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Clinical and Bacteriologic Efficacy of Cefdinir on Pharyngitis and Pharyngotonsillitis Caused by Group A Beta Hemolytic Streptococci in Children (Group A-beta Hemolytic Streptococci에 의한 소아 인두편도염에 있어서 Cefdinir의 항균력과 임상적 및 세균학적 효과에 관한 연구)

  • Chung, Ji-Young;Sin, Seon-Hee;Ahn, Young-Min;Ahn, Byung-Moon;Sin, Young-Gyu;Bae, Young-Min;Park, Soo-Eun;Kim, Jong-Guk;Lee, Jong-Guk;Ma, Saung-Hyuk;Chang, Jin-Kun;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.95-101
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    • 2003
  • Objective : To determine the clinical and bacteriologic efficacy and safety of Cefdinir in acute pharyngitis and pharyngotonsillitis caused by group A beta hemolytic streptococci in pediatric patients. Methods : Children aged 3 through 12 years who visited the hospitals enrolled in this study with signs and symptoms of pharyngitis or pharyngotonsillitis since May to December 2002, were taken throat culture and given Cefdinir(12 mg/kg/day, in three divided doses) for 7 days. Two hundred thirty five patients were enrolled and 90 patients who showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Follow-up culture were done at the end of the study and bacteriologic efficacy was determined Results : Ninety out of 235 patients who visited the hospitals with the signs and symptoms of pharyngitis showed positive growth on throat culture. Seventy nine patients were clinically and microbiologically assessable. The bacteriologic eradication rates of S. pyogenes were 100% in all the children treated with Cefdinir. Clinical cure rates were not different between less than 7 days-treated group(75%) and just 7 days-treated group(98.6%)(P=0.077). Two patients reported adverse reaction during Cefdinir treatment. Antimicrobial sensitivity of Cefdinir against S. pyogenes was 100% with range of MIC being less than 0.5 ${\mu}g/mL$. Conclusion : It seems that Cefdinir is one of reliable and well-tolerated drugs for the treatment of group A beta hemolytic streptococcal pharyngotonsillitis in children. It needs to be investigated short term efficacy in terms of improving drug compliance and impact of economic point of view. We can recognized that still high rate of the erythromycin resistant group A streptococci in our community should be monitored every year.

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Changing Patterns of Antibiotic-resistant Rates and Clinical Features in Pneumococcal Infections (폐구균의 질병양상 및 항균제 내성률의 변화)

  • Jang, Gwang-Cheon;Shin, Kyoung Mi;Yong, Dong-Eun;Lee, Kyung-Won;Kim, Dong-Soo
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.81-86
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    • 2003
  • Purpose : Streptococcus pneumoniae remains a leading cause of meningitis, sepsis, pneumonia, and otitis media in children worldwide. Emergence of drug-resistant organism has substantially complicated the therapy of these infections. This study was conducted to determine the clinical features and changing patterns of antibiotic-resistant rates of Streptococcus pneumoniae. Methods : We have retrospectively examined 306 cases of culture proven patients who were admitted to the Department of Pediatrics, Severance hospital, from the year 1991 to year 2000. The type of culture specimen used, presence of penicillin resistance, characteristics according to various presenting diseases and their prevailing year were also examined. Results : The mean age of cases was 7.9 year and the ratio of male to female was 1.6 : 1. The main age group of pneumococcal infection was under 2 years(42%). Systemic infections associated with pneumococci were sepsis(19.3%) and meningitis(9.5%), while local infections presented as pneumonia(29.2%), otitis media(19.3%), exudative tonsillitis(13.3%), and sinusitis(9.2%) in the order of frequency. Seasonal variation was seen in the incidence of pneumococcal infection: high incidence of infection was seen in Spring(Mar.~Apr; 32%), while the incidence was low during summer(Aug.~Sep.; 6%). Penicillin-resistant rate of pneumococci was steadily on the increase since the year 1991(65%) to year 2000(84%). Conclusion : Antibiotic-resistant pneumococci increased during the past decade. For effective prevention of pneumococcal infections, national survey of pneumococcal infections and expanded use of pneumococcal vaccination would be needed.

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A Small Outbreak of Measles in 2013: In a Single Hospital in Northern Gyeonggi-do (2013년 경기 북부 한 병원에서 확인된 소규모 홍역 유행)

  • Kim, Min Jae;Kim, So Hyun;Kim, Sung Un;Jang, Mi Jin;Lee, Hyun Seung;Kim, Young Hoon;Han, Ji Whan;Kim, Jin Tack;Jang, Pil Sang
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.63-68
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    • 2015
  • Purpose: This study analyzed a small outbreak of measles at a single hospital located in northern Gyeonggi-do in 2013. Methods: We reviewed the medical records of measles patients at The Catholic University of Korea Uijeongbu St. Mary's Hospital from August to October, 2013. Results: Fifteen children were confirmed to have measles by RT-PCR and serum IgM test; 1 neonate, 11 infants, and 3 toddlers. None of the patients had received Measles-Mumps-Rubella vaccination. All patients showed B3 type in viral genotyping. Nine children (60%) had been exposed to measles during treatment for other diseases in the pediatric ward. Incubation period was between 8 and 15 days. Fever started at a median 10 days after exposure and persisted for a median of 8 days. Rash showed at a median 13 days after exposure. Respiratory complications were observed in 40% of patients. Diarrhea developed in 53% of patients. Conclusion: Although measles has been well-controlled due to the high rate of vaccination coverage, it is possible to have an outbreak at any given time, especially in infants. We must learn from this outbreak, and remain fully aware of the possibility of reemergence and provide proper management, including vaccination or immune globulin administration, to infants exposed to measles. Reevaluation of serum IgG titer of neonates, infants, and pregnant women may be the first step to prevent further outbreaks.

Pulmonary Embolism In Childhood Minimal Change Nephrotic Syndrome (소아 미세변화 신증후군에서 폐색전증에 대한 연구)

  • Sung, Seung-Joon;Hong, Ki-Woong;Kim, Eun-Ryoung;Kim, Il-Soo;Cho, Byung-Soo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.100-108
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    • 2001
  • Purpose : We investigated the incidence and predisposing factors of pulmonary embolism in minimal change nephrotic syndrome(MCNS). Methods : Lung perfusion scan using 99mTC-MAA were done on 14 patients who were diagnosed to minimal change nephrotic syndrome. Group h: Five patients who had perfusion defects on scan, Group B; Nine patients who had no perfusion defect on scan. Between the two groups, the differences of platelet number, hematocrits, albumin, cholesterol, triglyceride, proteinuria were evaluated. Results : Five patients were found to have perfusion defect consistent with pulmonary embolism($35.7\%$). However, there were minimal or no respiratory symptoms and signs. In our laboratory studies, the mean proteinuria on admissions was $676{\pm}31\;mg/m2/hr$ in the group with pulmonary embolism, and $313{\pm}28\;mg/m2/hr$ in the group without pulmonary embolism. There were more severe proteinuria in group with pulmonary embolism(P<0.05). The mean platelet count at early stage of remission after steroid treatment was $746,600{\pm}280,000/mm3$ in the group with pulmonary embolism, $511,890{\pm}90,000/mm3$ in the group without pulmonary embolism. There were significant difference of platelet count between the two groups(P<0.01). In patients with pulmonary embolism, there were more higher and sustained increasement of platelet count. All cases of pulmonary embolism were treated with dipyridamole(5 mg/kg). In 4 cases the perfusion defects were improved in two weeks, however, one case showed persistent perfusion defect after 1 month. Conclusion : Our study suggested that pulmonry embolism might be one of tile major complications in childhood MCNS The occurrence rate was correlated with severity of proteinuria before treatment and sustained increasement of platelet counts in early remission state after steroid treatment. Therefore, the scintigraphic pulmonary perfusion study is mandatory in childhood MCNS, especially in the high risk patients, such as the patients with severe proteinuria and sustained increasement of platelet count. (J Korean Soc Pediatr Nephrol 2001;5 : 100-8)

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Analysis of Urinary Mass Screening for Second Grade of Elemantary School Children in Paju City (파주 지역 초등학교 2학년생에게 실시된 집단 뇨검사 분석)

  • Kim Sung Kee;Kim Young Kyoun;Park Yong Won;Lee Chong Guk
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.156-163
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    • 2001
  • Purpose We performed urinary mass screening(UMS) program for 2,804 children of second grade elemantary school 8 years of age in Paju city with cooperation of Paju City Health Center to determine the prevalence of asymptomatic proteinuria and hematuria, and to estimate the risk of incipient renal diseases. Also we attempted to evaluate the significance of hematuria in UMS in addidtion to proteinuria. Methods : 2,804 children of the 2nd grade of elementary school who lived in Paju city were included to our UMS program in 2000. They were constituted with 1,428 boys and 1,376 girls. The screening program was carried out in 3 steps The 1st screenig test was performed at schools and then students with abnormal results were examined repeatedly at Paju City Health Center and our hospital. Those students who showed proteinuria and/or hematuria in the 1st and 2nd test were referred to our hospital to undertake the 3rd close examination including physical examination, laboratory tests and radiologic tests. Results : (I) The prevalence of urinary abnormality in the 1st screening test was $8.3\%$(233 students), comprised of $5.9\%$ of boys, $10.8\%$ of girls. (2) Among 2,804 children tested in the first screening, prevalences of asymptomatic proteinuria and isolated hematuria were 64($2.3\%$), 163($5.8\%$) respectively, and the prevalence of proteinuria with hematuria was 6($0.2\%$). (3) Among 233 students with urinary abnormalities at the 1st screening test, 102 students applied to the 2nd test. 32 children, about one third of them, were also found to have abnormal urinary findings ; isolated hematuria 30, proteinuria with hematuria 2. (4) Those findings of clinical evaluation for children with isolated hematuria at the hospital showed as follows: idiopathic isolated microscopic hematuria 21, normal 6, urinary tract infection 1, idiopathic hypercalciuria 1 and simple renal cyst 1. Those 2 students with proteinuria and hematuria seemed to have chronic glomerulonephritis. Conclusion : (1) The clinical evaluation for children who showed positive results at the 1st screening test should be done judiciously. Because of high false positive rate, almost who showed positive results was normal, only a few of them had pathologic conditions. In this study, actual incidence of incipient renal diseases in children of 8 year old was calculated to be $0.4\%$. (2) The definite conclusion whether a urinary mass screening test can alter the prognosis of incipient renal diseases could not be drawn with this study. Further study must be necessary (3) We could acknowledge the significance of hematuria in UMS, but it is necessary that one should be judicious in managing and follow-up those that show abnormal results. (J Korean Soc Pediatr Nephrol 2001;5 : 156-63)

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Deterioration of the Physical Chemical Properties of the Vinyl House Soils by Continuous Vegetable Cropping (비닐하우스내(內) 토양(土壤)의 이화학적(理化學的) 성질(性質)에 관(關)하여)

  • Yoo, Sun Ho;Jeong, Yeong Sang;Shin, Yong Hwa
    • Korean Journal of Soil Science and Fertilizer
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    • v.7 no.4
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    • pp.227-234
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    • 1974
  • A survey on the vinyl house soils was conducted to investigate the salt accumulation status and it's effects on the deterioration of soil aggregates. The survey was made for the vinyl house soils in Suwon, Yesan, and Kimhae areas where vegetables are extensively grown under a vinyl house. Physical and chemical properties of the soils at the inside and outside of the vinyl house were compared to continuous vegetable cropping. Electrical conductivity of the soil solution (Y) in vinyl house was closely related to the number of cropping years (X), and the relations are given by the following regression equations: $Y=0.54X{\times}1.44$ ($r=0.580^*$) for loamy textured soils and $Y=0.58X{\times}2.61$ ($r=0.524^*$) for clayey textured soils. Electrical conductivity of the soils, where vegetable cropping in winter and rice in summer were rotated, was lower than that given by the regression equations. Analyses for extractable cations, the concentration of calcium, sodium and potassium was high in the inside vinyl house soils compared to the outside. Soil aggregates larger than 1mm in diameter were greatly deteriorated, while the content of the soil aggregates smaller than 0.5mm in diameter remained unchanged. Aggregate stability of the soil was negatively correlated to the accumulation rate of extractable sodium ($r=-0.681^{**}$), potassium ($r=-0.528^*$) and the amount of daily irrigated water (r=-0.477), while positively correlated to the content of organic matter ($r=-0.692^{**}$) and calcium (r=0.391).

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Nutritional Effects of Paper Board Sludge on the Garlic(Allium sativum L.) (마늘에 대(對)한 판지(板紙) SLUDGE의 영양학적(營養學的) 연구(硏究))

  • Kim, Moon-Kyu;Chang, Ki-Woon;Choi, Woo-Young;Lee, Chang-Jun
    • Korean Journal of Soil Science and Fertilizer
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    • v.23 no.3
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    • pp.208-213
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    • 1990
  • The parer board sludge (PBS) itself and compost sludge manure (CSM) made of sawdust, fowl droppings, and urea to the PBS were treated to garlic to determine the effects of growing characters, yield components, and nutritional compounds in the plants. 1. The differences of the rate of missing plants were not found between control and treatments. 2. Plant height of the garlic increased in the treatments of PBS and CSM rather than control. Numbers of leaf, and width of the largest leaf and stem did not have any distinct tendency to change. 3. Total weight and weight of the above ground part were highest in the treatment of 1,600kg/10a PBS, and CS-2 treatment mixed with high portion of additives. The weight of underground part and yield increased with the increase of paper board sludge, and highest in CS-2 treatment. 4. The contents of nitrogen in the plant were higher in the treatments of PBS and CSM than control. And CSM treatments had generally higher concentrations than PBS treatments. 5. In conclusion, PBS itself had nutritional effects. The PBS could be used to some crops after fermentation with adequate additives.

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Changes in Inorganic Phosphorus Fractions in P Accumulated Plastic Film House Soils under Different Cropping Condition (인산축적 시설 재배지 토양에서 작물재배에 따른 무기태 인의 형태별 함량 변화)

  • Jin, Sheng-Ai;Lee, Sang-Mo;Choi, Woo-Jung;Yoo, Sun-Ho
    • Korean Journal of Soil Science and Fertilizer
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    • v.34 no.4
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    • pp.255-264
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    • 2001
  • This study was conducted to investigate changes in inorganic phosphorus fractions in phosphorus accumulated plastic film house soils under cropping condition. Pot experiment was conducted with surface soils taken from plastic film house fields cultivated for 3, 8 and 16 years. Phosphorus fertilizer was applied at the rates of 0 (P0), $100kg\;ha^{-1}$ (recommended application rate. P1) and $200kg\;ha^{-1}$ (P2) as fused phosphate. Crops were grown sequentially in the order of corn-Chinese cabbage-Chinese cabbage-corn for 3 years. The content of easily soluble-P fraction was decreased with cropping. There were significantly positive relationship not only between the contents of easily soluble-P and the amounts of soil available P ($r=0.839^{**}{\sim}0.952^{**}$ for Bray-1 P, $r=0.895^{**}{\sim}0.967^{**}$ for Lancaster P, and $r=0.491^{**}{\sim}0.821^{**}$ for Olsen P), but also between the amounts of P absorbed by plants and the amounts of easily soluble P decreased ($r=0.644^{**}{\sim}0.822^{**}$). The decrease of easily soluble-P during cropping period could be described by a first-order reaction. The number of cropping times needed to decrease the content of easily soluble-P to an index level of $0.2mg\;kg^{-1}$, which is commonly reported as the desired concentration for soil P, was predicted in the range of 26~33 cropping times by using the equations. Regardless of P fertilization, the proportion of Al-P to total P was little varied during cropping period, but the proportion of Fe-P to total P increased with cropping. Although the content of Ca-P was high before cropping, the proportion of Ca-P to total P was increased with cropping. The proportion of reductant soluble-P to total P was little varied for P fertilizer treatment but was increased for no P fertilizer treatment. The residual-P was decreased during cropping period due to the absorption by crops and the conversion to other inorganic P fractions.

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Effects of Cryosurgery in Primary Lung Cancer (원발성 폐암에서 냉동수술의 치료 효과)

  • Jung, Won-Jae;Kim, Kwang-Taik;Yi, Eun-Jue;Lee, Sung-Ho;Kang, Moon-Chul;Chung, Jae-Ho;Ham, Soo-Yeoun;Jo, Sung-Bum
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.201-205
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    • 2009
  • Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, $54{\sim}77$ years). The average size of the tumors was 48.8mm (range, $36{\sim}111mm$) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A $x^2$-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

The Surgical Management of Hypoplastic Left Heart Syndrome and the Results of a Fontan Operation (좌심형성부전증후군의 외과적 치료 및 폰탄수술의 결과)

  • Chung, Eui Suk;Kim, Woong-Han;Jeon, Jae-Hyun;Choi, Chang-Hyu;Lee, Chang-Ha;Lee, Young-Tak
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.9-13
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    • 2009
  • Background: Hypoplastic left heart syndrome is uniformly fatal if this condition is not properly treated. We reviewed the surgical results of treating hypoplastic left heart syndrome, and we evaluated the hemodynamics and functional status of these patients after they underwent a Fontan operation. Material and Method: To assess the surgical results, we retrospectively reviewed the medical records of 6 (M/F=4/2) patients who underwent a staged operation, including a Norwood procedure, a bidirectional Glenn procedure and a Fontan procedure between October 1997 to May 2005. The mean age of the patients was $17.3{\pm}10.8$ days (range: 9~36 days) at the $1^{st}$ staged operation, $8.9{\pm}7.1$ months (4.6~23.3 months) at the $2^{nd}$ staged operation (the Bidirectional Glenn procedure) and $32.4{\pm}9.8$ months at the final staged operation (the Fontan procedure). During the $2^{nd}$ staged operation, one of the patients received tricuspid valve repair due to regurgitation. All the patients underwent an extracardiac Fontan procedure using Gore-Tex conduit (20 mm: 2 patients, 18 mm: 4 patients) and one of them required fenestration. Result: 21 patients underwented a Norwood procedure. There were 7 early deaths and 4 interstage deaths. Bidirectional cavopulmonary shunt was performed in 10 patients and the Fontan procedure was done in 6 (mortality: 1 patient, Flow up loss: 1 patient, Awaiting a Fontan procedure: 2 patients). After the Fontan procedure, there was no complication except for one case of post operative bleedings. All the patients had good ventricular function and 2 had grade I tricuspid regurgitation, as noted on their echocardiography. The average follow up period after the Fontan procedure was $19.6{\pm}14.9$ months (range: 1.5~39.1 month). All the patients had normal sinus rhythm and they were put on aspirin and cardiac medication. During follow up period, all the patients had a good functional status (NYHA functional class I). Conclusion: All the patients who suffered with hypoplastic left heart syndrome and who underwent a Fontan procedure achieved a good hemodynamic and functional status, even though there was a relatively high operative mortality rate after stage I Norwood palliation. Therefore, thise staged operation should be strongly recommended as an important surgical strategy for treating hypoplastic left heart syndrome.