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Analysis of causative microorganisms and choice of antibiotics according to the onset of neonatal sepsis (신생아 패혈증에서 발현시기에 따른 원인균 분석과 항생제 선택)

  • Sung, June Seung;Kim, Dong Yeon;Kim, Sun Hee;Byun, Hyung Suk;Hwang, Tai Ju;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.623-629
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    • 2006
  • Purpose : The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. Methods : One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. Results : The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. Conclusion : Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.

Follow-up in Adult after Total Repair of Tetralogy of Fallot (수술 후 성인 Fallot 4징 환자의 임상적 고찰)

  • Jang, Gi Young;Kim, Sun Young;Moon, Joo Ryung;Huh, Joon;Kang, I-Seok;Park, Seung Woo;Jun, Tae Gook;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.661-667
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    • 2003
  • Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who underwent total correction. Results : Mean age at retrospective study was 30.8(range : 16-53) years old. Age at total correction was 15.8(range : 2-49) years old. Problems after corrective surgery were assessed. They were arrhythmia, pulmonary valve regurgitation, left pulmonary artery stenosis, residual ventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation, right ventricle outflow tract obstruction, aortic valve regurgitation, infective endocarditis and protein losing enteropathy. After repair of TOF, such arrhythmias as atrial arrhythmia and AV conduction disturbances were observed in some patients. Cardiomegaly was found significantly in the subjects with arrhythmia(P<0.05), and arrhythmia was less observed in patients who underwent surgery at a young age. Eight patients required a reoperation; the main indications were residual ventricular septal defect, right ventricle outflow tract obstruction and peripheral pulmonary artery stenosis. Conclusion : The majority of the patients seemed to live normal lives after Tetralogy of Fallot repair. However, as residual anatomic and functional abnormalities exist postoperatively, continued careful follow-up is needed to detect and correct structural and functional abnormalities.

Short-lasting headaches in children and adolescents (소아청소년에서 short-lasting headaches)

  • Rho, Young-il
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.869-874
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    • 2009
  • Purpose : Short attacks of headache are present in the pediatric age group. Short-lasting headaches (SLH) have been infrequently reported in children and adolescents. This study aims to assess the prevalence, clinical characteristics, treatment, and prognosis of short-lasting headaches in children and adolescents. Methods : One hundred twenty-three consecutive patients attended the Chosun University Hospital Headache Center between March 2006 and July 2007. Among 123 headache patients, 44 patients with one key criterion, namely, recurrent headaches episodes of a few seconds to less than 30 minutes, were selected. Results : Of the 123 headache patients, 44 (35.8%, males 18, females 26) had SLH. The mean age was 9.24 years (range 2.3-14.2). The mean headache frequency was $11.50{\pm}10.30$ per month, mean severity was $4.86{\pm}1.36$ out of 10, and the mean PedMIDAS score was $7.97{\pm}17.51$. SLH was significantly more common in children <6 years old (10/22, 45.5%) than in ${\geq}6$ years old (34/101, 33.7%) (P=0.015). The nature of pain was pressure in 30.2%, stabbing in 27.9%, throbbing in 18.6%, and dull in 11.7%. In 52.4% patients, the pain occurred in the front, one side of the temple in 28.5%, both sides of the temple in 7.1%, and back in 4.8% patients. The duration of attacks was <6 minutes in 38% and ${\geq}6$ minutes in 61.4%. The intensity of the pain was 4-6 out of 10 in 75.0%, in 13.6% 1-3, and in 11.4% 7-10. Treatment was significantly effective in reducing the frequency, duration, and severity of headaches and the PedMIDAS score after 3 months (P<0.05). Conclusion : Short attacks of headache are common (35.8%) in children and adolescents. These are difficult to classify according to International Headache Society criteria. The outcome, after a period of 3 months to 2 years, was favorable in most patients. Further studies are needed to gather more data and to obtain a better description of these forms of headache in the pediatric group.

Radiation Exposure Dose on Persons Engaged in Radiation-related Industries in Korea (한국에서 방사선 관련 종사자들의 개인피폭선량 실태에 관한 연구)

  • Lim, Bong-Sik
    • Journal of radiological science and technology
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    • v.29 no.3
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    • pp.185-195
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    • 2006
  • Purpose: This study investigated the status of radiation exposure doses since the establishment of the "Regulations on Safety Management of Diagnostic Radiation Generation Device" in January 6, 1995. Method: The level of radiation exposure in people engaged or having been engaged in radiation-related industries of inspection organizations, educational organizations, military units, hospitals, public health centers, businesses, research organizations or clinics over a 5 year period from Jan. 1, 2000 to Dec. 31, 2004 was measured. The 149,205 measurement data of 57,136 workers registered in a measurement organization were analysed in this study. Frequency analysis, a Chi-square test, Chi-square trend test, and ANOVA was used for data analysis. Results: Among 57,136, men were 40,870(71.5%). 50.3% of them were radiologic technologists, otherwise medical doctors(22.7%), nurse(2.9%) and others(24.1%). The average of depth radiation and surface radiation during the 5-year period were found to decrease each year. Both the depth radiation and surface radiation exposure were significantly higher in males, in older age groups, in radiological technologists of occupation. The departments of nuclear medicine had the highest exposure of both depth and surface radiation of the divisions of labor. There were 1.98 and 2.57 per 1,000 person-year were exposed more than 20 mSv(limit recommended by International Commission on Radiological Protection) in depth and surface radiation consequently. Conclusion: The total exposure per worker was siginifcantly decreased by year. But Careful awareness is needed for the workers who exposed over 20 mSv per year. In order to minimize exposure to radiation, each person engaged in a radiation-related industry must adhere to the individual safety management guidelines more thoroughly. In addition, systematic education and continuous guidance aimed at increasing the awareness of safety must be provided.

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Association between Ureaplasma urealyticum Colonization and Adverse Outcomes in Premature Infants (출생 시 Ureaplasma urealyticum 집락이 조산아의 임상 양상에 미치는 영향)

  • Yun, Jin-Sang;Chang, Sun-Jung;Jo, Heui-Seung;Lee, Kyu-Hyung
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.47-54
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    • 2009
  • Purpose: Present evidences suggest that Ureaplasma urealyticum is a cause of pneumonia, septicemia, and bronchopulmonary dysplasia (BPD) in newborn infants, particularly those born prematurely. The purpose of this work was to examine the relationship between Ureaplasma urealyticum in the tracheal aspirates and adverse outcomes, such as BPD and early onset neonatal sepsis in premature infants. Methods: A polymerase chain reaction (PCR) was performed on tracheal aspirates collected within 24 hour after birth in 176 premature infants less than 35 weeks of gestation and admitted to the neonatal intensive care unit of Bundang CHA Hospital. Results: U. urealyticum was detected in 37 of 176 preterm infants (21.0%). Gestational age ($29^{+5}{\pm}2^{+5}$ wk vs. $30^{+6}{\pm}2^+{-5}$ wk, P=0.0l3) and birth weight (1.39${\pm}$0.44 kg vs. 1.59${\pm}$0.55 kg, P=0.037) were lower in the U urealyticum-positive group compared to the control group. The incidence of early onset neonatal sepsis (16.2% vs. 6.5%, P=0.045) and BPD (45.9% vs. 29.5%, P=0.047) was higher in the U urealyticum-positive group compared to the control group, but the severity of BPD was not different between two groups. However, multiple logistic regression analysis revealed that the presence of U. urealyticum was not independently related to the development of early onset neonatal sepsis and BPD. Conclusion: The results suggest that colonization of the lower respiratory tract by U. urealyticum might not be related to the development of neonatal sepsis and BPD directly in preterm infants.

Development of Aceclofenac Soft Capsule (Clanza S Soft Capsule) (아세클로페낙 연질캡슐(클란자 에스 연질캡슐)의 개발)

  • Yong, Chul-Soon;Lee, Kyung-Hee;Choi, Jin-Suck;Park, Byung-Joo;Jung, Se-Hyun;Kim, Yong-Il;Park, Sang-Man;Bae, Myung-Soo;Kim, Gui-Ja;Gill, Young-Sig;Yu, Chang-Hun;Kang, Sung-Lyoung;Yoo, Bong-Kyu;Rhee, Jong-Dal;Choi, Han-Gon
    • Journal of Pharmaceutical Investigation
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    • v.34 no.1
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    • pp.49-55
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    • 2004
  • To develop a aceclofenac soft capsule, four preparations with various solubilizers were prepared and their dissolution test was carried out. Among four preparations tested, a preparation with ethanolamine was selected as a formula of aceclofenac soft capsule (Clanza $S^{TM}$), since it showed the fastεst dissolution rate. Bioequivalence of aceclofenac tablet, $Airtal^{TM}$ (Dae-Woong Pharmaceutical Co., Ltd.) and aceclofenac soft capsule, Clanza $S^{TM}$ (Korea United Pharmaceutical Co., Ltd.) was evaluated according to the guideline of KA Fourteen normal male volunteers (age 20 - 25 years old) were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After oral administration of one tablet or capsule containing 100 mg of aceclofenac, blood was taken at predetermined time intervals and the concentration of aceclofenac in plasma was determined with an HPLC method under UV detector The pharmacokinetic parameters ($C_{max}$ and $AUC_t$) were calculated and ANOVA was utilized for the statistical analysis of parameters using logarithmetically transformed $AUC_t$, $C_{max}$ and $T_{max}$. The results showed that the differences in $AUC_t$, $C_{max}$ and $T_{max}$ between Aral tablet and Clanza soft capsule were 2.89%, 0.18% and 43.0%, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(15) (e.g. log(0.81) -log(1.23) ad log(0.89) -log(1.4)) fo $AUC_t$ and $C_{max}$, respectively. Thus, the criteria of the KFDA guidelines for the equivalence was satisfied, indicating that Clanza $S^{TM}$ soft capsule is bioequivalent to$Airtal^{TM}$ tablet.

Effect of Glycerol and Ethylene Glycol on Post-Thawed Sperm Function in Jeju Horse (제주마의 동결정액 제조에 있어 Glycerol과 EthyleneGlycol이 동결 융해 후 정자의 기능에 미치는 영향)

  • Oh, Shin-Ae;Ko, Min-Hee;Ko, Moon-Suck;Lee, Chong-Eon;Park, Yong-Sang;Kang, Tae-Young;Ko, Jae-Hyoung;Cho, Won-Mo
    • Reproductive and Developmental Biology
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    • v.36 no.3
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    • pp.199-206
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    • 2012
  • Cryopreservation induces sublethal damage to the spermatozoa, which leads to their reduced fertile life. This study was designed to determine effect of glycerol and ethylene glycol as cryoprotectant in extender on improve the freezability of Jeju horse semen. The semen was cryopreserved with glucose-EDTA extender containing each 5% glycerol, 5% ethylene glycol, 8% glycerol or 8% ethylene glycol, respectively. Post-thawed sperm were evaluated motility, viability, Membrane integrity and acrosome integrity. Post-thawed sperm motility were not significantly differences among treatments. However, sperm viability were significantly higher (p<0.05) in 8% glycerol ($39.85%{\pm}11.41$) than in 5% glycerol treatment ($18.08%{\pm}1.61$). In membrane integrity, swelling sperm ratio was significantly higher (p<0.05) in 8% glycerol ($34.12%{\pm}11.02$) than other treatments. In the percentage of capacitated sperm assessed by CTC staining, F pattern was significantly higher in 8% ethylene glycol than 5% glycerol and 5% ethylene glycol (p<0.05). B pattern ratio was significantly increased in 5% ethylene glycol compared with 8% glcerol and 8% ethylene glycol (p<0.05). Moreover, 8% ethylene glycol treatment was significantly decreased AR pattern ratio compared with other treatments (p<0.05). It is concluded that treatment of 8% glycerol was improved the sperm viability and 8% ethylene glycol was improved the sperm ascrosome integrity after thawing. However, they were not significantly difference between 8% glycerol and 8% ethylene glycol on post-thawed sperm viability. Therefore, 8% ethylene glycol was more effective sperm cryoprotectant than 8% glycerol in Jeju Horse.

The Development of a Cryotherapy System (한냉물리치료기의 개발)

  • Kim, Yeong-Ho;Yang, Gil-Tae;Jang, Yun-Hui;Park, Si-Bok;Ryu, Jin-Sang
    • Journal of Biomedical Engineering Research
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    • v.19 no.6
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    • pp.617-622
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    • 1998
  • A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.

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Effect of Cadmium-contaminated Brown Rice Diet on Accumulation of Heavy Metal in Rats (카드뮴 오염 현미 섭취에 의한 랫드의 체내 중금속 축적)

  • Kim, Jae-Young;Im, Hyo-Bin;Kim, Seong-Jo;Baek, Seung-Hwa
    • Journal of Food Hygiene and Safety
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    • v.27 no.2
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    • pp.133-140
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    • 2012
  • Movement and accumulation of cadmium in male Sprague-Dawley rats, fed with brown rice from nearby Janghang smeltery area were investigated. The rat fed with five different cadmium level diets made with Cd-polluted during 12 weeks. The brown rice-polluted with 0.87 ppm Cd (PBR) was sampled from products in the Janghang smeltery area. Diets of brown rice group were brown rice (BR, 0.002 ppm Cd), each 50% of BR and PBR (BR+PBR 50%, 0.44 ppm Cd) and PBR (PBR 100%, 0.87 ppm Cd). To compare with BR+PBR 50%, the another group diet composed the feed (FE, 0.002 Cd ppm) and each 50% of FE and PBR (FE+PBR 50%, 0.44 ppm Cd). Accumulation of Cd, Zn and Cu in blood, liver and kidney rats was measured by GF-AAS. The weight gain in BR groups and FE groups were different 0.22-0.26 and 1.08-1.26 g/day, respectively. Daily intake cadmium was 10.77 and 22.36 ${\mu}g/rat$ in BR+PBR 50% and PBR 100%, and 8.83 ${\mu}g/rat$ in FE+PBR 50%. Cadmium contents in diets were higher, and total intake of the heavy metals was more increased on the whole. Weights of liver and kidney in FE+PBR 50% group was 2.64 and 2.27 folds higher than those in BR+PBR 50% group. Cadmium contents in blood were increased with intake of BR diet, but Zn and Cu were decreased with them. In the diet groups with the same Cd concentration, Cd content of FE+PBR 50% was higher 1.27 times than that of BR+PBR 50%. In the diet group of BR, BR+PBR 50%, and PBR 100%, the increase of Cd concentration was significantly different to the increase of Cd content in the livers. In the same condition of Cd concentration, Cd contents were higher in the BR+PBR 50% group. In the diet groups of BR, BR+PBR 50%, and PBR 100%, the increase of Cd content in the kidneys led to the increase of Zn and Cu contents. In the same condition of Cd concentration, the diet group with the addition of BR was shown to be 3.11 times higher than with the addition of FE. In view of the results so far achieved, It was closely related with Cd, Zn, and Cu content.

Hospice and Palliative Care for Cancer Patients with Brain Metastases (전이성 뇌암 환자의 호스피스 완화의료)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.30-36
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    • 2005
  • Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

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