• Pediatric Infection and Vaccine
• /
• v.14 no.2
• /
• pp.162-170
• /
• 2007

Purpose : While cases of vancomycin-resistant enterococci (VRE) have increasingly been reported worldwide since it was first reported in the late 1980s, there have been few systemic studies on the pediatric population. The purpose of this study is to contribute to the planning of VRE prevention by investigating the prevalence, risk factors and transmission of VRE infection. Methods : We studied 230 patients under age 15 years who were isolated VRE between January 2001 and December 2006 retrospectively. The patients were classified into the intensive care unit (ICU) and the non-ICU groups. We reviewed the procedures before VRE detection as well as antibiotic sensitivity of detected organisms. Results : The number of VRE-isolation cases was higher in the ICU group than the non-ICU group. Instances of VRE-isolation were also more prevalent in patients who underwent operations or active procedures while taking 3rd-generation cephalosporins or glycopeptides. Almost all antibiotics except tetracycline were resistant to VRE. The proportion of 3rd-generation cephalosporin use was higher than those of any other antibiotics before VRE detection. Additionally, the use of 3rd-generation cephalosporins has increased annually, but that of glycopeptides had decreased in 2006. Also, the rates of VRE isolation have been increasing since 1998. Conclusion : VRE infection is increasing in pediatric population. Strict adherence to appropriate infection control guidelines for the prevention of VRE transmission in hospitals, and tracking of VRE colonization through active surveillance in high risk units are recommended.

• Korean Journal of Microbiology
• /
• v.41 no.3
• /
• pp.216-224
• /
• 2005

Chromatography has now been used successfully to provide the requisite purity for human plasma-derived biop-harmaceuticals such as coagulation factors and immunoglobulins. Recently, increasing attention has been focused on establishing efficient cleaning procedures to prevent potential contamination by microorganisms as well as carry-over contamination from batch to batch. The purpose of present study was to develop a cleaning validation system for the assurance of virus removal and/or inactivation during chromatography process. In order to establish an assay system for the validation of virus clearance during chromatography cleaning process, a quantitative real-time PCR method for porcine parvovirus(PPV) was developed, since PPV, a model virus for human parvovirus B19, has a high resistance to a range of physico-chemical treatment. Specific primers for amplification of PPV DNA was selected, and PPV DNA was quantified by use of SYBR Green I. The sensitivity of the assay was calculated to be 1.5 $TCID_{50}/ml$. The established real-time PCR assay was successfully applied to the validation of PPV removal and cleaning during SP-Sepharose cation chromatography for thrombin purification and Q-Sepharose anion chromatography for factor VIII purification. The comparative results obtained by real-time PCR assay and infectivity titrations suggested that the real-time PCR assay could be a useful method for chromatography cleaning validation and that it could have an additive effect on the interpretation and evaluation of virus clearance during the virus removal process.

• The Korean Journal of Pain
• /
• v.5 no.1
• /
• pp.37-43
• /
• 1992

Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxemia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine for control of postoperative pain was reported by Behar and associates. This study was carried out for twenty patients who received posterolateral thoracostomy with bleb resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes under general endotracheal anesthesia. For the relief of post-thoracotomy pain following of the general anesthesia, we selected ten patients as control group which were treated intermittently IM with injection of pethidine(50 mg) according to the conventional method and another ten patients as study group which were managed with thoracic epidural analgesia. The tip of the catheter was inserted to T4-5 epidural space through T12-L1 or L1-2 interspinous region before the induction of the general anesthesia and then the epidural analgesics(0.25% bupivacaine 15 ml+morphine 3 mg) was injected once a day via the catheter until 4 th POD in the study group. The epidural catheters were removed at postoperative 4 th day in study group. Clinical observations were done about vital signs, ABG, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; (1) The values of $V_T$ and FVC were significantly improved in study group(85% and 66%) as compared with control group(76% and 61%) during the postoperative 4 day of the epidural analgesia. (2) After the end of the epidural analgesia(7th POD), the values of FVC were improved invertly rather in control group(98%) than study group(84%). It suggested that the reduction of FVC in study group were caused by the raised pain sensitivity following the end of epidural analgesia. (3) The side effects of epidural analgesia such as transient urinary retention(2 cases), itching sensation(1) and headache(1) were noted.

• Clinical and Experimental Pediatrics
• /
• v.46 no.9
• /
• pp.898-902
• /
• 2003

Purpose : To determine the clinical association of diagnostic criteria and the prevalence of autoantibodies in newly diagnosed children with juvenile dermatomyositis(JDM). Methods : Thirty-two children with JDM were identified at Seoul National University Children's Hospital from March 1985 to March 1999 by retrospective review. The diagnosis of JDM was based on the criteria proposed by Bohan and Peter. We investigated for the presence of several autoantibodies: antinuclear(ANA), double-stranded DNA, anti-Sm, anti-ribonucleoprotein(RNP), anti-SSA/ SSB, anti-Jo1, anti-Scl-70 antibodies and rheumatoid factor(RF). Results : Sex ratio and age at diagnosis were similar to data published in other studies. All the newly diagnosed children with JDM had a typical rash(100%) and proximal muscle weakness(100%); 17(53%) had muscle pain or tenderness; 10(31%) calcinosis; eight(25%) dysphagia; eight(25%) arthritis, and seven(22%) fever. Muscle enzymes were elevated in 90% of the patients. Of the 27 patients who had an electromyogram, 20(70%) had diagnostic results. Sixteen(70%) of biopsied patients had appropriated results for JDM. Patients were negative for all autoantibodies except ANA and RF. ANA and RF were detected in 47% and 7% of the patients respectively. Conclusion : Although the sensitivity of the criteria proposed by Bohan and Peter is superior, each of these criteria has possible confounding factors. Additional criteria may be needed for early diagnosis of JDM. Based on our findings of autoantibodies in JDM, we do not recommend routine testing for autoantibodies in children with typical JDM.

• Clinical and Experimental Pediatrics
• /
• v.46 no.12
• /
• pp.1224-1229
• /
• 2003

Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

• Korean Journal of Cognitive Science
• /
• v.16 no.4
• /
• pp.305-322
• /
• 2005

Watermarking is a widely employed method tn protecting copyright of a digital image, the owner's unique image is embedded into the original image. Strengthened level of watermark insertion would help enhance its resilience in the process of extraction even from various distortions of transformation on the image size or resolution. However, its level, at the same time, should be moderated enough not to reach human visibility. Finding a balance between these two is crucial in watermarking. For the algorithm for watermarking, the predefined strength of a watermark, computed from the physical difference between the original and embedded images, is applied to all images uniformal. The mean brightness or contrast of the surrounding images, other than the absolute brightness of an object, could affect human sensitivity for object detection. In the present study, we examined whether the detectability for watermark noise might be attired by image statistics: mean brightness and contrast of the image. As the first step to examine their effect, we made rune fundamental images with varied brightness and control of the original image. For each fundamental image, detectability for watermark noise was measured. The results showed that the strength ot watermark node for detection increased as tile brightness and contrast of the fundamental image were increased. We have fitted the data to a regression line which can be used to estimate the strength of watermark of a given image with a certain brightness and contrast. Although we need to take other required factors into consideration in directly applying this formula to actual watermarking algorithm, an adaptive watermarking algorithm could be built on this formula with image statistics, such as brightness and contrast.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.6
• /
• pp.656-663
• /
• 2005

Background : The B-type natriuretic peptide (BNP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload. Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea. Methods : A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results : The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 6-47 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed, the BNP levels were also significantly higher in the patients with heart failure than in those without(p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion : BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

• Tuberculosis and Respiratory Diseases
• /
• v.71 no.2
• /
• pp.120-125
• /
• 2011

Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.

• Journal of the Korean earth science society
• /
• v.41 no.5
• /
• pp.469-477
• /
• 2020

Salinity is not only an important variable that determines the density of the ocean but also one of the main parameters representing the global water cycle. Ocean salinity observations have been mainly conducted using ships, Argo floats, and buoys. Since the first satellite salinity was launched in 2009, it is also possible to observe sea surface salinity in the global ocean using satellite salinity data. However, the satellite salinity data contain various errors, it is necessary to validate its accuracy before applying it as research data. In this study, the salinity accuracy between the Soil Moisture Active Passive (SMAP) satellite salinity data and the in-situ salinity data provided by the Ieodo ocean research station was evaluated, and the error characteristics were analyzed from April 2015 to August 2020. As a result, a total of 314 match-up points were produced, and the root mean square error (RMSE) and mean bias of salinity were 1.79 and 0.91 psu, respectively. Overall, the satellite salinity was overestimated compare to the in-situ salinity. Satellite salinity is dependent on various marine environmental factors such as season, sea surface temperature (SST), and wind speed. In summer, the difference between the satellite salinity and the in-situ salinity was less than 0.18 psu. This means that the accuracy of satellite salinity increases at high SST rather than at low SST. This accuracy was affected by the sensitivity of the sensor. Likewise, the error was reduced at wind speeds greater than 5 m s^-1. This study suggests that satellite-derived salinity data should be used in coastal areas for limited use by checking if they are suitable for specific research purposes.

• The Korean Journal of Financial Management
• /
• v.24 no.2
• /
• pp.1-40
• /
• 2007

We test a model of investment-cashflow-growth opportunities relationship in order to estimate the sensitivities to investments. In this study, we use a new proxy variable for the value of growth opportunities(hereafter "VGO"), which is based on the seminal papers of M&M(1958:1961:1963) and Lee(2006;2007). The empirical findings on the sensitivities of cashflow and growth opportunities are as follows. First, when the traditional proxy variables for the growth opportunities such as Tobin's Q, MBR and sales growth are included with the new proxy VGO in the estimation, their coefficients are turned out to be insignificant. Second, only the new proxy variable VGO shows a statistically significant positive sensitibity to investment, which can be regarded that the growth opportunities hold the positive influences to investments. Third, the Tobin's Q can be decomposed into three factors such as the value of growth opportunities(VGO), the value of asset-in-place and valuation errors. It turns out that only the VGO shows a statistically significant positive relationship with investment among others. This means that the new variable VGO is a good proxy variable for the growth opportunities in the investment-cashflow sensitivity analysis. In sum, thanks to the above findings in this study, we can say that it will not be proper to choose a proxy variable for the growth opportunities from the traditional set of proxies such as Tobin's Q, MBR, or sales growth rate.