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A Retrospective Study of Invasive Bacterial Infections in Children with Asplenia (18세 이하 무비증 환자에서 발생한 침습성 세균 감염증에 대한 후향적 연구)

  • Choe, Yong-Joon;Seo, Euri;Lee, Jina
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.160-167
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    • 2017
  • Purpose: Because children with asplenia have an increased risk of fulminant infection associated with a high fatality, chemoprophylaxis, and vaccinations against encapsulated bacteria are recommended. However, there have been few reports of the burden of severe bacterial infection and the current status of chemoprophylaxis and immunization among children with asplenia in Korea. Methods: We conducted a retrospective study including children with asplenia who were treated at our institute between January 1997 and December 2016. Results: From a total of 213 children with asplenia, 114 (53.5%) had congenital asplenia and 58 (27.2%) had functional asplenia. The remaining 41 (19.3%) had acquired asplenia with the median age at splenectomy being 12.2 years (range, 5.0 to 16.9 years); the most common cause of splenectomy was hereditary spherocytosis (39.0%). The chemoprophylaxis rate was 16.4%. The immunization rates were 44.1% for pneumococcus, 53.0% for Haemophilus influenzae type B, and 10.7% for meningococcus. The incidence of invasive bacterial infection among children with asplenia was 0.28/100 person-year; a total of six episodes (2.8%) were observed in five patients with congenital asplenia and one patient with functional asplenia. The median age for these infections was 15 months (range, 4 to 68 months). Five of the six episodes were bacteremia, and the other was meningitis. The most common pathogen was Streptococcus pneumoniae (n=3), followed by H. influenzae (n=1). Three of the six patients (50.0%) died, all of whom had pneumococcal bacteremia. None of the six had chemoprophylaxis or proper vaccinations. Conclusions: Although there is an increased risk of a severe infection proper vaccinations and chemoprophylaxis are still lacking. Physicians should be encouraged to implement appropriate chemoprophylaxis and immunizations for patients with asplenia.

Antineutrophil Cytoplasmic Antibody in Korean Children with Henoch-$Sch{\ddot{o}}nlein$ Purpura (소아 Henoch-$Sch{\ddot{o}}nlein$ 자반증에서의 항호중구 항체)

  • Choi, Ji-Na;Shin, Jae-Il;Lee, Jae-Seung;Kim, Hyon-Suk
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.164-169
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    • 2008
  • Purpose : There have been some reports on the prevalence of positive antineutrophil cytoplasmic antibody(ANCA) in Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the results were conflicting. We performed this study to evaluate the clinical significance of ANCA(c-ANCA and p-ANCA) in Korean children with HSP. Methods : The medical records of 30 patients(13 boys and 17 girls) aged 6.0$\pm$1.9(5-12) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2008, the sera from children with acute HSP were tested for antineutrophil cytoplasmic antibodies(ANCA). The target antigens of these autoantibodies are proteinase 3(c-ANCA) or myeloperoxidase(p-ANCA). Results : Palpable purpura was seen in all 30 patients(100%), abdominal pain in 20(67%), arthralgia in 17(57%), and renal involvement in 11(37%). Laboratory findings showed leukocytosis in 4 patients(13%), thrombocytosis 18 in(60%), and elevated erythrocyte sedimentation rate in 18(60%). Anti-streptolysin O titers were elevated in 7% of the patients and no patient showed elevation of serum IgA level. The sera from 29 patients were negative for c-ANCA and p-ANCA by indirect immunofluorescence, but only one patient had weakly positive results, which became negative at follow-up. Conclusions : We conclude that c-ANCA or p-ANCA is not an important serologic marker in children with HSP, because it was neither diagnostically nor immunologically specific in children with HSP. These results suggest that ANCA are not involved in the pathogenesis of HSP in children.

Systematic Study on the Fishes of the Family Cobitidae(Pisces, Cypriniformes). 2. Taxonomic Study on the Cobitis taenia complex from Korea (기름종개과(family Cobitidae)어류의 계통분류에 관한 연구 2. 한국산 Cobitis taenia complex의 분류학적 고찰)

  • 양서영;이혜영;양홍준;전상린;박병상;김재흡
    • Animal Systematics, Evolution and Diversity
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    • v.9 no.2
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    • pp.151-170
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    • 1993
  • Morphometric, band-pattern and electrophoretic analysis on Cobitis taenia complex were performed to investigate the morphological and genetic differentiation and to clarify their taxonomic status. Intermediate types of band-pattern (C and D type) were more frequently expressed than that of types of C. t. taenia(type A) and C. t. lutheri (type B). Sexual dimorphism of band-pattern was observed not only in C. t. taenia(type A) and C. t. lutheri(type B). Sexual dimorphism of band-pattern was observed not only in C. t. lutheri but also in C. t. taenia and C. t. striata as well. Discriminant function analysis based on 19 morphological characters shows no significant differences among C. taenia complex. The degree of genic variation of C. t. striata was higher ( =1.48, P=31.2%, HD=0.009) than those of C. t. striata was higher( =1.48, P=31.2%, HD=0.082 and HG=0.009) than those of C. t. lutheri ( =1.37, P=2.7%, HD=0.058 and HG=0.065). The average genetic similarities between C. t. lutheri and C. t. taenia-C. t. striata were S=0.62 and S=0.66 respectively and these values indicate that C. t. tanenia has evolved specific level of differentiation. C. t. striata and C. t. lutheri show subspecifc level of close genetic similarity (S=0.82). Based on the divergent time estimate (Nei, 1975) it is assumed that C. t. tanenia was branched off from the other subspecies about two million years before present (MYBP) and C. t. striata and C. t. lutheri were differentiated about 0.6 MYBP. The use of C. sinesis an the scientific name for the Korean C. t. taenia, proposed by Kim and Lee (1988) seems incorrect since they are quite different in the structure of lamina circularis (Vladycov, 1935), the external morphology and distribution (Cheng and Zheng, 1987) and the chromosome number(Yu et al., 1989). Kim and Lee(1988) also argued that C.t. striata and C. t. lutheri should be treated as distinct species but the present study and other reports (Kim and Lee, 1984; Kim and Yang, 1993) do not support it. We conclude that C. t. taenia is a good species and C. t. striata and C. t. lutheri are subspecific status. Their scientific names should be revised in the future.

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Sequential Chemotherapy and Radiation Therapy for Advanced Nasopharyngeal Carcinoma (진행된 비인강암의 화학요법 및 방사선 치료)

  • Park, In-Kyu;Kim, Song-Bo;Yun, Sang-Mo;Kim, Jae-Cheol;Park, Jun-Sik
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.259-265
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    • 1993
  • Between January 1985 and July 1992, 52 patients with locally advanced nasopharyngeal carcinoma were studied retrospectively for the effectiveness of sequential chemotherapy and radiation therapy. The male to female ratio was 3.3:1 with a median age of 41 years. Forty patients had squamous cell carcinoma and the remaining 12 had undifferentiated carcinoma. Seven patients had stage III disease and the remainder had stage IV disease at time of presentation. All patients were treated two courses of chemotherapy followed by radiation therapy. Chemotherapy consisted of either CVB (cisplatin, vincristine and bleomycin) or CF (cisplatin and 5-FU). Total radiation dose to the primary site ranged from 6000 cGy to 7500 cGy. Neck nodes were given booster treatment to maximum of 7000 cGy, depending on the extent of disease. Local control, overall survival and disease-free survival rates were analyzed. The complete response (CR) rate to chemotherapy was $15\%$ and the partial response (PR) rate was $46\%,$ for overall major response rate of $61\%.$ The CR rate was $87\%$ after radiation therapy. Median follow-up time was 51 months. The overall survival and disease-free survival rates at 36 months were $54\%\;and\;49\%,$ respectively. Median time to relapse was 15 months. The patterns of initial relapse in CR patients was as follows: locoregional failure only, 12 patients; distant metastasis only,11: both,2. Cox's multivariate regression model revealed that nodal status was the single most important independant prognostic factor influencing disease-free survival (p=0.001). Comparision of these results with other published reports with radiation therapy alone showed that a high rate of initial response to chemotherapy did not translate into local control or survival. At present time radiation therapy alone remains the standard treatment for locoregional cancer of the nasopharyngeal cancer. More controlled clinical trials must be completed before acceptance of chemotherapy as a part of treatment of advanced nasopharyngeal carcinoma.

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Hypersensitive Large Intestine Syndrome in Hyungsang Medicine (과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로-)

  • Choi Byung-Tae;Choi Yung-Hyun;Han Jin-Soo;Lee Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.5
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

Project to increase productivity of livestock in Honam area against UR (호남지역의 양축농가에 있어서 UR에 대처한 가축의 생산성 향상에 관한 연구)

  • Lee, Joo-mook;Kwon, Oh-deog;Chae, Joon-seok;Kim, Myeong-chul;Kim, Heung-seob;Lee, Sung-jae;Lee, Hoo-sik;Roh, Soo-il;Kim, Kil-soo
    • Korean Journal of Veterinary Research
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    • v.34 no.1
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    • pp.195-212
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    • 1994
  • For the purpose to increase productivities of livestock the present investigations were undertaken in order to clarify the clinical and suclinical status of Korean native cattle, dairy cattle(holstein) and Korean native goat. Blood, feces and urine samples were collected from 247 Korean native cattle(222 adult and 25 calf), 224 dairy cattle(211 adult and 13 calf) and 142 Korean native goat rearing at Chonbuk area and analyzed for clinical, serum chemical, hematological and urinary findings. In addition, we were examined the infection rate of theileriosis, internal parasite and ring worm. The mean value for each component was calculated by statistical analysis using Excel computer program. From these investigations the following results were obtained. The mean values for RBC, PCV and etc in 433 adult cow(Korean native cattle and dairy cattle) were similar with other reports. But the mean values for MCHC of all species were lower than normal. Adult Korean native cattle and adult dairy cattle which showed hematologically normal levels were only 9.01% and 9.48%, respectively. Abnormally high values for PCV, RBC and Hb were recorded in 7.66% of adult Korean native cattle, 20% of korean native calf, 15.38% of dairy calf and 13.36% of Korean native goat. Adult Korean native cattle and adult dairy cattle which showed hematologically anemia were 4.95% and 19.43% respectively, but Korean native calf and dairy calf showed normal. Adult Korean native cattle, adult dairy cattle, Korean native calf and dairy calf which showed normal serum protein level 84.0%, 90.8%, 50% and 44.4%, respectively. In present investigations, 50% of Korean native calf and 55.6% of dairy calf were decreased serum protein values under range. These abnormally decreased serum protein values mean the shortage of antibody, and these have a possibility to occurs to pneumonia and diarrhea. From these results, the economical loss caused by pneumonia was calculated as 124,038,833 won in the KNC and 742,703,430 won in the dairy calf rearing in Chonbuk area. Calculated economical loss caused by enteritis was 56,658,690 won in Korean native cattle, 476,775,799 won in dairy calf, and the total loss amount of 533,434,488 won in Chonbuk area. Abnormally high values$(21.7{\pm}4.0mg/dl)$ for serum calcium were recorded 49.6% in dairy cattle. The mean values for serum total cholesterol were $170.8{\pm}99.8mg/dl$ in Korean native cattle, $196.0{\pm}40.6mg/dl$ in Korean native calf, $202.9{\pm}86.0mg/dl$ in adult dairy cattle and $289.4{\pm}97.5mg/dl$ in dairy calf. The infection rate of internal parsite were as follows; adult Korean native cattle: 21.2%, Korean native calf: 8.0%, adult dairy cattle: 67.8% and Korean native goat: 81.5%. The estimated economical loss caused by internal parasites infection were 1,120,855,837 won in Korean native calf, 4,994,959,405 won in adult Korean native cattle, 3,334,751,066 won in adult holstein, and the total loss amount to 9,450,566,308 won. The infection rate of theileriosis were 1.4% in Korean native cattle and 6.6% in dairy cattle. The presumed economical loss by T. sergenti infection were 154,408,482 won in Korean native cattle and 171,577,237 won in dairy cattle rearing at Chonbuk area. The infection rate of ringworm were 0.5% in Korean native cattle, 0.9% adult dairy cattle and 7.7% in dairy calf. The presumed economical loss by dermatomycophyte were 12,061,532 won in Korean native cattle, 16,895,403 won in dairy cattle, and the total estimated loss amount to 28,955,935 won a year in Chonbuk area.

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Coronary Angiography after Coronary artery Bypass Grafting (관상동맥 우회술후 관상동맥 조영검사 소견)

  • Choi, Jin-Ho;Park, Kay-Hyun;Jun, Tae-Gook;Lee, Young-Tak;Park, Pyo-Won;Chae, Hurn;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.182-187
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    • 2002
  • Background: There have been many reports of coronary angiographic findings after coronary bypass grafting, most of which are focused on the graft patency rate of the bypass conduits. However, postoperative angiography can provide numerous informations other than patency rates that are useful for establishing operative strategy. Material and Method: We studied 73 patients in whom coronary angiography was done after more than 1 month of CABG. Mean interval from the operation to coronary angiography was 10.6 months and the reasons for coronary angiography follow up were residual or recurrent angina in 54 patients, abnormalities on myocardial perfusion scan or echocardiography in 13 patients, and for simple follow up in 6 patients. Result: Overall graft patency rate was 80.9% (internal thoracic artery 100%, saphenous vein 75.0%) in patients of simple follow up and 61.6%(internal thoracic artery 81.1%, saphenous vein 55.3%) in patients with ischemia. Progression of native coronary arterial disease proximal to the grafting site was found in 50 patients(68.5%). Among 201 coronary arterial branches that had not been completely occluded preoperatively, ninty five branches(47.3%) revealed progression of diameter stenosis by more than 20% on the follow up study. Among them, 64 branches(31.8%) progressed to total occlusion. The incidence of disease progression was highter in the coronary arteries with patent grafts(57.5%) than in those with occluded grafts(36.3%)(p<0.05), Comparing internal thoracic artery graft with saphenous vein graft, internal thoracic artery was superior to saphenous vein, not only in terms of patency(83.3% vs 56.6%), but also in terms of result of later percutaneous intervention success rate(100% vs 62%, p<0.05). Conclusion: Due to the considerable incidence of progression of native coronary artery stenosis in the early postoperative periods, bypass grafting of a vessel with borderline stenosis, especially with vein graft, must be done prudently. And it was confirmed again that revascularization of left anterior descending artery is most important and that internal thoracic artery was superior to saphenous vein.

Systemic Candida Infection in Very Low Birth Weight Infants : Epidemiological Features Over 5 Years (극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성)

  • Lee, Seung-Woo;Lee, Jeong-Eun;Lee, Ju-Young;Lee, Hyun-Seung;Lee, Jung-Hyun;Sung, In-Kyung
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.190-196
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    • 2009
  • Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

Growth and Production of Sinonovacula constricta (Bivalvia) from the Hwaseong Tidal Flat in the Namyang Bay, Korea (가리맛조개(Sinonovacula constricta: Bivalvia)의 성장과 생산 (경기 남양만 화성조간대))

  • Koh, Chul-Hwan;Yang, Mee-Ra;Chang, Won-Keun
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.2 no.1
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    • pp.21-30
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    • 1997
  • The present study reports the density, growth and production of a razor clam, Sinollovacula constricta, which is known to be one of the important fishreies catches from the Korean tidal flat. The annual yield reached to about 6,000 metric tons per year till 1994. The study was conducted on the Hwaseong tidal flat located on the central west coast, 40 kilometers south-west from Seoul. The annual yield of the razor clam in this area reached to about 50% of the total catch from the whole Korean coast. Samples were colleted monthly at 14 occasions from May 1992 to August 1993. Density of S. constricta ranged from 92~165 individuals per square meter during the study period. General trend of decreasing density was observed when the animal became older, but an exception was the year class of 1991 whose density was lower than that of 1990. The size of the shell was clearly separated into two classes during fall and winter (from September to February), however, the maximum frequency of the length of small size classes moved to right after February. It indicates a fast growth of young clams from spring to summer. Fast growth of the shell could also be examined by the growth curve. The shell growth of the whole life span was described by the von Bertalanffy equation of $L_t=89.3{\times}[1{\exp}\{-0.58{\times}(t+0.73\}]$. The growth in flesh dry weight was well fitted to the Gompertz growth model with the equation, $W_t=5.00{\times}{\exp}\{-4.31{\times}{\exp}(-0.043{\times}t)\}$. The clam lost about 30% of the body weight during spawning in August. The annual production calculated based on the data from September 1992 to August 1993 amounted to 150 g $DW{\cdot}m^{-2}{\cdot}yr^{-1}$ which was 2~50 fold higher than those of other bivalves occurred in Korea. This estimate was patitioned by each year classes; 87.5 by 1992, 53.4 by 1991, 59.0 by 1990 and -30.0 g $DW{\cdot}m^{-2}{\cdot}yr^{-1}$ by 1989 year class.

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Functional Assessment of Gangcheon Replacement Wetland Using Modified HGM (수정 수문지형학적 방법을 적용한 강천 대체습지의 기능평가)

  • Kim, Jungwook;Lee, Bo Eun;Kim, Jae Geun;Oh, Seunghyun;Jung, Jaewon;Lee, Myungjin;Kim, Hung Soo
    • Journal of Wetlands Research
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    • v.19 no.3
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    • pp.318-326
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    • 2017
  • Riverine wetlands were reduced and damaged by dredging of rivers and constructing parks in wetlands by Four Rivers Project from 2008 to 2013. Therefore, replacement wetlands were constructed for the compensation of wetland loss by the government. However, It is not enough to manage replacement wetlands. In order to manage the wetlands efficiently, it is necessaty to assess the functions of the wetlands and to manage them according to their functions. Here we performed functional assessments for a replacement wetland called Gangcheon wetland using the modified HGM approach. Hydrological, biogeochemical, animal habitat, and plant habitat functions for the wetland were assessed. To assess the functions, we collected informations for modified HGM approach from the monitored hydrologic data, field survey, published reports and documents for before and after the project, and hydraulic & hydrologic modeling. As the results of the assessment, the hydrological function for the replacement wetland showed 65.5% of the reference wetland, biogeochemical function showed 66.6%, plant habitat function showed 75%, and animal habitat function showed 108.3%. Overall, Gangcheon wetland function after the project was reduced to 78.9% of the function before the project. The decrease in hydrological function is due to the decrease of subsurface storage of water. And the decrease in biogeochemical & pland habitat functions is due to the removal of sandbank around the Gangcheon wetland. To compensate for the reduced function, it is necessary to expand the wetland area and to plant the various vegetation. The modified HGM used in this study can take into account the degree of improvement for replacement wetlands, so it can be used to efficiently manage the replacement wetlands. Also when the wetland is newly constructed, it will be very useful to assess the change of function of the wetland over time.