Kim, Woo Jin;Lee, Hui Young;Lee, Sung Ho;Cho, Seong Joon;Park, Weon-Seo;Kim, Ja Kyoung;Lee, Seung-Joon
Tuberculosis and Respiratory Diseases
/
v.57
no.2
/
pp.138-142
/
2004
Background : To evaluate exudative pleural fluid, thoracentesis for microbiological and cytological examination and pleural biopsy by using a Cope needle are traditionally performed. Even after these studies, about 20% of patients remain undiagnosed. We evaluated the diagnostic accuracy and complications of 2-mm minithoracoscopy instead of blind biopsy in patients with undiagnosed exudative pleural effusion. Method : Fifteen patients with exudative pleural effusion underwent thoracoscopy between April 2002 and August 2003. The indication was undiagnosed pleural effusions after having performed sputum and pleural fluid exami-nations both microbiologically and cytologically. Results : The median age of the patients was 56 years (range 21-77). Pleural effusions were lymphocyte-dominant in 11 patients (73.3%) and neutrophil-dominant in 3 (20.0%). The remaining patient (6.7%) had pleural-fluid eosinophilia. Minithoracoscopic biopsy revealed accurate diagnosis in 14 patients (93.3%), consisting of tuberculous pleurisy in 8 (66.7%), malignant effusions in 4 (33.3%), and parapneumonic effusions in 2 (13.3%). One was diagnosed as having paragonimiasis from thoracoscopic findings and clinical considerations. There was no procedure-associated mortality. There were six cases of new onset fever (40%) and one of pneumothorax (6.7 %). Conclusion : Two-millimeter minithoracoscopy, which is less invasive than conventional thoracoscopy, was an accurate and safe method for undiagnosed exudative pleural effusion.
Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.
Song, Suk Ho;Hahn, Hye Sook;Kyung, Sun Young;Hwang, Jun Kyu;An, Chang Hyeok;Lim, Young Hee;Park, Gye Young;Park, Jeong Woong;Jeong, Seong Hwan
Tuberculosis and Respiratory Diseases
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v.52
no.4
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pp.330-337
/
2002
Background : A pulmonary tuberculoma is one of the most common causes of a solitary pulmonary lesion. Treating a tuberculoma is still controversial and there are few reports on antituberculosis chemotherapy. In this study, the clinical findings and changes in the size of tuberculomas on a radiograph after completing antituberculosis chemotherapy was investigated. Methods : The medical records, an chest radiographs of 18 pulmonary tuberculoma patients who were admitted to the Gachon medical school, Ghil medical center between April 1998 and August 2001, were reviewed. The symptomatic changes were recorded and the size of the tuberculomas following treatment were compared. To compare the size, the long distance of each tuberculoma on the chest radiographs were measured and the additional radiological findings of calcification, satellite nodules and cavities were investigated. Results : Fifteen patients were men and 3 were women. The median age was 46 (24-74). Among these 18 patients, 14 patients had clinical symptoms. The other 4 patients were diagnosed incidentally as during a routine chest radiograph. The mean size of the tuberculomas on the initial plain chest film was $4.3{\pm}2.3cm$(range : 1.7-10 cm) and after 6 months treatment, it had decreased to $1.68{\pm}2.00cm$(range : 1.5-6.5 cm) (P<0.05). At least 6 months of antituberculosis chemotherapy resulted in the findings of a tuberculoma with a disappearance in 9, a decreased size in 4, and no change in 5 on the chest radiograph. Calcifications were found in 3 patients on the initial chest film and the chest CT and all calcified tuberculomas had disappeared after treatment. Conclusion : Although a pulmonary tuberculoma can remain as an inactive lesion for a long time, if it is confirmed by pathological or bacteriological methods, antituberculosis chemotherapy will be beneficial despite the presence of calcification.
Kang, Min Joo;Shin, Hye Kyung;Yim, Hyung Eun;Je, Bo-Kyung;Eun, So Hee;Choi, Byung Min;Park, Jong-Tae;Eun, Baik Lin;Yoo, Kee Hwan
Clinical and Experimental Pediatrics
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v.49
no.3
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pp.278-286
/
2006
Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.
Sikhe, a traditional Korean drink, was prepared with Hovenia dulcis extract (HDE), and its quality and storage characteristics were evaluated through sensory and microbial analyses. In the color analysis, the lightness of the Sikhe showed a decreasing tendency according to the addition of HDE, while redness and yellowness increased. The Sikhe prepared with 20% HDE had the highest sugar concentration at 12days of storage ($4^{\circ}C$). Interms of sensory quality, both the 20% and 40% HDE-added Sikhes had the highest overall preference. The microbial cell counts presented no distinct differences early in the storage. period, but the general bacteria counts of the Sikhe made with the increasing concentrations of extracts decreased with a longer storage period. The coliform counts of the Sikhe prepared without HDE (control) was 10.5 CFU/g at 10 days of storage, but the 100% HDE-added Sikhe had a level of 7.9 CFU/g at 16 days of storage. These results indicates that Hovenia dulcis may inhibit normal microbial growth and extend the shelf-life on Sikhe.
Purpose : DMSA renal scan is known as a valuable method for evaluating acute pyelonephritis and renal scar in patients with febrile urinary tract infection or vesicoureteral reflux. We made this study, to determine the most effective use of DMSA renal scan. Methods : 155 children were admitted to the Pediatric Department of Yonsei University, Severance hospital with the symptom of urinary tract infection from January, 1992 to June, 1995. DMSA scan, renal ultrasound and VCUG were performed. One consisted of 29 patients with the diagnosis of acute pyelonephritis without vesicoureteral reflux and the otherconsistedofllpatientswithvesicoureteralreflux. Results : The follow-up DMSA scans at mean $0.99{\pm}0.46$ months after the initial DMSA scans were performed in the 29 children with acute pyetonephritis. 21($72.4\%$) of 29 children showed normal DMSA scans. 8 children with abnormal DMSA scans had follow-up DMSA scans at 2.5 months after the initial scans and 6 of 8 children showed normal DMSA scans. Only 12($41.4\%$) of 29 children showed abnormal renal ultrasound. The data about DMSA scans in 32 children with vesicoureteral reflux showed that there were abnormal DMSA scans in Grade $I;25.0\%$, Grade $II;44.5\%$, Grade $III;64.3\%$, Grade $IV;92.9\%$ and Grade $V;100.0\%$. There was a significant difference in that 36 renal unit ($68.0\%$) on DMSA renal scan and 26 renal units ($49.1\%$) on renal ultrasound showed abnormal finding(P<0.05). Conclusion : DMSA renal scan is more useful than renal ultrasound for the diagnosis of acute pyelonephritis. It is considered that if the initial DMSA scan is abnormal, a follow-up DMSA scan must be performed after 10weeks (8-12weeks) and the change in DMSA scan evaluated.
Kim, Young Kwang;Lee, Kyoung Hoon;Yun, Ki Wook;Lee, Mi Kyung;Lim, In Seok
Pediatric Infection and Vaccine
/
v.23
no.3
/
pp.194-201
/
2016
Purpose: Monitoring pneumococcal carriage rates is important. We developed and evaluated the accuracy of a real-time reverse transcription polymerase chain reaction (RT-PCR) protocol for the detection of Streptococcus pneumoniae. Methods: In October 2014, 157 nasopharyngeal aspirates were collected from patients aged <18 years admitted to Chung-Ang University Hospital. We developed and evaluated a real-time PCR method for detecting S. pneumoniae by comparing culture findings with the results of the real-time PCR using genomic DNA (gDNA). Of 157 samples, 20 specimens were analyzed in order to compare the results of cultures, real-time PCR, and real-time RT-PCR. Results: The concordance rate between culture findings and the results of real-time PCR was 0.922 (P<0.01, Fisher exact test). The 133 culture-negative samples were confirmed to be negative for S. pneumoniae using real-time PCR. Of the remaining 24 culture-positive samples, 21 were identified as S. pneumonia -positive using real-time PCR. The results of real-time RT-PCR and real-time PCR from 20 specimens were consistent with culture findings for all S. pneumoniae -positive samples except one. Culture and real-time RT-PCR required 26.5 and 4.5 hours to perform, respectively. Conclusions: This study established a real-time RT-PCR method for the detection of pneumococcal carriage in the nasopharynx. Real-time RT-PCR is an accurate, convenient, and time-saving method; therefore, it may be useful for collecting epidemiologic data regarding pneumococcal carriage in children.
Many BNR (Biological Nutrient Removal) plants have experienced a bulking problem, mainly due to the growth of filamentous organisms, particularly during the winter months. This study investigated the problem of bulking due to the growth of M. parvicella both at a full-scale municipal wastewater treatment plant and a pilot scale plant located in the C city. The full-scale facility was operated at a flow rate of $51,000m^3/d$, an F/M (Food-to-Microorganism) ratio of 0.12 kgBOD/kgMLVSS/d and an SRT (Solids Retention Time) higher than 25 days, respectively. This plant experienced bulking and foaming problems at low temperatures below $15^{\circ}C$ since it was retrofitted with the BNR system in 2003. The pilot plant employed had an identical process configuration as the full scale one and used the same wastewater source. It was operated at a flow rate of $3.8m^3/d$, temperatures between 10 to $25^{\circ}C$ and SRTs between 10 and 25 days. At full scale, the M. parvicella growth and SVI (Sludge Volume Index) patterns were studied in conjunction with temperature variations. At pilot scale, DO and SRT variations were also explored, in addition to the filamentous bacteria growth and SVI patterns. During the full-scale investigation, over a 3 year period, it was noted that the SVI was maintained within acceptable operational values (i.e. under 160) during the summer months. Moreover settling in the secondary clarifiers was good and was not affected by the presence of M. parvicella. In contrast, at low mean temperatures during winter, the SVI increased to over 300. Overall, as the temperature decreased, the predominance of M. parvicella became apparent. According to this study, M. parvicella growth could be controlled and SVI could drop under 160 by a change in operational conditions which involved an increase in DO concentration between 2 and 4 mg/L and a decrease in SRT to less than 20 days.
Kim, Won-Il;Jung, Hyang-Mi;Kim, Se-Ri;Park, Kyeong-Hun;Kim, Byung-Seok;Yun, Hye-Jung;Yun, Jong-Chul;Ryu, Kyoung-Yul
Journal of Food Hygiene and Safety
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v.26
no.4
/
pp.296-301
/
2011
This study was to evaluate the growth potential of E. coli O157:H7 in lettuce leaf extracts and on lettuce leaf surface at various temperatures. The pathogen can survive and multiply in the extracts and leaf surface of lettuce. The population of E. coli O157:H7 in the lettuce extracts reached to 4.79 log CFU/mL at $37^{\circ}C$. The multiplication of pathogen in lettuce extracts initiated within 10 hours of inoculation over $15^{\circ}C$ conditions. And it can survive in the lettuce leaf extracts at $4^{\circ}C$ for 100 hours at least. And this pathogen can multiply on lettuce leaf surface and the population of pathogen on the lettuce leaf surface increased to 1.82 log CFU/g at $25^{\circ}C$. At $37^{\circ}C$, the pathogen density increased to 1.53 CFU/g within 3 days after inoculation. At all temperature, irrespective of the inoculation level, similar trends in growth of E. coli O157:H7 were observed. These results emphasize the growth potential of E. coli O157:H7 in lettuce leaf extract and on lettuce leaf surface. To reduce the risk of outbreak, it is important to maintain the cold chain system during storage before the consumption.
The adsorption characteristics of sodium chloride into Ca-alginate beads have been investigated and the result were as follows: Sodium chloride uptake by Ca-alginate beads increased with time. The highest uptake volume of sodium chloride was 4.2g after 10 minutes. The uptake volume by Fe, Ca, Ba, and Sr-alginate beads was 5.6g, 4.2g, 4.2g and 4.0g, respectively but in case of Fe-alginate beads, the induced hydrogel beads were very fragile and the strength of Fe-alginate beads were weaker than Ca- and Ba-alginate beads. Mg-alginate bead was not formed and Ca-, Ba- and Sr-alginate beads had a similar uptake volume about 4.2g, respectively. The uptake volume of sodium chloride by CaCl$_2$concentration(0.1M. 0.2M and 1M), curing solution, was 4.8, 4.2g and 4.1g, respectively. The uptake volume by sodium alginate concentration(0.6%, 1% and 2%) was 2.8g, 4.0g, and 4.4g, respectively and Ca-alginate bead size was not effected in uptake sodium chloride. The uptake rate on initial sodium chloride concentration(4%, 8%, 12% and 16%) was 30%, 28%, 27% and 25%, respectively. The uptake rate on basic pH(10.0) was higher than when compared to other neutral pH(6.8) and acidic pH(4.0). The initial uptake velocity of sodium chloride from immobilization beads with salt resistant bacteria was lower than that of non-immobilization beads. The uptake rate of sodium chloride was decreased according to elongation of curing time. Reusability of Ca-alginate beads was possible but according to reutilization, the salt uptake volume of beads was also decreased. The uptake volume of sodium chloride from Doengjang by Ca-alginate beads on time course(3, 6, 12, and 24 hour) was revealed 5g, 6g, 7g and 7g, respectively.
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