Purpose : Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess the adequacy of empiric antimicrobial therapy. Methods : From September 1995 to August 2003, we retrospectively evaluated 58 episodes in 39 pediatric cancer patients with bacteremia treated at the Pediatric Department of Yeungnam University Hospital. We investigated and analyzed the causative organisms and the antibiotic sensitivity test results by reviewing the records of the microbiologically proven positive blood culture results. Results : The incidence of bacteremia in pediatric cancer patients in this study was 5.7 percent (58 episodes out of 1,022 occasions of blood cultures). Gram-positive organisms were isolated more often than gram-negative organisms (63.8 percent vs 36.2 percent) in the following order : Staphylococcus epidermidis (37.9 percent), Staphylococcus aureus (17.3 percent), Escherichia coli (12 percent), Streptococcus (8.6 percent), Enterobacter (6.9 percent), Klesiella (6.9 percent), Serratia (3.5 percent), Acinetobacter (3.5 percent), Proteus (1.7 percent) and Morganella morganii (1.7 percent). In antibiotic sensitivity tests, only six of 37 isolates (16 percent) of gram positive bacteria were sensitive to penicillin and 15 of 37 isolates (40 percent) were sensitive to oxacillin. All except one Staphylococcus aureus were sensitive to vancomycin and all except one Staphylococcus epidermidis were sensitive to teicoplanin among 37 isolates of gram positive bacteria. In the case of gram negative bacteria, two of 21 isolates (10 percent) and four of 21 isolates (19 percent) were sensitive to cefotaxime and ceftazidime, respectively. Only six of 21 isolates (29 percent) were sensitive to aminoglycoside, but all 21 isolates (100 percent) were sensitive to imipenem. All seven isolates tested after the year 2000 were sensitive to meropenem. Conclusion : In conclusion, we should choose the proper antimicrobials in treating pediatric cancer patients with suspected bacteremia, reflecting the increasing episodes of gram positive bacteremia and polymicrobial resistance of gram positive and negative organisms.
Purpose : This study was designed to document the etiologies and the characteristics of parapneumonic effusion in children. Methods : During a 17-year period from 1987 to 2004, parapneumonic effusion was confirmed in 86 children at Gyeongsang National University Hospital. The clinical records of these children were reviewed and radiological findings and laboratory data, especially results of thoracentesis, were analyzed retrospectively. Results : M. pneumoniae(34 subjects) was the most common pathogen at all over age, especially above 1-years-old. There were diagnosed with clinical characteristics and serologic tests. The $2^{nd}$ most common pathogen revealed non tuberculous bacteria(14 subjects). A species of bacteria at no tuberculous bacteria revealed S. aureus(5), S. pneumoniae(3), P. aeroginosa(3), other staphylococcus (2), and K. pneumoniae(1). There were confirmed with sputum culture or pleural fluid culture or blood culture. S. aureus was most common pathogen in infants. The $3^{rd}$ common pathogen was M. tuberculosis(7). There were confirmed with skin tuberculin tests and AFB stains. Another that was classified as a non bacteria was adenovirus(2). Complications of parapneumonic effusion such as pleural thickness occurred on M. tuberculosis(1). Non tuberculous bacteria, especially S. aureus revealed a serious predominance of polymorphocyte at pleural fluid, and lowest pleural pH and glucose, and highest pleural protein and LDH. Tuberculosis revealed high pleural protein and LDH. Conclusion : Age and chemistries of pleural fluid might be helpful in differentiating various etiologies of parapneumonic effusion. If there were suspicious of tuberculosis and non-tuberculous bacteria, more aggressive approaches were needed to prevent complication.
Park, Chan-Beom;Kim, Young-Du;Choe, Mi-Sun;Jin, Ung;Moon, Seok-Whan;Kim, Yong-Han;Kim, Chi-Kyung;Jo, Keon-Hyon;Kweon, Jong-Bum
Journal of Chest Surgery
/
v.41
no.6
/
pp.687-694
/
2008
Background: Although aortic valve sclerosis causes no significant hemodynamic alterations, it is associated with an increased risk of cardiovascular death and myocardial infarction. However, the role of ${\beta}_3$ integrin in aortic valve sclerosis remains unclear. Material and Method: Twenty male New Zealand rabbits were divided into two groups. Group 1 rabbits (n=10) received a normal chow diet, while group 2 (n=10) rabbits received a diet containing 1% cholesterol for 12 weeks. After the rabbits were euthanized, their aortic valves and ascending aortas were excised for analysis. Result: Total serum cholesterol ($2,148.3{\pm}1,012.5\;mg/dL$ versus $53.7{\pm}31.8\;mg/dL$, p<0.05), triglyceride ($240.4{\pm}218.3\;mg/dL$ versus $31.6{\pm}6.4\;mg/dL$, p<0.05), and low density lipoprotein (LDL)-cholesterol($2,065.3{\pm}960.9\;mg/dL$ versus $29.1{\pm}30.9\;mg/dL$, p<0.05) levels were significantly higher in the cholesterol diet group compared with the normal diet group. Myofibroblasts and macrophages were more highly expressed in the aortic valve leaflets of rabbits in the cholesterol diet group than of those in the normal diet group. A real-time polymerase chain reaction revealed decreased ${\beta}_3$ integrin mRNA levels in the hypercholesterolemic aortic valves and aortas. Conclusion: The present study shows that hypercholesterolemia induces aortic valve sclerosis. These findings suggest that alterations in ${\beta}_3$ integrin may playa role in the development of aortic valve sclerosis.
Jang, Tae Won;Park, Jung Pil;Kim, Hee Kyoo;Ok, Chul Ho;Jeung, Tae Sig;Jung, Maan Hong
Tuberculosis and Respiratory Diseases
/
v.57
no.3
/
pp.257-264
/
2004
Background : There are many combinations of treatment for locally advanced non-small cell lung cancer (NSCLC). Recent studies have showed the efficacy of concurrent chemoradiotherapy (CCRT) in NSCLC. At present, however, there is no consensus about the optimal dosages and timing of radiation and chemotherapeutic agents. The aims of study were to determine the feasibility, toxicity, response rate, and survival rate in locally advanced NSCLC patients treated with doxetaxel and cisplatin based CCRT. Method : Sixteen patients with unresectable stage III NSCLC were evaluated from May 2000 until September 2001. Induction chemoradiotherapy consisted of 3 cycles of docetaxel (75 $mg/m^2/IV$ on day 1) and cisplatin (60 $mg/m^2/IV$ on day 1) chemotherapy every 3 weeks and concomitant hyperfractionated chest irradiation (1.15 Gy/BID, total dose of 69 Gy) in 6 weeks. Patient who had complete or partial response, and stable disease were applied consolidation chemotherapy of docetaxel and cisplatin. Results : All patients showed response to CCRT. Four patients achieved complete response (25%), partial responses in 12 patients (75%). The major common toxicities were grade III or more of neutropenia (87.3%), grade III esophagitis (68.8%), pneumonia (18.8%) and grade III radiation pneumonitis (12.5%). Thirteen patients were ceased during follow-up period. Median survival time was 19.9 months (95% CI; 4.3-39.7 months). The survival rates in one, two, and three years are 68.7%, 43.7%, and 29.1%, respectively. Local recurrence was found in 11 patients (66.8%), bone metastasis in 2, and brain metastasis in 1 patient. Conclusion : The response rate and survival time of CCRT with docetaxel/cisplatin in locally advanced NSCLC were encouraging, but treatment related toxicities were high. Further modification of therapy seems to be warranted.
The Journal of the Korean bone and joint tumor society
/
v.16
no.1
/
pp.1-7
/
2010
Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.
Do, Sung Suk;Ma, Sang Hyeok;Park, Jae Sun;Lee, Young Ho;Lee, Hwan Jong;Lee, Gyu Man
Pediatric Infection and Vaccine
/
v.5
no.2
/
pp.258-266
/
1998
Purpose : Cases of adenoviral penumonia with rapidly progressive clinical course were experienced. We reviewed these patients in viewpoint of clinical manifestation and adenoviral serotypes. Methods : Culture and indirect immunofluorescence for respiratory viruses including respiratory syncytial virus, influenza virus, parainfluenza virus, adenovirus was done with nasopharyngeal aspirates from patients who admitted due to respiratory infections in Fatima Hospital, Masan from Nov. 1996 to Jul. 1997. Cultured adenovirus was serotyped by both neutralization and hemagglutination inhibition test. Medical records were reviewed for 5 patients with respiratory failure from adenovirus was isolated and serotyped. Results : The total number of examined patients was 460 patients. We isolated respiratory viruses in 143(30.9%) patients. Adenovirus was isolated from 66 out of 143(46.2%) patients. During Jan 1997 to May 1997, five patients with ages of 18 days to 11 months who were infected by adenovirus and had high fever with dyspnea and required assisted mechanical ventilation. One patients discharged against doctor's advice then died. Two of four patients had complications of disseminated intravascular coagulation; two had bronchiolitis obliterans. Two isolates were serotype 7, and one was serotype 5, and two were untyped. Conclusion : Severe pneumonia caused by serotype 7 continued to occur in 1997 following the epidemic in 1996, and severe pneumonia may also be caused by serotype 5 and other serotypes.
Authors obtained the results of the investigation for healthy people through the routine health examination of public officers and school personnels in private schools which were conducted in 1986. The results were as follows; 1) Those who were above 20% incidence of body weight for 3917 study population were revealed 5.2% in males and 15.1% in females of $45{\sim}49$ years of age, 6.8% in males and 24,4% in females of $50{\sim}54$ years old, 5.8% in males and 13.5% in females of $55{\sim}59$ years old, and they showed that the incidences were significantly higher in females than in males at 0.01, 0.01 & 0.05 in P-values respectively. 2) Mean$\pm$SD of total cholesterol level for 3,265 healthy people with both sexes combined showed $181.63{\pm}34.67$ and it was $188.61{\pm}33.96$ in people of $40{\sim}59$ years old with both sexes combined. Mean$\pm$SD of fasting blood sugar level for 3,266 healthy people showed $87.28{\pm}11.67$ and that in $40{\sim}59$ years of age were $89.14{\pm}11.74$. Therefore, mean$\pm$2SD of total cholesterol and fasting blood sugar were $112.26{\sim}250.98mg/dl$ in males and $58.93{\sim}110.61mg/dl$ in females. 3) This investigation showed 3.0% in above 251 mg/dl of total cholesterol and 3.5% in above 111 mg/dl of fasting blood glucose. 4) Those who were above 251 mg/dl of total cholesterol and above 111 mg/dl of blood glucose in above 20% incidence of body weight according to the Broca' index were 12.9% and 7.6% respectively. 5) Those who have hypertension according to the criteria of WHO with obesity of above 20% incidence of body weight showed 8.4% in both sexes (8.2% in males and 8.7% in females). 6) Blood pressures increased according to more aging and gaining body weight.
Background : Current studies on multimodal strategy for N2 non-small cell lung cancer are being high interest, have drawn much attention. N2 lung cancer, however, is composed of is divided into several sub groups with that have different prognoses. The prognostic factors still remain controversial. Methods : Between January 1990 and June 1999, 180 patients with N2 lung cancer who underwent surgical resection were investigated, excluding 10 of these for surgical mortality. All patients underwent mediastinal lymph node dissection. 20 clinicopathologic factors were investigated by univariable and multivariable analyses to identify significant prognostic factors among resected N2 disease. Results : The overall 5-year survival rate was 20.6%. Multivariable analyses among overall patients revealed 3 significant prognostic factors : Age, Histologic type, Vascular invasion. Based on the result, 49 patients with both age more than 60 and pathologic Non-squamous cell showed a 5-year survival of 5.0%, whereas 37 patients with neither of the factors showed a 5-year survival of 56.6%(p<0.001). And 12 patients with both vascular invasion and pathologic Non-squamous cell showed a 5-year survival of 11.9%, whereas 67 patients with neither of the factors showed a 5-year survival of 33.6%(p=0.01). Conclusion : The prognosis of surgically resected N2 disease varies according to the 3 significant prognosis factors. Tumor size may be an additional influencing factor in the prognosis of N2 disease.
Journal of the Korean Society of Food Science and Nutrition
/
v.30
no.2
/
pp.350-356
/
2001
The purpose of this study is to verify the relation among vegetarian diet, physical activity and the risk factors of cardiovascular disease. Two hundred and forty five buddhist nuns (age : 23~79 yrs) were selected as vegetarians. For control subjects, 235 healthy female adults (age : 23~79 yrs) were selected. Study period was from October 1996 to February 1997. The contents are consist of food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Results were summarized as follows : The average ages of vegetarians were $44.2{\pm}17.3\;yrs$ and those of non-vegetarians were $40.5{\pm}18.4\;yrs$. Average body mass indices (BMI) of vegetarians and non-vegetarians were $22.5{\pm}2.7\;and\;21.1{\pm}2.5$, WHRs were $0.9{\pm}0.1\;and\;0.8{\pm}0.1$, and the average duration of vegetarian diet of the vegetarians was 13.1{\pm}12.9 years. All the nutrient intakes of both groups were over RDA's except calcium and vitamin A intakes of non-vegetarians that were below RDA's Fiber and vitamin C intakes of the vegetarians were significantly higher than those of non-vegetarians (p<0.01). Average energy intakes of vegetarians and non-vegetarians were $2177.1{\pm}420.6\;kcal/day\;and\;2103.2{\pm}534.9\;kcal/day$, total daily energy expenditure were $1789.9{\pm}325.8\;kcal/day\;and\;1703.8{\pm}344.8\;kcal/day$, those by physical activity were $507.8{\pm}360.9\;kcal/day\;and\;400.0{\pm}247.8\;kcal/day$. Serum lipid level, blood sugar, systolic blood pressure of vegetarians were significantly lower than those of non-vegetarians, but ratio of HDL-cholesterol/total-cholesterol was higher than those of non-vegetarians. Levels of total serum cholesterol of vegetarians and non-vegetarians were 161.4{\pm}33.3 mg/dL and 189.6{\pm}33.6mg/dL, HDL-cholesterol were $48.2{\pm}11.4\;mg/dL\;and\;50.8{\pm}12.2\;mg/dL$, LDL-cholesterol were $86.6{\pm}26.9\;mg/dL\;and\;111.1{\pm}17.0\;mg/dL$, atherogenic indice(AI) were $2.4{\pm}0.6\;and\;2.9{\pm}0.7$, fasting blood sugar were $90.8{\pm}14.3\;mg/dL\;and\;103.6{\pm}24.6\;mg/dL$, systolic blood pressure were $107.5{\pm}14.9\;mmHg\;and\;119.3{\pm}15.3\;mmHg$. Energy expenditure by physical activity was negatively correlated with levels of serum total-cholesterol and LDL-cholesterol and atherogenic indice(AI). Therefore, physical activity and vegetarian diet effectively helped reduce blood lipids related to cardiovascular disease.
The present study was carried out to investigate the acute oral toxicity and anti-obesity effects of a diglyceride preparation containing conjugated linoleic acid (DG+CLA). To test its acute oral toxicity, the DG+CLA was injected into 30 rats (15 males and 15 females) at dosage of 2,000 mg/kg and 5,000 mg/kg. Mortality rates, clinical signs, and body weight changes were monitored for 14 days following administration. According to the results, the lethal dose ($LD_50$) of DG+CLA was determined as >5,000 mg/kg in both sexes. There were no significant changes in general conditions, clinical signs, body weight, and gross lesions between the vehicle control and DG+CLA groups. For the anti-obesity studies, obese Zucker rats were randomly divided into 4 groups and fed saline, soybean oil, diglyceride, and DG+CLA, respectively, for 8 weeks. The DG+CLA groups presented significant differences in body weight, food efficiency ratio, serum lipid levels, and fat weight. Overall, the results showed that the DG+CLA did not have acute oral toxicity and reduced body weight, serum lipid levels, and fat gain.
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