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Clinical characteristics and risk factors for staphylococcal infections in neonatal intensive care unit (신생아 중환자실에서 포도알균 감염에 대한 임상적 고찰과 위험 요인 조사)

  • Chung, Min Kook;Choi, Jeong Ho;Chang, Jin Keun;Chung, Sung Hoon;Bae, Chong Woo;Cha, Sung Ho
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1287-1295
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    • 2006
  • Purpose : The importance of staphylococcal infections in NICU has been emphasized in terms of increased resistant strains and increased incidence of morbidity and mortality. In this study, we inrestignted the clinical characteristics and risk factors for staphylococcal infections, and looked into sensitivity trends of antibiotics in the era of a high rate of methicillin-resistant staphylococcus aureus (MRSA) in our society. Methods : This study included 240 neonates with positive blood, urine and other sites cultures for staphylococci who were admitted to NICU of Hanil General Hospital and Kyunghee University Hospital from January 2000 to December 2004. The analyses included clinical characteristics of staphylococcal infections and the relationship of incidence rate among various factors, including invasive procedures. Results : For 5 years, 3,593 patients were hospitalized in the NICU and 7,481 specimens were cultured from blood, urine, and other sites. During the study period, staphylococci were isolated from 240 patients, of whom 88 patients had MRSA, 41 patients methcillin sensitive staphylococcus aureus (MSSA), 63 patients S. epidermidis, 48 patients coagulase-negative staphylococcus (CNS) except S. epidermidis infections. The risk factors associated with staphylococcal infections were less than 37 weeks of gestational age, less than 7 on a 5 minutes Apgar score, receiving TPN, applied mechanical ventilation, use of central venous catheters and other tubes. The sensitivity to vancomycin was 100 percent. A relatively high sensitivity against teicoplanin, trimethoprim-sulfamethoxazole, chloramphenicol, clindamycin and low sensitivity against gentamicin and erythromycin were shown. Conclusion : To reduce staphylococcal infections in NICU, we need to monitor and manage premature neonates from the beginning of the birth process and to avoid as many invasive procedures as possible in NICU. Considering MRSA, control of preceding factors and early use of appropriate antibiotics is expected to reduce the morbidity and mortality caused by MRSA infections.

The auditory evoked potential in premature small for gestational age infants (미숙아로 태어난 부당 경량아의 청각유발전위검사)

  • Moon, Il Hong;Ha, Kee Soo;Kim, Gui Sang;Choi, Byung Min;Eun, Baik-Lin;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1308-1314
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    • 2006
  • Purpose : This study aimed to evaluate the usefulness of auditory evoked potential (AEP) in clarifying neuronal development in premature small for gestational age (SGA), and appropriate for gestational age (AGA) infants. Methods : A total of 183 premature infants who were born from August 2002 to July 2005, were examined with AEP. They were divided into three groups; AGA, symmetric-SGA and asymmetric-SGA group. Results : Statistically significant differences in the head circumference were observed in three groups. Among the risk factors, prevalence of hypoglycemia and hypoalbuminemia between AGA and asymmetric SGA infants were significantly different. V absolute peak latency (APL) in the right side of AGA infants was delayed were than that of asymmetric SGA infants. III-V interpeak latency (IPL) of asymmetric SGA infants was delayed more than that of symmetric SGA infants. Moreover, I-V IPL on both sides of symmetric SGA infants was shortened more than that of AGA infants. However, all the results of AEP were within the reference range, according to gestational age. Birth weight of, only asymmetric SGA, was related to the III APL on both sides and the III-V IPL on right side. Conclusion : This study shows that the values of APL and IPL of premature SGA infants are different than that of premature AGA infants. These data could be an indicator in evaluating the neurologic functions of small for gestational age infants.

Factors which contribute to time of first stool and first urine passage in Newborns (신생아에서 첫 태변 배출과 초뇨 배출 시간 결정인자)

  • Lee, Hye Jin;Jae, Hyun Gon;Son, Sang Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.482-488
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    • 2006
  • Purpose : To evaluate the factors which contribute to the time of the first stool and the first urine passage. Methods : We retrospectively reviewed a chart of 1,221 infants ${\geq}34$ weeks of gestational age admitted to the normal newborn nursery of Il Sin Christian Hospital, Busan, from November 2004 to April 2005. We compared the time to first stool and urine according to maternal factors(maternal age, parity, mode of delivery, meconium-stained amniotic fluid, and maternal diabetes) and infant factors (gender, Apgar score, gestational age, type of feeding during first 24 hours, age at the first feeding, number of feeds during the first 12 hours and age at discharge). Results : In total, 95.3 percent of our infants had passed their first stool by 24 hours and 99.8 percent of them had a stool by 36 hours. A total of 95.8 percent of our infants had passed urine by 24 hours of age and 98.3 percent of them by 36 hours. Comparing preterm and term infants, the time to first urine is $6.5{\pm}5.8$ hours and $12.1{\pm}6.6$ hours, respectively(P=0.000). The time to first stool is $20.7{\pm}13.5$ hours and $10.0{\pm}6.3$ hours, respectively(P=0.000) Early-fed infants were significantly earlier in time to first urine(P=0.023) and first stool(P=0.012). There was no statistically significant relationship between the number of feeds in 0-12 hours, mode of delivery, Apgar score, parity, gender, type of feeding, maternal diabetes and the time of the first urine and first stool. Conclusion : Gestational age, birth weight and age at first feeding were significantly related to the time of the first urine and first stool passage. When there is delayed passage of the first urine and first stool, we should consider close observation of other associated symptoms and other factors previously mentioned, to avoid extensive evaluation and intervention.

The timing of sexual maturation and secular trends of menarchial age in Korean adolescents (한국 청소년의 성성숙 시기 및 장기간의 초경연령 추세분석)

  • Park, Mi Jung;Lee, In-Sook;Shin, Eun-Kyung;Joung, Hyojee;Cho, Sung-Il
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.610-616
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    • 2006
  • Purpose : The purpose of this study was to evaluate the timing of sexual maturation and secular trends of menarchial age in Korean adolescents. Methods : Nine hundred eighty two school students and 119 university female students were included. Tanner's pubertal assessment method was applied using a self-assessment sheet with pictures for their developmental stages. A medical checkup database from 1,156,022 women was also used to analyze the age of menarche from the year 1900 to 1980. Results : Onset of puberty was at $11.3{\pm}1.3$ years(y) in girls and $12.1{\pm}1.5$ y in boys and total pubertal duration was 3.6 y in girls and 3.3 y in boys. Height at the onset of puberty was $146.1{\pm}7.9cm$ in girls and $152.7{\pm}9.8cm$ in boys. Weight at the onset of puberty was $39.3{\pm}6.9kg$ in girls and $47.7{\pm}14.4kg$ in boys. The mean age of menarche was $12.0{\pm}1.0y$ and mean age at nocturnal emission was $12.3{\pm}1.8y$. By age ten, 3.0 percent of girls experienced menarche, which increased to 41.1 percent by age 12, and 98.0 percent by age over 15. By SMR 2 breast stage, 18.2 percent of girls experienced menarche, which increased to 66.1 percent and 91.7 percent by SMR stages 3 and 4, respectively. By SMR 2 pubic hair stage, 52.0 percent and by SMR 3, 93.8 percent of girls experienced menarche. While the menarchial age of women born around 1980 was $12.4{\pm}1.1y$, the menarchial age of women born around 1990 was $12.0{\pm}1.1y$. Age at menarche has been advanced approximately by 2 years between 1900 and 1980 birth cohorts. Conclusion : There was a downward secular trend in pubertal timing. Age at menarche has been advanced by 2 years during the last 80 years. Further large scale, prospective studies, including inspection by specialists, are needed to provide reference data for pubertal timing in Korean adolescents.

The Clinical Study on the Neonate Delivered Under the Condition of the Maternal Smoking and Alcohol in Pregnancy (재태기간 중 산모의 음주와 흡연에 노출된 신생아의 임상적 고찰)

  • Kong, Sun Hui;Kim, Soo Yeon;Lee, Ho Jun;Kim, Hak Sung;Lee, Dong Woo;Kim, Jae Yoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.34-39
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    • 2005
  • Purpose : Perinatal complications associated with maternal smoking and alcohol ingestion in pregnancy have been well documented. But until now there has been no clinical data on it collected in our country. In this paper, we tried to research the association between maternal smoking and alcohol ingestion in pregnancy and the physical indices of the neonate at delivery among unmaried mothers from one charitable institution. Methods : We enlisted 125 unmarried with a history of smoking and alcohol consumption during pregnancy who delivered a baby in National Medical Center from March, 2001 to March, 2004 as a study group. As a control, 174 unmarried mothers without a history of smoking and alcohol were enlisted. Then, we compared the physical indices - birth weight, height, and the head circumference - of the neonates from both groups. Furthermore, we investigated the effects of the period and the quantity of maternal smoking and alcohol ingestion on the physical indices of the neonates from the both groups. Results : Low physical indices of neonates were found in the study group(either smoking group, or drinking group) compared with the control group. The quantity of smoking or drinking and the period of smoking or drinking have no significant effect on physical indices. Conclusion : We found that maternal smoking and alcohol result in the low physical index of neonates, and educational initiatives must be directed at expectant mothers to emphasize the harmful effects of smoking and alcohol ingestion in pregnancy.

The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis (임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과)

  • Na, Hyun Jung;Kim, Ji Young;Lee, Gyeong Hoon;Lee, Jun Hwa;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1187-1192
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    • 2005
  • Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

Clinical Evaluation of Nephrotic Syndrome Manifesting in the First Year of Life (1세 이하의 소아에서 발병한 신증후군의 임상적 고찰)

  • Cho, Sung-Hee;Lee, Joo-Hoon;Cho, Young-Mi;Park, Young-Seo;Cheong, Hae-Il
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.161-169
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    • 2009
  • Purpose : This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. Methods : We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. Results : Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. Conclusion : Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.

Improvement of Reproductive Disturbances by In Vitro Fertilization and Spermatozoa Cryopreservation in a Mouse Strain Showing Behavior Abnormality Derived from Korean Wild Mouse (Mus musculus molossinus) (한국야생유래 행동이상 Mouse 에 있어서 체외수정에 의한 번식장애 개선과 정자의 동결보존)

  • 남윤이;김상근;김명수;이철호;최양규;현병화
    • Korean Journal of Animal Reproduction
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    • v.23 no.3
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    • pp.247-256
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    • 1999
  • The present study was performed to improve the reproductive disturbance as well as the elimination of microbiological contamination for animals bred under conventional conditions followed by in vitro fertilization and embryo transfer techniques including embryo and sperm freezing, using a mouse strain(M. m. molossinus-tt@Kist) showing the abnormal behavior disorder derived from Korean wild mice (Mus musculus molossinus). Moreover, hematological and serum biochemical analyses were also carried out to obtain the basic data of this mouse strain The results are summarized as follows: 1. In comparison with hematological data, the numbers of RBC and platelet of this mouse strain were appeared as the higher value those that of the same aged inbred strains such as BALB/c, DBA/2, C57BL/6 and C3H /Hen. However, no differences were found in values of WBC, Hb and Ht. Moreover, total cholesterol of this strain showed a low value but triglyceride, total protein and albumin values were similar as in inbred strains. 2. The average numbers of superovulated oocytes treated with 2.5/2.5 IU and 5.0/5.0 IU of PMSG/hCG were 11.6 and 12.7, respectively. The fertilization rates of 2.5/2.5 IU PMSG /hCG treatment(87.9%) was higher than 5.0/5.0 IU treatment(52.0%) (p<0.05) and the developmental rate of 2 cell stage embryos were 외 so appeared as higher value 99.0% and 90.6%, respectively. 3. The rates of in vitro fertilization treated with frozen sperm(24.8%) was significantly lower than of that fresh sperm(87.9%), (p<0.05). 4. The five, six and ten heads of offspring were obtained from frozen-thawed 2 cell embryos by in vitro fertilized, 2 cell embryos from in vitro fertilized by frozen-thawed spermatozoa. and 2 cell embryos by in vitro fertilization, respectively. These offspring developed the expected disease about 2 weeks after birth, which was confirmed that the disease character of this mutant mouse strain was reliably reproduced. 5. MHV(Mouse hepatitis virus) and Staphylococcus aureus were successfully eliminated from conventional animals by in vitro fertilization-embryo transfer and the use of SPF recipient animals.

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Estimation of Growth Curve for Evaluation of Growth Characteristics for Hanwoo cows (한우암소의 성장특성 평가를 위한 성장곡선의 추정)

  • Lee, C.W.;Choi, J.G.;Jeon, K.J.;Na, K.J.;Lee, C.;Yang, B.K.;Kim, J.B.
    • Journal of Animal Science and Technology
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    • v.45 no.4
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    • pp.509-516
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    • 2003
  • Growth curves were estimated for 1083 female Korean cattle raised in Daekwanryeong branch, National Livestock Research Institute (NLRI). Comparisons were made among various growth curve models for goodness of fit for the growth of the cows. Estimated growth curve functions were $W_t=370.2e^{-2.208e^{-0.00327t}$ for Gompertz model, for von Bertalanffy model, and $W_t=341.2(1+5.652e^{-0.00524t})^{-1}$ for Logistic model. Ages at inflection estimated from Gompertz model, von Bertalanffy model and Logistic model were 242.2 days, 191.5 days, and 330.5 days respectively, body weight at inflection were 136kg, 115kg, and 170kg, and daily gain at inflection were 0.445kg, 0.451kg, and 0.446kg. The predicted weights by ages from Gompertz model, von Bertalanffy model, and Logistic model were onsistently overestimated at birth weight and underestimated at 36 month weight. The von Bertalanffy model which had a variable point of inflection fit the data best.

A Study on the Comparative Art theory in the Arts and Crafts Movement and Post-impressionism (미술 공예 운동과 후기 인상주의 비교 예술론 연구)

  • 박연실
    • Archives of design research
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    • v.20
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    • pp.279-291
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    • 1997
  • The history of modern design begins with the arts and crafts movement(1860). The importance of the movement which decorated the outset gave birth to all the trends of thought which would occur under the circumstances within it, and is deemed that the ideas of the figures who played an active part in the movement might be ceaselessly continued through the works and ideas of their outstanding juniors or purpils as a doctrine of the philosophy of design. Therefore, it might be a prerequisite that the significance and spirit of the movement, and its developing process should be addressed in detail in the first place, but for the limited space of this paper, it was intended to desvribe only the part which can be interpreted in duplicate, linked with post-impressionism. The subject of this thesis is about a theory of art in which both ideas of the movement(1860) and the post-impressionism(1910) are comparatively reviewed. The genre, strictly speaking, is classified into the history of painting, and there is a gap fo about an half century between the issues which are comparatively discussed here. Both the movements began in a same environmental place of England, specially the movement at Milieu in England, and since there is a common point that the representative runners of each movement, William Morries(1834-1896) and Roger Fry(1866-1934), belong to a same race of Engol-Saxon, their ideas coincide with an aesthetic scholar, H. Tanie's aesthetic interpretation method and the more important is, as being elucidated in the comment and aesthetic theory for which Roger Fry gave effort and activity in his later life, that when he read intensively Ruskin's books, $\ulcorner$Modern Painters$\lrcorner$and$\ulcorner$Stones of Venice$\lrcorner$he had solidified his idea of post-impressionism while giving approval and criticism on them. After all, as in a co-painter, Windyham Lewis's reference of 'Roger Fry's Too Late Morris Movement', he, inspired by the actual activities of Morris, played activities similar to that of Morris in which exhibiting and selling some of his decorative art works signed by him and the works of post-impressionism through (1913-1920). Herein, that is wished to add a remark by this author is a point that the author of$\ulcorner$Vision and Design$\lrcorner$, Roger Fry, has not be made a subject of discussion specially in the Korean world of design. So, with this case of a thesis, it's wished that many latent awakened, design persons in korea give efforts to researching into Roger Fry so that their findings could be officially announced in the would. By the way, what is tried to describe in this paper from now on is to analyse and review the origin of post-impressionism which idea was first coined in the art world through the 1st and 2nd exhibitions of 'Manet and Post-impressionism' which were opened each at the Grafton Gallery in 1910 and 1913 by him. And also, it is intended to review it through the art journals and some references by critics of the day in which favorable criticism or severe criticism were ready to comment through the opinions and influences of the coworkers of Roger Fry, say, Clive Bell, Desmond Maccarthy, etc. and of himself as a main axis, on the art ideas of Gauguin, Gogh, Matisse, and Cezanne whose works were the typical ones participated and exhibited in those 1st and 2nd exhibitions.

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