To investigate viral pathogenesis and in vivo efficacy of acyclovir (ACV) in mouse HSV-1 encephalitis models, female BALB/c mice aged 5 weeks were inoculated with strain F either intranasally (IN) or intracerebrally (IC). ACV-treatment by intraperitorneal injection with 0, 5, 10 and 25 mg/kg b.i.d. for 6days was commenced 1 h after infection. Body weight and signs of clinical disease were noted daily up to 2 weeks. ED50 of ACV in IN infection was 5mg/kg and 14.1 mg/kg in IC infection. Tissues of cental nervous system were collected from 2 mice per group everyday up to 5 days p.i. and the virus titers were measured. In IN infection model, high titers in eyes and trigeminal nerves were observed. ACV-treatment showed significant reduction of the titers in all the isolated. In IC infection model, cerebrum, cerebellum and brain stem showed high virus titers. ACV-treatment showed less significant reduction of virus titers than that in IN infection model. Reactivation of explanted trigeminal nerves from mice 30 day p.i. was monitored. In all of ACV treated mice reactivation was observed, i.e. even the highest dose of ACV did not inhibit the establishment of viral latency.
Acyclovir* ; Animals ; Body Weight ; Brain Stem ; Cerebellum ; Cerebrum ; Encephalitis* ; Female ; Herpes Simplex* ; Herpesvirus 1, Human* ; Humans ; Mice* ; Nervous System ; Simplexvirus* ; Trigeminal Nerve ; Virus Latency

PURPOSE: To develop a new scoring method for predicting the mortality at 28 days of life in premature infants. METHODS: From January 2000 to August 2001 (period I), medical records of 138 premature infants less than 32 weeks' gestation admitted at Asan Medical Center were reviewed retrospectively, and a predictive model (named as KCRIB28) was developed based on several steps of regression analysis. From January 2001 to December 2002 (period II), KCRIB28 was validated for 99 premature infants admitted at Ulsan University Hospital using retrospective cohort study, and compared with results of CRIB score for those infants. The primary outcome variable was death at 28 days of life. RESULTS: One hundred twenty seven (92%) of 138 infants during period I and 86 (86.9%) of 99 infants during period II survived over 28 days of life (P=0.07). The mean gestational age and birth weight (+/-SD) were 29.1+/-2.0 weeks and 1.23+/-0.35 kg, respectively, during period I, and 29.6+/-2.0 weeks and 1.37+/-0.46 kg, respectively, during period II. Gestational age, birth weight, 5-min. Apgar score and peak inspiratory pressure divided by birth weight at 12 hours of age were selected as parameters of KCRIB 28. Areas under the receiver operator characteristic curves (AUCs) were 0.84 (SEM, 0.08; 95%CI, 0.77-0.90) during period I and 0.89 (SEM, 0.06; 95%CI, 0.81-0.94) during period II. No differences in AUCs were found between KCRIB 28 and CRIB for patients during period II (P=0.75). CONCLUSION: KCRIB 28 can be used as a valuable measurement to predict the mortality of premature infants at 28 days of life.
Apgar Score ; Area Under Curve ; Birth Weight ; Chungcheongnam-do ; Cohort Studies ; Gestational Age ; Humans ; Infant ; Infant Equipment* ; Infant, Newborn ; Infant, Premature* ; Medical Records ; Mortality* ; Predictive Value of Tests ; Pregnancy ; Research Design* ; Retrospective Studies ; Ulsan

PURPOSE: The extended-spectrum beta-lactamase(ESBL) producing organism have emerged to be an important pathogen in neonatal intensive care unit(NICU). This study was conducted to investigate incidence, characteristics and risk factors associated with ESBL organism among newborns in NICU. METHODS: The subjects included 98 newborns admitted to NICU at Asan Medical Center between September 1998 to July 2002, from whom a total of 177 ESBL organisms were detected. Annual number of isolates, distribution of cultured sites, types of illness and patient profile were retrospectively reviewed and risk factors associated with the infection were identified between control group of 115 non-infected newborns. RESULTS: Of 177 ESBL isolates, 150(84.7%) and 27(15.3%) were ESBL producing K. pneumoniae and E. coli, respectively. The annual number of isolates were 2(1.1%), 23(13.0%), 126(71.2%), 17(9.6%) and 9(5.1%) for years 1998 to 2002. The annual incidence of sepsis due to ESBL organism was 2.9%, 8.2%, 17.8%, 3.1% and 2.8% for years 1998 to 2002:Year 2000 being an outbreak. The ESBL organisms were largely found in bronchial aspirates and urine. The infected patients were younger gestational age. The mean cultivation period was at 29.1+/-2.8 days. The risk factors for infection included, in the order of frequency, total parenteral nutrition, central venous catheterization, ventilator care, respiratory distress syndrome and dexamethasone therapy. CONCLUSION: Awareness of increasing infection due to ESBL producing organism in NICU is important not only for infection control but also placing a great limit in use of antibiotics, especially in premature infants.
Anti-Bacterial Agents ; beta-Lactamases* ; Catheterization, Central Venous ; Central Venous Catheters ; Chungcheongnam-do ; Dexamethasone ; Epidemiologic Studies* ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Infection Control ; Intensive Care, Neonatal* ; Parenteral Nutrition, Total ; Pneumonia ; Retrospective Studies ; Risk Factors ; Sepsis ; Ventilators, Mechanical