BACKGROUND: The incidence of fungal infections varies among hospitals and between different time periods. We performed a nationwide survey in Korea to investigate the distribution of yeast and mold species recovered from clinical specimens. METHODS: The distributions of clinical isolates of yeast and mold species obtained from 12 university hospitals between January and December 2011 were evaluated relative to the hospital and specimen type. RESULTS: A total of 39,533 fungal isolates (37,847 yeast and 1,686 mold isolates) were obtained. C. albicans was the predominant species (49.4%) among the yeast isolates from all clinical specimens, followed by C. glabrata (7.2%) and C. tropicalis (6.5%). For 5,248 yeast isolates from sterile body fluids, blood was the most common source of yeasts (71.1%), followed by peritoneal fluid (9.4%). Although C. albicans was the predominant species at all but two hospitals, the rate of non-albicans Candida species varied from 71.2% to 40.1%, depending on the hospital. The yeast species recovered most frequently from the sterile body fluids was C. albicans (41.7%), followed by C. parapsilosis (17.8%) and C. glabrata (14.4%), while that from non-sterile sites was C. albicans (50.7%), followed by C. glabrata (6.0%) and C. tropicalis (5.5%). For mold-forming fungi, Aspergillus species (62.3%) were most common, followed by Trichophyton species (15.4%). Respiratory specimens were the most common source of molds (39.6%), followed by abscesses/wounds (28.4%) and tissues (17.5%). CONCLUSION: The rank order of distribution for different fungal species varied among hospitals and specimen types. Continual national surveillance programs are essential for identifying possible changes in fungal infection patterns.
Ascitic Fluid ; Aspergillus ; Body Fluids ; Candida ; Fungi ; Hospitals, University ; Incidence ; Korea ; Trichophyton ; Yeasts

We report the case of 60-yr-old female in which therapeutic hypothermia (TH) was successfully induced maintaining the target temperature of 34degrees C for 12 hr despite a risk of hypothermia-induced coagulation abnormalities following an emergent coronary artery bypass grafting (CABG) due to failed percutaneous coronary intervention, who suffered a cardiac arrest. Emergent CABG may be a relative contraindication for TH in post-cardiac arrest patients because hypothermia may increase the risk of infection and bleeding. However, the possibility of an improved neurologic outcome outweighs the risk of bleeding, although major surgery may be a relative contraindication for TH.
Body Temperature ; Coma/complications ; *Coronary Artery Bypass ; Electrocardiography ; Female ; Heart Arrest/complications/*diagnosis/therapy ; Humans ; *Hypothermia, Induced ; Intensive Care Units ; Middle Aged ; Percutaneous Coronary Intervention ; Treatment Outcome

PURPOSE: To compare the protective effects of saponin and non-saponin Sun-ginseng extract fractions in a selenite-induced rat cataract model. METHODS: A total of 101 Sprague-Dawley rat pups were divided into four groups by treatment: Sun-ginseng, saponin fraction, non-saponin fraction, and control. For induction of cataracts, sodium selenite 15 nmol/g was injected subcutaneously in 13 day-old rat pups. Sun-ginseng extract 100 microgram/g (Group I, Ginseng Science, Seoul, Korea), saponin fraction 100 microgram/g (Group II), non-saponin fraction 100 microgram/g (Group III), and phosphate buffered saline (Control group) were injected intraperitoneally every two days for a total of seven injections. The rats were sacrified and their lenses were dissected and photographed at day 7 and 14, and the cataracts were graded according to the ratio of the cataract area to the total lens area. The blind method was used for the evaluation of the cataract area. RESULTS: At day 14, cataract formation rates (CFR) were 33.3% in group I, 76.4% in group II, 41.2% in group III, and 77.7% in the control group. The mean cataract area (MCA) was 13.4+/-20.8% in group I, 14.4+/-11.7% in group II, 5.7+/-7.7% in group III, and 15.8+/-12.1% in the control group. Group III showed statistically significant results compared with those of control group (CFR p=0.001, MCA p=0.001). We observed significantly lower incidence and smaller mean cataract area in Group I and Group III at day 7 compared with the control group (Group I, CFR p=0.018; Group III, CFR p=0.032, MCA p=0.005). CONCLUSIONS: The protective effects of Sun-ginseng extract are caused by the components in the non-saponin fraction, not by those in the saponin fraction, in a selenite-induced cataract rat model.
Animals ; Cataract ; Incidence ; Panax ; Rats ; Saponins ; Sodium Selenite ; Solar System

OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
Adoption ; Confidentiality ; Delivery of Health Care ; Electronic Health Records ; Hospital Information Systems ; Information Systems ; Management Information Systems ; Quality of Health Care ; Radiology Information Systems ; Referral and Consultation

The Beijing family of Mycobacterium tuberculosis has been emerging in the world. However, there are few nationwide data of genotypic distribution in Korea. This study aimed to identify the genotypic diversity of clinical isolates of M. tuberculosis and to demonstrate the population of Beijing family in Korea. We collected 96 clinical M. tuberculosis isolates from 11 university hospitals nationwide in Korea from 2008 to 2009. We observed 24 clusters in IS6110-RFLP analysis and 19 patterns in spoligotyping. Seventy-five isolates were confirmed to be Beijing family. Two isolates of the K strain and 12 isolates of the K family strain were also found. We found that drug resistance phenotypes were more strongly associated with Beijing family than non-Beijing family (P=0.003). This study gives an overview of the distribution of genotypes of M. tuberculosis in Korea. These findings indicate that we have to pay more attention to control of M. tuberculosis strains associated with the Beijing family.
Drug Resistance, Bacterial ; Genotype ; Humans ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis/*classification/genetics/isolation & purification ; Phenotype ; Polymorphism, Restriction Fragment Length ; Republic of Korea ; Tuberculosis/*epidemiology/genetics/microbiology

PURPOSE: Small size of recombinant scFv antibody has many advantages such as rapid blood clearances and improved targeting antibodies to tumor region. On the other hand owing to small size, number of amino group is insufficient in conjugation with chelator and fluorescence labeling. This study is to introduce poly lysine tag to the C-terminal end of scFv lym-1 sequence for fluorescence chelator conjugation. MATERIALS AND METHODS: Poly lysine scFv lym-1 gene, cloned into pET-22b (+) vector, was expressed in E. coli BL21 (DE3) strain. Antibody purification was performed with Ni-NTA column and then size exclusion column chromatography. Expression and purification levels of poly lysine tagged scFv lym-1 antibody were confirmed by western blot analysis. I-124, I-125, I-131 and Tc-99m were used for radiolabeling of purified poly lysine scFv lym-1. Flow cytometry analysis of FITC conjugated poly lysine scFv lym-1 was performed for confirmation of immunoreactivity of human Burkitt`s lymphoma cells. RESULTS: Poly lysine scFv lym-1 antibody was purified through two steps and identified as molecular weight of 48 KDa. Radiolabeling yields of I-124, I-125, I-131 and Tc-99m into poly lysine scFv lym-1 were >99%, >99%, >95% and >99%, respectively. Flow cytometry analysis of poly lysine scFv and scFv lym-1 was showed similar immunoreactivity to human Burkitt`s lymphoma cells. CONCLUSION: Poly lysine tag was useful for the sufficient number of amino groups to scFv lym-1 antibody for chelator conjugation with minimizing loss of immunoreactivity.
Antibodies ; Blotting, Western ; Chromatography ; Clone Cells ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; Fluorescence ; Hand ; Humans ; Lymphoma ; Lysine ; Molecular Weight ; Sprains and Strains

PURPOSE: The HSV1-tk gene has been extensively studied as a type of reporter gene. In hepatocellular carcinoma (HCC), only a small proportion of patients are eligible for surgical resection and there is limitation in palliative options. Therefore, there is a need for the develoopement of new treatment modalities and gene therapy is a leading candidate. In the present study, we investigated the usefulness of substrate, 2'-fluoro-2'-deoxy-1-beta-D-arabino-furanosyl-5-[124/125I]iodo- uracil ([124/125I]FIAU) as a non-invasive imaging agent for HSV1-tk gene therapy in hepatoma model using small animal PET. MATERIAL AND METHODS: With the Morris hepatoma MCA cell line and MCA-tk cell line which was transduced with the HSV1-tk gene, in vitro uptake and correlation study between [125I]FIAU uptake according to increasing numeric count of percentage of MCA-tk cell were performed. The biodistribution data and small animal PET images with [124I]FIAU were obtained with Balb/c-nude mice bearing both MCA and MCA-tk tumors. RESULTS: Specific accumulation of [125I]FIAU was observed in MCA-tk cells but uptake was low in MCA cells. Uptake in MCA-tk cells was 15 times higher than that of MCA cells at 480 min. [125I]FIAU uptake was linearly correlated (R2=0.964, p=0.01) with increasing percentage of MCA-tk numeric cell count. Biodistribution results showed that [125I]FIAU was mainly excreted via the renal system in the early phase. Ratios of MCA-tk tumor to blood acting were 10, 41, and 641 at 1 h, 4 h, and 24 h post-injection, respectively. The maximum ratio of MCA-tk to MCA tumor was 192.7 at 24 h. Ratios of MCA-tk tumor to liver were 13.8, 66.8, and 588.3 at 1 h, 4 h, and 24 h, respectively. On small aninal PET, [124I]FIAU accumulated in substantial higher levels in MCA-tk tumor and liver than MCA tumor. CONCLUSION: FIAU shows selective accumulation to HSV1-tk expressing hepatoma cell tumors with minimal uptake in normal liver. Therefore, radiolabelled FIAU is expected to be a useful substrate for non-invasive imaging of HSV1-tk gene therapy and therapeutic response monitoring of HCC.
Animals ; Arabinofuranosyluracil ; Carcinoma, Hepatocellular ; Cell Count ; Cell Line ; Genes, Reporter ; Genetic Therapy ; Herpes Simplex ; Herpesvirus 1, Human ; Humans ; Liver ; Liver Neoplasms, Experimental ; Methylmethacrylates ; Mice ; Polystyrenes ; Simplexvirus ; Statistics as Topic ; Uracil ; Ursidae

Intraventricular hemorrhage is common in premature infants, and post-hemorrhagic hydrocephalus may follow. Rarely, intraventricular hemorrhage can occur in utero and may lead to congenital hydrocephalus. In most cases no underlying disease is identified. The fetus may be compromised by intrauterine hypoxia leading to hemorrhage. Fetal hydrocephalus can be identified by ultrasonography, but the hemorrhagic lesion can be identified with high sensitivity by magnetic resonance imaging. There are neurologic deficit in neonate with fetal hydrocephalus. Early surgical treatment is recommended for neurodevelopmental outcome. We experienced a case of congenital hydrocephalus associated with fetal intraventricular hemorrhage in our hospital. We report the case with a brief review of the literature.
Anoxia ; Fetus ; Hemorrhage ; Humans ; Hydrocephalus ; Infant, Newborn ; Infant, Premature ; Magnetic Resonance Imaging ; Neurologic Manifestations

PURPOSE: The purpose of this study is to image metastaic lung melanoma model with optimal pre-conditions for animal handling by using [18F]FDG small animal PET and clinical CT. MATERIALS AND METHODS: The pre-conditions for lung region tumor imaging were 16-22 h fasting and warming temperature at 30 degrees C. Small animal PET image was obtained at 60 min postinjection of 7.4 MBq [18F]FDG and compared pattern of [18F]FDG uptake and glucose standard uptake value (SUVG) of lung region between Ketamine/Xylazine (Ke/Xy) and Isoflurane (Iso) anesthetized group in normal mice. Metastasis tumor mouse model to lung was established by intravenous injection of B16-F10 cells in C57BL/6 mice. In lung metastasis tumor model, [18F]FDG image was obtained and fused with anatomical clinical CT image. RESULTS: Average blood glucose concentration in normal mice were 128.0+/-23.87 and 86.0+/-21.65 mg/dL in Ke/Xy group and Iso group, respectively. Ke/Xy group showed 1.5 fold higher blood glucose concentration than Iso group. Lung to Background ratio (L/B) in SUVG image was 8.6+/-0.48 and 12.1+/-0.63 in Ke/Xy group and Iso group, respectively. In tumor detection in lung region, [18F]FDG image of Iso group was better than that of Ke/Xy group, because of high L/B ratio. Metastatic tumor location in [18F]FDG small animal PET image was confirmed by fusion image using clinical CT. CONCLUSION: Tumor imaging in small animal lung region with [18F]FDG small animal PET should be considered pre-conditions which fasting, warming and an anesthesia during [18F]FDG uptake. Fused imaging with small animal PET and CT image could be useful for the detection of metastatic tumor in lung region.
Anesthesia ; Animals ; Animals* ; Blood Glucose ; Fasting ; Glucose ; Injections, Intravenous ; Isoflurane ; Lung* ; Melanoma ; Mice* ; Neoplasm Metastasis*

BACKGROUND: Emergence and spread of antimicrobial resistant bacteria make it difficult to treat infections. A rapid increase in antimicrobial-resistant bacteria has become a serious problem in many countries including Korea, and it is important to perform a nationwide study of antimicrobial resistance to obtain some basic data that will help solve these problems. The aim of this study was to determine the nationwide prevalence of resistance among frequently isolated bacterial pathogens in 2005 and 2006 in Korea. METHODS: We collected routine susceptibility data for medically important bacterial pathogens from 12 university and general hospital laboratories in Korea from April to September in 2005 and from January to June in 2006. Collected data was analyzed by patient group. RESULTS: The proportions of methicillin-resistant Staphylococcus aureus (MRSA) were 65% in 2005 and 72% in 2006, respectively. The resistance rates of Enterococcus faecium to vancomycin were 29% in 2005 and 24% in 2006. The non-susceptible rates of Streptococcus pneumoniae to penicillin were 68% in 2005 and 74% in 2006. The resistant rates of Escherichia coli and Klebsiella pneumoniae to the 3rd generation cephalosporin were 10~12% and 25~39%, respectively, in 2005 and 11~15% and 30~34% in 2006. In Citrobacter freundii, Enterobacter cloacae and Serratia marcescens, the resistance rates to 3rd generation cephalosporin were 23~31%, 32~34%, and 17~27%, respectively, in 2005 and 21~37%, 37~43%, and 13~31% in 2006. The resistance rates to imipenem and meropenem were 21% and 18%, respectively, in Pseudomonas aeruginosa and 18% and 25% in Acinetobacter baumannii in 2005; 29% and 20% in P. aeruginosa and 18% and 23% in A. baumannii in 2006. Cotrimoxazole and levofloxacin resistance rates of Stenotrophomonas maltophilia were 5% and 13%, respectively, in 2005 and 3% and 7% in 2006. There were no isolates resistant to 3rd generation cephalosporin and fluoroquinolone among non-typhoidal Salmonella in 2005. CONCLUSION: Antimicrobial resistance of medically important bacteria is still a serious problem in Korea. To manage the problem, a continuous nationwide surveillance and diversified investigation and effort have become more important.
Acinetobacter baumannii ; Bacteria* ; Citrobacter freundii ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Hospitals, General ; Humans ; Imipenem ; Klebsiella pneumoniae ; Korea* ; Levofloxacin ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Prevalence ; Pseudomonas aeruginosa ; Salmonella ; Serratia marcescens ; Stenotrophomonas maltophilia ; Streptococcus pneumoniae ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin