• Title/Summary/Keyword: 2005년4

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The Etiologies and Initial Antimicrobial Therapy Outcomes in One Tertiary Hospital ICU-admitted Patient with Severe Community-acquired Pneumonia (국내 한 3차 병원 중환자실에 입원한 중증지역획득폐렴 환자의 원인 미생물과 경험적 항균제 치료 성적의 고찰)

  • Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.522-529
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    • 2005
  • Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

Study on Types and Counterplans of Medical Accident Experienced by Dentists in Seoul(2004) (서울특별시 개원 치과의사의 의료사고 및 분쟁의 유형과 대책에 관한 연구(2004년))

  • Yoon, Jeong-Ah;Kang, Jin-Kyu;Ahn, Hyoung-Joon;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.163-199
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    • 2005
  • Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

Growth Efficiency, Carcass Quality Characteristics and Profitability of 'High'-Market Weight Pigs ('고체중' 출하돈의 성장효율, 도체 품질 특성 및 수익성)

  • Park, M.J.;Ha, D.M.;Shin, H.W.;Lee, S.H.;Kim, W.K.;Ha, S.H.;Yang, H.S.;Jeong, J.Y.;Joo, S.T.;Lee, C.Y.
    • Journal of Animal Science and Technology
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    • v.49 no.4
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    • pp.459-470
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    • 2007
  • Domestically, finishing pigs are marketed at 110 kg on an average. However, it is thought to be feasible to increase the market weight to 120kg or greater without decreasing the carcass quality, because most domestic pigs for pork production have descended from lean-type lineages. The present study was undertaken to investigate the growth efficiency and profitability of ‘high’-market wt pigs and the physicochemical characteristics and consumers' acceptability of the high-wt carcass. A total of 96 (Yorkshire × Landrace) × Duroc-crossbred gilts and barrows were fed a finisher diet ad laibtum in 16 pens beginning from 90-kg BW, after which the animals were slaughtered at 110kg (control) or ‘high’ market wt (135 and 125kg in gilts & barrows, respectively) and their carcasses were analyzed. Average daily gain and gain:feed did not differ between the two sex or market wt groups, whereas average daily feed intake was greater in the barrow and high market wt groups than in the gilt and 110-kg market wt groups, respectively(P<0.01). Backfat thickness of the high-market wt gilts and barrows corrected for 135 and 125-kg live wt, which were 23.7 and 22.5 mm, respectively, were greater (P<0.01) than their corresponding 110-kg counterparts(19.7 & 21.1 mm). Percentages of the trimmed primal cuts per total trimmed lean (w/w), except for that of loin, differed statistically (P<0.05) between two sex or market wt groups, but their numerical differences were rather small. Crude protein content of the loin was greater in the high vs. 110-kg market group (P<0.01), but crude fat and moisture contents and other physicochemical characteristics including the color of this primal cut were not different between the two sexes or market weights. Aroma, marbling and overall acceptability scores were greater in the high vs. 110-kg market wt group in sensory evaluation for fresh loin (P<0.01); however, overall acceptabilities for cooked loin, belly and ham were not different between the two market wt groups. Marginal profits of the 135- and 125-kg high-market wt gilt and barrow relative to their corresponding 110-kg ones were approximately -35,000 and 3,500 wons per head under the current carcass grading standard and price. However, if it had not been for the upper wt limits for the A- and B-grade carcasses, marginal profits of the high market wt gilt and barrow would have amounted to 22,000 and 11,000 wons per head, respectively. In summary, 120~125-kg market pigs are likely to meet the consumers' preference better than the 110-kg ones and also bring a profit equal to or slightly greater than that of the latter even under the current carcass grading standard. Moreover, if only the upper wt limits of the A- & B-grade carcasses were removed or increased to accommodate the high-wt carcass, the optimum market weights for the gilt and barrow would fall upon their target weights of the present study, i.e. 135 and 125 kg, respectively.

Changes in Serum IGF-I and Spermatogenesis Analysed by Flow Cytometry in Growing Male Rabbit (성장 중인 수토끼에서 혈청 IGF-I 수준과 Flow Cytometry 측정에 의한 정자 형성의 변화)

  • Lee J. H.;Kim C. K.;Chang Y. M.;Ryu J. W.;Park M. Y.;Chung Y. C.;Pang M. G.
    • Reproductive and Developmental Biology
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    • v.29 no.3
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    • pp.163-168
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    • 2005
  • The aim of this study was to investigate the changes in insulin-like growth factor-I (IGF-I) and growth hormone (GH) in serum, the quantitation of spermato-genesis and the comparable relationships among these measurements during pubertal period in New Zealand White male rabbits. To investigate the age-related testicular changes in DNA contents of spermatogenic cells, the fine-needle testicular biopsies from males aged 10 to 28 wks were evaluated by flow cytometry(FCM). Body weight increased significantly between the ages of 12 and 20 wks (P<0.05) and reached 3.4 kg at 28 wks of age. The highest serum IGF-I level (451.3ng/mL) was observed at 20wks of age (P<0.05) and thereafter remained stable at low levels. Serum GH level at 18 wks of age was 183.3 pg/mL which was significantly higher compared to the other ages (P<0.05), and the rising time in serum GH tend to be somewhat earlier than that of IGF-I. The relative percentage of It-cells in testicular cell compartments was $48.2\%$ at the age of 18 wks which significantly increased than those of 16-wk-old (P<0.05) and thereafter increased with the advance of age to $68\%$. The percentage of 2C-cells in testis was $26.8\%$ at 18 wks of age which was significantly lower than $54.3\%$ at 16 wks old (P<0.05). The percentage of 4C-cells was constantly maintained $2\~6\%$ except the $9.9\%$ at 18 wks of age. In conclusion, the results suggest that the puberty onset occurred at about the 18 wks of age and that the IGF-I and GH in serum during the pubertal period showed the age/growth-specific changes and these changes might be related to the spermatogenesis. The DNA FCM combined with fine-needle testicular biopsy could offer a very sensitive method to monitor the quantitative spermatogenic events related to the puberty onset.

Assessment of Water Pollution by Discharge of Abandoned Mines (휴폐광산 지역에서 유출되는 하천수의 오염도 평가)

  • Kim Hee-Joung;Yang Jay-E.;Ok Yong-Sik;Lee Jai-Young;Park Byung-Kil;Kong Sung-Ho;Jun Sang-Ho
    • Journal of Soil and Groundwater Environment
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    • v.10 no.5
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    • pp.25-36
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    • 2005
  • Several metalliferous and coal mines, including Myungjin, Seojin and Okdong located at the upper watershed of Okdong stream, were abandoned or closed since 1988 due to the mining industry promotion policy. Thus these disposed an enormous amount of mining wastes without a proper treatment facilities, resulting in water pollution in the downstream areas. Acid mine drainage (AMD) and waste water effluents from the closed coal mines were very strongly acidic showing pH ranges of 2.7 to 4.5 and had a high level of Total Dissolved Solids (TDS) showing the ranges of 1,030 to 1,947 mg/L. Also heavy metal concentrations in these samples such as Fe, Cu, Cd and anion such as sulfate were very high. Concentrations of water soluble heavy metals in the Okdong streams were in the orders of Fe>Al>Mn>Zn>Cu>Pb>Cd, indicating Fe from the AMD and waste water effluents contributed greatly to the quality of water and soil in the lower watershed of Okdong stream. Copper concentrations in the effluents from the tile drainage of mine tailings dams were highest during the raining season. Water Pollution Index (WPI) of the surface water at the upper stream of Okdong river where AMD of the abandoned coal mines was flowed into main stream were in the ranges of 16.3 to 47.1. On the other hand, those at the mid stream where effluents from tailings dams and coal mines flowed into main stream were in the WPI ranges of 10.6 to 19.5. However, those at the lower stream were ranged from 10.6 to 14.9. These results indicated that mining wastes such as AMD and effluents from the closed mines were the major source to water pollution at the Okdong stream areas.

Study on the Community Structure of Meiofauna in Marian Cove, King George Island, Antarctica (남극 King George Islands, Marian Cove의 중형저서생물 군집 구조에 관한 연구)

  • Bang Hyun Woo;Kang Sung-Ho;Lee Wonchoel
    • Korean Journal of Environmental Biology
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    • v.23 no.2 s.58
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    • pp.191-199
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    • 2005
  • The community structure, vertical distribution and harpacticoids composition of the meiofauna community were observed from five stations in Marian Cove, King George Island and one station on the northeastern side of Nelson Island. Sample was taken by a free-fall corer in December 2002. Generally, 11 taxa of meiofauna were found, and meiofauna abundance ranged from 322 to 1575 indiv. $10cm^{-2}$ (mean 781 indiv. $10cm^{-2}$). Nematodes were the most dominant group, making up $89\%$ of total meiofauna, followed by harpacticoids $(6.8\%)$. Benthic harpacticoids appeared 19 species of nine families at all the stations, and most various taxa appeared at station B (13 species of seven families). For vertical distribution, more than $70\%$ of meiofauna was concentrated in the upper $0\~2cm$ sediment layers, and the density abruptly decreased with depth in all the stations. Total biomass of meiofauna varied between 41 and $360{\mu}gC\;10cm^{-2}$, and overall mean biomass was $205{\mu}gC\;10cm^{-2}$. Also nematodes had the highest percentage of total maiofauna biomass $(62.4\%)$. The analysis results of Canonical Correspondence Analysis between meiofauna community and sediment grain size showed that polychaets, oligochaets and cumaceans were influenced by silt&cray, and sand, granule and pebble had a influence on harpacticoids, kinorhynchs and ostracods respectively. But nematodes were not affected by sediment grain size.

Usefulness of the transcutaneous bilirubinometer during phototherapy in neonatal jaundice (신생아 황달에서 광선치료 동안에 경피적 빌리루빈 측정기의 유용성)

  • Lee, Yung Kwun;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1296-1300
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    • 2006
  • Purpose : We studied the usefulness of transcutaneous bilirubinometers in follow-up of bilirubin levels during phototherapy in neonatal jaundice patients. Methods : Transcutaneous bilirubin (TcB) was measured twice per day on 90 neonatal jaundice patients without risk factors of jaundice by transcutaneous bilirubinometer JM-103(Minolta/Hill-Rom Air-shields, Japan). TcB was measured simultaneously on the patched-forehead (TcB-PF), patchedchest(TcB-PC), unpatched-forehead (TcB-UF) and unpatched-chest (TcB-UC) of infants with neonatal jaundice. Plasma bilirubin (PB) was measured by American Optical bilirubinometer (American Optical Co, Buffalo, USA) within 30 minutes after transcutaneous bilirubinometer measurement. Each TcB was compared with PB. Results : In the study group, the mean gestational age was $38.6{\pm}1.3wk$, the mean birthweight was $3,207.0{\pm}472.1g$, the mean age at start of phototherapy was $4.9{\pm}0.9days$ and the mean duration of phototherapy was $1.3{\pm}0.6days$. The correlation between TcB and PB level was observed. The correlation between TcB of the patched part (TcB-PF, TcB-PC) and PB was more significant than that of the unpatched part (TcB-UF, TcB-UC) and PB. The most significant correlation was between PB and TcB-PC. Conclusion : TcB was useful in the follow-up of jaundice during phototherapy as well the screening of jaundice in neonatal jaundice patients. TcB of patched-chest area was the most reliable site in transcutaneous bilirubinometer examination in neonatal jaundice patients.

Gonadal Development, First Sexual Maturity and Sex Ratio of the Sun and Moon Scallop Amusium japonicum japonicum on the Coastal Waters of Jejudo, Korea (한국 제주도산 해가리비 Amusium japonicum japonicum의 생식소 발달, 군성숙도 및 성비)

  • Son, Pal-Won;Chung, Ee-Yung
    • Development and Reproduction
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    • v.9 no.2
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    • pp.95-103
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    • 2005
  • Reproductive cycle, gonadosomatic index(GSI), egg diameter composition, first sexual maturity, sexually matured length(50% of first sexual maturity), and sex ratio of Amusium japonicum japonicum, were investigated by histological observations and morphometric data. Samples were collected monthly from the subtidal zone of Sogwipo, Jejudo, Korea, for two years. The sun and moon scallop Amusium japonicum japonicum is dioecious. Monthly variation in the GSI showed similar patterns with the reproductive cycle. Ripe oocytes were about $70{\sim}90\;{\mu}m$ in diameter and had thick egg membranes. The spawning period was from November to January, and the main spawning occurred between November and December when the seawater temperature was relatively low. From monthly changes in egg diameter composition, the spawning period was once a year, although the number of spawning frequencies is assumed to occur more than twice during the spawning season. The reproductive cycle of this species could be divided into five successive stages: early active stage(April to June), late active stage(June to September), ripe stage(October to November), spawning stage(November to January), and spent/resting stage(February to April). First sexual maturities in female and male scallops ranging from 85.1 to 90.0mm in shell length were over 50% and they were 100% for scallops over 90.0mm in shell length. In this population, sexually matured shell lengths(50% of rate of group maturity) in females and males were 86.96 and 86.59mm, respectively. The female to male sex ratio among individuals over 85.1mm in shell length was not significantly different from 1:1($X^2=0.18$, p>0.05). No evidence of hermaphrodite was found in histological sections of any scallop examined.

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A Domestic Outbreak of Bacterial Dysentery Caused by Extended-Spectrum β-Lactamase(ESBL)-producing Shigella sonnei (집단 발생한 Extended-spectrum β-lactamase(ESBL) 생산 Shigella sonnei 감염에 의한 세균성 이질에 관한 연구)

  • Lim, Hyun Taek;Lee, So Hee;Lee, Jung Hwa;Kim, Jeong Eun;Kim, Kyo Sun;Jeong, Eun Ju;Lee, Seung Hyun;Kang, Chang Gyu;Hong, Seong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1107-1115
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    • 2005
  • Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

The Importance-Performance Analysis of Bakery Cafe Choice Attributes Perceived by Customers in Seoul (베이커리카페 선택속성의 중요도 및 수행도 분석: 서울지역을 중심으로)

  • Choi, Mi-Kyung;Jung, Jae-Chan
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.4
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    • pp.456-463
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    • 2006
  • The purposes of this study were to extract choice attributes of bakery cafe customers and to conduct important- performance analysis (IPA) of choice attributes perceived by bakery cafe customers. The questionnaire was developed through literature review and focus group interview, and modified after pilot test. The questionnaires for main survey were distributed to 320 males and females aged 20 and over in Seoul. A total of 275 questionnaires were used for analysis (85.9%) and the statistical analyses were conducted using SPSS Win (12.0) for descriptive analyses, exploratory factor analysis, reliability analysis, and correlation analyses. The main results were as follows. 'Products', 'convenience to use', 'services and price', 'interior environments' 'brand' and 'location' dimensions were extracted as choice attributes dimensions of bakery cafe customers and customers of bakery cafe regarded 'sanitation and cleanness', 'kindness of employees', 'quality of products', 'comfortable and pleasant facilities' and 'taste of bakery products' as more important than other attributes. In addition, the results of IPA showed that marketing managers of bakery cafes should focused on the dimension of 'services and price' in the reason that this dimension was low at performance although customers regarded it very important. Overall, researchers and managers of bakery cafes should understand unique choice attributes of bakery cafe customers, and make efforts to establish marketing strategies that meet bakery cafe customers' needs.