Close Encounter of V. vulnificus with Host Cells is a Prerequisite to the Cytotoxicity of yet Unidentified New Virulence Factor

Kim, Young-Ran,Kim, Choon-Mee,Rhee, Joon-Haeng The Korean Society for Microbiology 2003 Journal of Bacteriology and Virology Vol.33 No.1

Live Vibrio vulnificus is highly cytotoxic to host cells in vivo and in vitro. The two most representative cytotoxins, cytolytic hemolysin and elastolytic protease, have been regarded to play major roles in the cytotoxicity of V. vulnificus. To further determine roles of the two cytotoxins in V. vulnificus pathogenesis, we constructed a double mutant of vvhA and vvpE genes, encoding a hemolysin and a protease, respectively. However, the cytotoxicity and the $LD_{50}$ of a vvhA/vvpE double mutant showed no significant difference from those of the isogenic wild type strain. From these results, we came to speculate that yet unidentified, key cytotoxic factors should playa major role in the cytotoxic activity of V. vulnificus. The HeLa cells encountered with V. vulnificus became rounded, following detachment from the bottom of culture plate, and were killed eventually. However, the bacterial culture supernatant did not show any effect on the morphology and viability of HeLa cells. Also, no cytotoxicity could be noted when V. vulnificus was not allowed to contact with HeLa cells in the $Transwell^{(R)}$ system. Chloramphenicol, at lower concentration than minimum inhibitory concentration (MIC), decreased the cytotoxicity of a vvhA/vvpE double mutant to HeLa cells in a dose dependent manner. These results suggest that close encounter of V. vulnificus with host cells is a prerequisite to the cytotoxicity and that a yet unidentified virulence factor (s) should play an important role in the contact-dependent cytotoxicity.

Differentiating Uterine Sarcoma From Atypical Leiomyoma on Preoperative Magnetic Resonance Imaging Using Logistic Regression Classifier: Added Value of Diffusion-Weighted Imaging-Based Quantitative Parameters

Kim Hokun,Rha Sung Eun,Shin Yu Ri,Kim Eu Hyun,Park Soo Youn,Lee Su-Lim,Lee Ahwon,Kim Mee-Ran 대한영상의학회 2024 Korean Journal of Radiology Vol.25 No.1

Objective: To evaluate the added value of diffusion-weighted imaging (DWI)-based quantitative parameters to distinguish uterine sarcomas from atypical leiomyomas on preoperative magnetic resonance imaging (MRI). Materials and Methods: A total of 138 patients (age, 43.7 ± 10.3 years) with uterine sarcoma (n = 44) and atypical leiomyoma (n = 94) were retrospectively collected from four institutions. The cohort was randomly divided into training (84/138, 60.0%) and validation (54/138, 40.0%) sets. Two independent readers evaluated six qualitative MRI features and two DWI-based quantitative parameters for each index tumor. Multivariable logistic regression was used to identify the relevant qualitative MRI features. Diagnostic classifiers based on qualitative MRI features alone and in combination with DWI-based quantitative parameters were developed using a logistic regression algorithm. The diagnostic performance of the classifiers was evaluated using a cross-table analysis and calculation of the area under the receiver operating characteristic curve (AUC). Results: Mean apparent diffusion coefficient value of uterine sarcoma was lower than that of atypical leiomyoma (mean ± standard deviation, 0.94 ± 0.30 10-3 mm2/s vs. 1.23 ± 0.25 10-3 mm2/s; P < 0.001), and the relative contrast ratio was higher in the uterine sarcoma (8.16 ± 2.94 vs. 4.19 ± 2.66; P < 0.001). Selected qualitative MRI features included ill-defined margin (adjusted odds ratio [aOR], 17.9; 95% confidence interval [CI], 1.41–503, P = 0.040), intratumoral hemorrhage (aOR, 27.3; 95% CI, 3.74–596, P = 0.006), and absence of T2 dark area (aOR, 83.5; 95% CI, 12.4–1916, P < 0.001). The classifier that combined qualitative MRI features and DWI-based quantitative parameters showed significantly better performance than without DWI-based parameters in the validation set (AUC, 0.92 vs. 0.78; P < 0.001). Conclusion: The addition of DWI-based quantitative parameters to qualitative MRI features improved the diagnostic performance of the logistic regression classifier in differentiating uterine sarcomas from atypical leiomyomas on preoperative MRI.

Essential role of an adenylate cyclase in regulating <i>Vibrio vulnificus</i> virulence

Kim, Young Ran,Kim, Soo Young,Kim, Choon Mee,Lee, Shee Eun,Rhee, Joon Haeng Elsevier 2005 FEMS microbiology letters Vol.243 No.2

<P><B>Abstract</B></P><P><I>Vibrio vulnificus</I>, a halophilic estuarine bacterium, causes a fatal septicemia and necrotizing wound infection. To investigate the role of cAMP in <I>V. vulnificus</I> virulence regulation, an in-frame deletion mutant of the <I>cya</I> gene encoding adenylate cyclase was constructed. The <I>cya</I> null mutation resulted in a pleiotropic change of virulence phenotypes. The production of hemolysin and protease, the motility, and the cytotoxicity were decreased by the <I>cya</I> mutation. The defects in the <I>cya</I> mutant were functionally complemented <I>in trans</I> by a plasmid carrying the wild type <I>cya</I> allele. The <I>V. vulnificus cya</I> mutant exhibited a 100-fold increase in LD<SUB>50</SUB> to mice. The result indicates that cAMP plays an essential role in the global regulation of <I>V. vulnificus</I> virulence.</P>

Selection and characterization of tenascin C targeting peptide

Kim, Mee Young,Kim, Ok Ran,Choi, Yong Seok,Lee, Heuiran,Park, Keerang,Lee, Choon-Taek,Kang, Keon Wook,Jeong, Sunjoo Springer-Verlag 2012 Molecules and cells Vol.33 No.1

Effect of Salinity, Temperature, and Glucose on the Production of Vibrio vulnificus Hemolysin

Kim, Hyun-Soo,Shin, Sung-Heui,Park, Hae-Ryoung,Lee, Shee-Eun,Kim, Choon-Mee,Kim, Soo-Young,Kim, Young-Ran,Lee, Hyun-Chul,Chung, Sun-Sik,Rhee, Joon-Haeng The Korean Society for Microbiology 2002 Journal of Bacteriology and Virology Vol.32 No.4

Among the exotoxins produced by V. vulnificus, hemolysin (HS) has been reported to be the most potent one. To investigate the factors up- or down-regulating HS production in the context of pathogenesis, we observed the effects of salinity or/and temperature shifting, glucose, and acidic pH on the production of HS by V. vulnificus C7184 strain in vitro. Significantly more HS was produced when V. vulnificus was cultured in 0.9% salinity and $37^{\circ}C$ than in 2.5% and $25^{\circ}C$. When the culture condition reflecting natural habitat of V. vulnificus (2.5% salinity and $25^{\circ}C$) was changed into that reflecting human body (0.9% salinity and $37^{\circ}C$), 2.5 fold or more HS was produced than in the V. vulnificus being cultured continuously in 0.9% NaCl at $37^{\circ}C$. This result suggests that V. vulnificus somehow recognizes the shifting in salinity and temperature and stimulate HS production. Glucose addition in the culture medium resulted in a dose-dependent decrease in the HS production. Glucose itself and acidic pH resulting from its metabolism both appeared to inhibit the HS production. Glucose in itself had more dominant role in suppressing the HS production than the lowered pH accompanying the metabolism of glucose. This result suggests that HS production is down-regulated in the presence of glucose and under environmental acidic pH.

<i>Ex Vivo</i> Characteristics of Human Amniotic Membrane-Derived Stem Cells

Kim, Jiyoung,Kang, Hyun Mi,Kim, Haekwon,Kim, Mee Ran,Kwon, Hyuck Chan,Gye, Myung Chan,Kang, Sung Goo,Yang, H. Seung,You, Juice Mary Ann Liebert 2007 Cloning & stem cells Vol.9 No.4

<P>Cells were isolated from four human amniotic membranes, and their biological characteristics analyzed during ex vivo expansion. Morphologically homogenous populations of fibroblast-like cells were obtained from the second or third passage. Under the appropriate culture conditions, these human amniotic membrane-derived mesenchymal cells (HAM) were shown to differentiate into adipocytes, osteocytes, chondrocytes and neuronal cells, as visualized by Oil Red O, von Kossa, alcian blue, anti-Neu N, and anti-Gal C antibody staining, respectively. Immunophenotype analysis of HAM cells revealed the presence of antigens for SSEA-3, SSEA-4, collagen type-I, -II, -III, -IV, -XII, fibronectin, alpha-SMA, vimentin, desmin, cytokeratin18 (CK18), HCAM-1, fibroblast surface protein, and human leukocyte antigen (HLA) ABC. ICAM-1 protein was weakly detectable, and proteins of TRA-1-60, VCAM-1, von Willebrand factor, PECAM-1, and HLA DR were not detected. HAM cells reached senescence after 14.5+/-0.9 passages, over a period of 146.8+/-8.9 days, and underwent an average of 36.9 4.7 population doublings. RT-PCR analysis showed that all four HAM cell lines consistently expressed genes of Oct-4, Rex-1, SCF, NCAM, nestin, BMP-4, GATA-4, HNF-4alpha, vimentin, and CK18, regardless of the passage number. The genes of Brachyury, FGF-5, Pax-6, and BMP2 were never expressed. Strikingly, alpha-fetoprotein (alphaFP), HLA ABC, and HLA DR genes were expressed in an earlier passage but not expressed in later passages. Telomerase activity of two HAM lines was discernable upon the third passage. These observations strongly suggest that HAM might be immune-privileged and, thus, advantageous as therapeutic cells.</P>

Loss of heterozygosity of chromosome 3p in patients with carcinoma of the cervix

Kim, Jin Woo,Hong, Sung Ran,Park, So Yeon,Ryu, Hyun Mee,Park, Chong Taik,Lee, Ki Heon,Chung, Hwan Wook,Lim, Kyung Taek,Seong, Seok Ju,Park, In Sou,Shim, Jae Uk,Kim, Tae Jin 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.1

건축물 해체공사용 친환경 방음/방진막 개발

김영태 ( Kim Young-tae ),원지민 ( Won Ji-min ),최하란 ( Choi Ha-ran ),이은미 ( Lee Eun-mee ) 한국건축시공학회 2023 한국건축시공학회 학술발표대회 논문집 Vol.23 No.2

This paper discusses an innovative acoustic membrane developed by doAZ Co., Ltd., offering enhanced noise barrier and dust control for urban construction and demolition, surpassing the performance of traditional non-woven fabrics. The membrane is made from recyclable bubble sheets and designed to be seamlessly integrated into single and double-row scaffolding systems, ensuring broader applicability and sustainability.

Assessing Obstetric and Newborn Outcomes: A Comparative Analysis of Chorionic Villus Sampling and Amniocentesis

( Nari Kim ),( Eun Hui Joo ),( Young Ran Kim ),( Hyun Mee Ryu ),( Ji Yeon Lee ) 대한산부인과학회 2023 대한산부인과학회 학술대회 Vol.109 No.-

병동 간호사의 임상등급 간호역량 평가도구 개발

박미란(Mee Ran Park),김남초(Nam Cho Kim) 한국간호행정학회 2014 간호행정학회지 Vol.20 No.3

본 연구는 병동 간호사의 간호역량 평가도구 개발을 위해 문헌고찰과 간호대학 교수, 임상간호 전문가에 의한 내용타당도검증, 병동 간호사 대상의 설문지 조사, 임상등급 4등급 간호사 대상의 자가평가 과정을 통해 이루어진 방법론적 연구이다.연구의 개념적 기틀은 Carper[19]가 제시한 간호지식의 4가지 유형 모델을 기반으로 한 Jang[1]의 간호역량 모형을 근거로 4개 영역, 13개의 간호역량 요소, 30개의 핵심간호역량 요소 목록과 4개 임상등급별 간호역량수행 평가기준으로 적합한 항목을 선정하였다.4가지 간호지식의 유형에는 과학적, 윤리적, 인격적, 심미적 간호영역이 포함되어 있다. 과학적 간호역량이란 ‘경험과학적 지식을 바탕으로 상황을 객관적으로 파악하는데 도움을 주며 간호실무의 전문성과 효율성을 확보하고 간호지식을 체계화하는데 도움이 되는 역량이므로[1] 본 연구에서는 간호사에게 필요한 중요 핵심역량 영역인 간호전문 영역을 포함하였다.둘째, 심미적 간호역량은 ‘의식적인 심사숙고 없이도 즉각적으로 그 순간에 해야 할 일이 무엇인지 알고, 직면한 상황의 의미를 알고 해결할 수 있는 능력’으로 정의되어[1] ‘임상적 판단과 대처’에 포함되었던 개념 중 ‘조기 대처와 위기관리’를‘위기관리’로 수정하였다. 또한 ‘환자이해’와 ‘환자 지향성’에 관한 간호역량의 내용이 유사하여 이를 ‘환자 지향성’으로 통합하였고 ‘타인육성’ 역량에는 환자, 가족, 동료 및 기타 사람들을 지도 교육하고 발전시키는 것으로 ‘교육 및 상담’으로 수정하였다. 국외 의료기관의 경우 2000년 이전에는 4~6개 영역으로 구분하였고[15], 2003년 이후 주로 4개 영역으로 분류됐다[9,22]. 국내 병원은 대부분 4개 영역으로 분류하여 적용하고 있으며 본 연구에서도 4개 영역으로 분류하였다. 기관별로 영역에 대한 차이가 있는 것은 그 기관의 미션과 비전에 따라 목표와 핵심가치가 다르기 때문인 것으로 여겨진다[21]본 연구에서의 임상등급은 Benner[7]의 기술 습득 모형을수정 . 보완하여 1등급은 초보 등급(입사~1년), 2등급은 상급초보 등급(2~3년), 3등급은 유능 등급(4~6년), 4등급은 숙련등급(7년 이상)으로 구성하였다. 임상등급을 활용한 최초의 사례는 캘리포니아 대학 의료기관에서 간호사들의 임상적 능력, 지식 및 성과에 따라 보상받을 수 있는 임상경력시스템(Clinical ladder system)으로 간호역량에 따라 4개 등급의실무 수준을 개발한 것이다[23]. 임상등급 기준은 임상경력 기간 뿐 만 아니라 등급이 높아질수록 간호사의 업무능력이 향상되고 전문성 개발을 위한 연구 및 교육에 시간과 노력을 기울이며 문제해결 능력, 부서 간 협력 및 대인관계에서 발전된 수준을 기대할 있다[24,25]. 이와 같이 4개의 임상등급으로 구분한 것은 국내 Kim[25]의 연구에서도 타당하게 받아들여졌고 현재 경력개발제도를 운영하고 있는 국내 병원에서도 대부분 4개의 임상등급을 적용하고 있는 실정이다[23].본 연구에서는 간호역량 평가 예비문항 구성에서 간호사의 핵심역량과 중요도 인식 정도가 높은 문항을 우선적으로 반영 하였고 근무 부서 특성을 고려하여 병동에서 중요도가 높은128개 예비문항을 구성하였다. 13개의 간호역량 요소를 정의한 후 각 역량 요소에 따른 핵심간호역량을 결정하였으며 임상등급별로 수행평가 기준을 차별화하여 기술하였다.간호역량 중환자에게 직접 제공되는 부분을 간호전문분야로 정의하였고 환자와 공감하는 부분은 환자에게 서비스를 제공하는 것으로 정의하여 ‘환자지향성’으로, ‘기타 사람들을 지도, 교육하는 것’을 ‘교육 및 상담’으로 정의하였다. Choi와Eun[26]은 수술실의 특징을 반영하여 ‘환자 이해’와 ‘대상자 지향성’을 제외하고 ‘안전관리’를 포함하여 12개의 간호역량을 개발하였다. 또한 Liu 등[15]의 연구결과 도출된 ‘지도력,간호행위, 인간관계, 윤리적 활동, 교육, 전문성 개발 노력, 비판적 사고, 연구 경향’은 본 연구의 ‘간호전문 영역, 전문성 개발 노력, 병동업무 처리력, 윤리적 가치 지향성, 자기조절, 유연성, 교육 및 상담’과 유사한 영역으로 나타났다. Kang 등[17]은 일반병동 간호사의 간호역량을 9개로 구분하고 70개 문항으로 평가도구를 개발하였다. 9개 영역에서 본 연구와 유사한 영역은 ‘자원관리와 전문성 개발 노력, 병동업무 처리력,간호과정 적용력, 위기관리, 환자 지향성’이고 비판적 사고와 도덕적 의무, 인격적 배려 부분은 본 연구와 차이를 보였다.임상등급별 간호역량 평가문항 선정에서 128개 예비문항중 8개 문항이 삭제되었다. 이는 생리적 적응 증진, 측정 및 검사 부분의 중요도 인식이 다른 항목에 비해 낮고 내용이 중복 되었기 때문이다.최종 개발된 임상등급별 간호역량 평가도구를 임상등급 4등급 간호사 전체를 대상으로 자가평가를 실시한 결과 도구의 신뢰도 Cronbach``s .=.92였고, 점수는 4점 만점에 3.38~ 3.75점으 로 나타나 병동 간호사의 간호역량 평가도구로서 활용 가치가 높을 것으로 판단된다. 아울러 임상등급에 따른 전문성을 기준으로 선정된 것이어서 임상간호 질의 유지와 공정한 승급 도구로서의 가치가 있어 간호인적 자원관리의 과학적이고 합리적인 체계를 구축하는데 기여할 수 있을 것이다. This methodological study was done to develop a Nursing Competency Measurement Scale based on the clinical ladders of nurses working in wards. Methods: Thirty clinical experts and 501 ward nurses evaluated the content validity of the scale. A survey using the Nursing Competency Measurement Scale was conducted with 114 nurses to evaluate reliability and applicability of the instrument. Data were analyzed using SPSS/WIN 21.0. Results: A review of the literature identified 13 components of nursing competencies and 30 core nursing competencies based on each of the 4 grade clinical ladders. Cronbach`s . coefficient for the total was .92. Cronbach’s . reliabilities of each clinical ladder grade were .83 for GradeⅠ, .84 for Grade Ⅱ, .81 for Grade Ⅲ, and .84 for Grade Ⅳ. The Content Validity Index (CVI) of the scale with 120 individual items was 0.976~1.000 for GradeⅠ scale, 0.986~1.000 for Grade Ⅱ scale,0.984~1.000 for GradeⅢ scale, and 0.992~1.000 for Grade Ⅳ scale. The expert group nurses’ average degree of nursing competence measured using the scale was 3.38~3.75 out of 4.0. Conclusion: Through this process, 120 final questions were confirmed to represent items of the Nursing Competency Measurement Scale based on clinical grade.