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Significance of Random Urine ${\beta}_2$-Microglobulin as a Marker for Vesico-ureteral Reflux in Children with Urinary Tract Infection (요로감염 환자에서 방광요관역류의 지표로서 무작위 추출뇨중 ${\beta}_2$-microglobulin의 의의)

  • Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.72-79
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    • 1999
  • Renal scarring associated with vesico-ureteral reflux(VUR) is one of the major causes of end stage renal failure and renal hypertension in children. Urinary ${\beta}_2$-microglobulin(MG) has been suggested as a potential marker for presence of renal tubular damage. This study was designed to evaluate the significance of random urine ${\beta}_2$-MG as a predictor of presence of vesico-ureteral reflux in children with urinary tract infection(UTI). 57 children with urinary tract infection were studied. Patients were devided into two groups; 35($78.9\%$) children have UTI without VUR and 12($21.1\%$) children have UTI and VUR. Beta2-MG and creatinine in random urine sample was measured to decide the excretion ratio(${\beta}_2$-MG/creatinine). Among the 57 children with UTI, 44 children were confirmed by urine culture study and 13 children suspected by compatible clinical feature. Random urine ${\beta}_2$-MG of VUR group ($2.2{\pm}5.91$ mg/L) were significantly higher than that of simple UTI group($0.19{\pm}0.16mg/L$)(P=0.03). The ${\beta}_2$-MG/creatinine ratio of VUR group($32.41{\pm}25.7$) were significantly higher than that of simple UTI group($3.93{\pm}3.44$)(P=0.007). In conclusion, random urine ${\beta}_2$-MG and excretion ratio deserved early predictor of presence of VUR in children with UTI. And this method was more simple and inexpensive than the method of measuring ${\beta}_2$-MG with 24 hour urine collection, so might be a useful screening test for VUR in children with UTI.

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Variations in Nutrients & CO2 Uptake Rates and Photosynthetic Characteristics of Saccharina japonica from the South Coast of Korea (다시마(Saccharina japonica)의 생장에 따른 영양염 및 CO2 흡수율과 광합성 특성 변화)

  • Hwang, Jae-Ran;Shim, Jeong-Hee;Kim, Jeong-Bae;Kim, Sook-Yang;Lee, Yong-Hwa
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.16 no.4
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    • pp.196-205
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    • 2011
  • To investigate the contribution of macroalgae to biogeochemical nutrients and carbon cycles, we measured the uptake rates of nutrients and $CO_2$ and characteristics of fluorescence of Saccharina japonica (Laminaria japonica Areschoug) using an incubation method in an acrylic chamber. From January to May 2011, S.japonica was sampled at Ilkwang, one of well-known macroalgae culture sites around Korea and ranged 46~288 cm long and 4.8~22.0 cm wide of whole thallus. The production rate of dissolved oxygen by S. japonica (n=25) was about $6.9{\pm}5.8{\mu}mol\;g^{-1}$ fresh weight(FW) $h^{-1}$. The uptake rate of total dissolved inorganic carbon ($TCO_2$), calculated by total alkalinity and pH, was $8.9{\pm}7.9{\mu}mol\;g^{-1}\;FW\;h^{-1}$. Mean nutrients uptake were $175.6{\pm}161.1\;nmol\;N\;g^{-1}\;FW\;h^{-1}$ and $12.7{\pm}10.1\;nmol\;P\;g^{-1}\;FW\;h^{-1}$. There were logarithmic relationships between thallus length and uptake rates of nutrients and $CO_2$, which suggested that younger specimens (<100-150 cm) were much more efficient at nutrients and $CO_2$ uptake than old specimens > 150 cm. There was a positive linear correlation ($r^2$=9.4) existed between the dissolved oxygen production rate and the $TCO_2$ uptake rate, suggesting that these two factors may serve as good indicators of S. japonica photosynthesis. There was also positive linear relationship between maximal quantum yield ($F_v/F_m$) and production/uptake rates of dissolved oxygen, $TCO_2$ and phosphate, suggested that $F_v/F_m$ could be used as a good indicator of photosynthetic ability and $TCO_2$ consumption of macroalgae. Maximum relative electron transport rate ($rETR_{max}$) of S. japonica increased as thallus grew and was high in distal part of thallus which may be resulted from the increase of photosynthetic cell density per area. The annual $TCO_2$ uptake by S. japonica in Gijang area was estimated about $1.0\sim1.7{\times}10^3C$ ton, which was about 0.02-0.03% of carbon dioxide emission in Busan City. Thus, more research should be focused on macroalgae-based biogeochemical cycles to evaluate the roles and contributions of macroalgae to the global carbon cycle.

Study of Serious Bacterial Infections in Febrile Infants Younger than Three Months of Age (열이 있는 3개월 이하의 영아에서 세균성 감염의 예측에 대한 연구)

  • Jeon, Myeoung Won;Lee, Ji Young;Jang, Young Taek
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.215-222
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    • 2003
  • Purpose : This study was to analyze serious bacterial infections in infants younger than three months of age and to review the direction of treatments for these patients. Methods : 378 febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ visited from Jan. 2001 through Dec. 2002 were retrospectively studied. Infants with the following criteria belonged to the low risk group. WBC $5,000{\sim}15,000/mm^3$, WBC negative in urine stick test and negative for nitirite test, CSF WBC < $10/mm^3$ and negative in CSF gram stain, negative chest X-ray, stool WBC <5/HFP(high power field), and focal infection. If any of the above criteria were not met, they belonged to the high risk group. SBI was defined as a positive culture of urine, blood or CSF. SI was defined as aseptic meningitis or pneumonia including above laboratory tests of SBI. SBI patients were separately compared with two groups, high risk and low risk. Results : Of the 378 infants that were tested 216(57.1%) were in the high risk group and 162(42.9%) in the low risk group. Among 105 SBI(27.8%) and 172 SI(45.5%), there were 98 urinary tract infection(25.2%), 10 bacteremia(2.6%), 2 bacterial meningitis(0.6%), and 77 aseptic meningitis(22.8%). There were 76 SBI(35.2%) from the high risk group and 29 SBI(17.9%) from the low risk group identified. The results of the sensitivity(72.4%), the specificity(48.7%), the negative predictive value(82.1%) and the positive predictive value (35.2%) were calculated. Conclusion : Even though the probability of SBI in the low risk group is insignificant, it should still be considered in febrile infants younger than 3 months of age. I believe the CSF study is necessary because of the moderate high incidence of abnormal finding in our study.

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Clinical and Phylogenetic Characteristics of Escherichia coli Urinary Tract Infections (대장균에 의한 요로감염의 연령별, 계통군별 특징)

  • Lee, Ji Eun;Lee, Youn Hee;Nam, Chan Hee;Kwak, Ga Young;Lee, Soo Young;Kim, Jong Hyun;Hur, Jae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.16-22
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    • 2010
  • Purpose : We aimed to investigate the clinical and phylogenetic characteristics of Escherichia coli Urinary Tract Infections (E. coli UTI). Methods : We enrolled patients with culture-proven E. coli UTI, who were admitted at the study hospital from September 2008 to August 2009. We investigated clinical data of patients with E. coli UTI and characteristics of isolated E. coli strains. The phylogenetic groups were classified using triplex polymerase chain reaction (PCR), and the distribution of nine virulent genes was determined by multiplex PCR. Results : A total of 47 patients have participated in this study. Thirty (63.8%) were under 6 months; eight (17.0%) were between 6-12 months; and nine (19.1%) were over 12 months. We compared two age groups between under 6-month and over 6-month. In the age group under 6-month, higher proportion of male (P =0.002) and group B2 strains (P =0.020) were observed. In contrast, higher proportion of female and group non-B2 strains were observed in age group over 6-month. Frequencies of papC, papGII, papGIII, sfa/foc, hlyC, cnf1, fyuA, iroN and iucC were estimated as 68.1%, 57.4%, 42.6%, 46.8%, 46.8%, 31.9%, 87.2%, 48.9% and 63.8%, respectively. In the comparison of phylogenetic groups, group B2 showed higher distribution of virulent genes, while group D included more strains resistant to trimethoprim/sulfamethoxazole (TMP/SMZ) than other groups. Conclusion : We showed the age group-specific difference in the distribution of sex ratios and phylogenetic groups; more male and group B2 strains in age group under 6-month, while more female and group non-B2 in age group over 6-month. However, further evaluation including larger number of patients will be necessary to confirm above thesis in future molecular epidemiological studies.

Islamist Strategic Changes against U.S. International Security Initiative (미국(美國)의 대외안보전략(對外安保戰略)에 대응한 이슬람Terrorism의 전술적(戰術的) 진화(進化))

  • Choi, Kee-Nam
    • Korean Security Journal
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    • no.14
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    • pp.517-534
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    • 2007
  • Since the beginning of human society, there have always been struggles and competitions for survival and prosperity, terrorism is not a recent phenomenon, however in modern times it has progressed to reflect the advances in civilization and power structures. At the time of the 9.11 terrorist attacks in the U.S. A., a new world order was in the process of being established after the breakdown of the Cold War era. The attacks drove both the Western and the Islamic worlds into heightened fear of terrorism and war, which threatened the quality of life of the whole mankind. Through two war campaigns against the Islamic world, it seems the U.S. has been pushing its own militaristic security road map of the Greater Middle East democratic initiative, justifying it as a means to retaliate and eradicate the terrorist threats towards themselves. However, with its five-year lopsided victories that cost the nation almost four thousand military casualties, and the war expenses that could match the Vietnam war, the U.S. does not yet seem to be totally emancipated from the fears of terrorism. Terrorism, in itself, is a means of resisting forced rules a form of alternative competition by the weak against the strong, and a way of expressing a dismissive response against dictatorial ideas or orders which allow for no normal changes. Intrinsically, the nature of terrorism is a reaction opposing power logics. Confronted with the absolute military power of the U.S., the Islamic strategies of terrorism have begun to rapidly evolve into a new stage. The new strategies take advantage of their civilization and circumstances, they train and inspire their front-line fighters on the Internet, and issue their orders through the clandestine network of the Al Qaeda operatives. These spontaneously generated strategies have been gained speed among the second, and third Islamic generations, many of whom are now spread throughout western societies. This represents a failure of the power-driven, one-sided overseas security initiatives by the U.S., and is creating a culture of fear and distrust in western societies. It is feared that the U.S. war campaigns have made the clash of religions far worse than before, and may ever lead to global ethnic separations and large-scale population movements. Eventually, it may result in the terrorist groups, enlarged and secretly supported by the huge sums of oil money, driving all mankind into a series of irreparable catastrophes.

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Clinical Usefulness of the Line Probe Assay for Rapid Detection of Rifampicin-resistant Tuberculosis (Line probe assay를 이용한 신속한 rifampicin내성결핵 진단법의 임상적 유용성)

  • Hong, Sang-Bum;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.334-342
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    • 2001
  • Background : RpoB gene mutations have been found in about 96-98% of rifampicin (RMP)-resistant Mycobacterium tuberculosis. Recent reports confirm that the in laboratory settings a rpoB gene mutation can be used as a surrogate marker for multi-drug resistant tuberculosis. However, its usefulness in clinical applications has not been evaluated. This study was performed to confirm whether mutation analysis of the rpoB gene of M. tuberculosis is useful in clinical settings. Methods : The medical records of 33 patients in whom rpoB gene analysis was conducted using an INNOLiPA Rif. TB assay (LiPA) from June, 1998, to July, 2000, at the Asan Medical Center were retrospectively reviewed in 33 patients. The clinical characteristics in addition to the drug susceptibility and LiPA results were analyzed. The drug susceptibility test was considered as a gold standard method for M. tuberculosis susceptibility and these results were compared with those of the rpoB gene study and sequencing analysis. Sequencing analysis of the rpoB gene was done in cases where there was a discrepancy between the results of the drug susceptibility an d rpoB gene study. Results : The mean age and sex ratio was $42{\pm}18$, and 24:9 (M:F), respectively. There were 19 RMP susceptible (58%) and 14 RMP-resistant cases (42%) according to the rpoB gene study. The mean time from the request to reporting the results of the rpoB gene study was $5.2{\pm}2.6$ days. The mean gap from reporting the rpoB gene study to reporting the susceptibility was $56{\pm}35$ days. Twenty-eight cases (85%) showed identical results compared with the drug susceptibility results, whereas five cases (15%) showed contradictory results. When compared with the sequencing analysis, of the five cases that showed contradictory results, two had LiP A analysis errors and the remaining three were identical to the sequencing results. The rpoB gene study was of assistance in choosing the appropriate drugs in 28 cases (85%). Conclusions : An rpoB gene study using an LiP A assay was useful in rapidly diagnosing RMP-resistant tuberculosis, which enabled a proper choice of the appropriate drugs in clinical practices. However, an LiPA assay always should be performed in conjunction with microscopy, culture, and susceptibility tests.

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The Length of Postoperative Antituberculous Therapy in Patients with Pulmonary Tuberculosis (폐결핵 환자의 폐절제술 후 항결핵제 투여기간)

  • Kwon, Eun-Su;Song, Jin-Ho;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.421-431
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    • 2000
  • Background : The length of postoperative drug therapy remains controversial in pulmonary tuberculosis. We analyzed our experiences to determine the postoperative duration of chemotherapy after resection. Method : A retrospective review was performed in 66 of 95 patients that underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1998. We compared the relapse rates according to the length of postoperative chemotherapy in each group, classified by the results of sputum AFB culture before the surgery, the number of resistant drugs, the number of prior treatment and the division of anti-TB drugs used postoperatively. Results : Fifty three of 66(80.3%) were men and 13(19.7%) were women with a median age of 33.5 years(range, 16 to 63). The mean lengths of the pre- and post-operative chemotherapies were 4.9 months, and 12.9 months respectively. Five of 66 patients (7.6%) relapsed during the mean period of follow up (39.7 months). In the group less than three times of the prior treatment, there were two relapses (20%) in Ed-the highlight above-rephrase 10 patients that were medicated for 6 months or less, and one relapse in 43 patients (2.3%) that took medicine for more than 6 months (p=0.03). In the group using second-line drugs postoperatively, there was one relapse (25%) in four patients that were medicated for 12 months or less. No patient in a total of 17 that received medicine for more than 12 months relapsed (p=0.03). Conclusion : We recommend that patients with the prior treatment less than three times should be treated for more than 6 months after resection and patients using the second-line drugs postoperatively should be medicated for more than 12 months.

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Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.300-308
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    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

The Diagnostic Value of Interferon-γ Assay in Patients with Active Tuberculosis (활동성 결핵의 진단에서 혈청 인터페론 감마 측정법의 유용성)

  • Park, So Young;Park, Yong Bum;Choi, Jeong Hee;Lee, Jae Young;Kim, Jae-Seok;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.13-19
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    • 2009
  • Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

Salinity Tolerance of Eggs and Juveniles of Flounder, Paralichthys olivaceus (Temminck et Schlegel) (넙치, Paralichthys olivaceus (Temminck et Schlegel) 난 및 자치어의 염분 내성에 관한 연구)

  • CHUN Je-Cheon;RHo Sum
    • Journal of Aquaculture
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    • v.4 no.2
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    • pp.73-84
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    • 1991
  • Underground sea water is widely utilized for land based aquaculture in Cheju province, Korea nowadays. Salinity of this water($20{\~}30$ ppt) is slightly lower than natural sea water but because of its good water quality and temperature which is maintained at $16{\~}18^{\circ}C$ all year-round, many fish farmers are using this water for finfish culture. To evaluate the possibility of utilizing underground sea water for the seed production of the flounder, Paralichthys olivaeceus, hatching rate of fertilized eggs, survival rate of hatched larvae, and growth rate of the juveniles were tested with various salinity levels ranged from 14.1 ppt to 40.2 ppt. The salinity ranges which showed over $70{\%}$ survival rate for fertilized eggs to hatchout were 33.7 ppt${\~}$40.2 ppt, for hatched larvae to 2-day-old were 20.6 ppt${\~}$40.2 ppt, from 10-day-old to 12-day-old were 27.2 ppt${\~}$40.2 ppt, and from 45-day-old to 47-day-old were 20.6 ppt${\~}$40.2 ppt. Two hundred day old fingerlings showed no mortality when exposured to 7.6 ppt${\~}$40.2 ppt for 2 days. All fish died within 3 days when 45-day-old juveniles were transferred directly from normal sea water to 14.1 ppt sea water. However, they were all survived when transferred first to 20.6 ppt for 3 days then to 14.1 ppt sea water. The highest growth rates of fingerlings reared at 4 different salinities (33.7, 27.0, 31.0, or 15 ppt) were obtained at the 27 ppt group followed by 33.7, 21.0, 15 ppt respectively. The relationship between the days of rearing (X) and the total length of the fingerlings were as follows. $33.7\%$ group : Y=8.8109 + 0.1104X(r=0.999) $27.0{\%}$ group : Y=8.6797 + 0.1208X(r=0.997) $21.0{\%}$ group : Y=8.4081 + 0.1052X(r=0.990) $15.0{\%}$ group : Y=8.4309+ 0.0995X(r=0.990)

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