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Study of Serious Bacterial Infections in Febrile Infants Younger than Three Months of Age (열이 있는 3개월 이하의 영아에서 세균성 감염의 예측에 대한 연구)

  • Jeon, Myeoung Won;Lee, Ji Young;Jang, Young Taek
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.215-222
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    • 2003
  • Purpose : This study was to analyze serious bacterial infections in infants younger than three months of age and to review the direction of treatments for these patients. Methods : 378 febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ visited from Jan. 2001 through Dec. 2002 were retrospectively studied. Infants with the following criteria belonged to the low risk group. WBC $5,000{\sim}15,000/mm^3$, WBC negative in urine stick test and negative for nitirite test, CSF WBC < $10/mm^3$ and negative in CSF gram stain, negative chest X-ray, stool WBC <5/HFP(high power field), and focal infection. If any of the above criteria were not met, they belonged to the high risk group. SBI was defined as a positive culture of urine, blood or CSF. SI was defined as aseptic meningitis or pneumonia including above laboratory tests of SBI. SBI patients were separately compared with two groups, high risk and low risk. Results : Of the 378 infants that were tested 216(57.1%) were in the high risk group and 162(42.9%) in the low risk group. Among 105 SBI(27.8%) and 172 SI(45.5%), there were 98 urinary tract infection(25.2%), 10 bacteremia(2.6%), 2 bacterial meningitis(0.6%), and 77 aseptic meningitis(22.8%). There were 76 SBI(35.2%) from the high risk group and 29 SBI(17.9%) from the low risk group identified. The results of the sensitivity(72.4%), the specificity(48.7%), the negative predictive value(82.1%) and the positive predictive value (35.2%) were calculated. Conclusion : Even though the probability of SBI in the low risk group is insignificant, it should still be considered in febrile infants younger than 3 months of age. I believe the CSF study is necessary because of the moderate high incidence of abnormal finding in our study.

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Usefulness of Interferon-$\gamma$ Measurement Following Stimulation of Tuberculosis-specific Antigens for Diagnosis of Latent Tuberculosis Infection in Children Exposed to Pulmonary Tuberculosis (폐결핵 접촉력을 가진 소아에서 잠복 결핵 감염의 진단을 위한 결핵 특이항원 자극 인터페론-감마 측정의 유용성)

  • Sung, Ji Yeon;Ki, Joo Hwa;Yang, Mi Ae;Kim, So Hee;Eun, Byung Wook;Kim, Nam Hee;Park, Kyoung Un;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.52-58
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    • 2008
  • Purpose : Whole blood interferon-$\gamma$ assay was developed and many studies showed its usefulness in diagnosing tuberculosis (TB) including latent tuberculosis infection (LTBI). However, assessment in children has been limited. This study was undertaken to evaluate the usefulness of QuantiFERON-TB Gold for the diagnosis of LTBI in children exposed to pulmonary TB. Methods : Children who visited Seoul National University Bundang Hospital with a history of TB exposure were enrolled from January 2006 to December 2007. They were evaluated with chest x-rays, tuberculin skin test (TST) and QuantiFERON-TB Gold test. TST was retested 3 months later for those with initial negative reactivity. Definition of LTBI was made on the basis of the TST reactivity. Results : Among the 103 children with a history of TB exposure, 49 children were tested with chest x-ray, TST, and QuantiFERON-TB Gold. Twenty-two were males. Median age was 7.5 years (range; 3 months to 14.7 years). According to TST reactivity, LTBI was in 8 (19%), no infection was in 21 (50%), possible LTBI was in 13 (31%). QuantiFERON-TB Gold test was positive in 5 of the 49 subjects (10%); 3 of the 13 subjects (23.1%) in unknown status, 1 of the 8 subjects (13%) in LTBI, and 1 of the 21 subjects (5%) without infection. The agreement between the QuantiFERON-TB Gold and the TST was poor (${\kappa}=0.101$). Conclusion : QuantiFERON-TB Gold showed poor sensitivity for the diagnosis of LTBI in children with exposure to TB. QuantiFERON-TB Gold alone does not seem to be useful in the diagnosis of LTBI in children.

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Studies on the Mineralogical Characteristics of Apple Orchard Soils (사과원토양(園土壤)의 광물학적특성(鑛物學的特性)에 관(關)한 연구(硏究))

  • Lee, Mahn Jung
    • Korean Journal of Soil Science and Fertilizer
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    • v.6 no.3
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    • pp.141-152
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    • 1973
  • The mineralogical studies of the eleven sub-soil samples derived from granite, granodiorite, diorite and arkose sandstone, taken from apple orchards in the province of Kyungsangbukdo, Korea are made to investigate the relationships between the mineral weathering, soil forming processes and mineralogical composition. The fine sand fraction (less than 0.2mm) and the clay fraction (less than 2 micron) are dispersed with the shaker after hydrogen peroxide treatment for the removal of organic matter, and separated from each suspension by gravity sedimentation. The fine sand are observed by mineral microscope and the clay are observed by X-ray diffraction patterns, differential thermal analysis curves and infrared spectrum. The outline of the results are as follows. 1. The primary minerals ; Quartz, changed-feldspar, plagioclase, alkali-feldspar are dominant in almost all samples, and some samples contain an appreciable amount of hornblende, biotite, muscovite and plant opal. There are also those samples which contain very small quantity of pyroxene group, tourmaline, epidote, cyanite, magnetite, volcanic glass and zircon. They are mainly derived from weathering products of granite, granodiorite, diorite, arkose or its mixtures. 2. All samples contain expanding or nonexpanding $14{\AA}$ minerals, illite and kaolin minerals, and some samples contain chlorite, cristobalite, gibbsite, and those primary minerals as quartz and feldspar, but the quantities vary according to the parent matrials. 3. Non-expanding $14{\AA}$ minerals may be dioctahadral vermiculite which sandwiches gibbsite layer or chlorite in between layer lattices. 4. As for clay minerals, montmorillonite was principal component in the samples derived from weathering products of arkose sandstone and tertiary. Minerals which are derived from weathering products of arkose have kaolin minerals and vermiculite as their principal component, and minerals derived from weathering products of acidic rock group are generally classified into two groups, the kaolin mineral group, and the kaolin minerals and vermiculite group.

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Change of Volume of Isoflow in Pneumoconiosis Patients with Small Opacity (소음영 진폐증 환자에서의 등기류용량(Volume of Isoflow)의 변화)

  • Oh, Sang-Yong;Kim, Jee-Won;Jung, Chang-Young;Kim, Kyung-Ah;Yun, Im-Goung
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.540-547
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    • 1993
  • Backgrounds: The measurement of volume of isoflow has been considered as a sensitive test for detecting small airway diseases showing normal pulmonary function in a routine pulmonary function test. To evaluate the functions of small airway among dust exposed workers, the changes of volume of isoflow were measured and its applicability of managing early stage pneumoconiosis patients was studied. Method: The subjects were 67 male, pneumoconiosis with small opacity and FEV1>80%, FEV1/FVC>75% in spirometry and the controls were 20 male, no dust-exposed office workers. The maximal epiratory volume curves after inhalation of indoor air and $He-O_2$ gas mixtures were measured and ${\Delta}V_{max50},\;{\Delta}V_{max75},\;V_{iso}V/VC$ between the dust exposed and control workers were compaired. Results: 1) There were no significant differences between two group in ${\Delta}V_{max50}$ and ${\Delta}V_{max75}$. But the ratio of $V_{iso}V/VC$ of the subjects was siginificantly higher than that of the control (p<0.01). This study confirms that $V_{iso}V/VC$ is a very useful index in early detection of small airway dysfunction. 2) The ratio of $V_{iso}V/VC$ of the subjects was signigicantly different between only smoker group and mixed group(smoker and nonsmoker). It suggestes that smoking is an important cousative factor of small airway dysfunction. 3) As the profusion of the chest X-ray increased, the rartio of $V_{iso}V/VC$ increased, but no significant difference of $V_{iso}V/VC$ was found between categories of pneumoconiosis. The categories of pneumoconiosis and small airway dysfunction may not be related. 4) No significant relationship was established between the duration of work and the ratio of $V_{iso}V/VC$. Conclusions : It is concluded that the measurement of $V_{iso}V/VC$ is useful to detect small airway dysfuction of early stage pnuemoconiosis patents with small opacities but showing normal pulmonary function in a routine pulmonary function test.

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The Diagnostic Value of Interferon-γ Assay in Patients with Active Tuberculosis (활동성 결핵의 진단에서 혈청 인터페론 감마 측정법의 유용성)

  • Park, So Young;Park, Yong Bum;Choi, Jeong Hee;Lee, Jae Young;Kim, Jae-Seok;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.13-19
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    • 2009
  • Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

Development of Quality Assurance Program for the On-board Imager Isocenter Accuracy with Gantry Rotation (갠트리 회전에 의한 온-보드 영상장치 회전중심점의 정도관리 프로그램 개발)

  • Cheong, Kwang-Ho;Cho, Byung-Chul;Kang, Sei-Kwon;Kim, Kyoung-Joo;Bae, Hoon-Sik;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.17 no.4
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    • pp.212-223
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    • 2006
  • Positional accuracy of the on-board imager (OBI) isocenter with gantry rotation was presented in this paper. Three different type of automatic evaluation methods of discrepancies between therapeutic and OBI isocenter using digital image processing techniques as well as a procedure stated in the customer acceptance procedure (CAP) were applied to check OBI isocenter migration trends. Two kinds of kV x-ray image set obtained at OBI source angle of $0^{\circ},\;90^{\circ},\;180^{\circ},\;270^{\circ}$ and every $10^{\circ}$ and raw projection data for cone-beam CT reconstruction were used for each evaluation method. Efficiencies of the methods were also estimated. If a user needs to obtain an isocenter variation map with full gantry rotation, a method taking OBI image for every $10^{\circ}$ and fitting with 5th order polynomial was appropriate. However for a mere quality assurance (QA) purpose of OBI isocenter accuracy, it was adequate to use only four OBI Images taken at the OBI source angle of $0^{\circ},\;90^{\circ},\;180^{\circ}\;and\;270^{\circ}$. Maximal discrepancy was 0.44 mm which was observed between the OBI source angle of $90^{\circ}\;and\;180^{\circ}$ OBI isocenter accuracy was maintained below 0.5 mm for a year. Proposed QA program may be helpful to Implement a reasonable routine QA of the OBI isocenter accuracy without great efforts.

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Comparative Analysis of Bone Mineral Contents with Dual-Energy Quantitative Computed Tomography (이중에너지광자선의 전산화단층촬영술을 이용한 정량적 골무기물함량의 비교분석)

  • Choi, Tae-Jin;Yoon, Seon-Min;Kim, Ok-Bae;Lee, Sung-Moon;Suh, Soo-Jhi
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.153-158
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    • 1997
  • Purpose : The Dual-Energy Quantitative Computed Tomography(DEQCT) was compared with bone equivalent $K_2HPO_4$ standard solution and ash weight of animal cadaveric trabecular bone in the measurement of bone mineral contents(BMC). Method and Materials : The attenuation coefficient of tissues highly depends on the radiation energy density and effective atomic number of composition, The bone mineral content of DEQCT in this experiments was determined from empirical constants and mass attenuation coefficients of bone,fat and soft tissue equivalent solution in two photon spectra. In this experiments, the BMC of DEQCT with 80 and $120kV_p$ X rays was compared to ash weight of animal trabecular bone. Results : We obtained the mass attenuation coefficient of 0.2409 0.5608 and 0.2206 in $80kV_p$, and 0.2046, 0.3273 and $0.1971cm^2/g$ in $120kV_p$ X-ray spectra for water bone and fat equivalent materials, respectively. The BMC with DEQCT was acomplished with empirical constants $K_1=0.3232,\;K_2$=0.2450 and mass attenuation coefficients has very closed to ash weight of animal trabecular bone The BMC of empirical DEQCT and that of manufacturing DEQCT were correlated with ash weight as a correlation r= 0.998 and r= 0.996, respectively. Conclusion : The BMC of empirical DEQCT using the experimental mass attenuation coefficients and that of manufacture have showed very close to ash weight of animal trabecular bone.

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The Role of Postoperative External Irradiation for the Incompletely Resected Meningiomas (불완전절제된 수막종에서 수술 후 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Young;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.85-91
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    • 2000
  • Purpose : The aim of this study is to look for the possible efficacy of postoperative external irradiation for incompletely resected meningiomas. Methods and Materials : From August 198: to January 1997, forty-four patients with intracranial meningioma were treated by postoperative external irradiation. Of the 44 meningiomas, 18 transitional, 13 meningotheliomatous, 6 hemangiopericytic, 4 atypical, 2 fibroblastic and 1 malignant meningioma were identified. We classified all patients into two groups by the histology. The benign group was consisted of the meningotheliomatous, transitional and fibroblastic types. The malignant group was consisted of the atypical, hemangiopericytic and malignat types. In the means of surgery, 37 patients were resected incompletely and 7 patients were managed by biopsy only. After surgery, all patients were received postoperative external irradiation. Radiotherapy was deliverd using Co-60 or 4 MV photon beam to a total dose of 50 to 65 Gy (mean dose 57.4 Gy) with a 1.8 to 2 Gy per fraction. The median follow-up was 48 months (range : 21 $\~$ 101 months). Multivariate analysis of the Influence by age, sex, location, histology and radiation dose on local control has been done using Cox's proportional hazard model. Results : 5-year local control rate was 93.8$\%$ for the benign histology and 51.8$\%$ for the malignant histology (p=0.0110) and overall local control rate at 5 years was 87.4$\%$. The analysis of the prognostic factors, such as age, sex, location, and radiation dose were not significant except for the histology. Conclusion : Adjuvant postoperative external irradiation appears to be significantly improved local control in the patients with incompletely resected meningiomas.

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Predictive Value for Vesicoureteral Reflux in Children with Urinary Tract Infection (요로감염 환아에서 방광요관 역류를 예측할 수 있는 인자에 대한 연구)

  • Lee, Seung-Hyun;Noh, Sung-Hoon;Oh, Jeung-Eun;Kim, Min-Sun;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.62-69
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    • 2008
  • Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.

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Detection Characteristics of Gamma-Irradiated Seeds by using PSL, TL, ESR and GC/MS (PSL, TL, ESR 및 GC/MS 분석을 통한 감마선 조사된 유지종실류의 검지 특성 연구)

  • Kim, Kyu-Heon;Son, Jin-Hyok;Kang, Yoon-Jung;Park, Hye-Young;Kwak, Ji-Young;Lee, Jae-Hwang;Park, Yong-Chjun;Jo, Tae-Yong;Kim, Jae-I;Lee, Hwa-Jung;Lee, Sang-Jae;Han, Sang-Bae
    • Journal of Food Hygiene and Safety
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    • v.28 no.2
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    • pp.130-137
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    • 2013
  • In this study, we investigated the applicability of the photostimulated luminescence (PSL), thermoluminescence (TL), electron spin resonance (ESR) and gas chromatography/mass spectrometry (GC/MS) methods for 5 seeds which are not allowed to be irradiated in Korea. All 5 seeds including evening primrose seed, safflower seed, rape seed, sunflower seed and flax seed were analyzed. Samples were irradiated at 1~10 kGy using a $^{60}Co$ gamma-ray irradiator. In PSL study, the photon counts of all the unirradiated samples showed negative (lower than 700). The photon counts of irradiated (1, 5, 10 kGy) samples showed positive (higher than 5,000). In TL analysis, results showed that it is possible to apply TL method to all foods containing minerals. In ESR measurements, the ESR signal (single-line) intensity of irradiated foods was higher than non-irradiated foods. The hydrocarbons 1,7-hexadecadiene ($C_{16:2}$) and 8-heptadecene ($C_{17:1}$) from oleic acid were detected only in the irradiated samples before and after the treatment at doses ${\geq}$ 1 kGy, but they were not detected in non-irradiated samples before and after treatment. These two hydrocarbons could be used as markers to identify irradiated safflower seed, rape seed, Sunflower seed and flax seed. And then, the hydrocarbons 1,7,10-hexadecatriene ($C_{16:3}$) and 6,9-heptadecadiene ($C_{17:2}$) from linoleic acid were detected in the evening primrose seed, safflower seed and sunflower seed. According to the results, PSL, TL and GC/MS methods were successfully applied to detect the irradiated foods. It is concluded that PSL, TL and GC/MS methods are suitable for detection of irradiated samples and a combined method is recommendable for enhancing the reliability of detection results.