Enterobacter cloacae is isolated from 10 newborns in the neonatal Intensive care unit(NICU) of Seoul Red Cross Hospital from April, 1997 to June, 1997. Their gestational age is from 195-299 days(mean 244.3 days), and their birth weight was from 980-4,100g(mean 2,287g). We obtained 16 E, cloacae strains form their blood, urine, endotracheal tube, umbilical catheter and 4 of them were isolated from the same patient at different culture sites. We also obtained another 3 strains of E. cloacae from 14 persons who worked in NICU and 26 places of NICU. We analysed the molecular types of 19 isolates by using rep-PCR method. We get 6 different types of PCR-products from the patients and NICU workers, and NICU environments. We observed that the incidence of E. cloacae was decreased by handwashing and wearing personal plastic gloves during the care of NICU patients.
Birth Weight ; Catheters ; Cloaca ; Cross Infection ; Enterobacter cloacae* ; Enterobacter* ; Epidemiologic Studies* ; Gestational Age ; Hand Disinfection ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal* ; Plastics ; Red Cross ; Seoul

PURPOSE: We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. METHODS: This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. RESULTS: Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. CONCLUSION: The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.
Child ; Electroencephalography ; Epilepsy ; Humans ; Neurology ; Pediatrics ; Seizures

Background: The Advanced RBC Application of the CellaVision DM9600 system (CellaVision AB, Lund, Sweden) automatically characterizes and classifies red blood cells (RBCs) into 21 morphological categories based on their size, color, shape, and inclusions. We evaluated the diagnostic performance of the CellaVision Advanced RBC Application with respect to the classification and grading of RBC morphological abnormalities in accordance with the 2015 International Council for Standardization in Haematology (ICSH) guidelines. Methods: A total of 223 samples, including 123 with RBC morphological abnormalities and 100 from healthy controls, were included. Seven RBC morphological abnormalities and their grading obtained with CellaVision DM9600 pre- and post-classification were compared with the results obtained using manual microscopic examination. The grading cut-off percentages were determined in accordance with the 2015 ICSH guidelines. The sensitivity and specificity of the CellaVision DM9600 system were evaluated using the manual microscopic examination results as a true positive. Results: In pre-classification, > 90% sensitivity was observed for target cells, tear drop cells, and schistocytes, while > 90% specificity was observed for acanthocytes, spherocytes, target cells, and tear drop cells. In post-classification, the detection sensitivity and specificity of most RBC morphological abnormalities increased, except for schistocytes (sensitivity) and acanthocytes (specificity). The grade agreement rates ranged from 35.9% (echinocytes) to 89.7% (spherocytes) in pre-classification and from 46.2% (echinocytes) to 90.1% (spherocytes) in post-classification. The agreement rate of samples with withinone grade difference exceeded 90% in most categories, except for schistocytes and echinocytes. Conclusions The Advanced RBC Application of CellaVision DM9600 is a valuable screening tool for detecting RBC morphological abnormalities.

PURPOSE: Respiratory viral infection is one of the most common diseases in febrile infants. This study evaluates the clinical characteristics of febrile infants who were hospitalized for respiratory symptoms, with or without respiratory viral detection. METHODS: Seventy-six hospitalized infants aged 28-90 days with fever and respiratory symptoms from January 2011 to December 2012 were enrolled in this study. We performed reverse transcriptase polymerase chain reaction to identify 7 respiratory viruses from nasopharyngeal swabs. Also, we retrospectively reviewed the medical records to analyze the clinical features. RESULTS: Respiratory viruses were detected in 45 patients (RVP group). Respiratory syncytial virus (n=16) was most frequently detected, followed by human rhinovirus (n=10). Age, sex, past illness, and sibling's respiratory symptoms showed no differences between the 2 groups. Infants in the RVP group had a significantly higher incidence of tachypnea (22.2%) and abnormal breathing sounds (wheezing and rales, 57.8%) than those in the negative group (P=0.021, P=0.002 each). There were no significant differences in laboratory findings between the 2 groups. CONCLUSION: In our study, RSV was the most common virus in febrile infants aged 28-90 days with respiratory symptoms. Tachypnea and abnormal breathing sounds were more reliable clinical features to guess the detection of respiratory viruses. Further studies are required to confirm the values of these clinical features in febrile infants who have lower respiratory tract infections.
Fever ; Humans ; Incidence ; Infant* ; Medical Records ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Tachypnea

BACKGROUND: The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels. METHODS: Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records. RESULTS: Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups. CONCLUSION: The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.
Blood Glucose ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Energy Intake ; Female ; Humans ; Meals ; Obesity ; Weight Loss

BACKGROUND: The rheumatoid factor (RF) is the only serological marker in American College of Rheumatology criteria for the diagnosis of rheumatoid arthritis (RA), but its specificity is not satisfactory for the diagnosis of RA. We evaluated the diagnostic performance of a new anti-cyclic citrullinated peptide antibodies (anti-CCP) test with those of RF isotypes for the diagnosis of RA. METHODS: Anti-CCP was determined in 186 serum samples: 110 from RA patients, 30 from non-RA patients(rheumatic diseases other than RA), and 46 normal individuals. IgM RF by latex fixation test and IgA RF by ELISA were also assayed in each samples, and the results were compared to anti-CCP for sensitivity and specificity by the receiver-operating characteristic curve on optimal cut-off values. RESULTS: The sensitivity of anti-CCP was highest (80.0%) and the sensitivities of IgM RF, IgA RF were 71.8%, 45.5%, respectively. The sensitivity increased (from 80.0% to 88.2%) especially in the combination of anti-CCP with IgM RF. The specificity of IgA RF by ELISA were highest (96.0 %) and the specificity of anti-CCP (94.7%) was higher than that of IgM RF (71.4%). Anti-CCP was positive in 58.1% in 31 RA patients with negative IgM RF. CONCLUSIONS: The results said that the combination test of anti-CCP with IgM RF might be useful for the diagnosis of RA because of its higher sensitivity and specificity than IgM RF alone.
Antibodies* ; Arthritis, Rheumatoid* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Latex Fixation Tests ; Rheumatoid Factor* ; Rheumatology ; Sensitivity and Specificity

No abstract available.
Humans ; Respiratory Distress Syndrome, Newborn*

The inhalation of volatile substances has becoming a popular fad among adolescents in the world. Glue sniffing is associated with injury of nervous system, liver and kidney. And rarely abnormality of blood and bone marrow suppression can develop. The main components of volatile substances that cause hematologic abnormality is thought to be benzene, toluene, and xylene. A 24 year-old male was admitted to our hospital due to gum bleeding. He was a chronic glue and organic solvents sniffer for 6 years, and quit sniffing 1 year before admission. He had no specific drug history. On admission, CBC was as follows: WBC 2,500/mm3; hemoglobin 8.9g/dl; hematocrit 25.1%; platelet 2,000/mm3. Bone marrow biopsy showed severe hypocellular marrow compatible with aplastic anemia. We report a case of aplastic anemia after habitual sniffing of glue and volatile substances with brief review of the literature.
Adhesives* ; Adolescent ; Anemia, Aplastic* ; Benzene ; Biopsy ; Blood Platelets ; Bone Marrow ; Flavin-Adenine Dinucleotide ; Gingiva ; Hematocrit ; Hemorrhage ; Humans ; Inhalant Abuse ; Inhalation ; Kidney ; Liver ; Male ; Nervous System ; Solvents ; Toluene ; Xylenes ; Young Adult

PURPOSE: During the last few decades, very low birth weight (VLBW) infants had been treated with time-cycled pressure-limited ventilation. According to a recent study, however, lung damage is much more likely following volutrauma rather than barotrauma. Therefore, other researchers have started to study volume-guaranteed (VG) ventilation as a new method for infant respiratory distress syndrome. The aims of this study are to compare the effects and safety of VG ventilation with conventional intermittent mandatory ventilation (IMV) on mechanical ventilation in VLBW infants with respiratory distress syndrome (RDS). METHODS: A prospective study was performed from Jan, 2005 to Jun, 2006 in Dong-A University Medical Center NICU on 28 VLBW infants who were diagnosed with respiratory distress syndrome. The infants were randomly assigned to IMV or VG ventilation. The IMV and VG groups consisted of sixteen and twelve patients, respectively. We compared arterial blood gas analysis (ABGA), fraction of inspired oxygen (FiO2), peak inspiratory pressure (PIP), mean airway pressure (MAP) and ventilation index (VI) between the two groups during the four days after their birth. RESULTS: The mean gestational age of our infant patients was 27.8 (+/-2.2) weeks in the VG group and 27.7 (+/-2.3) weeks in the IMV group; the mean birth weight was 1103 (+/-239.1) g and 1061.2 (+/-322.4) g, respectively (P>0.05). Although the two groups had a similar FiO2 and VI, PIP and MAP were significantly lower in VG than IMV during the study pediod (P<0.001). There was no significant difference in the complications between the two groups. CONCLUSION: In this study, PIP and MAP are significantly lower in VG group than IMV group. These findings suggest that the new VG ventilation could reduce lung damage in VLBW infants with RDS. To achieve more effective results, this study needs to continue a long term study with a greater number of subjects.
Academic Medical Centers ; Barotrauma ; Birth Weight ; Blood Gas Analysis ; Gestational Age ; Humans ; Infant* ; Infant, Very Low Birth Weight* ; Lung ; Oxygen ; Parturition ; Prospective Studies ; Respiration, Artificial ; Ventilation*

PURPOSE : To evaluate the frequency of urinary tract anomalies in male neonates less than 3months old who presented with urinary tract infection(UTI) and to evaluate a appropriate imaging approach after first UTI. MATERIALS AND METHODS : During a period of 5 years, from March 1994 to February 1999, 65 male infants less than 3months old(range: 4-92 days, mean: 43 days) with UTI were evaluated. Ultrasound(US) and Voiding cystourethrogram(VCUG) were done in 60 patients. Due to refusal and technological problem, 5 patients were missed. 99mTc-dimercaptosuccinic acid renal scan (99mTc-DMSA renal scan) was recommended to most patients but performed in 40 patients. Renal scan was performed at least 3 months later after urinary tract infection. RESULTS : Urinary tract anomalies were found in 26 of 65 infants. Twenty-six had vesicoureteral reflux(VUR), two had both VUR and double ureter, two had both VUR and posterior urethral valve. In patients with VUR, eight had renal scar or renal atrophies. In case of renal scar or atrophy, grades of VUR were III or above. CONCLUSION : We suggest that US and VCUG should be routinely performed in infants(<3months)with first UTI. 99mTc-DMSA renal scan should be performed only when renal parenchymal damage was observed in US and VUR grade III or above in VCUG.
Atrophy ; Cicatrix ; Disulfiram ; Humans ; Infant* ; Infant, Newborn ; Male* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ureter ; Urinary Tract Infections* ; Urinary Tract*