• Childhood Kidney Diseases
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• v.11 no.1
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• pp.41-50
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• 2007

Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.131-134
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• 2012

Purpose : The labeling efficiency of radiopharmaceuticals in nuclear medicine is important in terms of accuracy and reliability of the examination. Usually $^{99m}Tc$-HMPAO used for brain SPECT scan is chemically unstable since lots of impurities are existing. Therefore, occurrence of loss of labeling efficiency is easy to appear. In this paper, labeling and use of $^{99m}Tc$-HMPAO should be helpful through experiments on factors affecting the labeling efficiency of $^{99m}Tc$-HMPAO. Materials and Methods : Domestic HMPAO vials (Dong-A) used for brain SPECT scan were tested. Domestic Samyeong Generator 55.5 GBq (1,500 mCi), TLC measurement sets (ITLC-SG, butanone, saline, TLC chamber) and radio-TLC scanner (Advantest, Bioscan) were used. In the first experiment, after eluting generator at 1, 8, 16, 24, 28 hours apart, each eluted $^{99m}Tc$-pertechnetate were labeled with HMPAO and the labeling efficiency was measured. In the second experiment, after eluting $^{99m}Tc$-pertechnetate from a generator, $^{99m}Tc$-pertechnetate was drawn at 0, 1, 3, 6 hours. And each drawn $^{99m}Tc$-pertechnetate were labeled with HMPAO for measuring labeling efficiency. In the third experiment, labeling efficiency was measured at 0, 0.5, 3, 5, 7 hours after labeling $^{99m}Tc$-HMPAO. Results : In the first experiment, measured values were appeared 95.05, 94.64, 94.94, 95.64, 96.76% in passing order of time. In the second experiment, measured values were appeared 94.38, 94.23, 93.26, 91.03% in passing order of time. In the third experiment, measured values were appeared 95.76, 94.17, 88.19, 83.6, 76.86% in passing order of time. Conclusion : In the first experiment of this paper, labeling efficiency of $^{99m}Tc$-HMPAO labeled with $^{99m}Tc$-pertechnetate eluted after 24 hours from first elution. Additional experiments will be needed to discuss for usability. In the second experiment, the labeling efficiency was slightly decreased in chronological order, but it was measured higher than 90%. Also, additional experiments will be needed to discuss for usability. In the third experiment, the labeling efficiency was decreased considerably. Especially, within 3 hours after the labeling is recommended to use $^{99m}Tc$-HMPAO

• Journal of Plant Biotechnology
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• v.43 no.2
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• pp.213-222
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• 2016

This study aims to establish a system for the rapid discrimination of Zoysia species using metabolite fingerprinting of FT-IR spectroscopy combined with multivariate analysis. Whole cell extracts from leaves of 19 identified Zoysia japonica, 6 identified Zoysia sinica, and 38 different unidentified Zoysia species were subjected to Fourier transform infrared spectroscopy (FT-IR). PCA (principle component analysis) and PLS-DA (partial least square discriminant analysis) from FT-IR spectral data successfully divided the 25 identified turf grasses into two groups, representing good agreement with species identification using molecular markers. PC (principal component) loading values show that the $1,100{\sim}950cm^{-1}$ region of the FT-IR spectra are important for the discrimination of Zoysia species. A dendrogram based on hierarchical clustering analysis (HCA) from the PCA and PLS-DA data of turf grasses showed that turf grass samples were divided into Zoysia japonica and Zoysia sinica in a species-dependent manner. PCA and PLS-DA from FT-IR spectral data of Zoysia species identified and unidentified by molecular markers successfully divided the 49 turf grasses into Z. japonica and Z. sinica. In particular, PLS-DA and the HCA dendrogram could mostly discriminate the 47 Z. japonica grasses into two groups depending on their origins (mountainous areas and island area). Considering these results, we suggest that FT-IR fingerprinting combined with multivariate analysis could be applied to discriminate between Zoysia species as well as their geographical origins of various Zoysia species.

• Pediatric Infection and Vaccine
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• v.10 no.2
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• pp.208-214
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• 2003

Purpose : We performed a retrospective study on bacterial meningitis in children, pertaining to the causative organisms, bacterial resistance to antibiotics and the effect of recent introduction of Haemophilus influenzae type b(Hib) vaccine. Methods : We analysed the forty-three cases of bacterial meningitis which had been treated at the Inha University Hospital from June 1996 to June 2003. Results : Nineteen cases(44.2%) of them were infants younger than 2 months of age, and 29 cases(67.5%) younger than 1 year of age. The common causative organisms under 2 months of age were group B streptococcus(GBS)(47.4%), E. coli(21.1%), and Klebsiella pneumoniae(21.1%). In the age group beyond 2 months of age, S. pneumoniae were seen in 50 %, H. influenzae in 16.7% and N. meningitidis in 16.7%. All of the five cases of Hib meningitis had not been vaccinated for Hib. There has been no Hib meningitis cases since 2001. Overall fatality rate was 4.5%, and complication occurred in 39%. Complications was significantly less frequent in patients resumed to be treated within 48 hours after onset compared to after 48 hours after onset. Penicillin resistance of S. pneumoniae and GBS isolated among bacterial meningitis cases was high. Conclusion : Timing of treatment after the onset of the disease appeared the most important factor for prognosis of bacterial meningitis. The cases of H. influenzae meningitis have decreased probably due to Hib vaccination.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.36-48
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• 2010

Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

• Pediatric Infection and Vaccine
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• v.26 no.3
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• pp.148-160
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• 2019

Purpose: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU). Methods: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested. Results: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene. Conclusions: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.

• Korean Journal of Veterinary Research
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• v.42 no.2
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• pp.137-146
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• 2002

The immunohistochemical localization of the nerve growth factor (NGF), glial fibrillary acidic protein (GFAP) and ciliary neurotrophic factor (CNIF) in the developing Mongolian gerbil forebrain was investigated by the immunohistochemical and electron microscopy methods. Generally, the NGF specifically recognizes the neurons, the GFAP does the glia, and the CNIF does the motor neurons. This study demonstrates the location of the NGF, GFAP and CNTF in the developing Mongolian gerbil from the embryonic days 17 (E17) to the postnatal weeks 3 (PNW 3). The NGF was localized at E19 in the olfactocy bulb and the cerebral cortex, expanded to the hippocampus, and the diagonal bond from the late prenatal period to PNW 3. GFAP was observed in the lateral ventricle and the third ventricle at E17, projected into the cerebral cortex at E19. The GFAP was observed to have the largest numbers in several parts of the forebrain at the postnatal days 2 (PND2), while the most numerous CNTF was observed at PNW 2. The CNTF-IR cells were observed only in the postnatal days and were found in the olfactory bulb, cerebral cortex both neuron and neuroglia at PND3. Electron microscopy showed that the NGF, GFAP and CNTF were not related to any connections with any particular subcellular structure. These results suggest that NGF, GFAP and CNTF be related to the neuron and neuroglia at the prenatal and postnatal stages in the developing Mongolian gerbil.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.125-133
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• 1998

This study was designed to identify the efficiency of serum troponin-T(s-TnT) level as a diagnostic indicator for the perioperative myocardial damage with open heart surgery(OHS) and to compare with the conventional myocardial enzyme tests such as isoenzyme fraction of creatine kinase(% CK-MB) and isoenzyme ratio of lactate dehydrogenase(LDH1/LDH2 ratio). The study was performed on 30 adult patients who underwent OHS from Jan. 1996 to June 1996 at Inje University Pusan Paik Hospital, and they were divided into two groups accor- ding to aortic clamping time(ACT) duration : group I(ACT＜60 minutes, n=15); group II (ACT＞60 minutes, n=15). S-TnT, % CK-MB, and LDH1/LDH2 ratio were measured in serial blood samples from all subjected patients. The results were obtained as follows. 1. In both groups, s-TnT concentrations increased gradually during OHS and elevated significantly at CPB-10(p＜0.001). The peak level was noticed at POD 1 in group I(1.10 $\pm$0.19 ng/ml), whereas, at CPB-off in group II(1.88$\pm$0.42 ng/ml). The elevated levels remained until POD 7 in both groups. 2. %CK-MB was risen significantly with the initiation of operations(p＜0.001) and the peak levels were noticed at CPB-off in both groups(7.14$\pm$0.86% in group I, 10.69$\pm$1.27% in group II). Thereafter, these levels returned to normal values at POD 3. 3. There were no significant changes in the values of LDH1/LDH2 ratio during and after OHS compared with the control levels(p＞0.05). 4. The serial changes of s-TnT were relatively well correlated with those of changes of % CK-MB(r=0.64, p＜0.05). 5. The serial s-TnT levels were significantly higher in group II than group I from B-ACR to POD 1(p＜0.05), suggesting that duration of aortic clamping time was a major factor concerned with perioperative myocardial injury. In conclusion, measurement of s-TnT is a very useful indicator in assessing the myocardial cell damage and therefore it is expected that serial checking and evaluation of the s-TnT is very available for identification of the perioperative myocardial damage and for postoperative cares in patients with OHS.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.597-603
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• 2009

Background: Atrioventricular valve regurgitation in pediatric patients with a functional single ventricles (FSV) - has been known as one of the important risk factors for death and unfavorable long-term results after a Fontan operation. We evaluated early and mid-term results of bivalvation valvuloplasty in FSV patients. Material and Method: We retrospectively evaluated 11 patients with a functional single ventricle who underwent bivalvationvalvuloplasty between 1999 and 2007. The degree of common atrioventricular valve regurgitation (CAVVR) was determined by color Doppler echocardiography (regurgitation grade scoring, trivial; 1, mild; 2, moderate; 3, severe; 4). Mean age at valve surgery was $6.9{\pm}7.0$ months (median 4 months, 24 days$\sim$21 months)and mean body weight was $6.2{\pm}2.8\;kg$ ($3.1{\sim}11.3\;kg$). Nine patients had isomerism heart and two of them had TAPVC. The concomitant procedures were performed in all but one patient. Additional commissural closure was performed in 3 patients and commissural annuloplasty in another 3 patients. Result: There was one hospital death after. surgery. A 32-day old patient who had been preoperatively dependent on a ventilator died of air way and lung problems 4.3 months after pulmonary artery banding and bivalvation valvuloplasty. Mean follow-up duration was 40 months ($4.3{\sim}114$ months). Mean preoperative CAVVR score was $3.3{\pm}0.6$, which decreased to $1.9{\pm}0.7$ postoperatively (p<0.0001). This residual regurgitation slightly increased to $2.2{\pm}0.4$ (no statistical significance) after a mean follow-up of 1.4.3 months. Six patients (60%) required re-operations for residual regurgitation at a subsequent bidirectionalcavopulmonary shunt or Fontan operation. One patient with Ebsteinoid malformation of the right sided atrioventricular valve required valve replacement due to stenoinsufficiency. Another patient required edge-to-edge repair at the right sided AV valve (between the right mural leaflet and the bridging leaflets). The remaining 4 patients required additional suture placements between bridging leaflets with or without commissural annuloplasty. All survivor had trivial or mild CAVVR at the latest follow-up. Conclusion: Bivalvation valvuloplasty for CAVVR in FSV patients is. an effective and safe procedure. However, significant numbers of the patients have small residual regurgitation and require additional valve procedures at subsequent operations. Long-term observations to monitor progression of the CAVVR is mandatory.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.285-291
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• 2010

Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.