No abstract available.
Thorax*

No abstract available.
Diagnosis*

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

No abstract available.
Humans ; Immunity, Cellular* ; Lung*

Waldenstrom's macroglobulinemia is characterized by overproduction of immunoglobulin M (IgM), which can lead to development of a hyperviscosity syndrome. Plasmapheresis has been used to reduce plasma viscosity and IgM levels. However, plasmapheresis not only removes pathogenic substances but also the normal components in plasma. Post-centrifugal plasma filtration (PCPF) using a filter with an appropriate pore size has been shown to be effective for selective removal of macromolecules in plasma without requiring a replacement fluid. Here, we report on a patient with hyperviscosity syndrome due to Waldenstrom's macroglobulinemia, which was ameliorated by a single treatment of PCPF using an Evaflux 5A filter. After centrifugation, the separated plasma of the patient was subjected to membrane filtration for removal of IgM in the plasma. After PCPF, a 56.5% reduction in the IgM level (from 9,370 mg/dL to 4,080 mg/dL) was achieved, whereas the level of albumin showed a slight decrease, from 2.7 g/dL to 2.4 g/dL (11.1% reduction). The patient's symptoms were relieved and she was discharged on the seventh hospital day.
Centrifugation ; Filtration ; Humans ; Immunoglobulin M ; Membranes ; Plasma ; Plasmapheresis ; Viscosity ; Waldenstrom Macroglobulinemia

No abstract available.
Humans ; Immunity, Cellular* ; Lymphocytes* ; Tuberculosis, Pulmonary*

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber disease, is a rare autosomal dominant vascular disorder involving arteriovenous malformation (AVM) due to angiodysplasia. HHT is characterized by mucocutaneous hemorrhagic telangiectasia and AVM of various different organs. The mutated genes in HHT encode proteins that mediate signaling by the transforming growth factor-beta superfamily, leading to migration and proliferation of endothelial cells to finally result in AVMs of various organs. Amongst various affected organs, pulmonary AVM is the most common. This 11-year-old female patient with a past and familial history of frequent epistaxis visited the hospital for abdominal pain and vomiting which developed on the same day. Nodular opacity was found in chest X-ray. Subsequently, AVMs in the lungs and the spleen were recognized in chest computed tomography along with detection of ENG gene mutation. Here we report a case of hereditary hemorrhagic telangiectasia diagnosed by incidental chest X-ray findings followed by genetic and radiologic studies.
Abdominal Pain ; Angiodysplasia ; Arteriovenous Malformations ; Endothelial Cells ; Epistaxis ; Female ; Humans ; Lung ; Proteins ; Spleen ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Thorax ; Vomiting

BACKGROUND: Rapid and sensitive detection of transfusion adverse reaction is fundamental to reducing transfusion-related morbidity and mortality. The aim of this study was to develop an effective system for reporting of transfusion adverse reaction. METHODS: Inpatient lists with transfusion adverse reaction on a nurse electronic medical records (EMR) from December 4th, 2014 to May 21st, 2015 were automatically selected and displayed to the computer screen of the blood bank data management system. After review of clinical and laboratory data of suspected patients with transfusion reaction, frequency of transfusion adverse reaction according to blood components was calculated. RESULTS: The frequency of transfusion adverse reactions according to blood components was, in decreasing order, red blood cells (RBC) 0.91% (58/6,404), frozen fresh plasma (FFP) 0.20% (5/2,549), and platelets 0.10% (6/5,728). Of 47 allergic reactions, the relative ratio by blood components was RBC 76.6%, platelets 12.8%, and FFP 10.6%. All of 22 febrile nonhemolytic transfusion reactions were RBC related reactions. CONCLUSION: The online transfusion adverse reaction reporting system based on a nurse EMR is helpful in easy and accurate estimation of transfusion adverse reaction incidence.
Blood Banks ; Blood Group Incompatibility ; Electronic Health Records* ; Erythrocytes ; Humans ; Hypersensitivity ; Incidence ; Inpatients ; Mortality ; Plasma

BACKGROUND: Vibrio species may be classified as halophilic or nonhalophilic on the basis of their requirement of NaCl for optimal growth. Recently, attention has been focused on the halophilic vibrios and Vibrio cholerae non-O1/O139 causing extraintestinal infections such as septicemia. The aim of this study is to elucidate the isolation rate and clinical manifestations of Vibrio species isolated from clinical specimens between 1996 and 2000 at Wonju Christian Hospital. METHODS: Stool specimens were inoculated onto the thiosulfate-citrate-bile salt-sucrose media, blood cultures were performed by automated blood culture systems with commercial bottles, and the others were cultured according to the routine procedures. RESULTS: The isolation rate of Vibrio in decreasing order were: V. parahaemolyticus; 87%(62/71), V. alginolyticus; 6%(4/71), V. cholerae non-O1; 4%(3/71), and V. vulnificus; 3%(2/71). The proportions of gastroenteritis and septicemia by Vibrio species were 89% and 7%, respectively. Patients with gastroenteritis recovered without special problem, but the mortality of septicemia was 80%. CONCLUSIONS: Ninety-seven percentage of clinical isolates of Vibrio species were halophilic vibrios, and the mortality of Vibrio septicemia was as high as 80%.
Cholera ; Gangwon-do* ; Gastroenteritis ; Humans ; Mortality ; Sepsis ; Tertiary Healthcare* ; Vibrio cholerae ; Vibrio Infections* ; Vibrio*