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The Influence of the Preoperative Chronic Cyanosis on the Cardiac Troponin I in the Pediatric Cardiac Operation (지속적인 청색증에 노출된 선천성 심장병에서 수술 후 Cardiac Troponin I의 농도 변화)

  • Song, Jinyoung;Lee, Sungkyu;Lee, Jaeyoung;Kim, Soojin;Shim, Wooseup
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.498-504
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    • 2002
  • Purpose : The purpose of this study was to evaluate the perioperative myocardial damage in pediatric congenital heart disease with the cardiac specific protein of cardiac troponin I(cTpn-I). Methods : All 25 pediatric patients who were diagnosed with tetralogy of Fallot or double outlet right ventricle were classified as group A(acyanotic, $SaO_2$ >90%), group B(mildly cyanotic, $SaO_2$ >80-90%) and group C(moderately cyanotic, $SaO_2$ <80%). The control group D was consisted of 10 patients with ventricular septal defects who were operated in the same period. We measured preoperative hemoglobin, preoperative and postoperative(24 and 72 hour) arterial oxygen saturation, cTpn-I and creatine kinase(CK-MB). Results : Total 25 patients were subdivided into 6 of group A, 12 of group B and 7 of group C. The concentrations of preoperative cTpn-I were $0.23{\pm}0.12ng/mL$ in group A, $0.25{\pm}00.12 ng/mL$ in group B, $0.26{\pm}0.13ng/mL$ in group C. And the concentrations of cTpn-I in postoperative 24 hour were $10.04{\pm}5.28ng/mL$ in group A, $12.50{\pm}6.86ng/mL$ in group B, $12.55{\pm}9.90ng/mL$ in group C. Which revealed cTpn-I in group C was higher than that of the another less cyanotic groups. In addition, the concentration of cTpn-I of group C in postoperative 72 hour was higher than any other groups. The concentration of cTpn-I in postoperative 72 hour was statistically correlated with that in postoperative 24 hour and preoperative arterial oxygen saturation(P=0.001). Conclusion : Preoperative chronic cyanosis can influence on the postoperative concentration of cTpn-I in pediatric cardiac patients, which means impairment on the postoperative myocardial recovery.

The Prevalence of Obesity and Underweight in Adolescents in Incheon Area and the Relationship between Serum Cholesterol Level and Obesity (인천지역 청소년의 비만도와 혈청 콜레스테롤치와의 관계)

  • Kim, Myung Hyun;Kim, Tae Wan;Hong, Young Jin;Son, Byong Kwan;Pai, Soo Hwan;Chang, Kyung Ja;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.174-182
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    • 2002
  • Purpose : The purpose of this study was to investigate the prevalence of obese and underweight adolescents in Incheon area and to examine the relationship between serum cholesterol level and obesity, then to assess the nutritional condition of adolescents. Methods : With a questionnaire regarding their demographic characteristics, blood samples were obtained from apparently healthy students aged 12 to 24 years by venipuncture at April and May, 2000. We measured the obesity index using standard body weight and the body mass index(BMI) according to the criteria established by the Korean Pediatric Society in 1998. Obesity was defined as BMI more than 95 percentile, and underweight less than 15 percentile by age and sex. Results : A total of 1,456 students(M : F=685 : 771) aged 12 to 24 years were included in this study. The prevalence of obesity by standard body weight in adolescents in Incheon were 11.7% : mild obesity 6.5%, moderate 4.6%, and severe 0.5%. By BMI, the prevalence of obesity was 6.4% in males and 6.2% in females. In males, the prevalence of obesity in rural areas was 8.5%, lower than in urban areas(14.3%). The prevalence of underweight by obesity index was 34.1% in rural areas and 22.9% in urban areas. In females, the prevalence of obesity was 12.5% in rural areas and 19.6% in urban areas. There were no significant differences between the two regions(P=0.529). The prevalence of obesity increased with age till 16.3% of peak prevalence in 16 years of age, and then decreased. In males, the prevalence of obesity in academic and vocational school were 13.7% and 9.7%, respectively(P=0.116). In females of the academic and vocational school, the prevalence of obesity was 6.8% and 18.0%, respectively(P=0.001). In obese adolescents, serum total cholesterol was over 200 mg/dL in 6.2%. Conclusion : This study revealed that the prevalence of obesity in adolescents was about 12% and that the prevalence of underweight adolescents was considerably high. We think nutritional assessment and intervention are warranted for adolescent students.

Plasma G-CSF and GM-CSF Concentration and Amount of Their Receptors on the Granulocyte in Kawasaki Disease (가와사키병 환아의 혈장내 G-CSF와 GM-CSF 농도 및 과립구에서의 이들 수용체의 발현 변화)

  • Yoo, Young-Kyoung;Lee, Gibum;Kim, Hyun-Hee;Kim, Soo-Young;Kim, You-Jeong;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.376-381
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    • 2003
  • Purpose : This study aimed to demonstrate the possible pathogenesis of granulopoiesis in patients of Kawasaki disease(KD) using quantitative analysis of G-CSF, GM-CSF and their CSFr. Methods : The plasma levels of G-CSF, GM-CSF, G-CSFr and GM-CSFr were studied in 14 patients in the acute phase of KD; 13 children with normal peripheral white blood cell counts were used as the normal control group. The plasma concentration of G-CSF, GM-CSF were analyzed by ELISA. The G-CSFr and GM-CSFr on the peripheral granulocytes were analyzed by a quantitative flow cytometric assay and QuantiBRITE, and the quantitative changes of receptors which did not combine with G-CSF and GM-CSF were measured. Results : The total number of leukocytes in KD was similar to normal control group, but the leukocytes increased according to the number of neutrophils. The plasma concentration of G-CSF were decreased similar to normal control group(P=0.133), but that of GM-CSF decreased more than the normal control group(P=0.227). The quantity of G-CSFr, GM-CSFr were revealed to be no less than the normal control(P=0.721, P=0.912). After incubation with excessive G-CSF, the expressed G-CSFr on the neutrophils were decreased in both groups(P=0.554). The quantities of expressions of GM-CSFr on the neutrophil after incubation with the excessive GM-CSF were always increased in both groups(P=0.255). The amount of GM-CSFr of neutrophils are in proportion to total white blood cells (r=0.788, P=0.035), but it wasn't in the case of KD(P=0.644). Conclusion : The leukocytosis in KD that mediated by increasing neutrophil was not correlated with the plasma concentrations of G-CSF and GM-CSF, and the amount of expression of G-CSFr and GM-CSFr on granulocyte. It is possible that the reduction of concentration of GM-CSF results by increasing the active GM-CSFr.

Plasma G-CSF and GM-CSF Concentrations and Expression of their Receptors on the Granulocyte in Children with Leukocytosis (백혈구 증가증 환아의 혈장내 G-CSF와 GM-CSF의 농도 및 과립구에서의 이들 수용체의 발현)

  • Choi, Won Seok;Ryu, Kyung Hwan;Kim, You Jeong;Kim, So Young;Kim, Hyun Hee;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.271-276
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    • 2003
  • Purpose : Granulocyte-colony stimulating factor(G-CSF) and granulocyte macrophage-colony stimulating factor(GM-CSF) are principal cytokines in granulopoiesis and their physiologic effects are mediated through binding to specific cell surface receptors. Although it is known that the level of serum G-CSF and GM-CSF, and presentation of the receptors are increased in infectious diseases, there have been no studies to find the correlation between the granulopoiesis and leukocytosis. This study was designed to measure G-CSF and GM-CSF in leukocytosis and in control and to demonstrate the possible pathogenesis of granulopoiesis in leukocytosis using quantitative analysis of G-CSF, GM-CSF and their CSFr. Methods : The plasma levels of G-CSF, GM-CSF of 13 children without leukocytosis and 14 children with leukocytosis were measured. Counts of cell surface G-CSFr and GM-CSFr were measured by combining anti G-CSFr and anti GM-CSFr monoclonal antibodies to their respective receptors by using quantitative flow cytometric assay. Results : There was no significant difference betweeen the plasma concentration of G-CSF and GM-CSF in acute leukocytosis and in the control group. However, levels of G-CSFr in acute leukocytosis decreased significantly compared to the control(P=0.012) and the levels of GM-CSFr in both groups revealed no significant difference. Conclusion : Increase in the number of leukocyte in leukocytosis was mediated by increasing the number of neutrophil, and increased plasma concentration of G-CSF may be the cause of neutrophilia. But GM-CSF did not have any influence on leukocytosis.

Current feeding practices and maternal nutritional knowledge on complementary feeding in Korea (이유기 보충식 현황과 어머니 인식 조사)

  • Yom, Hye Won;Seo, Jeong Wan;Park, Hyesook;Choi, Kwang Hae;Chang, Ju Young;Ryoo, Eell;Yang, Hye Ran;Kim, Jae Young;Seo, Ji Hyun;Kim, Yong Joo;Moon, Kyung Rye;Kang, Ki Soo;Park, Kie Young;Lee, Seong Soo;Shim, Jeong Ok
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1090-1102
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    • 2009
  • Purpose:To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. Methods:Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. Results:Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). Conclusion:Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.

Clinical review of acute seizures among children who visited the emergency room in Masan Samsung hospital from 2004 to 2006 (최근 3년간(2004-2006년) 응급실로 내원한 소아환자 중 급성 발작으로 인한 환자들에 대한 임상적 고찰)

  • Lee, Won Deok;Yoo, Jae Wook;Lee, Ju Suk;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.420-425
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    • 2008
  • Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children (일부 초등학생의 대표적 신체활동의 에너지소비량 측정 및 에너지소비량과 체중과의 상관성 분석)

  • Kim, Jae-Hee;Son, Hee-Ryoung;Choi, Jung-Sook;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.48 no.2
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    • pp.180-191
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    • 2015
  • Purpose: There is a lack of data on the energy cost of children's everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system ($K_4b^2$, Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 cm and 43.6 kg, respectively. Oxygen consumption ($VO_2$), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/kg/min, 1.44 kcal/kg/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, $R^2$ values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

A study of the difference of Dongeui-Suse-Bowon and past Oriental-Medicine appeared in the argument of Interior-overheating-sympton of the Tae-Eum-In caused by liver's receiving heat (태음인(太陰人) 간수열(肝受熱) 이열병론(裡熱病論)을 통해 살펴본 과거의학(過去醫學)과 동의수세보원(東醫壽世保元)의 음양관(陰陽觀)의 차이(差異))

  • Kim, Jong-Weon
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.1
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    • pp.127-153
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    • 1997
  • Sasang-Medicine can classify all sympton with more simple classifying system than past Oriental-Medicine, because Sasang Byeon-Zeung(=classifying system of the sympton) separate by four clearly. The merit of this Sasang Byeon-Zeung can be seen more clearly on the part of the pathology of the expiratory-scattering and inspiratory-gathering of the Tae-Eum and Tae-Yang. On this view point, this thesis discussed the following subjects. 1. Investigate the theory of raising-falling and scattering-gathering developed in the Dongeui-Suse-Bowon. 2. Investigate the changes of the recognition of the Yang-Dog sympton and Jo-Yeol sympton argued as Interior-overheating-sympton of the Tae-Eum-In caused by liver's receiving heat. 3. Investigate the Yi-Je-Ma's view on the Eum-Yang in the argument of interior-overheating-sympton of the Tae-Eum-In caused by liver's receiving heat. As a result, the following conclusions were led to. 1. Dongeui-Suse-Bowon considers Spleen-Kidney has the couple motion of the raising Yang and falling Eum, and Liver-Lung has the couple motion of the expiratory-scattering and inspiratory-gathering. This theory of raising-falling and scattering-gathering is same as in the concept with the gathering. This theory of raising-falling and scattering-gathering is same as in the concept with the theory of raising-falling and floating-sinking of past Oriental-Medicine, but more consistently systematized in the pathology and prescription. 2. Dongeui-Suse-Bowon considers the Yang-Dog sympton and Jo-Yeol sympton as the interior-overheating-sympton of the Tae-Eum-In. As following the book, the fire of desire weeken the expiratory-scattering power of the lung, and deepen the shortage of the expiratory-scattering power comparison to the inspiratory-gathering power. Therfore the sympton can be treated by releasing ourselves from the desire and taking medicine strengthening the expiratory-scattering power. 3. In the early stage of the orintal medicine, they used prescriptions composed of So-Yang medicine and Tae-Eum medicine which can cool heat. Galgeun, Mawhang and Seungma were used in the age of Sanghanron, thereafter Jugoing's Jojung-Tang and Gongsin's Galgeunhaegi-Tang were developed as prescriptions of the interior-overheating-sympton of the Tae-Eum-In, and finally Tea-Uem-In Galgeunhaegi-Tang was settled by Yi-Je-Ma.

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The effects of temperatures on the development of Oriental -tobacco budmoth, Heliothis assulta Guenee, and control effects of Thuricide $HP^{(R)}$- (고추담배나방의 생태 및 방제에 관한 연구 -온도가 담배나방의 생육에 미치는 영향 및 Thuricide $HP^{(R)}$의 방제 효과-)

  • Chung C. S.;Hyun J. S.
    • Korean journal of applied entomology
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    • v.19 no.1 s.42
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    • pp.57-65
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    • 1980
  • The oriental tobacco budmoth, Heliothis assulta Guenee were reared under various temperatures; $20^{\circ}C,\;25^{\circ}C,\;30^{\circ}C$ and the control effects of Thuricide $HP^{(R)}$ were examined. The results obtained were as fellows: 1. The adult longevity of oriental tobacco budmoth was 11.35 days, and 3.00 days for preovipositional period, 4.75 days for ovipositional Period, and 3.50 days for postovipositional period. 2. The total number of eggs laid by a female were 307 at $20^{\circ}C$, 413 at $25^{\circ}C$ and 189 at $30^{\circ}C$. The number of eggs per female per day were 64.05 in average. 3. The average egg Periods were 7.71 days at $20^{\circ}C$, 4.12 days at $25^{\circ}C$ and 3.58 days at $30^{\circ}C$ and the hatchiabilities were $71.25\%,\;78.49\%\;and\;81.05\%$ at the respective incubation temperatures. 4. The larval developmental periods were 43.51 days at $20^{\circ}C$, 21.79 days at $25^{\circ}C$ and 18.05 days at $25^{\circ}C$ and the mortalities were $80.70\%,\;95.93\%$ and $87.01\%$ at the respective temperatures. 5. The pupal developmental periods were 24.22 days at $20^{\circ}C$, 12.36 days at $25^{\circ}C$ and 11.50 days at $30^{\circ}C$ and the mortalities at the respective temperatures were $18.18\%,\;42.11\%\;and\;40.00\%$. 6. The calculated threshold temperatures for the development were $11.61^{\circ}C$ for the eggs, $11.96^{\circ}C$ for the larvae, and $10.06^{\circ}C$ for the pupae. The estimated total effective temperatures were 60.41 day degrees for e eggs, 319.35 day degrees for the larvae, 222.66 day degrees for the pupae, and overall total effective temperatures, however, would be ranged 640-660 day degrees if the reproductive period of the adult was considered. 7. The relationship between the overall developmental periods and the rearing temperature could be Y=-4.272X+155.39 (r=0.9105), where Y; number of days required to complete the life cycle, X; treated temperatures. 8. The control effects of Thuricide $HP^{(R)}$ were $73.43\%$ for spray and $58.22\%$ for bait applications.

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Antibiotic Resistance for Common Hospital Acquired-pneumonia Pathogens in the Intensive Care Unit of Newly Opened Hospital (새로 개원한 병원 중환자실에서 주요 원내획득 폐렴 감염균의 연도별 항생제 내성율 변화)

  • Lee, Jae-Hyung;Shin, Sung-Joon;Kim, Young-Chan;Oh, Seung-Il;Kim, Mi-Ok;Park, Eun-Joo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.207-218
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    • 2002
  • Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.