Background Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns.
Methods We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks.
Results Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32–37, 28–31, and <28 weeks were 2.568 (95% confidence interval [CI], 1.141–5.778), 5.917 (95% CI, 2.264–15.464), and 7.441 (95% CI, 2.617–21.159) times higher, respectively, than those delivered at term. The ORs of CH in infants weighing 1,500–2,499 g, 1,000–1,499 g, and <1,000 g were 4.664 (95% CI, 1.928–11.279), 11.076 (95% CI, 4.089–29.999), and 12.544 (95% CI, 4.350–36.176) times greater, respectively, than those in infants weighing ≥2,500 g. The OR of CH was 6.795 (95% CI, 3.553–13.692) times greater in SGA than in non-SGA infants.
Conclusion The CH incidence in South Korea has increased significantly compared with that in the past. Gestational age, birth weight, and SGA were significantly associated with CH incidence.
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BACKGROUND The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment. METHODS: A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected. RESULTS: Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia. CONCLUSION: Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.
Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can be done using single photon emission computed tomography(SPECT) or positron emission tomography(PET) and multidetector CT(MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronary lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate developmnt of a comprehensive non-invasive assessment of coronary artery disease.
BACKGROUND Power spectrum analysis method is a powerful noninvasive tool for quantifying autonomic nervous system activity. In this paper, we developed a data acquistion system for estimating the activity of the autonomic nervous system by the analysis of heart rate and respiratory rate variability using power spectrum analysis. MATERIALS AND METHODS: For the detection of QRS peak and measurement of respiratory rate from patient's ECG, we used low-pass filter and impedence method respectively. This system adopt an isolated power for patient's safety. In this system, two output signnals can be obtained: R-R interval(heart rate) and respiration rate time series. Experimental ranges are 30-240 BPM for ECG and 15-80 BPM for respiration. RESULTS: The system can acquire two signals accurately both in the experimental test using simulator and in real clinical setting. CONCLUSION: The system developed in this paper if efficient for the acquisition of heart rate and respiration signals. The system will play a role in research area for improving our understanding of the pathophysiologic involvement of the autonomic nervous system in various disease states.
BACKGROUND Extended-spectrum beta-lactamases(ESBL) are enzymes that confer resistance to oxyimino-beta-lactams as well as to penicillins and cephalosporins. Strains of Klebsiella pneumoniae and Escherichia coli that produce ESBL have been increasingly prevalent in many countries. The purpose of this study was to investigate the ESBL production rate of K. pneumoniae and E. coli at the in Yeungnam University Medical Center. MATERIALS AND METHODS: Thirty-one isolates of K. pneumoniae and twenty-five isolates of E. coli were examined for ESBL by double disk synergy test, using 20/10microgram ticarcillin/clavulanic acid and 30microgram oxymino-beta-lactam(ceftazidime, ceftriaxone and aztreonam) disks. RESULTS: Fifty-two percent of K. pneumoniae and sixteen percent of E. coli isolates revealed double disk synersism. Majority of ESBL-producing strains(fifty-five percent) were isolated from patients in the intensive care unit. CONCLUSION: ESBL production of K. pneumoniae and E. coli were also common at the Yeungnam Univercity Medical Center and pose a serious problem for antimicrobial therapy.
The World Association for Sexology (WAS) will adopt a Declaration of Sexual Right as basic and fundamental human lights August this year in Hong Kong. Two years ago WAS has been developing a declaration of Sexual Rights in order to further promote sexual health and protect the sexual rights of everyone. Undoubtedly sexuality is one of the most intriguing subject in the area of human behavior abd psychology, and has been so since antiquity. The influence of sexual factors of human on all aspects of the society has been immense. The varieties of marriage, from traditional to the open marriage model are presented in front of our sight. The influences of women's movement in Korea, which has produced sexual, psychological, economic, political, familial and social changes look so small and the changes are not that much in America. But the profound effects of the woman's movement affect on Korean society being realized as man's view of woman and woman's view of herself undergo constant change and revaluation. With increased sexual awareness on the part of the public owing to mass media, for example AH-U-SEONG aired in TV and with increased emphasis on sexual matters in daily life, more and more physicians are being asked to deal with and manage sex-related problems in thei daily practice. Yet, despite the obvious need for informed sexual counseling, doctors are often uncomfortable about sexual matters and many physicians have no special expertise in this area. So physicians concerned in sexology especially such as gynecologists, urologists, psychiatrists and endocrinologists must realize well about sex-related knowledge which is needed for counseling the patient as medical consumer and gap between reality and ideality in sexual diagnosis and treatment. Establishment of management system for the people who have sexual problems is strongly needed to promote sexual health and protect the sexual rights of everyone and for the Sexual Rights as basic and fundamental human rights.
Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epilepsy children have associated problems such as physical and mental handicaps, psychological disorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized tonic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), atypical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%) were found. 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisciplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.