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Incidence and Clinical Manifestations of Rotaviral Infections in a Neonatal Intensive Care Unit (신생아중환자실 내 로타바이러스 감염의 발생 및 임상 양상)

  • Baek, Jae-Moon;Kim, Hee-Young;Lee, Jang-Hoon;Choi, Byung-Min;Lee, Jung-Hwa;Lee, Kwang-Chul;Hong, Young-Sook
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.55-63
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    • 2009
  • Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

A Study on status of school health and analysis of factors affecting school nursing activities in the secondary school in Seoul (서울지역 국민학교(國民學校) 양호교사의 학교간호업무(學校看護業務) 수행정도(遂行程度)에 관(關)한 연구(硏究))

  • Kim, Eun Hee
    • Journal of the Korean Society of School Health
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    • v.1 no.2
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    • pp.50-65
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    • 1988
  • This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

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Antrum Formation and Growth of Mouse Pre-antral Follicles Cultured in Two Different Culture Media without Hormones

  • Kim, Ju-Hwan;Kim, Hwan-Tae;Park, Kee-Sang;Song, Hai-Bum;Chun, Sang-Sik
    • Proceedings of the KSAR Conference
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    • 2001.03a
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    • pp.8-8
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    • 2001
  • Mouse follicles require the addition of gonadotropins (Gns) to complete maturation and ovulation of oocyte and antrum formation of follicles in vitro. However, we tried examination of in vitro growth of mouse pre-antral follicles in medium without Gns and physiological factors. And also, pre-antral follicles were isolated from ovaries by mechanical method. Our present studies were conducted to evaluate on the growth of follicles and intra-follicular oocytes and antrum formation in vitro of mouse pre-antral follicles in two different media. Pre-antral follicles (91-120${\mu}{\textrm}{m}$) were isolated mechanically by fine 30G needles not using enzymes from ovary of 3-6 weeks old female ICR mice. Isolated pre-antral follicles were cultured in 20 ${mu}ell$ droplets of TCM (n=17; follicles: 107.8 $\pm$ 1.58 ${\mu}{\textrm}{m}$; oocytes: 59.9$\pm$1.2 ${\mu}{\textrm}{m}$) or MEM (n=12; follicles: 109.3$\pm$2.53 ${\mu}{\textrm}{m}$; oocytes: 55.4 $\pm$1.6${\mu}{\textrm}{m}$) under mineral oil on the 60mm culture dish. All experimental media was supplemented with 10% FBS but without Gns and/or physiological factors. Pre-antral follicles were individually cultured in drops for 8 days. Antrum formation and growth of pre-antral follicles and intra-follicular oocytes were evaluated using a precalibrated ocular micrometer at $\times$200 magnifications during in vitro culture. Results between different groups were analyzed using combination of Student's t-test and Chi-square, and considered statistically significant when P<0.05. Antrum formation of pre-antral follicles had started in two culture media on day-2. On day-8, antrum formation had occurred in 58.3%(7/12) of pre-antral follicles cultured in MEM, but only in 23.5% (4/17) of those cultured in TCM (P=0.0364). Growth of pre-antral follicles and intra-follicular oocytes were observed on day-4 and -8. On day-4, follicular diameters was similar (P=0.1338) in TCM (119.4$\pm$2.58 ${\mu}{\textrm}{m}$) and MEM (125.4$\pm$4.52 ${\mu}{\textrm}{m}$). However, on day-8, diameters of pre-antral follicles cultured in MEM (168.9$\pm$17.29 ${\mu}{\textrm}{m}$) was significantly (P=0.0248) bigger than that in TCM (126.7$\pm$4.28 ${\mu}{\textrm}{m}$). On day-4 and -8, diameters of intra-follicular oocytes were similar TCM (67.1$\pm$1.3 and 72.4$\pm$0.9${\mu}{\textrm}{m}$) and MEM (65.2$\pm$1.7 and 73.3$\pm$1.5 ${\mu}{\textrm}{m}$), respectively. We can conform that medium not supplemented with Gns and/or physiological factors can be used for in vitro antrum formation and growth of mouse pre-antral follicles and intra-follicular oocytes. In conclusion, MEM supplemented with FBS can be used for growth in vitro of mouse pre-antral follicles isolated mechanically.

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Efficacy of Frozen-Thawed ET in Patients with Old Age or Non-Pregnant in Fresh ET Cycles (고령 환자와 신선주기 배아이식에서 임신에 실패한 환자에서 동결-융해 배아이식의 효용성)

  • Choi, Su Jin;Lee, Sun Hee;Song, In Ok;Koong, Mi Kyoung;Kang, Inn Soo;Jun, Jin Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.4
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    • pp.237-243
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    • 2006
  • Objective: The aim of this study was to evaluate the efficacy of frozen-thawed ET in poor prognosis patients such as the old age (38~44 years; OA group) and the patients who did not achieve clinical pregnancy with the first fresh ET cycle (non-pregnant patients; NP group). Methods: Laboratory and clinical data were collected from fresh and frozen-thawed ET cycles of OA and NP group. Controlled ovarian hyperstimulation (COH) and conventional insemination or ICSI, in vitro culture and ET were performed by routine procedures. Supernumerary embryos were frozen by the slow freezing method, and frozen embryos were thawed by the rapid thawing method. Embryo development, pregnancy and implantation rates were statistically analyzed by Student t-test and chi square test Results: Mean ages were similar between fresh ET ($40.0{\pm}1.8$ years, n=206) and frozen-thawed ET ($39.9{\pm}1.9$ years, n=69) cycles in OA group. However, the clinical pregnancy and implantation rate of subsequent frozen-thawed ET significantly higher than those of fresh ET cycles (29.0% and 11.2% vs. 16.5% and 7.0%, p<0.05). In NP group, there was no difference in the mean age between fresh ET ($31.2{\pm}2.3$ years, n=40) and frozen-thawed ET ($31.9{\pm}3.1$ years, n=119) in subsequent cycles. The clinical pregnancy and implantation rates were similar between the subsequent fresh ET (42.5% and 22.6%) and the frozen-thawed ET (40.3% and 18.8%). Conclusion: In old age patients, higher pregnancy rate of frozen-thawed ET compared to fresh ET cycles in this study. It may be related that better uterine environments for implantation in frozen-thawed ET cycles than that of non-physiological hormonal condition in uterus of fresh COH cycles.

Effectiveness of Soft Stimulation Protocol, Compared with Conventional GnRH Antagonist Multiple dose Protocol in Patients Undergoing Controlled Ovarian Stimulation with Intrauterine Insemination (과배란유도하 자궁강내 인공수정시술을 받는 환자에서 연성자극요법과 성선자극호르몬 길항제 다회투여법의 효과 비교)

  • Kim, Chung-Hoon;Kang, Hyuk-Jae;Kim, So-Ra;Jeon, Gyun-Ho;Lee, Hyang-Ah;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.135-142
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    • 2010
  • Objective: To evaluate the effectiveness of soft stimulation protocol using GnRH antagonist/clomiphene citrate (CC)/recombinant FSH (rFSH) in patients undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI), compared with GnRH antagonist multiple dose protocol (MDP) using GnRH antagonist/rFSH. Methods: Eighty infertile women were randomized to soft stimulation protocol group (n=40) or GnRH antagonist MDP group (n=40). In both groups, IUI was performed 36~40 hours after hCG injection. Statistical analysis was performed using Student's t-test, $\chi^2$ test or Fisher's exact test as appropriate. Results: Total dose and days of rFSH required for COS were significantly fewer in soft stimulation protocol group (p<0.001, p<0.001). A premature LH surge did not occur in any patients of both groups. Clinical pregnancy rate per cycle was similar between the two groups. Conclusion: Soft stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP despite fewer total dose and days of rFSH, and so can become one of the patient-friendly, cost-effective alternatives for infertile patients undergoing COS with IUI.

A Survey on the Knowledge and Attitudes of Women in Taegu toward Weaning Diet for Infants (이유식에 대한 대구지역 여성들의 인식조사)

  • Kim, Kyung-Ah;Lee, Eun-Sil;Lee, Young-Hwan;Shin, Son-Moon;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.370-382
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    • 1997
  • Successful weaning is very important to provide adequate nutrients for normal growth and to induce a good diet habit. We conducted a survey on the knowledge and attitudes of women who live in Taegu toward weaning in infants, to figure out how much they know about weaning diet for the infants, which source they prefer to get the information about weaning diet, whether their knowledge affect their practice about weaning in infants, and the most effective way to educate them. A survey was conducted with the prepared questionnaire on women who responded at the residential area and market place, and those who visited Department of Pediatrics, Yeungnam University Hospital from July 25 to September 15, 1997. Statistical analysis was done with student t-test and ANOVA using SPSS program. Among total 303 responders, those who aged between 30 and 39 years were 37.2%. Scores for the six questions about weaning policy showed highest in the age group between 30 and 39 years. Higher score was recorded in the more educated group, in those who get informations about weaning diet from books, magazines and pediatricians. The majority of the responders had wrong concepts, such as feeding weaning diet using bottle(69.1%), feeding mixed with formula in the same bottle(64.5%), addition of salt(68.4%). Those who had higher educational level preferred books, magazines rather than neighbors or mother to get informations about weaning diet. Those who preferred books or magazines started weaning, stopped bottle feeding, and used spoon earlier, and their children had unbalanced diet habits less frequently. Home-made food was used most frequently, and commercial products were used less frequently. Those who were employed preferred home-made food rather than commercial products, it may be caused by the difference of the educational backgrounds from those of the unemployed. In conclusion, most responders ask neighbors and mother to get informations about weaning, and the incorrect knowledge from them could cause inadequate weaning practice and induce bad diet habit in their children. We have to find the reasons why they did not refer books or magazines frequently, and the way to resolve the problem.

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Therapeutic Effect of Different Doses of Recombinant Human Granulocyte Colony-Stimulating Factor(rhG-CSF) on Neonatal Sepsis Complicated by Neutropenia (호중구 감소증이 합병된 신생아 패혈증에서 Recombinant Human Granulocyte Colony-Stimulating Factor(rhG-CSF)의 투여 용량에 따른 치료 효과)

  • Choi, Moon Young;Jung, Yeon Sook;Son, Dong Woo;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.439-448
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    • 2002
  • Purpose : The aim of this study is to determine and compare the effects of adjunctive therapy with different doses of recombinant human granulocyte-colony stimulating factor(rhG-CSF) on reversing sepsis-associated neonatal neutropenia, and their survival rate in a group I/II-type trial. Methods : RhG-CSF was injected subcutaneously to 10 septic-neutropenic neonates with doses of $10{\mu}g/kg$ from Oct. 1995 to Sep. 1996, and was administered to another 12 septic-neutropenic neonates with doses of $5{\mu}g/kg$ from Oct. 1996 to Sep. 1997. Neutrophilic responses and the outcomes of both groups were compared. Results : In the rhG-CSF $10{\mu}g/kg$ treated group and in the $5{\mu}g/kg$ treated group, the absolute neutrophil count(ANC) was $1,065{\pm}89$($mean{\pm}SEM$) and $1,053{\pm}131$, respectively. The only difference between the two groups was the peak ANC at 48 hours. Eight patients from the remaining nine of rhG-CSF $10{\mu}g/kg$ treated group(88.9%) and ten in $5{\mu}g/kg$ treated group(83.3%) survived the sepsis and were discharged without any problems. Conclusions : RhG-CSF can increase the neutrophil count in critically ill septic neutropenic neonats. The survival rate of both groups were up to 90%. This finding suggests that both doses of rhG-CSF may be effective in a therapeutically useful time frame to treat septic neonates with neonatal neutropenia attributable to bone marrow supression or neutrophil consumption.

A study of total sugar intake by middle school students in Jeju Province (제주지역 중학생의 총당류 섭취실태 연구)

  • Ko, Yang Sook;Kim, Eun Mi;Chae, In Sook;Lee, Hyun Sook
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.248-257
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    • 2015
  • Purpose: The aim of this study was to estimate total sugar intake and sugar intake-related dietary habit and nutrient intake of middle school students. Methods: Subjects included 1,184 middle school students (476 males and 708 females) residing in Jeju. This research analyzed daily dietary intakes of subjects using the 24 hour recall method and surveyed the dietary habit related to total sugar intake using questionnaires. Descriptive analysis, chi-square test, t-test, and ANOVA, using the SAS program were used for analysis of data. Results: The average daily total sugar intake was 60.3 g (male 50.5 g, female 66.9 g). Total sugar intake per meal was 6.5 g (10.8%) from breakfast, 9.0 g (14.9%) from lunch, 11.8 g (19.6%) from dinner, and 33.0 g (54.7%) from snacks. Food groups that contribute to the majority of total sugar intake were grains and their products (23.0 g), milk (11.0 g), fruits and their products (7.3 g), sugars and sweets (6.1 g), and vegetables and their products (5.8 g). In terms of total sugar intakes by cooking methods, desserts showed a greater amount than main and side dishes, and indicated in order of amount as follows: bread and cookies (11.5 g), dairy products (7.5 g), ice cakes (6.2 g), beverages (5.3 g), and fruits (4.5 g). Total sugar consumption was high for rice and side dishes such as noodles (10.2 g), fried foods (2.9 g), stir-fried foods (2.0 g), and cooked rice with seasoning (1.7 g). The daily intake of natural sugar, added sugar, and natural and added sugar was 18.3 g, 35.8 g, and 6.2 g, respectively. The high sugar intake group, which was over 20% of the energy from total sugar intakes, consumed significantly less Fe, Zn, vitamin B6, niacin, and vitamin E than the low sugar intake group, which was below 20%. Conclusion: Total sugar intake of second graders of middle schools on Jeju Island was 60.3 g/day, mostly obtained from snacks (54.7%). Therefore, nutritional education for proper selection of better snacks and for reduction of dietary sugar intake is needed for middle school students.

THE EFFECT OF VARIOUS BONDING SYSTEMS ON THE MICROTENSILE BOND STRENGTH OF IMMEDIATE AND DELAYED DENTIN SEALING (수종의 상아질 접착시스템이 즉시 및 지연 상아질 봉쇄의 미세인장결합강도에 미치는 영향)

  • Ha, Jin-Hee;Kim, Hyeon-Cheol;Hur, Bock;Park, Jeong-Kil
    • Restorative Dentistry and Endodontics
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    • v.33 no.6
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    • pp.526-536
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    • 2008
  • The purpose of this study was to compare the effect of various dentin bonding systems on microtensile bond strength of immediate dentin sealing (IDS) and delayed dentin sealing (DDS). Eighteen extracted permanent molars were used in this study. The teeth for DDS group were restored with a provisional restorations, and immersed in saline solution for 1 week, and divided into 3 subgroups according to various dentin bonding adhesives; SB subgroup (3 step total-etch adhesive), SE subgroup (2 step self-etch adhesive), XE subgroup (1 step self-etch adhesive). In IDS group, the teeth were divided into 3 subgroups, and applied with bonding adhesives as in DDS group. The teeth were restored with provisional restorations, and immersed in saline solution for 1 week. Indirect composite disc was cemented with resin cement, and all specimens were subjected to microtensile bond strength. The data were statistically analyzed with oneway ANOVA and Student t-test. The results were as follows: 1. The IDS group showed significantly higher ${\mu}TBS$ than DDS group in 3 step total-etch and 2 step selfetch adhesive (p < 0.05). 2. In IDS and DDS group, 3 step total-etch adhesive showed the highest ${\mu}TBS$ value, followed by 2 step self-etch, and 1 step self-etch adhesive. In IDS group, the ${\mu}TBS$ value for 1 step self-etch adhesive was significantly different from those of the other subgroups (p < 0.05), and in DDS group, there were statistical differences in all subgroup (p < 0.05). 3. Failure modes of tested dentin bonding adhesives were mostly mixed failure and only 1 step self-etch adhesive showed adhesive failure.

A Study on the Perception of Students in the Radiation Study on the Clinical Practices (임상실습에 대한 방사선 전공 학생들의 인식에 관한 연구)

  • Lee, Byung-Ryul;Kim, Hyun-Gil;Yoon, Myeong-Kwan;Lee, Gi-Jong;Cha, Sang-Young;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.37 no.3
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    • pp.211-221
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    • 2014
  • The clinical practices provide the students with a good opportunity to study the practical experiences in their field through the clinical training education in hospital. Now, in this study, comparing the perceptions of the clinic teachers with those of students at the clinical site. The study was conducted to the students attending universities located in Seoul and who finished the clinical practices in 2013. The questionnaires were distributed to the student and collected from them. The study were conducted to 275 questionnaires with frequency analysis, crosstabs, chi-square test and McNemar test. The major motivation was of the select radiography course was high employment rate(44.0%) and the satisfaction of radiography course was general(53.1%). 51.3% of the study answered 8 weeks current duration of clinical practices is proper. The 3-year course students answered that the period of clinical practices would be proper if it is performed in the winter vacation in their second year in college(47.3%). The 4-year course students answered that the first semester in their third years is proper for clinical practices( 27.7%). The students answered that they felt the lack in their knowledge on the professional field(32.4%) during the clinical practices and some of the practical training is different from the education performed at school(68.4%). Most of answered that they were satisfied with the clinical practices and among them they recognized the importance of the clinical practices ($3.94{\pm}0.89$). After the clinical practices, their desire for getting job as a radiography has changed from 84.1% to 82.9%. The reason why they want the job related to the radiation is because the job is stable (changed from 49.0% to 46.0% after the clinical practice) while the reason why they don't want be a radigrapher because that job is not proper for them (changed from 37.0% to 40.7% after the clinical practice) The effort should be made to enhance the position of radiation professionals through the improved education system to the students, rather giving them education for just employment.