Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.
Journal of the Korean Society of Food Science and Nutrition
/
v.43
no.2
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pp.300-308
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2014
The purpose of this study was to investigate the night eating habits of middle schoolers. A total of 705 middle school students residing in Gyeonggi were surveyed about their dietary habits related to night eating. Among the total subjects, 59.9% (n=422) had night eating more than once a week and were classified into a night eating group (NEG). The main reason for night eating was hunger (79.1% of NEG) and the highest proportion of night eating was related to food purchased by family (39.3% of NEG). Most of the NEG had night eating in their home with family members, and the time with highest frequency of night eating was between 10 p.m. and 11 p.m.. About 33% of the NEG went to bed within an hour after night eating and 69.2% of the NEG did not report any change after night eating. The most common factors considered when choosing a night eating menu, in order of frequency, were taste, hygiene, and amount. The favorite items on the night eating menu were frozen desserts, fresh fruits, chicken, fruit juice, Ramen, pizza, and Jajangmyeon. The most frequent menu choices were fresh fruits, frozen desserts, Ramen, chicken, yogurt, and fruit juice. The NEG had higher scores for picky eating (P<0.01), overeating (P<0.01), salty eating (P<0.01), and irregular meal times (P<0.001) compared to the non-NEG. Consequently, the NEG had more dietary problems than the non-NEG and their night eating behaviors were related to family habits. Night eating was mainly dominated by a diet of carbohydrates and fats, and the intake frequency and preference for foods with low nutritional value were high; thus, a practical and systematical nutrition education is required. Seasonal and comparative studies on night eating status according to various times and amounts of night eating are also required.
Occlusal stabilization appliance is one of the most common treatment option for management of temporomandibular disorders. It acts in oral cavity for several hours per day, and usually it will take at least 6 months to 2 years of total wearing periods to take a treatment goal. In the oral cavity, occlusal stabilization appliance, unintentional manner, is able to acts as a reservoir of bacteria and protect bacteria from saliva and oxygen. This condition is so favorable to many bacteria such as S. mutans and other anaerobes, usually have been reported as causative factors of dental caries, periodontal disease and oral malodor. In this study, we investigated anaerobic bacteria and S. mutans count before and after occlusal stabilization appliance use to evaluate the possible role of occlusal stabilization appliance as protector of these bacteria. Four men(average 27.5 years) wore maxillary occlusal stabilization appliance at each night(average 9 hours) for 5 days. we swabbed saliva-plaque mixed sample at 3 different site(maxillary left 2nd molar, maxillary left central incisor, mandibular left 2nd molar) before and after occlusal stabilization appliance use. Each samples were plated in (1) anaerobic blood agar medium, (2) selective S. mutans medium(MS-MUTV) and incubated in anaerobic chamber($CO^2$ 10%, $37^{\circ}C$) for 72 hours. Each bacterial colony forming unit(CFU) were counted with naked eyes. From obtained data, we can conclude as follows: 1. There was some changes about anaerobic bacteria and S. mutans count in oral cavity after occlusal stabilization appliance use. 2. The number of anaerobic bacteria was significantly increased at maxillary 2nd molar(P=0.003), maxillary central incisor(P=0.020) after occlusal stabilization appliance use compared with before. 3. Occlusal stabilization appliance use itself had indirect effect to increase the number of anaerobic bacteria at other uncovered opponent tooth site. 4. The number of S. mutans was significantly increased at maxillary 2nd molar(P=0.043), maxillary central incisor (P=0.049) after occlusal stabilization appliance use compared with before. 5. Occlusal stabilization appliance use itself had not any effect on the number of S. mutans at other uncovered opponent tooth site.
Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.
Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.
The purpose of this study is to examine the increasing number of unregistered manufacturing plants and related problems, and to recommend alternative solutions to the problems. Data are obtained from a field survey of randomly selected small scale manufacturing plants in Seoul and its suburban cities. A total number or respondents are 533, and 416 of them are unregistered plants. The Capital Regional Planning has had a goal during last three decades to lead a balanced regional economic development by restriction manufacturing plants in the Capital Region and by encouraging them in other regions in the nation. It was 1984 when a comprehensive planning was established to achieve this goal. Sets of various regulations, by-laws and codes have been implemented to regulate manu-facturing activities in the Capital Region to achieve the goal. The region is divided into three sub-regions, and a different degree of regulations is applied to each sub-region. Only a certain types of industries are allowed in a particular sub-region. For instance, a plant manufacturing high-technology products could be allowed in the most urbanized sub-region. All manu-facturing plant in the Capital Region which has ares size of larger than 200"\;"$m^2$ is compulsory to register to the local government office. In practice, however, it is not common or sometimes almost impossible to get approval for many applicant manufacturers because of strict regulations. There have been increasing number of plants in the Capital Region during last several decades, despite the strict regulations. Many of those newly established plants are without formal registration at the local administration office. howerver. These are so called 'unregisterd' plants. Surveyed data and many government official data show that many of unregistered plants have been established in recent years. which indicate that current regulations are no longer effective. The number of unregistered plants are increasing tin the Capital Region because of many locational advantages in the region for plants, particularly those in small scale. Unregistered plants are the source of many problems, such as local water pollution or noise pollution in residential areas. There are also many administration problems, bed\cause they are not registered. The central government has attempted to cure the problems of unregistered plants. For example, the government allowed a unregistered plant to remain at present site for three ydars, if it met certain conditions in three years. However, this program was unsuccessful because many of those plants were not able to meet the concitions. Three times the government renewed the term for those which did not meet conditions since 1989, but it was afraid to be without success. There are many evidences that current policies to control manufacturing plants are not effective. The Capital Region must face mounting problems if ploicies are not reformed soon. This study suggests that the policy of the Capital Regional Planning has to be reoriented to provide more favorable policies for manufacturing plants in the Capital Region than current regulations which is aimed to restrict manufacturing activities. It is time to improve many existing problems in the region through reforms and of current regulations to foster unregistered plants. This study also proposes many smaller-area sub-divisions instead of current three large area sub-regions which is too broad to apply single kind of regulation, or codes. Flexible regulations and codes can be applied to such a small-area sub-divivisions based on location and industrial characteristics of the individual sub-divisions. It is necessary to provide decent industrial environment in the Capital Region, which is best equipped to provide many favorable industrial locational factors in the nation, thus this nation can be further prepared to compete in an inter-national market at an era of globalization in manufacturing.
Seo, In-Soo;Choi, Byoung-Mi;Yun, Jae-Seong;Kim, Dae-Ik;Lee, Jong-Uk;Hwang, Choul-Hee;Kang, Yang-Soon;Kang, Young-Shil;Son, Min-Ho
Korean Journal of Environmental Biology
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v.28
no.3
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pp.133-142
/
2010
This study was performed to investigate the community structure of the macrobenthic invertebrates around Ui Island, Sinan-gun, Jeollanam-do, Korea. Benthic invertebrates were collected during May and September 2008 at seven stations. A total of 63 macrobenthic species was collected. The overall average macrobenthos density and biomass were 268 inds. $m^{-2}$ and 11.54 gWWt $m^{-2}$, respectively. Based on abundance data, there were 5 dominant species accounting for approximately 72.00% of total individuals. The polychaetes Notomastus latericeus, Scolelepis sagittaria, Amaeana occidentalis, Glycera chirori and the amphipoda Mandibulophoxus mai were found in high densities. The conventional multi-variate statistics (cluster analysis and non-metric multidimensional scaling) applied to assess spatial variation in macrobenthic assemblages. As a result, three communities could be distinguished: a sand dominated, a mixed sediment and a third community in the mud dominated station. The community in the sand dominated station was characterized by high abundance of the polychaetes S. sagittaria and the amphipods M. mai, Monoculodes sp. and Grandifoxus malipoensis. However, the most common species within the mixed sediment station were the polychaetes N. latericeus, A. occidentalis and amphipoda Urothoe sp.. Finally the mud dominated station was numerically dominated by the polychaetes Scolelepis sp., Heteromastus filiformis and Sigambra tentaculata. In conclusion, the sediment composition may be important factors controlling of the macrobenthic community structure in the study area.
Kim, Nam Young;Sung, Tae Jung;Shin, Seon Hee;Kim, Sung Koo;Lee, Kon Hee;Yoon, Hae Sun
Pediatric Infection and Vaccine
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v.12
no.1
/
pp.67-74
/
2005
Purpose : The incidence of mortality associated with respiratory difficulties is decreasing nowadays contributed to the development of neonatology. However, complications associated with mechanical ventilator are increasing. This study is to determine clinical manifestations, diagnositc availability of the endotracheal tip culture in patients with Ventilator-Associated Pneumonia(VAP) in neonatal intensive care unit(NICU). Methods : A retrospective analysis of 50 neonates who were admitted to the NICU of Kangnam Sacred Heart Hospital and had given mechanical ventilator from 1 January 2000 to 30 June 2003. VAP group defined as neonates who had pneumonia with mechanical ventilation longer than 48 hours. They were classified into VAP group(n=13) and control group (n=37) and the prevalence, microorganisms cultured from the endotracheal tube tip and risk factors were investigated. Results : The prevalence of VAP was 26.0%(n=13) and the most dominant microorganism cultured in our NICU was methicillin-resistant coagulase negative staphylococcus(MR-CNS) in 4 cases. Other microorganisms were Pseudomonas, Enterobacter, methicillin-resistant Staphylococcus aureus(MRSA) and Klebsiella. Gestational age, birth weight, Apgar score, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, sepsis, renal failure, pulmonary hemorrhage, pneumothorax were not different significantly between two groups except intraventricular hemorrhage(P<0.001) and patent ductus arteriosus(P<0.05). Duration of hospital stay and mortality rate were also not different significantly. Conclusion : VAP occurred at a significant rate among mechanically ventilated NICU patients. Despite of limitation of encotracheal tip culture, the most common microorganism was MR-CNS. We should be aware of occurrence of VAP in NICU neonate who were with mechanical ventilator and should treat with great care.
Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.
Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)
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