• Title/Summary/Keyword: 성빈센트병원

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Causative Pathogens and Therapeutic Assessment of Cefprozil in Acute Otitis Media (급성 중이염의 원인 병원균과 Cefprozil 치료의 임상적 평가)

  • Kang, Jin-Han;Kim, Jong Hyun;Park, Yong-Soo;Choi, Young-Chul;Noh, Heil;Yang, Hoon Shik;Kim, Kyu Sung;Moon, Yeon Sook;Hong, Young Jin
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.459-466
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    • 2003
  • Purpose : AOM is the most common bacterial URI in children. The bacteriology and antibiotic Tx of AOM in children has been studied in many countries. But, there is few study of causative pathogens and antibiotic Tx of AOM in our country. In this aspect, we performed prospective clinical study to confirm the causative pathogens and assess the clinical responses of cefprozil in AOM patients. Methods : Thirty three AOM patients enrolled in this study. Tympanocentesis for isolation of causative pathogens were performed before Tx of cefprozil. The study patients received cefprozil with dose of 15 mg/kg/bid.po/day for 10-12 days, and initially assessed the clinical response at 4-5 days after receiving cefprozil and finally at the end visit. In vitro susceptibility tests of cefprozil to isolated pathogens were done by disc diffusion method, and in vitro susceptibility tests of cefaclor and cefixime to isolated pathogens were simultaneously performed. Results : Bacterial pathogens[S. pneumoniae(10), H. influenzae(5), S. aureus(2), M. catarrhalis(1) and Group A stretococcus(1)] were isolated from 19 patients. Clinically, all patients had history of abrupt high fever except one. Tympanic perforation was dominant in pathogens isolated cases, and otalgia was significantly developed in non-pathogens isolated cases. The ages of pathogens isolated cases were usually below 2 years. Eighty four point nine percent of the patients including two cases with isolation of intermediate resistant S. pneumoniae were clinically improved. Antimicrobial in vitro activity to S. pneumoniae of cefprozil were superior than that of cefacor and cefixime. Conclusion : We confirm that bacteria has the causative role in about 60% cases, and S. pneumoniae is the most common pathogen. Clinically, there were some differences in symptoms, signs and ages between pathogens isolated and non-pathogens isolated cases. The clinical responses of cefprozil in our patients revealed similar outcomes to other countries. And we reconfirm that cefprozil may be clinically effective in cases of AOM due to intermediate resistant S. pneumoniae.

MicroRNA Profile in the Helicobacter pylori-infected Gastric Epithelial Cells (Helicobacter pylori 감염 위상피세포에서 MicroRNA 발현 변화)

  • Chang Whan Kim;Sung Soo Kim;Tae Ho Kim;Woo Chul Chung;Jae Kwang Kim
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.105-112
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    • 2017
  • Background: The expression of miRNAs in response to Helicobacter pylori infection has not been well explored. The aims of this study were to evaluate the H. pylori associated miRNAs in the gastric epithelial cells. Methods: We investigated gastric epithelial cell-line (HS3C) exposed H. pylori over 3 months and AGS cell-line (AGS) exposed H. pylori for 6 hour. After the extraction of miRNA from these cell-lines, microarray and real time PCR were performed to confirm the alteration of expression. Results: All 12 miRNAs chosen for real-time PCR are based on the result of microarray and their potential functions related to H. pylori infection. miR-21, miR-221, miR-222 were upregulated in the H. pylori infected AGS cell for 6 hours and HS3C cells. miR-99b, miR-200b, miR-203b and miR-373 were downregulated in the H. pylori infected AGS cell for 6 hours and HS3C cells. miR-23a, miR-23b, miR-125b, miR-141 and miR-155 were upregulated in HS3C cell line but not in H. pylori infected AGS cell for 6 hours. Conclusion: miR-21, miR-99b, miR-125b, miR-200b, miR-203b, miR-221, miR-222, and miR-373 are supposed to be related with oncogenesis of H. pylori infection. Further studies are needed for the evaluation of the function of these confirmed miRNAs.

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Early Gastric Mucosal Cancer Associated with Synchronous Liver Metastasis (위 점막암에 동반된 간전이 1예)

  • Bong Sung-Joon;Jun Kyong-Hwa;Chin Hyung-Min;Cho Hyeon-Min;Won Yong-Sung;Park Woo-Bae
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.277-281
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    • 2004
  • Early gastric cancer (EGC) is defined as a carcinoma confined to the mucosa or submucosa of the stomach, with or without lymph-node metastasis. Synchronous liver metastasis is 5. $12.8\%$ in advanced gastric cancer, but is very low in EGC. A 64-year-old woman was admitted to St. Vincent's Hospital with a complaint of epigastric pain. Gastrofiberscopic examination showed a polypoid mass on the gastric antrum. Abdominal computed tomography demonstrated an intraluminal polypoid mass in the gastric antrum, but no tumor mass in the liver. A laparotomy revealed a solitary liver metastasis, we performed a distal partial gastrectomy with a group-2 lymph-node dissection and resection of metastatic liver tumor. Histologic examination showed a tubular adenoma with a focal carcinomatous change, Which was confined to the gastric mucosa and to the metastatic adenocarcinoma in the liver. We present a case of early gastric mucosal cancer associated with synchronous liver metastasis, along with a review of the literature.

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Clinical Analysis of Pulmonary Hamartoma ; 29 Cases (폐과오종 29예에 대한 임상적 고찰)

  • Lee, Sang-Haak;Yoon, Hyung-Kyu;Song, So-Hyang;Lee, Sook-Young;Kim, Seok-Chan;Ahn, Joong-Hyun;Choi, Young-Mi;Kim, Chi-Hong;Kwon, Soon-Seong;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Lee, Kyo-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.644-649
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    • 2002
  • Background : Pulmonary hamartomas are the most common form of benign tumors, occurring in approximately 0.2% of routine autopsies. However, only a few reports on the clinical characteristics of pulmonary hamartoma in Korea have been published. Materials and Methods : The charts, X-rays and pathological specimens of 29 pulmonary hamartoma patients who were diagnosed by a pathological examination from 1990 to 1999 at the Catholic Medical Center were retrospectively reviewed. Results : The peak incidence of the tumor occurred in the sixth decade of life (37.5%). Seventeen patients (58.6%) were asymptomatic and 12 patients (41.4%) had symptoms. Chest discomfort was the most common symptom (31.0%). A total of 25 tumors (86.2%) were parenchymal, and 4 (13.8%) were endobronchial. Twenty cases were in the right lung and 9 cases were in the left lung (approximately 1:2.2). The RLL was the most commonly involved lobe (31.0%). Calcification was noted in 5 cases(19.2%) on a plain X-ray and in 5 cases (29.4%) on chest CT. Accompanied neoplasms were observed in 2 cases. Twenty-four hamartomas (82.8%) were diagnosed by a surgical resection and 4 cases(13.8%) were diagnosed by a fine needle aspiration biopsy. Twenty-six hamartomas (89.7%) were managed by a surgical resection. The follow up ranged from 4 to 55 months (mean, 19.6 months) and no recurrent pulmonary hamartomas were noted. Conclusion : Pulmonary hamartoma is more common in females and more commonly in the right lung. Calcification was noted only in 19.2% on a plain chest X-ray and 29.4% on a chest CT. No recurrent hamartomas had developed during the follow up period.

Mid-Term Results of Modified Hoffman Procedure for Rheumatoid Forefoot Deformity (류마티스 전족부 변형에 대한 변형 Hoffman 술식의 중기 결과)

  • Kim, Yoon-Chung;Choi, Hyun Chul;Lee, Hyo Jin;Ahn, Jae Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.484-490
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    • 2021
  • Purpose: A rheumatoid forefoot deformity includes severe hallux valgus and claw toe of the four lateral toes. The authors intended to analyze the mid-term results of the modified Hoffman procedure for a rheumatoid forefoot deformity. Materials and Methods: Twenty-two feet of eighteen patients were followed up for more than two years after the modified Hoffman procedure. The mean age was 54.7 years, and the mean follow-up period was three years and four months. Clinically visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) MP-IP score were analyzed preoperatively and postoperatively. The postoperative complications, the satisfaction of patients, and the presence of plantar callosity were also analyzed. Radiographically, the hallux valgus angle, the 1st intermetatarsal angle, the 1st interphalangeal angle, the 1st interphalangeal joint arthritic change after the operation, and the dorsiflexion angle and the time to union of the 1st metatarsophalangeal joint were analyzed. Results: Clinically, the VAS and AOFAS score were respectively improved from 7.1 points and 30.3 points preoperatively to 1.5 points and 83.1 points postoperatively (p<0.001). All patients were satisfied with the results. Plantar callosity disappeared in all cases. Radiographically, the mean hallux valgus angle, the 1st intermetatarsal angle, and the 1st interphalangeal angle changed from 52.8°, 13.3°, and 7.5° preoperatively to 16.2°, 8.7°, and 14.6° postoperatively (p<0.001). The mean dorsiflexion angle of the 1st metatarsophalangeal joint was 17.2° postoperatively. The mean time to radiographic union of the 1st metatarsophalangeal joint was 11.1 weeks. There were two cock-up deformities of the lesser toe, one wound problem, and two hallux interphalangeal joint arthritis as a complication. There were no cases of nonunion of the 1st metatarsophalangeal joint. Conclusion: The modified Hoffman procedure appears to be a safe and satisfactory procedure for a rheumatoid forefoot deformity.

Clinical Study of Tuberculous Meningitis in Children (소아 결핵성 뇌막염의 임상적 고찰)

  • Kim, Woo Sik;Kim, Jong Hyun;Kim, Dong Un;Lee, Won Bae;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.64-72
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    • 1997
  • Purpose : The incidence of tuberculous meningitis in Korean children has been markedly decreased after 1980s, but this disease has still occurred with low rate. Therefore, it may be suspected that delayed diagnosis and treatment will be happened because of lacking of clinical experiences and indistinguishable other meningitis, so it is important to make early diagnosis and treatment of tuberculous meningitis concerning with the prognosis. In this aspect, we conducted study to concern and investigate sustainly about the diagnostic criteria, clinical characteristics, radiological findings, complications, and prognosis of typical or atypical tuberculous meningitis in children. Methods : Forty four children who were hospitalized and treated due to tuberculous meningitis in pediatric wards of Our Lady of Mercy Hospital, St. Holy Hospital, St. Vincent Hospital and Uijungbu St. Mary Hospital from January 1985 to June 1996 were included in this study. We reviewed medical records of these patients retrospectively. Results : 1) The tuberculous meningitis has occured continuosly since mid-1980s. The highest 2) The diagnosis was made by contact history of active tuberculous patients, positive tuberculin test, responses of antituberculous antibiotics and discovery of Mycobacterium tuberculosis from CSF or other specimens. Among patients, 7 children(16%) were not vaccinated with BCG, and only 18 children(40%) were positive in tuberculin test. 3) The symptoms and signs of our patients on initial examinations were fever, vomiting, headache, lethargy, poor feeding, weight loss, neck stiffness, convulsion, abdominal pain and motor deficits. 4) The findings of initial CSF samples revealed leukocyte $239.5/mm^3$(mean) with lymphocyte predominant, elevated protein levels(mean;259.5mg%) and low sugar level(mean;40.7mg%). And the ratio of CSF/blood sugar was 0.407. But, atypical CSF findings were seen in 31.8% patients. 5) On brain imaging study, 34 out of 39 children had findings of hydrocephalus, basilar meningeal enhancement, infarction and subarachnoidal inflammations etc. On chest X-ray, the findings of miliary tuberculosis(34.1%), normal finding(29.5%), parenchymal infiltrations (11.4%) and calcifications(9.1%) were showed. 6) In neurological clinical stage, there were twenty-six children(59%) in stage 1, fourteen children(32%) in stage 2 and four children(9%) in stage 3. The late sequeles were encountered by 29.5% with mild and 4.6% with severe neurological injury. The most common neurological injury was quadriplegia and the mortality rate was 6.8%. 7) The SIADH was developed in 20 children(45.5%) after the 4th hospital day. Half of all SIADH patients were symptomatic. Conclusion : Tuberculosis meningitis is still an important extrapulmonary disease with high morbidity and mortality. Early diagnosis with clinical contact history of active tuberculosis and radiological imaging examinations and early treatments are essential in order to prevent and decrase the rate of late sequeles and death.

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The Attitude of the Bereaved Family Attending a Bereavement Memorial Service (사별가족모임과 관련된 사별가족 태도 연구)

  • Jung, In-Soon;Shim, Byoung-Yong;Kim, Young-Seon;Lee, Ok-Kyung;Han, Sun-Ae;Shin, Ju-Hyun;Lee, Jong-Ku;Hwang, Su-Hyun;Ok, Jong-Sun;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.143-151
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    • 2005
  • Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

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Meta-analysis of Intravitreal Injection of Anti-vascular Endothelial Growth Factors for Diabetic Macular Edema (당뇨황반부종에서 항혈관성장인자의 유효성과 안전성: 네트워크 메타분석)

  • Tchoe, Hajin;Shin, Sang Jin;Suh, Jae Kyung;Cho, Songhee;Yang, Jangmi;Kang, Min Joo;Jee, Donghyun
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.2
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    • pp.144-151
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    • 2019
  • Purpose: Intravitreal aflibercept, ranibizumab, bevacizumab, and dexamethasone are the most widely used drugs in the treatment of diabetic macular edema (DME). The aim of this study was to compare the efficacy and safety of anti-vascular endothelial growth factors and dexamethasone for the treatment of DME. Methods: There were nine previous systematic reviews on this topic; we updated these high-quality reviews. Seven studies were added to two studies following a literature search. Efficacy outcomes were 1) average improvement in visual acuity, 2) proportion of patients who experienced an improvement in vision (an increase in best-corrected visual acuity (BCVA) of ${\geq}15$ in the Early Treatment Diabetic Retinopathy Study [ETDRS]), and 3) proportion of patients who experienced worsening vision (a decrease in BCVA of ${\geq}15$ in the ETDRS). Safety outcomes included systemic adverse events and ocular-related adverse events. Results: The mean difference in the BCVA for ranibizumab versus bevacizumab treatment was 0.16 (95% confidence interval [CI]: -0.02, 0.34), and that for ranibizumab versus aflibercept was -0.08 (95% CI: -0.26, 0.10). The mean difference in the change of BCVA for aflibercept versus ranibizumab was -0.20 (95% CI: -0.40, -0.01), and that for aflibercept versus bevacizumab was -0.34 (95% CI: -0.53, -0.14). Other efficacy outcomes showed similar trends, and there was no significant difference between treatments. There was also no significant difference in both systemic and ocular adverse events rates between the treatments. Conclusions: In DME patients, the efficacy of aflibercept was found to be higher with respect to BCVA changes compared with ranibizumab or bevacizumab. However, there were no significant difference in terms of visual acuity improvement or visual acuity of more than 15 letters, nor in terms of anti-vascular endothelial growth factors (as a safety outcome).

Final Impact of Anti-Vascular Endothelial Growth Factor Treatment in Age-related Macular Degeneration (연령관련황반변성 환자에서 항혈관내피성장인자의 치료 방법과 재정 영향 분석)

  • Yang, Jangmi;Shin, Sang Jin;Suh, Jae Kyung;Cho, Songhee;Tchoe, Hajin;Kang, Min Joo;Jee, Donghyun
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1039-1048
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    • 2018
  • Purpose: To evaluate the effects of anti-vascular endothelial growth factor (VEGF) treatment on the healthcare-related finances of patients with age-related macular degeneration. Methods: Changes in health care financing due to newly introduced benefit standards were predicted over the coming 5-year period (2018-2022). We also analyzed the financial impact of scenarios in which agents similar to anti-VEGF, such as the over-licensed drug bevacizumab, were introduced. For this purpose, the future number of patients receiving anti-VEGF treatments was estimated for various scenarios based on National Health Insurance Corporation claims data followed by an estimate of the financial burden. Results: In the case of age-related macular degeneration, the current standard of care (14 times in a lifetime) was maintained in scenario 1. In 2018, the insurance budget for the coming 5-year period was estimated at approximately 440.3 billion won. The insurance cost for that period was estimated at approximately 560.1 billion won under the revised standard of December 2017 (scenario 2). For scenarios wherein, after 2020, similar treatments (scenario 3) and bevacizumab (scenario 4) were introduced, the estimated health insurance costs were 521 billion won and 419.7 billion won, respectively. Conclusions: Health insurance costs are projected to increase substantially due to the elimination of the 14 time pay standard; however, the actual budget will only moderately increase, due to new limitations of visual acuity ${\leq}0.1$ or in case of scarring/atrophic lesions. Clinically similar agents and bevacizumab could be considered as alternatives to anti-VEGF treatment for age-related macular degeneration.

Deep Neck Abscesses in Korean Children (소아 심부 경부 농양에 대한 임상적 고찰)

  • Lee, Dae Hyoung;Kim, Sun Mi;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.81-89
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    • 2004
  • Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

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