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Clinical Manifestations of Invasive Infections due to Streptococcus pyogenes in Children (소아에서 발생한 A군 연쇄구균에 의한 침습성 질환의 임상적 특성 분석)

  • Yang, Nuri;Lee, Hyeon Seung;Choi, Jae Hong;Cho, Eun Young;Choi, Eun Hwa;Lee, Hoan Jong;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.21 no.2
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    • pp.129-138
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    • 2014
  • Purpose: Streptococcus pyogenes is an important cause of invasive diseases in children. We aimed to describe the clinical characteristics of invasive infections due to S. pyogenes in children in Korea. Methods: A retrospective study of children under 18 years of age with invasive infections due to S. pyogenes at Seoul National University Children's Hospital between March 1992 and December 2012, and Seoul National University Bundang Hospital between March 2003 and December 2012 was conducted. Demographic factors, clinical characteristics, laboratory findings, treatment, mortality and morbidity of all patients were reviewed. Results: A total of 30 among 36 cases identified as invasive disease due to S. pyogenes were available for review. There was a predominance for male subjects (male:female=2.75:1). The median age was 50 months (range 12 days to 15 years) and 53.3% were under 5 years of age. Skin and soft tissue infections (9/30, 30.0%), bacteremia without identified focus (4/30, 13.3%) and bone and joint infections (6/30, 20.0%) were the most frequent clinical presentations. Streptococcal toxic shock syndrome (3/30, 10.0%) pulmonary, abdomen and central nervous system infections (2/30, 6.7%) were also seen. There was a peak in number of patients in year 2012 (9/30, 30.0%). There were no cases of mortality. Erythromycin and clindamycin resistance rates were low by 3.8% and 7.5%, respectively. Conclusion: We studied the clinical presentations of invasive infections due to S. pyogenes during the past 20 years in Korean children. The findings of this study help us understand the characteristics of the disease, enhancing early recognition and prompting adequate antibiotic therapy which is important in reducing morbidity and mortality.

Design of a Crowd-Sourced Fingerprint Mapping and Localization System (군중-제공 신호지도 작성 및 위치 추적 시스템의 설계)

  • Choi, Eun-Mi;Kim, In-Cheol
    • KIPS Transactions on Software and Data Engineering
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    • v.2 no.9
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    • pp.595-602
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    • 2013
  • WiFi fingerprinting is well known as an effective localization technique used for indoor environments. However, this technique requires a large amount of pre-built fingerprint maps over the entire space. Moreover, due to environmental changes, these maps have to be newly built or updated periodically by experts. As a way to avoid this problem, crowd-sourced fingerprint mapping attracts many interests from researchers. This approach supports many volunteer users to share their WiFi fingerprints collected at a specific environment. Therefore, crowd-sourced fingerprinting can automatically update fingerprint maps up-to-date. In most previous systems, however, individual users were asked to enter their positions manually to build their local fingerprint maps. Moreover, the systems do not have any principled mechanism to keep fingerprint maps clean by detecting and filtering out erroneous fingerprints collected from multiple users. In this paper, we present the design of a crowd-sourced fingerprint mapping and localization(CMAL) system. The proposed system can not only automatically build and/or update WiFi fingerprint maps from fingerprint collections provided by multiple smartphone users, but also simultaneously track their positions using the up-to-date maps. The CMAL system consists of multiple clients to work on individual smartphones to collect fingerprints and a central server to maintain a database of fingerprint maps. Each client contains a particle filter-based WiFi SLAM engine, tracking the smartphone user's position and building each local fingerprint map. The server of our system adopts a Gaussian interpolation-based error filtering algorithm to maintain the integrity of fingerprint maps. Through various experiments, we show the high performance of our system.

A Retrospective Analysis of Characteristics of Probiotics Associated with Invasive Bacterial Infections in Children (소아청소년에서 발생한 유산균 제제에 포함된 균주에 의한 침습성 감염증의 후향적 분석)

  • Koh, June Young;Seo, Euri;Lee, Jina
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.168-177
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    • 2017
  • Purpose: The purpose of this study was to analyze the clinical features and risk factors of invasive infections caused by Lactobacillus spp. and Saccharomyces spp., components of commercially available probiotics. Methods: We analyzed demographic and clinical data from children ${\leq}18$ years of age with an invasive infection caused by Lactobacillus spp. or Saccharomyces spp. at the Asan Medical Center Children's Hospital from January 1998 to June 2016. Probiotic consumption data were also analyzed. Results: During the study period, a total of 24 episodes of invasive infections were caused by Lactobacillus spp. (n=16) and Saccharomyces cerevisiae (n=8). Along with the increase of probiotic use (755,594 [days/1,000 patient-admission days] in 2001 to 2005, 1,444,066 in 2006 to 2010, and 6,904,736 in 2011 to 2016), the incidence of probiotic-associated invasive infection increased ($R^2=0.70$). The median age of the patients was 1.8 years (range, 2 months to 17 years), and most of them had underlying medical conditions. The 30-day mortality rate was 20.8% (5/24), and 11 (45.8%) of these patients resulted from a severe invasive infection. We determined the risk factors for invasive infection to be: previous intensive care unit stay (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.5 to 6.1] and the presence of a central venous catheter (OR, 2.2; 95% CI, 1.2 to 4.3). Conclusions: Although the probiotic-associated invasive infections rarely occurred in children, the incidence has increased along with probiotic pressure. Judicious use of probiotics is mandatory, especially in young children with underlying medical conditions and continuous surveillance will be needed to minimize the safety concerns.

Sedimentological Characteristics of the Surface Sediments in the Southern Sea off Cheju Island, Korea. (제주남방해역 표층퇴적물의 특성)

  • 윤정수;고기원
    • 한국해양학회지
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    • v.22 no.3
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    • pp.130-142
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    • 1987
  • Sedimentological characteristics of the surface sediments in the southern sea off Cheju Island are described from analyses of bottom sediments. The sediments are subdivided into seven textural classes, muddy sand, slightly gravelly muddy sand, sand, clayey sand, sandy clay, sandymud, silty sand. Sand-size sediments are distributed in the southeastern part and/or around the Island, whereas sandy and muddy sediments are mainly distributed in the central and southern parts of the study area. A small portion of mud patch is located in the southwestern part of the area. According to the textural parameters analysis, sediments in the study area are poorly sorted(av.2.52 ), positive skewed(av.1.61 ), leptokurtic(av.1.74 ), transported by saltation and/or suspension, and roundness of quartz is varied from angular to surrounded, which suggesting that the depositional environment is not simple. The calcium carbonate content is on the average 26.99%, and commonly abundant in sand-size sediments, whereas organic matter content in the bulk sediment is on the average 6.70% and usually dominant in fine-grained sediments.Light minerals consist of quartz(av56.01%),Na-Ca feldspar(av.6.15%),K-feldspar(av.9.22%) and rock fragments(av28.11%).The contect onquartz and K-feldspar increases continuously away from the Cheju Island. As a result of geochemical analysis,concentrations of the elements are as follow:Zn:19.42-43.52 ppm (av.30.67ppm),Mn:50-304 ppm(av139.39ppm),Cr:3.54-10.68ppm(av6.50ppm),Pb:5.52-41.68ppm(av.15.60ppm), Co:7.08-14.68ppm (av.10.78ppm),Ni:19.70-42.42ppm(av.29.57ppm),Cu:3.14-9.12ppm(av.5.14ppm),Fe:0.48-2.08% (av1.22%),Ca:0.32-13.16%(av6.60%),Al:0.06-0.08%(av.0.27%),Mg:0.12-0.76%(av.0.53%)na:0.11-0.51%(av.0.36%) Ag:0.48-4.08ppm(av.1.22ppm).Among these elements,the content of Zn,Cu,Cr,Mn,Fe,Al,Mg,Pb and Na increase toward the southwestern area,while the content of Ca and Ag SHOWS the reversed distribution trend.Such a distribution pattern seems to imply that spatial distrivution of heavy metals is closely related to the variation in grain size. X-ray diffractogram show that the minerals in clay from the southwestern mud patch are illite ,chlorite, kaolinte,feldspar and calcite.The bulk of illite in th mud zone is believed to be originated from Huanghe and Yangytze River.The mud patch in this region contains the diagnostic calcite peak,and the concentration of Ca,ni,Pb,Ag are similar to Huanghe type,which indicates that the greater part of these clay fractions may have been derived from the Huanghe River.

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Sedimentological Characteristics of Surface Sediments in the Southwestern Sea off Cheju Island, Korea (제주도 서남해역의 해저퇴적물 특성)

  • Youn, Jeung-Su;Kim, Soung-Bok;Koh, Gi-Won
    • 한국해양학회지
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    • v.24 no.3
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    • pp.132-147
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    • 1989
  • A total of 83 surface sediments and 55 sea water samples, collected from the southwestern sea of Cheju Island, were analyzed in order to understand their textural characteristics, geochemical composition and the clay mineralogical features. The sediments were subdivided into ten textural classes, namely clayey sand, slightly gravelly muddy sand, sandy clay, clay and mud. The coarse and fine-grained mixed sediments are distributed in the northern part and around the Island, whereas the fine-grained deposits are mainly distributed in the central and southern parts of the study area; small scale mud patches are distributed in the southwestern and northern parts of Cheju Island. The high concentration of total suspended matter in study area gradually increase toward the southwestern and northwestern offshore area. The concentration of geochemical elements is as follow: the content of Mn, Al, Zn, Cr, Cu and Sn increase toward the southern part which is covered mainly with fine-grained deoposits, whereas the content of Ca, Mg and Ag is higher in the northern area; the elements such as Ni, Na, Fe and Pb are more concentrated relatively in muddy deposits rather than in sandy sediments. The light minerals such as Na-Ca feldspars show a high content around the Socotra Rock, toward the Soheugsan and Cheju Islands, but the K-feldspars are relatively high around the Cheju Island. It was noticed that the provenance of these sediments is partly influenced by the geological characteristics near the island. X-ray diffractogram for clay minerals from the southeastern mud patch and around the Soheugsan Island shows the diagnostic calcite peak indicating that the greater part of these clay fraction may have been derived from present and ancient Hwangho River. The high concentration of smectite in the northern part near the Cheju and around the Soheugsan Islands, eastern side of Socotra Rock probably result from supplies smectite altered from volcanic materials distributed in the Cheju Island and Socotra Rock, whereas the samples near the Chuja and northern parts of the Cheju Island contain weak calcite peak and high concentration of kaolinite and chlorite which is closely related to the geolgical characteristics on the adjacenting land area.

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Clinical Characteristic and Respiratory Disturbance Index as Correlates of Sleep Architecture in Obstructive Sleep Apnea Syndromes Diagnosed with Polysomnography (수면다원기록법으로 확진된 폐쇄성 수면무호흡증 환자의 임상특성, 그리고 호흡장애지수와 수면 구조간의 상관관계)

  • Kim, Seog-Joo;Park, Doo-Heum;Kim, Yong-Sik;Woo, Jong-Inn;Ha, Kyoo-Seob;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.113-120
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome is common and may produce various symptoms and serious complications. A substantial number of research articles on obstructive sleep apnea syndrome have been published in Korea. However, we found such limitations as lack of sufficient sample size and lack of polysomnography-proven cases. Therefore, we aimed at studying clinical features and sleep structure in a sufficient number of Korean patients with obstructive sleep apnea syndrome diagnostically confirmed with polysomnography. Methods: We studied 801 subjects referred to the Division of Sleep Studies, Seoul National University Hospital, who were diagnosed as having obstructive sleep apnea syndrome with polysomnography. Subjects were excluded if they had central sleep apnea syndrome, periodic limb movement disorder, narcolepsy or REM sleep behavior disorder. Foreign patients were also excluded. First of all, we studied the clinical features of the subjects. Secondly, we compared sleep-related parameters of the study subjects with those of age/sex-matched normal values. Thirdly, correlations of respiratory disturbance index (RDI) with each of the sleep-related parameters were calculated. Results: Among the 801 subjects, 668 were male subjects (83.4%) and 133 female subjects (16.4%). Their mean age was 46.6 years (${\pm}13.5$). The mean body mass index (BMI) was 25.8 (${\pm}3.8$) and subjects with BMI was over 28.0 accounted for 22.8% of the total. Fifty subjects (6.2%) were found to take benzodiazepines. Mean RDI and mean nocturnal oxygen saturation of all subjects was 31.2 (${\pm}24.4$) and 94.5% (${\pm}3.6$), respectively. In comparison with normal values, the subjects showed longer sleep latency, lower sleep efficiency, decreased total slow wave sleep % (TSWS %), and decreased total REM sleep % (TREM %)(p<0.01 in all). RDI had a negative correlation with each TSWS % and TREM % (p<0.01, p<0.01). However, RDI did not have significant correlation with either sleep latency or sleep efficiency. Conclusion: In this study, 6.2% of patients diagnosed as having obstructive sleep apnea syndrome were found to take benzodiazepines, although they are generally considered to be of litte benefit or even dangerous because of the respiratory suppressing effect. The proportion of obese subjects was only 22.8% and Korean patients with obstructive sleep apnea syndrome seem to be less obese than those described in foreign journals. This study also suggests that the severity of obstructive sleep apnea syndrome may have a more significant effect on sleep architecture defined as TSWS % and TREM % than on sleep efficiency.

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A Clinical Therapeutic Results on Small Cell Lung Cancer (소세포 폐암의 치료성적에 대한 고찰)

  • Kim, Eun-Hwa;Lee, Soon-Hyoung;Huh, Won-Young;Kim, Han-Sik;Jo, Jin-Ung;Kim, Mee-Ae;Kim, Sang-Kyun;Kim, Kwi-Wan;Chung, Weon-Kuu;Kim, Soo-Kon
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.3
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    • pp.262-269
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    • 1994
  • Background : A clinical study was carried out on 153 new cases with small cell lung cancer registered at Presbyterian Medical Center, Chonju during the 7 years from 1986 to 1992. They were analyzed by sex and age distribution, symptoms and signs, classification of stage and site and its treatments. Especially, an effort was made to compare the overall survival time between limited stage and extensive stage. Methods : Among 806 lung cancer patients diagnosed by biopsy or cytologic evaluation for the 7 years, 153 patients was shown small cell lung cancer. These 153 cases was analyzed retrospectivery through patient's records, letters or telephones. Results : The results of evaluation of small cell lung cancer are as follows. Over 85 percent of the small cell lung cancer patients were over 50 years of age and prominent clinical features were cough(86.3%), sputum(75.8%) and dyspnea(54.9%). One hundred and five patients(68.7%) was staged to have limited stage. Mean survival time of the chemotherapy and chemoradiotherapy in limited stage has significant difference and its survivals are 5.3 months and 15.0 months. Patients whose disease was staged as limited, regardless of whether or not chemotherapy was administered, had a median survival time of 10.9 months, compared with 4.8 months for those with extensive stage. Conclusion : Lung cancer is one of the malignant diseases tend to increase gradually in Korea and proven to be the most common cancer next to the gastric cancer among various cancers in males found at the Presbyterian Medical Center in the past seven years. This report is a retrospective view of the clinical therapeutic results of the small cell lung cancer patients. Especially at the limited stage, the combined therapy revealed higher survival rate than the chemotherapy alone. For a more accurate evaluation. a prospective view, without any bias, of patients selected at random is needed.

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Clinical Studies about diagnostic Yields according to Variable Diagnostic Methods in Lung Cancer (폐암에서 각종 진단수기에 따른 진단율에 관한 연구)

  • Kang, Dae-Song;Cho, Jin-Ung;Kim, Sang-Gyun;Kim, Mi-Ae;Yang, Sung-Uk;Lee, Tae-Quan;Lee, Tae-Hun;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.700-708
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    • 1993
  • Background: Lung cancer has become one of the most common cancers in Korea. It is important to determine the accurate histologic types and stages because of different therapeutic modlaity, especially in small cell carcinoma. This study was designed to evaluate diagnostic yields according to variable diagnostic methods in lung cancer. Methods: The records of 683 patients with a confirmed diagnosis of primary lung cancer during the period of 7 years, from January, 1986 until December, 1992 at Presbyterian Medical Center were analyzed retrospectively. Results: 1) Age and sex distributions Male: female sex ratio was 5.57:1 and age distributions were 7th decade 41.4%, 6th decade 30.2%, 8th decade 17.0%, 5th decade 7.9%, 4th decade 2.5%, 9th decade 1.3%, and 3rd decade 0.2% in decreasing order. 2) The frequencies according to histologic cell types were squamous cell carcinoma 44.7%, small cell carcinoma 23.9%, adenocarcinoma 22.8%, alveolar cell carcinoma 2.5%, large cell carcinoma 1.2%. mixed forms 1.2%, undifferenciated cell carcinoma 0.6% and malignant fibrous histiocytoma 0.2%(1 case) in decreasing order. 3) The most common locations of lung cancer were in left upper lobe and right lower lobe, and no differences of diagnostic methods according to locations were noted. 4) In central lesions, bronchoscopic examination was very accurate and frequently used diagnostic method, and in peripheral lesions, transthoracic lung biopsy(TTLB) was apparent1y accurate method. 5) The diagnostic yields of bronchoscopic biopsy, bronchial brushing, sputum cytology, transthoracic lung biopsy and transbronchial lung biopsy(TBLB) were 81.3%, 57.5%, 31.1%, 69.6% and 61.6%, respectively. 6) The concordance rates between the histologic diagnosis with bronchial brushing and sputum-cytology were 91.3% and 98.4%, respectively. 7) It was appropriate in lung cancer to repeat sputum cytology 3 to 5 times. Conclusion: Bronchoscopic examination is important to determine the histologic cell types in lung cancer. In addition, we should be interrested in improving diagnostic yields of sputum cytology as an easy method.

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A Clinical Review of Mucoepidermoid Carcinoma of The Lung in Korea (점액상피암의 임상적 고찰)

  • Kim, Yeon-Jae;Park, Jae-Yong;Shin, Moo-Chul;Bae, Moon-Sup;Kim, Jeong-Seok;Chae, Sang-Cheol;Park, Tae-In;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.311-321
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    • 1998
  • Background: Mucoepidermoid carcinoma of the lung arises from submucosal gland of tracheobronchial tree. Histologically, the tumor is composed of mucin-secreting cells, squamous cells, and intermediated cells, which show no particular differentiating characteristics, in varying proportions. The tumor is divided into low grade and high grade depending on the proportion of cells, and the degree of the mitotic activity, cellular necrosis and nuclear pleomorphism. While favorable prognosis of low grade tumor, high grade tumor, which is very difficult to differentiate from adenosquamous carcinoma, has an aggressive clinical course. The tumor is rare, comprising 0.1 to 0.2% of primary lung cancers and 1 to 5% of bronchial adenomas. Method: A retrospective clinical study was done on 17 cases of mucoepidermoid carcinoma. The study investigated the clinical features, radiologic findings, bronchoscopic findings, histology and clinical courses. Results: Age ranged between second to seventh decade with a mean age of 42 years. Twelve out of 17 cases were male. Five out of 17 cases were smokers with a mean 11 pack-years. Common symptoms included dyspnea, cough, hemoptysis, and wheezing. Two out of 17 cases was asymptomatic. Atelectasis or mass was common radiologic finding. Plain chest radiography was normal in one patient whom the tumor was located in upper trachea. Bonchoscopy revealed exophytic mass in 12 cases and nodular infiltrations in 4 cases. One case having solitary pulmonary nodule in the right lower lung was normal on bronchoscopy. Histologically, ten out of 17 cases were low grade, and seven out of 17 cases were high grade. Among 10 patients with low grade tumor,9 patients were performed operation and have been alive without recurrence during a mean follow-up of 30 months. Two out of 7 patients with high grade tumor were performed pneumonectomy and have been alive during a follow-up of 3 and 8 months, respectively. Conclusion: Most of mucoepidermoid carcinoma is located at central airway and is presented symptoms by mucosal irirtation. Although atelectasis or mass is common radiologic finding. chest X -ray can be normal. The histologic grading and the extent of tumor are two most important factors for prognosis.

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Preliminary Report on the Geology of Sangdong Scheelite Mine (상동광산(上東鑛山) 지질광상(地質鑛床) 조사보고(調査報告))

  • Kim, Ok Joon;Park, Hi In
    • Economic and Environmental Geology
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    • v.3 no.1
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    • pp.25-34
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    • 1970
  • Very few articles are available on geologic structure and genesis of Sangdong scheelite-deposits in spite of the fact that the mine is one of the leading tungsten producer in the world. Sangdong scheelite deposits, embedded in Myobong slate of Cambrian age at the southem limb of the Hambaek syncline which strikes $N70{\sim}80^{\circ}W$ and dips $15{\sim}30^{\circ}$ northeast, comprise six parallel veins in coincide with the bedding plane of Myobong formation, namely four footwall veins, a main vein, and a hangingwall vein. Four footwall veins are discontinuous and diminish both directions in short distance and were worked at near surface in old time. Hangingwall vein is emplaced in brecciated zone in contact plane of Myobong slate and overlying Pungchon limestone bed of Cambrian age and has not been worked until recent. The main vein, presently working, continues more than 1,500 m in both strike and dip sides and has a thickness varying 3.5 to 5 m. Characteristic is the distinct zonal arrangement of the main vein along strike side which gives a clue to the genesis of the deposits. The zones symmetrically arranged in both sides from center are, in order of center to both margins, muscovite-biotite-quartz zone, biotite-hornblende-quartz zone and garnet-diopside zone. The zones grade into each other with no boundary, and minable part of the vein streches in the former two zones extending roughly 1,000 m in strike side and over 1,100 m in dip side to which mining is underway at present. The quartz in both muscovite-biotite-quartz and biotite-hornblende-quartz zones is not network type of later intrusion, but the primary constituent of the special type of rock that forms the main vein. The minable zone has been enriched several times by numerous quartz veins along post-mineral fractures in the vein which carry scheelite, molybdenite, bismuthinite, fluorite and other sulfide minerals. These quartz veins varying from few centimeter to few tens of centimeter in width are roughly parallel to the main vein although few of them are diagonal, and distributed in rich zones not beyond the vein into both walls and garnet-diopside zone. Ore grade ranges from 1.5~2.5% $WO_3$ in center zone to less than 0.5% in garnet-diopside zone at margin, biotite-hornblende-quartz zone being inbetween in garde. The grade is, in general, proportional to the content of primary quartz. Judging from regional structure in mid-central parts of South Korea, Hambaek syncline was formed by the disturbance at the end of Triassic period with which bedding thrust and accompanied feather cracks in footwall side were created in Myobong slate and brecciated zone in contact plane between Myobong slate and Pungchon limestone. These fractures acted as a pathway of hot solution from interior which was in turn differentiated in situ to form deposit of the main vein with zonal arrangement. The footwall veins were developed along feather cracks accompanied with the main thrust by intrusion of biotite-hornblende-quartz vein and the hangingwall vein in shear zone along contact plane by replacement. The main vein thus formed was enriched at later stage by hydrothermal solutions now represented by quartz veins. The main mineralization and subsequent hydrothermal enrichments had probably taken place in post-Triassic to pre-Cretaceous periods. The veins were slightly displaced by post-mineral faults which cross diagonally the vein. This hypothesis differs from those done by previous workers who postulated that the deposits were formed by pyrometasomatic to contact replacement of the intercalated thin limestone bed in Myobong slate at the end of Cretaceous period.

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