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Incidence and Risk Factors for Extended-Spectrum ${\beta}-Lactamase-Producing$ Escherichia coli in Community-acquired Childhood Urinary Tract Infection (지역사회 획득 소아 요로 감염에서 Extended-Spectrum ${\beta}-Lactamase$ 생성)

  • Lee Jung-Won;Shin Jee-Sun;Seo Jeong-Wan;Lee Mi-Ae;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.214-222
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    • 2004
  • Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.

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Analysis of Hepatobiliary Disorders from a Nationwide Survey of Discharge Data in Korean Children and Adolescents (전국 퇴원자료조사를 통한 소아청소년 간담도 질환의 분석)

  • Park, Hyun-Ju;Shin, Chang-Gyun;Moon, Jin-Soo;Lee, Chong-Guk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.16-22
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    • 2009
  • Purpose: To update the epidemiologic information of hepatobiliary diseases in pediatric inpatients using cross-sectional survey data throughout the Republic of Korea. Methods: Nationwide cross-sectional survey was obtained from the 85 residency training hospitals in Korea to gather the final diagnosis on discharge. The surveyed periods were from 2004 to 2006. All the reports regarding the diagnosis were based on ICD-10 system. In this study, we focused on hepatobiliary diseases. Results: A total of 826,896 cases with discharge data were collected, of which 4,151 (5.0%) hepatobiliary cases were identified; 2,385 cases (57.4%) of hepatobiliary disease were hepatitis, which was the most common hepatobiliary disease. Other diseases included congenital hepatobiliary diseases (524 cases [12.6%]) and biliary diseases (315 cases [7.6%]). The prevalence of hepatobiliary disease according to age differed. Biliary atresia was the most common hepatobiliary disease in the neonatal period, whereas the prevalence of hepatitis increased in adolescents. The total number of hepatobiliary operations was 416 cases. With the comparison of annual data, there was no definite difference in the total number of hepatobiliary cases. The average duration of hospital stay appeared to decrease gradually. Conclusion: In this study, we have summarized the recent epidemiology of hepatobiliary disorders in Korean children based on discharge data. Hepatobiliary disorders in pediatric inpatient units consisted of diverse disorders with a low prevalence, so multi-center approaches should be considered to enhance the clinical and public health outcomes. To improve this nationwide survey, a new data collecting system should be developed.

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Analysis of The Adverse Events Following Immunization of the National Compensation Program and the Surveillance System in Korea, 1995~2000 (1995~2000년 예방접종 후 이상반응 사례 분석 - 국가보상 신청 사례와 예방접종 후 이상반응 감시체계 보고 사례를 중심으로 -)

  • Lee, Hong Jue;Sohn, Young Mo;Kim, Joung Soon;Kim, Young Taek;Lee, Jong Gu;Choi, Bo Youl
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.135-149
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    • 2001
  • Purpose : To describe the characteristics of the claims for compensation and the methodology of investigations concerning adverse events following immunization(AEFI) and epidemiologic characteristics of the AEFI. From these results, to give a suggestion for improving AEFI surveillance system, consequently to stabilize National Immunization Program. Methods : Totally 61 cases were reported to the National Compensation Program and surveillance system of AEFI from 1995 to 2000. Documents from National Compensation Program, medical records and epidemiologic investigation reports of the cases were collected and analyzed. Results : The number of reported cases was 12 in 1995, 3 in 1996, 12 in 1998, 5 in 1999, and 29 in 2000, respectively. That of deaths was 24(39.3%) and 16 cases among them were autopsied(66.7%). That of claims for compensation was 36 and 17 cases among them were compensated(47.2%). The proportion of claim was lower in 1999~2000 than in 1995~1998, but proportion of compensation increased. Although proportion of investigation was lower in 1999~2000 than in 1995~1998, cases which were not epidemiologically investigated, decreased. The epidemiologic investigation launched within 24 hours after report increased from 25% in 1995~1998 to 48.3% in 1999~2000. Among reported cases, the number of boys was 31(50.8%), and 75.4% of subjects were from 2 months to 24 months old. 78.4% of adverse events occurred within one week after immunization. Conclusion : We can find that surveillance system of AEFI and quality of epidemiologic investigation has been somewhat improved. But, it seems that severe cases were more frequently reported than moderate or mild cases, and reporting rate was lower than that of other developed countries. We could not identify the detailed epidemiologic characteristics of AEFI due to these limitation of data. To achieve the stabilization of National Immunization Program, reporting rate and the quality of investigation should be improved.

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Prevalence and Risk Factors of the Gallbladder Polyps Diagnosed by Ultrasound (복부초음파검사로 진단된 담낭용종의 유병률과 위험인자 분석)

  • LEE, Mi-Hwa;Cho, Pyong-Kon;Kwon, Duck-Moon
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.127-134
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    • 2015
  • This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above $23kg/m^2$ (OR 0.713, p=0.002) triglyceride (OR 0.571, P<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible.

Mapping and estimating forest carbon absorption using time-series MODIS imagery in South Korea (시계열 MODIS 영상자료를 이용한 산림의 연간 탄소 흡수량 지도 작성)

  • Cha, Su-Young;Pi, Ung-Hwan;Park, Chong-Hwa
    • Korean Journal of Remote Sensing
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    • v.29 no.5
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    • pp.517-525
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    • 2013
  • Time-series data of Normal Difference Vegetation Index (NDVI) obtained by the Moderate-resolution Imaging Spectroradiometer(MODIS) satellite imagery gives a waveform that reveals the characteristics of the phenology. The waveform can be decomposed into harmonics of various periods by the Fourier transformation. The resulting $n^{th}$ harmonics represent the amount of NDVI change in a period of a year divided by n. The values of each harmonics or their relative relation have been used to classify the vegetation species and to build a vegetation map. Here, we propose a method to estimate the annual amount of carbon absorbed on the forest from the $1^{st}$ harmonic NDVI value. The $1^{st}$ harmonic value represents the amount of growth of the leaves. By the allometric equation of trees, the growth of leaves can be considered to be proportional to the total amount of carbon absorption. We compared the $1^{st}$ harmonic NDVI values of the 6220 sample points with the reference data of the carbon absorption obtained by the field survey in the forest of South Korea. The $1^{st}$ harmonic values were roughly proportional to the amount of carbon absorption irrespective of the species and ages of the vegetation. The resulting proportionality constant between the carbon absorption and the $1^{st}$ harmonic value was 236 tCO2/5.29ha/year. The total amount of carbon dioxide absorption in the forest of South Korea over the last ten years has been estimated to be about 56 million ton, and this coincides with the previous reports obtained by other methods. Considering that the amount of the carbon absorption becomes a kind of currency like carbon credit, our method is very useful due to its generality.

Actual Status of and Measure for False Alarm of Electronic Security in Korea (한국 기계경비업무의 오경보 대응책)

  • Park, Dong-Kyun;Kim, Tae-Min
    • Korean Security Journal
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    • no.30
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    • pp.33-60
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    • 2012
  • False alarm of Electronic security causes various serious side effects such as decrease of electronic security guard's morale caused by unnecessary mobilization, increase of fatigue caused by workload increase, increase of electronic security company owner's management burden and decrease of electronic security service utilization rate caused by customer's distrust. Therefore, the study considered the Korean regulation related with false alarm of electronic security and proposed actual status of false alarm and measure for it. The study proposed systematic resolution assignments and political assignments in relation with the measure for false alarm. Systematic resolution assignments are as follows. First, electronic security company should construct electronic security system accurately from the initial step of security consulting and security planning related with target facility. Second, it is necessary to encourage installation and operation of video monitoring system. Third, sensor wiring should be separated. Fourth, the measures for false alarm depending on main system causes should be prepared. It is necessary to encourage the installation of 'arming disarming alarm sound' generator. In addition, the measures for false arm depending on the characteristics of sensor should be prepared and standardized. Fifth, system maintenance should be reinforced. Political assignments related with the measures for false alarm are as follows. First, it is necessary to reinforce education & training. Individual nurturing & education process should be run by electronic security company or the education focusing on the measure for false alarm should be performed in job training defined in "Security Industry Act". Second, it is necessary to establish and reinforce legal regulation and establish device. If police authority standardizes the documents related with false alarm, provides their forms and requires them for periodical reports or documents, it is expected that good measures for false alarm will be prepared on the basis of actual data in the future. Third, cooperation organization to discuss the measures for false alarm like 'Conference for False Alarm of Electronic Security' should be organized and operated. Fourth, interest and role of electronic security company and electronic security supervisor should be enlarged.

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A study on the recent trends of Islamic extremism in Indonesia (인도네시아 이슬람 극단주의 실태 연구)

  • Yun, Min-Woo
    • Korean Security Journal
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    • no.50
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    • pp.175-206
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    • 2017
  • The current study described the history of Islamic extremism and the recent expansion of international Islamic extremism in Indonesia. For doing so, both content analysis of the existing written documents and qualitative interviews were conducted. For the content analysis, media reports and research articles were collected and utilized. For qualitative interviews, Indonesian students and workers in Korea, Korean spouses married to Indonesian, and Korean missionaries in Indonesia were contacted and interviewed. Qualitative interview was conducted between 30 minutes and 2 hours. On the spot, interviews were recorded and later transcribed into written documents. Due to the difficulty of identification of population and the uneasiness of accessability to th study subjects, convenient sampling and snowball sampling were used. According to the results, Islamic extremism in Indonesia had a deep historical root and generally shared similar historical experience with other muslim countries such as Afghanistan, Pakistan, Egypt, and Saudi Arabia where Islamic extremism was deeply rooted in. That is, Islamic extremism began as a reaction to the western imperialism, after independence, Islamic extremism elements were marginalized in the process of construction of the modern nation-state, and Islamic extremist movement was radicalized and became violent during the Soviet-Afghan War. In addition, after 9.11, Islamic extremism in Indonesia was connected to international Islamic extremism network and integrated into such global movement. Such a historical development of Indonesian Islamic extremism was quite organized and robust. Meanwhile, the eastward infiltration and expansion of international Islamic extremism such as IS and Al Qaeda was observed in Indonesia. Particularly, such a worrisome expansion was more clearly visible in the marginalized and underdeveloped countrysides in Indonesia. Such expansion in Indonesia could negatively affect on the security of South Korea. Geographically, Indonesia is proximate to South Korea. This geographical proximity could be a direct security threat to the Korean society, as if Islamic extremism in North Africa and Middle East becomes a direct security threat to Europe. Considering the presence of a large size of Indonesian immigrant workers and communities in South Korea, such a concern is very realistic. The arrest of an Indonesian Islamic extremism supporter in November, 2016, could be a harbinger of the coming trend of Islamic extremism expansion inside South Korea. The Indonesian Islamic community in South Korea could be a passage of Indonesian Islamic extremism into the South Korean society. In this context, it is timely and necessary to pay an attention to the recent trend of Islamic extremism expansion in Indonesia.

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Probabilities of Pulmonary and Cardiac Complications and Radiographic Parameters in Breast Cancer Radiotherapy (유방암의 방사선치료에서 방사선학적 지표에 따른 폐 및 심장의 부작용 확률)

  • Noh, O-Kyu;Park, Sung-Ho;Ahn, Seung-Do;Choi, Eun-Kyung;Lee, Sang-Wook;Song, Si-Yeol;Yoon, Sang-Min;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.28 no.1
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    • pp.23-31
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    • 2010
  • Purpose: To evaluate the relationship between the normal tissue complication probability (NTCP) of 3-dimensional (3-D) radiotherapy and the radiographic parameters of 2-dimensional (2-D) radiotherapy such as central lung distance (CLD) and maximal heart distance (MHD). Materials and Methods: We analyzed 110 patients who were treated with postoperative radiotherapy for breast cancer. A two-field tangential technique, a three-field technique, and the reverse hockey stick method were used. The radiation dose administered to whole breast or the chest wall was 50.4 Gy, whereas a 45 Gy was administered to the supraclavicular field. The NTCPs of the heart and lung were calculated by the modified Lyman model and the relative seriality model. Results: For all patients, the NTCPs of radiation-induced pneumonitis and cardiac mortality were 0.5% and 0.7%, respectively. The NTCP of radiation-induced pneumonitis was higher in patients treated with the reverse hockey stick method than in those treated by other two techniques (0.0%, 0.0%, 3.1%, p<0.001). The NTCP of radiation-induced pneumonitis increased with CLD. The NTCP of cardiac mortality increased with MHD ($R^2=0.808$). Conclusion: We found a close correlation between the NTCP of 3-D radiotherapy and 2-D radiographic parameters. Our results are useful to reanalyze the previous 2-D based clinical reports about breast radiation therapy complications as a viewpoint of NTCP.

Open Heart Surgery of Congenital Heart Diseases -Report of Four Cases- (선천성심질환(先天性心疾患)의 심폐기(心肺器) 개심수술(開心手術) - 4례(例) 보고(報告) -)

  • Kim, Kun Ho;Park, Young Kwan;Jee, Heng Ok;Kim, Young Tae;Rhee, Chong Bae;Chung, Yun Chae;Oh, Chull Soo
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.1-9
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    • 1976
  • The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

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Long Term Clinical Results of Triple Valve Replacement (삼중 판막 대치술의 장기 결과)

  • Yu, Song-Hyeon;Hong, You-Sun;Chang, Byung-Chul;Kang, Meyun-Shick;Lim, Sang-Hyun
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.675-679
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    • 2005
  • Background: Clinical reports on replacement of all three (AV + MV + TV) valves are rare. Material and Method: From January 1992 to December 2003, 38 patients received triple valve replacement (aortic, mitral, tricuspid) at Yonsei Cardiovascular Center. Mean age of patients was $49.5\pm10.7 (28\~69)$ years, and 24 patients $(63.1\%)$ were female. Rheumatic valve disease was the most common cause of operation (n=37). Preoperative New York Heart Association functional class were II in 4, III in 24 and IV in 10. Fifteen patients (group 1) received triple valve replacement at their first operation. Twenty three patients (group 2) received one or more operations before tricuspid valve replacement (TVR). Seven patients received tricuspid valve annuloplasty at first operation and received TVR later. Result: Six patients died at hospital after operation $(15.8\%)$ and all these patients were in group 2. All patients in group I survived and were discharged. Three patients $(9.4\%)$ died during follow up periods. Most of the survivors had improved functional class (I in 22, II in 8, III in 1, IV in 1). During follow up period, there were 4 valve related complications. The 10-year survival rate was $68.8\%$ and survival rate for free from valve related event at 10 years was $85.5\%$. Conclusion: After triple valve replacement, most patients showed improvement of symptoms. And during follow up period, valve related complications and survival were acceptable. Therefore, if indicated, triple valve replacement is recommended before the patients' conditions get worse.