• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.27-33
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• 2017

Purpose: Gastrostomy is commonly used procedures to provide enteral nutrition support for severely handicapped patients. This study aimed to identify and compare outcomes and complications associated with percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG). Methods: A retrospective chart review of 51 patients who received gastrostomy in a single tertiary hospital from January 2000 to May 2016 was performed. We analyzed the patients and the complications caused by the procedures. Results: Among the 51 patients, 26 had PEG and 25 had SG. Four cases in the SG group had fundoplication for gastroesophageal reflux disease. PEG and SG groups were followed up for an average of 29 months and 44 months. Major complications occurred in 19.2% of patients in the PEG group and 20.0% in the SG group, but significant differences between the groups were not observed. Minor complications occurred in 15.4% of patients in the PEG group and 52.0% in the SG group. Minor complications were significantly lower in the PEG group than in the SG group (p=0.006). The average use of antibiotics in the PEG and SG groups was 6.2 days and 15.7 days (p=0.002). Thirteen patients died of underlying disease but not related to gastrostomy, and only one patient died due to complications associated with general anesthesia. Conclusion: The duration of antibiotics use and incidence of minor complications were significantly lower in the PEG group than those in the SG group. Early PEG could be recommended for nutritional supports.

• Neonatal Medicine
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• v.15 no.1
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• pp.54-60
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• 2008

Purpose : To set up an appropriate treatment plan for neonatal sepsis by investigating changes in pathogens and antibiotic sensitivities. Methods : The medical records of very low birth weight infants (VLBWI) admitted to the neonatal intensive care unit (NICU) of the Eulji University Hospital between January 2000 and June 2006 were retrospectively reviewed. The culture reports were analyzed for causative microorganisms and antibiotic sensitivities. Results : Among 164 neonates, 19 neonates (11.6%) had 26 episodes of culture-proven sepsis. Very late onset sepsis was the most common type. The dominant pathogens of sepsis included Klebsiella pneumoniae, Streptococcus spp., coagulase negative Staphylococcus and Enterobacter spp., and were mostly multi-drug resistant. Conclusion : For the appropriate treatment of neonatal sepsis, proper use of antibiotics through the periodic review and understanding of changes of the microorganisms and antimicrobial sensitivities is necessary to prevent multi-drug resistant microorganisms and to avoid excessive use of broad-spectrum empiric antibiotics.

• Food Science of Animal Resources
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• v.27 no.4
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• pp.517-521
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• 2007

Questionnaire on utilization of colostrum was carried out in 33 farms. Highest milking cow numbers were 20-40 heads in 45.5% of the farms. Calf numbers were 20-40 heads in 39.4% of the dairy farms and 40-60 heads in 42.4% of the farms. The amount of colostrum production per day was 20-30 kg in 30.3% of the farms and 30-40 kg in 30.3% of the farms. Colostrum intake per calf per day was 4 kg in 45.5% farms. Surplus colostrum after intake by calf was farms (85%) was wasted in 67% of the farms. More than 90% of dairy farms recognize an necessity to use surplus colostrum. Selling price of surplus colostrum was below 1,000 won per kg at 15 dairy farms and 1,000-2,000 won per kg at 4 dairy farms. Colostrum collection and use should be done by the dairy farms of antibiotics free. Quality control of colostrum should be done by testing antibiotics, microbacterium, chemical composition, somatic cells and etc. The colostrum is subjected to cool down below $4^{\circ}C$ just after milking and process for the colostrum products.

• Acute and Critical Care
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• v.33 no.4
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• pp.238-245
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• 2018

Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.623-629
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• 2006

Purpose : The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. Methods : One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. Results : The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. Conclusion : Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.203-209
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• 2010

Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.111-120
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• 2012

Purpose: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. Methods: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. Results: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). Conclusion: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.523-526
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• 2005

Purpose : Hypoalbuminemia is a rare cause of pleural effusion. The relationship between the severity of hypoalbuminemia and the clinical course of pleural effusion is unclear. The aim of this study was to evaluate the change of clinical course according to the severity of hypoalbuminemia due to pleural effusion in children. Methods : A total of 96 patients admitted to Pusan National University Hospital with pleural effusion from August 1998 to August 2004 were studied retrospectively. The 79 patients who had only infectious causes were evaluated according to their albumin levels. They were divided into the two groups : group 1 had serum albumin levels of ${\leq}2.5g/dL$; group 2 : >2.5 g/dL. The clinical courses of each group were compared. Results : The nature of pleural effusion was transudates in seven cases and exudates in 89 cases. The most commom causes of transudates were renal failure(four cases) and the most common causes of exudates were parapneumonic effusion(58 cases). There was no statistical significance in mean ages, BUN, creatinine, potassium, bilirubin and WBC in each group. Four patient in group 1 and 26 patients in group 2 improved after medication of antibiotics or anti-tuberculosis agents only. Fourteen patients in group 1 and 26 patients in group 2 improved after thoracostomy with use of antibiotics. Eight patients in group 1 and one patient in group 2 had ventilator care with use of antibiotics therapy. Conclusion : Children who were diagnosed as pleural effusion with low serum albumin levels on admission had poorer prognoses than those with normal levels. We conclude that lower serum albumin level on admission is an important prognosis factor in a patient with pleural effusion.

• Korean Journal of Poultry Science
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• v.36 no.3
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• pp.215-222
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• 2009

The objective of this study was to evaluate the effects of dietary Solanum nigrum L. (SNL) and Glycyrrhiza uralensis Fisch (GUF) mixture powder on performance and blood compositions of broilers. Seven-day old Ross broiler male chickens were randomly given into one of the 5 dietary treatments for 5 weeks: 1) no SNL-GUF and antibiotics (control); 2) 5 ppm avilamycin (T1); 3) 0.5% SNL and GUF (T2); 4) 1.0% SNL and GUF (T3); and 5) 2.0% SNL and GUF (T4). Each dietary group (n = 10) had three replicates. Body weight gain, feed intake and feed conversion ratio of broiler chickens were not significantly different among treatments. Carcass weight was highest at both 4 (P<0.05) and 6 weeks (P>0.05) in the treatment with 1.0% SNL and GUF. Liver, but not Spleen, weights at both 4 and 6 weeks were significantly higher in the treatments with 0.5% SNL and GUF treatment (P<0.05). The contents of protein, albumin, bilirubin, glutamic-oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), glucose, triglyceride (TG) and cholesterol in blood serum at the 4weeks and 6 weeks were not significantly influenced. These results suggest that addition of SNL and GUF could be use a substitutes for antibiotics since they did not influence to the productivity and the blood composition of the broilers.

• Fisheries and Aquatic Sciences
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• v.22 no.12
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• pp.30.1-30.11
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• 2019

Marine natural products isolated from the sponge Fascaplysinopsis cf reticulata, in French Polynesia, were investigated as an alternative to antibiotics to control pathogens in aquaculture. The overuse of antibiotics in aquaculture is largely considered to be an environmental pollution, because it supports the transfer of antibiotic resistance genes within the aquatic environment. One environmentally friendly alternative to antibiotics is the use of quorum sensing inhibitors (QSIs). Quorum sensing (QS) is a regulatory mechanism in bacteria which control virulence factors through the secretion of autoinducers (AIs), such as acyl-homoserine lactone (AHL) in gram-negative bacteria. Vibrio harveyi QS is controlled through three parallel pathways: HAI-1, AI-2, and CAI-1. Bioassay-guided purification of F. cf reticulata extract was conducted on two bacterial species, i.e., Tenacibaculum maritimum and V. harveyi for antibiotic and QS inhibition bioactivities. Toxicity bioassay of fractions was also evaluated on the freshwater fish Poecilia reticulata and the marine fish Acanthurus triostegus. Cyclohexanic and dichloromethane fractions of F. cf reticulata exhibited QS inhibition on V. harveyi and antibiotic bioactivities on V. harveyi and T. maritimum, respectively. Palauolide (1) and fascaplysin (2) were purified as major molecules from the cyclohexanic and dichloromethane fractions, respectively. Palauolide inhibited QS of V. harveyi through HAI-1 QS pathway at 50 ㎍ ml^-1 (26 μM), while fascaplysin affected the bacterial growth of V. harveyi (50 ㎍ ml^-1) and T. maritimum (0.25 ㎍). The toxicity of fascaplysin-enriched fraction (FEF) was evaluated and exhibited a toxic effect against fish at 50 ㎍ ml^-1. This study demonstrated for the first time the QSI potential of palauolide (1). Future research may assess the toxicity of both the cyclohexanic fraction of the sponge and palauolide (1) on fish, to confirm their potential as alternative to antibiotics in fish farming.