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Molecular Epidemiology of Bacillus cereus in a Pediatric Cancer Center (소아 암 환자에서 발생한 Bacillus cereus 균혈증의 분자역학 분석에 관한 연구)

  • Kim, Jong Min;Park, Ki-Sup;Lee, Byung-Kee;Kim, Soo Jin;Kang, Ji-Man;Kim, Yanghyun;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Lee, Nam Yong;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.172-179
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    • 2016
  • Purpose: Bacillus cereus has been reported as the cause of nosocomial infections in cancer patients. In our pediatric cancer ward, a sudden rise in the number of patients with B. cereus bacteremia was observed in 2013 to 2014. This study was performed to investigate the molecular epidemiology of increased B. cereus bacteremia cases in our center. Methods: Pediatric cancer patients who developed B. cereus bacteremia were identified from January 2001 to June 2014. The B. cereus bacteremia in this study was defined as a case in which at least one B. cereus identified in blood cultures, regardless of true bacteremia. Available isolates were further tested by multilocus sequence typing (MLST) analysis. A retrospective chart review was performed. Results: Nineteen patients developed B. cereus bacteremia during the study period. However, in 2013, a sudden increase in the number of patients with B. cereus bacteremia was observed. In addition, three patients developed B. cereus bacteremia within 1 week in July and the other three patients within 1 week in October, respectively, during emergency room renovation. However, MLST analysis revealed different sequence types without consistent patterns. Before 2013, five tested isolates were ST18, ST26, ST177, and ST147-like type, and ST219-like type. Isolates from 2013 were ST18, ST73, ST90, ST427, ST784, ST34-like type, and ST130-like type. Conclusions: MLST analyses showed variable ST distribution of B. cereus isolates. Based on this study, there was no significant evidence suggesting a true outbreak caused by a single ST among patients who developed B. cereus bacteremia.

Real Option Analysis to Value Government Risk Share Liability in BTO-a Projects (손익공유형 민간투자사업의 투자위험분담 가치 산정)

  • KU, Sukmo;LEE, Sunghoon;LEE, Seungjae
    • Journal of Korean Society of Transportation
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    • v.35 no.4
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    • pp.360-373
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    • 2017
  • The BTO-a projects is the types, which has a demand risk among the type of PPP projects in Korea. When demand risk is realized, private investor encounters financial difficulties due to lower revenue than its expectation and the government may also have a problem in stable infrastructure operation. In this regards, the government has applied various risk sharing policies in response to demand risk. However, the amount of government's risk sharing is the government's contingent liabilities as a result of demand uncertainty, and it fails to be quantified by the conventional NPV method of expressing in the text of the concession agreement. The purpose of this study is to estimate the value of investment risk sharing by the government considering the demand risk in the profit sharing system (BTO-a) introduced in 2015 as one of the demand risk sharing policy. The investment risk sharing will take the form of options in finance. Private investors have the right to claim subsidies from the government when their revenue declines, while the government has the obligation to pay subsidies under certain conditions. In this study, we have established a methodology for estimating the value of investment risk sharing by using the Black - Scholes option pricing model and examined the appropriateness of the results through case studies. As a result of the analysis, the value of investment risk sharing is estimated to be 12 billion won, which is about 4% of the investment cost of the private investment. In other words, it can be seen that the government will invest 12 billion won in financial support by sharing the investment risk. The option value when assuming the traffic volume risk as a random variable from the case studies is derived as an average of 12.2 billion won and a standard deviation of 3.67 billion won. As a result of the cumulative distribution, the option value of the 90% probability interval will be determined within the range of 6.9 to 18.8 billion won. The method proposed in this study is expected to help government and private investors understand the better risk analysis and economic value of better for investment risk sharing under the uncertainty of future demand.

Film Dosimetry for Intensity Modulated Radiation Therapy : Dosimetric Evaluation (필름을 사용한 세기변조치료법에 대한 선량측정)

  • Ju Sang Gyu;Yeo Inhwan Jason;Huh Seung Jae;Choi Byung Ki;Park Young Hwan;Ahn Yong Chan;Kim Dae Yong;Kong Young Kun
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.172-178
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    • 2002
  • Purpose : X-ray film over responds to low-energy photons in relative photon beam dosimetry because its sensor is based on silver bromide crystals, which are high-Z molecules. This over-response becomes a significant problem in clinical photon beam dosimetry particularly in regions outside the penumbra. In intensity modulated radiation therapy (IMRT), the radiation field is characterized by multiple small fields and their outside-penumbra regions. Therefore, in order to use film dosimetry for IMRT, the nature the source of the over-response in its radiation field need to be known. This study is aimed to verify and possibly improve film dosimetry for IMRT. Materials and Method : Modulated beams were constructed by a combination of five or seven different static radiation fields using 6 MeV X-rays. In order to verify film dosimetry, we used X-ray film and an ion chamber were used to measure the dose profiles at various depths in a phantom. In addition, in order to reduce the over-response, 0.01 inch thick lead filters were placed on both sides of the film. Results : The measured dose profiles showed a film over-response at the outside-penumbra and low dose regions. The error increased with depths and approached 15% at a maximum for the field size of $15{\times}15cm^2$ at 10 cm depth. The use of filters reduced the error to 3%, but caused an under-response of the dose in a perpendicular set-up. Conclusion : This study demonstrated that film dosimetry for IMRT involves sources of error due to its over-response to low-energy Photons. The use of filers can enhance the accuracy in film dosimetry for IMRT. In this regard, the use of optimal filter conditions is recommended.

A LONGITUDINAL STUDY OF THE CHILDREN WHO EXPERIENCED NURSING CARIES (우유병우식증 경험아동의 5년 후 추적 조사 연구)

  • Lee, Sang-Eon;Jung, Tae-Ryun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.262-273
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    • 2000
  • The purpose of this study was to investigate the difference between the children who experienced nursing caries and the children who were caries-free in the prevalence of enamel hypoplasia and DMF rate and to analyse causal factors from questionnaires. Oral examination was performed on 101 children(nursing caries group-45, caries-free group-56)in the 1994 at first, later in 1999. Parents were asked to write questionnaires. As a cotrol group, 50 children were chosen randomly. The results obtained from this study were as follow: 1. The prevalence of enamel hypoplasia of the children who experienced nursing caries was higher significantly than that of the all of the examined children (P<0.01). 2. DMF Tate of the children who experienced nursing caries was higher significantly than that of the children who were caries-free (P<0.01), and higher than that of the all of the examined children also(P<0.05). 3. The children who experienced nursing caries performed tooth brushing less frequently (P<0.05) and started tooth brushing later than the children who were caries-free (P<0.01). 4. The children who experienced nursing caries ate cariogenic food more frequently(P<0.05) and had higher preference(P<0.05) than the children who were caries free. 5. The children who experienced nursing caries showed lower frequency of periodic dental examination than the children who were caries-free or centre) group(P<0.05).

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The effects of blocking the oxygen in the air during the polymerization of sealant (광중합 시 공기 중 산소의 차단이 치면열구전색제의 중합에 미치는 영향)

  • Oh, You-Hyang;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.3
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    • pp.365-376
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    • 2006
  • The purpose of this study was to evaluate the efficacy of blocking the oxygen in the air during the polymerization of sealant. All curing were performed with various light curing units under the application of oxygen gel barrier, stream of nitrogen and carbon dioxide gas for inhibition of oxygen diffusion into sealant surface. The results of present study can be summarized as follows : 1. The amount of eluted TEGDMA form the specimens cured with all the three different light units in the stream of $N_2$ and $CO_2$ gas and application of Oxygen gel barrier($DeOx^{(R)}$) were significantly lower than in the room-air atmosphere (Control) (p<0.05). 2. In the $DeOx^{(R)}$ application, the amount of eluted TEGDMA the specimen cured with PAC light for 10seconds was less than that cured in the stream of $N_2$ and $CO_2$ atmospheric conditions (p<0.05) 3. In the LED using 10 or 20sec irradiation times under the stream of $N_2$ and $CO_2$, the eluted TEGDMA showed to be no statistically significant difference (p>0.05). 4. The microhardness from the specimens cured with all the three different light units under each treated conditions were significantly higher than in the room-air atmosphere (p<0.05). 5. The surface treatment by $DeOx^{(R)}$, $N_2$ and $CO_2$ reduces the thickness of oxygen inhibited layer by sp proximately 49% of the untreated control value.

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The Predictors of Cerebral Infarction in Mitral Stenosis (승모판협착증 환자에서 뇌경색발생의 예측인자)

  • Kim, Hyung-Jun;Kim, Woong;Lee, Jong-Suk;Hong, Gue-Ru;Park, Jong-Sean;Sin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.75-81
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    • 2000
  • Background: Systemic embolism, especially, cerebral infarction is one of the most important complications in patients with mitral stenosis. The authors analyzed the some factors that could predict the development of cerebral infarction in cases of mitral stenosis and propose preventive therapeutic measures. Methods: Retrospective study of 127 patients with rheumatic mitral stenosis was performed by analyzing their medical records for transthoracic(TTE) or transesophageal echocardiography(TEE) over a 12 months period. The patients were divided into two groups according to the presence (Group I: n=26, age: $55.0{\pm}13$ years) or absence (Group II: n=101, age: $48.5{\pm}13$ years) of cerebral infarction. No significant difference was observed between the two groups with respect to sex and functional class. Results: Patients in group I were older ($55.0{\pm}13$ vs $48.5{\pm}13$;p<0.05). had more dilated left atrial size($5.10{\pm}0.48$ vs $4.81{\pm}0.70$;p<0.05) and smaller mitral surface area($1.01{\pm}0.39$ vs $1.21{\pm}0.45$;p<0.05). In Group 1. the incidence of atrial fibrillation(22 out of 26 vs 57 out of 101;p<0.05) and spontaneous left intra-atrial contrast phenomenon(22 out of 26 vs 44 out of 101;p<0.05) was more frequently observed. On multivariate analysis. atrial fibrillation and anticoagulant therapy were the independent predictive factors. Conclusion: Age, left atrial dilatation, the severity of mitral stenosis, the presence of spontaneous contrast, and especially the presence of atrial fibrillation are the main predictive factors of the development of cerebral infarction in mitral stenosis. Patients presenting one or several of these factors may benefit from prophylactic anticoagulant treatment.

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Growth Environment Characteristics and Decline in Mt. Seunghak's Miscanthus sinensis Community (승학산 참억새군락의 생육환경 특성 및 쇠퇴에 관한 연구)

  • Park, Seul-Gi;Choi, Song-Hyun;Hong, Suk-Hwan;Lee, Sang-Cheol;Yu, Chan-Yeol
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.5
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    • pp.14-28
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    • 2017
  • Mt. Seunghak's Miscanthus sinensis community is not only a landscape resource in terms of cultural services within the Ecosystem Services but also a site that is visited by many mountaineers in autumn. As the current Miscanthus sinensis community has been experiencing a rapid decline due to Korean forest succession characteristics, ongoing artificial management is thought to be needed for landscape resource use. The purpose of this study was to determine growth environment characteristics and the cause of the rapid decline of the Miscanthus sinensis community in Mt. Seunghak, which is located inside a large city with a large scale and outstanding accessibility. As the Miscanthus sinensis community is the representative early vegetation that appears temporarily in dry, barren soil, the Miscanthus sinensis community in Korean forest succession tends to be unsustainable. As the current soil on Mt. Seunghak is inappropriately fertile for the Miscanthus sinensis community, other wetland woody plant communities are anticipated to succeed it. If Miscanthus sinensis community maintenance is needed for Miscanthus sinensis landscape scenery, various alternatives apart from overall Miscanthus sinensis community maintenance should be determined for cost-effective management. For example, while many byways toward the inside of the Miscanthus sinensis community have affected the Miscanthus sinensis community growth environment, the installation of wooden fences and ropes has been a control in approach. As a result of this positive effect, many byways toward the inside of Miscanthus sinensis community have been restored naturally. Through viewable range analysis, as good scenery sites on the observatory have a good viewable range on the main trail as well, if these scenery sites are intensively managed, effective Miscanthus sinensis ccommunity management will be done despite maintenance budget cutbacks. This study is expected to be used as a basic material regarding the alternatives for a sustained Miscanthus sinensis community and the possibility of cultivating other growth in poor soils of fallow fields and unused land.

Development of New Mushroom Substrate of Pleurotus Ostreatus Using Foodwaste and Wormcast (남은 음식물과 지렁이 분변토를 이용한 느타리버섯의 대체 배지개발)

  • Park, Jang-Woo;Park, Ki-Byung;Lee, Eun Young
    • Journal of the Korea Organic Resources Recycling Association
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    • v.20 no.4
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    • pp.75-85
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    • 2012
  • This study was investigated to develop an alternative medium for the cultivation of oyster mushrooms. The cultivation characteristics for major cultivated varieties of oyster mushrooms were campared with the food waste medium. In addition, water control & a gap formation of food waste is being pointed out as a problem of the medium material. Therefore, certain amounts of earthworm casting were supplied to the food waste medium to overcome the water and compaction phenomenon. This study investigated the use of the total 6 cultivars of oyster mushrooms, the Suhan(PL.1), Chiak No. 5(PL.2), Chiak No. 7(PL.3), Samgu No. 5(PL.4), Samgu No. 8(PL.5), Jangan No. 5(PL.6). In terms of medium, the optimum growth of the mycelium of the oyster mushroom was observed in the beet pulp medium but in food waste, the mycelium's growth was observed as insufficient in the bulk of cultivars. The Jangan No. 5(PL.6) was superior to other cultivars relative to the mycelium's growth. The optimum concentration of earthworm casting added the foodwaste medium was 30%. When Jangan No. 5(PL.6) was incubated in the foodwaste meidum containing 30% earthworm casting, the early days to germination were long, almost double the amount of time than that of the beet pulp medium. However, it was found that the fruit body size was larger than that of the beet pulp by up to 20.5%, and the length of the fruit body was up to 6.2% longer than that of the beet plup. The total yields increased by 60.5%. The analysis results of the oyster mushroom's nutritional contents cultured using the food waste medium, shows that the protein, vitamin A and vitamin E increased 70.6%, 2.4%, 0.8% respectively, the fat decreased by 12.6% and the oleic acid increased in a very small amount compared to that of the beet pulp medium.

Clinical characteristics of deep neck abscess in children; 15 year experience in a university hospital (소아 심경부농양의 임상적 고찰 : 일개 대학병원에서 15년간의 경험)

  • Goo, Min-Ji;Yeom, Jeong-Suk;Kim, Eo-Jin;Park, Jung-Je;Seo, Ji-Hyun;Park, Eun-Sil;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.649-654
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    • 2007
  • Purpose : The objective of this study was to clarify the presentation, associated preceding illness, pathologic organisms, treatment and outcome of deep neck abscess in children according to age and location. Methods : We retrospectively reviewed the in-patient charts of children treated at our hospital for deep neck abscess. Thirty-five such patients were identified as having been treated from March 1990 to December 2005. Results : A total of 35 were enrolled in our study: 25 boys and 10 girls. Their ages ranged from 11 months to 15 years. Presenting symptoms included mass, fever, irritability, trismus and dysphagia. The most commonly known associated preceding illness was viral upper respiratory infection (53%). The most common site of infection was the submandibular space (37%). Bacteria was identified in 16 patients. The most common pathogen was Staphylococcus aureus. Thirteen (37%) children recovered from the infection with conservative treatment and twenty-four (68%) children received surgical drainage. The duration of hospitalization was longer in the group who underwent surgery than in the group who were managed with conservative treatment. No complication occurred. Conclusion : Unexplained torticollis, trismus or irritability in children were suggestive of deep neck abscess. Our results demonstrate that deep neck abscesses in children is respond well to conservative treatment if diagnosed early.

The Comparison of Noise-induced Hearing Loss Evaluation Criteria for Management (소음성난청 관리를 위한 판정기준간의 비교)

  • 남궁원자;원정일
    • Journal of environmental and Sanitary engineering
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    • v.13 no.1
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    • pp.123-134
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    • 1998
  • The study was performed to investigate the differences among various evaluation criteria for noise-induced hearing loss(NIHL). The subjects were 100 workers who had received detailed audiometric examinations after the periodic annual examination for hearing loss. The evaluation criteria included were as follows: The criterion I was NIHL of 50dB or greater at 4,000Hz in either ear which is one of the legal requirements for determining occupational hearing loss in Korea. The criterion II was NIHL of 40dB or greater by 4-divided classification(a+b+c+d/4 at 500Hz(a), 1,000Hz(b), 2,000Hz(c), 4,000Hz(d)) which is also one of the legal requirements for determining occupational hearing loss in Korea. The criterion III was NIHL of 31dB of greater by 6-divided classification(a+2b+2c+d/6) which is the workers' compensation standard. The criterion IV was NIHL of 40dB or greater by 6-divided classification(a+2b+2c+d/6), the criterion used to prohibite workers to be employed in the noisy workplace. The criterion V was NIHL of 40dB or greater by 3-divided classification(a+b+c/3) which is the guideline of the Japanes Labour Department. The results were as follows; 1. The percentage of workers with NIHL by the criterion I was the highest(96%) and covered all workers with NIHL diagnosed by other criteria. Therefore, this criterion was the most sensitive one for early detection of NIHL among various evaluation criteria. 2. The percentage of workers with NIHL by the criterion II was 29% of the subjects, but all of them could be diagnosed as having NIHL by the criterion I and 33.1% of the NIHL by the criterion III could not be covered by the criterion II. Thus, this criterion was not considered suitable as an initial step for determining occupational hearing loss. 3. The percentage of workers with NIHL by the criterion III was 45% of the subjects. This percentage was 46.9% of the NIHL by the criterion I and was estimated to cover 3.6% of all noise exposed workers. 4. The percentage of workers with NIHL by the criterion IV was 28% of the subjects, but 37.8% of the NIHL by the criterion III and 70.8% of the NIHL by the criterion I were not covered by the criterion. Therefore, these workers could have been employed in the noisy workplaces. 5. Employed relocation which was one of the post management methods was an option in the criterion I in Korea and in the criterion V in Japan. The number of NIHL by the criterion I was 6.7times greater than that by the criterion V. Thus, although employee relocation was not used exclusively, many more workers with NIHL could have been relocated. In conclusion, this study revealed that the criteria being used for managing occupational hearing loss showed a lack uniformity among them. In addition, since these criteria are all relied on the total threshold shifts caused by the noise exposure at the time of hearing test with no consideration given to the past noise exposure history nor age, it can be said that they are not an effective tool for occupational hearing loss management. Since legal requirements are usually followed after being diagnosed as having NIHL, it is recommended that a uniform diagnostic criterion should be used to minimize confusion. Pre-employment hearing tests should also be utilized so as to managing occupational hearing loss after employment rather than being used as a legal roadblock of prohibiting workers with mild hearing loss from being employed. Thus, what is needed is an establishment of a rational criterion for occupational hearing loss management rather than for legal requirements.

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