• Childhood Kidney Diseases
• /
• v.10 no.2
• /
• pp.192-200
• /
• 2006

Purpose : This study was performed to identify longitudinal changes in the prevalence of organisms isolated from urinary tract infection(UTI) and in the pattern of Escherichia coli susceptibility to antibiotics during the past 10 years in children with UTI. Methods : We performed a retrospective study of a total of 192 urine cultures from children with UTI in the Department of Pediatrics, Seoul Adventist Hospital over two periods(1st: 1995-2000, 2nd:2001-2005). Antimicrobial susceptibility of the isolates was compared between the two groups. Results : The pathogens of UTI in the two groups were similar. In the first period, E. coli was the leading uropathogen(66.2%) followed by Klebsiella pneumoniae(7.8%), Enterobacter cloacae(6.5%), and others(19.5%). In the second period, E. coli was the leading uropathogen(67%) followed by K. pneumoniae(12.2%), E. cloacae(3.5%), Enterobacter aerogenes(3.5%), and others(13.8%). The susceptibility pattern of E. coli to amoxicillin/clavulanate(87.5%, 81.0%) did not present any statistically significant difference between the two periods(P>0.05). The susceptibility of E. coli to TMP/SMX(52.4%, 50.0%) was still low with no significant difference between the two periods(P>0.05). Conclusion : Our results suggest that the use of amoxicillin/clavulanate is still an excellent therapeutic option in children with UTI. The low rate of susceptibility to TMP/SMX against uropathogens suggest that TMP/SMX may be reevaluated as the first-line therapeutic drug for UTI.

• Journal of Korean Medical classics
• /
• v.26 no.2
• /
• pp.47-59
• /
• 2013

Objective : Syndrome differentiation(辨證) has clinical importance in East Asian Traditional Medicine. There are several ways for Syndrome differentiation. However, Eight Principle Pattern Identification(八綱辨證) is the base of other Syndrome differentiations. Of the physicians focused on Eight Principle Patterns(八綱), I have researched for Eight Principle Pattern Identification concerning with Zhang Jie-Bin(張介賓), Cheng Guo-Peng(程國彭), and Jiang Han-Tun(江涵暾) in Ming(明) and Qing(淸.) Method : Applying to Eight Principle Pattern Identification, I have researched comparatively for 3 kinds for. First, Zhang Jie-Bin's Jingyuequanshu(景岳全書) that involves Yinyangpian(陰陽篇), Liubianbian(六變辨), Biaozhengpian(表證篇), Lizhengpian(裏證篇), Xushipian(虛實篇), and Hanrepian(寒熱篇), secondly, Cheng Guo-Peng's Yixuexinwu(醫學心悟) Hanrexushibiaoliyinyangbian(寒熱虛實表裏陰陽辨), at lastly Jiang Han-Tun's Bihuayijing(筆花醫鏡) Biaolixushihanreyinyangbian(表裏虛實寒熱辨). Results : All of sick cases can be explained totally by Eight Principle Patterns. Of Eight Principle Patterns, Yin(陰) and Yang(陽) include last Six Principle Patterns(六綱 : 表裏, 寒熱, 虛實). Six Principle Patterns can be divided normally by 6 pulses(六脈 : 浮沈 遲數 虛實). In all of pain cases, feeling comfortable(可按) or discomfortable(拒按) to palpation can be important foundation for distinguishing Xu(虛) from Shi(實). Physical constitution(體質) for Hanre Xushi(寒熱 虛實) and tongue-diagnosis(舌診) for Biaoli Hanre(表裏 寒熱) are used effectively. Related with tongue-diagnosis, tongue-coating(舌苔) for Biaoli and tongue status(舌質) for Hanre are used effectively. Symptoms should be divided following this sequence, Biaoli ${\rightarrow}$ Hanre ${\rightarrow}$ Xushi and lastly should be summarized of Yinyang. Conclusion : Diagnosing with Eight Principle Patterns, digestive function, urine, and feces should be checked at first. In addition, the pulse, tongue, physical constitution, and good or bad from palpation(觸診), these should be checked and give a result. And then the result can be an important evidence of syndrome differentiation. As a result, it would be the best to diagnosis that discriminating the sequence as Biaoli Hanre Xushi and summarizing with Yinyang.

• Journal of Korean Biological Nursing Science
• /
• v.3 no.2
• /
• pp.51-61
• /
• 2001

This study was done to investigate the effect of the first experience of the clinical experience for psychiatric nursing on urinary $Na^+$, $Cl^-$, $K^+$, $Ca^{++}$ of the nursing students. We analyzed the urine of 36 students on curriculum who were students of D college in K city. The data were analyzed with SAS Statistical analysis was performed by using paired t-test, GLM. The second day group increased 18.56 at 8AM, 31.90 at 4PM in case of $Na^+$(p=0.004). The second day group increased 27.61 at 8AM, 45.53 at 4PM in a case of $Cl^-$(p=0.009). The first day group increased 2.62 at 8AM, 7.09 at 4PM in case of $K^+$(p=0.018). The second day group increased 3.69 at 8AM, 5.19 at 4PM in a case of $K^+$(p=0.013). The second day group increased 20.65 at 8AM, 14.07 at 4PM in a case of $Ca^{++}$(p=0.033). There was a significant difference in $Na^+$ according to group at 8AM(F=4.17, p=0.024) and 4PM(F=3.58, p=0.040). There was a significant difference in $Cl^-$ according to group at 8AM(F=4.38, p=0.020) and 4PM(F=6.29, p=0.003). There was a significant difference in $K^+$ according to group at 8AM(F=5.03, p=0.012). In conclusion, $Na^+$, $Cl^-$, $K^+$, $Ca^{++}$ may be used as a indicator of the amount of stress to improve the educational environment for the students.

• Journal of Yeungnam Medical Science
• /
• v.29 no.2
• /
• pp.102-105
• /
• 2012

Collapsing glomerulopathy (CG) has become an important cause of end-stage renal disease (ESRD). First delineated from other proteinuric glomerular lesions in the 1980s, CG is now recognized as a common, distinct pattern of proliferative parenchymal injury that portends a rapid loss of renal function and poor responses to empirical therapy. The first cases in the literature trace back to human-immunodeficiency-virus(HIV)-negative patients who underwent biopsy in 1979. A 45-year-old male patient complained of hematuria and proteinuria eight years ago. He showed an abrupt serum creatinine increase from 1.75 to 2.65 mg/dL in the last preceding months. Afterwards, his serum creatinine progressively increased up to 6.82 mg/dL. Moreover, his 24 h urine protein level was determined to have reached 6,171 mg/day, as opposed to 670 mg/day a year earlier. Consequently, renal biopsy was performed, and its result showed collapsing glomerulopathy, compatible with the diagnosis. He has undergone continuous ambulatory peritoneal dialysis as renal replacement therapy. Thus, it is reported herein that a patient clinically diagnosed with chronic kidney disease eight years ago showed a sudden renal-function decrease and was clinicopathologically diagnosed with collapsing glomerulopathy based on the results of his renal biopsy.

• Biomedical Science Letters
• /
• v.7 no.3
• /
• pp.117-125
• /
• 2001

This study was performed in order to evaluate the risk factors for nosocomial urinary tract infection and the frequencies of organisms isolated, and to provide the epidemiologic and basic data of hospital acquired urinary tract infection in intensive care unit. A prospective analysis was performed with 1,235 urine samples following urinary bladder catheterization in 569 patients, who had no evidence of UTI at the time of catheter insertion, admitted to intensive care unit in Pusan P hospital between June 1997 and May 1998. To identify risk factors for UTI, clinical characteristics of infected patients were analyzed. We analyzed these data by percentage, chi-square and odd ratio. Obtained results were as follows: A total of 569 patients (male 341 and female 228) were an average age of 50.8 years and catheterization of 8.04 days. Incidence of UTI was 16.1% (199/1,235) and The risk factors of UTI were duration of catheterization over 7 days, no use of systemic antibiotics, summer and female, and During the first 7 days these risk factors were no use of systemic antibiotics, summer, place of first catheter insertion (ICU) and type of intensive care unit (NSICU). A total of 220 the isolated strains were Gram negative rod 83 (37.7%), yeast like fungi 74 (33.6%) and Gram positive cocci 63 (28.6%). The common organisms isolated were Enterococcus faecalis 23 (10.5%), Serratia marcescens 19 (8.6%), Pseudomonu spp.17 (7.7%), E. ooh 16 (7.3%), Staphylococcus epidemidis 11 (5.0%) mdklebsiellapneumoniae 8 (3.6%). Therefore, in these results 199 of 569 (35%) patients in ICU with indwelling urinary catheter developed UTI. The risk factors for UTI are prolonged duration of catheterization, no use of systemic antibiotics, summer, and female.

• The Journal of the Korean Society for Microbiology
• /
• v.19 no.1
• /
• pp.1-10
• /
• 1984

The occurrence of Hemorrhagic fever with renal syndrome was noted for the first time among the United Nations troops in Korea in 1951. In 1976, Lee and Lee demonstrated for the first time an antigen in the lungs of a striped field mouse, Apodemus agrarius, which gave specific immunofluorescent reactions with sera from patients convalescent from Korean hemorrhagic feve (KHF). The natural reservoir host of KHF is Apodemus agrarius coreae mice in rural endemic areas in Korea. Clinical manifestations of acute illness do not occur in infected Apodemus agrarius. Infected rodents excrete large amounts of virus in saliva, in urine and in feces for a long period of time. In this study, the tissues of Apodemus agrarius, Wistar rat and Balb/C mouse were inoculated with Hantaan virus and subsequently observed for any histopathologic findings. 1. In lungs, infiltration of lymphocytes in alveolar septa and peribronchial region and thickening of and giant cell formation in alveolar septa were observed. 2. In kidney, vascular congestion, interstitial hemorrhage in corticomedullary junction and partial microscopic hemorrhage in urinary space were found. 3. In spleens, vascular congestion, old and recent hemorrhage and multinucleated giant cell formation were seen.

• Journal of Korean Medical Science
• /
• v.33 no.51
• /
• pp.324.1-324.6
• /
• 2018

Oxysterol $7{\alpha}$-hydroxylase deficiency is a very rare liver disease categorized as inborn errors of bile acid synthesis, caused by CYP7B1 mutations. As it may cause rapid progression to end-stage liver disease even in early infancy, a high index of suspicion is required to prevent fatal outcomes. We describe the case of a 3-month-old boy with progressive cholestatic hepatitis and severe hepatic fibrosis. After excluding other etiologies for his early liver failure, we found that he had profuse urinary excretion of $3{\beta}$-monohydroxy-${\Delta}^5$-bile acid derivatives by gas chromatography/mass spectrometry analysis with dried urine spots on filter paper. He was confirmed to have a compound heterozygous mutation (p.Arg388Ter and p.Tyr469IlefsX5) of the CYP7B1 gene. After undergoing liver transplantation (LT) from his mother at 4 months of age, his deteriorated liver function completely normalized, and he had normal growth and development until the current follow-up at 33 months of age. We report the first Korean case of oxysterol $7{\alpha}$-hydroxylase deficiency in the youngest infant reported to undergo successful living donor LT to date.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.6 no.2
• /
• pp.134-137
• /
• 2008

Methylene blue is the first choice for treating methemoglobinemia, any increase in normal methemoglobin levels. Methemoglobin is an abnormal hemoglobin in which the iron has been oxidized to the ferric(+3) state, making it incapable of oxygen transport. Methemoglobinemia most commonly results from exposure to oxidizing chemicals, but may also arise form genetic, dietary, or even idiopathic etiologies. Patients with low methemoglobin levels are asymptomatic, but high methemoglobin levels can lead to headaches or even death. Methylene blue, the first-line treatment for methemoglobinemia, can also produce hemolytic anemia. Jaundice or dark urine during methylene blue treatment may indicate hemolytic anemia. A 47-year-old female patient with a history of depressive mood disorder developed significant methemoglobinemia after ingesting a Propanil overdose. Twenty-two hours after ingestion, methemoglobin levels in the blood were 73.2%. She was treated with intravenous methylene blue in the therapeutic range (1 mg/kg every 4 h for 3days). The 2nd day after methylene blue use, methemoglobin levels in the blood were 33%, and the 5th day decreased to 10% with better general condition. The patient had hyperbilirubinemia after hemolytic anemia, but she recovered completely.

• Clinical and Experimental Pediatrics
• /
• v.64 no.6
• /
• pp.293-300
• /
• 2021

Background: Understanding the epidemiology and prevalence of febrile urinary tract infection (fUTI) in children is important for risk stratification and selecting appropriate urine sample collection candidates to aid in its diagnosis and treatment. Purpose: This study aimed to analyze the epidemiology, etiology, and changes in antibiotic susceptibility patterns of the first fUTI in children. Methods: This retrospective observational cohort study included children younger than 19 years of age who were diagnosed and treated for their first fUTI in 2006-2016. Electronic medical records were analyzed and radiologic images were evaluated. Results: A total of 359 patients (median age, 5.1 months; interquartile range, 3.0-10.5 months) fit the inclusion criteria; of them, 78.0% (n=280) were younger than 12 months old. The male to female ratio was 5.3:1 for patients aged 0-2 months, 2.1:1 for those 3-5 months, and 1.6:1 for those 6-11 months. Beyond 12 months of age, there was a female predominance. Escherichia coli was the leading cause (83.8%), followed by Enterococcus species (6.7%), and Klebsiella pneumoniae (3.6%). Significant yearly increases in the proportions of multidrug-resistant strains (P<0.001) and extended-spectrum beta-lactamase (ESBL) producers (P<0.001) were observed. In patients with vesicoureteral reflux (VUR), the overall recurrence rate was 53.6% (n=15). A significantly higher recurrence rate was observed when the fUTI was caused by an ESBL versus non-ESBL producer (75.0% vs. 30.0%, P=0.03). Conclusion: fUTI was most prevalent in children younger than 12 months of age and showed a female predominance in patients older than 12 months of age. The proportion of ESBL producers causing fUTI is increasing. Carbapenems, rather than noncarbapenems, should be considered for treating fUTI caused by ESBL-producing enteric gram-negative rods to reduce short-term recurrence rates in children with VUR.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.26 no.2
• /
• pp.189-198
• /
• 2012

Our former study indicated efficacy of apoptotic cell death on animal study by using Egg white combined Chalcanthite (EC). Clinically, bamboo salt is using because of safety. Hence we investigated a toxicity study for determining safety by adding bamboo salt in former materiel. We had two studies: toxicity of EC and of Bamboo salt with egg white combined Chalcanthite (BC). Both were studied in 1-week single and 5-week repeated oral dose toxicity tests on male Imprinting Control Region mice. In EC, doses used in 1 week single oral dose toxicity tests were 0, 0.05, 0.5, 5 and 50 mg/kg/day and 0, 0.01, 0.05, 0.25 and 0.5 mg/kg/day. In BC, doses used by 0, 0.08, 8.3, 83.3 and 166.6 mg/kg/day in single oral dose toxicity and 0, 4.2, 8.3, 41.7 and 83.3 mg/kg/day in repeated oral dose toxicity tests. Their blood and urine were assayed and organ morphology were examined. Mann-Whitney U test and ANOVA tests were used by analysing methods. First, significant increased left renal weight in all groups of EC and BC. Second, increased ALT score was found in EC-S2 and increased relative liver weight was found in EC-S3. In addition, increased relative weight and urine bilirubin and urobilinogen were found in EC-R2 and EC-R3. There was no significant toxic change in BC. The Mixture of EC had a possibility of hepatotoxicity in the short and long term. Processed BC appears to be safe and non-toxic in these studies and a no-observed adverse effect level (NOAEL) was established at 83.3 mg/kg/day in mice. Relatively, The BC were safer than The EC.