1.Exercise tolerance tests in patients with tetralogy of Fallot repaired earlier: correlation with 2-dimensional echocardiography and cardiac catheterization.
Jin Yong LEE ; Jun Hee SUL ; Sung Kyu LEE ; Dong Shik CHIN ; Bum Koo CHO ; Soo Kwan HWANG ; Dong Soo YEOUN
Journal of the Korean Pediatric Society 1992;35(2):157-167
No abstract available.
Cardiac Catheterization*
;
Cardiac Catheters*
;
Echocardiography*
;
Exercise Tolerance*
;
Humans
;
Tetralogy of Fallot*
2.Risk of Clostridium difficile Infection with the Use of a Proton Pump Inhibitor for Stress Ulcer Prophylaxis in Critically Ill Patients.
Youngouk RO ; Chang Soo EUN ; Hyun Soo KIM ; Ji Yeoun KIM ; Young Jae BYUN ; Kyo Sang YOO ; Dong Soo HAN
Gut and Liver 2016;10(4):581-586
BACKGROUND/AIMS: Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are commonly prescribed for stress ulcer prophylaxis (SUP) in critically ill patients. Several studies have suggested that the use of PPIs is a potential risk factor for Clostridium difficile infection (CDI). We compared the incidences of CDI in the PPI group and H2RA group for SUP in critically ill patients. METHODS: From August 2005 to July 2012, the incidences of CDI were retrospectively analyzed in patients who were admitted directly to intensive care units and stayed for more than 3 days. SUP-related CDI was defined as a CDI diagnosed during the SUP period. Patient clinical data were analyzed to identify potential risk factors for SUP-related CDI. RESULTS: Of the 1,005 patients enrolled (444 patients received PPI and 561 received H2RA), 38 (3.8%) were diagnosed with SUP-related CDI. The incidence of SUP-related CDI was considerably higher in patients who received PPI than in those who received H2RA (6.7% vs 1.8%). PPI use for SUP (odds ratio [OR], 3.3; confidence interval [CI], 1.5 to 7.1; p=0.003) and diabetes mellitus (OR, 2.3; CI, 1.2 to 4.7; p=0.019) were independent risk factors for SUP-related CDI. CONCLUSIONS: PPI therapy is associated with a higher risk of SUP-related CDI than H2RA therapy in critically ill patients.
Clostridium difficile*
;
Clostridium*
;
Critical Care
;
Critical Illness*
;
Diabetes Mellitus
;
Humans
;
Incidence
;
Intensive Care Units
;
Proton Pump Inhibitors
;
Proton Pumps*
;
Protons*
;
Retrospective Studies
;
Risk Factors
;
Ulcer*
3.A Case of Spontaneous Bacterial Peritonitis Caused by Listeria monocytogenes.
Byung Sihk KIM ; Tae Yeob KIM ; Ji Yeoun KIM ; Kyo Sang YOO ; Yong Chul JEON ; Dong Soo HAN ; Joo Hyun SOHN ; Jieun KIM
The Korean Journal of Gastroenterology 2013;62(3):179-181
Spontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with ascites caused by advanced liver disease. While gram negative bacteria, such as Escherichia coli and Klebsiella pneumonia are the common pathogens, Listeria monocytogenes has been recognized as a very rare pathogen. Empirical treatment with third generation cephalosporins does not provide adequate antibiotics coverage against L. monocytogenes. Diagnosis is often delayed as it requires confirmation from ascitic fluid culture. Herein, we describe the first case of SBP caused by L. monocytogenes in a patient with advanced alcoholic liver cirrhosis in Korea. Clinicians should be aware of the atypical pathogens, especially in patients with inadequate response to empirical antibiotics.
Ampicillin/therapeutic use
;
Anti-Bacterial Agents/therapeutic use
;
Ascites/microbiology
;
Humans
;
Listeria monocytogenes/*physiology
;
Listeriosis/*diagnosis/drug therapy
;
Liver Cirrhosis, Alcoholic/*diagnosis
;
Male
;
Middle Aged
;
Peritonitis/*diagnosis/*microbiology
4.Usefulness of Nested PCR for Diagnosis of Scrub Typhus in Clinical Practice: Prospective study.
Dong Min KIM ; Na Ra YUN ; Tae Young YANG ; Key Up MOON ; Keun Seong PARK ; Ji Hyun LEE ; Jong Tae YANG ; Hyeon Je SONG ; Eun Na CHOI ; Soo Kyoung SHIM ; Mi Yeoun PARK
Infection and Chemotherapy 2006;38(2):55-60
BACKGROUND: Laboratory studies as diagnostic tools of scrub typhus have shown PCR to be sensitive and specific, but there have been few clinical studies. The aims of this study were to determine the diagnostic accuracy and clinical usefulness of the nested PCR through a prospective comparison of the nested PCR and indirect immunofluorescence assay (IFA). MATERIALS AND METHODS: We conducted a multicenter prospective study of patients with possible scrub typhus. Adult patients who have had fever together with eschar or a maculopapular skin rash and more or equal to two of the following symptoms: headache, malaise, myalgia, coughing, nausea, and abdominal discomfort were enrolled. Each patient was admitted between September, 2004 and December, 2004 to Chosun University Hospital and one of its three community branch hospitals (Haenam General Hospital, Jangheung Hospital, Muan Hospital), which are all located in the southwest of Korea. Whole blood samples were collected for PCR testing and sera were obtained for serology evaluation using the IFA and passive hemagglutination assay (PHA). RESULTS: We enrolled 135 possible scrub typhus patients, and 118 scrub typhus patients were confirmed on the basis of either a single indirect immunofluorescent specific IgM titer against O. tsutsugamushi of > or =1:10 or 4-fold or greater rise in IFA follow up titer. One hundred eighteen patients were confirmed as scrub typhus, 7 patients were undetermined and 10 patients were confirmed as the other diseases. The result of nested PCR assay demonstrated a sensitivity of 82.2% (95% confidence interval 0.74-0.88), a specificity of 100% (95% confidence interval 0.66-1), positive predictive value of 1 (95% confidence interval 0.95-1) and negative predictive value of 0.32 (95% confidence interval 0.17-0.51). 96 patients out of 118 patients were positive for IgM on the admission day. Of 22 patients with negative for IgM antibody at admission, 19 had positive results for nested PCR using buffy coat. CONCLUSION: The nested PCR assay of buffy coat is useful for rapid and reliable test for confirmation of the diagnosis of scrub typhus.
Adult
;
Cough
;
Diagnosis*
;
Exanthema
;
Fever
;
Fluorescent Antibody Technique, Indirect
;
Follow-Up Studies
;
Headache
;
Hemagglutination
;
Hospitals, General
;
Hospitals, Satellite
;
Humans
;
Immunoglobulin M
;
Korea
;
Myalgia
;
Nausea
;
Orientia tsutsugamushi
;
Polymerase Chain Reaction*
;
Prospective Studies*
;
Scrub Typhus*
;
Sensitivity and Specificity
5.Usefulness of Nested PCR for Diagnosis of Scrub Typhus in Clinical Practice: Prospective study.
Dong Min KIM ; Na Ra YUN ; Tae Young YANG ; Key Up MOON ; Keun Seong PARK ; Ji Hyun LEE ; Jong Tae YANG ; Hyeon Je SONG ; Eun Na CHOI ; Soo Kyoung SHIM ; Mi Yeoun PARK
Infection and Chemotherapy 2006;38(2):55-60
BACKGROUND: Laboratory studies as diagnostic tools of scrub typhus have shown PCR to be sensitive and specific, but there have been few clinical studies. The aims of this study were to determine the diagnostic accuracy and clinical usefulness of the nested PCR through a prospective comparison of the nested PCR and indirect immunofluorescence assay (IFA). MATERIALS AND METHODS: We conducted a multicenter prospective study of patients with possible scrub typhus. Adult patients who have had fever together with eschar or a maculopapular skin rash and more or equal to two of the following symptoms: headache, malaise, myalgia, coughing, nausea, and abdominal discomfort were enrolled. Each patient was admitted between September, 2004 and December, 2004 to Chosun University Hospital and one of its three community branch hospitals (Haenam General Hospital, Jangheung Hospital, Muan Hospital), which are all located in the southwest of Korea. Whole blood samples were collected for PCR testing and sera were obtained for serology evaluation using the IFA and passive hemagglutination assay (PHA). RESULTS: We enrolled 135 possible scrub typhus patients, and 118 scrub typhus patients were confirmed on the basis of either a single indirect immunofluorescent specific IgM titer against O. tsutsugamushi of > or =1:10 or 4-fold or greater rise in IFA follow up titer. One hundred eighteen patients were confirmed as scrub typhus, 7 patients were undetermined and 10 patients were confirmed as the other diseases. The result of nested PCR assay demonstrated a sensitivity of 82.2% (95% confidence interval 0.74-0.88), a specificity of 100% (95% confidence interval 0.66-1), positive predictive value of 1 (95% confidence interval 0.95-1) and negative predictive value of 0.32 (95% confidence interval 0.17-0.51). 96 patients out of 118 patients were positive for IgM on the admission day. Of 22 patients with negative for IgM antibody at admission, 19 had positive results for nested PCR using buffy coat. CONCLUSION: The nested PCR assay of buffy coat is useful for rapid and reliable test for confirmation of the diagnosis of scrub typhus.
Adult
;
Cough
;
Diagnosis*
;
Exanthema
;
Fever
;
Fluorescent Antibody Technique, Indirect
;
Follow-Up Studies
;
Headache
;
Hemagglutination
;
Hospitals, General
;
Hospitals, Satellite
;
Humans
;
Immunoglobulin M
;
Korea
;
Myalgia
;
Nausea
;
Orientia tsutsugamushi
;
Polymerase Chain Reaction*
;
Prospective Studies*
;
Scrub Typhus*
;
Sensitivity and Specificity