• Title/Summary/Keyword: 항생제 치료

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Significance of Random Urine ${\beta}_2$-Microglobulin as a Marker for Vesico-ureteral Reflux in Children with Urinary Tract Infection (요로감염 환자에서 방광요관역류의 지표로서 무작위 추출뇨중 ${\beta}_2$-microglobulin의 의의)

  • Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.72-79
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    • 1999
  • Renal scarring associated with vesico-ureteral reflux(VUR) is one of the major causes of end stage renal failure and renal hypertension in children. Urinary ${\beta}_2$-microglobulin(MG) has been suggested as a potential marker for presence of renal tubular damage. This study was designed to evaluate the significance of random urine ${\beta}_2$-MG as a predictor of presence of vesico-ureteral reflux in children with urinary tract infection(UTI). 57 children with urinary tract infection were studied. Patients were devided into two groups; 35($78.9\%$) children have UTI without VUR and 12($21.1\%$) children have UTI and VUR. Beta2-MG and creatinine in random urine sample was measured to decide the excretion ratio(${\beta}_2$-MG/creatinine). Among the 57 children with UTI, 44 children were confirmed by urine culture study and 13 children suspected by compatible clinical feature. Random urine ${\beta}_2$-MG of VUR group ($2.2{\pm}5.91$ mg/L) were significantly higher than that of simple UTI group($0.19{\pm}0.16mg/L$)(P=0.03). The ${\beta}_2$-MG/creatinine ratio of VUR group($32.41{\pm}25.7$) were significantly higher than that of simple UTI group($3.93{\pm}3.44$)(P=0.007). In conclusion, random urine ${\beta}_2$-MG and excretion ratio deserved early predictor of presence of VUR in children with UTI. And this method was more simple and inexpensive than the method of measuring ${\beta}_2$-MG with 24 hour urine collection, so might be a useful screening test for VUR in children with UTI.

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Arthroscopic Management for Pyogenic Arthritis with Positive Culture in the Knee Joint (배양 검사로 증명된 화농성 슬관절염의 관절경적 치료)

  • Baek, Seung-Hoon;Kim, Se Sik
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.167-174
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    • 2012
  • Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

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Preference and Performance Fidelity of Modified Korean Physician Order for Life-Sustaining Treatment (MK-POLST) Items in Hospice Patients with Cancer (수정된 한글 연명의료계획서(Modified Korean Physician Order for Life-Sustaining Treatment, MK-POLST) 분석을 통한 호스피스 병동 환자의 의료 중재 항목별 선호도 및 충실도 조사)

  • Han, Ji Hee;Chun, Hye Sook;Kim, Tae Hee;Kim, Rock Bum;Kim, Jung Hoon;Kang, Jung Hun
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.198-206
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    • 2019
  • Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

Longitudinal flowcytometric measurement of respiratory burst activity of neutrophils in patients with pneumonia (폐렴경과 중 순환 호중구의 Respiratory Burst 활성도 변화)

  • Lee, Jae Myung;Lee, Jong Min;Kim, Dong Gyu;Choi, Jeong Eun;Mo, Eun Kyung;Park, Myung Jae;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki-Suck;Park, Chan Jeoung
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.728-735
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    • 1996
  • Background : Recognition and ingestion of opsonized microorganisms by neutrophils induces the burst of oxidative metabolic activity. Products of the respiratory burst activity provide powerful oxygen dependent killing mechanism. Measurement of respiratory burst activity has been a major indicator of the functional capacity of neutrophils. We determined the respiratory burst activity of neutrophils in patients with pneumonia and observed the changes during the clinical course of pneumonia. Methods: The EDTA blood was drawn from 24 normal controls and same numbers of pneumonia patients. The respiratory burst activity(with the production of $H_2O_2$ which changes nonfluorescent DCF-DA to green fluorescent DCF) in the non-stimulated state and the stimulated state with fMLP and PMA of neutrophils was measured by flowcytometry at day 1, 3, 5, 7 and 9 of admission. Results: The respiratory burst activity of neutrophils was mildly increased by stimulation with fMLP. But there was no statistical significance between normal control and patients with pneumonia. The respiratory burst activity of neutrophils was markedly increased by stimulation with PMA in both groups. There was a significant difference in response to PMA between normal control and patients with pneumonia. The production of hydrogen peroxide from neutrophils was decreased during early course of pneumonia and it was recuperated gradually to normal level in 9 days. Conclusion : Hydrogen peroxide production from neutrophils was suppressed during early course of pneumonia and restored after treatment. It is suggested that the production of oxygen radical in response to PMA stimulation from each neutrophils is decreased rather than increased during the early course of pneumonia.

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A Clinical Study of Cavitary Lesions on Nondependent Region (비의존성(Nondependent) 위치의 공동성 병변에 관한 임상적 연구)

  • Moon, Soo-Nam;Kim, Do-Jin;Kim, Ki-Up;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.410-415
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    • 1993
  • Background: The lung abscess predominantly occurs on a dependent region, because its major predisposing factor is aspiration. However, a lung abscess appeared on a nondependent region occasionally. Traditionally bronchoscopy has been performed in patients with lung abscess on a nondependent region for evaluating the endobronchial obstruction such as bronchogenic carcinoma. But the clinical characteristics and necessities of bronchoscopy in patients with lung abscess located at nondependent region have not been discussed previously. Thus, we investigated the underlying etiologies and the necessities of bronchoscpy in patients with lung abscess in a nondependent region. Method: Fifteen patients with cavitary lesion on a nondependent location have been studied retrospectively by reviewing their clinical records, chest PAs, computerized tomograms, and bronchoscopic findings. Results: 1) Most patients were older than 30 years except one, and their mean age was 51 years. The ratio of male to female was 6.5:1. 2) The underlying etiologies were bacterial infections in 13 cases, and tuberculous infection in two cases. However, bronchogenic carcinoma was not found as its etiology. 3) Among thirteen bacterial lung abcess, tweleve cases located at right middle lobe. 4) The findings of bronchoscopy were non-speicifc mucosal change in 8 cases and segmental obstructions in 2 cases. There were no malignant evidences in the finings of cytology and bronchscopic biopsy. 5) Among thirteen bacterial lung abcess, eleven patients showed good clinical reponse to antibiotic therapy. Conclusion: The necessity of early bronchoscopy may need to be re-evaluated in the lung abscess on a nondependent region, unless evidences of bronchial obstruction or bronchogenic carcinoma exist. The pulmonary tuberculosis shoud be regarded as the underlying etiology of the nondependent lung abscess.

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Predictive Factors of Renal Scarring in Children with Acute Urinary Tract Infection (급성 요로감염 환아의 신장 반흔 예측요인)

  • Baik, Jun-Hyun;Park, Young-Ha;Hwang, Sung-Su;Jeon, Jung-Su;Kim, Sung-Hoon;Lee, Seong-Yong;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.245-253
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    • 2003
  • Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

The acute toxicity and efficacy evaluation against Aeromonas salmonicida of aquatic drugs oxolinic acid, neomycin-oxytetracycline, and florfenicol in guppy (Poecilia reticulata) (구피(Poecilia reticulata)에서 수산용의약품 oxolinic acid, neomycin-oxytetracycline, florfenicol의 급성독성 및 Aeromonas salmonicida에 대한 약효 평가)

  • Jun Sung Bae;Chae Won Lee;Chan Yeong Yang;Eun Ha Jeong;Areum Kim;Young-Sik Chae;Jung-Jin Park;Kwan Ha Park
    • Journal of fish pathology
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    • v.36 no.2
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    • pp.293-302
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    • 2023
  • This study evaluated the acute toxicity induced by oxolinic acid (OA), neomycin-oxytetracycline combination (NEO-OTC) and florfenicol (FF) administered to guppy (Poecilia reticulata) by comparing standard formulations with commercial preparations (COOaqua curinpotion, COOaqua terafinpotion and COOaqua profenpotion, respectively) for ornamental fish at concentrations of 2-4%. NEO-OTC exhibited the highest acute toxicity in guppy, with no difference observed between the pstandard formulation and commercial preparation (LC50 = 126.08 mg/L and 112.44 mg/L, respectively). OA acute toxicity was assessed in the form of sodium salt, with an LC50 of 504.61 mg/L for the standard formulation and a slightly increased toxicity of 316.11 mg/L for the commercial preparation. In contrast, no mortality was observed during the 96-hour exposure period with the standard formulation in the form of oxolinic acid. The acute toxicity of FF was measured to be above 1,000 mg/L for the standard formulation; however, the commercial preparation significantly increased to 158.53 mg/L. These results indicate that toxicity can significantly increase in commercial formulations, especially those with low levels of active ingredients. This is presumed to be attributed to the organic solvents or solubilizing agents present in the commercial preparations, which may enhance toxicity. Additionally, guppy infected with Aeromonas salmonicida were effectively protected against mortality by administering OA, NEO-OTC and FF at concentrations of 50 mg/L, 100 mg/L and 15 mg/L, respectively, for 2 hours and at half the dose for 24 hours. This result indicates that liquid formulations containing low concentrations of antibiotics may partially increase toxicity, but there is no problem in effectively treating diseases in ornamental fish.

[Lactic Acid Bacteria] Probiotic Lactic Acid Bacteria ([유산균] 프로바이오틱 유산균)

  • Ann, Yong-Geun
    • The Korean Journal of Food And Nutrition
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    • v.24 no.4
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    • pp.817-832
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    • 2011
  • It is said that the reason Bulgarians enjoy longevity is that they have a lot of yogurt, whose $Lactobacillus$ controls intestinal poison-producing germs. In young individuals, the number of bifidobacteria exceeds 10 billion per 1 g of intestinal content, but this number decreases for older or senile individuals, who have a larger number of harmful microorganisms such as $Clostridium$. In addition, it is well known that artificially increasing intestinal bifidobacteria can help control harmful microorganisms and thus facilitate a healthier and longer life. The microorganisms used for artificial spawn are referred to as probiotic microorganisms, and in general, lactic acid bacteria(LAB) are used. Unlike antibiotics, which kill harmful microorganisms, probiotic microorganisms coexist with and control them, while improving the health of the individual, that is, they can improve and invigorate host cells. Because probiotic microorganisms and its products based on LAB are known to help prevent and treat constipation, diarrhea, intestinal inflammation, and blood cholesterol and generally improve health through the purification of intestines, its market has been continuously expanding. Korea imports approximately 90% of spawn and uses them. It is likely that they are not appropriate for Korean's physical condition. Thus, considering this problem into account, Entecbio, a biotech firm in Korea, has produced various products by using its proprietary microorganisms. In this paper, the effects, characteristics, and kinds of products from based on proprietary microorganisms, with its prospect for market, etc., are generally examined.

Etiology of Acute Pharyngotonsillitis in Children: The Presence of Viruses and Bacteria (소아에서 급성 인두편도염의 원인에 대한 연구)

  • Pyeon, Jong Seok;Moon, Kyung Pil;Kang, Jin Han;Ma, Sang Hyuk;Bae, Song Mi
    • Pediatric Infection and Vaccine
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    • v.23 no.1
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    • pp.40-45
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    • 2016
  • Purpose: The purpose of this study was to investigate the etiology of acute pharygotonsillitis in pediatric patients. Methods: Pharyngeal swabs from patients with acute pharyngotonsillitis were evaluated for viruses and bacterial organisms from March 2010 through March 2011. Results: Of 615 patients, potentially pathogenic bacteria were isolated in 40 (6.5%), viruses were isolated in 310 (50.4%), and no pathogens were isolated in 267 patients (43.4%). Both viral and bacterial pathogens were found in 2 (0.3%). Of 40 patients with bacterial pathogens, group A streptococci were found in 31 (77.5%). Among 310 patients with virus infection, adenovirus was the most frequently recovered (203 patients; 65.5%), followed by rhinovirus (65 patients; 21.0%), enterovirus (43 patients; 13.9%) and coronavirus (18 patients; 5.8%). There were 25 patients who had been coinfected with 2 viruses. In viral pharyngotonsillitis, cough, rhinorrhea, conjunctivitis and diarrhea were prominent. On the other hand, pharyngeal injection and pharyngeal petechiae were prominent in bacterial pharyngotonsillitis. Conclusions: Virus infection was a big part of acute pharyngotonsillitis and there were differences in clinical manifestations among viral and bacterial infections. Therefore, we need to distinguish between virus infection and bacterial infection using clinical signs for preventing the abuse of antibiotics.

Tracheal Hypoplasia in 6 English Bulldogs (잉글리쉬 불독에서 발생한 기관 저형성증: 6 증례)

  • Yoon, Won-Kyoung;Ahn, Hyo-Jin;Ahn, Woonchan;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.32-35
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    • 2013
  • Six English Bull dogs from the same dog training camp were referred with main complaints of stridor, gagging and coughing. Diagnostic imaging studies on these dogs revealed hypoplastic trachea with/without bronchopneumonia. The mean age of affected dogs was $4.83{\pm}2.63$ months, while the mean body weight was $9.03{\pm}5.30$ kg. The mean ratio of the tracheal diameter to the thoracic inlet distance (TD/TI) was $0.085{\pm}0.022$ (normally 0.16 or greater), whereas the mean ratio tracheal diameter to the width of the third rib (TD/W3R) was $1.36{\pm}0.36$ (normally 2 or greater). All dogs had marked inspiratory dyspnea with variable degree of coughing. Of 6 dogs, 4 dogs had either bronchitis or bronchopneumonia. Treatment with antibiotics and bronchodilators made improvement on clinical signs on these dogs. Although some dogs still had mild inspiratory dyspnea (especially after exercise or excitement), most dogs live normally.