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>

Three zone of purple, red and white patch, A characteristic dermoscopic sign for glomus tumor

( Woo-haing Shim ),( Geun-hwi Park ),( Sung-min Park ),( Hyun-joo Lee ),( Tae-wook Kim ),( Hyunju Jin ),( Hyang-suk You ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-b 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: Despite characteristic clinical features of glomus tumor, dermatologists can meet diagnostic difficulty in some cases with glomus tumor. Objectives: To investigate clinical features and dermoscopic findings of glomus tumors. Methods: For 22 cases of glomus tumors, sex, age of initial visit, disease duration, site of lesion, size, associated symptoms and nail deformities and dermoscopic findings were investigated. Results: Mean age of initial visit and disease duration was 43.4±13.4 years old and 5.6±5.1 years, respectively(19 female, 3 male). Both 1st Fingers(9, 40.9%) were most common involved site. Nail lunula(12,54.5%) was more frequently involved than proximal nail fold(6,27.3%) or nail bed(4,18.2%). 15 cases were identifiable for size, and mean size was 6.0±1.9mm. There was associated symptoms such as pain(16,72.7%), tenderness(7,31.8%) and cold intolerance(2,9.1%). Onychoschizia(13,59.1%), longitudinal ridging(12,54.5%) and distal nail notching(8,36.4%) were commonly associated nail changes. On dermoscopic examination, whitish patch(16, 72.7%), purplish patch(15, 68.2%), erythematous patch(13, 59.1%) and irregular linear vessel(1, 4.5%) were observed. In 9 cases(40.9%), characteristic three zone consisting of central purplish patch, middle erythematous patch and peripheral whitish patch were observed. Conclusion: Characteristic dermoscopic findings of this study can help making more accurate diagnosis and performing appropriated treatment in glomus tumors

Cerebral vascular burden on hippocampal subfields in first-onset drug-naïve subjects with late-onset depression

Choi, Woo Hee,Jung, Won Sang,Um, Yoo Hyun,Lee, Chang Uk,Park, Young Ha,Lim, Hyun Kook Elsevier 2017 Journal of affective disorders Vol.208 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Although there is substantial evidence of associations between frontal-striatal circuits and cerebral vascular burden in late-onset depression (LOD), relationships between vascular burden and hippocampal subfields are not clear. The purpose of this study was to investigate relationships between cerebral vascular burden and hippocampal subfield volume in LOD patients.</P> <P><B>Methods</B></P> <P>Fifty subjects with LOD and 50 group-matched healthy control subjects underwent magnetic resonance imaging scanning. Hippocampal subfields volumes were measured and compared between the groups. In addition, association patterns between white matter hyperintensity (WMH) volumes, clinical measures and hippocampal subfield volumes were investigated in the LOD group.</P> <P><B>Results</B></P> <P>Subjects with LOD exhibited significant hippocampal volume reductions in the total hippocampus, cornu ammonis (CA) 1 and 3 and dentate gyrus (DG) areas compared with healthy subjects. Total WMH volume was negatively correlated with left total hippocampal volume and CA1 in the LOD group. In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group.</P> <P><B>Limitation</B></P> <P>Our findings of distinctive relationships between WMH and hippocampal subfields demonstrate a simple correlation, but do not prove causation</P> <P><B>Conclusion</B></P> <P>This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. These structural changes in the hippocampal CA1, CA3 and DG areas might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in LOD. However, longitudinal studies will be needed to identify the mechanisms of these structural changes.</P> <P><B>Highlights</B></P> <P> <UL> <LI> This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. </LI> <LI> White matter hyperintensity was negatively correlated with left total hippocampal volume and CA1 in the LOD group. </LI> <LI> In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group. </LI> </UL> </P>

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : Changing Pattern Of Digestive And Liver Disease In Korea, 1990-2006 Year; A Single Center Study

( Jung Hyun Kwon ),( Sang Woo Kim ),( In Sik Chung ),( Myung Gyu Choi ),( Kwan Woo Nam ),( Jung Pil Suh ),( Jae Hyuck Chang ),( Won Haing Hur ),( Yu Kyung Cho ),( Jae Myung Park ),( In Seok Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: Westernization in many Asian countries have changed lifestyles and diets, so once rare diseases have now become prevalent. The aim of this study is to investigate the changing pattern of digestive and liver disease in Korea, from 1990 to 2006. Methods: We extracted data specific gastrointestina (GI) disease based on the International Classification of Diseases code from the in-patients records at the Kangnam St. Mary`s Hospital in 1990, 1996 and 2006. This hospital is a tertiary-care hospital in Seoul, Korea, which has a capacity of 800 beds. Results: The admission rate for GI disease increased between 1990 and 2006. Overall in-patients were 1,623 persons in 1990, 2,368 persons in 1996 and 4,166 persons in 2006. The mean age of in-patients increased as time went by. A stomach cancer was the most common diagnosis during all periods, but its prevalence has decreased. Colon cancer ranked the 7th in 1990, but markedly increased and now ranks the second. The third was a hepatocellular carcinoma. The bile duct and gallbladder cancer, pancreas and esophageal cancer ranking followed with little interval change. In cases of cancer patients, a regular admission dramatically increased for chemotherapy. The number of patients admitted with pre-malignant neoplasm of stomach and colon increased remarkably with the development of endoscopy. The liver transplant, inflammatory bowel discase, and reflux esophagitis emerged form mid-1990s with greater frequencies, yet much below the levels found in the West. The admission rate for peptic ulcer, especially ulcer bleeding remained relatively stable, despite a decreased rate for ulcer perforation. Liver cirrhosis, hepatitis, cholelithiasis with cholecystitis-cholangitis, appendicitis, hemorrhoid and gastritis all decreased. Conclusions: The stomach cancer is the leading cause of admission, despite a recent decline. Colon cancer showed a marked rise. The liver transplant, inflammatory bowel disease and reflux esophagitis were new diagnosis with an increased tendency.

대장암종에서 암관련 유전자들의 Promoter Methylation과 암종 발생 및 진행과의 관게에 대한 연구

정동준,이정은,민영기,조성우,백무준,양승하,김의한,김창진 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

The colorectal corcinoma is one of the most common malignant tumor in Korea and its carcinogenic mechanism has not been elucidated exactly yet. So far, the most common carcinogenic mechanism has been known to be multiple genetic changes. But, the CpG island hypermethylation has been revealed to be one of the most important carcinogenic mechanism second to the genetic changes. The epigenetic changes characteristically imprint and transfer to the next generation without changes of nucleotide sequences. When the CpG island of promoter or 5'- exon 1 of a specific gene is methylated by DNA methyltrasferases (DNMTs), the gene expression is inhibited. Carcinogenic mechansisms by promoter methylation has been well known, but the progression of the cancer has not been elucidated yet. The molecular researches on the carcinogenic mechanisms largely depended on the tumor tissue containing various components of cell, due to difficulties in harvesting pure homogeneous tumor cells. Promoter methylatonof the cancer related genes as APc, hMLH2, p16, DAP-K and MGMT in 50 cases of sporadic colorectal carcinoma was studied. The pure normal colorectal epithelial cells, and cancer cells from superficial and deep invasive portion were harvested respectively by laser captured microdissection(LCM), and DNA was extracted from them. The promoter methylation was studied by methylation specific poymerase reaction (MSP) after bisulfite modification of the DNA and the expression of the genes by immunohistochemistry. The results suggests that promoter methylation of the cancer related genes are closely related with the colorectal carcinogenesis and it occurrs from early phase of carcinogenesis, progressing constantly to the late stage. And the promoter methylation of normal epithelial cells increased by age. The p15, known to be the genes related to hematologic malignancy, was closely related to the colorectal carcinoma as well.

P177 Dermoscopic findings during the course of β -blocker treatment for infantile hemangioma

( Jin-hwa Son ),( Hyun-ju Jin ),( Hyang-suk You ),( Woo-haing Shim ),( Jeong-min Kim ),( Gun-wook Kim ),( Hoon-soo Kim ),( Byung-soo Kim ),( Moon-bum Kim ),( Hyun-chang Ko ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Dermoscopy is a useful tool for examining morphology and structure of blood vessels in vascular skin lesions like infantile hemangioma (IH). However, dermoscopic findings are not fully elucidated in the course of β-blocker treatment for IH. Objectives: To investigate changes of dermoscopic findings during the course of β-blocker treatment for IH. Methods: Superficial or mixed-type IH patients treated with topical timolol solution or oral propranolol were enrolled in Pusan National University Hospitals (Busan and Yangsan) from November 2011 to January 2016. Clinical photograph and dermoscopic findings were recorded and assessed at the baseline, 1, 2, 3 and 6 months. Results: Total 115 patients (male: 38 and female: 77 / superficial type: 48 and mixed type: 67 / timolol: 77 and propranolol: 38) were included. Diffuse light erythema tended to be diminished but milky-red area increased gradually during the course of treatment. The patients treated with oral propranolol showed more prominent changes on each dermoscopic findings than those treated with topical timolol (p=0.023 and p=0.018, respectively). But, other findings like red-globular vessels, red-dot vessels, red-circulated vessels, red-linear vessels did not show significant changes. Conclusion: Dissolution of diffuse light erythema and increase of milky-red area were significant dermoscopic findings in accordance with clinical improvement after β -blocker therapy for IH.

수리적 간극변화를 고려한 수리적 굴착손상영역의 정의에 관한 연구

박종성,류창하,이정인,류동우,Park, Jong-Sung,Ryu, Chang-Ha,Lee, Chung-In,Ryu, Dong-Woo 한국터널지하공간학회 2007 한국터널지하공간학회논문집 Vol.9 No.2

굴착손상영역(EDZ)은 굴착으로 인해 현지 암반이 역학적으로 손상을 입게 되어 응력상태, 변위상태, 암반의 안정성, 지하수의 흐름상태 등에 변화가 일어나는 영역을 의미한다. EDZ의 역학적 특성과 관련한 많은 연구들이 수행되었지만, EDZ에서의 지하수 유동 특성에 관한 연구는 아직 부족한 수준이다. 따라서 본 연구에서는 굴착으로 인해 굴착면 주변의 수리적 간극이 늘어나는 영역을 산정하여 '수리적 굴착손상영역'이라 정의하고 이를 위해 수리-역학적 상호작용(coupling)해석을 수행하였다. 이는 개별 불연속면 망의 생성을 통한 역학적, 수리적 변화의 모사가 가능한 개별요소법(discrete element method; DEM)을 이용하여 수행하였다. 이를 통해 EDZ에서 지하수의 흐름에 영향을 미치는 각종 조건들(불연속면의 간극, 불연속면 군의 방향, 불연속면 군의 길이, 불연속면의 각도 등)의 변화와, 응력분포, 지하수의 유동 등으로 인해 수리적 간극 값이 어떻게 변화하는지를 파악하였다. 이 결과를 토대로 수리적 간극이 커지는 영역, 수리적 EDZ를 공동 주변의 불연속면 방향에 수직 방향으로 존재하는 타원형의 형태로 모델링 하였다. The excavation damaged zone (EDZ) is an area around an excavation where in situ rock mass properties, stress condition, displacement, groundwater flow conditions have been altered due to the processes induced by the excavation. Various studies have been carried out on EDZ, but most studies have focused on the mechanical bahavior of EDZ by in situ experiment. Even though the EDZ could potentially form a high permeable pathway of groundwater flow, only a few studies were performed on the analysis of groundwater flow in EDZ. In this study, the 'hydraulic EDZ' was defined as the rock zone adjacent to the excavation where the hydraulic aperture has been changed due to the excavation by using H-M coupling analysis. Fundamental principles of distinct element method (DEM) were used in the analysis. In the same groundwater level, the behavior of hydraulic aperture near the cavern was analyzed for different stress ratios, initial apertures, fracture angles and fracture spacings by using a two-dimensional DEM program. We evaluate the excavation induced hydraulic aperture change. Using the results of the study, hydraulic EDZ was defined as an elliptical shape model perpendicular to the joint.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

초음파 센서 배열을 이용한 컨베이어 벨트상의 이동물체의 위치 검출

하창우,도용태 대구대학교 2006 대구대학교 학술논문집 Vol.1 No.2

In this paper, we design an ultrasonic sensor array for measuring the position of a moving object on a belt conveyor. Nine 50kHz ultrasonic sensor modules are arrayed to detect the shape of an object moving on a belt and to measure its center position. Three ultrasonic sensors that can operate simultaneously without intereference are grouped into a team and three teams are made in total considering the performance of control circuits. After completing sequential measurements of the three teams of sensors, the timing gaps between measurements are calibrated so that they can be regarded as if they all are measured at the same time. In experiments for measuring the center position of a box-shaped object, the measurement ranges of sensors are divided into sub-regions and redundantly employed sensors are fused by various methods. Using the maximum of redundant measurements showed the best result. When an artificial neural network was used, the mean squared error of 7.94mm was obtained and it was better than that by using the maximum of redundant measurements by more than 10%. 본 논문에서는 컨베이어 벨트에 의해 움직이는 물체의 위치를 검출하기 위한 초음파 센서 배열을 설계한다. 9개의 50kHz 초음파 센서 모듈을 배열로 구성하여 컨베이어 벨트 위의 물체 형태를 검출하고 중심 위치를 계측하였다. 초음파 센서들이 서로 간섭을 받지 않게 하면서, 제어회로의 성능을 고려하여 센서들 중 3개씩 3조로 나누고, 각 조내 센서들은 동시 측정되도록 하였다. 3조의 센서들이 순차적으로 측정을 마친 후, 9개의 초음파 센서가 동시에 측정한 것과 같은 계측치를 얻을 수 있도록 센서 계측치 간의 간격을 보정하였다. 사각 상자형의 물체 중심을 계측하는 실험에서, 센서들의 계측영역을 분할하고 각 영역별로 중첩된 계측치를 다양한 방법으로 융합하였을 때, 최대치를 이용하는 방법이 가장 좋은 결과를 보였다. 인공신경망을 적용하였을 때는 약 7.94mm의 제곱평균오차를 얻을 수 있었는데, 이는 영역별 최대치를 이용하는 방법보다 10% 이상 정확도가 좋아진 것이다.

Defect cell 위치 탐색을 위한 DRAM 병렬 I/O테스트

河昌佑,柳在熙 弘益大學校 科學技術硏究所 2001 科學技術硏究論文集 Vol.12 No.-

A multibit DRAM test ng methodologies capable of counting and locating of defect cells simultaneously. which reduces redundancy programming overhead has been proposed. If DRAM cells are composed of n blocks generally, the proposed testing methodology can detect the state of no error, the location of defect cells if there is one error in a block, the state of errors in two or more blocks, which are n + 2 states totally, with n comparators and an encoder for 3 states. Based on the proposed methodology, the testing scheme which can detect the number and locations of defect cells with the errors in two or more blocks, can be easily implemented.