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Serotypes and Penicillin Susceptibility of Streptococcus pneumoniae Isolated from Clinical Specimens and Healthy Carriers of Korean Children (소아의 임상 검체 및 건강한 소아의 비인두에서 분리된 폐구균의 혈청형 및 페니실린 감수성)

  • Lee, Jin-A;Kim, Nam-Hee;Kim, Dong-Ho;Park, Ki-Won;Kim, Yun-Kyung;Kim, Kyoung-Hyo;Park, Jin-Young;Choi, Eun-Hwa;Lee, Hoan-Jong
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.846-853
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    • 2003
  • Purpose : Pneumoccocus is one of the most important causes of invasive infection through the childhood period and the prevelance of antibiotics resistance of pneumococcus is increasing worldwide. A 7-valent conjugate vaccine has been developed. It is important to know the prevalence of each serotype of pneumococci in the countries where the vaccine is used to estimate the coverage rate by the vaccine. Methods : One hundred and twenty seven strains of clinical isolates and 72 strains from healthy carriers recovered from Korean children during the period from 1997 to 2002 were subjected to determination of serotype by Quellung reaction and penicillin susceptibility with oxacillin disc diffusion test. Results : Forty-three per cent of clinical isolates were obtained from children under two years of age. Thirty strains(24%) were isolated from normally sterile body fluids. The frequent serotypes were 19F, 19A, 23F, 6A, 6B and 9V. Fifty-six per cent of the clinical isolates were represented in the current 7-valent protein conjugate pneumococccal vaccine, and 84% when the cross-reactive serotypes were included. Frequent serotypes of strains isolated from one to five year-old healthy children were 19F, 14, 11A, 23F, 18C, and 19A. Seventy-one per cent of the carrier strains were included in the 7-valent vaccine. Ninety-three per cent of the clinical isolates and 86% of carrier strains were not susceptible to penicilline. Conclusion : Fifty-six to 84% of pneumococci recovered from Korean children are covered by the current 7-valent protein conjugate pneumococcal vaccine and the prevalence of penicillin resistance was very high.

Clinical Study of Group B β-Hemolytic Streptococcal Meningitis (B군 연쇄상구균 뇌막염에 대한 임상적 고찰)

  • Lee, Seo-Young;You, Sou-Jeong;Kim, Deok-Soo;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1224-1229
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    • 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.

Maternal and Neonatal Outcome of Twin Pregnancies after in vitro Fertilization and Embryo Transfer (체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석)

  • Kim, Kyung-Ah;Min, Uoo-Gyung;Lim, Jae-Woo;Jun, Nu-Lee;Won, Hye-Sung;Kim, Chung-Hoon;Kim, Ellen Ai-Rhan;Lee, Pil-Ryang;Lee, In-Sik;Kim, Ki-Soo;Kim, Ahm;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.224-229
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    • 2003
  • Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

The prevalences of asthma and allergic diseases in Korean children (한국 소아알레르기 질환의 유병률)

  • Hong, Soo-Jong;Ahn, Kang-Mo;Lee, Soo-Young;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.343-350
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    • 2008
  • Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

Dynamic Decision Making using Social Context based on Ontology (상황 온톨로지를 이용한 동적 의사결정시스템)

  • Kim, Hyun-Woo;Sohn, M.-Ye;Lee, Hyun-Jung
    • Journal of Intelligence and Information Systems
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    • v.17 no.3
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    • pp.43-61
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    • 2011
  • In this research, we propose a dynamic decision making using social context based on ontology. Dynamic adaptation is adopted for the high qualified decision making, which is defined as creation of proper information using contexts depending on decision maker's state of affairs in ubiquitous computing environment. Thereby, the context for the dynamic adaptation is classified as a static, dynamic and social context. Static context contains personal explicit information like demographic data. Dynamic context like weather or traffic information is provided by external information service provider. Finally, social context implies much more implicit knowledge such as social relationship than the other two-type context, but it is not easy to extract any implied tacit knowledge as well as generalized rules from the information. So, it was not easy for the social context to apply into dynamic adaptation. In this light, we tried the social context into the dynamic adaptation to generate context-appropriate personalized information. It is necessary to build modeling methodology to adopt dynamic adaptation using the context. The proposed context modeling used ontology and cases which are best to represent tacit and unstructured knowledge such as social context. Case-based reasoning and constraint satisfaction problem is applied into the dynamic decision making system for the dynamic adaption. Case-based reasoning is used case to represent the context including social, dynamic and static and to extract personalized knowledge from the personalized case-base. Constraint satisfaction problem is used when the selected case through the case-based reasoning needs dynamic adaptation, since it is usual to adapt the selected case because context can be changed timely according to environment status. The case-base reasoning adopts problem context for effective representation of static, dynamic and social context, which use a case structure with index and solution and problem ontology of decision maker. The case is stored in case-base as a repository of a decision maker's personal experience and knowledge. The constraint satisfaction problem use solution ontology which is extracted from collective intelligence which is generalized from solutions of decision makers. The solution ontology is retrieved to find proper solution depending on the decision maker's context when it is necessary. At the same time, dynamic adaptation is applied to adapt the selected case using solution ontology. The decision making process is comprised of following steps. First, whenever the system aware new context, the system converses the context into problem context ontology with case structure. Any context is defined by a case with a formal knowledge representation structure. Thereby, social context as implicit knowledge is also represented a formal form like a case. In addition, for the context modeling, ontology is also adopted. Second, we select a proper case as a decision making solution from decision maker's personal case-base. We convince that the selected case should be the best case depending on context related to decision maker's current status as well as decision maker's requirements. However, it is possible to change the environment and context around the decision maker and it is necessary to adapt the selected case. Third, if the selected case is not available or the decision maker doesn't satisfy according to the newly arrived context, then constraint satisfaction problem and solution ontology is applied to derive new solution for the decision maker. The constraint satisfaction problem uses to the previously selected case to adopt and solution ontology. The verification of the proposed methodology is processed by searching a meeting place according to the decision maker's requirements and context, the extracted solution shows the satisfaction depending on meeting purpose.

Human Risk Assessment of Polybrominated Diphenyl Ethers by Breast Milk Feeding of Infants (영유아의 모유 섭취에 따른 폴리브롬화디페닐에테르의 위해성 평가)

  • We, Sung-Ug;Cho, Bong-Hui;Cho, Yu-Jin;Yoon, Cho-Hee;Choi, Shi-Nai;Min, Byung-Yun
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.2
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    • pp.109-118
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    • 2012
  • This study achieves results from 22 maternity breast milk samples in total to demonstrate exposure level and risk assessment of PBDEs in Seoul area. PBDEs were detected in all the breast milk samples of the present study, indicating that general population in these Seoul area are widely exposed to these chemicals. Residue levels of total PBDEs (sum PBDEs from tri- to hepta-BDE) ranged of 0.84~13.1 ng/g lipid with an arithmetic mean and median of 3.56 ng/g lipid and 2.6 ng/g lipid, respectively. Global comparison shows that the levels of total PBDEs were relatively similar to those of China, Taiwan and European country (Sweden), and somewhat higher than those in some Asian (Vietnam, Philippines, and Indonesia). In the present study, however, the levels of total PBDEs in human milk are still one to two orders of magnitude lower than those in North America. Contribution rate of each congener appeared to be predominant with BDE-47, followed by BDE-153, BDE-100, BDE-99, BDE-154 and BDE-183. The sum of BDE-47 and BDE-153 accounted for more than 65% of total PBDEs in most samples. From the result of the human risk assessment of infants for total PBDEs and BDE-47 by breast milk feeding, we could find out that the average daily doses and hazard index (95th percentile) were 16.5 ng/kg bw/day and $1.2{\times}10^{-1}$ each other when nursing for 6 months after infants born. However, it was concluded that the infant health hardly had adverse seriously effects under this research condition.

Development of Visible Light Responsive Nitrogen Doped Photocatalysts ($TiO_2$, $Nb_2O_5$) for hydrogen Evolution (수소 생산을 위한 가시광선 감응 질소 도핑 $TiO_2$$Nb_2O_5$ 광촉매의 개발)

  • Choi, Mi-Jin;Chae, Kyu-Jung;Yu, Hye-Weon;Kim, Kyoung-Yeol;Jang, Am;Kim, In-S.
    • Journal of Korean Society of Environmental Engineers
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    • v.33 no.12
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    • pp.907-912
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    • 2011
  • Development of visible light responsive photocatalysts is a promising research area to facilitate utilization of solar energy for hydrogen production via photocatalytic water splitting. In this study two groups of samples, nitrogen (N)-doped niobium pentoxide ($Nb_2O_5$) and titanium dioxide ($TiO_2$) ($Nb_2O_5-N$, $HNb_3O_8-N$, $TiO_2-N$) and N-undoped ones ($Nb_2O_5$ and $TiO_2$) were tested. In order to utilize visible light, nitrogen atoms were doped in selected photocatalysts by using urea. A shift of the absorption edges of the Ndoped samples in the visible light region was observed. Under visible light irradiation, N-doped samples were more prominent photocatalytic activities than the N-undoped samples. Specifically, 99.7% of rhodamine B (RhB) was degraded after 60 minutes of visible light irradiation with $TiO_2-N$. Since $TiO_2-N$ shows the highest activity of RhB degradation, it was supposed to generate the highest current response. However, $HNb_3O_8-N$ showed the highest current response ($63.7mA/cm^2$) than $TiO_2-N$. More interestingly, when we compare the hydrogen production, $Nb_2O_5-N$ produced $19.4{\mu}mol/h$ of hydrogen.

Effects of Biomass Gasification by Addition of Steam and Calcined Dolomite in Bubbling Fluidized Beds (기포유동층에서 수증기 및 소성된 백운석 첨가에 의한 바이오매스 가스화의 영향)

  • Jo, WooJin;Jeong, SooHwa;Park, SungJin;Choi, YoungTai;Lee, DongHyun
    • Korean Chemical Engineering Research
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    • v.53 no.6
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    • pp.783-791
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    • 2015
  • A fluidized-bed reactor with an inside diameter of 0.1 m and a height of 1.2 m was used to study the effect of steam and catalyst additions to air-blown biomass gasification on the production of producer gas. The equipment consisted of a fluidized bed reactor, a fuel supply system, a cyclone, a condenser, two receivers, steam generator and gas analyzer. Silica sand with a mean particle diameter of $380{\mu}m$ was used as a bed material and calcined dolomite ($356{\mu}m$), which is effective in tar reduction and producer gas purification, was used as the catalyst. Both of Korea wood pellet (KWP) and a pellet form of EFB (empty fruit bunch) which is the byproduct of Southeast Asia palm oil extraction were examined as biomass feeds. In all the experiments, the feeding rates were 50 g/min for EFB and 38 g/min for KWP, respectively at the reaction temperature of $800^{\circ}C$ and an ER (equivalence ratio) of 0.25. The mixing ratio (0~100 wt%) of catalyst was applied to the bed material. Air or an air-steam mixture was used as the injection gas. The SBR (steam to biomass ratio) was 0.3. The composition, tar content, and lower heating value of the generated producer gas were measured. The addition of calcined dolomite decreased tar content in the producer gas with maximum reduction of 67.3 wt%. The addition of calcined dolomite in the air gasification reduced lower heating value of the producer gas. However The addition of calcined dolomite in the air-steam gasification slightly increased its lower heating value.

Survey on Radiotherpv Protocols for the Rectal Cancers Among the Korean Radiation Oncologists in 2002 for the Development of the Patterns of Care Study of Radiation Therapy (방사선치료 Patterns of Care Study 개발을 위한 2002년 한국 방사선종양학과 전문의들의 직장암 방사선치료 원칙 조사연구)

  • Kim, Jong-Hoon;Kim, Dae-Yong;Kim, Young-Ho;Kim, Woo-Chul;Kim, Chul-Yong;Sung, Jin-Shil;Son, Seung-Chang;Shin, Hyun-Su;An, Young-Chan;Oh, Do-Hum;Oh, One-Yong;Yu, Mi-Ryung;Yu, Hung-Jun
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.44-65
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    • 2003
  • Purpose : To conduct nationwide surgery on the principles In radiotherapy for rectal center, and develop the framework of a database of Korean Patterns of Care Study. Materials and Methods : A consensus committee was established to develop a tool for measuring the Patterns in radiotherapy Protocols for rectal cancer. The Panel was composed of radiation oncologists from 18 hospitals in Seoul Wetropolltan area. The committee developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer. The survey items developed for measuring the treatment principles were composed of 1) 8 eliglblllty criteria, 2) 20 Items for staging work-ups and prognostic factors, 3) 7 Items for principles of combined surgery and chemotherapy, 4) 9 patient set-ups, 5) 19 determining radiation fields, 6) S radiotherapy treatment pians, 7) 4 physicalilaboratory examination to monitor a patient's condition during treatment, and 8) 10 follow-up evaluations. These items were sent to radiation oncoioglsts In charge of gastrolntestlnal malignancies in all hospitals (48 hospitals) In Korea to which 30 replies were received (63$\%$). Results : Most of the surrey Items were replied to without no major between the repliers, but with the fellowing items only 50$\%$ of repliers were in agreement : 1) Indications of preoperative radiation, 2) use of endorectal ultrasound, CT scan, and bone scan for staging work-ups, 3) principles of combining chemotherapy with radiotherapy, 4) use of contrast material for small bowel delineation during simulation, 5) determination of field margins, and 6) use of CEA and colonoscopy for follow-up evaluations. Conclusions : The Items where considerable disaggrement was shown among the radiation oncologists seemed to make no serious difference In the treatment outcome, but a practical and reasonable consensus should be reached by the committee, with logical processes of agreement. These Items can be used for a basic database for the Patterns of Care Study, which will survey the practical radiotherapy Patterns for rectal cancer in Korea.

Expression of Matrix Metalloproteinase-2 and Tissue Inhibitor of Metalloproteinase-2 in Radiation Exposed Small Intestinal Mucosa of the Rat (방사선조사를 받은 흰쥐 소장 점막의 손상과 재생과정 중 금속단백효소 및 억제자의 발현)

  • Kwag, Hyon-Joo;Lee, Kyoung-Ja;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.66-74
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    • 2003
  • Purpose : The matrix metalloprotelnases (MMPs) are a family of enzymes whose main function is the degradation of the extracellular matrix. Several studies have revealed that MMPs and TIMPS are related to the wound heating process and in photoaging caused by ultraviolet Irradiation. However, the expressions of MMP and TIMP after irradiation have not, to the best of our knowledge, been studied. This study investigates the expressions of MMP-2 and TIMP-2 in rat Intestinal mucosa following irradiation. Materials and Methods : The entire abdomen of Sprague-Dawley rats was irradiated using a single dose method. The rats were sacrificed on day 1, 2, 3, 5, 7 and 14 following irradiation. Histopathological observations were made using hematoxilin & eosin staining. The expressions of MMP-2 and TIMP-2 were examined using immunohistochemistry, Irnrnunoblotting and ELISA. Results : Radiation induced damage associated with atrophic villi, and infiltration of inflammatory cell was observed from the first postirradiation day, and severe tissue damage was observed on the second and the third postirradiation days. An increase in mitosis and the number of regenerating crypts, as evidence of regeneration, were most noticeable on the fifth postirradiation day. From the immunohistochemlstry, the MMP-2 expression was observed from the first postirradiation day, but was most conspicuous on the third and the fifth postirradiation days. The TIMP-2 expression was most conspicuous on the fifth postirradiation day. From the irnrnunoblotting, the MMP-2 expression was strongly positive on the third postirradlatlon day, and that of TIMP-2 showed a strong positive response on the fifth postirradiation day. In ELISA tests, the expressions of MMP-2 and TIMP-2 were increased in the postirradiation groups compared to those of the normal controls, and showed a maximum increase on the fifth postirradiatlon day. These results were statistically significant. Conclusion : The expressions of MMP-2 and TIMP-2 were increased in the intestinal mucosa of the rats following irradiation, and these results correlated with the histopathological findings, such as tissue damage and regeneration. Therefore, this study suggests that MMP-2 and TIMP-2 play roles in the mechanisms of radiation-induced damage and regeneration of intestinal mucosa of rats.