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A STUDY ON THE CHANGE OF SALIVARY FLUORIDE CONCENTRATION WITH TIME AFTER VARIOUS TOPICAL FLUORIDE TREATMENTS (각종 불소처치 이후 시간변화에 따른 타액내 불소농도 변화에 관한 연구)

  • Park, Soo-Jin;Kim, Hyung-Doo;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.262-274
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    • 1999
  • Several alternatives for increasing the fluoride concentration in the mouth, such as water fluoridation, ingestion of fluoride supplements, fluoride paste, fluoride mouthrinse, application of fluoride gel are available. There is an impressive body of evidence that the topically deliverd fluorides are clinically effective in inhibiting the progression of dental caries. Recent studies on the cariostatic action of fluoride have indicated the importance of fluoride in the fluid environment of the teeth. The fluoride levels in unstimulated whole saliva can be considered indicative of F in the aqueous phase available for interaction with the tooth surface at a given time. The retention of F in the mouth after topical fluoride treatment is considered to be an important factor in the clinical efficacy of F. The aim of this study was to determine the elevation and clearance of fluoride in whole saliv after the following topical flouride treatments using HMDS-diffusion technique and fluoride ion electrode. The obtained results were as follow: 1. Average salivary fluoride concentration in the unstimulated whole saliva was $0.0152ppm{\pm}0.0091ppm$. Unstimulated salivary flow rate was between 0.34-0.36ml/min and there was no statistically significant difference among the groups(p>0.05). 2. Except for the immediate time after treatment, fluoride levels followed as APF gel>neutral gel>F-rinse>F-paste. There was no statistical difference between the salivary F concentration of F-paste group and that of control group after 2 hours. In case of F-rinse group, after 3 hours the concentration had dropped to baseline value. But there was statistically significant difference among the F concentraion of F gel groups and that of control group(p<0.05). 3. The mean $AUC_{0-120min}$ values were followed as neutral gel>APF gel>F-rinse>F-paste, and the values of the two former groups were significantly higher than those of the two latter groups(p<0.05).

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The Usefulness Evaluation of Radiation Shielding Devices in PET Scan Procedures (PET 검사 프러시저별 방사선 차폐기구의 유용성 평가)

  • Kim, Yeong-Seon;Seo, Myeong-Deok;Lee, Wan-Kyu;Jeong, Yo-Cheon;Kim, Sang-Wook;Seo, Il-Teak;Song, Jae-Beom
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.65-76
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    • 2010
  • Purpose: he use of PET scanners and the number of patient in Korea have been increased for recent several years dramatically. For this reason, technologists have more possibilities to be exposed to the radiation. The hospitals using PET scanners should make an effort to reduce the radiation exposure dose. The purpose of this study was to evaluate the radiation exposure does when using radiation shielding devices. The evaluation was performed through questionnaire survey and experiment. Materials and Methods: First, the technologists who had experience working in PET center in 2008-2009 were surveyed with questionnaire and TLD Figures, personal opinion of utilization of radiation shielding devices are analyzed. Second, we measured the shielding rate of shielding devices which have been using in PET study procedures. We divided the procedures into four steps; distribution, moving, injection of $^{18}F$-FDG and patient setup. Results: First, the results of this survey, using of L-block+Syringe shield, L-block, Syringe shield, No shield during the injection, were each 58.5%, 20%, 9%, 12.3%. The TLD values according to utilization of radiation shield, using both L-block+Syringe Shield and L-block showed the lower TLD values, and Syringe shield only or No shield showed the higher TLD values. Second, the results of experiments according to PET study procedures measured the shielding rates as follows. The shielding rates during the distribution using L-block, L-block+Apron shield were measured 97.4%, 97.7%. The shielding rates during the $^{18}F$-FDG delivery to the injection room using mobile Syringe shield, Syringe holder, Syringe shield carrier were each 81.7%, 98.9%, 99.7%. The shielding rates during the injection using Syringe shield, L-block, L-block+Syringe shield were measured each 51.9%, 98.3%, 98.7%. The shielding rates of Apron were measured in each 30, 60, 90, 120, 150 cm distance. The measurement were each 16.9%, 14.2%, 16.6%, 17.1%, 18.1%, 18.6%. Conclusion: The most effective method for radiation shielding is to using L-block during the $^{18}F$-FDG distribution and Syringe shield carrier during in moving $^{18}F$-FDG. For the $^{18}F$-FDG injection, L-block+Syringe shield have to be used. The shielding effect of Apron has shown average 16.4%. According to the survey of questionnaire, the operators recognized well risk of the radiation exposure but, tended ignore in working. The radiation dose according to recognition of radiation exposure risk was not relevant. but radiation dose according to utilization of radiation shield lower the more use it. The main reason of no use of shielding devices is cumbersome, 55% of the respondents answered. I'm sure, by use of radiation shield in all PET procedure, radiation exposure will be reduced considerably.

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Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county) (의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究))

  • Park, Jung-Yeon
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.47-76
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    • 1989
  • The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

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A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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Application of Patient Safety Indicators using Korean National Hospital Discharge In-depth Injury Survey (퇴원손상심층자료를 이용한 환자안전지표의 적용)

  • Kim, Yoo-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2293-2303
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    • 2013
  • Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

An analysis of factors affecting aspects of disease and satisfied medical treatments for oriental medical users (한방의료(韓方醫療) 이용자의 질병양상(疾病樣相)과 치료만족도(治療滿足度)에 영향(影響)을 미치는 요인분석(要因分析))

  • An Chang-Su;Nam Chul-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.3 no.2
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    • pp.101-128
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    • 1999
  • A study on disease treated at oriental medical treatment facilities (OMTF) and patients' satisfaction levels was conducted in order to figure out why the patients visited oriental medical doctors and the level of satisfaction of the patients for the services offered to them by oriental medical doctors. This study was performed from March 2 through May 31, 1998 by interviewing 1.532 persons living in major and small cities in korea. The results obtained were summarized as follows; 1. The general characteristics of subjects. The highest portion of each part was, 66.9% female, persons in the age group of over 60's 22.7%, high school graduated 34.9%, house wife 30.8%, The married 65.0%, Buddhist 36.9%, maj or city residents 60.2%, company covered insurance benefiter 39.0% and etc. 2. 40.5% of subjects visited OMTF for skeletal and connective tissue diseases. 21.5% for digestive system diseases. 16.2% for respiratory system diseases. 13.3% for circulatory system diseases and 9.0% for neurological problems. 3. 42.7% of males visited OMTF for skeletal and connective tissue diseases, which were the highest and respiratory system disorders, digestive system disorders, circulatory system disorders and neurological diseases in order. 39.4% of females visited OMTF for skeletal and connective tissue disorders which were the highest and other conditions such as digestive system, circulatory, respiratory, and neurological disorders in order. 4. The males with circulatory system disorders were treated by herbal medicine, combination of herbal medicine and acupuncture, only in order. The females with the some conditions above were treated by combination of herbal medicine and herbal medical and acupuncture only in order. The males and females with respiratory system and digestive system diseases were treated by herbal medicine, combination of herbal medicine and acupuncture only in order. But the males and females with skeletal and connective tissue diseases were by acupuncture are the highest in order. 5. The females and persons in the age group of over 60' s and house wife. the not married, the unhealthy persons, residents living in small cities, the persons with high income by medical treatments frequency in circulatory system diseases are the highest. 6, The females, middle school graduated and the married, persons in the age group of over 60's, unemployed, sales and service industry workers, Buddhists, major city residents, the unhealthy persons, the persons with middle income by medical treatments frequency in respiratory system diseases are the highest. 7. The females, persons in the age group of over 60's, under graduated or elementary school graduated, the unemployed and house wife, the unmarried, Buddhists, major city residents, the unhealthy persons, the persons with low income by medical treatments frequency in digestive system diseases are the highest. 8. The males, major city residents, old ages, under graduated or elementary school graduated, go earn officials, people grown in small city, the persons who had health insurance policies, the persons with low income, the unhealthy persons by medical treatments frequency in skeletal and connective tissue disorders diseases. 9. 50.8% of the respondents said that the treatments at the OMTF were very effective. 47.7% of them said that the treatments were effective. The males, persons in the age group of 40's, high school graduates, official workes, the married, the persons who did not have religion, major city residents, the persons who had health insurance policies, the persons with high income and the healthy persons said that the treatment effects at OMTF were satisfactory. 10. The patients' satisfaction rate for OMTF on each disease is, 1st. Musculo-Skeletal system(most satisfied), 2nd. the pregnancy & delivery complications, 3rd. Eye & ophthalmics, 4th. Respiratory system, 5th. Mental & bodily disorder, 6th. Digestive system and etc. 11. The factors affect OMTF are age, satisfaction for OMTF, current disease, religion, efficiency of Oriental Medicine, health condition and etc. This explained power of variable were 39.0%. 12. The satisfied factors for OMTF is correlate to educational level, and economical variables.

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Extra Dose Measurement of Differential Slice Thickness of MVCT Image with Helical Tomotherapy (토모테라피 치료 시 MVCT Image의 Slice Thickness 차이에 따른 선량 비교)

  • Lee, Byungkoo;Kang, Suman
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.145-149
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    • 2013
  • Helical Tomotherapy is an innovative means of delivering intensity modulated radiation therapy (IMRT) using a device that merges features of a linear accelerator and helical computed tomography (CT) scanner. Hereat, during helical tomotherapy process, megavoltage computed tomography (MVCT) image are usually used for guiding the precise set-up of patient before/after treatment delivery. But which would certainly increase the total dose for patients, this study was to investigate the imaging dose of MVCT using the cylindrical "Cheese" phantom on a tomotherapy machine. A set of cylindrical "Cheese" phantom was adopted for scanning with respectively pitch value (1, 2, 3 mm) with same number slice (10 slice), same length (approximately 9 cm) and phantom set-ups on the couch of tomotherapy system. The average MVCT imaging dose were measured using A1SL ion chamber inserted in the phantom with preset geometry. The MVCT scanning average dose for the cylindrical "Cheese" phantom was 2.24 cGy, 1.02 cGy, 0.81 cGy during respectively pitch value (pitch 1, 2, 3 mm) with same number slice (10 slice), and same length's average dose was 2.47 cGy, 1.28 cGy, 0.88 cGy respectively (pitch 1, 2, 3 mm). Two major parameters, the assigned pitch numbers and scanning length, where the most important impacts to the dose variation. The MVCT dose was inversely proportional to the CT pitch value. The results may provide a reliable guidance for proper planning design of the scanning region, which is valuable to help minimize the extra dose to patient. Questionnaires were distributed to Radiology departments at hospitals with 300 sickbeds throughout the Pohang region of North Gyeongsang Province concerning awareness and performance levels of infection control. The investigation included measurements of the pollution levels of imaging equipment and assistive apparatuses in order to prepare a plan for the activation of prevention and management of hospital infections. The survey was designed to question respondents in regards to personal data, infection management prevention education, and infection management guidelines.

Study on shipment time of low-temperature stored apple (저온저장 사과의 출하시기에 대한 실태조사 연구)

  • Yu, Chang-Hwan;Kim, Yun-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.554-564
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    • 2017
  • The purpose of this study is to assist farmers in determining the optimal time for the shipment of stored apples by investigating the market trends, storage status and release dates of low-temperature stored apples. We surveyed 300 apple cultivation farms in Daegu, Gyeongbuk Province, which is the main producer of apples, and examined the cultivars, cultivation areas, storage conditions, and shipment status of apples. The main results are as follows: the proportion of apples cultivatedat different ripening times was surveyed. According to the results, the proportions of early, middle and late varieties were 78.3%, 63.7% and 96.0%, respectively. Also, 48.7% of the farm households surveyed had cold storage facilities. The average storage cost per apple box(15kg) was 978.3 won for self-storage and 1,771.8 won for consignment storage. For the six(6) months between November and April, the proportion of shipped apples was 91.6% of the total stored apples. The (average total?)annual apple shipment, including apples stored in general storage warehouses, was 744.4 boxes. The (average total?) annual shipment of cold storage apples was 616 boxes. The stored apples were mainly shipped to 'wholesale markets', which have the highest sales share, followed by 'production site collectors' and then 'supermarkets'. The most common shipping method of the apples was by general trucks, followed by low-temperature trucks, and finally by delivery services. The analysis of the factors influencing the decision to release apples by period showed that it was affected by the storage cost, loss rate, and customary shipping in the off-season(from May to August). On the other hand, in the general release season(from November to April), the statistically significant decision factors for the release of apples were the future expected price, storage cost and decision of the leading farmer groups. For farmers with a high share of general shipment, the deciding factors for the release of apples were the future expected price, storage cost, high income expectation, and decision by leading farmers.

Evaluation of X-ray System for Nondestructive Testing on Radioactive Waste Drums (방사성폐기물 드럼 비파괴 검사를 위한 X-ray 장비 평가)

  • Park, Jong-Kil;Maeng, Seong-Jun;Lee, Yeon-Ee;Hwang, Tae-Won
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.6 no.3
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    • pp.189-203
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    • 2008
  • The physical and chemical properties of radioactive waste drums, which have been temporarily stored on site, should be characterized before their shipment to a disposal facility in order to prove that the properties meet the acceptance guideline. The investigation of NDT(Nondestructive Test) method was figured out that the contents in drum, the quantitative analysis of free standing water and void fraction can be examined with X-ray NDT techniques. This paper describes the characteristics of X-ray NDT such as its principles, the considerations for selection of X-ray system, etc. And then, the waste drum characteristics such as drum type and dimension, contents in drum, etc. were examined, which are necessary to estimate the optimal X-ray energy for NDT of a drum. The estimation results were that: $(R)\acute{A}$ the proper X-ray energy is under 3 MeV to test the drums of 320 ${\beta}\S$ and less; $(R)\ddot{E}$ both X-ray systems of 450 keV and/or 3 MeV might be needed considering the economical efficiency and the realization. The number of drums that can be tested with 450 keV and 3 MeV X-ray system was figured out as 42,327 and 18,105 drums (based on storage of 2006. 12), respectively. Four testing scenarios were derived considering equipment procurement method, outsourcing or not, etc. The economical and feasibility assessment for the scenarios was resulted in that an optimal scenario is dependent on the acceptance guide line, the waste generator's policy on the waste treatment and the delivery to a disposal facility, etc. For example, it might be desirable that a waste generator purchases two 450 keV mobile system to examine the drums containing low density waste, and that outsourcing examination for the high density drums, if all NDT items such as quantitative analysis for 'free standing water' and 'void fraction', and confirmation of contents in drum have to be characterized. However, one 450 keV mobile system seems to be required to test only the contents in 13,000 drums per year.

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Clinical Study of Group B β-Hemolytic Streptococcal Meningitis (B군 연쇄상구균 뇌막염에 대한 임상적 고찰)

  • Lee, Seo-Young;You, Sou-Jeong;Kim, Deok-Soo;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1224-1229
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    • 2003
  • Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.