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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.

Recurrence and Follow-up after Urinary Tract Infection (요로감염 후의 재발과 추적관찰에 관한 연구)

  • Kim, Ji Hee;Shin, Hye Kyung;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won;Kim, Soon Kyum
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.561-565
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    • 2003
  • Purpose : Urinary tract infection(UTI) is the most common bacterial infectious disease that may induce severe renal injury unless early diagnosis and appropriate treatment are performed. If recurrent UTI is prevented, renal injury can be also reduced. Therefore, we studied the risk factors of recurrent UTI in children. Methods : We performed a retrospective study of 168 children(58 girls and 110 boys) who were treated for UTI in the Department of Pediatrics, Korea University Medical Center, during 2000-2001. Among 168 children, 93 children were followed up for more than six months. For the detection of recurrence of UTI, we performed monthly routine urine cultures and physical examinations. Results : The total rate of recurrence was 32.3%. The recurrent rate in boys and girls were 37.1% and 17.4%, respectively(P<0.05). The most common causative bacteria in the first onset and in recurrence were Escherichia coli. There was a significant difference in the onset age of UTI between boys with recurrence($4.8{\pm}1.0months$) and without recurrence($16.5{\pm}3.8months$)(P<0.01). In 77% of cases, urinary tract infection recurred within six months of the first infection. The time of the first recurrence after UTI was $3.7{\pm}0.6months$ in boys and $14{\pm}8.2months$ in girls(P<0.01). The number of recurrences showed a significant difference between the group under the age of one year($0.69{\pm}0.8/year$) and those above the age of one year($0.16{\pm}0.4/year$)(P<0.05). There was no difference in the recurrent rate between those with structural abnormality and those with normal anatomy. Conclusion : Monthly routine urine cultures are efficient in detecting recurrent UTI in children. Because the male sex and young age especially less than one year of age are risk factors for increased recurrence rate of UTI, these children should be followed-up with urine cultures.

Microbiological spectrum and antibiotic susceptibility pattern in more than 24-month-old children with urinary tract infection: A6-year retrospective, single center experience (24개월 이상 소아에서 요로 감염의 원인균과 항생제 감수성의 양상 : 6년간 단일 기관 경험)

  • Ko, Jeong Hee;Lee, Jee Hyun;Sim, Eun Jung;Cho, Do Jun;Min, Ki Sik;Yoo, Ki Yang;Lee, Dae Hyoung;Kang, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1147-1152
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    • 2009
  • Purpose:To characterize the pathogens and their antibiotic susceptibilities in more than 24-month-old children with urinary tract infection (UTI) and to study the Escherichia coli antimicrobial susceptibility trend. Methods:We retrospectively reviewed the record of more than 24-month-old children with UTI between January 2003 and December 2008. Positive results for 1 bacterial species with a colony count of ${\geq}10^5CFU/mL$ was considered statistically significant. We analyzed uropathogens and their antibiotic susceptibilities. To investigate E. coli antibiotic susceptibility trend, we compared 2 study periods (group A: 2003-2005 versus group B: 2006-2008) using the chi-square test for trend. Results:In all, 63 bacterial isolates were identified in children with febrile UTI. The most common pathogen was E. coli (77.8%). There was no difference in the resistance patterns of uropathogens during the 2 study periods (P>0.05). Antibiotic susceptibility of the E. coli isolates to aztreonam, cefotetan, cefotaxime, ceftriaxone, cefepime, amikacin, and imipenem was >90% to trimethoprim/sulfamethoxazol, 49% and to ampicillin and ampicillin/sulbactam, 20-25%. Over the 2 study period, the E. coli susceptibilities to most antibiotics did not change: the susceptibility to cefuroxime increased from 74.1% to 95.5% (P=0.046) and that to ciprofloxacin increased from 59.3% to 86.4% (P=0.039). Conclusion:Empirical treatment with trimethoprim/sulfamethoxazole, ampicillin, and ampicillin/sulbactam alone appeared to be insufficient in childhood UTI because of the high resistance of E. coli and other gram-negative uropathogens. Antibiotics for empirical therapy should be selected based on the sensitivity and resistance pattern of uropathogens found in a particular region.

Incidence of Rice stripe virus during 2002 to 2004 in Korea and Chemical Control of Small Brown Plant Hopper (2002-2004년의 벼줄무늬잎마름병 발생상황 및 약제처리에 의한 애멸구의 화학적 방제)

  • Park, Jin-Woo;Jin, Tae-Seong;Choi, Hong-Soo;Lee, Su-Heon;Shin, Dong-Bum;Oh, In-Seok;Lee, Sang-Guei;Lee, Min-Ho;Choi, Byeong-Ryeol;Bae, Soon-Do;Kim, Jin-Young;Han, Kwang-Seop;Noh, Tae-Hwan;Ko, Sug-Ju;Park, Jong-Dae;Lee, Bong-Choon;Kim, Tae-Sung;Chung, Bu-Keun;Hong, Sung-Jun;Kim, Choong-Hoe;Park, Hyung-Man;Lee, Key-Woon
    • The Korean Journal of Pesticide Science
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    • v.13 no.4
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    • pp.309-314
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    • 2009
  • Incidence of rice stripe disease, caused by Rice stripe tenuivirus (RSV), was surveyed during 2002 to 2004. The incidence area and ratio of diseased fields were decreased gradually during those period. Rate of diseased plants were 45.8%, 45.0% and 43.7% in the susceptible cultivars Chucheong, Saechucheong and Ilpum, respectively. However, the rate was 4.4% in resistant cultivar Hwaseong. In addition, breakdown rate was also significantly high in the susceptible cultivars in Chucheong, Saechucheong and Ilpum showing 33.6, 33.2 and 31.9%, respectively. In Hwaseong, the breakdown rate was 0.8%. Collection efficiency was compared between two insect vector collection methods. Insect-sucking machine method was much more efficient than sweeping net method in collecting small brown plant hopper (SBPH). According to the survey of the population density of the insect vector during 2002 to 2004, the national average population density was gradually decreased year by year, 3.6, 2.3, and 1.3%, respectively. This result was significantly related with the decrease of the incidence of rice stripe disease. Control efficiency of rice stripe disease by treating several seedling box and water surface with insecticides against SBPH resulted that imidacloprid GR, Fipronil FG, Clothianidin+Probenazole GR and Thiamethoxam GR showed over 80% of control efficiency at 28 days after treatment at the early stage in nursery.

Analysis on Longitudinal Dose according to Change of Field Width (선속 폭(Field Width) 변화에 따른 종축선량 분석)

  • Jung, Won-Seok;Back, Jong-Geal;Shin, Ryung-Mi;Oh, Byung-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gu
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.2
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    • pp.109-117
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    • 2011
  • Purpose: To analyze the accuracy of tumor volume dose following field width change, to check the difference of dose change by using self-made moving car, and to evaluate practical delivery tumor dose when tomotherapy in the treatment of organ influenced by breathing. Materials and Methods: By using self-made moving car, the difference of longitudinal movement (0.0 cm, 1.0 cm, 1.5 cm, 2.0 cm) was applied and compared calculated dose with measured dose according to change of field width (1.05 cm, 2.50 cm, 5.02 cm) and apprehended margin of error. Then done comparative analysis in degree of photosensitivity of DQA film measured by using Gafchromic EBT film. Dose profile and Gamma histogram were used to measure degree of photosensitivity of DQA film. Results: When field width were 1.05 cm, 2.50 cm, 5.02 cm, margin of error of dose delivery coefficient was -2.00%, -0.39%, -2.55%. In dose profile of Gafchromic EBT film's analysis, the movement of moving car had greater motion toward longitudinal direction and as field width was narrower, big error increased considerably at high dose part compared to calculated dose. The more field width was narrowed, gamma index had a large considerable influence of moving at gamma histogram. Conclusion: We could check the difference of longitudinal dose of moving organ. In order to small field width and minimize organ moving due to breathing, it is thought to be needed to develop breathing control unit and fixation tool.

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The Usefulness Assessment of Verifying Daily Output by Using CHECKMATE$^{TM}$ (CHECKMATE$^{TM}$를 이용한 일일 출력 검증의 유용성 평가)

  • Cho, Han-Sang;Nam, Sang-Soo;Park, Hae-Jin;Kim, Mi-Hwa;Park, An-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.51-58
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    • 2011
  • Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

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Chemical Structure of Ozonized Waste Cooking Oil and Wood Bonding Strengths of Reaction Products with pMD (오존 처리한 폐식용유의 화학구조와 pMDI로 제조한 접착제의 목재 접착강도)

  • Kang, Chan-Young;Lee, Eung-Su;Ryu, Jae-Yun;Lee, Hyun-Jong;Seo, Jun-Won;Park, Heon
    • Journal of the Korean Wood Science and Technology
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    • v.38 no.4
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    • pp.316-322
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    • 2010
  • The research attempted to develop a wood adhesive based on waste cooking oil, using ozonification technology for the chemical structure modification. The waste cooking oil (WCO) was reacted with $O_3$ for different times; 1 h, 2 h, and 3 h. The chemical structure modifications of the ozonized WCOs were examined by Fourier transform Infrared (FT-IR) spectrum. The FT-IR spectrum of WCO had an absorbance peak at 3,010 $cm^{-1}$ that was the characteristic peak of the unsaturated double bonds. As ozone treatment time increased, the peak of the double bond was disappeared and carboxyl peak appeared at 1,700 $cm^{-1}$. Especially, the double bond of 3 hrs-ozonized WCO was vanished almost. In results of the dry bonding strengths of the 3 hrs-ozonized WCO mixed with polymeric methylene diphenyl diisocyanate (pMDI) were the strengths of weight ratio of 3hrs-ozonized WCO : pMDI, 1 : 0.5, 8.08 kgf/$cm^2$, 1 : 0.75, 9.53 kgf/$cm^2$ 1 : 1, 44.16 kgf/$cm^2$, 1 : 2, 58.08 kgf/$cm^2$, 1 : 3, 61.41 kgf/$cm^2$, and 1 : 4, 46.95 kgf/$cm^2$. Therefore, it was found that the optimum equivalent ratio was formed at the ratio of 1 : 2 or 1 : 3. Under wetting the bonding strength of 1 : 3 ratio was appeared higher than that of 1 : 2 ratio, while the results obtained from hot-water and cyclic boiling shear test were similar.

Effects of Cover Plants on Soil Microbial Community in Organic Apple Orchards (피복작물이 유기 사과과원 토양미생물상에 미치는 영향)

  • Oh, Young-Ju;Kang, Seok-Boem;Song, Yang-Ik;Choi, Jin-Ho;Paik, Woen-Ki
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.5
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    • pp.822-828
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    • 2012
  • Organic fruit production has increased due to consumer's interest and government's political support for environmentally-friendly agriculture. The aim of this study was to investigate the effects of cover plants on soil microbial community and establish the fruit cultivation method by organic farming techniques. Cover plants used as an organic nutrient source in an apple orchard were rye and barley, the Gramineae and red clover and hairy vetch, the Leguminosae. In the effects of cover plants on the soil chemical characteristics, the soil pH values were higher than that of conventional organic pear orchard. The content of P showed no significant difference between control and cover plant plots. Organic matter level was similar in control and Gramineae cover plant plots, while organic matter content in cover plants belong to Leguminosae was lower than that of control plot. K content was lower in the plots treated with rye and red clover than control plot, while K content in hairy vetch treated plot was higher than control plot. Ca content was lower in control plot than in cover plant treated plots. Concentrations of Mg in the plots treated with barley and hairy vetch was lower than control plot. In August rye and red clover covered soil showed higher bacterial community density than that of control soil and barley treated soil showed highest Actinomycetes community density among treatments. Barley and hairy vetch soils showed higher level of fungi community density than that of control soil in August. In pyrosequencing analysis barley treated soil showed highest distribution ratio of Actinomycetes among treatment. Our findings might be used as basic data for choosing cover plant with effective organic matter decomposition and nutrition supply capacity.

Dry Matter Yield and Nutrients Uptake of Sorghum${\times}$Sudangrass Hybrid Grown with Different Rates of Livestock Manure Compost (가축분퇴비 시용 수준에 따른 수수${\times}$수단그라스 교잡종의 건물생산 및 양분 흡수)

  • Lim, Sang-Sun;Lee, Sang-Mo;Lee, Seung-Heon;Choi, Woo-Jung
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.4
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    • pp.458-465
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    • 2010
  • To investigate the growth and nutrient uptake response of sorghum${\times}$sudangrass ($S{\times}S$) hybrid to different rate of livestock manure compost, a field experiment was conducted in the experimental grassland of Chonnam National University. Six treatments were laid out in a randomized block design with triplicates; control (no input), synthetic fertilizer (20 g N $m^{-2}$ and 20 g $P_2O_5\;m^{-2}$), compost 1 (3.4 g N $m^{-2}$ and 3.6 g $P_2O_5\;m^{-2}$), compost 2 (6.8 g N $m^{-2}$ and 7.2 g $P_2O_5\;m^{-2}$), compost 4 (13.4 g N $m^{-2}$ and 14.4 g $P_2O_5\;m^{-2}$), and compost 6 (20.2 g N $m^{-2}$ and 21.6 g $P_2O_5\;m^{-2}$). Ninety days after treatment, above-ground parts of the plants were harvested and measured for dry matter yield (DMY) and amounts of nutrients (N and P) uptake. Synthetic fertilizer application achieved the greatest DMY (2.4 kg $m^{-2}$) and nutrient uptake (38.3 g N $m^{-2}$ and 15.3 g $P_2O_5\;m^{-2}$). Increasing compost application rate tended to enhance DMY accumulation and nutrient uptake (P<0.01), but DMYs of compost 4 (1.9 kg $m^{-2}$) and 6 (1.8 kg $m^{-2}$) treatments were not different. Therefore, it was suggested that application compost alone may not achieve DMY of $S{\times}S$ hybrid compatible to synthetic fertilizer application. As nutrient uptake efficiency data showed that availability of compost P could be better than SF, it might be a strategy to apply compost as P source with supplementary N application such as liquid manure, SF or green manure if necessary considering availability of N input and the yield goals.

The Role of Radiotherapy in Patients with Brain Metastasis (고형암의 뇌전이시 방사선치료 효과)

  • Lee Soon Nam;Choo Mi-Soon;Lee Kyung-Ja;Nam Eunmi
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.281-286
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    • 1999
  • Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.

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