Bloodstream Infections and Clinical Significance of Healthcare-associated Bacteremia: A Multicenter Surveillance Study in Korean Hospitals

Son, Jun Seong,Song, Jae-Hoon,Ko, Kwan Soo,Yeom, Joon Sup,Ki, Hyun Kyun,Kim, Shin-Woo,Chang, Hyun-Ha,Ryu, Seong Yeol,Kim, Yeon-Sook,Jung, Sook-In,Shin, Sang Yop,Oh, Hee Bok,Lee, Yeong Seon,Chung, Doo The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.7

<P>Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. <I>Escherichia coli</I> was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, <I>Staphylococcus aureus</I> (15.2%), coagulase-negative <I>Staphylococcus</I> (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.</P>

남북이산가족과 관련한 법률상의 혼란과 문제점

河喆永,柳在喆 동의대학교 법정연구소 2001 공공정책연구 Vol.17 No.-

사철나무 알칼로이드, Euojaponine의 NMR스펙트럼의 분석

柳載夏,李沼映,李叔淵,韓秉勳 숙명여자대학교 약학연구소 1994 약학논문집-숙명여자대학교 Vol.10 No.-

The strutures of euojaponines, alkaloidal components from Euonymus japonica are composed of β-agarofuran type sesquiterpene and pyridic dibasic acid, and they are linked via cyclodiester bonds. The structures of these compounds were elucidated by the application of various two dimensional NMR methods. From the results of complete interpretation of NMR spectra, several correlating aspects between structure and spectral pattern of sesquiterpene moiety were found, which can be utilized for the structural determination of the same family compounds.

인삼의 Thromboxane 합성저해 활성분획에 관한 연구

류재하,이소영 숙명여자대학교 약학연구소 1996 약학논문집-숙명여자대학교 Vol.12 No.-

Crude ginseng saponin fraction reduced the production of thromboxane A_2-the final product of prostaglandin H synthase(PGHS), in the lipopolysaccharide(LPS)-stimulated rat aveolar macrophages. By the treatment of LPS, macrophages induce the isoform of PGHS (PGHS-2) which is involved in the inflammation. Recently, the inhibitor of PGHS-2 is the major target for the development of anti-inflammation. Recently, the inhibitor of PGHS-2 is the major target for the development of anti-inflammatory agents having no side effect of non-steroidal anti-inflammatory drugs. In order to make more potent preparation of ginseng, several kinds of ginseng fractions were monitored for the inhibitory activity of thromboxane synthesis in macrophages. The cold methanol extract and saponin poor fraction are more potent than hot water extract and saponin rich fraction, respectively. These results showed that non-polar components of ginseng may be the good source for PGHS-2 antagonist for the development of anti-inflammatory agents.

생약추출물 유도형 Nitric Oxide Synthase 저해활성 검색

류재하,이소영,박재현,이화진,장세란,은진희,김남이,정연수,장미경,최영은,이숙현,손행자,안한나,고혜진 숙명여자대학교 약학연구소 2001 약학논문집-숙명여자대학교 Vol.17 No.-

Nitric Oxide (NO), derived from L-arginine, is produced by two types (constitutive and inducible) of nitric oxide synthase (NOS: cNOS and iNOS). The NO produced in large amounts by the iNOS is known to be responsible for the vasodilation and hypotension observed in septic shock and inflammation. The inhibitors of iNOS, thus, may be useful candidate for the treatment of inflammatory diseases accompanied by the overproduction of NO. We prepared alcoholic extracts of herbal drugs which have been used for the treatment of inflammation in oriental medicine. We have screened the inhibitory activity of NO production in lipopolysaccharide (LPS)-activated macrophages after the treatment of these extracts. Among the 81 kinds of extracts of herbal drugs, 34 extracts showed potent inhibitory activity of NO production above 50% at the concentration of 50 (μg/ml. The inhibitory activities of NO production were also evaluated for several solvent fractions at three different concentrations. Especially, hexane soluble fractions of Agrimonia pilosa, Hydrangea serrata, Machilus thunbergii, Prunella vulgaris, Saussurea lappa, Tussilago farfara, and ethyl acetate soluble fractions of Angelica gigas, Ostericum koreanum, Torilis japonica, Perilla frutescence showed moderate activity at 10 and/ or 25 (μg/ml. These fractions are promising candidates for the study of the activity-guided chromatographic purification of active compounds.

인삼의 polyacetylene 성분 PQ-6의 분리

류재하,장세란 숙명여자대학교 약학연구소 1998 약학논문집-숙명여자대학교 Vol.15 No.-

C-17 polyacetylene compound was isolated from the roots of Panax ginseng. Its structure was determined by 'H-NMR, ^(13)C-NMR and 'H-'H COSY spectra as PQ-6 (C_(19)H_(26)O_(4); 8- acetoxy-9,10-epoxy-heptadeca-l-ene-4, 6-diyne-3-ol). This compound was previously reported from Panax quinquefolium, but purified from Panax ginseng firstly at this time. PQ-6 from ginseng showed the strong inhibitory activity of nitric oxide synthesis in LPS-activated macrophages. The IC_(50) value of this activity was 1.5㎛.

임신과 동반된 난소섬유난포막종 1례

류은석,김윤숙,전섭,김종수,최승도,선우재근,배동한,양승화 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Fibrothecoma are mesenchymal tumors deriving from the ovarian stroma and consisting of theca-like elements and fibrous tissues. The reported incidence is between 0.4 and 8.0% of all ovarian tumors and this side variability can be attributed to the difficulty in differentiation fibrothecoma from ovarian fibroma or hyperplastic stroma nodules. We experienced a rare case of ovarian fibrothecoma in woman at 38 weeks gestation with previous repeat cesarean section diagnosed after tertiary cesarean delivery and bilateral tubal ligation with a brief review of literature.

(S)-5-Isopropyl-N³-phenyl-2-thiohydantoin을 도입한 polystyrene resin을 이용한 amino acid enantiomer의 분리

류재하 숙명여자대학교 약학연구소 1999 약학논문집-숙명여자대학교 Vol.16 No.-

An asymmatric resin containing copper(II) ions with (S)-5-isopropyl~N³- phenyl-2-thiohydantoin (IPTH) ligands fixed in a cross-linked polystyrene matrix has been prepared for the separation of optical isomers of amino acids. Enantioselectivity and retention parameters for various amino acids on the sorbent containing IPTH have been evaluated using ligand-exchange chromatography. After treatment with copper (II) sulfate and elution with ammonia-water-methanol mixtures, resolution of DL-alanine, glutamic acid, histidine, isoleucine, methionine, phenylalanine and valine is observed. The enantioselectivity of the sorbents with respect to the optical isomers of several amino acids is high enough to show the big difference of free energy (□□G^(0)) of diastereomeric sorption complex (250-400 cal/mol) to allow their preparative separation.

노인주거의 주요동선 안전과 조명의 역할에 관한 연구

宋秉夏,柳在憲 홍익대학교 산업기술연구소 2000 産業技術 Vol.10 No.-

Primary circulation areas such as corridors, stairs, ramp, and elevators are functionally the most essential portion in the building for most users. Nevertheless, these areas can present serious mobility difficulties, or even hazardous situations particularly for the elderly,if not designed properly. Properly designed, these areas are safe by providing helpful visual and tactile clues, as well as esthetically enjoyable. This study examines these areas in case of assisted living for the elderly. Based on the concept of Universal Design, detailed specifications and features that should confer safe circulation for the elderly in the areas, including lighting aspects, are included in the study.

한국인 제2형 당뇨병 환자에 있어 지속적 피하 인슐린 주입법 치료시 Lispro insulin와 Regular insulin의 효과 비교

유재등,박봉안,류하근,류주성,김정수,김치훈,박선민,최수봉 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Objective: The Lispro insulin has faster onset of effects and shorter duration than the human regular insulin, an analog of human insulin. The differences in the pharmacodynamics between the two types of insulin in the continuous subcutaneous insulin infusion(CSII) with insulin pump for treating the Korean Type 2 DM patients were analyzed. The effects on the regulation of blood sugar, the amount of insulin injected, and the frequency of hypoglycemia were compared between the lispro insulin and the regular human insulin. Method and Material: One hundred and three Korean Type 2 DM patients were randomly divided into two groups, 49 Lispro insulin and 54 Regular insulin.(Table 1) Both groups were treated for 14 days. Also at a set time before meal, insulin was injected as bolus, using a portable insulin pump, in both groups, 15 minutes before for lispro insulin and 30 minutes before for human insulin The HbA1C, C-peptide, AC/PC, height and weight were measured for each patients at the time of admission. The peripheral blood sugar level and insulin injection profile were recorded 7 times per day for each patients. Results: After treating for 7 days and 14 days, the blood sugar level normalized in both groups. There weren't any significant differences in blood sugar levels in both groups at point of the study, and also there weren't any differences in the frequency of hypoglycemia. In order to maintain the normalized blood sugar level, the lispro insulin group had higher total daily insulin requirement than the regular insulin group after 14 days of treatment (0.90±0.35 vs 0.73±0.39u/kg/day, p<0.05) This difference is probably due to the difference in basement insulin requirements rather than prandial insulin requirements (0.32±0.1 vs 0.43± 0.09u/kg/day, p<0.001). Discussion: In the hospitalized Korean Type 2 DM patients with CSII treatment, continuous subcutaneous insulin infusion therapy using lispro insulin has convenience in usage compared to the regular insulin. However, there were not any differences in the blood sugar levels. Also lispro insulin requires more insulin in order to maintain normal blood sugar level, which is probably due to the increase in the basal requirement. Also there were not any difference in the frequency of hypoglycemia.