• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.321-330
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• 1999

Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.6
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• pp.694-708
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• 2009

The principal objective of this study was to determine the effects of smoking & drinking on the diet, nutrient intake, and overall health. A sample of 262 youths, aged 16 to 18 year-old, was randomly selected from Seoul and its vicinity. The subjects participated by answering survey questions including general questions, questions regarding health, smoking & drinking habits, dietary habits, nutrient intake, physical characteristics, and smoking cessation plans. The average height, weight, and BMI of the subjects were $173.5{\pm}6.8\;cm$, $64.8{\pm}11.8\;kg$, and $21.4{\pm}3.7\;kg/m^2$, respectively. Among the subjects, 88% appeared to be interested in health and 43.5% of youth asserted that the best way to keep healthy was to engage in regular exercise. Among 63 smokers, 52 students (82.5%) used alcoholic beverages while 11 students (17.5%) did not use alcoholic beverages, meaning that smoking was a causative factor in drinking. 55.6% of youth reported beginning to smoke in middle school, and 38.1% of them asserted that curiosity was the motive for smoking. The youth reported that the craving for smoking was highest when hungry, and the best place to smoke was the restroom. 20 students (69.0%) answered that the only way to quit smoking was just to stop. 12 students (44.4%) reported that the main reason for failures in smoking cessation attempts was a lack of intention or willpower. 87.1% of all subjects answered that they were inclined to quit smoking, and 56.7% of them would be interested in attending a smoking cessation program if they had the opportunity. Among the smoking and drinking group, 50% of drinkers began to drink in high school, and the reason for drinking given was peer pressure-40% of drinkers answered that they wished to quit drinking. 34.4% of students appeared to have breakfast everyday, but 16.4% of students answered that they had quit eating breakfast. 52.5% of all students reported that the principal reason for overeating was the presence of one's favorite food, and the smoking and drinking group reported overeating more frequently than other groups (p<0.05). 72.6% of all subjects reported eating interim meals $1{\sim}2$ times daily, 36.4% of smokers ate carbonated beverages, 38.5% ate ice cream as a interim meal, and 38.5% of the drinking and smoking groups ate fruits, 26.9% of them ate fried foods, and some of them ate fast foods as a interim meal. Among smokers, the ratio of eating fat-rich foods, and meats such as kalbi and samgyupsal more than two times per week was higher, and 54.3% of smokers ate ice cream, cookies, and carbonated beverages more than two times per week (p<0.05). The total nutrient intake of the $15{\sim}19$-year youth group was much higher than the standard value. The energy intake of the smoking group and the drinking and smoking group was significantly higher than that of the normal group (p<0.05). Intakes of phosphorus (p<0.05), cholesterol (p<0.05), and sodium (p<0.05) were the highest among all groups. Accordingly, it is recommended that practical education programs be implemented to teach young students to resist peer pressures to smoke and drink. Additionally, education that acknowledges the importance of nutrition is necessary to avoid preferential eating and overeating due to smoking and drinking.such education can also teach students to eat a balanced diet and improve their physical development.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.777-783
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• 2006

Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.