• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.158-170
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• 2020

Purpose: We evaluated the incidence and characteristics of Clostridioides difficile infection (CDI) in Korean children. Methods: Medical records of patients aged 2-18 years and diagnosed with CDI at a tertiary hospital between 2009 and 2018 were analyzed. The patients were classified into three CDI groups: community-acquired (CA), community onset-health care facility-associated (CO-HCFA), and healthcare facility onset (HO). Results: The incidence of CDI increased from 1.00 to 10.01 cases per 10,000 admissions from 2009 to 2018 (P<0.001). As compared to the CA group, the HO group had a higher frequency of operation and malignancy as predisposing factors (40.4% vs. 0.0%, P=0.001; and 27.7% vs. 0.0%, P=0.027, respectively), frequency and number of previous antibiotic use (97.9% vs. 31.3%, P<0.001; and 2 vs. 0, P<0.001, respectively), and median postdiagnosis hospital stay (13 vs. 5 days, P=0.008). The CO-HCFA group had a lower median age and higher frequency of malignancy than the CA group (5 vs. 13 years, P=0.012; and 30.8% vs. 0.0%, P=0.030, respectively). As compared to the HO group, the CA group had a higher frequency of abdominal pain and hematochezia (56.3% vs. 10.6%, P=0.001; and 50.0% vs. 10.6%, P=0.002, respectively), inflammatory bowel disease (68.8% vs. 2.1%, P=0.001), and intravenous metronidazole treatment (37.5% vs. 2.1%, P=0.001). Conclusions: With the increasing incidence of pediatric CDI, awareness regarding its epidemiology and clinical characteristics is important to manage nosocomial infections.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.189-193
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• 2012

Oral pigmentation has numerous etiologies. It can be associated with congenital diseases and syndromes, certain acquired diseases, and systemic medications. Pigmented lesions caused by serious disease such as melanoma should be diagnosed correctly, because it would be fatal. For appropriate differential diagnosis, clinicians should know about the etiologies causing oral pigmentation and take patients history carefully. Biopsies would be necessary for histopathological findings. Close follow up for clinical symptoms are also necessary. In this case report, we presented a case of oral hyperpigmentation in Asian patient who was receiving pegylated interferon and ribavirin combination therapy for hepatitis C virus infection.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.2
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• pp.229-243
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• 1997

Especially in NICU(Neonatal Intensive Care Unit), handwashing is an important factor in decresing nosocomial infections due to reduced immunity, prematurity and various invasive procedures. The purpose of this study was to investigate the basic characteristics related to handwashing by NICU nurses. It was composed of three parts ; questionnaire survey I (genoral characteristics of handwashing), questionnaire survey II(the awareness degree of handwashing importance) and actual performance. This study was performed from Oct. 8 to 14 in 1994. The results of this study were as follows ; 1. Frequency of handwashing were different by shift of working about 47.1% of the respondents. They were washing most frequently during day-shift about 75% of above. According to self evaluation to handwashing frequency, 64.7% of the respondents said their frequency of handwashing was inadequate, because of being too busy.(45.1%), bothering caused by detergent or disinfectant(17.6%), and too far from handwashing facilities(17.6%). 2. The most common handwashing agent was soap(88.2%), 52.9% of the subjects experienced adverse effects after handwashing ; rough hand(44.5%), dryness(33.3%) All subjects washed their hands with running water, and 70.6% of the subjects washed upto wrist. In duration of handwashing, 52.9% of subjects washed hands 5 to 10 seconds, 29.5% of them did 11 to 15 seconds. 3. 29.4% among subjects had participated to take in the handwashing educational program. About 60% responded they would like to take the course of handwashing if possible. 4. The important nursing activities that need handwashing were chaning of caring ostomy, suctioning, chaning IV dressing site. On the other hand, they responded handwashing was not essential before dealing with omitus, before and after transfering machine, before chaning diaper(stool) 5. Handwashing performance was 61.7%. Among seven nursing activities, suctioning(73.4%) was the highest, the next was dealing with discharge or sampling(71.1%), the lowest was bathing(34.6%). The performance was better after(70.2%) nursing activities that before(52.5%), and day(63.6%) or evening(68.3%) shift than night(56.7%)

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.763-768
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• 2010

Purpose: Reconstruction of soft tissue defect using tissue expander can provide better flap which is more similar to surrounding tissue in color, skin texture and hair compared to other methods. Many pediatric patients need reconstruction of soft tissue defect because of giant congenital nevi, congenital or acquired malformations and burn scars. Reconstruction using tissue expander is adequate to minimize dysmorphism in these patients. We intended to assess outcomes of using tissue expander in pediatric patients by retrospective study. Methods: Total cases were 168 of pediatric patients who received soft tissue reconstruction using tissue expander by the same surgeon from February, 1982 to May, 2009. All patients who received soft tissue reconstruction were under 10 years old. Mean age was 4.3 years old, the youngest 13 months, the oldest 8 years. Eightynine cases were male and 79 cases were female. Most common cause was giant hairy nevi (67 cases, 39.9%), secondary cause was burn scar/scar contracture (61 cases, 36.3%). Trunk (38 cases, 22.6%) was most common anatomical location. Results: Soft tissue defects were successfully covered using tissue expander in 149 cases (88.7%) without major complications. There was infection on 8 cases (4.7%) and we treated by adequate antibiotics in these cases. There were tissue expander folding or valve displacement on 5 cases (3%). Conclusion: Usage of tissue expander is useful on pediatric patients because tissue expansion is rapid on children and there are less secondary contractures on operation site than full thickness skin graft. Because of psychological stress due to tissue expander, operation should be performed before school age.

• Korean Journal of Radiology
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• v.23 no.8
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• pp.803-810
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• 2022

Objective: To investigate the clinical application of differential subsampling with Cartesian ordering (DISCO) contrast-enhanced (CE) magnetic resonance angiography for anterolateral thigh (ALT) flap transplantation, using operative findings as a reference. Materials and Methods: Thirty patients (21 males and nine females; mean age ± standard deviation, 45.5 ± 15.6 years) who were scheduled to undergo reconstruction with ALT flaps between June 2020 and June 2021 were included in the prospective study. Before ALT flap transplantation, patients were scanned using CE-DISCO imaging. All acquired DISCO images of the 60 lower limbs (both sides from each patient) were analyzed using maximum intensity projection and volume rendering methods. Two experienced radiologists were employed to examine the patterns of the lateral circumflex femoral artery (LCFA), its branches, and perforators and their skin termini, which were compared with the operative findings. Results: Using CE-DISCO, the patterns of the LCFA and its branches were clearly identified in all patients. Four different origins of the LCFA were found among the 60 blood vessels: type I (44/60, 73.3%), type II (6/60, 10.0%), type III (8/60, 13.3%), and type IV (2/60, 3.3%). Owing to a lack of perforators entering the skin, two patients did not undergo ALT flap transplantation. For the remaining 28 patients, the ALT flaps in 26 patients were successfully operated without flap reselection during the operation, while the remaining two patients underwent other surgical procedures due to the thin diameter of the perforator or injury of the perforator during the operation. The success rate of flap transplantation was 92.8% (26/28). All transplanted flaps exhibited good blood supply and achieved primary healing without infection or delayed healing. Conclusion: CE-DISCO imaging can be an effective method for preoperative perforator imaging before ALT flap transplantation.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.30-35
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• 2010

Purpose : We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. Methods : Children diagnosed with UTI at the Department of Pediatrics, Kwandong University MyMyongji Hospital by pyuria and bacterial growth of greater than $1.0{\times}10^5CFU/mL$ on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. Results : Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), $\beta$-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4 %. Only one case of the E. coli was extended spectrum $\beta$-lactamase (ESBL) positive. Conclusion : Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.

• Neonatal Medicine
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• v.15 no.1
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• pp.61-66
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• 2008

Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

• Journal of Korean Academy of Nursing
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• v.29 no.2
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• pp.371-382
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• 1999

Nurses are at the forefront of providing hands-on care to patients infected with HIV(Human Immunodeficiency Virus). Therefore, appropriate and sensible infection control precaution should be taken at all times. The purpose of this study is to find out nurse's loaming needs about HIV/AIDS ; and nurse's willingness to perform nursing care to HIV/AIDS patients ; and the degree of fellowing universal precautions in nursing care ; and the degree of knowledge of HIV/AIDS to provide information on the guide for the further continuing education. The respondents of this study were 280 nurses in a university hospital in Kwang-Ju city. Data were collected using a self-administered questionnaire and analyzed by using percentages, means, Pearson's correlation, t-test, ANOVA, Duncan's grouping. The findings were as follows ; 1. The mean age of the nurses was 28.9 years, and the mean duration of their clinical experience was 6.8 years. Majority of the nurses(83.9%) had no experience in taking care of the AIDS patients. 2. The content s nurse's need to learn were showed in order such as clinical manifestations, infection control, patient care, and the mode of transmission of HIV/AIDS. 3. Even though the nurses had quite low knowledge about HIV/AIDS(mean score was 12.2 from the total of 26), they are willing to take care of the AIDS patients (mean score was 39.5 from the total of 60), and the degree of following universal precaution was also not so bad (mean score was 40.8 from the total of 50). 4. Nurses who are over 35 years old and had informal education regarding HIV/AIDS better following universal precautions. Nurses who had over 12 years of clinical experiences have more willingness to perform nursing care to the AIDS patients. Nurses who had experiences in taking care of the AIDS patients were more knowledgeable about HIV/AIDS. These findings suggest that some strategies should be develope to increase the willingness to perform the nursing care to the AIDS patients. And also continuing education program should be develope and run for the clinical nurses so that they can provide effective and appropriate nursing care to the AIDS patients.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.84-88
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• 2018

A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

• Journal of Microbiology and Biotechnology
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• v.32 no.1
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• pp.46-55
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• 2022

Clostridioides difficile infection (CDI) is a significant cause of hospital-acquired and antibiotic-mediated intestinal diseases and is a growing global public health concern. Overuse of antibiotics and their effect on normal intestinal flora has increased the incidence and severity of infections. Thus, the development of new, effective, and safe treatment options is a high priority. Here, we report a new probiotic strain, Bacillus amyloliquefaciens (BA PMC-80), and its in vitro/in vivo anti-C. difficile effect as a prospective novel candidate for replacing conventional antibiotics. BA PMC-80 showed a significant anti-C. difficile effect in coculture assay, and its cell-free supernatant (CFS) also exhibited a considerable anti-C. difficile effect with an 89.06 ㎍/ml 50% minimal inhibitory concentration (MIC) in broth microdilution assay. The CFS was stable and equally functional under different pHs, heat, and proteinase treatments. It also exhibited a high sensitivity against current antibiotics and no toxicity in subchronic toxicity testing in hamsters. Finally, BA PMC-80 showed a moderate effect in a hamster CDI model with reduced infection severity and delayed death. However, further studies are required to optimize the treatment condition of the hamster CDI model for better efficacy and identify the antimicrobial compound produced by BA PMC-80.