1.A Case of Septicemia by Granulicatella adiacens.
Ohgun KWON ; Soon Duk PARK ; Young UH ; Kap Jun YOON ; Sang Ok KWON ; Hyo Youl KIM
Infection and Chemotherapy 2005;37(6):368-371
Granulicatella adiacens was first described as nutritionally variant streptococci, and named as Streptococcus adjacens and Abiotrophia adiacens. Granulicatella species are flora of oral cavity, upper respiratory, urogenital, and gastrointestinal tracts, and are normal often isolated from patients with infective endocarditis. G. adiacens endocarditis is associated with high mortality, but the species hardly grow in the ordinary growth media. We report a case of septicemia caused by G. adiacens in a 52-year-old woman with liver cirrhosis and chronic renal failure.
Abiotrophia
;
Endocarditis
;
Female
;
Gastrointestinal Tract
;
Humans
;
Kidney Failure, Chronic
;
Liver Cirrhosis
;
Middle Aged
;
Mortality
;
Mouth
;
Sepsis*
;
Streptococcus
2.A Case of Septicemia by Granulicatella adiacens.
Ohgun KWON ; Soon Duk PARK ; Young UH ; Kap Jun YOON ; Sang Ok KWON ; Hyo Youl KIM
Infection and Chemotherapy 2005;37(6):368-371
Granulicatella adiacens was first described as nutritionally variant streptococci, and named as Streptococcus adjacens and Abiotrophia adiacens. Granulicatella species are flora of oral cavity, upper respiratory, urogenital, and gastrointestinal tracts, and are normal often isolated from patients with infective endocarditis. G. adiacens endocarditis is associated with high mortality, but the species hardly grow in the ordinary growth media. We report a case of septicemia caused by G. adiacens in a 52-year-old woman with liver cirrhosis and chronic renal failure.
Abiotrophia
;
Endocarditis
;
Female
;
Gastrointestinal Tract
;
Humans
;
Kidney Failure, Chronic
;
Liver Cirrhosis
;
Middle Aged
;
Mortality
;
Mouth
;
Sepsis*
;
Streptococcus
3.Use of Boronic Acid Disks for the Detection of Extended-spectrum beta-lactamase and AmpC beta-lactamase in Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis.
Soon Deok PARK ; Young UH ; In Ho JANG ; Ohgun KWON ; Kap Jun YOON ; Hyo Youl KIM
Korean Journal of Clinical Microbiology 2009;12(1):24-29
BACKGROUND: Accurate detection of organisms producing extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase is very important for treatment of patients. However, unlike the ESBL confirmatory test, there are no guidelines for detection of organisms producing AmpC beta-lactamase. We evaluated a detection method using boronic acid (BA) for ESBL and AmpC beta-lactamase. METHODS: Clinical isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, and Proteus mirabilis showing intermediate resistance or resistance to cefoxitin (FOX) or positive for ESBL were tested. A > or =5 mm increase in zone diameter of ceftazidime/clavulanic acid/BA (CAZ/CA/BA) and/or cefotaxime/clavulanic acid/BA (CTX/CA/BA) versus CAZ/BA and/or CTX /BA was considered positive for ESBL. Likewise, a > or =5 mm increase in zone diameter of FOX/BA and/or cefotetan/BA (CTT/BA) versus FOX and/or CTT alone was considered positive for AmpC beta-lactamase. RESULTS: Among 622 clinical isolates, ESBL positive rates by the CLSI ESBL confirmatory test or by the BA method were 18.1% or 18.4% for E. coli, 38.3% or 40.4% for K. pneumoniae, 8.7% or 8.7% for K. oxytoca, and 14.8% or 14.8% for P. mirabilis, respectively. AmpC beta-lactamase positive rates using the BA method were 3.7% for E. coli, 33.3% for K. pneumoniae, 0% for K. oxytoca, and 7.4% for P. mirabilis. The detection rates of coproducing ESBL and AmpC beta-lactamase were 2.4% in E. coli 27.1% in K. pneumoniae, and 3.7% in P. mirabilis. CONCLUSION: The ESBL confirmatory method using BA was found to enhance the detection of ESBLs, even when potentially masked by AmpC beta-lactamase.
Bacterial Proteins
;
beta-Lactamases
;
Boron
;
Cefoxitin
;
Escherichia
;
Escherichia coli
;
Humans
;
Klebsiella
;
Klebsiella oxytoca
;
Klebsiella pneumoniae
;
Masks
;
Mirabilis
;
Penicillinase
;
Pneumonia
;
Proteus
;
Proteus mirabilis
4.Therapeutic Potential of the Rhizomes of Anemarrhena asphodeloides and Timosaponin A-III in an Animal Model of Lipopolysaccharide-Induced Lung Inflammation.
Byung Kyu PARK ; Kyung Su SO ; Hye Jung KO ; Hyun Joong KIM ; Ki Sun KWON ; Yong Soo KWON ; Kun Ho SON ; Soon Youl KWON ; Hyun Pyo KIM
Biomolecules & Therapeutics 2018;26(6):553-559
Investigations into the development of new therapeutic agents for lung inflammatory disorders have led to the discovery of plant-based alternatives. The rhizomes of Anemarrhena asphodeloides have a long history of use against lung inflammatory disorders in traditional herbal medicine. However, the therapeutic potential of this plant material in animal models of lung inflammation has yet to be evaluated. In the present study, we prepared the alcoholic extract and derived the saponin-enriched fraction from the rhizomes of A. asphodeloides and isolated timosaponin A-III, a major constituent. Lung inflammation was induced by intranasal administration of lipopolysaccharide (LPS) to mice, representing an animal model of acute lung injury (ALI). The alcoholic extract (50–200 mg/kg) inhibited the development of ALI. Especially, the oral administration of the saponin-enriched fraction (10–50 mg/kg) potently inhibited the lung inflammatory index. It reduced the total number of inflammatory cells in the bronchoalveolar lavage fluid (BALF). Histological changes in alveolar wall thickness and the number of infiltrated cells of the lung tissue also indicated that the saponin-enriched fraction strongly inhibited lung inflammation. Most importantly, the oral administration of timosaponin A-III at 25–50 mg/kg significantly inhibited the inflammatory markers observed in LPS-induced ALI mice. All these findings, for the first time, provide evidence supporting the effectiveness of A. asphodeloides and its major constituent, timosaponin A-III, in alleviating lung inflammation.
Acute Lung Injury
;
Administration, Intranasal
;
Administration, Oral
;
Alcoholics
;
Anemarrhena*
;
Animals*
;
Bronchoalveolar Lavage Fluid
;
Herbal Medicine
;
Humans
;
Lung*
;
Mice
;
Models, Animal*
;
Plants
;
Pneumonia*
;
Rhizome*
5.Epitheliogenesis imperfecta in a bovine fetus of Korean native cattle.
Moon Young RHYOO ; Ji Youl JUNG ; Ji Woong HER ; Myoung Heon LEE ; Kyung Nyer KU ; Kwon Rac CHOI ; Soon Seek YOON
Korean Journal of Veterinary Research 2014;54(4):253-256
In this study, we describe a case of epitheliogenesis imperfecta (EI) observed in the fetus of Korean native cattle. The fetus had multifocal areas of skin defect, especially on the distal portions of the four limbs, and the affected areas were bright-red and glistening. Histopathologically, these areas were characterized by complete absence of squamous epithelium, infiltration of inflammatory cells into the dermis, atrophy of hair follicles, sebaceous and sweat glands. To the best of our knowledge, this is the first report of epitheliogenesis imperfecta in Korean native cattle.
Animals
;
Atrophy
;
Cattle*
;
Dermis
;
Epithelium
;
Extremities
;
Fetus*
;
Hair Follicle
;
Skin
;
Sweat Glands
6.A case of malignant dysgerminoma in a slaughtered dairy cow.
Ji Youl JUNG ; Ji Woong HER ; Yea Ji JEONG ; Kyung Nyer KU ; Kwon Rac CHOI ; Byung Jae SO ; Soon Seek YOON
Korean Journal of Veterinary Research 2015;55(2):149-152
An abnormally enlarged right ovary and a mass in fat surrounding the right kidney were discovered in a dairy cow during routine postmortem examination at slaughter. The ovary was dark reddish and multinodular in shape. Numerous cystic structures were identified in the mass. Histopathologically, the ovary was completely replaced with large, uniform, polyhedral neoplastic cells containing vesicular nuclei and prominent nucleoli. The mitotic index was high. In the lymphatic vessels, tumor emboli were observed. Another mass in the fat surranding the right kidney had the same histological features as the ovarian mass. This animal was diagnosed with malignant dysgerminoma and metastasis to other peritoneal organs.
Animals
;
Autopsy
;
Dysgerminoma*
;
Female
;
Kidney
;
Lymphatic Vessels
;
Mitotic Index
;
Neoplasm Metastasis
;
Ovary
7.Prognostic Factors of Community-acquired Bacteremic Patients with Severe sepsis: A Prospective, Observational Study.
Young Kyung YOON ; Min Ja KIM ; Dae Won PARK ; Soon Sun KWON ; Byung Chul CHUN ; Hee Jin CHEONG ; Jun Yong CHOI ; Hee Jung CHOI ; Young Hwa CHOI ; Hyo Youl KIM ; Joong Sik EOM ; Sang Il KIM ; Young Goo SONG ; Kyong Ran PECK ; Yang Soo KIM ; June Myung KIM ; Jang Wook SOHN
Infection and Chemotherapy 2012;44(3):168-174
BACKGROUND: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis. MATERIALS AND METHODS: Adult patients (> or =18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May, 2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms, and the appropriateness of initial empirical antibiotic therapy. RESULTS: During the study period, 1,152 patients were diagnosed with community-acquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality. CONCLUSIONS: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.
Adult
;
APACHE
;
Bacteremia
;
Community-Acquired Infections
;
Escherichia coli
;
Hospitalization
;
Hospitals, Teaching
;
Humans
;
Prospective Studies
;
Respiratory Tract Infections
;
Risk Factors
;
Sepsis
;
Shock
;
Shock, Septic
8.Effect of shared decision-making education on physicians’ perceptions and practices of end-of-life care in Korea
Byung Chul YU ; Miyeun HAN ; Gang-Jee KO ; Jae Won YANG ; Soon Hyo KWON ; Sungjin CHUNG ; Yu Ah HONG ; Young Youl HYUN ; Jang-Hee CHO ; Kyung Don YOO ; Eunjin BAE ; Woo Yeong PARK ; In O SUN ; Dongryul KIM ; Hyunsuk KIM ; Won Min HWANG ; Sang Heon SONG ; Sung Joon SHIN
Kidney Research and Clinical Practice 2022;41(2):242-252
Evidence of the ethical appropriateness and clinical benefits of shared decision-making (SDM) are accumulating. This study aimed to not only identify physicians’ perspectives on SDM, and practices related to end-of-life care in particular, but also to gauge the effect of SDM education on physicians in Korea. Methods: A 14-item questionnaire survey using a modified Delphi process was delivered to nephrologists and internal medicine trainees at 17 university hospitals. Results: A total of 309 physicians completed the survey. Although respondents reported that 69.9% of their practical decisions were made using SDM, 59.9% reported that it is not being applied appropriately. Only 12.3% of respondents had received education on SDM as part of their training. The main obstacles to appropriate SDM were identified as lack of time (46.0%), educational materials and tools (29.4%), and education on SDM (24.3%). Although only a few respondents had received training on SDM, the proportion of those who thought they were using SDM appropriately in actual practice was high; the proportion of those who chose lack of time and education as factors that hindered the proper application of SDM was low. Conclusion: The majority of respondents believed that SDM was not being implemented properly in Korea, despite its use in actual practice. To improve the effectiveness of SDM in the Korean medical system, appropriate training programs and supplemental policies that guarantee sufficient application time are required.
9.Clinical Guidance for Point-of-Care Ultrasound in the Emergency and Critical Care Areas after Implementing Insurance Coverage in Korea
Wook Jin CHOI ; Young Rock HA ; Je Hyeok OH ; Young Soon CHO ; Won Woong LEE ; You Dong SOHN ; Gyu Chong CHO ; Chan Young KOH ; Han Ho DO ; Won Joon JEONG ; Seung Mok RYOO ; Jae Hyun KWON ; Hyung Min KIM ; Su Jin KIM ; Chan Yong PARK ; Jin Hee LEE ; Jae Hoon LEE ; Dong Hyun LEE ; Sin Youl PARK ; Bo Seung KANG
Journal of Korean Medical Science 2020;35(7):54-
Point-of-care ultrasound (POCUS) is a useful tool that is widely used in the emergency and intensive care areas. In Korea, insurance coverage of ultrasound examination has been gradually expanding in accordance with measures to enhance Korean National Insurance Coverage since 2017 to 2021, and which will continue until 2021. Full coverage of health insurance for POCUS in the emergency and critical care areas was implemented in July 2019. The National Health Insurance Act classified POCUS as a single or multiple-targeted ultrasound examination (STU vs. MTU). STU scans are conducted of one organ at a time, while MTU includes scanning of multiple organs simultaneously to determine each clinical situation. POCUS can be performed even if a diagnostic ultrasound examination is conducted, based on the physician's decision. However, the Health Insurance Review and Assessment Service plans to monitor the prescription status of whether the POCUS and diagnostic ultrasound examinations are prescribed simultaneously and repeatedly. Additionally, MTU is allowed only in cases of trauma, cardiac arrest, shock, chest pain, and dyspnea and should be performed by a qualified physician. Although physicians should scan all parts of the chest, heart, and abdomen when they prescribe MTU, they are not required to record all findings in the medical record. Therefore, appropriate prescription, application, and recording of POCUS are needed to enhance the quality of patient care and avoid unnecessary cut of medical budget spending. The present article provides background and clinical guidance for POCUS based on the implementation of full health insurance coverage for POCUS that began in July 2019 in Korea.
Abdomen
;
Budgets
;
Chest Pain
;
Critical Care
;
Dyspnea
;
Emergencies
;
Heart
;
Heart Arrest
;
Insurance Coverage
;
Insurance
;
Insurance, Health
;
Korea
;
Medical Records
;
National Health Programs
;
Patient Care
;
Point-of-Care Systems
;
Prescriptions
;
Shock
;
Thorax
;
Ultrasonography
10.Clinical Guidance for Point-of-Care Ultrasound in the Emergency and Critical Care Areas after Implementing Insurance Coverage in Korea
Wook Jin CHOI ; Young Rock HA ; Je Hyeok OH ; Young Soon CHO ; Won Woong LEE ; You Dong SOHN ; Gyu Chong CHO ; Chan Young KOH ; Han Ho DO ; Won Joon JEONG ; Seung Mok RYOO ; Jae Hyun KWON ; Hyung Min KIM ; Su Jin KIM ; Chan Yong PARK ; Jin Hee LEE ; Jae Hoon LEE ; Dong Hyun LEE ; Sin Youl PARK ; Bo Seung KANG
Journal of Korean Medical Science 2020;35(7):e54-
Point-of-care ultrasound (POCUS) is a useful tool that is widely used in the emergency and intensive care areas. In Korea, insurance coverage of ultrasound examination has been gradually expanding in accordance with measures to enhance Korean National Insurance Coverage since 2017 to 2021, and which will continue until 2021. Full coverage of health insurance for POCUS in the emergency and critical care areas was implemented in July 2019. The National Health Insurance Act classified POCUS as a single or multiple-targeted ultrasound examination (STU vs. MTU). STU scans are conducted of one organ at a time, while MTU includes scanning of multiple organs simultaneously to determine each clinical situation. POCUS can be performed even if a diagnostic ultrasound examination is conducted, based on the physician's decision. However, the Health Insurance Review and Assessment Service plans to monitor the prescription status of whether the POCUS and diagnostic ultrasound examinations are prescribed simultaneously and repeatedly. Additionally, MTU is allowed only in cases of trauma, cardiac arrest, shock, chest pain, and dyspnea and should be performed by a qualified physician. Although physicians should scan all parts of the chest, heart, and abdomen when they prescribe MTU, they are not required to record all findings in the medical record. Therefore, appropriate prescription, application, and recording of POCUS are needed to enhance the quality of patient care and avoid unnecessary cut of medical budget spending. The present article provides background and clinical guidance for POCUS based on the implementation of full health insurance coverage for POCUS that began in July 2019 in Korea.