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Pseudomembranous colitis in children: Experience of a university hospital in Korea (소아 가막성 대장염: 단일 대학병원의 경험)

  • Park, Jae Hyun;Kang, Kyung Ji;Kang, Yu Na;Kim, Ae Suk;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.184-189
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    • 2010
  • Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

The Stakeholder's Response and Future of Mountain Community Development Program in Rep. of Korea (한국 산촌개발사업에 대한 이해관계자의 의식과 향후 발전방안)

  • Yoo, Byoung Il;Kim, So Heui;Seo, Jeong-Weon
    • Journal of Korean Society of Forest Science
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    • v.94 no.4 s.161
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    • pp.214-225
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    • 2005
  • The mountain village development program in Korea started in the mountain villages, the 45.9% of total land and one of the typical marginal region, from 1995 to achieve the equilibrium development of national land and the sustainable mountain development in Chapter 13 in Agenda 21, and it has been accelerated to increase the happiness and the quality of life of mountain community residents through the expansion by province and the improvement of related laws and regulations. This study has been aimed to analyze the response of main stakeholder's -mountain village residents and local government officials - on mountain villages development, and to provide the future plan as community development. The survey and interview data were collected from the mountain villages which already developed 59 villages and developing 15 villages in 2003. The mountain village development program has achieved the positive aspects as community development plan in the several fields, - the voluntary participation of residents, the establishment of self-support spirit as the democratic civilians, the development of base of income increasement, the creation of comfortable living environment, the equilibrium development with the other regions. Especially the mountain residents and local government officials both highly satisfy with the development of base of income increasement and the creation of comfortable living environment which are the main concerns to both stakeholder. However through the mountain development program, it is not satisfied to increase the maintenance of local community and the strengthening of traditional value of mountain villages. Also to improve the sustainable income improvement effects, it is necessary to develop the income items and technical extension which good for the each region. In the decentralization era, it is necessary for local government should have the more active and multilateral activities for these. With this, the introduction of methods which the mountain community people and the local government officials could co-participate in the mountain villages' development from the initial stages and the renovation of related local government organizations and the cooperatives will be much helpful to the substantiality of mountain development program. Also it is essential for the assistance of central government to establish the complex plan and the mountain villages network for all mountain area and the exchange of information, the education and training of mountain villages leader who are the core factor for the developed mountain villages maintenance, the composition of national mountain villages representatives. In case the development proposals which based on the interests of the main stakeholder's on mountain community could be positively accepted, then the possibility of the mountain village development as one of community development will be successfully improved in future.

Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia (연소형 골수단구성 백혈병에서의 동종 조혈 모세포 이식)

  • Yoo, Keon Hee;You, Dong Kil;Lee, Soo Hyun;Sung, Ki Woong;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.178-185
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    • 2005
  • Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.

Treatment and Attachment Characteristics of Biofilm of Phanerochaete chrysosporium PSBL-1 in Wastewater (Phanerochaete chrysosporium PSBL-1 생물막을 이용한 오.폐수 처리 및 부착특성)

  • Lee, Soon-Young;Kang, Ki-Cheol;Won, Chan-Hee
    • Journal of Korean Society of Environmental Engineers
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    • v.30 no.3
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    • pp.271-277
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    • 2008
  • The biofilm of white-rot fungi fully exposed in atmosphere are that operation is easy, management cost and energy waste is low. To develop biofilm of white-rot fungi fully exposed in atmosphere, basic test are as follows. To select most effective microoganism species, investigated treatment characteristics of wastewater containing non-biodegradable material for three species of white-rot fungi(Phanerochaete chrysosporium PSBL-1, Phanerochaete chrysosporium KCTC 6147, Trametes sp. KFCC 10941) and activated sludge. And then investigated attached and detached biomass of selected white-rot fungi species on HBC ring surface. Among the three strains tested, P. chrysosporium PSBL-1 and P. chrysosporium KCTC 6147 showed higher efficiency for organics removal than Trametes sp. KFCC 10941, and P. chrysosporium PSBL-1 showed higher efficiency for nitrogen removal than P. chrysosporium KCTC 6147 and Trametes sp. KFCC 10941. Respectively, 51$\sim$59.8%, 57.5$\sim$60.3% of NBDCOD was removed for P. chrysosporium PSBL-1 and P. chrysosporium 6147 in pH 3.5$\sim$5.5. TN removal efficiency showed 39.3$\sim$85.3%, 3.4$\sim$7.6% for P. chrysosporium PSBL-1 and P. chrysosporium 6147 in pH 4.5$\sim$11.5 respectively. Considered that white-rot fungi remove organism and nitrogen simultaneously, the microorganism selected white-rot fungi P. chrysosporium PSBL-1. White-rot fungi P. chrysosporium PSBL-1 attached on HBC ring surface 4,538 mg/L, 4,546 mg/L, 4,531 mg/L after 5 minutes, 4,575 mg/L, 4,573 mg/L, 4,568 mg/L after 10 minutes from initial MLSS 4,600 mg/L in pH 4, 7 and 10 respectively. Also detached biomass is negligible from right after attachment to 10 day in pH 4, 7 and 10.

A Study on the Lime Stabilization of Livestock Waste (축산폐기물의 안정화 처리에 대한 연구)

  • Kim, Hyun-Chul;Choi, Yong-Su
    • Analytical Science and Technology
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    • v.8 no.1
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    • pp.91-99
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    • 1995
  • One of alternative conventional technologies used for treatment of livestock wastes is composting process, and recently some mechanical composting processes are being practiced. It is, however, recognized the composting process also has its own limitations such as longer time requirement, and difficulties to estimate the degree of decomposition, etc. The incomplete compost contains potentially harmful materials to crops and public health due to instabilized organic contents and pathogenic organisms. The purpose of this investigation is to develop an innovative system whereby anxious livestock wastes are thoroughly stabilized and disinfected. Thus the overall management scheme should meet the following requirements. 1. A system should be in a cost-effective and environmentally sound manner. 2. Sludges must be chemically stabilized and bacteriologically safe. 3. Odor-free by product should be applied to crop land. 4. Sludges are sources of fertilizer nutrients and/or soil amendments to enhance crop production. 5. And they can be used as potential pH adjusting agent of the acidified soils. Overall effectiveness of the developed system is experimentally tested to satisfy the preset criteria and requirements. Major experiments are divided into four categories: they are 1. chemical stability test, 2. optimal condition test of stabilization process, 3. bacteriological examination and disinfection tests, and 4. deodorization tests The stabilization process is consisted of the stabilizing reaction process and the drying process. Stabilized wastes is dried by both sun dryer and rotary dryer. It is shown that an additive dosage of about g/kg solid in wastes with a minimum of 5-minutes reaction would be necessary for effective stabilization reaction. The stabilization process is consisted of the stabilizing reaction process and drying process. Stabilized wastes are dried by both sun dryer and rotary dryer. It is shown that an additive dosage of about 300g/kg solid in wastes with a minimum of 5-minutes reaction would be necessary for effective stabilization reaction. In the stabilization reaction process, the pH of wastes is lowered from initial values of 12.3 to 8.6. High pH prevents odor production and kills pathogenic organisms. Organic matter contents in the stabilized wastes are about 50% and the sum of contents of fertilizer elements such as total nitrogen, $P_2O_5$ and $K_2O$ are about 5.3%. The livestock wastes that are stabilized chemically and hygienically can be used as a good soil conditioner and/or organic fertilizer.

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Management of Regional Lymph Nodes in Localized Vulvar Carcinoma (국소 외음부 암에서 영역 림프절의 치료)

  • Jang, Won-Il;Wu, Hong-Gyun;Park, Charn-Il;Ha, Sung-Whan;Lee, Hyo-Pyo;Kang, Soon-Beom;Song, Yong-Sang
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.1-9
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    • 2008
  • Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center (단일 병원에서의 재발성 장중첩증과 병적 선두에 대한 임상적 고찰)

  • Lee, Kun-Song;Park, Yun-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.163-170
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    • 2009
  • Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130${\pm}$175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7${\pm}$1.9 in 7 patients with PLP, which was significantly higher than (2.4${\pm}$0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4${\pm}$19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

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Microwave Vacuum Drying of Germinated Colored Rice as an Enzymic Health Food (효소식품으로서 발아유색미의 마이크로파 진공건조)

  • Kim, Suk-Shin;Kim, Sang-Yong;Noh, Bong-Soo;Chang, Kyu-Seob
    • Korean Journal of Food Science and Technology
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    • v.31 no.3
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    • pp.619-624
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    • 1999
  • This work was to study the potential health food use of germinated colored rice after germinating and drying using microwave under vacuum. Colored rice was soaked in water at $15^{\circ}C$ for 2 days and then germinated at $25^{\circ}C$ for $3{\sim}4\;days$. The germinated colored rice was dried by different drying methods: microwave vacuum drying 1, microwave vacuum drying $2\;(drying{\rightarrow}crushing{\rightarrow}drying)$, hot air drying, vacuum drying and freeze drying. Each drier except freeze drier was set to maintain the sample temperature at $60^{\circ}C$. During microwave vacuum drying 1 or 2, the sample reached $60^{\circ}C$ much faster (within 5 min) and was dried much faster ($2{\sim}3\;hrs$ than the other drying methods. The initial drying rate of microwave vacuum drying was ten times faster than that of hot air drying. The microwave vacuum drying 2 retained the highest ${\alpha}-amylase$ activity, followed by microwave vacuum drying 1, freeze drying, vacuum drying, and hot air drying.

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A Simulation of Agro-Climate Index over the Korean Peninsula Using Dynamical Downscaling with a Numerical Weather Prediction Model (수치예보모형을 이용한 역학적 규모축소 기법을 통한 농업기후지수 모사)

  • Ahn, Joong-Bae;Hur, Ji-Na;Shim, Kyo-Moon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.12 no.1
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    • pp.1-10
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    • 2010
  • A regional climate model (RCM) can be a powerful tool to enhance spatial resolution of climate and weather information (IPCC, 2001). In this study we conducted dynamical downscaling using Weather Research and Forecasting Model (WRF) as a RCM in order to obtain high resolution regional agroclimate indices over the Korean Peninsula. For the purpose of obtaining detailed high resolution agroclimate indices, we first reproduced regional weather for the period of March to June, 2002-2008 with dynamic downscaling method under given lateral boundary conditions from NCEP/NCAR (National Centers for Environmental Prediction/National Center for Atmospheric Research) reanalysis data. Normally, numerical model results have shown biases against observational results due to the uncertainties in the modelis initial conditions, physical parameterizations and our physical understanding on nature. Hence in this study, by employing a statistical method, the systematic bias in the modelis results was estimated and corrected for better reproduction of climate on high resolution. As a result of the correction, the systematic bias of the model was properly corrected and the overall spatial patterns in the simulation were well reproduced, resulting in more fine-resolution climatic structures. Based on these results, the fine-resolution agro-climate indices were estimated and presented. Compared with the indices derived from observation, the simulated indices reproduced the major and detailed spatial distributions. Our research shows a possibility to simulate regional climate on high resolution and agro-climate indices by using a proper downscaling method with a dynamical weather forecast model and a statistical correction method to minimize the model bias.

Water Treatment and Oxygen Transfer by Rotating Biological Contactor in Pilot-Scale Recirculating Aquaculture System (Pilot-scale 순환여과식 양식장에서 회전원판 반응기의 순환수 처리 및 산소전달)

  • Suh Kuen Hack;Kim Byong Jin;Lee Jung Hoon;Kim Yong Ha;Lee Seok Hee;Kim Sung Koo;Jo Jea Yoon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.35 no.5
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    • pp.469-475
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    • 2002
  • The rotating biological contactor (RBC) was tested for treatment of aquacultural water in a pilot-scale recirculating aquaculture system. Performance of RBC on the treatment of nitrogen source such as total ammonia nitrogen (TAN), nitrite nitrogen and nitrate nitrogen and chemical oxygen demand (CODcr.) was evaluated. A system was stocked with nile tilapia at an initial rearing densities of $5\%$ and $7\%$ over 30 days. As increasing rearing density from $5\%$ to $7\%$, the TAN removal rates was increased from $39.4 g/m^3{\cdot}day$ to $86.0 g/m^3{\cdot}day$. But TAN removal efficiency was decreased from $24.5\%$ to $16.0\%$. The removal rate of $COD_Cr$ was higher than TAN. The RBC as an aerator was also evaluated for increasing dissolved oxygen concentration. For $5\%$ and $7\%$ of rearing density, the average aeration rate were $280 g/m^3{\cdot}day$ and $255 g/m^3{\cdot}day$, respectively.