• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1065-1070
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• 2008

Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. Results : The mean gestational age (GA) was $26{\pm}2weeks$ (range, 23-32 wk), and the birth weight was $782{\pm}146g$ (range, 430-990 g). The delayed closure group was associated with early GA ($25.7{\pm}1.7wk$ vs $27.1{\pm}2.0wk$, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010). Conclusion : Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.226-232
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• 2009

Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.759-764
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• 2007

Background: Thymoma occurs in approximately 10% of myasthnia gravis patients. The thymus or a thymoma plays a role in the pathogenesis of myasthenia gravis. However, there is currently no definitive position about the effect of thymectomy on patients' symptoms and prognosis. We retrospectively studied the effect of thymoma on re-mission in patients who underwent thymectomy for myasthenia gravis. Material and Method: From July, 1992 to December, 2002, we performed extended thymectomy due to myasthenia gravis for 100 patients. The thymoma group included 30 people, the non-thymoma group included 70 people and the change of the Ossermann stage between the two groups after surgery was compared. Result: For the non-thymoma group, the average age was 34.7 years (range: $12.7{\sim}47.7$). Before the surgical operation, the Ossermann stage for the non-thymoma group was an average of 3.00, and this was reduced to an average of 1.41 after operation. For the thymoma group, the average age was 50.9 years (range: $37.3{\sim}64.5$). Before the surgical operation, the Ossermann stage for the thymoma group was an average of 3.00, and this was reduced to an average of 1.47 after operation. The non-thymoma patients had a higher proportion of males than the thymoma patients (35% vs 30%, respectively), The Masaoka stage was stage of the thymoma group was I for 27 patients and stage II for 3 patients. There was no statistically significant Ossermann stage change between the thymoma and non-thymoma groups. Conclusion: Whether thymoma was present or not, there was no significant difference on remission and improvement of myasthenia symptoms after thymectomy in the myasthenia gravis patients.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.5 no.1
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• pp.39-52
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• 2007

Quantitative analysis on release behavior of the $^{85}Kr\;and\;^{14}C$ fission gases from the spent fuel material during the voloxidation and OREOX process has been performed. This thermal treatment step in a remote fabrication process to fabricate the dry-processed fuel from spent fuel has been used to obtain a fine powder The fractional release percent of fission gases from spent fuel materials with burn-up ranges from 27,000 MWd/tU to 65,000 MWd/tU have been evaluated by comparing the measured data with these initial inventories calculated by ORIGEN code. The release characteristics of $^{85}Kr\;and\;^{14}C$ fission gases during the voloxidation process at $500^{\circ}C$ seem to be closely linked to the degree of conversion efficiency of $UO_2\;to\;U_3O_8$ powder, and it is thus interpreted that the release from grain-boundary would be dominated during this step. The high release fraction of the fission gas from an oxidized powder during the OREOX process would be due to increase both in the gas diffusion at a temperature of $500^{\circ}C$ in a reduction step and in U atom mobility by the reduction. Therefore, it is believed that the fission gases release inventories in the OREOX step come from the inter-grain and inter-grain on $UO_2$ matrix. It is shown that the release fraction of $^{85}Kr\;and\;^{14}C$ fission gases during the voloxidation step would be increased as fuel burn-up increases, ranging from 6 to 12%, and a residual fission gas would completely be removed during the OREOX step. It seems that more effective treatment conditions for a removal of volatile fission gas are of powder formation by the oxidation in advance than the reduction of spent fuel at the higher temperature.

• Journal of Food Hygiene and Safety
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• v.27 no.2
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• pp.169-175
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• 2012

Five kinds of selective media, such as mannitol salt agar (MSA), Baird-Parker agar (BPA), Baird-Parker supplemented with rabbit plasma fibrinogen (BPA+RPF), CHROMagar Staphylococcus aureus (CSA), and Petrifilm Staph Express count system (Petrifilm), were compared to recommend the optimum selective media for isolation of Staphylococcus aureus from agricultural products. Seventy four target and non target bacteria were inoculated on five selective media to analyze sensitivity and specificity. In the recovery test of injured S. aureus cells, S. aureus was exposed to acid (1% lactic acid for 10 min), heat ($60^{\circ}C$ for 90s), and cold ($-20^{\circ}C$ for 1h) conditions. And artificially contaminated agricultural products (iceberg lettuce, green pepper, and cherry tomato) was enumerated on five selective media. The sensitivity of BPA+RPF, CSA, Petrifilm, MSA, and BPA were 100%, 100%, 100%, 90.5%, 90.5%, respectively. In addition, the specificity of BPA+RPF, CSA, MSA, BPA and Petrifilm were 100%, 100%, 84.6%, 75.0%, 67.3%, respectively. However, no difference among five selective media was observed in recovery on injured S. aureus cell and enumeration from agricultural products. This results suggest that BPA+RPF and CSA are the optimum media for detection of S. aureus from agricultural products.

• Journal of Food Hygiene and Safety
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• v.27 no.2
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• pp.161-168
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• 2012

This study was conducted to evaluate microbial contamination levels of Korea traditional rice cakes such as Sirutteok, Garaetteok and Gyeongdan in the manufacturing process and environment. The microbial contamination levels such as total aerobic bacteria, fungi, coliforms, Escherichia coli, Staphylococcus aureus, Bacillus cereus and Clostridium perfringens of rice cake products were analyzed. The contamination levels of total aerobic bacteria, coliforms, fungi and B. cereus in raw materials were in the range of 2.4~4.5, ND~1.9, 1.2~2.1 and 1.0~2.1 log CFU/g, respectively. The microbial contamination levels of total aerobic bacteria, coliforms, fungi and B. cereus in manufacturing process of rice cakes were increased in the soaking and grinding steps and were decreased in steaming step. E. coli, S. aureus and C. perfringens were not detected in any manufacturing process and environment. The microbial contamination levels of raw materials and final products of rice cake were suitable for microbial safety standard in Korea. However, the manufacturing environment such as equipments and employee's sanitation were in trouble for microbial safety. The results of this study suggest that safety educatio n for personal hygiene and safetymanagement in processing environment are continuously required to assure safety in working environment and employee's individual hygiene.

• Journal of Food Hygiene and Safety
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• v.27 no.2
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• pp.127-132
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• 2012

This study was conducted to investigate of changes for organic acids in takju during storage conditions. Two types of takju, unsterilized and sterilized, were used. Acetic acid, citric acid, lactic acid, malic acid and succinic acid were detected in sample. Residues of malic acid was not detected after 7 days storage in room temperature($25^{\circ}C$). In contrast to lactic acid was increased by times after storage. Acetic acid concentrations was gradually increased in room temperature but was not changed in cold temperature($4^{\circ}C$). After storage for 10 days, the organic acid residues lactic acid > citric acid > succinic acid > malic acid > acetic acid in unsterilized takju. Compared to unsterilized sample, organic acid residues in sterilized sample was not significantly changed. Consequently, organic acids residues mainly affected by sterilization.

• Korean Journal of Food Science and Technology
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• v.36 no.1
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• pp.162-167
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• 2004

In this study, untreated (UT), water soaking (WT), and sanitizing solutions [chlorine at 100 ppm (CL): ethanol at 10% (ET); hydrogen peroxide at 1% (HP); chlorine at 100 ppm + ethanol at 10%(CE); chlorine at 100 ppm + hydrogen peroxide at 1% (CH); ethanol at 10% + hydrogen peroxide at 1% (EH); chlorine at 100 ppm + ethanol at 10% + hydrogen peroxide at 1% (CEH)] were compared in terms of their antimicrobial effectiveness against natural microflora of wild cabbage (Brassica oleracea var. capitata). All samples were kept in sanitizing solutions for 2 min, and effectiveness of sanitizing agents was evaluated based on number of decimal reduction of total aerobic mesophilic, total coliforms, E. coli, lactic acid bacteria, and yeast and mold counts. Average initial levels of these organisms in samples were $9.21{\pm}0.15,\;6.60{\pm}0.06,\;6.08{\pm}0.03,\;and\;3.66{\pm}0.08\;log_{10}\;CFU/g$ for total aerobic mesophilic bacteria, total coliforms, lactic acid bacteria, and yeasts and molds, respectively, Escherichia coli was not detected in any tested samples. Decimal reduction of populations of total aerobic mesophilic, total coliforms, E. coli, lactic acid bacteria, and yeasts and molds were: in $WT\;8.09,\;5.36,\;5.82,\;and\;3.57 log_{10}\;CFU/g;\;in \;CL\;7.39,\;4.10\;5.24,\;2.45\;log_{10}\;CFU/g;\;in\;ET\;6.78,\;4.23,\;5.20,\;2.50\;log_{10}\;CFU/g;\;in\;HP\;6.11,\;4.27,\;5.28,\;2.46\;log_{10}\;CFU/g;\;in\;CE\;6.18,\;4.26,\;5.31,\;2.49\;log_{10}\;CFU/g;\;in\;CH\;6.10,\;3.77,\;5.33,\;2.46\;log_{10}\;CFU/g;\;in\;EH\;6.07\;3.82,\;4.76,\;2.41\;log_{10}\;CFU/g;\;and\;in\;CEH\;5.27,\;3.45,\;4.45,\;2.15\;log_{10}\;CFU/g,$ respectively. Statistical analysis of the results showed effectiveness of CEH sanitizing solution for elimination of microbial contamination was the highest among all sanitizer treatments.

• Journal of Hospice and Palliative Care
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• v.15 no.3
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• pp.155-161
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• 2012

Purpose: In this study, we evaluated the effects of training for survival prediction of terminally ill patients in terms of medical professionals' confidence, accuracy and knowledge of survival prediction. Methods: Twenty-nine participants completed a self-administered questionnaire where they scored their confidence, accuracy and knowledge of survival prediction before and after the training session. The training was provided in July 2009 at a university hospital located in Gyeonggi province, Republic of Korea. The participants were instructed by a professor of family medicine specialized in hospice palliative medicine to predict survival of a case using the palliative prognostic score and objective prognostic score. The training was provided in the form of a PowerPoint presentation for 40 minutes. Results: Participants' confidence in survival prediction significantly increased from $4.00{\pm}1.73$ ($mean{\pm}SD$) (0~10, visual analogue scale) to $5.83{\pm}1.71$ after the training (P<0.001). Before training, participant's level of confidence significantly correlated with their age (P=0.04). The training significantly improved the correlation between the confidence level and the number of terminal cancer patients whom they have experienced (P=0.005 before training, P=0.017 after training). Participant's accuracy in survival prediction also significantly improved from 14 of 29 (48%) to 27 of 29 (93.1%) (P<0.001). The change in knowledge of survival prediction was too small to be statistically analyzed. Conclusion: After training, the confidence and accuracy scores significantly improved. Further study with a greater number of participants is needed to generalize this finding.

• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.758-762
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• 2003

Purpose : Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. Methods : We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no identifiable source of fever. Peripheral blood leukocyte count(WBC), absolute neutrophil count(ANC), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were measured at the same time. All patients received blood culture, urine culture and/or CSF culture. Bacterial infection was defined as single pathogen isolated from the CSF or blood or a urinary tract infection (UTI). Patients were dichotomized into two groups : those with bacterial infection and no bacterial infection. We analyzed the characteristics of the children in the two groups. Results : Seventy-one patients(44 males; 27 females) were enrolled in the study. Twenty patients (28%) had a serious bacterial infection(twelve urinary tract infection, five bacteremia, three meningitis) and fifty-one(72%) had no serious bacterial infection. WBC, ESR and CRP were significantly different between the two groups(P<0.05). The cutoff point of WBC, ESR and CRP were $20,000/mm^3$, 30 mm/hr and 3.0 mg/dL, respectively. The sensitivity and specificity of each cutoff point were WBC(75%, 75%), ESR(79%, 68%) and CRP(83%, 77%), respectively. Conclusion : These data show the ability of predictors to identify febrile children less than 3 years of age with bacterial infection. Febrile children who reach the cutoff point must be treated intensively and those who do not reach the cutoff point can be carefully managed without administering antimicrobial agents.