• Title/Summary/Keyword: Response Rates

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A Domestic Outbreak of Bacterial Dysentery Caused by Extended-Spectrum β-Lactamase(ESBL)-producing Shigella sonnei (집단 발생한 Extended-spectrum β-lactamase(ESBL) 생산 Shigella sonnei 감염에 의한 세균성 이질에 관한 연구)

  • Lim, Hyun Taek;Lee, So Hee;Lee, Jung Hwa;Kim, Jeong Eun;Kim, Kyo Sun;Jeong, Eun Ju;Lee, Seung Hyun;Kang, Chang Gyu;Hong, Seong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1107-1115
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    • 2005
  • Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

The prevalences of asthma and allergic diseases in Korean children (한국 소아알레르기 질환의 유병률)

  • Hong, Soo-Jong;Ahn, Kang-Mo;Lee, Soo-Young;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.343-350
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    • 2008
  • Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

Analysis of Seismic Velocity Change and AVO Response Depending on Saturation of Kerogen and GOR in Shale Reservoirs (셰일 저류층에서 케로젠, GOR 변화에 따른 속도 변화 및 AVO 반응 분석)

  • Choi, Junhwan;Lee, Jaewook;Byun, Joongmoo;Kim, Bona;Kim, Soyoung
    • Geophysics and Geophysical Exploration
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    • v.19 no.1
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    • pp.29-36
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    • 2016
  • Recently, the studies about rock physics model (RPM) in shale reservoir are widely performed. In shale reservoir, the degree of the maturity can be estimated by kerogen and GOR (Gas-Oil Ratio). The researches on the rock physics model of shale reservoir with the amount of kerogen have been actively carried out but not with GOR. Thus, in this study, we analyzed the changes in seismic velocity and density, and AVO (Amplitude Variation with Offset) response depending on changes in GOR and the amount of kerogen. Since the shale consists of plate-like particles, it has vertical transverse isotropy (VTI). Therefore we estimated the seismic velocity and density by using Backus averaging method and analyzed AVO responses based on these estimated properties. The results of analysis showed that the changes in the velocity with the GOR variation are small but the velocity changes with the variation in kerogen amount are relatively larger. In case, GOR 180 (Litre/Litre) which is boundary between heavy oil and light oil, when volume fraction of kerogen increased from 5% to 35%, the P-wave velocity normal to the layering increased 51%. That is, it helps estimating maturity of kerogen through the velocity. Meanwhile, when rates of oil-gas mixture are large, the effect of GOR variation on the velocity change became larger. In case volume fraction of kerogen is 5%, the P-wave velocity normal to the layering was estimated $1.46km/s^2$ in heavy oil (GOR 40) but $1.36km/s^2$ in light oil (GOR 300). The AVO responses analysis showed class 4 regardless of the GOR and amount of kerogen because variation of poisson's ratio is small. Therefore, shale reservoir has possibility to have class 4.

Effective Tillering Pattern and Grain Yield on Different Seeding Dates in Barley (보리 파종기에 따른 유효분벽의 양상과 수량)

  • 신만균
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.40 no.4
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    • pp.460-472
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    • 1995
  • This study was aimed to provide understanding on the eco-physiological response of barley tillers as affected by difference in seeding date. Yield and yield contribution rates of tillers were investigated with the data of field experiments in the former Wheat and Barley Research Institute of Suwon, Korea from September 1982 to July 1984. When barley was sowed 15 days earlier than or at the locally recommended sowing date (i.e. October 5), it produced more mainstem leaves than the that sowed 15 days later than the local recommendation. The effective tillers (i.e. ear-bearing tillers) were observed in concurrently occurring leaves up to 10/0 (abbreviation of the 10th mainstem leaf) from early and optimum sowed crops, while 9/0 from late sowed crops. Tillering followed the production rule of Gatayama(l952) which has the linear leaf appearance pattern. Early sowing produced more effective tillers, but the highest production of effective ears (i.e. ears heavier than 0.505g) was noticed in sowing at the recommended date. The tillers in the axil of first leaf in mainstem (abbreviated as 1) produced more effective ears than other mainstem tillers (i.e. primary tillers such as C, 2, 3 and 4). The tillers from the axil of first leaf, whether they were primary or secondary, always performed better in the production of effective tillers, grains per ear, grain weight, and grain yield per ear than those from the axil of coleoptile or prophyll. Other tillers from subsequent leaves were also inferior in production with the order of their appearance, thus making first leaf tillers as the best performer(e.g. 1 against C, 2, 3, 4 of primary tillers, 11 and 21 against 1P, 12, 13, 2P, 22 of secondary tillers). Even though the first leaf tiller from the first mainstem leaf(i.e. 11) emerged at a same time with the fourth mainstem leaf tiller(i.e. 4), it was always a better producer of ears and grains. The above observations of hierarchy among tillers were persistent irrespective of cropping conditions and treatments. Sowing at the recommended date produced more effective tillers and grains per ear than early or late sowing. In early and late sowings, more grains per effective ear were observed by early sowing, whereas more grains per ear were produced by late sowing. The order of performance in production of effective tillers and ears per plant was as follows: optimum > early > late sowings. In optimum sowing the mainstems were the highest in grain weight per ear, while the first leaf tillers were the ones in early sowing probably due to winter damage on mainstem ears. Yield contribution by the tillers was greater with the following order irrespective of sowing dates: mainstem, 1, 2, 3, C, 11, 12 and Cl. The contribution of CP, 2P, 21 and 31 varied with sowings.

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Effect of Multidisciplinary Emergency Consultation System for Drug Intoxicated Patients (응급실을 내원한 약물중독 환자에 대한 다학제 응급협진체계의 효과 검증)

  • Kang, Jino;Kim, Hye Ri;Min, Kyungjoon;Kim, Na Ryoung;Heo, Yoon Kyung;Kim, Sun Mi
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.130-137
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    • 2019
  • Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ2=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ2=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ2=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

Influence of Intracerebroventricular Yohimbine on the Renal Function of the Rabbit (가토 신장기능에 미치는 측뇌실내 Yohimbine의 영향)

  • Kook, Young-Johng;Kim, Kyung-Keun;Kim, Sei-Jong
    • The Korean Journal of Pharmacology
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    • v.21 no.2
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    • pp.119-127
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    • 1985
  • The renal function is under regulatory influence of the central nervous system, mainly through activation of sympathetic nerve to the kidney, and it was recently reported that clonidine, an agonist to ${\alpha}_2$-adrenoceptors, induces diuresis and natriuresis when injected directly into a lateral ventricle of the rabbit brain (i.c.v.). This study was undertaken, therefore, to obtain further information as to the role of the central ${\alpha}_2$-adrenoceptors in regulating renal function, by observing the effects of i.c.v. yohimbine, a specific antagonist of adrenoceptors of ${\alpha}_2$-type, on the rabbit renal function, and to elucidate the mechanism involved in it. With 10 ${\mu}g/kg$ i.c.v. of yohimbine sodium excretion transiently increased along with increasing tendency of urine flow, renal plasma flow and glomerular filtration rate. These responses decreased with increasing doses. With 100 and 300 ${\mu}g/kg$ i.c.v. marked antidiuresis and antinatriuresis as well as profound decreases of renal perfusion and glomerular filtration were noted. Systemic blood pressure transiently increased. In reserpinized rabbits, 100 ${\mu}g/kg$ yohimbine i.c.v. did not produce any significant changes in urine flow, sodium excretion as well as in renal hemodynamics. The pressor response was also abolished. In preparations in which one kidney was denervated and the other left intact as control, i.c.v. yohimbine elicited typical antidiuretic antinatriuretic response in the innervated control kidney, whereas the denervated experimental kidney responded with marked diuresis and increases in excretory rates of sodium and potassium and in osmolar clearance in spite of absence of increased filtration and perfusion . Systemic blood pressure responded as in the normal rabbits. These observations indicate that i.c.v. yohimbine affects renal function in dual ways in opposite directions, the first being the antidiuretic antinatriuretic effects which results from decreased renal perfusion and glomerular filtration due to sympathetic activation and which is predominantly expressed in the normal rabbits, and the second less apparent effect being the diuretic and natriuretic action which is not mediated by nerve pathway but brought about by some humoral mechanism and which is effected by decreased sodium reabsorption in the tubules, possibly of the proximal portion.

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Response of the Resistant Biotype of Echinochloa oryzoides to ACCase and ALS inhibitors, and Effect of Alternative Herbicides (ACCase 및 ALS 저해 제초제들에 대한 저항성 강피의 반응과 대체약제들의 효과)

  • Park, Tae-Seon;Ku, Bon-Il;Kang, Sin-Koo;Choi, Min-Kyu;Park, Hong-Kyu;Lee, Kyong-Bo;Ko, Jae-Kwon
    • Korean Journal of Weed Science
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    • v.30 no.3
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    • pp.291-299
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    • 2010
  • Cyhalofop-butyl and penoxsulam, known for respective acetyl CoA carboxylase (ACCase) and acetolactate synthase (ALS) inhibitor, have been widely using as a post-emergence foliar application for many years in wet-seeded rice field in Korea. Since 2009, control of Echinochloa oryzoides with cyhalofop-butyl and penoxsulam was no longer satisfactory. Greenhouse and experiment in rice field were conducted to confirm E. oryzoides resistance to ACCase and ALS inhibitors and to compare herbicide treatments for control of the resistant E. oryzoides to ACCase and ALS inhibitors. Three resistant E. oryzoides to ACCase and ALS inhibitors accessions were tested for levels of resistance to cyhalofop-butyl and penoxsulam, base on survival rate. Iksan and Kimje accessions were not any affected to the survival by treatment with recommended doses of two herbicides tested. Buan accession displayed an intermediate response of 62 and 72% survival at recommended doses of cyhalofop-butyl and penoxsulam, respectively. Survival rates to herbicides mixed with ACCase and ALS inhibitors at 3.5 leaf stage of E. oryzoides was over 80%. Benzobicyclon+fentrazamide+bensulfuron SC, benzobicyclon+mefenacet+bensulfuron SC, benzobicyclone +cafenstrole+pyrazosulfuron-ethyl GR controlled effectively by 2 leaf stage of resistant E. oryzoides to ACCase and ALS inhibitors. In the field experiment, single treatment of benzobicyclon+ fentrazamide+bensulfuron SC and benzobicyclon+mefenacet+bensulfuron SC failed to control E. oryzoides, but squential treatment of benzobicyclon+thiobencarb SE and benzobicyclon+ mefenacet+ bensulfuron SC controlled effectively it in rice infant seedling culture with machine. Our results suggest that resistant E. oryzoides to ACCase and ALS inhibitors had not developed multiple resistance to herbicides with different modes of action. In particular, cafenstrole, fentrazamide, mefenacet were effective control measures.

Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal Cavity (비강 및 부비동 Non-Hodgkin's Lymphoma의 방사선 치료)

  • Kim Soo Kon;Park Kyung Ran;Lee Chang Gul;Suh Chang Ok;Kim Gwi Eon;Loh John J.K.;Hong Won Pyo;Kim Byung Soo;Ryu Samuel
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.97-104
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    • 1987
  • From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation.13 patients were stage It and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were $25\%,\;28\%$ for IE and $0\%$ for IIE. Total tumor dose varied from 40 to 68 Gy. $100\%$ complete response with a total tumor dose of more than 55 Gy and $73\%$ complete response with less than 55Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was $50\%$ as compared with $14\%$ for T3 and T4. Failure rate by stage was $33\%(2/6)$ for T1 and T2, $86\%(6/7)$ for T3 and T4, and $100\%$(2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tuner dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.

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The Optimal Radiation Dose in Localized Head and Neck Diffuse Large Cell Lymphoma (국한성 두경부 대세포성(Diffuse Large Cell) 림프종의 적정 방사선 조사선량)

  • Koom Woong Sub;Suh Chang Ok;Kim Yong Bae;Shim Su Jung;Pyo Hongryull;Roh Jae Kyung;Chung Hyun Cheol;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.303-308
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    • 2002
  • Purpose : To determine the optimal radiation dose in a localized non-Hodgkin's lymphoma of the head and neck in the treatment setting for combined chemoradiotherapy. Materials an Methods :Fifty-three patients with stage I and II diffuse large ceil non-Hodgkin's lymphoma of the head and neck, who were treated with combined chemoradiotherapy between 1985 and 1998 were retrospectively reviewed. The median age was 49 years, and the male-to-female ratio was approximately 1.6. Twenty-seven patients had stage 1 disease and 26 had stage II. Twenty-three patients had bulky tumors $(\geq5\;cm)$ and 30 had non-bulky tumors (<5 cm). The primary tumors arose mainly from an extranodal organ $(70\%)$, most cases involving Waldeyer's ring $(90\%)$. All patients except one were initially treated with $3\~6$ cycles of chemotherapy, which was followed by radiotherapy. Radiation was delivered either to the primary tumor area alone $(9\%)$ or to the primary tumor area plus the bilateral neck nodes $(91\%)$ with a minimum dose of 30 Gy $(range\;30\~60\;Gy)$. The failure patterns according to the radiation field were analyzed, and the relationship between the dose and the in-field recurrence was evaluated. Results : The 10-year overall survival and the 10-year disease free survival rates were similar at $75\%\;and\;76\%$, respectively. A complete response (CR) after chemotherapy was achieved in 44 patients $(83\%)$. Subsequent radiotherapy showed a CR in all patients. Twelve patients $(23\%)$ had a relapse of the lymphoma after the initial treatment. Two of these patients had a recurrence inside the radiation field. No clear dose response relationship was observed and no significant prognostic factors for the in-field recurrences were identified because of the small number of in-field recurrences. However, for patients with tumors <5 cm in diameter, there were no in-field recurrences after a radiation dose 30 Gy. The 2 in-field recurrences encountered occurred in patients with a tumor $\geq5\;cm$. Conclusion .A dose of 30 Gy is sufficient for local control in patients with a non-bulky (<5 cm), localized, diffuse large cell non-Hodgkin's lymphoma when combined with chemotherapy. An additional boost dose in the primary site is recommended for patients with bulky tumors $(\geq5\;cm)$.

The Results of Radiation Therapy in Stage III Non-Small Cell Lung Cancer (III기 비소세포성 폐암의 방사선치료 성적)

  • Choi, Sang-Gyu;Oh, Do-Hoon;Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.311-319
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    • 1995
  • Purpose : To evaluate the survival and prognostic factors in patients with stage III non-small cell lung cancer treated with curative radiotherapy alone or combined with chemotherapy Materials and Methods : A retrospective analysis was undertaken of 35 patients who had locally advanced non-small-cell lung cancer and treated with curative radiotherapy in Department of Therapeutic Radiology, Kangdong Sacred Heart Hospital, from January 1991 through December 1993. According to AJCC staging, 15 patients were stage IIIA, and 20 were stage IIIB. Radiotherapy was delivered with 1 8-2 Gy per fraction/day. 5 days per week using 6 MV X-ray, to a total dose ranging from 48.8 Gy to 66.6 Gy (median, 61.2 Gy) in 4 to 9 weeks. Ten patients received neoadjuvant or concurrent chemotherapy with FIP (5-FU, ifosfamide, and cisplatin) or FP (5-FU and cisplatin) Results : For all Patients, median survival was 6 months. 1-year and 2-year survival rates were 23.3% and 6.7%, respectively The median survival was 8 months in stage IIIA and 5.5 months in stage IIIB. In patients treated with radiation therapy alone, median survival was 5 months and 1-year survival rate was 9%. In patients who received chemotherapy, median survival was 11 months and 1-year survival rate was 60%. The difference of survival between these two groups was statistically significant (p=0.03). Total radiation dose, degree of response, and Post-treatment ECOG score were also significantly associated with survival. But it was not affected by age, sex, pretreatment ECOG score, presence or absence of weight loss, tumor location. pathologic type, N stage, and degree of response to treatment. Conclusion : Conventional radiotherapy alone is unlikely to achieve long term survival in patients with stage III NSCLC. Radiotherapy with altered fractionation schedule or multimodality treatment combined with surgery and/or chemotherapy should be considered if feasible.

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