PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants

BACKGROUND: Volatile anesthetics exert direct depressant and vasodilator effects on vascular smooth muscle. These effects may result in clinically relevant hemodynamic changes. However, the mechanism is not well known whereby volatile anesthetics inhibit the vasoconstrictor actions of catecholamines at vascular smooth muscle. METHODS: The present study examined the direct effects of isoflurane on responses of isolated rabbit thoracic arteries to the norepinephrine(a mixed alpha1- and alpha2-adrenoceptor agonist) and phenylephrine(a selective alpha1-adrenoceptor agonist) applied exogenously. The role of extra- and intracellular Ca2+ in norepinephrine-induced contractions was also examined. RESULTS: Norepinephrine and phenylephrine produced maximal responses of about the same magnitude; however, norepinephrine was more potint than phenylephrine. Isoflurane depressed only the upper portion(10(-5)~10(-4)M) of norepinephrine dose-response curves. The depression of contraction caused by isoflurane on the dose-response curves of norepinephrine and phenylephrine was more marked with phenylephrine than with norepinephrine; isoflurane(2~3%) caused a concentration-dependent attenuatian of the responses evoked by 10(-5) to 10(-3)M phenylephrine. Ryanodine(a selective inhibitor of sarcoplasmic reticulum Ca2+ channels) attenuated the contractile response to norepinephrine. In the Ca2+-free medium the contractile response to norepinephrine was attenuated as compared to control. CONCLUSIONS: Theses results suggest that isoflurane attenuates the contractile responses of isolated rabbit thoracic arteries to norepinephrine and phenylephrine probably interfering with postjunctional alpha1-receptor function.
Anesthetics ; Catecholamines ; Depression ; Hemodynamics ; Isoflurane* ; Muscle, Smooth, Vascular ; Norepinephrine* ; Phenylephrine ; Rabbits* ; Receptors, Adrenergic, alpha ; Sarcoplasmic Reticulum ; Sympathetic Nervous System ; Thoracic Arteries

No abstract available.
Infant ; Infant, Newborn ; Lissencephaly* ; Spasms, Infantile*

The addition of epinephrine to local anesthetics for peipheral nerve blocks reduces the risk of local anesthetic toxicity by delaying systemic absorption and prolongs block duration. But there is general agreement that epinephrine causes a decrease in plama K+ in humans that can be associated with a variety of cardiac dysrhythmias. Clonidine, a selective 2 adrenergic agonist, has been reported to increase the local anesthetic effect. And the addition of clonidine to local anesthetics in peripheral nerve block prolongs block duration and postoperative analgesia. The admixture of clonidine or epinephrine to bupivacaine for brachial plexus block was studied with regard to plasma potassium concentrations and hemodynsmie changes. Thirty-three patients of ASA physical statue I and II received an admixture of clonidine (150g; n=11), epinephrine (200g; n=11), or normal saline (placebo; n=11) to 30 ml of 0.5% bupivacaine in a randomized, double blind fashion. There were no differences in arterial blood pressure and heart rate among the three groups. In patients who had received epinephrine admixture, decrease of plasma potassium at 15min after block was significant compared with patients who had received clonidine. Clonidine may be a useful adjunt to loeal anesthetics in those patients in whom the administration of epinephrine is contraindicated.
Absorption ; Adrenergic Agonists ; Analgesia ; Anesthetics ; Anesthetics, Local ; Arrhythmias, Cardiac ; Arterial Pressure ; Brachial Plexus* ; Bupivacaine* ; Clonidine* ; Epinephrine* ; Heart Rate ; Humans ; Nerve Block ; Peripheral Nerves ; Plasma* ; Potassium*

No abstract available.
Osteoblastoma*

Odontogenic myxoma is one of rare tumors in oral and maxillofacial region and it is thought to be mesenchymal or ectomesenchymal origin. Its characteristics are benign and non-metastatic but it has the potential of local invasion and high recurrence rate. It originally occurs in atrium of heart and in central case, my xoma is located mainly in the maxilla and mandible. Most odontogenic myxoma develops in 2nd or 3rd decades of life and rarely occurs in child or older persons over fifty. The distribution of reported cases between the sexes is similar and the maxilla and mandible are equally affected or slightly higher in mandible. Clinically it is usually asymptomatic, however it can cause pain and paresthesia is complained in the advanced stages. Displacement and mobility of teeth have also been reported Odontogenic myxoma is not a frequent tumor, but in case of slow and painless growing tumor it must be considered as a differential diagnosis.
Child ; Diagnosis, Differential ; Heart ; Humans ; Jaw ; Mandible ; Maxilla ; Myxoma* ; Paresthesia ; Recurrence ; Tooth

OBJECTIVES: Although mercury (Hg) exposure is known to be neurotoxic in humans, its effects on liver function have been less often reported. The aim of this study was to investigate whether total Hg exposure in Korean adults was associated with elevated serum levels of the liver enzymes aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT). METHODS: We repeatedly examined the levels of total Hg and liver enzymes in the blood of 508 adults during 2010-2011 and 2014-2015. Cross-sectional associations between levels of blood Hg and liver enzymes were analyzed using a generalized linear model, and nonlinear relationships were analyzed using a generalized additive mixed model. Generalized estimating equations were applied to examine longitudinal associations, considering the correlations of individuals measured repeatedly. RESULTS: GGT increased by 11.0% (95% confidence interval [CI], 4.5 to 18.0%) in women and 8.1% (95% CI, -0.5 to 17.4%) in men per doubling of Hg levels, but AST and ALT were not significantly associated with Hg in either men or women. In women who drank more than 2 or 3 times per week, AST, ALT, and GGT levels increased by 10.6% (95% CI, 4.2 to 17.5%), 7.7% (95% CI, 1.1 to 14.7%), and 37.5% (95% CI,15.2 to 64.3%) per doubling of Hg levels, respectively, showing an interaction between blood Hg levels and drinking. CONCLUSIONS: Hg exposure was associated with an elevated serum concentration of GGT. Especially in women who were frequent drinkers, AST, ALT, and GGT showed a significant increase, with a significant synergistic effect of Hg and alcohol consumption.
Adult* ; Alanine Transaminase ; Alcohol Drinking ; Aspartate Aminotransferases ; Drinking ; Female ; gamma-Glutamyltransferase ; Humans ; Linear Models ; Liver* ; Longitudinal Studies* ; Male

No abstract available.
Prevalence* ; Ulsan*

No abstract available.
Hemorrhage*

OBJECTIVES: On September 2, 2010 and November 25, 2011, the Korean Research Project on Integrated Exposure Assessment to Hazardous Materials for Food Safety (KRIEFS) organized two international symposia in Seoul, Korea. KRIEFS, established by the Korean Food and Drug Administration in March 2010, envisioned these international symposia as means to obtain advanced experiences from other countries and to reflect on and refine the KRIEFS's survey design and methods. METHODS: For the first symposium KRIEFS invited human biomonitoring (HBM) experts from Germany, the US, and Canada. The visiting HBM experts shared the details of their national studies while the KRIEFS discussed study design, as well as the methods, results and policymaking processes of the KRIEFS project. The second symposium was organized to share the survey design and results on endocrine disruptors from Taiwan. RESULTS: The Speaker from Germany introduced the German Environmental Survey and shared their experiences in HBM design, such as the process of developing reference values, and discussed the new HBM plan in Germany and the European Union. The Representative from Canada shared insights from national HBM approach. In the case of the US, the speaker focused on risk communication with subjects in epidemiological studies. In the second international symposium, the speaker shared the experience of endocrine disruptors'studies from Taiwan. CONCLUSIONS: KRIEFS was able to better understand previous nationwide HBM research designs, policy making process, and risk communication with research subjects.
Canada ; Cohort Studies ; Endocrine Disruptors ; Epidemiologic Studies ; European Union ; Food Safety ; Germany ; Hazardous Substances ; Humans ; Korea ; Policy Making ; Reference Values ; Research Design ; Research Subjects ; United States Food and Drug Administration