Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. Results: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). Conclusion Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

Background/Aims: The fecal microbiota of Korean patients with inflammatory bowel disease (IBD) was investigated with respect to disease phenotypes and taxonomic biomarkers for diagnosis and prognosis of IBD. Methods: Fecal samples from 70 ulcerative colitis (UC) patients, 39 Crohn’s disease (CD) patients, and 100 healthy control individuals (HC) were collected. The fecal samples were amplified via polymerase chain reaction and sequenced using Illumina MiSeq. The relationships between fecal bacteria and clinical phenotypes were analyzed using the EzBioCloud database and 16S microbiome pipeline. Results: The alpha-diversity of fecal bacteria was significantly lower in UC and CD (P<0.05) compared to that in HC. Bacterial community compositions in UC and CD were significantly different from that of HC according to Bray-Curtis dissimilarities, and there was also a difference between community composition in UC and CD (P=0.01). In UC, alpha-diversity was further decreased when the disease was more severe and the extent of disease was greater, and community composition significantly differed depending on the extent of the disease. We identified 9 biomarkers of severity and 6 biomarkers of the extent of UC. We also identified 5 biomarkers of active disease and 3 biomarkers of ileocolonic involvement in CD. Lachnospiraceae and Ruminococcus gnavus were biomarkers for better prognosis in CD. Conclusions The fecal microbiota profiles of IBD patients were different from those of HC, and several bacterial taxa may be used as biomarkers to determine disease phenotypes and prognosis. These data may also help discover new therapeutic targets for IBD.

OBJECTIVE: We tried to confirm the effects of green tea extracts (polyphenon E, EGCG) in patients with human papilloma virus (HPV) positive cervical lesion. METHODS: We divided 51 HPV positive cervical lesion patients (chronic cervicitis, mild dysplasia, moderate dysplasia and severe dysplasia) into 4 group and 37 patient as placebo control. We applied poly E ointment two times per week (27 patients), poly E ointment plus poly E capsule (8 patients), poly E capsule (6 patients), EGCG capsule (10 patients) 200 mg each for 8 to 12 weeks. RESULTS: Among 27 patients with poly E ointment group, 20 patients responded (74%), such as chronic cervicitis (12/18), mild dysplasia (4/5), moderate dysplasia (2/2) and severe dysplasia (1/2). Among 8 patients with poly E ointment and poly E capsule group, 6 patients responded (75%), 6 patients poly E capsule group responded 3 patients (50%). 10 EGCG capsule patients group responded 6 patients (60%). Overall responsive rate is 69% (35/51) in case of green tea extracted treated group and 10% (4/39) in placebo controlled group (P<0.05). CONCLUSION: The effects of green tea extract in HPV positive cervical lesion were statistically significant (P<0.05). This result suggests that green tea extract has highly potential of new treatment agent for HPV infected cervical lesion.
Humans* ; Papilloma* ; Tea* ; Uterine Cervical Neoplasms ; Uterine Cervicitis

Isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) with sparing of the marrow after allogeneic stem cell transplantation is not common. We report a 32-year-old female patient with isolated ovarian relapse of T-cell ALL 18 months after allogeneic stem cell transplantation. She had no evidence of concomitant relapse in the bone marrow.
Adult ; Bone Marrow* ; Female ; Hematopoietic Stem Cell Transplantation* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Stem Cell Transplantation ; T-Lymphocytes

Identified first by Lancefield and Hare in 1935, the group G streptococcus occurs as commensals in the skin, pharynx, intestine, and vagina. It has been reported to cause a variety of human infections, such as sepsis, endocarditis, peritonitis, pharyngitis, and infective arthritis. Group G streptococcus sepsis could occur in chronic states such as malignancy, diabetes, alcoholics, neurologic disease, cardiovarscular disease, and end stage renal disease, however, there has been only a few case reports of endogenous endopthalmitis caused by group G streptococcus. We report herein endogenous endopthalmitis caused by group G streptococcus sepsis in 64-year-old man of alcoholic.
Alcoholics ; Arthritis ; Endocarditis ; Endophthalmitis* ; Hares ; Humans ; Intestines ; Kidney Failure, Chronic ; Middle Aged ; Peritonitis ; Pharyngitis ; Pharynx ; Sepsis* ; Skin ; Streptococcus* ; Vagina

Identified first by Lancefield and Hare in 1935, the group G streptococcus occurs as commensals in the skin, pharynx, intestine, and vagina. It has been reported to cause a variety of human infections, such as sepsis, endocarditis, peritonitis, pharyngitis, and infective arthritis. Group G streptococcus sepsis could occur in chronic states such as malignancy, diabetes, alcoholics, neurologic disease, cardiovarscular disease, and end stage renal disease, however, there has been only a few case reports of endogenous endopthalmitis caused by group G streptococcus. We report herein endogenous endopthalmitis caused by group G streptococcus sepsis in 64-year-old man of alcoholic.
Alcoholics ; Arthritis ; Endocarditis ; Endophthalmitis* ; Hares ; Humans ; Intestines ; Kidney Failure, Chronic ; Middle Aged ; Peritonitis ; Pharyngitis ; Pharynx ; Sepsis* ; Skin ; Streptococcus* ; Vagina

BACKGROUND: Combicin(R) is a new product of beta- lactam and beta-lactamase inhibitor combination which has antibacterial activity against aerobic and anaerobic bacteria, comprised of piperacillin and sulbactam. A phase III randomized clinical trial of Combicin(R) was done to evaluate and compare the efficacy and safety of piperacillin/sulbactam (Combicin(R)) with piperacillin in the treatment of urinary tract infection. METHODS: A total of 128 adult patients with acute urinary tract infection were enrolled and randomized into one of the two treatment groups during the period from August 1997 to September 1999 in Severance Hospital and Asan Medical Center, Seoul, Korea. Sixty-five patients were excluded in the analysis according to the exclusion criteria, and the rest 63 patients (3 men, 60 women) were eligible for the study. Clinical and bacteriologic responses were evaluated at entry and during the study period. Adverse effects were monitored by daily examination of the patients and periodic evaluations of laboratory findings. Statistical analyses were done by Chi-square test, Fisher's exact test, and Student t-test. RESULTS: Symptoms and signs such as fever, pyuria, dysuria, frequency, tenesmus, and costovertebral angle tenderness showed improvement in both group. Most commonly isolated microorganism was E. coli. The bacteriological eradication was found in 96.7% of the Combicin(R)-treated patients and in 90.9% of the piperacillin-treated patients. Adverse drug reactions in Combicin(R)-treated patients and piperacillin-treated patients occurred in 3.33% (2/60) and 5.88% (4/68) of the patients, respectively. Adverse events included liver function test elevation, drug fever, rash, indigestion, leukopenia, and nausea. Combicin(R) was well tolerated and side effects were negligible. CONCLUSION: Combicin(R) is safe and effective in the treatment of urinary tract infections.
Adult ; Bacteria, Anaerobic ; beta-Lactamases ; Chungcheongnam-do ; Drug-Related Side Effects and Adverse Reactions ; Dyspepsia ; Dysuria ; Exanthema ; Fever ; Humans ; Korea ; Leukopenia ; Liver Function Tests ; Male ; Nausea ; Piperacillin ; Pyuria ; Seoul ; Sulbactam ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Instead of hepatitis C virus (HCV) RNA test using RT-PCR, an enzyme immunoas-say for detection of HCV core protein as a simple, rapid method for the detection of HCV viremia has been developed recently. In this study, we investigated the usefulness of HCV core protein for the detection of HCV viremia by comparing the results of HCV RNA. METHODS: The study group included 71 patients; some of whom showed anti-HCV Ab. The HCV core protein assay was performed by enzyme immunoassay (Ortho Clinical Diagnostics, Raritan, NJ, USA). RESULTS: The concordance rate between HCV RNA and HCV core protein assay was 75%. Compared with the HCV RNA results, HCV core protein assay showed 50% sensitivity and 97% specificity. Among 17 patients whose results for HCV RNA were positive and those of HCV core protein were negative, all of them had anti-HCV Ab. CONCLUSIONS: Although the sensitivity of HCV core protein was not high in cases with anti-HCV Ab, the positive results for HCV core protein suggests the presence of HCV viremia. So, HCV core protein may be used as a simple and rapid method for detection of HCV viremia.
Hepacivirus ; Humans ; Immunoenzyme Techniques ; RNA ; Sensitivity and Specificity ; Staphylococcal Protein A ; Viremia*

BACKGROUND: Recently, we noticed an increased isolation rate for Candida tropicalis from urine of the patients in the intensive care unit (ICU) of the neurosurgery department in our hospital. We inves-tigated the risk factors for funguria and performed randomly amplified polymorphic DNA (RAPD) analysis for the isolates. METHODS: A total of 27 strains including 12 strains of C. tropicalis from the urine of ICU patients collected during a one-month period, 13 strains from other wards than ICU, and 2 control strains were analyzed. RAPD analysis was performed using 2 primers (UBC78 and CD16S). Medical re-cords of the patients were reviewed to determine the risk factors for funguria by C. tropicalis. RESULTS: RAPD analysis showed an identical pattern for all strains of C. tropicalis from ICU patients and a heterogeneous pattern for the isolates from other wards. C. tropicalis funguria of these ICU patients was significantly associated with the use of an urinary catheter (100%, P < 0.001), previous surgery (44%, P < 0.05) and trachostomy (40%, P < 0.05), when compared with those of non-ICU patients. CONCLUSIONS: The identical RAPD pattern of all C. tropicalis strains from ICU patients indicates that they possibly originated from one clone. Through the investigation of risk factors, we can postulate that an urinary catheter might be a source for the outbreaks of urinary tract infections in the ICU. In addition, RAPD analysis might be a very useful test as one of the molecular epidemiologic tools for C. tropicalis funguria.
Candida tropicalis* ; Candida* ; Clone Cells ; Disease Outbreaks ; DNA* ; Epidemiologic Studies* ; Humans ; Intensive Care Units ; Neurosurgery ; Risk Factors* ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*