Kang, Jin Han;Kim, Sun Mi;Kim, Jong Hyun;Hur, Jae Kyun;Lee, Kyung Yil;Shin, Young Ku;Park, Su Eun;Ma, Sang Hyuk;Hong, Young Jin
Clinical and Experimental Pediatrics
/
v.48
no.1
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pp.40-47
/
2005
Purpose : S. pneumoniae is one of major pathogens of community-acquired respiratory infections. The rate of antibiotic resistance to this organism has increased, and resistance to multiple antimicrobial agents in a single strain of S. pneumoniae may compromise the efficacy of empiric antimicrobial treatment commonly used for respiratory infections. We did this study to find out the penicillin resistant distributions and oral antibiotics susceptibility patterns against S. pneumoniae, isolated from pediatric patients with community-acquired respiratory infections in Korea. Methods : One hundred fifty six pneumococcal isolates obtained from pediatric patients with community-acquired respiratory infections such as acute otitis media(AOM), sinusitis and pneumonia between May 2000 to June 2003. And MICs of penicillin and oral antibiotics(amoxicillin, amoxicillin-clavulanate, cefaclor) were performed by broth microdilution methods according to the NCCLS(2003a). Results : Seventy eight percent of the isolates were resistant to penicillin. The isolates, collected from AOM patients showed the highest penicillin resistance(92.7%). The resistant rates of amoxicillin (16.7%) and amoxicillin-clavulanate(9.6%), based on susceptibility breakpoints established by the NCCLS, were markedly lower than these of penicillin. But, the resistant rate of cefaclor was very high, above 95%. Conclusion : We concluded that pneumococci isolated from study cases may be one of the world's highest penicillin resistant rates. But, amoxicillin and amoxicillin-clavulanate can be used as a first-line antibiotics. Finally, we hope that a continuous surveillance study to monitor resistant patterns of pneumococcal respiratory infections will be needed for the standard guidelines of empiric antibiotic treatment.
Sung, June Seung;Kim, Dong Yeon;Kim, Sun Hee;Byun, Hyung Suk;Hwang, Tai Ju;Choi, Young Youn
Clinical and Experimental Pediatrics
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v.49
no.6
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pp.623-629
/
2006
Purpose : The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. Methods : One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. Results : The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. Conclusion : Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.
Purpose : Although renal ultrasonography (USG) has improved the detection rate of hydronephrosis (HN), its clinical courses and postnatal management remains controversial. Here, we reviewed the clinical features of patients with HN according to the grades. Methods : We retrospectively studied 207 patients who were regularly followed-up among 367 patients with HN detected by renal USG postnatally between April 1998 and December 2007. These patients were grouped into four groups, grades 1-4, according to renal pelvic diameter (RPD). For analysis, each group was merged into two categories (mild: grade 1, 2; severe: grade 3, 4). Results : During follow-up, 128 episodes of urinary tract infection (UTI) occurred in 91 patients. According to grades from 1 to 4, 35/89 (39.3%), 41/88 (46.5%), 11/22 (50%), and 4/8 (50%), respectively, had UTI, without any significance between the mild and severe groups. However, the severe group presented a higher risk in cumulative episodes of UTI per year (P=0.041). The spontaneous resolution of HN was observed in 103 (58.8%) of the 175 mild group patients and in 3 (10.7%) of the 28 severe group patients (P<0.001). Furthermore, the detection rate of prenatal HN by prenatal USG was much higher in patients with severe RPD (P<0.001). Conclusion : We found that the severer the grade of HN, the lower was the rate of spontaneous resolution and higher was the frequency of UTI. Therefore, the establishment of guidelines for managing treatments such as antibiotic prophylaxis for patients with HN is needed to improve renal prognosis.
Purpose: This study investigated the status of radiation exposure doses since the establishment of the "Regulations on Safety Management of Diagnostic Radiation Generation Device" in January 6, 1995. Method: The level of radiation exposure in people engaged or having been engaged in radiation-related industries of inspection organizations, educational organizations, military units, hospitals, public health centers, businesses, research organizations or clinics over a 5 year period from Jan. 1, 2000 to Dec. 31, 2004 was measured. The 149,205 measurement data of 57,136 workers registered in a measurement organization were analysed in this study. Frequency analysis, a Chi-square test, Chi-square trend test, and ANOVA was used for data analysis. Results: Among 57,136, men were 40,870(71.5%). 50.3% of them were radiologic technologists, otherwise medical doctors(22.7%), nurse(2.9%) and others(24.1%). The average of depth radiation and surface radiation during the 5-year period were found to decrease each year. Both the depth radiation and surface radiation exposure were significantly higher in males, in older age groups, in radiological technologists of occupation. The departments of nuclear medicine had the highest exposure of both depth and surface radiation of the divisions of labor. There were 1.98 and 2.57 per 1,000 person-year were exposed more than 20 mSv(limit recommended by International Commission on Radiological Protection) in depth and surface radiation consequently. Conclusion: The total exposure per worker was siginifcantly decreased by year. But Careful awareness is needed for the workers who exposed over 20 mSv per year. In order to minimize exposure to radiation, each person engaged in a radiation-related industry must adhere to the individual safety management guidelines more thoroughly. In addition, systematic education and continuous guidance aimed at increasing the awareness of safety must be provided.
Purpose: The primary gastrointestinal non-Hodgkin's lymphoma(GI-NHL) is the most common extranodal NHL. Surgery with postoperative radiotherapy or chemotherapy was tried with some success, but proper management guidelines have not been estabilished in localized GI-NHL due to its rarity and the lack of randomized trials. So we designed this study to evaluate treatment results and the lack of randomized trials. So we designed this study to evaluate treatment results and prognostic factors in localized GI-NHL, and to assess proper treatment mdality after surgical resection accordig to risk factors by survival analysis. Method: Seventy three patients who received surgical resection due to localized GI-NHL from Jan. 1916 to Apr. 1991 were reviewed in this study. Prognostic factors were analyzed by multivariate analysis program including postoperative treatment methods, and treatment results were compared according to prognostic factors and treatment modalities. Results: Overall 5-year survival rate was 62.3%, for all patients. The 5-year survival rate was 80.0% for patients with stage I GI-NHL and 45.7% for those with stage II. Chemotherapy or not, stage and residuum or not after surgical resection were significant independent prognositic factors. Postoperative adjuvant treatments showed significant survival benefit. In patients with high risk factors such as stage II or residuum after surgical resection, postoperative combined chemotherapy and radiotherapy showed better survival than those treated with single modality. Conclusions: Chemothrapy or not, stage, and residuum or not were important prognostic factors of patients with localized GI-NHL after surgical resection. Either chemotherapy or radiation therapy alone after surgical resection is recommanded for patients without high risk factors(stage II or residuum after surgical resection) but the postoperative combined chemotherapy and radiotherapy seems to be beneficial for patients with high risk factors.
Placenta has been shown to be a site of expression of several of the monoamine membrane uptake transporters. However, the correlation between the expressions of norepinephrine transporter (NET) and placental development including gynecological diseases is still unknown. To investigate the expression and functions of NET in placenta, we conducted to compare NET expression in normal and preeclamptic placenta and analyzed the function of NET in HTR8-SV/neo trophoblast cells after NET gene transfection. The expression of NET was analyzed in placental tissues from the following groups of patients (none underwent labor): 1) term normal placenta (n=15); 2) term with preeclamptic placeneta (n=15); and 3) pre-term with preeclamptic placenta (n=11) using semi-quantitative RT-PCR, immunohistochemistry, and Western blot. In order to evaluate the function of NET, NET gene plasmid and NET gene-specific siRNA were trnasfected into HTR-8/SVneo trophoblast cells for 24 hours. NET had low expression in the pre-eclamptic placenta compare with normal placenta but no difference in western blot data. NET was expressed in the trophoblasts, and the up-regulation of NET gene stimulated the invasion of HTR-8/SVneo trophoblast cells by 2.5 fold (p<0.05), whereas the NET-siRNA treatment reduced invasion rates. Also, we observed that the expression of NET induces to expression and activity of MMP-9 in HTR-8/SVneo trophoblast cells in zymography. The results suggest that the expression of NET were reduced in pre-eclampsia and should be inhibited invasion activity of trophoblasts. Therefore, these findings provide useful guidelines for the mechanisms of trophoblast invasion as well as for the basic understanding of gynecological diseases including pre-eclampsia.
To develop a aceclofenac soft capsule, four preparations with various solubilizers were prepared and their dissolution test was carried out. Among four preparations tested, a preparation with ethanolamine was selected as a formula of aceclofenac soft capsule (Clanza $S^{TM}$), since it showed the fastεst dissolution rate. Bioequivalence of aceclofenac tablet, $Airtal^{TM}$ (Dae-Woong Pharmaceutical Co., Ltd.) and aceclofenac soft capsule, Clanza $S^{TM}$ (Korea United Pharmaceutical Co., Ltd.) was evaluated according to the guideline of KA Fourteen normal male volunteers (age 20 - 25 years old) were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After oral administration of one tablet or capsule containing 100 mg of aceclofenac, blood was taken at predetermined time intervals and the concentration of aceclofenac in plasma was determined with an HPLC method under UV detector The pharmacokinetic parameters ($C_{max}$ and $AUC_t$) were calculated and ANOVA was utilized for the statistical analysis of parameters using logarithmetically transformed $AUC_t$, $C_{max}$ and $T_{max}$. The results showed that the differences in $AUC_t$, $C_{max}$ and $T_{max}$ between Aral tablet and Clanza soft capsule were 2.89%, 0.18% and 43.0%, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(15) (e.g. log(0.81) -log(1.23) ad log(0.89) -log(1.4)) fo $AUC_t$ and $C_{max}$, respectively. Thus, the criteria of the KFDA guidelines for the equivalence was satisfied, indicating that Clanza $S^{TM}$ soft capsule is bioequivalent to$Airtal^{TM}$ tablet.
Satisfaction of consumer preferences is a key factor for the success of the products. Therefore, design mangers try to develop the profitable products through the intensive survey on the consumer preferences. Although the studies on the preferable product design and the design factors have long been carried out, most of these studies dealt only with the design factors preferable for individual product category ignoring the relationship of the product categories which are related to each other. For designers and design managers, in this study, we propose the guidelines of successful product development by finding preferred common and distinct design factors through analysis of the relations between the consumer preferences and design factors in various portable electric devices. To this end, we analyzed the preferred common and distinct design factors from portable electric devices including the electronic dictionaries, notebook computers, cellular phones, and MP3 players. We used hierarchical regression analysis for the effects of the design factors on the preferences among the product categories and regression analysis for the effects among each product category. The analysis on the preferred common design factors among the four product categories revealed that consumers did not care about the whole body type but preferred white color, metallic and glassy texture in the body. Also, the preferred design factors in the each product category are as follows; oval body shape and black color in electronic dictionaries, white color, metallic and glassy texture in notebook computers, plastic texture in cellular phones, rectangular body shape and plastic texture in MP3 players. In the case of notebook computers, the preferred common and distinct design factors were the same. We expect these results will be helpful for designers and design managers to identify the preferred design factors to consider when developing the various portable electric devices.
This study surveyed on the actual conditions of using sanitizers and disinfectants for improvements of sanitization on food utensils at 105 school and 20 industry foodservice operations. The questionnaire which was administered to 125 foodservices was used as a mail or visitation method. The answers of asking "Perception on temporary authorization system of sanitizers and disinfectants on food utensils" were 75% in contract managed school foodservices, 81.8% in self operated school foodservices, and 50% in industry. Main factors to choose sanitizers were sterilizing power (38.6%, 28.6%, 38.9%) and safety (32.6%, 46.1%, 33.3%) at every foodservices. Keeping ratio of sanitizers and disinfectants guidelines in contract managed school, self operated school and industry foodservices were 64.8%, 52% and 73.7%, respectively. If easy and practical guideline is developed, most foodservices replied to use if for disinfection of foodservices. Most of the foodservices were not only knowing sanitizers and disinfectants but also possessing a guideline. However, they didn't perform disinfection according to the guideline due to its complexity. Consequently, we suggest that it is necessary to provide an easy and practical "sanitizers and disinfectants guideline" and useful information.
For more efficient and proactive safety control of imported food, new trend in U.S. is emerging, which assesses the food safety control systems of exporting countries using Systems Recognition Assessment Tool and helps ensure safety of imported foods. This study examines trends in development and application of assessmemnt tool and country assessment reports in U.S. where an active discussion on this issue is in progress. The expert interviews were also conducted. U.S. Systems Recognition Assessment Tool was developed by FDA to recognize the potential value in leveraging the expertise of foreign food safety systems and help ensure safety of imported food. The tool is comprised of ten standards and provides an objective framework for determining the robustness of trading partners' overall food safety systems. Using its own tool, the U.S. FDA conducted a preliminary assessment of the food safety control systems of New Zealand and Canada. According to the U.S.-New Zealand and the U.S.-Canada assessment reports, the overall structure of the systems was similar between the countries. In summarizing the opinions of experts, such a trend in National Food Safety Control System Assessment may be utilized in the sanitary assessment and the control of imported food border inspection frequency before importing food. It would contribute to more effective distribution of national budget and increased public trust. Additionally, international collaboration as well as securing of qualified experts and sufficient budget appear to be crucial to further increase the utility of National Food Safety Control Systems Assessment. In conclusion, firstly, it is critically important for the competent authority of South Korea to proactively respond to international trend in National Food Safety Control System Assessment by identifying the details of its background, assessment purpose, core assessment elements, and assessment procedures. Secondly, it is necessary to identify and complement the weaknesses of Korea's food safety control system by reviewing it with U.S. Systems Recognition Assessment Tool. Thirdly, by adapting the assessment results from imported countries' food safety control systems to the imported food inspection intensity, the resources previously used in inspecting the imported food from accredited countries can be redistributed to inspecting the imported food from unaccredited countries, and it would contribute to more efficient imported food safety control. Fourthly, the competent authority of South Korea should also consider developing its own assessment tool designed to reflect the unique characteristics of its food safety control system and international guidelines.
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