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2009 Pandemic Influenza A(H1N1) Infections in the Pediatric Cancer Patients and Comparative Analysis with Seasonal Influenza (소아암 환자에서 2009 대유행 인플루엔자 A(H1N1) 감염의 임상적 고찰 및 계절 인플루엔자와의 비교 분석)

  • Choi, Soo Han;Yoo, Keon Hee;Ahn, Kangmo;Sung, Ki Woong;Koo, Hong Hoe;Kim, Yae Jean
    • Pediatric Infection and Vaccine
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    • v.19 no.2
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    • pp.61-70
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    • 2012
  • Purpose: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. Methods: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. Results: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. Conclusion: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.

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Current Status and Characteristics of Highly Pathogenic Avian Influenza (고병원성 가금인플루엔자의 최근 발생동향과 질병 특성)

  • Kim, J.H.;Sung, H.W.;Kwon, Y.K.;Lee, Y.J.;Choi, J.G.;Cho, S.J.;Kim, M.C.;Lee, E.K.;Jang, H.;Wee, S.H.;Mo, I.P.;Song, C.S.;Park, J.M.
    • Korean Journal of Poultry Science
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    • v.31 no.2
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    • pp.119-128
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    • 2004
  • Highly Pathogenic Avian Influenza (HPAI) is a very acute systemic disease in poultry, particularly in chickens and turkeys caused by HPAI viruses. An outbreak of HPAI caused by subtype H5N1, was first reported in a broiler breeder farm on December 10, 2003 in Korea, although there had been twenty one outbreaks of the disease reported in the world before. Since mid-December 2003, eight Asian countries have confirmed outbreaks of HPAI due to the same subtype. The outbreak has also resulted in at least twenty three fatal human cases in Vietnam and Thailand as of May 17, 2004 according to the WHO. Regarding the first outbreak of recent Asian HPAI, it has been suspected that some Asian countries with the exception of Korea and Japan veiled the fact of HPAI outbreaks since the last half of 2003, even though it was first reported in Korea. There have been total nineteen outbreaks of HPAI among chicken and duck farms in 10 provinces in Korea since Dec. 2003 and approximately 5,280,000 birds were slaughtered from 392 farms for eradication of the disease and preemptive culling. The origin of the H5Nl HPAI virus introduced into the country are unknown and still under epidemiological investigation. Current status of outbreaks and characteristics of HPAI will be reviewed and discussed on the basis of genetic, virological, clinicopathological, and ecological aspect, as well as future measures for surveillance and prevention of the disease in Korea.

The Clinical Characteristics and Mortality Factors of Patients with Hemorrhagic Complications after Anticoagulation Therapy with Warfarin (와파린 항응고 유지요법 중 발생한 급성출혈의 임상소견과 사망관련 인자)

  • Lee, Se-Ho;Kim, Nam-Kyu;Sohn, Chang-Hwan;Kim, Jung-Hun;Kim, Won;Lim, Kyung-Soo;Oh, Bum-Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.164-171
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    • 2009
  • Purpose: The number of patients who take warfarin is growing and so is the number of complications. Hemorrhage is the major complication, but the clinical characteristics and outcomes have not been determined for Korean patients. Therefore, we tried to evaluate the characteristics of the patients with hemorrhagic complications after taking warfarin as anticoagulation therapy. Methods: We retrospectively reviewed the medical records of the patients who visited the emergency room with bleeding complications after taking warfarin anticoagulation at the out-patient clinic for 1 year from 1 st January 2008. We compared between two groups (the major hemorrhage group vs. the minor hemorrhage group) according to the clinical criteria, the unstable vital signs that required blood transfusion, transfusion more than 2 units of blood, the need for further laboratory follow-up, the need for interventional treatment and the development of critical complications or death due to bleeding. Results: There were 150 patients who met the criteria and had acute hemorrhagic complications (the major group: 90 patients and the minor group: 60 patients). In the major hemorrhage group, the frequent sites of bleeding were the gastro-intestinal system (40 patients), lung (14 patients) and intracranium (7 patients). At the emergency room, the major group showed a higher initial INR of the activated prothrombin time than did the minor group (p=0.02). The bleeding sites of the fatal cases were the gastro-intestinal system (3 patients), lung (3 patients) and intracranium (3 patients), but the percentage of fatality was the highest for intracranium bleeding. Conclusion: In the major hemorrhage group, gastrointestinal bleeding was the most frequent complication and fatality was the highest for intracranium bleeding. An initially higher INR showed a greater risk of major bleeding, but not more fatalities.

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The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center (독극물정보센터 구축사업의 일환으로 시행한 전국단위 응급해독제 비축 및 배송경험)

  • Park, So Young;Oh, Bum Jin;Sohn, Chang Hwan;Jeong, Ru Bi;Lim, Kyoung Soo;Kim, Won;Ryoo, Seung Mok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.9-18
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    • 2013
  • Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

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A Case of Anticonvulsant Hypersensitivity Syndrome with Subcarinal Lymph node Enlargement and Eosinophilic Pneumonia Induced by Carbamazepine (Carbamazepine에 의한 기관분기부하 림푸절 종대와 호산구성 폐렴이 동반된 Anticonvulsant Hypersensitivity Syndrome 1예)

  • Jeon, Ik Soo;Jang, Jae Young;Park, Jee Eun;Song, Chun Young;Jung, Chang Wook;Kim, Sung Hun;Kang, Kyung Woo
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.55-60
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    • 2004
  • Anticonvulsant hypersensitivity syndrome (AHS) is an uncommon, but potentially fatal and mutilsystemic disorder that occurs after exposure to the arene oxide-producing anticonvulsants-carbamzepine, phenobarbital and phenytoin. The multisystemic reactions include fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis. The diagnosis of AHS is made by history of drug exposure and clinical course. No specific treatments are proved as benefit except discontinuing the offending drug and trying the steroids in some severe cases. We report a case of carbamazepine induced anticonvulsant hypersensitivity syndrome characterized by skin rash, eosinophilia, subcarinal lymphadenopathy and eosinophilic pneumonia. The patient was resolved completely after only discontinuing carbamazepine.

A Study for Raising up Entrepreneurship Facilitators with having Angel Investing Potentials to Promote "Creative Entrepreneurship" (창조형창업 활성화를 위한 엔젤투자역량 겸비 창업 Facilitators 양성방안 연구)

  • Yang, Young Seok;Hwangbo, Yun;Byun, Young Jo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.27-37
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    • 2013
  • In recent, Korean government TF Team announced new entrepreneurship policy of establishing virtuous cycle in high-tech venture startup financing ecosystem with emphasizing on 'boosting up angel investment and M&A.' This policy is brought not only to come up with the previous policy defects of creating less creative starts-up despite that government has put die-hard efforts, such as big chunk of budget dumping and policy preference, to promote high-tech starts-up since the year of 1997, but also to found right momentum of shifting entrepreneurship policy paradigm from government-direct to entrepreneur into indirect via utilizing the market forces. In particular, this policy puts a highlight on promoting angel investment, representing unfolding red carpets for creative economy. However, this policy confront critical fatal flaws such as a serious lacks of business angels which carry out the core function of government policy. In worse off, business angels cannot be raised up in short term period by taking other practical entrepreneurship ecosystem cases. As alternative, this paper propose the raising-up over entrepreneurship facilitators with having angel investing potentials in short term. In specific, this paper suggest the training methodology over the previous BI manager, passive simple angel investors, and consultants in entrepreneurship for embedding entrepreneurship facilitators. This paper carries four different specific studies. First, this paper implement literature review for entrepreneurship policy with respect to evaluating the previous entrepreneurship policies and making a diagnosis over its consequences. Second, it carries theoretical literature reviews relating to Korean angel investment and business incubation. Third, it proposes the concept of entrepreneurship facilitators. Fourth, it brings the alternatives of raising up entrepreneurship facilitators.

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A Clinical Review of Ectopic Pregnancy (자궁외임신의 임상적 고찰)

  • Hwang, Tai-Young;Nah, Yong-Yun;Kim, Jong-Wook;Park, Wan-Seok;Lee, Tae-Hyung;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.229-235
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    • 1985
  • This study was undertaken for the clinical evaluation and statistical analysis on the 88 women with histopathologically confirmed ectopic pregnancies who were admitted and treated from grand opening on May-28, 1983 to Sept.-30, 1985. Incidence of ectopic pregnancy was 1 in 22.2 deliveries and the most common age group was in 30~34 years of age. There was tendency of decreasing incidencies as the gravidity, panty or artificial abortion were over 3. The most common etiologic factor was pelvic inflammatory disease and procedures for family planning were the next common. Common symptoms were lower abdominal pain (85.2%) and vaginal spotting (56.8%). At the admission, hemoglobin level under 10gm% were 44.3%, 69.5% of urine HCG tests were positive. Culdocentesis was positive only in 75.9%. Termination was frequent at 6 ~ 7 weeks of gestation mostly with rupture or abortion. Free blood in the abdominal cavity was averaged 1,224 ml. 4 cases of clinicobiochemically suspected ectopic pregnancies with spontaneous regression were excluded, and there was no fatal case treated in hospital.

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A Study on the Calculation of Productive Rate of Return (생산투자수익률 계산방법에 대한 연구)

  • Kim, Jin Wook;Kim, Kun-Woo;Kim, Seok Gon
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.38 no.3
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    • pp.95-99
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    • 2015
  • The IRR(internal rate of return) is often used by investors for the evaluation of engineering projects. Unfortunately, it has serial flaws: (1) multiple real-valued IRRs may arise; (2) complex-valued IRRs may arise; (3) the IRR is, in special cases, incompatible with the net present value (NPV) in accept/reject decisions. The efforts of management scientists and economists in providing a reliable project rate of return have generated over the decades an immense amount of contributions aiming to solve these shortcomings. Especially, multiple internal rate of returns (IRRs) have a fatal flaw when we decide to accep it or not. To solve it, some researchers came up with external rate of returns (ERRs) such as ARR (Average Rate of Return) or MIRR (MIRR, Modified Internal Rate of Return). ARR or MIRR. will also always yield the same decision for a engineering project consistent with the NPV criterion. The ERRs are to modify the procedure for computing the rate of return by making explicit and consistent assumptions about the interest rate at which intermediate receipts from projects may be invested. This reinvestment could be either in other projects or in the outside market. However, when we use traditional ERRs, a volume of capital investment is still unclear. Alternatively, the productive rate of return (PRR) can settle these problems. Generally, a rate of return is a profit on an investment over a period of time, expressed as a proportion of the original investment. The time period is typically the life of a project. The PRR is based on the full life of the engineering project. but has been annualised to project one year. And the PRR uses the effective investment instead of the original investment. This method requires that the cash flow of an engineering project must be separated into 'investment' and 'loss' to calculate the PRR value. In this paper, we proposed a tabulated form for easy calculation of the PRR by modifing the profit and loss statement, and the cash flow statement.

A Case of Spontaneous Hemothorax Due to Rupture of Pseudoaneurysm in Type 1 Neurofibromatosis (신경섬유종증에 동반된 가성동맥류 파열로 발생한 자연 혈흉 1예)

  • Kim, Sun-Jong;Jeong, Hoon;Lee, Sung-Soon;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.122-126
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    • 2001
  • A non-traumatic, spontaneous hemothorax is rare. The most common causes are coagulopathy, due to anticoagulation treatment, and cancers with a metastasis to the pleural surface. Other unusual causes include thoracic endometriosis, ruptured aortic aneurysm, pulmonary arterio-venous malformation, coagulopathy, Osler-Rendeu-Weber syndrome, Ehlers-Danlos syndrome et cetera. A type 1 neurofibromatosis(Von Recklinghausen's disease) is an autosomal dominant disease that is characterized by multiple skin tumors(neurofibroma) and abnormal skin pigmentation(caf$\acute{e}$-au-lait spots). Some are accompanied by vasculopathy, and are present with a spontaneous hemothorax. Such cases are unusual but fatal. We have recently experienced a case where a young male patient with neurofibromatosis initially presented with hypovolemic shock due to a spontaneous hemothorax. Later, aortography revealed that the cause of the hemothorax was a rupture of a pseudoaneurysm of the right internal mammary artery and as a result, an embolization was performed. Here we report this case with a review of the appropriate literature.

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Expression Levels of GABA-A Receptor Subunit Alpha 3, Gabra3 and Lipoprotein Lipase, Lpl Are Associated with the Susceptibility to Acetaminophen-Induced Hepatotoxicity

  • Kim, Minjeong;Yun, Jun-Won;Shin, Kyeho;Cho, Yejin;Yang, Mijeong;Nam, Ki Taek;Lim, Kyung-Min
    • Biomolecules & Therapeutics
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    • v.25 no.2
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    • pp.112-121
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    • 2017
  • Drug-induced liver injury (DILI) is the serious and fatal drug-associated adverse effect, but its incidence is very low and individual variation in severity is substantial. Acetaminophen (APAP)-induced liver injury accounts for >50% of reported DILI cases but little is known for the cause of individual variations in the severity. Intrinsic genetic variation is considered a key element but the identity of the genes was not well-established. Here, pre-biopsy method and microarray technique was applied to uncover the key genes for APAP-induced liver injury in mice, and a cause and effect experiment employing quantitative real-time PCR was conducted to confirm the correlation between the uncovered genes and APAP-induced hepatotoxicity. We identified the innately and differentially expressed genes of mice susceptible to APAP-induced hepatotoxicity in the pre-biopsied liver tissue before APAP treatment through microarray analysis of the global gene expression profiles (Affymetrix $GeneChip^{(R)}$ Mouse Gene 1.0 ST for 28,853 genes). Expression of 16 genes including Gdap10, Lpl, Gabra3 and Ccrn4l were significantly different (t-test: FDR <10%) more than 1.5 fold in the susceptible animals than resistant. To confirm the association with the susceptibility to APAP-induced hepatotoxicity, another set of animals were measured for the expression level of selected 4 genes (higher two and lower two genes) in the liver pre-biopsy and their sensitivity to APAP-induced hepatotoxicity was evaluated by post hoc. Notably, the expressions of Gabra3 and Lpl were significantly correlated with the severity of liver injury (p<0.05) demonstrating that these genes may be linked to the susceptibility to APAP-induced hepatotoxicity.