• Title/Summary/Keyword: ST41

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Molecular Epidemiologic Study of a Methicillin-resistant Staphylococcus aureus Outbreak at a Newborn Nursery and Neonatal Intensive Care Unit

  • Kang, Hyun Mi;Park, Ki Cheol;Lee, Kyung-Yil;Park, Joonhong;Park, Sun Hee;Lee, Dong-Gun;Kim, Jong-Hyun
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.148-160
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    • 2019
  • Purpose: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU). Methods: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested. Results: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene. Conclusions: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.

Total Body Irradiation for Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia (만성 골수성 백혈병에서 동종 골수 이식을 위한 전신방사선조사)

  • Chung Su Mi;Choi Ihl Bohng;Kang Ki Mun;Kim In Ah;Shinn Kyung Sub;Kim Choon Choo;Kim Dong Jip
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.209-217
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    • 1994
  • Between July 1987 and December 1992, we treated 22 patients with chronic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation(TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6fractions/3days (6 patients) or 1320 cGy/8 fractions/4days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were $58.5\%$ and $41.2\%$, respectively, and the relapse rate was $36\%$ among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase ($76\%\;vs\;33\%$, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation ($50\%\;vs\;0\%$, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patients remains in the chronic phase.

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Effects of Heat, pH, and Gamma Irradiation Treatments on Lipase Inhibitory Activity of Sargassum thunbergii Ethanol Extract (지충이(Sargassum thunbergii) 에탄올 추출물의 Lipase 저해활성에 미치는 열, pH 및 감마선 조사의 영향)

  • Kim, Dong-Hyun;Kim, Koth-Bong-Woo-Ri;Kim, Min-Ji;SunWoo, Chan;Jung, Seul-A;Kim, Hyun-Jee;Jeong, Da-Hyun;Kim, Tae-Wan;Cho, Young-Je;Ahn, Dong-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.4
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    • pp.566-570
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    • 2012
  • Inhibitory activity of $Sargassum$ $thunbergii$ (ST) against porcine pancreatic lipase was assessed after heat treatment, pH changes, and gamma irradiation. This analysis revealed that the ST ethanol extract exhibited high lipase inhibitory activity (37.37%) at 5 mg/mL. The ST ethanol extract was treated with heat at $60^{\circ}C$ for 10, 30, and 60 min; 80 and $100^{\circ}C$ for 10 and 20 min; and $121^{\circ}C$ for 15 min, pH (2, 4, 6, 8 and 10) and ${\gamma}$-irradiation (3, 7 and 20 kGy). The lipase inhibitory activity of the ST ethanol extract increased in all heat treatments, especially at $121^{\circ}C$ for 15 min (51.55%) compared with the control. With regard to pH stability, the ST ethanol extract showed no significant changes at pH 4~8, but somewhat decreased inhibitory activity was revealed at pH 2 (26.25%) and 10 (29.93%). On the other hand, the ST ethanol extract was not affected by ${\gamma}$-irradiation treatment conditions used in this study. These results suggest that ST has a potential role as a functional food agent.

In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG (심폐기 가동하 관상동맥우회술 후 발생한 급성신부전 환자들에 있어 지속적 신대체요법의 병원 내 결과)

  • Kim, Young-Du;Park, Kuhn;Kang, Chul-Ung;Yoon, Jeong-Seob;Moon, Seok-Whan;Wang, Young-Pil;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.32-36
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    • 2007
  • Background: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. Material and Method: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with preexisting dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. Result: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis-dependent CRF patient. The mean time between the operation and the initiation of CRRT was $25.8{\pm}5.8$ hours and the mean duration of CRRT was $62.1{\pm}41.2$ hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. Conclusion: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.

Effectiveness Evalution of 18F-FDG Auto Dispenser (RIID: Radiopharmaceutical Intelligent Dispenser) (18F-FDG 자동분주기 사용에 따른 유용성 평가)

  • Yoo, Moon-Gon;Moon, Jae-Seung;Kim, Su-Geun;Shin, Min-Yong;Kim, Seung-Chul;Lee, Tea-hun;An, Sung-Hyeun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.79-83
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    • 2018
  • Purpose $^{18}F-FDG$, which is commonly used in PET-CT examinations, is low in capacity and it is difficult to keep the amount of radioactivity busy when the specific activity is high, increasing the amount of space dose and radioactive contamination in the distribution room. Therefore, while evaluating the actual dose administered to patients during the manual dispense process, the medical institution intends to assess the usefulness of the auto dispenser by comparing the differences from the actual dose administered to the patient using the new automatic dispense. Materials and Methods From July 2016 to December 2016, 846 patients were manually administered by workers using $^{18}F-FDG$ and $^{18}F-FDG$ 906 patients were using auto dispenser from July 2017 to December 2017. Results Capacity administered to patients during the manual dispense averaged $35.41{\pm}27.79%$ compared to the recommended dose, and the auto dispenser process showed a small difference of $-2.15{\pm}3.99%$ compared to the recommended dose(p<0.05). Conclusion Working people did not have to touch radioactive medicines directly while they were busy in the auto dispenser, and because of the availability of other tasks far away, the time and distance to receive the exposure were also advantageous. It is believed that future use by many medical institutions will not only reduce the dose to patients but also help reduce the exposure dose to workers.

A Characteristic of Community Distribution on Benthic Macro-invertebrates in Major Streams of Jirisan Mountain (지리산 주요 수계의 저서성 대형무척추동물 군집분포의 특성)

  • Kim, Hyoung-Gon;Yoon, Chun-Sik;Hwang, Jong-Woo;Park, Eun-Hee;Cheong, Seon-Woo
    • Journal of Environmental Science International
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    • v.23 no.2
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    • pp.291-302
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    • 2014
  • We have studied characteristics of community structure on the benthic macro-invertebrates at twelve selected sites in upstream, midstream and downstream of Paemsagol, Piagol, Chilseongol and Daeseonggol, major streams of Jirisan Mountain, for three years from April 2008 to September 2010. As a result, 2 phyla, 3 classes, 11 orders, 41 families, 119 species and 4,449 individuals of benthic macro-invertebrates have been collected and classified in this study. Among them EPT group (Ephemeroptera, Plecoptera, Trichoptera), commonly appearing taxa in clean stream ecosystem, was found most frequently. The highest species number of benthic macro-invertebrates were collected in 2008, the year with lower climatic influence including heavy rain. In almost all of survey sites 80% or over of EPT group were counted, and St. 1 scored highest rate of EPT group at 92.59%. Most dominant species was Ecdyonurus kibumensis at 12.83% of dominance index, and subdominant species was Goerodes KUb at 6.81% of dominance index. The investigation of the feeding function group indicated that gathering-collectors were dominant with 26 species and 1,334 individuals, while the number of filtering-collectors was lowest with 11 species and 230 individuals. This result represents that the feeding function group of Jirisan Mountain is mountainous stream-specific one. Both diversity index and richness index were lowest at the midstream of Chilseongol (St. 5), while the midstreams of Daeseonggol (St. 11) and Piagol (St. 8) were highest in diversity and richness indices respectively. The analyses of linear regression and correlation were performed in order to investigate and to predict the appearance aspect of EPT group by altitude. The results showed that the ratio of Plecopteran species number has increased by the elevation of the altitude at 0.05 significance level. Cluster analysis was also carried out for evaluating environmental similarities among survey sites. As a result, upper regions of Paemsagol (St. 1) and Piagol have clustered as most similar sites each other, while the midstream of Piagol (St. 8) has separated with lower similarity value than other sites in species composition.

SURFACE HARDNESS AND PRESSING ACCURACY OF REUSED IPS EMPRESS 2 (반복 사용된 IPS Empress 2의 표면경도와 pressing accuracy에 관한 연구)

  • Son Oe-Soo;Kim Yu-Lee;Lee Kyung-Ja;Jin Tai-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.5
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    • pp.596-605
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    • 2003
  • Statement of problem : IPS Empress2 system was developed and used in prosthodontic treatment, but the cost of ingot is expensive for wide application. Purpose : This study was to investigate the possibility on recycling of IPS Empress 2 ceramic for wide application of IPS Empress 2 ceramic in prosthodontic treatment. Material and Method : 1st, 2nd and 3rd pressed disc-shaped($10{\times}1.5mm$) IPS Empress 2 specimens were made with IPS Empress ingot(200, Ivoclar, Liechtenstein) and pressing furnace(IPS Empress EP 500, Ivoclar, Liechtenstein). Vicker's surface hardness and fracture toughness, acid resistance, and pressing accuracy of IPS Empress 2 ceramic were measured and analyzed. Surface hardness was measured by microhardness tester(MTX 70. Matsuzawa, Japan), before and after surface treatment with 0.5% hydrofluoric acid and carbonic acid(Coca cola) for evaluation of acid resistance. Results : The surface hardness of 1st pressed specimen was the higher(5.11 GPa) than those of 2nd pressed(4.89 GPa) and 3rd pressed specimen(4.86 GPa), and the fracture toughness of 1st pressed ($1.58MPam^{1/2}$) and 2nd pressed specimen($1.51MPam^{1/2}$) were higher than that of 3rd pressed specimen($1.39MPam^{1/2}$). The changes of surface hardness of 1st, 2nd, and 3rd pressed specimens after treatment with fluoric acid were 0.17, 0.06, 0.05 (GPa) respectively, and those of 1st, 2nd, and 3rd pressed specimens after treatment with carbonic acid were 0.07, 0.00, 0.05(MPa) respectively. The pressing accuracy of 1st,2nd and 3rd specimen were 77.22%, 85.681%, and 75.05%. The pressing accuracy of 2nd pressed specimen was higher than that of the 3rd specimen. Conclusion : The changes of physical properties according to recycling of IPS Empress 2 from this study were insignificant. Therefore the possibility of recycling of IPS Empress 2 can be suggested from the results.

Anatomic Feasibility of Posterior Cervical Pedicle Screw Placement in Children : Computerized Tomographic Analysis of Children Under 10 Years Old

  • Lee, HoJin;Hong, Jae Taek;Kim, Il Sup;Kim, Moon Suk;Sung, Jae Hoon;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.475-481
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    • 2014
  • Objective : To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement. Methods : A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011. Results : For the C1 screw placement, entry point height (EPH) was the most restrictive factor (47.3% patients were larger than 3.5 mm). All C2 lamina had a height larger than 3.5 mm and 68.8% (51/74) of C2 lamina had a width thicker than 3.5 mm. For C2 pedicle width, 55.4% (41/74) of cases were larger than 3.5 mm, while 58.1% (43/74) of pedicle heights were larger than 3.5 mm. For pedicle width of subaxial spine, 75.7% (C3), 73% (C4), 82.4% (C5), 89.2% (C6), and 98.1% (C7, 1/54) were greater than 3.5 mm. Mean lamina width of subaxial cervical spine was 3.1 (C3), 2.7 (C4), 2.9 (C5), 3.8 (C6), and 4.0 mm (C7), respectively. Only 34.6% (127/370) of subaxial (C3-7) lamina thickness were greater than 3.5 mm. Mean length of lateral mass for the lateral mass screw placement was 9.28 (C3), 9.08 (C4), 8.81 (C5), 8.98 (C6), and 10.38 mm (C7). Conclusion : C1 lateral mass fixation could be limited by the morphometrics of lateral mass height. C2 translamina approach is preferable to C2 pedicle screw fixation. In subaxial spines, pedicle screw placement was preferable to trans-lamina screw placement, except at C7.

Associations between Morphological Characteristics of Intracranial Arteries and Atherosclerosis Risk Factors in Subjects with Less Than 50% Intracranial Arterial Stenosis

  • Byun, Hokyun;Jang, Jinhee;Choi, Hyun Seok;Jung, So-Lyung;Ahn, Kook-Jin;Kim, Bum-soo
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.3
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    • pp.150-157
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    • 2018
  • Purpose: To assess associations between morphological characteristics of intracranial arteries in time-of-flight MR angiography (TOF-MRA) and atherosclerotic risk factors. Materials and Methods: From January 2014 to October 2015, a total of 129 patients (65 men and 64 women) without intracranial arterial stenosis > 50% were included in this study. All MRIs were performed using a 3T machine with 3D TOF-MRA sequences. We evaluated irregularity, tortuosity, and dilatation of intracranial arteries in maximal intensity projection (MIP) of TOF-MRA. Subjects' risk factors for atherosclerosis including history of hypertension and diabetes were collected by reviewing their medical records. Associations between morphological characteristics and each known atherosclerosis risk factor were examined using univariate regression analysis. Multivariate regression models were built to determine combined association between those risk factors and morphologic changes of intracranial arteries. Results: In multivariate analysis, hypertension (coefficient [95% CI]: 0.162 [0.036, 0.289], P = 0.012) and absence of diabetes (coefficient [95% CI]: -0.159 [-0.296, -0.023], P = 0.022) were associated with large diameter of intracranial arteries. Males (coefficient [95% CI]: 0.11 [-0.006, 0.23], P = 0.062) and higher age (coefficient [95% CI]: 0.003 [-0.001, 0.008], P = 0.138) had marginal association with increased diameter. Tortuosity was associated with old age (OR: 1.04 [1.02, 1.07], P < 0.001). Irregular contour of intracranial arteries was significantly associated with old age (OR: 1.05 [1.02, 1.09], P = 0.004), presence of diabetes (OR: 2.88 [1.36, 6.15], P = 0.0058), and previous ischemic stroke (OR: 3.91 [1.41, 11.16], P = 0.0092). Conclusion: Morphological characteristics (irregularity, tortuosity, dilatation) of intracranial arteries seen in TOF-MRA might be associated with atherosclerotic risk factors in subjects with no or mild stenosis.

A Comparative Study according to Diagnostic Time on Meningitis (무균성 뇌막염에서 증상발현부터 진단까지 걸린 시간에 따른 시기별 유병기간의 검토)

  • Kim, Tag Soo;Hur, Ji Yeon;Park, Young Hee;Jung, Min Goo;Kim, Sung Won
    • Pediatric Infection and Vaccine
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    • v.3 no.2
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    • pp.168-174
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    • 1996
  • Purpose : Aseptic meningitis is relatively frequent in children and caused mostly by enterovirus. The aim of the present study was to determine the effect of early diagnosis (spinal tapping) on symptom duration of childhood aseptic meningitis. Methods : One hundred fifty-three children who were hospitalized due to aseptic menigitis in the Department of Pediatrics St. Benedict Hospital from July 1996 through October 1996 were included in this study. Patients were divided to two groups according to the duration from first symptom onset to diagnosis. Early diagnosis group is diagnosed within 3 days from first symptom onset. Later diagnosis group is diagnosed after 4 days from first symptom onset. Results : 1) The average age of these patients was 4.3 years old in early diagnosis group and 4.1 years old in later diagnosis group. The sex ratio(male: female) was 2.04:1 in early diagnosis group and 2.5:1 in later diagnosis group. 2) The mean duration of diagnosis of this study was 2.04 day in early diagnosis group and 5.12 day in later diagnosis group. 3) The percentage of symptom and sign of the early diagnosis group were fever(100%), headache(88.4%), vomiting(86.9%), abdominal pain(39%), neck stiffness(36.2%), skin rash(18.8%), diarrhea(16.9%) and that of later diagosis group were fever(100%), headache(83.3), vomiting(80.9%), abdominal pain(47.6%), neck stiffness(41.6%), skin rash(29.7%), diarrhea(16.6%). 4) Initial CSF findings revealed leukocyte $146.8{\pm}386.3/mm^3$ with PMNL 38%, protein 32.47mg/dl, sugar 66.23mg/dl in early diagnosis group and leukocyte $458.1{\pm}663.2/mm^3$, protein 31.22mg/dl, sugar 64.21 mg/dl in later diagnosis group. 5) There was no statistically significant differance in the peripheral blood findings between early diagnosis group and later diagnosis group. 6) The duration of disappearance of symptom after spinal tap were 2.3 days in early diagnosis group and 2.24 days in later diagnosis group. Total symptom duration was 4.34 days in early diagnosis group and 7.36 days in later diagnosis group. Conclusions : Our results demonstrate that early diagnosis(early spinal tap) shortened duration of clinical symptoms.

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