Purpose: Rapid diagnosis and prompt treatment remain the cornerstone of management of patients with meningitis. Examination of cerebrospinal fluid(CSF) for glucose, protein, cells, and organisms is necessary for accurate diagnosis, but in many parts of the world facilities do not exist to do so. We tested CSF samples from 69 children with suspected meningitis with urinary reagent strips and analyzed the results to know the usability of urinary reagent strips in diagnosis of meningitis. Methods: 69 CSF samples obtained from children with suspected meningitis were analysed. Each sample was divided into two; one was sent to the laboratory for routine diagnostic evaluation, and the other was tested with the reagent strip(Combur10 Test M). Laboratory values of CSF glucose, protein, and leucocytes for each CSF sample were plotted against the corresponding reagent-strip category. Results: There was good agreement between the dipstick and laboratory values for CSF protein and cell count but not for glucose. Conclusion: Rapid diagnosis of meningitis could be made with three component of the Combur10 test strip. It is easy to do and would be of particular value to those working in parts of the world where no laboratory facilities exist.
Purpose : The purpose of this study was to identify useful predictors for diagnosing bacterial meningitis and performing CSF studies in febrile infants three months or younger. Methods : Six hundred and fifty two febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ presented from January 2003 to April 2008 and were retrospectively studied. The total white blood cell count (WBC), band count, absolute neutrophil count (ANC), quantitative C-reactive protein (CRP) and blood cultures were performed on admission. The clinical variables associated with bacterial meningitis were analyzed. Results : In patients with bacterial meningitis, the clinical variables including CRP (P=0.036), band count (P=0.037), ANC (P=0.036) and age (P=0.001) were significantly different. The area under the receiver-operating characteristic curve was 0.969 for CRP, 0.946 for the band count, 0.765 for the ANC and 0.235 for age. A CRP cutoff point of 8 mg/dL was determined to maximize both the sensitivity and specificity (sensitivity 83%, specificity 95%, likelihood ratio 16.6). A CRP concentration of <7 mg/dL "ruled-out" bacterial meningitis, with a likelihood ratio of 0.17, a posttest probability of <0.1% and negative predictive value 91%. A CRP concentration greater than 9 mg/dL had a much higher likelihood ratio (20.1) than the band count (16.6) and ANC (2.2). Conclusion : The CRP concentration was a useful laboratory test for the differential diagnosis of bacterial meningitis among febrile infants three months of age or younger. A CRP concentration of <7 mg/dL effectively ruled out bacterial meningitis; a value ${\geq}9mg/dL$ increased the clinical suspicion of bacterial meningitis and the need for CSF evaluation.
Kim, Seung Yun;Lee, Ko Eun;Kang, Su Young;Choi, Eun Hwa;Lee, Hoan Jong
Pediatric Infection and Vaccine
/
v.22
no.3
/
pp.172-177
/
2015
Purpose: This study aimed to analyze the epidemic period of RSV infection and evaluate the appropriate time of palivizumab immunoprophylaxis. Methods: From January 1991 to July 2012, nasopharyngeal (NP) aspirates were obtained from patients who visited Seoul National University Children's Hospital for respiratory symptoms. NP samples were used to detect respiratory viruses. Among them, we analyzed the positive number and detection rate of RSV infection in two-week interval. The beginning of RSV season was defined when RSV positive number was more than 4 and RSV detection rate was over 10%. From January 2007 to March 2014, we analyzed the starting time of palivizumab immunoprophylaxis for the infants at high risk. Results: The RSV detection rate was 2,013/21,698 (9.69%) over 22 years. The median RSV season was from $2^{nd}-3^{rd}$ week of October to $1^{st}-2^{nd}$ week of February. The earliest starting week was the 3rd week of July in year 2001, and the latest end week was the 3rd week of May in year 1990. Palivizumab immunoprophylaxis was initiated most frequently at the 3rd week of October (18.7%). However, the percentage of starting palivizumab on the 1st week of September has increased from 3.8% in the year 2007 to 14.1% in 2013. Conclusions: The year to year variability of RSV season exists. The starting time of palivizumab immunoprophylaxis should be adjusted based on the season of RSV epidemic.
Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.
Yoon, In Ae;Yun, Ki Wook;Lim, In Seok;Choi, Eung Sang;Yoo, Byung Hun
Childhood Kidney Diseases
/
v.17
no.2
/
pp.57-64
/
2013
Purpose: In children, 24-hour urine collections are unreliable for evaluating glomerular filtration rate (GFR) because of the difficulty of regulating voiding and the daily variation of urinary creatinine up to 25%. Additionally, creatinine clearance (Ccr) based on urinary creatinine is considered inaccurate. The purpose of this study was to compare estimated GFR determined using Ccr, formulas with serum cystatin C and creatinine, and $^{99m}Tc$-mercaptoacetyltriglycine (MAG3) dynamic renal scintigraphy. Methods: This retrospective study included 101 patients (age, <18 years) who visited Chung-Ang University Hospital between July 2011 and August 2012. GFR was estimated using 24-hour urinary creatinine, five formulas with serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan. Results: Of the 101 patients, glomerular renal diseases were present in 60 patients (59.4%) and non-glomerular diseases were present in 41 patients (40.6%). There was a significant correlation between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and Ccr (r=0.389, P <0.001). The correlation values between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and each formula of Schwartz, Counahan-Barratt, Cockcroft-Gault, Filler and Lepage, and Bokencamp were 0.265 (P=0.007), 0.128 (P=0.044), 0.230 (P=0.021), 0.356 (P<0.001), and 0.355 (P <0.001), respectively. $^{99m}Tc$-MAG3 renal scan was correlated with estimated-GFR by all formulas in decreased renal function. Conclusion: Estimated GFRs determined using serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan correlated well with estimated GFR determined using Ccr. $^{99m}Tc$-MAG3 renal scan may be replaced for evaluation of renal function with convenience in patients with renal disease and decreased renal function in childhood.
Purpose: We intended to evaluate myocardial oxygen consumption ($MVO_2)$ by applying recirculation correction and modified one-compartment model to have a reference range of $MVO_2$ in normal young population and to reveal the effect of recirculation on time-activity curve (TAC). Materials and Methods: In nine normal male volunteers with mean age of $26.3{\pm}4.0$, $MVO_2$ was estimated with 925 MBq (25mCi) of $^{11}C$-Acetate (Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Korea) and PET/CT (Biograph 6, Siemens Medical Solution, Germany). Analysis software such as $MATLAB^{(R)}$ v7.1 (Mathworks, Inc., United States), $Excel^{(R)}$ 2007 (Microsoft, United States), and $SPSS^{(R)}$ v12.0 (Apache Software Foundation, United States) were used. Twenty three frames were of $12{\times}10$, $5{\times}60$, $3{\times}120$, $2{\times}300's$ duration, respectively. The modified one-compartmental model and the recirculation correction method were applied. Statistical analysis was performed by using Test of Normality, ANOVA and Post-Hoc (Scheffe's) analysis, and p-value less than 0.05 was considered as significant. Results: The normal reference ranges of $MVO_2$ were presented as $3.18-4.64\;{\times}\;10^{-4}\;ml/g/sec$, $1.91-3.94\;{\times}\;10^{-4}\;ml/g/sec$, $4.31-6.40\;{\times}\;10^{-4}\;ml/g/sec$, $2.84-4.53\;{\times}\;10^{-4}\;ml/g/sec$ and $3.42-5.00\;{\times}\;10^{-4}\;ml/g/sec$ in the septum, the inferior wall, the lateral wall, the anterior wall and the entire wall, respectively. In addition, it was noted that the dual exponentiality of the clearance curve is due to the recirculation effect and that the characteristic of the curve is essentially mono-exponential. Conclusion: $^{11}C$-Acetate is a radiotracer worthwhile to assess $MVO_2$. Re-circulated $^{11}C$ can influence TAC of $^{11}C$ in myocadia and so the recirculation correction must be considered when measuring $MVO_2$.
Well-feathered (5.2 feathers, stem diameter 13 mm) trees of 'Fuji' apple/ M.9 EMLA were planted at $4.0{\tiems}1.5$ m and whip trees (stem diameter 10 mm) of 'Fuji'/M.26 at $4.0{\times}2.0$ m were trained to the slender spindle. The productivity and yield efficiency of two orchard systems were compared for 6 years. The canopy volume of the tree/M.9 EMLA reached $2.07m^3$ in 2nd year and increased slowly to almost the targeted tree volume of $2.9m^3$ in 4th year. Trees/M.26 grew slowly at the begin but from 3rd year the tree volume expanded quickly to reach $5.6m^3$ in 5th year, covering over the allowed space. Yield of M.9 EMLA per 10a increased from 0.3 ton in 2nd year to 4.6 ton in 5th year, and 5.0 ton in 6th year, but yield of M.26 per 10a increased from 0.5 ton in 3rd to 2.9 ton in 6th year. Cumulative yield per 10a up to 6th year was 13.9 ton for M.9 EMLA but only 9.8 ton for M.26. Fruit weight for M.9 EMLA was heavier than that for M.26. In conclusion, the high density planting system with well-feathered trees/M.9 EMLA was better than the conventional wide planting system with whip trees/M.26.
This study was performed in order to evaluate the antioxidant activities of red beet extracts as well as the physicochemical properties and microbial changes of pork patties containing red beet during refrigerated storage. Red beet was extracted with water and ethanol. Red beet water extracts (RBW) and red beet ethanol extracts (RBE) were diluted with various concentrations (0.05~1.0%). DPPH radical scavenging activity and iron chelation activity of RBW showed a higher level than those of RBE (p<0.05). In particular, the iron chelation activity of RBW was over 53.4% at all levels. In addition, RBW at 1% had nearly 100% activity. On the other hand, the reducing powers of RBE were higher than those of RBW (p<0.05), and the antioxidant activity on linoleic acid emulsion of RBW was over 83% at all levels. Based on these model studies, 0.5% levels of RBW and RBE were added to ground pork patties (GPP), and the physicochemical properties and microbial changes of red beet GPP were evaluated during storage (0~14 d) at $4^{\circ}C$. The pH and microbial counts increased with increased storage time (p<0.05). Pork patties with BHT showed the lowest thiobarbituric acid reactive substances (TBARS) and microbial counts, and those with red beet had lower TBARS than the control (p<0.05). These results indicated that both red beet water and ethanol extracts could be used as natural antioxidants of pork patties during storage.
A total of 40 Korean native pigs (gilt 21, boar 19) were used to investigate the meat quality, nutritional and sensory properties by gender. Gilts had significantly lower moisture and ash contents (%) than boars, but protein contents were not significantly different between the gender (p<0.05). Gilts contained high intramuscular fat contents were significantly lower in Warner-Bratzler shear force (WBS) and Water holding capacity (WHC) when compared to those of boars. There was no significant difference in meat color L (lightness) and a (redness) values between the gender (p>0.05), but gilt had higher b (yellowiness) values than boar. Regarding amino acid compositions, there were glutamic acid (3.25%), aspartic acid (1.94%) lysine (1.83%), leucine (1.77%), alanine (1.17%) and arginine (1.15%) for gilts and boars. There were no significant differences in the contents of the minerals such as calcium, potassium, phosphorous, sodium, magnesium, iron, zinc and copper (p>0.05). The results of fatty acid composition showed that gilts had significantly higher C16:1n7, C18:1n9, in intramuscular fat., whereas they had significantly higher contents of C14:0, C16:0, C20:1n9, C20:5n3 in subcutaneous fat than boars (p<0.05). Boars had significantly higher contents of C18:0, C18:1n7, C18:2n6, C20:1n9, C20:4n6, C22:4n6 in intramuscular fat and they had significantly higher contents of C18:2n6, C22:4n6 than gilts in subcutaneous fat (p<0.05). In sensory evaluation, gilts had significantly higher scores in juiciness, tenderness and flavor when compared to boars (p<0.05).
Analyses were conducted to estimate the effect of quality grade on the carcass characteristics, physico-chemical and sensory traits of Longissimus dorsi in Hanwoo. A total of 42,113 carcasses were selected on the basis of five quality grades (grade $1^{++}$, $1^+$, 1, 2, and 3) and an additional 258 samples of Longissimus dorsi were used to evaluate the beef quality. The increase in quality grade from grade 3 to grade $1^{++}$ was significant (p<0.05) for carcass weight (from 338.7 kg to 387.2 kg), backfat thickness (from 7.45 mm to 12.23 mm) and marbling score (from 1.09 to 8.31). In contrast, significantly decreased levels of meat color, fat color, texture and maturity were apparent with increasing quality grade (p<0.05). Increasing quality grade was also correlated with significant increases (p<0.05) in crude fat contents (from 3.57% to 25.68%) and water holding capacity (from 52.41% to 58.03), and a decrease of the Warner-Bratzler shear force from 8.29 kg to 2.83 kg. The highest $L^*$ value (41.53) and highest cooking loss (22.11%) were observed with grade $1^{++}$ and 3 beef, respectively. There was no difference observed on $pH_{24}$ (5.53 to 5.66) among the quality grades, which were within the normal range. Sensory evaluation experiments revealed that quality grades were associated with significantly altered (all p<0.05) tenderness, juiciness, flavor, and overall acceptability. The crude fat contents showed significant correlation with juiciness (r=0.59), tenderness (r=0.71), flavor (r=0.55), and overall acceptability (r=0.69). The lower sensory trait scores were related to higher WBs. Grade $1^+$ Hanwoo beef had a significantly higher WBs and lower fat contents when compared to grade $1^{++}$ Hanwoo beef (p<0.05).
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