• Title/Summary/Keyword: continuous monitoring

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Posttransplantation Lymphoproliferative Disorder after Liver Transplantation in Pediatric Patients: Report from a Single-center Over 21 Years (간 이식 소아에서 발생한 이식 후 림프 증식 질환: 단일 기관에서의 21년 경험)

  • Lee, Jung-Hwa;Ko, Jae-Sung;Seo, Jeong-Kee;Yi, Nam-Joon;Suh, Kyung-Suk;Lee, Kuhn-Uk;Kang, Gyeong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

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Use of Antimicrobial Agents for the Treatment of Inpatients in Chonbuk National University Hospital (전북대학교병원 입원환자에서의 항생제 사용 실태)

  • Song, Jae Ho;Kim, Jung Soo
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.225-232
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    • 2000
  • Purpose : The use antimicrobial agents is one of the important strategies for the treatment and prophylaxis of microbial infections. But injudicious abuse and misuse of antimicrobial agents is problem to add an extra weight on medical fee, increase of resistant bacteria and side effects according to the antibiotic use. This study was performed to establish the pertinent use of antimicrobial agent in Chonbuk National University Hospital(CNUH). Characteristics of antibiotics use was analysis by reviewing the medical records of patients admitted to CNUH during the period of May 1998. Methods : One thousand eight hundred and thirty three patients were enrolled in this study(medical division 1,014 cases, surgical division 819 cases). Medical records were retrospectively reviewed to classify the rate of antibiotics use, name of antibiotics used, appropriateness of antibiotics use. Results : The overall rate of antibiotic usage in CNUH was 67.2%(1,231/1,833), showing higher rate in surgical division(89.6%) compare to that of medical division(49.0%). Among 1,231 patients to whom antimicrobial agents were given, only 125(10.2%) were treated with single antimicrobial agents. 311(25.3%) were treated with two antimicrobial agents, and 795(64.5%) patients received 3 or more antibiotics. ${\beta}$-lactams(56.4%) were most frequently used followed by aminoglycosides(35.3%), the others(4.9%) and quinolons(3.4%). Amoxicillin-clavulanate was the mostly commonly used antibiotics followed by amoxicillin and unasyn. Prophylactic use of antibiotics was carried in seven hundred six patients(57.4%), mostly in surgical division, which can be considered somewhat inappropriate in the initiation time and duration of antibiotic use. Conclusion : Importance of monotherapy and appropriate prophylactic antibiotic use should be emphasized. Strategies of antibiotics use, such as restriction of drug use, continuous monitoring system, flow sheet system should be considered to reduce antibiotics use and establish the appropriate use of antibiotics as well as inhibiting the occurrence of resistant strains.

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A Study on Total Mercury and Methylmercury in Commercial Tuna, Billfish, and Deep-sea Fish in Seoul Metropolitan City (서울시 유통 다랑어류, 새치류 및 심해성 어류의 총수은 및 메틸수은 축적에 대한 고찰)

  • Kim, Jin-Ah;Yuk, Dong-Hyun;Park, Young-Ae;Choi, Hee-Jin;Kim, Youn-Cheon;Kim, Moo-Sang
    • Korean Journal of Food Science and Technology
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    • v.45 no.3
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    • pp.376-381
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    • 2013
  • In this study, we monitored total mercury and methylmercury concentrations in tuna, billfish, and deep-sea fish distributed in Seoul city. With the acquired data, we carried out statistical analysis and an exposure assessment for intake. The mean concentrations (mg/kg) of total mercury and methylmercury were $0.32{\pm}0.31/0.20{\pm}0.20$ for tuna, $0.43{\pm}0.48/0.20{\pm}0.17$ for patagonian toothfish, $0.99{\pm}0.72/0.51{\pm}0.40$ for billfish and $1.20{\pm}0.70/0.95{\pm}0.51$ for sharks, respectively. We found that sharks, billfish, patagonian toothfish, and tuna were more contaminated with total mercury and methylmercury, in sequence, and that 66% of the total mercury concentration consisted of methylmercury, on average. Although the estimated weekly intakes of methylmercury from commercial deep-sea fish were lower than the weekly intakes recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), we identified that the total mercury and methylmercury concentrations in tuna, billfish, and deep-sea fish continued to increase with the passage of time. Therefore, we confirmed the necessity of continuous monitoring and comprehensive analysis for general safety.

Vertical Distribution of Vascular Plant Species along an Elevational Gradients in the Gyebangsan Area of Odaesan National Park (오대산국립공원 계방산지구 관속식물의 고도별 수직분포)

  • An, Ji-Hong;Park, Hwan-Jun;Nam, Gi-Heum;Lee, Byoung-Yoon;Park, Chan-Ho;Kim, Jung-Hyun
    • Korean Journal of Ecology and Environment
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    • v.50 no.4
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    • pp.381-402
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    • 2017
  • In order to investigate distribution of vascular plants along elevational gradient in the Nodong valley of Gyebangsan, vascular plants of eight sections with 100-meter-high were surveyed from the Auto-camping site (800 m) to the top of a mountain (1,577 m). There were a total of 382 taxa: 89 families, 234 genera, 339 species, 7 subspecies, 34 varieties, and 2 forms. As a result of analyzing the pattern of species richness, it showed a reversed hump-shaped with minimum richness at mid-high elevation. As a result of analyzing habitat affinity types, the proportion of forest species increased with increasing elevation. But, the ruderal species decreased with increasing elevation, and then increased at the top of a mountain. As for the proportion of life forms, the annual herbs gradually decreased with increasing elevation, but it did not appear between 1,300 m and 1,500 m and then increased at the top of a mountain. The trees gradually increased with elevation and decreased from 1,300~1,400 m. The vascular plants divided into four groups by using DCA. The arrangement of each stands was arranged in order from right to left on the I axis according to the elevation. The distribution of vascular plants is determined by their own optimal ranges of vegetation. Also, rise in temperature due to climate change affects the distribution of vascular plants, composition, and diversity. Therefore, continuous monitoring is necessary to confirm ecological and environmental characteristics of vegetation, distribution ranges, changes of habitat. Furthermore, plans for conservation and management based on these data should be prepared according to climate change.

Mutation Patterns of gyrA, gyrB, parC and parE Genes Related to Fluoroquinolone Resistance in Ureaplasma Species Isolated from Urogenital Specimens (비뇨생식기계 검체로부터 분리된 Ureaplasma 종의 Fluoroquinolone 내성과 관련된 gyrA, gyrB, parC, parE 유전자의 돌연변이 양상)

  • Cho, Eun-Jung;Hwang, Yu Yean;Koo, Bon-Kyeong;Park, Jesoep;Kim, Young Kwon;Kim, Sunghyun
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.74-81
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    • 2016
  • Ureaplasma species can normally colonize in the bodies of healthy individuals. Their colonization is associated with various diseases including non-gonococcal urethritis, chorioamnionitis, neonatal meningitis, and prematurity. In 2012, the sum of the resistant and intermediate resistant rates of Ureaplasma spp. to ofloxacin and ciprofloxacin was 66.08% and 92.69%, respectively. DNA point mutations in the genes encoding DNA gyrase (topoisomerase II) and topoisomerase IV are commonly responsible for fluoroquinolone resistance. Each enzyme is composed of two subunits encoded by gyrA and gyrB genes for DNA gyrase and parC and parE genes for topoisomerase IV. In the current study, these genes were sequenced in order to determine the role of amino acid substitutions in Ureaplasma spp. clinical isolates. From December 2012 to May 2013, we examined mutation patterns of the quinolone resistance-determining region (QRDR) in Ureaplasma spp. DNA sequences in the QRDR region of Ureaplasma clinical isolates were compared with those of reference strains including U. urealyticum serovar 8 (ATCC 27618) and U. parvum serovar 3 (ATCC 27815). Mutations were detected in all ofloxacin- and ciprofloxacin-resistant isolates, however no mutations were detected in drug-susceptible isolates. Most of the mutations related to fluoroquinolone resistance occurred in the parC gene, causing amino acid substitutions. Newly found amino acid substitutions in this study were Asn481Ser in GyrB; Phe149Leu, Asp150Met, Asp151Ile, and Ser152Val in ParC; and Pro446Ser and Arg448Lys in ParE. Continuous monitoring and accumulation of mutation data in fluoroquinolone-resistant Ureaplasma clinical isolates are essential to determining the tendency and to understanding the mechanisms underlying antimicrobial resistance.

Monitoring Country-of-Origin Labels and Indication Contents for Meat on Electronic On-line Trading (전자상거래의 축산물 원산지 표시실태 및 표시규정 모니터링)

  • Nam, Jung-Oak;Nam, Bo-Ra;Park, Jung-Min;Lee, Ra-Mi;Gu, Hyo-Jung;Suh, Hyung-Joo;Chang, Un-Jae;Kim, Jin-Man
    • Food Science of Animal Resources
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    • v.27 no.1
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    • pp.117-121
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    • 2007
  • The number of internet users and the scale of electronic on-line trading are on the increase due to the development of information technology and the internet. The aim of this study was to monitor the accuracy of country-of-origin labels and the indicated contents of meat available by electronic on-line trading by using a structural interview sheet for 100 on-line meat product markets. The result of this investigation showed a 100% level of accuracy for business name and telephone number whereas the company address, meat manufacturer and supplier, and business registration were less reliable. We also investigated the accuracy of site policy, e-mail address, and fax number. The results showed that the accuracy of fax numbers was the lowest. The product name and the kind of meat actually in the product showed a 100% level of conformity, while the price (96.3%), place of origin (93.6%), capacity (90.4%), meat parts (80.9%) and contents of the product (73.4%) showed a relatively low level of conformity. Serious safety issues were exposed by the disturbingly low 20.2% accuracy of indicated expiration dates and 5.3% accuracy of indicated manufacturing dates. To ensure food safety, it is essential to improve consumer understanding and trust regarding food safety through continuous public relations. More education and information are needed to raise consumer awareness of the facts versus myths regarding food safety.

Peritoneal Dialysis-related Peritonitis in Children: A Single Center's Experience Over 12 Years (소아 복막 투석 환자에서 발생한 복막염 : 단일기관에서 12년간의 경험)

  • Oh, Seong Hee;Lee, Yoon Jung;Lee, Jina;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.80-88
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    • 2012
  • Purpose: The aim of our study was to investigate the characteristics of the peritoneal dialysis (PD) - related peritonitis and to evaluate the effectiveness of the empirical antibiotics recommended by the International Society for Peritoneal Dialysis in Korean children. Methods: We retrospectively reviewed the medical records of 72 children on peritoneal dialysis at the Department of Pediatrics, Asan Medical Center over the period from March 2000 to February 2012. Results: Seventy-nine episodes of peritonitis occurred in 32 patients. The incidence of peritonitis was 0.43 episodes/patient year. There were no significant differences in the incidence of peritonitis in terms of dialysis modality (P=0.459). Twenty-one patients experienced 51 catheter exit-site infections (0.28 episode/patient year). There were no significant differences in the incidence of peritonitis between those with and without history of exit-site infections (P=0.721). Specific pathogens were isolated from 68.4% (54/79) of the patient with peritonitis episodes, including Gram-positive bacteria (n=34), Gram-negative bacteria (n=25) and fungus (n=1). Among Gram-positive bacteria, 85.3% of the isolates were susceptible to ${\beta}$-lactam antibiotics, among Gram-negative rods, 94.7% of the isolates were susceptible to ceftazidime. Among 25 cases with unknown etiologies, 92.0% of cases demonstrated satisfactory responses to cefazolin and ceftazidime. Conclusions: The incidence of peritonitis was 0.43 episodes/patient year. Initial empirical therapy consisting of cefazolin and ceftazidime was appropriate for 91.1% of the PD-related peritonitis treatment. Continuous monitoring for the emergence of the resistant organisms is an important part of the appropriate managements of PD-related peritonitis.

Clinical Application of Compressed Spectral Array During Deep Hypothermia (초저체온하 대동맥수술 환자에서 완전 순환차단의 안전한 체온 및 기간에 대한 연구 - 뇌파 Compressed Spectral Array의 임상적 응용 -)

  • 장병철;유선국
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.752-759
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    • 1997
  • Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

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Distribution of Foodborne Pathogens from Garlic Chives and Its Production Environments in the Southern Part of Korea (남부지방 부추와 재배환경의 식품매개병원균의 분포)

  • Jung, Jieun;Oh, Kwang Kyo;Seo, Seung-Mi;Yang, SuIn;Jung, Kyu-Seok;Roh, Eunjung;Ryu, Jae-Gee
    • Journal of Food Hygiene and Safety
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    • v.35 no.5
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    • pp.477-488
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    • 2020
  • Recently, foodborne illness outbreaks linked to fresh produce are being increasingly reported in the United States, the EU, and Korea as well. Some of this increase may be due to improved surveillance, increase in consumption, change in consumers' habits, and complex distribution systems. Garlic chive is a green, fresh-cut vegetable consumed year-round as a nutrition-rich herb in Korea. It is also prone to contamination with foodborne pathogens during pre-harvest, as amendment with high amounts of livestock manure or compost to soil is required in its cultivation. Our aim in this study was to evaluate microbial contamination of garlic chives, garlic chives cultivation soil, compost, and irrigation water in the southern part of Korea. Samples were collected in A, B, and C regions in 2019 and 2020, and 69, 72, 27, and 40 of garlic chives, soil, compost, and irrigated water, respectively, were analyzed for the presence of sanitary indicator bacteria (total aerobic bacteria, coliforms and Escherichia coli), Bacillus cereus, Staphylococcus aureus, pathogenic E. coli, E. coli O157:H7, Listeria monocytogenes, and Salmonella spp. In A, B, and C regions, levels of total aerobic bacteria, coliform, B. cereus, and S. aureus on all samples were between 1.14 and 8.83 log CFU/g, 0.43 and 5.01 log CFU/g, 0.41 and 5.55 log CFU/g, and 1.81 and 6.27 log CFU/g, respectively. B. cereus isolated from garlic chives and environmental samples showed β-hemolysis activity. Incidence of S. aureus in garlic chive and its production environments in 2020 was different from 2019. In this study, B. cereus and S. aureus were the only pathogenic microorganisms detected in all samples. As a result, this work suggests that continuous monitoring in the production and pre-harvest environment is required to improve hthe hygiene and safety of garlic chive.

Novel Real Time PCR Method for Detection of Plasmodium vivax (새로운 Real Time PCR 방법을 통한 Malaria(Plasmodium vivax)의 검출)

  • Ki, Yeon-Ah;Kim, So-Youn
    • Microbiology and Biotechnology Letters
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    • v.33 no.2
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    • pp.148-153
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    • 2005
  • Malaria is a re-emerging infectious disease that is spreading to areas where it had been eradicated, such as Eastern Europe and Central Asia. To avoid the mortality from malaria, early detection of the parasite is a very important issue. The peripheral blood smear has been the gold standard method for the diagnosis of malaria infection. Recently, several other methods have been introduced for quantitative detection of malaria parasites. Real time PCR that employs fluorescent labels to enable the continuous monitoring of PCR product formation throughout the reaction has recently been used to detect several human malaria parasites. 18S rRNA sequences from malaria parasites have been amplified using Taqman real time PCR assay. Here, a SYBR Green-based real time quantitative PCR assay for the detection of malaria parasite-especially, Plasmodium vivax - was applied for the evaluation of 26 blood samples from Korean malaria patients. Even though SYBR Green-based real time PCR is easier and cheaper than Taqman-based assay, SYBR Green-based assay cannot be used because 18S rRNA cannot be specifically amplified using 1 primer set. Therefore, we used DBP gene sequences from Plasmodium vivax, which is specific for the SYBR Green based assays. We amplified the DBP gene from the 26 blood samples of malaria patients using SYBR Green based assay and obtained the copy numbers of DBP genes for each sample. Also, we selected optimal reference gene between ACTB and B2M using real time assay to get the stable genes regardless of Malaria titer. Using selected ACTB reference genes, we successfully converted the copy numbers from samples into titer, ${\sharp}$ of parasites per microliter. Using the resultant titer from DBP based SYBER Green assay with ACTB reference gene, we compared the results from our study with the titer from Taqman-based assay. We found that our results showed identical tendency with the results of 18S rRNA Taqman assay, especially in lower titer range. Thus, our DBP gene-utilized real time assay can detect Plasmodium vivax in Korean patient group semi-quantitatively and easily.