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Risk factors associated with complicated methicillin-resistant Staphylococcus aureus bacteremia in neonates (신생아의 MRSA 균혈증에서 합병증 발생과 연관된 위험인자)

  • Lee, Young Jin;Kim, Hyen Jin;Byun, Shin Yun;Park, Su Eun;Park, Hee Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.173-177
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    • 2010
  • Purpose : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes nosocomial infection in NICU. It contributes to neonatal morbidity and mortality with variable complications. This study was conducted to identify the risk factors associated with complicated MRSA bacteremia in neonates. Methods : We reviewed the medical records of 44 neonates with positive blood culture for MRSA who were admitted to the NICU of Pusan National University Hospital from January 2002 to December 2007. We compared various factors of the complicated and uncomplicated MRSA bacteremia cases. Results : Of the 44 neonates, 31 were male and 13, female. The mean gestational age and birth weight were $33.2{\pm}4.9$ weeks and $1,859.9{\pm}962.2g$, respectively. Twenty-one of infants were treated with a mechanical ventilator during a mean of $8.8{\pm}13.8$ days. There were 13 cases of complicated and 31 cases of uncomplicated MRSA bacteremia. Between the 2 groups, we compared the following variables: gestational age, birth weight, ventilator use, umbilical catheter use and central catheter insertion, $O_2$ inhalation, first oral feeding day after birth, underlying disease, transfusion, and initial vancomycin use. The underlying disease and transfusion were the risk factors related to complicated MRSA bacteremia. Conclusion : Complicated MRSA bacteremia is related to underlying disease and transfusion. Since this was a retrospective study with a small sample size, it offered limited capacity to compare complicated and uncomplicated MRSA bacteremia. A prospective study with a larger population is needed to determine the exact characteristics of MRSA bacteremia in NICU.

Surgical Approaches to the Middle Cranial Base Tumors (중두개와저 종양에 대한 수술적 치료)

  • Kim, Il Seub;Rha, Hyung Kyun;Lee, Kyung Jin;Cho, Kyung Keun;Park, Sung Chan;Park, Hae Kwan;Cho, Jeung Ki;Kang, Jun Ki;Choi, Chang Rhack
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1079-1085
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    • 2001
  • Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

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The Effects of Monoamine Oxidase A CA Repeat Polymorphism on Behavioral Trait and Clinical Characteristics in Korean Male Alcoholics (단가아민 산화제 A CA 반복 유전자 다형성이 한국 알코올의존 남자환자의 행동특성과 임상양상에 미치는 영향)

  • Lee, Jung-Sik;Yang, Byung-Hwan;Lee, Kyung-Mee;Kim, Hong-Kwan;Kim, Yong-In;Chai, Young-Gyu
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.64-73
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    • 2000
  • There are several candidate genes in genetic study of alcoholism. Among them, allelic associations have been reported between MAOA CA repeat polymorphism and alcohol dependence, recently. And also, several studies have been investigated genotype-phenotype relationships between MAOA CA repeat polymorphism and clinical manifestations. The authors tried to identify differences in allelic frequency of MAOA CA repeat polymorphism between alcohol dependence and controls, and in behavioral trait and clinical characteristics according to MAOA CA repeat polymorphism. We also tried to investigate genotype-phenotype relationships between MAOA CA repeat polymorphism and behavioral trait such as aggression. We examined 49 male patients with alcohol dependence(DSM-IV) who had been admitted in Yong-In Mental Hospital from June 1st 1998 to October 31th 1998. We performed semistructured interview for demographic and clinical characteristics. Self-report questionnaire for BDHI(Buss-Durkey Hostility Inventory) was given to all subject at least 4weeks later after admission. Using polymerase chain reaction and polyacrylamide gel electrophoresis, MAOA CA repeat polymorphism were observed in 52 male controls and 49 male patients with alcohol dependence. We devided alcoholic patients into two groups according to allelic length of MAOA CA repeat polymorphism ; alcoholics with short alleles(${\leq}$119bp, N=20) and alcoholics with long alleles(${\geq}$123bp, N=29). T-test, ${\chi}^2$-test and Fisher exact probability test were used for statistical analysis. There were no significant differences in frequency of each allele and short and long alleles of MAOA CA repeat polymorphism between alcoholics and controls. But there were significant differences in clinical symptoms and behavioral trait between alcoholics with short and long alleles. In clinical symptoms, alcoholics with long alleles used alcohol more frequently during one month before admission, had much more maximum amount of beer drinking and reported withdrawal seizure more frequently than with short alleles. In contrary, alcoholics with short alleles expressed depressed mood and guilty feeling more frequently and wanted complete abstinence as a treatment goal more frequently than with long alleles. In behavioral trait, alcoholics with long alleles had higher total aggression score and showed much more self-assertive attitude(subscale of expression of aggression) than with short alleles. Allelic length of MAOA CA repeat polymorphism was correlated with self-assertive attitude and accounted for 9% of the variance of self-assertive attitude. And also, predictable variables of allelic length of MAOA CA repeat polymorphism were drinking frequency and self-assertive attitude. Our findings suggest that MAOA CA repeat polymorphism may provide some behavior modifying role especially in self-assertive attitude and indirect symptom modifying role in Korean male alcoholics.

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Multi-Component Relaxation Study of Human Brain Using Relaxographic Analysis (Relaxographic 분석법을 이용한 뇌의 다중 자기이완특성에 관한 연구)

  • Yongmin Chang;Bong Soo Han;Bong Seok Kang;Kyungnyeo Jeon;Kyungsoo Bae;Yong-Sun Kim;Duk-Sik Kang
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.120-128
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    • 2002
  • Purpose : To demonstrate that the relaxographic method provides additional information such as the distribution of relaxation times and water content which are poentially applicable to clinical medicine. Materials and Methods : First, the computer simulation was performed with the generated relaxation data to verify the accuracy and reliabilility of the relaxographic method (CONTINI). Secondly, in or der to see how well the CONTIN quantifies and resolves the two different ${T_1}$ environments, we calculated the oil to water peak area ratios and identified peak positions of ${T_1}-distribution$ curve of the phantom solutions, which consist of four centrifugal tubes (10 ml) filled with the compounds of 0, 10, 20, 30% of corn oil and distilled water, using CONTIN. Finally, inversion recovery MR images for a volunteer are acquired for each TI ranged from 40 to 1160 msec with TR/TE=2200/20 msec. From the 3 different ROIs (GM, WM, CSF), CONTIN analysis was performed to obtain the ${T_1}$-distribution curves, which gave peak positions and peak area of each ROI location. Results : The simulation result shows that the errors of peak positions were less in the higher peak (centered ${T_1}=600$ msec) than in the lower peak (centered ${T_1}=150$ msec) for all SNR but the errors of peak areas were larger in the higher peak than in the lower peak. The CONTIN analysis of the measured relaxation data of phantoms revealed two peaks between 20 and 60 msec and between 500 and 700 msec. The analysis gives the peak area ratio as oil 10%: oil 20%: oil 30% = 1:1.3:1.9, which is different from the exact ratio, 1:2:3. For human brain, in ROI 3 (CSF), only one component of -distributions was observed whereas in ROI 1(GM) and in ROI 2 (WM) we observed two components of ${T_1}-distribution$. For the WM and CSF there was great agreement between the observed ${T_1}-relaxation$ times and the reported values. Conclusion : we demonstrated that the relaxographic method provided additional information such as the distribution of relaxation times and water content, which were not available in the routine relaxometry and ${T_1}/{T_2}$ mapping techniques. In addition, these additional information provided by relaxographic analysis may have clinical importance.

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Exact Solutions of Plasma Diffusion in a Fine Tube Positive Column Discharge (세관 양광주 방전에서 플라즈마 확산의 완전 해)

  • Jin, D.J.;Jeong, J.M.;Kim, J.H.;Hwang, H.C.;Chung, J.Y.;Cho, Y.H.;Lim, H.K.;Koo, J.H.;Choi, E.H.;Cho, G.S.
    • Journal of the Korean Vacuum Society
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    • v.19 no.1
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    • pp.36-44
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    • 2010
  • The ambipolar diffusion equation has been solved in a fine-tube lamp of a few mm in diameter. In the diffusion of radial direction, the plasma diffuses and vanishes away at the glass wall by recombination with the characteristic time of plasma loss is given by $\tau_r\;=\;(r_0/2.4)^2/D_a$. With the radius $r_0{\sim}1\;mm$ and the ambipolar diffusion coefficient $D_a{\sim}0.01\;m^2/s$, the vanishing time is calculated $\tau_r{\sim}10\;{\mu}s$ which corresponds to the least value of frequency 30 kHz for the sustaining the plasma in the operation of high voltage AC-power. In the diffusion of longitudinal z-direction, a high density plasma generated at the area of a high voltage electrode, diffuses into the positive column with the characteristic time $\tau_z{\sim}0.1\;s$. The plasma diffusion velocity at the boundary of high density plasma is $u_D{\sim}10^2\;m/s$ at the time $t{\sim}10^{-6}$ s and the diffusion velocity becomes slow as $u_D{\sim}1\;m/s$ at $t{\sim}10^{-3}\;s$. Therefore, for the long lamp of 1 m, it takes about several seconds for the high density plasma at the area of electrode to diffuse through the whole positive column space.

Pilot Research about Influential Factors and Efficacy Judgement of Acupoint Sticking in Dog-Days (삼복첩(三伏貼)의 영향 요인 및 임상 효과 판정에 관한 예비 연구)

  • Lee, Sun-Haeng;Kim, Cho-Young;Chang, Gyu-Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.25 no.1
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    • pp.72-81
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    • 2011
  • Backgrounds: Sticking warm and hot herbs to acupoint in Dog-Days where the strongest Yangqi takes place, Acupoint sticking in Dog-Days is one of Oriental medical treatment to cure winter diseases in the summer. This treatment is widespread in China and Taiwan, and is becoming popular in South Korea nowadays. Objectives: The research has been conducted to evaluate the influencial factors and efficacy in Acupoint sticking in Dog-Days. Methods: We visited one kindergarten in Dog-Days of 2010, and attached pills which are made of Sinapis Semen(白芥子), Corydalis Tuber(玄胡索), Asari Herba Cum Radix(細辛), Juice of Zingiber Officinale(薑汁) to BL-13(肺兪), BL-15(心兪), BL-17(膈兪) of 56 children for 4-6 hours(34 boys, 22 girls, $52.64{\pm}16.85$ months, 19-78 months). Exacerbating effect or non-significant changes in respiratory symptoms before and after the treatment were ified.. The influentialfactors of efficacy were analyzed by Pearson's $x^2$-test and Fisher's exact test. In addition, the efficacy and satisfaction among once, twice, and three times treatment groups were verified by ANOVA. Results: 27 children (48.2%) were effective, but efficacy felt by parents is 45 cases (80.4%). Sex, perspiration, stool, urine, sleep, cold of hands and feet, cold sensitivity, and frequency of Acupoint sticking in Dog-Days has no relation to efficacy(p>0.05). However, the efficacy is poor in 1 and 2 age(p=0.030). Difference among efficacy of once, twice, and three times treatment groups is not significant(p=0.069), whereas there are linear association in frequency of Acupoint sticking in Dog-Days and efficacy(p=0.030). 36 parents (64.3%) are satisfied with Acupoint sticking in Dog-Days, and we observed significant difference among once, twice, three times treatment groups(p=0.041). 19 parents (33.9%) had been known about Acupoint sticking in Dog-Days, but 53 parents (94.6%) wanted repetition, and 41 parents (73.2%) intended to recommend it to acquaintance. Side effects are minor itching in two cases. Twenty seven participants showed positive effect, and forty five people (80.4%) felt beneficial. Sex, perspiration, stool, urine, sleep, cold hands and feet, sensitivity in cold, and frequency of Acupoint sticking in Dog-Days has no relation to the efficacy(p>0.05). Though the efficacy was poor in one and two year old infants, it was linearly correlated with the frequency count and responses from the treatment (p=0.030). Thirty six participants (64.3%) satisfied with the treatment, and so did the first, second, and third participant groups (p=0.041). Even though, only nineteen participants (33.9%) were familiar with Acupoint sticking in Dog-Days, fifty three participants (94.6%) preferred to repeat the treatment, and 41 parents were preferable to recommend the treatment to others. Side effects of minor itching has been reported in a couple cases. Conclusions: Acupoint sticking in Dog-Days is effective in children older than three year old. The effect would be greater when going through the treatment three times. Based on significant satisfaction, intention of repetition and recommendation, strong promotion on Dog-Days are needed to make a better use of Acupoint sticking in Dog-Days for the effective treatment.

Design and Fabrication for the Development of Auto Pattern Maker (자동취형기 개발을 위한 설계 및 제작)

  • Lee, Young-Il;Kim, Jung-Hee;Park, Jee-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.3
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    • pp.231-239
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    • 2013
  • Purpose: To design and fabricate the auto pattern maker for the development. Methods: we got the necessary data, needed in design, by using CAD. Based on the these data, we fabricated the trial product for the development of the auto pattern maker. Results: The auto pattern maker were composed with combinations of many elements; pattern making assembly, control panel, frame attachment and prober unit. The pattern making assembly was comprised of the cutter, the pattern holder, pattern remover and silence cover which could minimize the sound during the cutting process. The control panel was designed to be connected and operated with the main printed circuit board. The prober could get the eye shape data by scanning of 1.8 degrees around the groove of the frame through the encoding data according to the address. After starting, scanning was carried out in two passes, i.e. one right-handed and one left-handed. Communication connector could send the eye shape data from auto pattern maker to outer system with the RS232C transmission system. By using the one-way analysis of variance, we got the error rate of cut pattern size for ${\Phi}22mm$, ${\Phi}55mm$ and ${\Phi}62mm$. Because F-value was 0.510 and p-value was 0.601, no statistically significant differences were found. Also, the mean cutting error of the auto pattern maker was 0.0274 mm. Conclusions: we could succeed in making the trial product by applying it to the development of the auto pattern maker. The role of this auto pattern maker is to find a exact required size of lens to fit the frame by measuring the frame. The acquired data are transferred to outer system for grinding and finishing with patternless process. Also, the trial product can produce pattern to fit the frame. Therefore, it was confidently expected that the optometrists could handily produce pattern to fit the frame with this trial product and dispense the ophthalmic lens because of its efficiency and convenience compared to the past.

A Follow-Up Study after Discontinuation of Antiepileptic Drug Therapy in Children with Well-Controlled Epilepsy : The Factors that Influence Recurrence (항전간제로 조절된 간질 환아에서 약물 중지 후 추적 관찰 - 재발위험인자)

  • Chung, Sa Jun;Chung, Hye Jeon;Choi, Young Mi;Cho, Eu Hyun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1559-1570
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    • 2002
  • Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.

Estimation of Trans Fatty Acids Intake and Behavior of Having Meals in Middle School Students of Busan (부산지역 중학생의 trans 지방산 섭취 수준과 식행동 조사)

  • 심영주;노경희;이미옥;송영선
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.3
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    • pp.485-493
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    • 2003
  • To assess trans fatty acids (tFAs) intake of middle school students in Busan, behavior of having meals and 3 day's food record were surveyed in 800 subjects. 35.3% of subjects responded to twice a day in frequency of snack intake. Preferred snack items were ice cream (68.6%) and milk (57.0%). Subjects of dining out preferred jajangmyon (54.6%), seasoned chicken (50.5%), fried chicken (35-3%) in order when dined out. Mean daily tFAs intake of subjects was 1.68$\pm$0.04 g. Mean daily intake level of girls was 1.89$\pm$0.06 g which was significantly higher than that of boys, 1.40 $\pm$ 0.05 g (p<0.001). Naturally derived tFAs intake was 1.04$\pm$0.03 g which corresponded to 62.1% of total tFAs intake per day and industrially derived tFAs intake was 0.64 $\pm$ 0.02 g, 37.9% of total tFAs intake per day. Calorie percentage of tFAs was 0.8% and fat percentage of tFAs was 3.16%. The level of tFAs intake showed a significant difference with monthly allowance (p<0.05) and frequency of snack intake (p<0.001) in girls, which was not the case in boys. The main sources of tFAs were milk and dairy products (34.3%), bakeries (18.3%), and fish and meat products (16.2%), in order. From above results, we can conclude that tFAs intake of middle school student is not as much as that of Western teenagers. However, exact estimation of tFAs intake requires database of tFAs in broad range of processed foods commonly consumed in Korea.

Analysis of Orthotropic Body under Ultimate Moment Load (극한(極限)모멘트 하중(荷重)을 받는 이방성(異方性) 구조체(構造體)의 해석(解析))

  • Chang, Suk Yoon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.5 no.3
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    • pp.95-105
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    • 1985
  • This dissertation presents an exact solution for the normal and shearing stresses of an orthotropic plane body loaded by a moment load. The solution satisfies the conditions of equilibrium compatibility equations concurrently and is governing for the body being in the elasto-plastic state. An Airy stress function is introduced to solve the problem related to an orthotropic half-infinite plane under a moment load. All the equations for orthotropy must be degenerated into the expressions for isotropy when orthotropic constants are replaced by isotropic ones. The author has evaluated all the equations of orthotropy and succeeded in obtaining exactly identical expressions to the equations of isotropy which were derived independently by of L'hosptials rule. The analytical results of isotropy are compared with the simple results of other investigator. Since moment Load under the elastic state and plastic state only is a particular case of moment load under the elasto-plastic state. All the equations of elasto-plastic state case are degenerated into the expressions for the each case. The formal solution is expressed in terms of closed form. The orthotropic constants are evaluated for two kinds and two different orientations of the grain of wood and two kinds of structures. The numerical results for orthotropy are evaluated for one kind and two different orientations of three-layered ply wood. The distribution of normal and shearing stresses are shown in figures. It is noted that the distribution of stresses of orthotropic materials depends on the type of materials and orientations of the grain and stiffening.

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