• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.191-198
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• 2011

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.249-260
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• 2013

Objectives: Previous observations propose that risk-taking behaviors such as cigarette smoking are prevailing among young people with chronic conditions including diabetes. The purpose of this study was to examine whether cigarette smoking is more prevalent among diabetics than non-diabetics and whether it differs by age at the time of diagnosis with diabetes from young adulthood (YAH) to adulthood (AH). Methods: We used US panel data from the National Longitudinal Study of Adolescent Health (Add Health Study) during the years 2001 to 2002 (Wave III, YAH) and 2007 to 2008 (Wave IV, AH). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of cigarette use behaviors according to age at the time of diagnosis with diabetes, after adjusting for demographic and selected behavioral factors. Results: Of 12 175 study participants, 2.6% reported having been diagnosed with diabetes up to AH. Early-onset diabetics (age at diagnosis <13 years) were more likely than non-diabetics to report frequent cigarette smoking (smoking on ${\geq}20$ days during the previous 30 days) in YAH (OR, 3.34; 95% CI, 1.27 to 8.79). On the other hand, late-onset diabetics (age at diagnosis ${\geq}13$ years) were more likely than non-diabetics to report heavy cigarette smoking (smoking ${\geq}10$ cigarettes per day during the previous 30 days) in AH (OR, 1.54; 95% CI, 1.03 to 2.30). Conclusions: The current study indicated that diabetics are more likely than non-diabetics to smoke cigarettes frequently and heavily in YAH and AH. Effective smoking prevention and cessation programs uniquely focused on diabetics need to be designed and implemented.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.91-97
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• 2015

Purpose: Occult hip fracture is not evident on radiographs and the diagnosis is often missed or delayed. This study was undertaken in order to identify the clinical characteristics and complications of patients with a delayed diagnosis of an occult hip fracture. Methods: We retrospectively reviewed patients with occult hip fracture who had normal findings on initial radiographs, the diagnosis was made on additional studies between August 2006 and February 2012. Patients who were diagnosed as having occult hip fractures at the first visit were categorized as non-delayed group and those who were not diagnosed at the first visit were categorized as delayed group. Results: Non-delayed group included 43 patients (86%). In the remaining 7 patients (delayed group), the diagnosis was delayed by a mean of 9.6 days (range 3~19 days). Patients who were diagnosed with an occult fracture on the initial visit presented later than those with a delayed diagnosis (41/43 .vs. 3/7, p=0.002). Other clinical features were no difference between the two groups. Patients in the delayed diagnosis group were more likely to have fracture displacement (4/7 .vs. 0/43)15patients in non-delayed group (34.9%) needed operative treatment, whereas all delayed patients (100%) needed operative treatment. Conclusion: A delayed diagnosis of occult hip fractures was associated with increased rate of displacement and operation. In patients suspected of having occult hip fractures, additional studies should be recommended.

• 한국임상수의학회지
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• 제16권2호
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• pp.309-320
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• 1999

Medial patellar luxation in dogs is one of the most common patellar problems presented to the veterinary practitioner. It is observed in toy and miniature breed and the majority of cases is a congenital form. Because of extensor mechanism's instability, it causes deformity and disorder in the growth of the affected limb when the luxation is left without treatment As lameness is not easily detectable in puppies, early diagnosis and correction are essential for therapy. Up to now, there has not been any reports refering to the diagnostic methods and the optimal age for correction in young dogs. Thirteen 45-90 days old puppies, have grade I and/or II medial patellar luxation. Only by palpation, all 13 dogs were diagnosed of patelar luxation. Skyline radiographic view was useful to interpret patellar morphology and depth of trochlear groove only above 60 days old. However, it was difficult to make definite diagnosis patellar luxation. The caudocranial and lateral radiographic view as well as ultrasonographic skyline view were not showed of patellar luxation. 2 puppies had unilateral patellar luxation and 11 puppies had bilateral patellar luxation which more serious on the left than on the right. Only 3 puppies among 11 puppies with bilateral patellar luxation were observed of lameness degree 1. Regardless of grade of patellar luxation and lameness, we performed trochlear chondroplasty using a U-shape sculpture blade to minimize cartilage injury, transposition of tibia tuberosity with No. 1 Supramid to align extensor mechanism and lateral imbrication. After surgery, we examined the operated animal daily for 10 days and on 15, 30 and 60 days after surgery respectively. After operation, pain and fever became normal on 7 days, swelling on 10 days, respectively. On 10 days after surgery, dogs showed normal standing position, and normal walking was observed in 15 days after surgery. In force plate analysis, the operated legs were normal weight bearing at 30 days after operation. After surgery, not only patellar luxation and clinical signs have been gradually reduced but also bone growth have become normal without showing growth physeal plate injury. The survival rate of puppies over 62 days old was 100%, while 42-45 days old 37.5%. The above results suggest that optimal age for surgical correction of congenital medial patellar luxation is recommended over 60 days old. In conclusion, combination of trochlear chondroplasty, transposition of tibia tuberosity, and lateral retinacular imbrication is appropriate for over 60 days old puppies to efficiently correct patellar luxation.

• Journal of Oral Medicine and Pain
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• 제24권2호
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• pp.137-143
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• 1999

Aucubin, the natural product, which is isolated from Aucuba japonica, has a variety of pharmacological effects such as liver-protective function, inhibition of liver RNA and protein biosynthesis, hypotensive activity and antimicrobial effect, etc. This study was performed to investigate the effects of iridoid compounds on wound healing. The author prepared 0.1% aucubin solution and 0.1% aucubin ointment as an active form, aucubigenin to which aucubin was converted by ${\beta}$-glucosidase. Artificial surgical wound was made on either 1cm lateral side of the dorsal midline along the axis of spine of Sprague-Dawley rats under sterile technique. Application of 0.1% aucubin solution or 0.1% aucubin ointment to surgical wound was done daily. Light microscopic examination was performed on the postsurgical 3 days, 5 days, and 9 days. The 0.1% aucubin solution group epithelialized earlier than the control group and the fibrosis of granulation tissue of both aucubin groups were more prominent than the control group. Collectively, this study suggests the possibility of aucubin as a topical agent. Further research should be performed on the mechanism of aucubin on wound healing and proper formulation for effective topical agents.

• Journal of Oral Medicine and Pain
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• 제19권2호
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• pp.205-219
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• 1994

Cigarette butts from 5 smokers were gathered and then, placed in room temperature for 1, 3, 5, 7, 15 days. The possible use of the cigarette butts for individual identification was evaluated in sex determination, amplification of D1S80 locus, polymorphisms of HLA-DQA1 gene from the extracted DNA. 1. DNA extraction was possible in cigarette butts weree left in room temperature for 15days, so it can be applicatable to individual identification by polymerase chain reaction(PCR). 2. Amplification of X-Y homologous amelogenin gene by PCR made it possible to identify the sex in saliva stains (cigarette butts). 3. Amplification of D1S80 locus can be acquired from adding the boving serum albumin and hot start PCR procedures from forensic samples such as saliva stains (cigarette butts), so the AMP-FLPs examining is possible. 4. Genotype could be determined simply and rapidly using Amplitype$TM$ HLA-DQ$\alpha$ forensic kit in examining the HLA-DQA1 gene. From the investigation, DNA extraction, sex determination, amplification of D1S80 locus, polymorphisms of HLA-DQA1 gene was successfully done even though the cigarette butts were left for 15 days at room temperature. Therefore cigarette butts are highly reliable and applicatable as molecular biologic samples for individual identification.

• Journal of Chest Surgery
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• 제19권3호
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• pp.506-514
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• 1986

Coarctation of aorta is rather common congenital cardiovascular defect in the western countries, but it is known to be rare in Korea. And no coarctation of Aorta has been reported and operated upon during early infancy in Korea. During 4 months period from May 1984 to September 1984, four small infants of coarctation of aorta were seen and treated surgically by subclavian flap aortoplasty in Guro Hospital, Korea University. All infants were male, ranging from 7 days to 54 days old [mean 29 days], weighing between 3.2 Kg and 5.0 Kg [mean 4.1 Kg], and all were in congestive heart failure. Examination of the femoral artery pulse gave in all cases clues to the diagnosis. By Two dimensional echocardiogram, detail anatomical features as well as the diagnosis were revealed and associated anomalies, for example, ventricular septal defect could be seen. Besides one case of isolated coarctation of aorta, other three infants had associated VSD. The 3 patients with VSD were treated by pulmonary artery banding in addition to aortoplasty. The postoperative course were smooth in all patients. In conclusion, coarctation of aorta may not be so rare in Korea as we thought previously. The importance of femoral pulse examination can not be overemphasized for the diagnosis. As we experienced, two-dimensional echocardiography in most cases can substitute those invasive examinations such as angiography and catheterization which carry difficulty and risk in infants.

• 대한수의학회지
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• 제30권2호
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• pp.249-253
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• 1990

Plasma progesterone concentrations were measured in 24 Korean native cows by a radioimmunoassay at 0, 6 and 20 days after insemination. As a result, 23 cows (95.8%) were judged to be in estrus with ovulation and one cow (4.2%) was judged to be in estrus without ovulation. Plasma progesterone concentrations at 20 days after insemination were $5.11{\pm}1.33$ (mean${\pm}$SD, range 3.20~7.86) ng/ml in pregnant cows and $0.35{\pm}0.10$ (range 0.30~0.50) ng/ml in nonpregnant cows. Of the 20 cows, 18 cows were confirmed the pregnant by rectal palpation at 60 days after insemination. The accuracy of the pregnancy diagnosis based on plasma progesterone concentration was 90 % for positive case and 100% for negative case.

• 한국수정란이식학회지
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• 제11권3호
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• pp.291-300
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• 1996

Real time B-mode ultrasound was used to detect the early conceptus in 187 Korean native cattles between days 10 and 60 after last insemination. The ultrasound diagnostic findings were systemically confirmed by palpation per rectum after the 60th day of last insemination. The embryonic vesicle and the embryo proper within the veside were first visible on mean day fl and 23, respectively. The heartbeat of the embryo proper could be detected on day 26, and the limb buds, placentomes, amnion, fetal movement, umbilical cord, optic area and split hooves were first visible on day 33, 34, 34, 44.5, 45, 32 and 48, respectively. The mean length of embryo proper was 3.8mm on day 23 which later increased to 56. 6rnrn on day 60. When ultrasound was used to detect the conceptus between days 20 and 30 after insemination and palpation per rectum after the 60th day of insemination, the accuracy rates of pregnancy detection by ultrasound scanning at days 20, 22, 24, 26, 28, 30 were 44.4, 69.2, 78.6, 87.5, 90.0, 93.3%. In summary, the early pregnancy diagnosis of Korean native cattle with ultrasound appears high accuracy rates. It is considered that ultrasound can be used in veterinary practice well.

• 한국동물생명공학회지
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• 제35권4호
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• pp.338-346
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• 2020

The present study was conducted in a goat farm for pregnancy diagnosis by using vaginal cytology and B-mode real time ultrasound using 5 MHz probe by transabdominal method. Seventeen pregnant does were used for this study. The objective of the study was to determine the earliest day of pregnancy and describe the chronological characteristics of pregnancy from day 22 to day 40 for vaginal cytology and day 25 to day 60 for ultrasonography of gestation. The differences among the average percentage of cell value in different age of pregnancy were significant (p < 0.05). The average percentage of intermediate cells (81.12%) was also significantly (p < 0.05) higher than superficial (9.41%), keratinized (7.10%) and neutrophil (2.61%) on 22-40th days of pregnancy. In case of real time B-mode ultrasonography, the gestational sac was observed only in three does out of seventeen (17.6 %) at 25-30 days whereas the placentomes and heart beat of the foetus were first detected at 31-35 days in six does (35.3%). The foetal leg buds were first visualized at 36-40 days in four does (23.5%) whereas the foetal vertebral column was first observed at 36-40 days of gestation in only three does (17.6%). In conclusion, vaginal cytology and trans-abdominal ultrasonography can be used for detection of early pregnancy in does.