Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants / 소아과

PURPOSE: With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. METHODS: We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. RESULTS: Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P=0.022) and fraction of inspired oxygen (P<0.001) were significantly higher in the dead group and values of base excess (P=0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, CO2, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P=0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P=0.022). CONCLUSION: Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.

Pathogens and Prognotic Factors for Early Onset Sepsis in Very Low Birth Weight Infants

PURPOSE: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants. METHODS: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated. RESULTS: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants. CONCLUSION: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.

Disinfection State and Effective Factors of Foodservice Facilities and Utilities of Elementary Schools in Busan

The purpose of this study was to investigate disinfection state and effective factors of foodservice facilities and utilities of elementary schools in Busan area. Foodservice facilities and utilities investigated in this study were ceiling, wall, floor, trench, greasetrap, hood, pest and dumb waiter. The questionnaire which was administered to 196 dietitians was used as a survey method. The results were as follows. The washing method of foodservice facilities and utilities was mainly used by detergent washing-natural dry. The disinfection method of foodservice facilities and utilities was mainly sanitized by sodium hypochlorite. Dumb waiter and hood were sanitized by 70% ethyl alcohol and iodine. In washing and disinfection frequencies of foodservice facilities and utilities ceiling was twice/year, wall, hood and pest control facilities were once/week, floor, trench, greasetrap and dumb waiter were everyday, respectively. Floor, trench, greasetrap and dumb waiter were disinfected properly, whereas ceiling, wall, hood and pest were not disinfected properly. The washing method was related to dietitian's marital status and education. The disinfection state was related to dietitian's age and career, having of sanitation check list. The disinfection method was also affected dietitian's marital status, number of employee, duration of foodservice, number of total serving and having of sanitation check list. Therefore based on the results of this study, it should be given to the microbiological study on disinfection of facilities and utilities such as ceiling, wall, floor, trench, greasetrap, hood, pest and dumb waiter and the dietitian and employee's sanitation training also should be conducted continuously.

Two Cases of Multiple Pilomatricoma / 대한피부과학회지

Pilomattiaoma, aften called calcifying epithelioma of Malherbe, is a benign tumor originating from the outer root sheath cell of the hair follicle and extending into the hair matrix, Pilomatricoma usually occurs as a single, asymptomatic dermal or subcutaneous nodule. Multiple lesions are quite unueuel, comprising only 2-3.5% of cases. We report two patients with multiple pilomatricoma.

Regulation of V-cadherin Expression on Human Dermal Microvascular Endothelial Cells / 대한피부과학회지

BACKGROUND: Cadherins are a supergene family of structurally related transmembrane glycoprotein. V-cadherin was a subclass of cadherin which expressed on endothelial cell as an endothelial cell cell adhesion molecule. The role of V-cadherin is still unclear in inflarnmation and immunologic responses. OBJECTIVE: Our purpose was to demonstrate the expression and the regulation of V-cadherin expression on human dermal microvascular endothelial cells(HDMEC) by biological response modifier(BRM). METHODS: The cell surface expression of V-cadherin on HDMEC that was unstimulated or pretreated with IL-1, TNF, IFN-, and PMA was evaluated by immunofluorescence flow cytometry and the enzyme-linked immunosorbent assay. RESULTS: 1. V-cadherin was constitutively expressed on unstimulated HDMEC. 2. Maximal expression of V-cadherin was observed at 16 hrs after stimulation with IL-1, at 6 hrs after stimulation with TNF and at 24 hrs after stimulation with IFN- on HDMEC. 3. V-cadherin expression on HDMEC was increased after stimulation with IL-1 or PMA. CONCLUSION: V-cadherin was constitutively expressed on HDMEC, and V-cadherin expression can be regulated by BRM. These results suggest V-cadherin may contribute to inflammation.

Clinical and Histopathological Characteristics of Trichrome Vitiligo / 대한피부과학회지

BACKGROUND: The term trichrome vitiligo was first suggested in 1964 by Fitzpatrick, There is a tan zone of varying width between the normal and the totally depigmented skin and this exhibits the intermediate hue. The etiopathogenesis and the histopathological characteristics of trichrome vitiligo are unknown. OBJECTIVE: Our purpose was to evaluate the clinical and histopathological characteristics of trichrome vitiligo. Methods . Four punch biopsies were taken from twenty-one patients with trichrome vitiligo; from vitiliginous skin, light brown skin, perilesional normal skin and normal skin as far as 5cm from the nearest vitiligo spot. The sections were stained with hematoxylin-eosin and S-100 protein. RESULTS: 1. Trichrome vitiligo occurred mostly on the trunk in active vitiligo vulgaris. 2. Vacuolar degeneration of the basal cell layer in the epidermis and mild inflammatory cell infiltration in the epidermis and dermis were more prominent in light, brown skin and perilesional normal skin than in vitiliginous skin and normal skin of trichrome vitiligo. 3. The number of melanocytes was decreased in light brown skin compared with perilesional normal skin(p<0.05), and in vitiligonous skin compared with light brown skin(p<0.05), 4. A few melanocytes were also observed in vitiliginous skin of trichrome vitiligo. 5. In the trichrome vitiligo, the result of treatment was excellent in cases of systemic PUVA therapy. CONCLUSION: Melanocytes, keratinocytes and lymphocytes may be involved in the genesis of depigmentation in trichrome vitiligo, which means cell-mediated immunity may play an important role in the pathogenesis of trichrome vitiligo.