Purpose : Multiple transfusions in patients with chronic anemia can result in excessive iron deposition in tissues and organs. Effective iron chelation therapy in chronically transfused patients can only be achieved when iron chelators remove sufficient amounts of iron equivalent to those accumulated in the body from transfusions, thus leading to maintain body iron load at a non-toxic level. This study was retrospectively carried out to investigate the effect of intravenous iron chelation therapy with deferoxamine in patients who have received multiple transfusions. Methods : From March 2005 to January 2007, 15 patients who have received multiple transfusions were included in this study. Transfusion dependent patients were defined as those receiving >1 packed red blood cell (RBC) units/month for at least 6 months. They received intravenous deferoxamine for 7 days (10-30 mg/kg/day, 24 hour continuous infusions). Before and after deferoxamine infusions and 3 months later, we compared serum iron, TIBC, and ferritin in transfusion dependent patients and transfusion independent patients. Results : There were 6 males and 9 females and their age range was 5.6-21.3 (median 8.3) years. Transfusion dependent patients were 7 and 8 were transfusion independent states after stem cell transplantation or chemotherapy. There was no significant change in ferritin level after deferoxamine treatment for the transfusion dependent patients but significant falling of ferritin level was observed for the transfusion independent patients 3 months later compared with baseline ferritin level (P=0.046). Some adverse events were observed but symptoms were mild and tolerable. Conclusion : Seven days of intravenous deferoxamine was safe and effective in transfusion independent patients. In transfusion dependent patients, chelation therapy should be maintained, in order to minimize or prevent iron accumulation and storage in the tissues.
Two experiments were conducted to determine the effects of deletion of vitamin and trace mineral premixes on growth, feed efficiency, backfat thickness, hemoglobin content, muscle vitamin E content, and fecal, serum and muscle trace mineral contents in finishing pigs raised under two different housing conditions. In Exp. 1, three pens (or experimental units) of five pigs each (average weight $\pm$ s.e., 70 $\pm$ 0.5 kg) were assigned to a control diet (with vitamin and trace mineral premixes) or diets with 50 or 100% of the premixes deleted. Pigs were fed to market weight under sub-optimal housing conditions with sawdust-covered concrete floor and no electrical ventilation. In Exp. 2, three pens of four pigs each (average weight $\pm$ s.e., 56 $\pm$ 1.1 kg) were assigned to a control (with vitamin and trace mineral premixes), Diet-P (100% of the premixes deleted) or Diet-P+E (Diet-P plus 100 mg $\alpha$-tocopherol acetate/kg diet fed for the last 2 wk before slaughter). Pigs were fed to market weight under optimal housing conditions with 70%-slatted concrete floor, electrical ventilation and temperature control. No significant differences were found in average daily gain (ADG), average daily feed intake (ADFI), and gain/feed among treatments in both experiments, but in Exp. 2 done with younger pigs, ADG and ADFI tended to be higher in the control group than in pigs fed diet without premixes. Hemoglobin content, hematocrit and red blood cell count were not influenced by the deletion of premixes. Backfat thickness was not different among treatments. Fecal Mn (twofold) and Zn (threefold) contents were higher in the control than in pigs fed diets without the premixes. Serum trace mineral contents were not influenced by diets. $\alpha$-Tocopherol content in gluteus maxima was decreased (P< 0.01) by deleting the dietary premixes, but increased to the level higher than the control by adding 100 mg $\alpha$-tocopheryl acetate/kg diet fed for the last 2 wk before slaughter. Results indicate that: 1) supplementary vitamins and trace minerals may not be necessary for optimum growth in finishing pigs, and 2) deletion of the dietary premixes reduces muscle vitamin E content, but the reduced content can be reversed by adding $\alpha$- tocopherol to diets fed for the last 2 wk before slaughter. The deletion may help to alleviate the environmental load of certain minerals from manure.
Purpose : Certain strains of lactobacilli are known to accelerate recovery from acute diarrhea. Lactobacillus reuteri is isolated from human breast milk and a commonly occurring Lactobacillus species with therapeutic potential in acute diarrhea. The purpose of the present study was to investigate the therapeutic effect of L. reuteri in acute diarrhea in young children. Methods : Fifty patients between 6 and 36 months of age hospitalized with acute diarrhea (rotavirus in 40 percent) were randomized into two groups to receive either $10^8$ colony-forming units of L. reuteri or a matching placebo, twice a day for their length of hospitalization, or for up to 5 days. Antidiarrheal drugs were not prescribed to either group. The clinical outcome of diarrhea was evaluated. Results : The mean duration of watery diarrhea after initiation of treatment was 2.3 days for the L. leuteri group(n=25) vs. 2.9 days for the placebo group(n=25)(P=0.072). By the second day of treatment, watery diarrhea persisted in 64 percent of patients receiving L. reuteri, compared to 84 percent of those receiving placebo(P=0.006). On the second day, the mean frequency of watery diarrhea was 1.9 in the L. leuteri group and 3.4 in the placebo(P=0.046). Also, vomiting continued to the second day in 16 percent of patients receiving L. reuteri and 40 percent of those recieving placebo(P=0.031). Conclusion : L. reuteri is effective as a therapeutic agent in acute diarrhea in children.
Kwon, Hye Jung;Kim, So Youn;Cho, Chang Yee;Choi, Young Youn;Shin, Jong Hee;Suh, Soon Pal
Clinical and Experimental Pediatrics
/
v.45
no.6
/
pp.719-726
/
2002
Purpose : Neonates in neonatal intensive care units(NICU) have a high risk of acquiring nosocomial infection because of their impaired host defence mechanism and invasive procedures. Nosocomial infection result in considerable morbidity and mortality among neonates. This study was carried out to survey both the epidemiology of nosocomial infection in our NICU and the annual trends of pathogens. Methods : We retrospectively reviewed culture proven nosocomial infection which occurred in our NICU from January 1995 to December 1999. The data included clinical characteristics, site of infection, pathogens, and mortality. Results : Nosocomial infection rates was 9.0 per 100 NICU admissions during the five-year period. Major sites of infection were bloodstream(32.3%), skin(18.4%), endotracheal tube(17.2%), and catheter(10.6%). The most common pathogen was S. aureus(29.9%). and the others were coagulase- negative staphylococci(CONS)(14.8%), Enterobacter(12.4%), and Candida(9.0%). During the five-year period, nosocomial infection rates increased from 9.5 to 11.6 per 100 admissions with the increase of CONS, Candida, Klebsiella, and Acinetobacter baumannii. The infection rate of S. aureus decreased. Multiple episodes of nosocomial infection occurred in 26.1% of all nosocomial infections. Overall bloodstream infection rates were 3.6 per 100 NICU admissions during five years. CONS(29.1%) and S. aureus(27.1%) were the two most common pathogens. Increasing rates of bloodstream infection by CONS, Candida, Klebsiella, and Acinetobacter baumannii were observed. Bloodstream infection related mortality was 11.9%. Conclusion : The predominant pathogens of nosocomial infection in NICU were S. aureus and CONS. Bloodstream infection, the most frequent nosocomial infection, should be a major focus of surveillance and prevention efforts in NICU.
Kim, Byeong-Hak;Park, Jung Jun;Son, Maeng-Hyun;Kim, Tae-Ik;Lee, Si-Woo
The Korean Journal of Malacology
/
v.32
no.2
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pp.95-102
/
2016
This study investigated the growth characteristics of juvenile abalone when has been rearing as other different feed rates by the commercial abalone formulated feed on indoor tank, during the winter period that was maintaining on the low water temperature. Experimental abalones were use to 1 year old (shell length $29.14{\pm}2.56mm$, wet weight $2.9{\pm}0.6g$), and it has cultured at six feeding rate groups (0.75 DFW, 1.50 DFW, 2.25 DFW, 3.00 DFW, 3.75 DFW, 4.5 DFW) that were set up the daily feeding rate about total weight (DFW), and two replicated. The average water temperature in the experiment period was $9.7{\pm}3.27^{\circ}C$. In the monthly change absolute growth rate (AGRSL) and specific growth (SGRSL) of shell length, at January, 3.00 DFW was significantly higher than all feeding rate groups (P < 0.05). And in the monthly change of weight change and weight gain (WG), at March, 3.75DFW was significantly higher than all feeing rate groups (P < 0.05). The growth coefficient of thermal units (TGC) was decreased rapid since January, and 3.75 DFW was show significantly higher than all feeding rate groups (P < 0.05). In monthly change of feed efficiency (FE), at December, the 0.75 DFW was significantly higher than all feeding rate groups (P < 0.05), and in February and March, there was no significant difference between all feeding period. Therefore, In this study, was show that juvenile abalones can do to maintain or increasing from weight to supply commercial artificial diet during winter period when rearing into the indoor tank.
Yoon, Hoe-Soo;Yum, Mi Sun;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Yoon, Chong Hyun;Moon, Dae Hyuk;Hahn, Hyewon
Clinical and Experimental Pediatrics
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v.49
no.1
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pp.64-70
/
2006
Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.
Eun, Byung Wook;Chung, Yoo Mi;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il;Lee, Hoan Jong;Choi, Yong
Clinical and Experimental Pediatrics
/
v.46
no.3
/
pp.265-270
/
2003
Purpose : To characterize the infants under 3 months of age with urinary tract infections(UTIs), and especially patients with bacteremia or meningitis Methods : Hospital records of all the infants under 3 months of age discharged from our hospital for 69 consecutive months with the diagnosis of initial episode of UTI were reviewed. UTI was defined when patients had fever with pyuria, and had urine culture results of ${\geq}10^5$ colony forming units/mL from a bag specimen. Patients with previously known urologic abnormality or immunodeficiency were excluded. Nosocomial infections were also excluded from the study. Results : The male:female ratio was 35 : 6. Of the urine cultures, 40(97.6%) yielded single pathogen, one yielded two pathogens. Escherichia coli was the predominant isolate from the urine. Five patients(12%) also had bacteremia. Pathogens isolated from the blood cultures were E. coli(4) and Enterococcus faecalis(1). No patient had culture-positive meningitis or cerebrospinal fluid pleocytosis. Clinical or laboratory findings between patients with and without bacteremia were not different significantly. The rate of vesicoureteral reflux(VUR) was 44%. The sensitivity of ultrasound for detection of VUR was 38%; specificity was 50%. Conclusion : Clinical and laboratory data were not helpful for identifying patients with bacteremia at the time of presentation. Consequently, blood cultures need to be obtained from all febrile infants under 3 months of age with UTIs. A large-scale study including the indication of lumbar puncture for infants with a febrile UTI and study of evaluation and treatment of infants under 3 months of age with UTIs are required.
Kim, Bo Eun;Ha, Eun Ju;Bae, Keun Wook;Kim, Seon Guk;Im, Ho Joon;Seo, Jong Jin;Park, Seong Jong
Clinical and Experimental Pediatrics
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v.52
no.10
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pp.1153-1160
/
2009
Purpose:To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods:We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal care were excluded. Results:Total 88 patients were analyzed. Overall ICU mortality rate was 34.1%. Mean age at PICU admission was $7.0{\pm}5.7$ years and mean duration of PICU stay was $18.1{\pm}22.2$ days. Hematologic diseases contributed to 77.3% of all the primary diagnoses, and the primary cause of admission was respiratory failure (39.8%). The factors related to increased mortality were C-reactive protein level (P<0.01), ventilation or dialysis requirement (P<0.01), and hematopoietic stem cell transplantation (P<0.05). In all, 3 scoring systems were investigated [Number of Organ System Failures (OSF number), the Pediatric Risk of Mortality III (PRISM III) score, and the Sequential Organ Failure Assessment (SOFA) score]; higher score correlated with worse outcome (P<0.01). The Oncological Pediatric Risk of Mortality (O-PRISM) scores of the 21 patients who had received hematopoietic stem cell transplantation were higher among the non-survivors, but not statistically significant (P=0.203). Conclusion:The PRISM III and SOFA scores obtained within 24 hours of PICU admission were found to be useful as early mortality predictors. The highest OSF number during the PICU stay was closely related to poor outcome.
Purpose: The purpose of this study was to observe the change of viscoelastic properties of dental resin cements during polymerization. Materials and methods: Six commercially available resin cement materials (Clearfil SA luting, Panavia F 2.0, Zirconite, Variolink N, RelyX Unicem clicker, RelyX U200) were investigated in this study. A dynamic oscillation-time sweep test was performed with AR1500 stress controlled rheometer at $32^{\circ}C$. The changes in shear storage modulus (G'), shear loss modulus (G"), loss tangent (tan ${\delta}$) and displacement were measured for twenty minutes and repeated three times for each material. The data were analyzed using one-way ANOVA and Tukey's post hoc test (${\alpha}$=0.05). Results: After mixing, all materials demonstrated an increase in G' with time, reaching the plateau in the end. RelyX U200 demonstrated the highest G' value, while RelyX Unicem (clicker type) and Variolink N demonstrated the lowest G' value at the end of experimental time. Tan ${\delta}$was maintained at some level and reached the zero at the starting point where G' began to increase. The tan ${\delta}$and displacement of the tested materials showed similar pattern in the graph within change of time. The displacement of all 6 materials approached to zero within 6 minutes. Conclusion: Compared to other resin cements used in this study, RelyX U200 maintained plastic property for a longer period of time. When it completed the curing process, RelyX U200 had the highest stiffness. It is convenient for clinicians to cement multiple units of dental prostheses simultaneously.
Kim, Young-Deuk;Han, Myung-Ki;Kim, Ai-Rhan E.;Kim, Ki-Soo;Pi, Soo-Young
Clinical and Experimental Pediatrics
/
v.49
no.8
/
pp.857-863
/
2006
Purpose : To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. Methods : A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. Results : The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. Conclusion : Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.
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