circ}C$ had increased the stress value, such as 9.09 GPa for the oxygen gas flow of 4 sccm and 8.17 GPa for the oxygen gas flow of 8 sccm. From these results, the temperature dependence of stress state of $HfO_2$ thin films were understood.

Development of an Aerodynamic Simulation for Studying Microclimate of Plant Canopy in Greenhouse - (2) Development of CFD Model to Study the Effect of Tomato Plants on Internal Climate of Greenhouse - (공기유동해석을 통한 온실내 식물군 미기상 분석기술 개발 - (2)온실내 대기환경에 미치는 작물의 영향 분석을 위한 CFD 모델개발 -)

  • Lee In-Bok;Yun Nam-Kyu;Boulard Thierry;Roy Jean Claude;Lee Sung-Hyoun;Kim Gyoeng-Won;Hong Se-Woon;Sung Si-Heung
    • Journal of Bio-Environment Control
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    • v.15 no.4
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    • pp.296-305
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    • 2006
  • The heterogeneity of crop transpiration is important to clearly understand the microclimate mechanisms and to efficiently handle the water resource in greenhouses. A computational fluid dynamic program (Fluent CFD version 6.2) was developed to study the internal climate and crop transpiration distributions of greenhouses. Additionally, the global solar radiation model and a crop heat exchange model were programmed together. Those models programmed using $C^{++}$ software were connected to the CFD main module using the user define function (UDF) technology. For the developed CFD validity, a field experiment was conducted at a $17{\times}6 m^2$ plastic-covered mechanically ventilated single-span greenhouse located at Pusan in Korea. The CFD internal distributions of air temperature, relative humidity, and air velocity at 1m height were validated against the experimental results. The CFD computed results were in close agreement with the measured distributions of the air temperature, relative humidity, and air velocity along the greenhouse. The averaged errors of their CFD computed results were 2.2%,2.1%, and 7.7%, respectively.

Clinical Features of Adolescent Tuberculosis: A Single Institute Study (단일기관에서 진단받은 청소년 결핵의 임상적 특징)

  • Hong, Sung Wan;Hong, Chan Eui;Lee, Dong Jean;Roh, Byung Hak
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.174-179
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    • 2008
  • Purpose : The purpose of this study was to investigate the clinical features of adolescent TB. Methods : We retrospectively reviewed the medical records of the adolescents aged 12 to 18 years and who are hospitalized with the diagnosis of TB at Dong Kang General Hospital between January 2003 and December 2007. Results : Of the 29 patients who were identified, 65.5% were male. The median age at diagnosis was 16.9 years (range: 12.1-18.9 years). A tuberculin skin test (TST) was performed for 6 patients (20.7%). Among them, 5 (5 of 8[62.5%]) in the 12-15 years age group (Group A) and 1 (1 of 21[4.8%]) in the 16-18 years of age group (Group B) were TST positive, which showed that the TST performing rate decreased with age (P<0.01). Twenty-five patients (86.2%) were detected by evaluating the clinical symptoms that suggested TB and 4 patients (13.8%) were detected by screening, but no cases were detected by contact tracing. Twenty patients (69.0%) had isolated pulmonary disease. Seven patients (24.1%) had pulmonary and extrapulmonary disease and 2 patients (6.9%) had exclusively extrapulmonary disease. Most patients presented with multiple symptoms, and the most common were cough (79.3%), fever (75.9%), sputum (65.8%) and chest pain (34.5%). M. tuberculosis was isolated from the sputum of 20 patients (69.0%). The culture-positive rate increased with age (range: 62.5% in Group A to 71.4% in Group B), but the difference between the groups was not significant. Cavitary lesions were found 13 patients (44.8%). The cavitary lesion rate increased with age (range: 25.0% in Group A to 52.4% in Group B), but the difference between the groups was not significant. Four patients (13.8%) were lost during follow-up. One patient (6.9%) relapsed. Conclusion : Clinicians need to be aware of the unique features of adolescent TB, and they also need awareness of the importance of TST and contact investigation for an adult suspected of having TB for making the diagnosis of TB.

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Analysis of the Change in Seropositive Rate of the Epstein-Barr Virus in Koreans: A Single-Center Study (한국인의 Epstein-Barr Virus 항체 양성률 변화양상에 대한 분석: 단일기관 연구)

  • Kim, Su Kyung;Choi, Joon-Sik;Kim, Dongsub;Kang, Cheol-In;Chung, Doo Ryeon;Peck, Kyong Ran;Kang, Eun-Suk;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.117-126
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    • 2020
  • Purpose: Epstein-Barr virus (EBV) infection is related to infectious mononucleosis or nasopharyngeal cancer, and its epidemiology may change according to the socioeconomic development of communities. This study aimed to evaluate the recent epidemiology of EBV seropositive rate in Korea. Methods: We retrospectively reviewed EBV serology test results obtained from a part of clinical care at Samsung Medical Center, Seoul, South Korea, from January 2000 to December 2017. Results: The EBV seropositive rate in 26,527 subjects during the study period was 81.0% (21,485/26,527): 44.4% (2,716/6,122) in subjects aged 0-9 years, 75.8% (2,077/2,739) in those aged 10-19 years, and 94.5% (16,692/17,666) in those aged ≥20 years. The EBV seropositive rate decreased from 89.4% (8,592/9,616) in 2000-2008 to 76.2% (12,893/16,911) in 2009-2017 (P<0.001). Especially, the EBV seropositive rate in subjects aged 0-19 years significantly decreased from 2000-2008 to 2009-2017 (0-9 years, 62.8% [1,172/1,866] in 2000-2008 and 36.3% [1,544/4,256] in 2009-2017; 10-19 years, 83.8% [745/858] in 2000-2008 and 70.8% (1,332/1,881) in 2009-2017) (P<0.001). Conclusions: The EBV seropositive rate in children has decreased in the last 20 years. As the age of patients with primary EBV infection increased, there is a need for interest in clinical manifestation, such as infectious mononucleosis, in adolescents and young adults.