Choi, Hye Sook;Hwang, Yeon Hee;Park, Myung Jae;Kang, Hong Mo
Tuberculosis and Respiratory Diseases
/
v.64
no.1
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pp.8-14
/
2008
Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.
The investigation of air fungal population in the storages to keep papers and textiles that are designated as important folk life materials or treasures was carried out from Dec. 17 to. 23, 1980. Isolation media was used for malt extract agar with chloramphnicol to prevent bacterial contamination. Isolation and identification of air fungi from the four preserved rooms were Cladosporium cladosporioides, Alternaria chlamydospora, Aspergillus fumigatus, A. versicolor, Eurotium chevalieri, Penicillium charlesii var. rapidum, P. oxalicum. P. viridicatum, Trichoderma viride, Acremomium sp., Mucor sp. and Yeast. It was found that nine species in eight genera was isolated. Among them, underscribed species in Korea was two species ; Eurotium chevalieri and Penicillium visidicatum. The fungal population of four storages was showed to be dominant species such as Cladosporium cladosporioides and the order was Acremonium, Penicillium, Aspergillus, Trichoderma, Alternaria and Eurotium. Eurotium chevalieri was ascomycetous fungi including distinctive ascospores in cleistothecia, the filamentous fungi was directly isolated from the papers and cellulose materials showing to be fourteen species in eight genera. The most species of the fungi isolated was also Cladosporium cladosporioides and the other fungi were found as Acremonium, Penicillium, Aspergillus and Trichoderma. It was confirmed that underscribed fungi were two species ; Mucor racemosus and Penicillium spinulosvm. The effect of four antifungal agents, benzoic acid, sorbic acid, dehydroacetic acid and thymol was also examined on eight species of Aspergillus, Penicillium, Cladosporium. and Tricoderma. this results were shown that more than 0.5% concentration of thymol inhibited the grow of all fungalspecies and other three chemicals appeared various inhibition zones of fungal growth depending in their different concentrations.
Background: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. Material and Method: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS blob resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mn VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. Result: The mean follow-up duration was 20,8$\pm$16.1 months in 10 mm VATS group, and 13.9 $\pm$8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax ($34\%$) in 10 mm VATS and patient's desire ($40\%$) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, $R^2$ values were lower than 0.1. The postoperative recurrence rate was $2.7\%$ in 10 mm VATS and $2.9\%$ in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. Conclusion: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.
Purpose : To analyze changes of the anterior translation, MRI findings and associated injuries at scarring of the torn ACL in the chronic ACL rupture. Materials & Method : From Dec. 1996 to May 2000, 19 patients who were diagnosed as the chronic ACL rupture were studied. We analyzed KT-2000 side to side difference of maximal manual anterior displacement(MMAD), MRI findings and associated injuries. Results : There was statistically significant difference in the average MMAD between the 7 cases$(37\%)$ with scar formation$(2.78{\pm}2.41mm)$ and the 12 cases without scarring$(5.75{\pm}2.52mm)$. The chronic ACL rupture without scarring had more meniscal injuries$(67\%)$ than with scarring$(28\%)$. MRI showed that relatively straight bands toward expected insertion site with single large fragment(5 cases) and continuous band with focal angulation(2 cases). Conclusion : If relatively straight bands toward expected insertion site with single large fragment or continuous band with focal angulation on MR imaging is showed in the patient without significant anterior translation at arthrometer, the possibility of the scar formation of the torn ACL should be considered. We think that the chronic ACL rupture with scarring had less meniscal injuries than without scarring will give additional information on the natural history of ACL injuries.
Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.
AIDS is worldwide problem. It has threatens societies and is potentially a big problem among youth. UNAIDS has warned that collective global responses are necessary; with half of the newly infected being children and young people in 1998, educating youth below age 24 is essential. Because of both their unexpected, strong sexual activities and an easjer tendency to change their behavior than adults, UNAIDS emphasizes the importance of prevention education for youth. In Korea, 4 cases of HIV infection have officially been reported among high school students. Considering the potential seriousness of HIV infection among youth, the Korean AntiAIDS Federation (KAAF) began an education programme for Korean youth (middle & high school pupils) as one intervention method in 1993. The purpose of this study is to evaluate the impact of the education programs performed and to develop a better programme. The intervention method used in this study was mainly a lecture in a big or small auditorium or through broadcasting systems using audio-visual teaching aids. The period of this survey was from Nov. 10 to Dec. 26. in 1998. The subjects surveyed were 792 pupils who were sampled from 12 different middle and high schools in Seoul by a two-stage cluster sampling. Self-recording the structured questionnaire was used for data collection. Data were analyzed by using a paired t-test to compare the knowledge difference before and after the interrention method. A chi-square test to compare the consciousness difference between pre-post-education results was used, and an ANOVA was ased to compare the knowledge difference among the selected groups. Major results of this study are summarized as follows: (1) AIDS knowledge significantly changed after AIDS prevention education. (2) The direct lecture in a big or small auditorium is more effective than an indirect lecture through a broadcasting system or through audio-visual teaching aids. (3) Those who had not seen obscene materials (e.g. pornography films, magazines etc.) acguired much more knowledge than others after AIDS prevention education. (4) Those who had no girlfriend/or boyfriend acquired much more knowledge than the others after AIDS prevention education. (5) As to the attitudes toward chastity, more girls than boys and students who had not seen obscene materials rather than those who already had were liable to support the state ment: "all should remain chase" and their consciousness on "being chaste" changed much more than that of others after intervention. (6) As to the individual evaluation of lectures, 23.1% shows "very good", 44.1% "good", 26.9% "normar" '-' thus, the positive evaluation was to 94.2%. The negative response was 5.8%. (7) As to the desire for AIDS education sponsored by KAAF in the future, more than 90.5% showed a positive reaction. (8) As to the educators in future education methods, pupils wanted lecturers from outside their schood. (9) Students from vocational high schools have seen obscene materials much more than other groups and the percentage of those who had a girlfriend/or boyfriend was higher than that of the others as wello. (10) 90% of those who watched obscene materials responded that they experienced these materials while at middle school and 100% before reaching the second grade of high school. (11) The number of boys who have experienced obscene materials is twice as many as that of girls. (12) The percentage of boys who have a girlfriend is much higher than the percentage of girls who have a boyfriend. (13) Among those who have friends of the opposite sex, 11.1% say that they hare had sexual contact and 20.8% hare experienced kissing and caressing.
Kim, Kyung-Sook;Lee, Moo-Sik;Hong, Jee-Young;Hwang, Hye-Jeong;Bae, Seok-Hwan
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.1
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pp.288-293
/
2011
This study was conducted to investigate the elementary school students' consciousness of safety, activities to prevent their accidents and factors causing such accidents. For this aim, a research was conducted from Nov. 19 through Dec. 22, 2007 by means of questionnaires distributed to 800 students enrolled in the 5th and 6th grades of 4 elementary schools in a urban-rural combined city. Out of the questionnaires distributed, 785 were collected and put to analysis by using SPSS 13.0 program to determine t-test, ANOVA, logistic regression, etc. 1. The maximum scores of safety consciousness revealing relatively high level of safety consciousness. There was, however, statistically significant difference by grade, type of residence, school life and academic achievements. In detail, 5th graders featured higher level of safety consciousness and those who live in apartments, lead a pleasant life at school and get better academic scores tended to keep higher level of safety consciousness. 2. The subjects of the high scored of activities to prevent accidents, with a statistically significant difference by gender, grade and individual personality. Females, 5th graders and active students were found to be more conscious of preventive activities for accidents. 3. In general, 6th graders and active students turned out to have experienced more accidents. 4. The main factors exerting influence on occurrence of accidents on the part of elementary school students are known to be preventive actions and consciousness of traffic safety in the category of safety consciousness. The significant variable in preventive actions was preventive actions of traffic accidents, burns and intoxication by category of accidents, but individual personality by category of general characters. Sixth graders and male students experienced more accidents, without significantly significant difference, though. As a result, From the above findings, prevention of safety accidents is found to be very important for elementary school students. It is therefore suggested that schools as well as homes should continue to conduct practical education to prevent accidents with priority placed on familiarizing students with preventive activities in daily life in consideration of their personal characters.
Purpose: The circular stapled Billroth I gastrectomy has been gradually popularized because of several advantages. Thus, this study aims to identify what to be supplemented for the safety of this technique by examining the potential complication after the circular stapled Billroth I gastrectomy. Materials and Methods: This study selected 594 patients who underwent the circular stapled Billroth I gastrectomy because of the gastric cancer in our department of surgery from Jan. 1998 to Dec. 2004 as the subjects. As of Jan. 2001 when the bleeding on the anastomosis site was visually checked through the small incision at the opposite curvature to the lesion of the stomach to be resected and so the operation was completed, the patients were divided into the Group I (n=219) and Group II (n=375), which were the patients before and after Jan. 2001, respectively. Then, the clinical characteristics and postoperative anastomotic complications of both groups were compared. Results: For the comparison of complications between two groups, the anastomotic leakage was found in four cases in Group I and three cases in Group II (p=0.196). The stenosis on the anastomosis region was not observed in both groups. The bleeding on the anastomosis region illustrates the statistically significant difference between Group I and Group II, with 43 cases and 2 cases, respectively (P=0.0019). Conclusion: The circular stapled Billroth I gastrectomy is recommended because of several advantages of this technique. However, the bleeding on the anastomosis site may be indicated as the critical issue. Accordingly, the visual check on the bleeding on the anastomosis site during the operation will improve the safety of circular stapler.
Kim, Hyun A;Chung, Ju-Young;Kim, Sang Woo;Lim, Sung Jig;Shin, Haeng Seop
Clinical and Experimental Pediatrics
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v.49
no.8
/
pp.875-881
/
2006
Purpose : The aims of this study were to analyze the clinical characteristics of children with Kikuchi's disease(KD) at a medical center and to investigate the etiologic role of human herpesvirus 8(HHV 8) or Epstein-Barr virus(EBV) in children with KD. Methods : Twenty six children who were diagnosed as KD between Jan. 1998 and Dec. 2005 were included. Medical records were reviewed on the clinical characteristics of children with KD. Follow up data were collected by chart review and telephone contact. Polymerase chain reaction(PCR) was performed in order to detect HHV 8 DNA, and in situ hybridization(ISH) was perfomed in order to detect EBV RNA from 20 lymph node tissues. Results : There were 15 girls and 11 boys with a mean age of 13 years. Posterior cervical lymph nodes were involved in 72 percent(18/25) of the patients. Extracervical lymphadenopathy was associated in one patient. Fever was an associated symptom in 31 percent(8/26) of the patients. Leukopenia was observed in six (46 percent) patients. The cervical lymphadenopathy usually resolved spontaneously within 6 months. Only one patient had a recurrence of lymphadenopathy with fever during follow-up. No children with KD in our series developed systemic lupus erythematosus. HHV 8 DNA was not amplified by nested PCR in any of the cases, and all cases were negative for EBV RNA by ISH. Conclusion : KD should be differentiated as a cause of cervical lymphadenopathy in children. HHV 8 and EBV may not play major causative roles in KD in children.
Background: A ThinPrep$^{(R)}$ Processor was developed to overcome the limitations of conventional cytology and is widely used to diagnose various cancers. This study compared the diagnostic efficacy of conventional cytology for lung cancer with that of the ThinPrep$^{(R)}$ cytology using the bronchial washing fluid. Methods: The bronchial washing fluid of 790 patients from Jan. 2002 to Dec. 2006, who were suspected of gaving a lung malignancy, was evaluated. Both ThinPrep$^{(R)}$ and conventional cytology were performed for all specimens. Result: Four hundred forty-six men and 344 women were enrolled in this study, and 197 of them were diagnosed with cancer from either a bronchoscopic biopsy or a percutaneous needle aspiration biopsy. ThinPrep$^{(R)}$ cytology showed a sensitivity, specificity, positive predictive value, negative predictive value and false negative error rate of 71.1%, 98.0%, 92.1%, 91.1%, 8.9%, respectively. The conventional cytology showed sensitivity, specificity, positive predictive value, nagative predictive value and false negative error rate of 57.9%, 98.0%, 90.5%, 87.5%, 12.5%, respectively. For central lesions, the sensitivity of conventional cytology and ThinPrep$^{(R)}$ were 70.1% and 82.8%, respectively. Conclusion: ThinPrep$^{(R)}$ cytology showed a higher sensitivity and lower false negative error rate than conventional cytology. This result was unaffected by the histological classification of lung cancer. Therefore, ThinPrep$^{(R)}$ cytology appears to be a useful method for increasing the detection rate of lung cancer in bronchial washing cytology test.
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