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Yae-Jean Kim,Ki Woong Sung,황혜숙,정신한,김주연,조은주,임수진,최영배,주희원,이수현,유건희,구홍회 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.2
Purpose: The risk of invasive fungal infection is greater for allogeneic hematopoietic stem cell transplantation (HSCT) than for autologous transplantation. Therefore,many transplantation centers use antifungal prophylaxis for allogeneic HSCT, however, there exists no standard guidelines or consensus regarding autologous HSCT. Materials and Methods: A prospective double-blind randomized study was conducted in autologous HSCT recipients who were divided into prophylaxis and empirical treatment groups, and we investigated the efficacy of itraconazole prophylaxis in pediatric autologous HSCT. Results: Total 87 autologous HSCT episodes in 55 children with high-risk solid tumors were studied. No invasive fungal infections occurred in either group. However, patients in the prophylaxis group had a significantly shorter duration of fever (p < 0.05) and received antibacterial treatment of shorter duration (p < 0.05) with fewer numbers of antibiotics (p < 0.05 for the use of second line antibiotics) than those in the empirical group. No significant additional adverse events were found with itraconazole prophylaxis. Conclusion: Although beneficial effects such as a shorter duration of fever and reduced need for antibiotic use were observed in the prophylaxis group, the results were not sufficient to draw a definite recommendation about the routine use of antifungal prophylaxis in pediatric autologous HSCT recipients with high-risk solid tumors (Trial registration: NCT00336531).
Evaluation of Metabolic Syndrome Risk in Korean Premenopausal Women
Hyun, Yae Jung,Kim, Oh Yoen,Jang, Yangsoo,Ha, Jong-Won,Chae, Jey Sook,Kim, Ji Young,Yeo, Hyun Yang,Paik, Jean Kyung,Lee, Jong Ho Japanese Circulation Society. 2008 CIRCULATION JOURNAL Vol.72 No.8
<P><B>Background</B> In clinical practice, using the patient's waist circumference (WC) to evaluate visceral obesity may underestimate disorders with a metabolic origin. This study examined whether or not the WC derived from the cut-off point of the visceral fat area (VFA) can reflect the features of metabolic syndrome (MetS) in premenopausal women. <B>Methods and Results</B> Computed tomography-scanned VFA, MetS components and the concentrations of high-sensitivity C-reactive protein (CRP) and adiponectin were measured in a total of 349 premenopausal women. The VFA at the L1 and the L4 sites was a significant index (p<0.001) of incremental MetS risk. Receiver-operating characteristic curve analysis showed that 75 cm<SUP>2</SUP> of VFA at L4 and 87.5 cm<SUP>2</SUP> at L1 were the optimal thresholds for discrimination of MetS risk. Significant differences in all MetS components, as well as CRP (p<0.05) and adiponectin levels (p<0.005), were observed when subjects were subdivided by the L4 VFA cut-off point (<75/≥75 cm<SUP>2</SUP>), whereas there was a significant difference only in the triglycerides level in the groups divided by WC (WC <88/≥88 cm). Moreover, subjects with a lower WC - higher VFA showed a similar pattern in MetS components and lower adiponectin than those with a higher WC - higher VFA. <B>Conclusions</B> This study clarified that VFA rather than WC is a major determinant of MetS risk in premenopausal women. (<I>Circ J</I> 2008; <B>72:</B> 1308 - 1315)</P>
Choi, Yong Jun,Kim, Yae-Jean,Yong, Dongeun,Byun, Jung-Hyun,Kim, Taek Soo,Chang, Yun Sil,Choi, Min Ji,Byeon, Seung Ah,Won, Eun Jeong,Kim, Soo Hyun,Shin, Myung Geun,Shin, Jong Hee U.S. Department of Health and Human Services * Cen 2018 Emerging Infectious Diseases Vol.24 No.9
<P>We recently observed the emergence of fluconazole-resistant <I>Candida parapsilosis</I> bloodstream isolates harboring a Y132F substitution in Erg11p in South Korea. These Y132F isolates had a higher propensity to cause clonal transmission than other fluconazole-resistant isolates and persisted within hospitals for several years, as revealed by microsatellite typing.</P>
International travel of Korean children and Dengue fever: A single institutional analysis
Choi, Soo-Han,Kim, Yae-Jean,Shin, Ji-Hun,Yoo, Keon-Hee,Sung, Ki-Woong,Koo, Hong-Hoe The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.6
Purpose: Dengue fever occurs in many popular tourist destinations and is increasingly imported by returning travelers in Korea. Since Korea is not an endemic country for dengue fever, pediatricians do not usually suspect dengue fever in febrile children even with typical presentation and exposure history. This study was performed to describe the international travel experiences and dengue fever in Korean children. Methods: Travel histories were collected based on questionnaires completed by all patients' guardians who visited the pediatric infectious diseases clinic at Samsung Medical Center from January 2008 to December 2008. For patients who were suspected of dengue fever, a serological test was performed. Results: Five hundred and seventeen children visited the pediatric infectious diseases clinic for the first time during this period. About 30% of patients who responded to the questionnaire (101/339) had experienced international travel within the last 2 years. Four patients were diagnosed with dengue fever by serological test. Conclusion: Increasing numbers of Korean children visit dengue endemic areas and they may return home with dengue fever. Dengue fever should be suspected in patients who have a travel history to endemic areas.
Recommendation for use of the newly introduced pneumococcal protein conjugate vaccines in Korea
Choi, Eun-Hwa,Kim, Kyung-Hyo,Kim, Yae-Jean,Kim, Jong-Hyun,Park, Su-Eun,Lee, Hoan-Jong,Eun, Byung-Wook,Jo, Dae-Sun,Choi, Kyong-Min,Hong, Young-Jin The Korean Pediatric Society 2011 Clinical and Experimental Pediatrics (CEP) Vol.54 No.4
Streptococcus pneumoniae remains a leading cause of invasive infections including bacteremia and meningitis, as well as mucosal infections such as otitis media and pneumonia among children and adults. The 7-valent pneumococcal conjugate vaccine (PCV7) was licensed for use among infants and young children in many countries including Korea. The routine use of PCV7 has resulted in a decreased incidence of invasive pneumococcal disease (IPD) by the vaccine serotypes among the vaccinees and substantial declines in IPD among unvaccinated populations such as older children and adults as well. In addition, there are increasing evidences to suggest that routine immunization with PCV7 is changing the epidemiology of pneumococcal diseases such as serotype distribution of IPD, nasopharyngeal colonization, and antibiotic resistance patterns. In contrast, there is an increase in the number of IPDs caused by nonvaccine serotypes, though it is much smaller than overall declines of vaccine serotype diseases. Several vaccines containing additional serotypes have been developed and tested clinically in order to expand the range of serotypes of Streptococcus pneumoniae. Recently two new pneumococcal protein conjugate vaccines, 10-valent pneumococcal conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13), have been approved for use in several countries including Korea. This report summarizes the recommendations approved by the Committee on Infectious Diseases, the Korean Pediatric Society.
Recommendation for the use of newly introduced Tdap vaccine in Korea
Choi, Kyong-Min,Kim, Kyung-Hyo,Kim, Yae-Jean,Kim, Jong-Hyun,Park, Su-Eun,Lee, Hoan-Jong,Eun, Byung-Wook,Jo, Dae-Sun,Choi, Eun-Hwa,Hong, Young-Jin The Korean Pediatric Society 2011 Clinical and Experimental Pediatrics (CEP) Vol.54 No.4
Pertussis is an acute respiratory infection characterized by paroxysmal cough and inspiratory whoop for over 2 weeks. The incidence of pertussis has decreased markedly after the introduction of DTwP/DTaP vaccine, but the incidence of pertussis has increased steadily among young infant and among adolescents and adults in many countries. Td vaccine was used in this age group but the increase in pertussis has lead to the development of a Tdap vaccine. The Tdap vaccine is a Td vaccine with a pertussis vaccine added and is thought to decrease the incidence and transmission of pertussis in the respective age group. In Korea, two products are approved by the KOREA FOOD & DRUG ADMINISTRATION, which are ADACEL$^{TM}$ (Sanofi-Pasteur, Totonto, Ontario, Canada) and BOOSTRIX$^{(R)}$ (GlaxoSmithKline Biologicals, Rixensart, Belgium) for those aged between 11-64. This report summarizes the recommendations approved by the Committee on Infectious Diseases, the Korean Pediatric Society.
Systemic use of fluoroquinolone in children
Choi, Soo-Han,Kim, Eun Young,Kim, Yae-Jean The Korean Pediatric Society 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.5
Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.
Brain abscess in Korean children: A 15-year single center study
Lee, Cha-Gon,Kang, Seong-Hun,Kim, Yae-Jean,Shin, Hyung-Jin,Choi, Hyun-Shin,Lee, Jee-Hun,Lee, Mun-Hyang The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.5
Purpose: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were $S$ $intermedius$ (n=3), $S$ $aureus$ (n=3), $S$ $pneumoniae$ (n=1), Group B streptococcus (n=2), $E.$ $coli$ (n=1), $P.$ $aeruginosa$ (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.