Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Kim, Jong Hun,Baik, Seung Hee,Chun, Byung Chul,Song, Joon Young,Bae, In-Gyu,Kim, Hyo Youl,Kim, Dong-Min,Choi, Young Hwa,Choi, Won Suk,Jo, Yu Mi,Kwon, Hyun Hee,Jeong, Hye Won,Kim, Yeon-Sook,Kim, Jeong Elsevier 2018 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.74 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK).</P> <P><B>Methods</B></P> <P>Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015.</P> <P><B>Results</B></P> <P>A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (<I>p<</I> 0.001). In particular, early death within 7days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped.</P> <P><B>Conclusions</B></P> <P>This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization of the elderly with the 23-valent polysaccharide vaccine (PPSV23) was implemented in Korea in 2013. </LI> <LI> Overall in-hospital mortality was 34.2% for adult invasive pneumococcal disease (IPD) and 51.0% for patients ≥75 years of age. </LI> <LI> Mortality risks were older age, higher bacteremia score, and immunocompromised status. </LI> <LI> An effective vaccination strategy for those at higher risk of IPD is needed. </LI> </UL> </P>

<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

어깨 근막통 증후군에서 어깨 관절운동범위에 대한 분석

김정수,김인아,이수진,김용규,박시복,고재우,송재철 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objective: This study was carried out to investigate if the measurement of range of motion(ROM) could be applied in the diagnosis of Myofascial Pain Syndrome(MPS) and to determine the severity by analyzing ROM in MPS patients. Methods: The study subjects were 476 female telephone number information service workers. Southampton Protocol and Pittsburgh Protocol were used to diagnose MPS and to measure ROM. ROMs were measured by 2 inclinometers exercising each shoulder passively and actively in 5 directions ; abduction, forward flexion, extension, external rotation, and internal rotation. Results: Compared to the normal group (n=147), the mean of right side ROM in the subjects (n=270) with same side MPS was 2.1˚ (SD=11.5) lesser in active extension and 1.7˚ (SD=10.4) lesser in passive extension. Compared to the mild group (n=210), the mean of right side ROM in the patients with same side severe MPS (N=58) was lesser in all directions. Especially in active forward flexion, passive forward flexion, active extension, passive extension and active external rotation, ROM in the subjects with severe MPS was lesser by 6.5˚ (SD=13.1), 5.1˚ (SD=12.8), 5.9˚ (SD=11.8), 5.0˚ (SD=10.6) and 3.9˚ (SD=9.8), respectively, than those of the subjects with mild MPS. Compared to the subjects with left side mild MPS(n=172), ROM in the subjects with left side severe MPS (n=59) was 5.3˚ (SD=13.3) lesser in active forward flexion. Conclusions: In this study, ROMs in the subjects with severe MPS tended to be lesser than those in mild patients. This tendency was more prominent in the right side than the left, active range of motion than passive and forward flexion and extension than others. The results of this study are expected to help diagnose shoulder MPS and determine severity.

Impact of total occlusion of an infarct-related artery on long-term mortality in acute non-ST-elevation myocardial infarction patients who underwent early percutaneous coronary intervention.

Kim, Min Chul,Ahn, Youngkeun,Rhew, Shi Hyun,Jeong, Myung Ho,Kim, Ju Han,Hong, Young Joon,Chae, Shung Chull,Kim, Young Jo,Hur, Seung Ho,Seong, In Whan,Chae, Jei Keon International Heart Journal Association 2012 International heart journal Vol.53 No.3

<P>Some patients with non-ST-elevation myocardial infarction (NSTEMI) have a total occlusive infarct-related artery. However, the long-term prognosis of these patients is uncertain, particularly for those who underwent an early invasive strategy. The aim of this study was to determine the clinical impact of total occlusion (TO) of an infarct-related artery (IRA) in these patients. A total of 2,094 patients with NSTEMI who underwent an early invasive strategy with percutaneous coronary intervention (PCI) in the Korea Acute MI Registry (KAMIR) were analyzed (TO group; 665 patients, and non-TO group; 1,429 patients).In-hospital and one-year clinical outcomes were compared between the two groups. The left circumflex (42.9%) and right coronary artery (31.9%) were the major IRA in the TO group, while the left anterior descending artery was more common as an IRA in the non-TO group (44.1%). In-hospital complications including death and cardiogenic shock occurred frequently in the TO group. Also, the rates of one-month and 12-month adverse cardiac outcomes were higher in the TO group. In the Cox-proportional hazard model, TO in IRA predicted 12-month all-cause death. In conclusion, NSTEMI patients with TO in IRA showed worse short- and long-term clinical outcomes compared with those of non-TO patients.</P>

항생제 혼합 시멘트 정을 이용한 장관골 감염성 불유합의 이단계 치료

조세현,정순택,박형빈,황선철,하용찬,황인환 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적: 장관골 감염성 불유합의 치료 시 항생제 혼합 시멘트 정을 이용한 이단계 재건술의 결과를 분석하고자 한다. 대상 및 방법: 1998년 1월부터 2002년 9월까지 장관골 감염성 불유합으로 이단계 재건 수술을 받은 41예 (대퇴골 26예, 경골 15예)를 대상으로 하였다. 일단계 수술에서는 광범위한 변연 절제술, 부골 제거 및 세척술과 기존 고정 장치의 제거 또는 외고정 장치로의 교환을 시행한 후 시공 (dead space)과 불유합 주변 연부조직 내 항생제 혼합 시멘트 정을 삽입하였다. 임상적 감염 증상이 호전된 평균 8.7주 (3주~32주) 후 이단계 재건술로서 Ⅰ군은 내고정 장치 (금속판 5예, 골수강내 금속정 8예), Ⅱ군은 외고정 장치 (Ilizarov 25예, Monofixator 3예)로 각각 고정하고 17예에서는 골내 이동술이나 골 연장술을 시행하였다. 양군 모두 필요한 경우 골 이식과 시멘트 정의 교환을 추가하였다. 추시 기간은 16개월에서 최장 71개월로 평균 45개월 이었다. 치료 결과는 골유합 기간 및 Paley 방법에 의한 방사선상 골유합 상태와 하지 기능으로 평가하였다. 결과: Ⅰ군 13예 전부와 Ⅱ군 28예 중 26예에서 감염의 치료와 골유합을 얻었다. 이단계 재건술 후 골 이식술, 골 소파술, 외고정 핀 교환과 각변형 교정술, 피부 이식 또는 근육 피판 회전술 등의 보조적 시술이 Ⅰ군은 평균 2회, Ⅱ군은 평균 6.2회 추가되었다. 평균 골유합 기간은 Ⅰ군이 19.3주이고 Ⅱ군이 23.1주로 내고정군이 더 빨랐다. 방사선상 Paley 골유합 상태는 Ⅰ군이 우수 8예, 양호 5예이었고, Ⅱ군이 우수 18예, 양호 7예, 보통 1예, 불량 2예 이었다 (p=0.492). 기능적 결과는 Ⅰ군에서 우수 6예, 양호 6예, 보통 1예 이었고, Ⅱ군에서는 우수 10예, 양호 13예, 보통 3예, 불량 2예 이었다 (p=0.267). 결론: 항생제 혼합 시멘트 정의 골수염 치료 효과가 관찰되었으며, 감염이 호전된 후 내고정 장치로 교환해 준 군이 외고정을 유지한 군에 비하여 추가 수술 횟수가 적고, 골유합 기간도 빨랐다. Purpose: To evaluate treatment results between internal na external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads. Materials and Methods: In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion sits was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group Ⅰ versus external fixation in group Ⅱ. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks). Results: The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group Ⅰ. Infection recurred in two of 28 cases in group Ⅱ, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group Ⅰ and group Ⅱ. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group Ⅰ was similar to group Ⅱ in bony and functional result (p>0.05). Conclusion: Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

특수교육대상학생 교육과정 운영에 대한 특수학급 교사 및 통합학급 교사의 인식

전혜인(Hae-In Jeon),정효철(Hyo-Chul Jeong) 한국콘텐츠학회 2021 한국콘텐츠학회논문지 Vol.21 No.5

특수교육 현장에서 특수교육대상학생들을 위한 교육과정 운영은 특수교사 및 통합학급 교사들에게 주어지는 역할인데, 많은 교사들이 교육과정 운영에 어려움을 경험한다는 선행연구들이 있다. 본 연구에서는 질적연구방법을 통해 특수교사와 통합학급 교사들의 교육과정 운영 경험 및 교육과정 운영의 어려움과 제안사항 등에 대해 알아보는 것을 통해 특수교육대상학생 교육과정 운영의 방향을 모색하고 교육과정 운영을 위한 적합한 지원방안을 찾고자 하였다. 본 연구의 참여자는 경력 15년 이상의 특수교사 및 통합학급 교사를 대상으로 이루어졌으며 모든 면담은 일대일 심층면담으로 실시하였다. 모든 면담을 전사본으로 작성 후, 지속적 비교법을 통해 분석한 결과 대주제 6가지와 하위주제 12가지가 도출되었으며 도출된 대주제와 하위 주제는 다음과 같다; 교사마다 다른 교육과정 운영, 교육과정 적용의 어려움, 부족한 지원체계, 전문적 자질 문제, 통합학급에서 더 어려운 특수교육 교육과정, 통학학급 교사의 매일의 고민. 논의에서는 특수교육대상학생 교육과정 운영의 방향과 교육과정 운영을 위한 적합한 지원방안에 대해 논의하고, 연구의 제한점을 제시하며 제언하였다. In special education, the operation of curriculum for students subject to special education is a role given to special teachers and integrated class teachers, and there are prior studies that many teachers experience difficulties in operating the curriculum. In this study, it was intended to find out the direction of special education courses and appropriate support measures for the operation of special education courses by exploring the experiences of special teachers and integrated class teachers, difficulties and suggestions in operating the curriculum. Participants in this study were special and integrated teachers with more than 15 years of experience, and all interviews were conducted in one-on-one in-depth interviews. After all the interviews have been prepared in full-length versions, the analysis has resulted in six major subjects and twelve subtopics; each teacher has different curriculum operations, difficulties in applying the curriculum, insufficient support systems, professional qualifications, and daily concerns of teachers in integrated classes. In the discussion, the direction of operation of special education courses for students and appropriate support measures for the operation of curriculum were discussed, and the limitations of research were presented and proposed.

Power Generation Using Magnetic Nanofluids in Millimeter-Sized Channel With In-Phase Mode of Magnetization

In-Ho Kim,Jong-Chul Lee,Sangyoup Lee,Geun-Young Jeong,Se-Hee Lee IEEE 2015 IEEE transactions on magnetics Vol.51 No.11

<P>Magnetic nanofluids (MNFs) are an interesting energy harvesting source. In this paper, the flow energy harvesting was experimentally and numerically investigated in a millimeter-sized channel using an externally applied permanent magnet to control the magnetizing direction of the magnetic nanoparticles (MNPs). Oil- or water-based MNF includes a certain percentage of magnetized nanoparticles and has unique features that vary with the strength of the external electromagnetic field. When the MNF flows through a cross-sectional area of the coil loop, the electromotive force can be obtained by following Faraday's law, because the MNPs act as permanent magnets. When the MNFs are used for flow energy harvesting, the main issue is the in-phase mode alignment of the MNPs magnetization with the coil loop. Without the in-phase mode, the electric power cannot be generated, because the net magnetization of the MNF is zero. Most of the previous research works, however, have not considered it. Thus, to implement this mode, we proposed an externally applied magnetic field generated by a cylindrically shaped permanent magnet. Short and closed Teflon tubing with a 1.5 mm inner diameter, containing the MNF, was located inside long silicon tubing and moved along the positive and negative directions by a pump. Then, the generated voltages were measured, and exhibited similar results to those obtained analytically. In the same way, we calculated and experimentally tested a chain type of Teflon tubing.</P>

셀레콕시브 및 그 합성유도체들의 항암활성 스크리닝

박정란,강진형,구효정,노지영,류형철,박상욱,고동현,조일환,이주영,황다니엘,김인경 한국약제학회 2003 Journal of Pharmaceutical Investigation Vol.33 No.2

Selective COX (cyclooxygenase)-2 inhibitors including celecoxib have been shown to induce apoptosis and cell cycle changes in various tumor cells. New inhibitors are recently being developed as chemomodulating agents. We evaluated celecoxib and screened 150 synthetic compounds for anti-proliferative activities in vitro. Effects of celecoxib on COX activity, cell growth, cell cycle distribution, and apoptosis induction were determined in A549 COX-2 overexpressing human non-small cell lung cancer (NSCLC) cells. The COX inhibition of celecoxib increased with concentration up to 82% at 1μM after 24 hr exposure. Forty μM and 50μM of celecoxib induce G_1 arrest, and TUNEL-positive apoptotic cells, respectively. Among 150 compounds, several compounds were selected for having greater COX-2 inhibitory activity and higher selectivity than celecoxib with growth inhibitory activity. Celecoxib showed concentration-dependent COX inhibitory activity, and ability to induce cell cycle arrest and apoptosis in human NSCLC cells in vitro. Among synthetic analogues screened, several compounds showed promising in vitro activity as COX-2 inhibitory anticancer agents, which warrant further evaluation in vitro and in vivo.

Optimal Timing of Percutaneous Coronary Intervention in Patients With Non–ST-Segment Elevation Myocardial Infarction Complicated by Acute Decompensated Heart Failure (from the Korea Acute Myocardial Infarction Registry-National Institutes of Healt

Kim, Min Chul,Jeong, Myung Ho,Sim, Doo Sun,Hong, Young Joon,Kim, Ju Han,Ahn, Youngkeun,Ahn, Tae Hoon,Seung, Ki Bae,Choi, Dong-Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, S Elsevier 2018 The American journal of cardiology Vol.121 No.11

<P>The optimal timing of percutaneous coronary intervention (PCI) in patients with non–ST-segment elevation myocardial infarction (NSTEMI), complicated by acute decompensated heart failure (ADHF), is unclear. A total of 1,027 patients with NSTEMI complicated by ADHF who underwent successful PCI were analyzed using a Korean multicenter registry. All patients were divided into 4 groups by the timing of PCI: group 1 (PCI < 2 hour after admission, n = 149), group 2 (2 to 24 hours, n = 577), group 3 (24 to 72 hours, n = 189), and group 4 (≥72 hours, n = 112). We analyzed the incidences of 12-month mortality, nonfatal myocardial infarction (MI), target-vessel revascularization, and rehospitalization because of HF. The prevalence of ADHF in patients with NSTEMI was 15.2% at initial presentation, and in-hospital mortality was higher in group 1 than in the other groups. There were no significant differences in mortality, nonfatal MI, target-vessel revascularization, or rehospitalization for HF during the 12-month follow-up between groups, regardless of initial PCI timing, except for a higher 12-month mortality in patients who received PCI within 24 hours (vs ≥24 hours) (hazard ratio 1.52, 95% confidence interval 1.09 to 2.29, p = 0.046). Early PCI did not reduce adverse clinical outcomes in patients with NSTEMI complicated by ADHF. Delayed PCI after stabilization may be reasonable in such high-risk patients.</P>

Mouse의 심폐이식에서 IL-2 Receptor의 역할에 관한 연구

김대원,조정희,한덕종,이인철 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

Improved graft survival after organ transplantation is relied upon the innumerable studies concerning the immunologic reactions following antigen exposure and the accompanying strategies against rejection response. Cellular immunity is known to act as a major role in organ transplantation. We performed heart-lung transplantation in mice in order to define cellular immune reactions. For that purpose we analysed the functional role of the immune cells by the cellular cytotoxicity and phenotypic reactions by the IL-2 receptor(R) positive immune cells in the spleen as well as in the graft. ·Mean graft survival after the allogenic heart-lung transplantation in mice(BALB/C to CBA) was 8.5±2.5 days. ·Splenocyte cytotoxicity was the highest on the postoperative day 6 and then decreased abruptly to even lower than that of control mouse. ·Immunohistochemical analysis of spleen harvested consecutively during the postoperative period showed that proportion of IL-2R positive lymphocyte was around 20% in white pulp and scarce in red pulp illustrating nonspecific pattern regardless of rejection. ·Quantitative assay of IL-2R positive splenocyte showed the peak level on the postoperative day 6. ·IL-2R analysis of transplanted heart showed that IL-2R positive lymphocyte infiltated the heart progressively from the epicardium toward the endocardium with the maximal cellular infiltrate progressively from the epicardium toward the endocardium with the maximal cellular infiltrate on the postoperative day 4. These results illustrate that cellular cytotoxicity and expression of IL-2R positive cells have the consistent finding in terms of roles and diagnostic aid graft rejection following heart-lung transplantation in mice.