Experience of Elizabethkingia meningoseptica Infection in a Tertiary Hospital

( Sun Young Ann ),( Sung Hyeok Ryou ),( Seong Jun Park ),( Hyun Don Joo ),( Chang Hyun Park ),( Ji Sung Choi ),( Doh Hyung Kim ) 대한내과학회 2013 대한내과학회 추계학술발표논문집 Vol.2013 No.1

Background: There have been limited number of reports documenting patients with Elizabethkingia meningoseptica (Chryseobacterium meningoseptica) infection in Korea. The knowledge of clinical and antimicrobial characteristics are still scarce. Methods: Medical records of patients with Elizabethkingia meningoseptica infection in a tertiary university hospital from March 1, 2006 to February 28, 2013 were retrospectively reviewed. The clinical features and antimicrobial susceptibilities of these patients were analyzed. Results: A total of 30 patients were identified to have Elizabethkingia meningoseptica infection. Median age of patients was 68.5 years, and male gender was more frequent (17, 56.7%). The most common site of isolation was sputum (23, 76.7%) and pneumonia was the most common type of infection (21, 70%). Prolonged hospitalization ≥ 28 days (26, 86.7%), prior intensive care unit stay (23, 76.7%), mechanical ventilation (23, 76.7%), and tracheostomy state (18, 60%) were most commonly observed in these patients. In-vitro antimicrobial susceptibility tests showed minocycline (27, 90%) and fluoroquinolones including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%) were most frequently susceptible. However, appropriate antibiotics based on culture reports were only provided for 8 (26.7%) patients and the overall mortality presumptive on Elizabethkingia infection was 20% (6/30). Conclusion: Elizabethkingia meningoseptica was most frequently isolated from respiratory specimen and usually manifested as respiratory infection. Minocycline and fluoroquinolones were most susceptible antibiotics in in-vitro tests. Although the mortality of infection by this organism was quite high, the rate of appropriate antibiotic use based on susceptibility test results was notably low.

Poster Session:PS 1123 ; Gastroenterology (Liver) : A Cystic Echinococcosis of the Liver: A Rare Case of Parasitic Zoonosis

( Sun Young Ann ),( Kyoung Hwang Shin ),( Sung Hwahn Hahn ),( Jae Hwan Kong ),( Suk Bae Kim ),( Il Han Song ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: Echinococcosis, so called hydatid disease, is a representative zoonosis. Human cystic echinococcosis usually occurs as a result of infection by the larval stage of species Echinococcus granulosus, genus Echinococcus, via the ingestion of food and water fecally contaminated with eggs from the primary hosts such as dogs and wolves. Case: A 58 year-old male was admitted for further evaluation of liver cystic mass detected on routine examination of liver ultrasound. He was an immigrant worker from North-East China 4 year ago. At the time on admission, past medical history, physical examination, and laboratory findings including tumor markers showed no specific. Computed tomography and magnetic resonance imaging showed three cystic nodular lesions with calcifi cation in the liver: one 9 cm-sized exophytic cyst with daughther cysts (cysts in cyst) on left lateral segment; another 3. 5 cm-sized cyst with a focal wall calcifi cation on segment 8; and the other 2. 3 cm-sized dense calcifi ed nodule on segment 4. Surgical resection was performed for diagnostic confirmation and complete removal. Grossly, the left liver mass showed a lobulated cyst with a well-demarcated, reddish yellow-colored, and smoothy round nature, measuring 9. 5x9,5x8. 5 cm. The cut-surface of this cystic mass showed a yellow-colored unilobular cystic wall containing variable-sized membranes with a thin, transparent, and fi abby appearance. Microscopically, Brood capsules containing protoscolices of E. granulosus were scattered on the laminated cystic walls with germinal layers. Two other cystic masses revealed calcifi ed degenerations. After successful recovery without any complication following surgery, the patient was discharged with the medication of antihelminthic albendazol 400 mg twice daily, with a fat-rich meal for 4 weeks. Conclusions: We report a case of cystic echinococcosis of liver with typical fi ndings of radiological and histological features in immigrant worker from China.

단일 3차 의료기관에 내원한 탈북자 환자들의 임상적 특징

안선영 ( Sun Young Ann ),류성혁 ( Sung Hyeok Ryou ),김석배 ( Suk Bae Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.1

Background/Aims: There are increasing numbers of North Korean defectors, and their health status differs from that of the South Korean population. This study was performed to investigate the clinical characteristics of North Korean defectors visiting a single tertiary hospital in South Korea. Methods: The medical records of North Korean defectors who visited Dankook University Hospital, Cheonan, South Korea from 1 February 2006 to 30 April 2014 were retrospectively reviewed. Their comorbidities, main reasons for the visit, and most common diseases were investigated. Results: A total of 169 North Korean defectors (163 females, 6 males) visited our hospital. Sixty-eight patients (40.24%) had comorbidities, the most common of which was tuberculosis (13.60%), followed by chronic hepatitis B (10.06%) and chronic hepatitis C (9.47%). North Korean refugees visited the department of ophthalmology (15.71%) most frequently, followed by gastroenterology (15.18%). Cataracts, chronic hepatitis C, chronic hepatitis B, and pulmonary tuberculosis were the most common reasons for the hospital visit. Chronic hepatitis B and chronic hepatitis C were diagnosed in 19.32% and 17.58% of the patients, respectively. Sixteen patients (9.47%) were diagnosed with tuberculosis, and eight of these patients showed multidrug resistance. Of all 169 patients, 17 underwent colonofibroscopy or stool examination, and parasites (Trichuris trichiura, n = 6; Clonorchis sinensis, n = 1) were found in 7 patients (41.18%). Conclusions: Most North Korean defectors who visited this tertiary hospital in South Korea were female, and they mainly visited the departments of ophthalmology, gastroenterology, and pulmonology. Compared with South Koreans, they showed high rates of chronic hepatitis B, chronic hepatitis C, pulmonary tuberculosis with multidrug resistance, and parasite infection. (Korean J Med 2015;89:54-63)

기술열위기업의 국제(國際) R&D제휴(提携)에 의한 흡수능력(吸收能力)과 기술이전(技術移轉) 성과(成果)에 관한 실증연구(實證硏究) -항공기(航空機) 공동(共同) 개발사업(開發事業)을 중심(中心)으로-

안영수 ( Young Sun Ann ) 한국국제통상학회 2008 국제통상연구 Vol.13 No.3

난소절제 흰쥐에서 이소플라본 섭취와 유산소성 운동이 혈중지질 및 Nitric Oxide, Paraoxonase에 미치는 영향

김대영 ( Dae Young Kim ),정선해 ( Sun Hae Jung ),이준협 ( Jun Hyoup Lee ),박재영 ( Je Young Park ),윤선 ( Sun Yoon ),양재용 ( Jae Yong Yang ),강현식 ( Hyun Sik Kang ),안의수 ( Eue Soo Ann ) 한국운동영양학회 2004 Physical Activity and Nutrition (Phys Act Nutr) Vol.8 No.3

The purpose of this study was to examine the effects of a combined treatment of isoflavone diet and aerobic exercise on blood lipids profile, nitric oxide, and paraoxonase in ovariectomized S.D rats (30 weeks) during 12 weeks. Ovariectomized S.D rats were devided into four groups (BD, BEX, ID, 1EX). The exercise and nonexercise group were fed a diet containing isoflavone or basal diet. The exercise group performed exercise on treadmill to grade 0%, 16-17 m/min for 30 minutes, four days per week during 12 weeks. Results of this study were following. 1. Isoflavone diet significantly decreased serum total-cholesterol, triglyceride, LDL-C level (p<0.05) and increased paraoxonase (p<0.05). 2. Aerobic exercise significantly decreased total-cholesterol, triglyceride level (p<0.05). 3. Combined treatment of isoflavone diet and aerobic exercise significantly decreased serum total-cholesterol. triglyceride level (p<0.05, 0.01). and increased nitric oxide (p<0.05). Consequently, it is suggested that isoflavone diet and aerobic exercise decrease serum total cholesterol, triglyceride, and low density liporotein cholesterol and increase serum nitric oxide and paraoxonase. therefore, it would have positive effects on cardiovascular disease ano atherosclerosis.

Inhibition of Notch1 signaling by Runx2 during osteoblast differentiation

Ann, Eun-Jung,Kim, Hwa-Young,Choi, Yun-Hee,Kim, Mi-Yeon,Mo, Jung-Soon,Jung, Jane,Yoon, Ji-Hye,Kim, Su-Man,Moon, Jeong-Sik,Seo, Mi-Sun,Hong, Ji-Ae,Jang, Won-Gu,Shore, Paul,Komori, Toshihisa,Koh, Jeong- Wiley (John WileySons) 2011 Journal of bone and mineral research Vol.26 No.2

The Effectiveness of an Instructor's Intervention Using Questioning Strategy in Physiology Class

Ann, Duck Sun,Hwang, Eun Young,Yang, Eunbae B. Yonsei university college of medicine 2011 의학교육논단 Vol.13 No.1

This study was done to analyze students' learning and its lasting effect by teaching strategy involving questioning. This study was performed with 68 students who were enrolled in a physiology class of the Yonsei University College of Medicine in Seoul, Korea, in 2003. The students were randomly divided into 2 groups. One group was taught in a way where students asked questions and the instructor answered the questions. For the other group of students, the instructor asked questions, and the students answered the questions. We performed a pre-test before the study begins and post-tests immediately, 3 weeks, and 6 weeks after the study. The results were analyzed by using analysis of covariance and repeated measures analysis of variance. A higher learning effect was observed in a group where questions were asked by students compared with the other group. The post-test results showed no significant difference in the lasting effect of learning according to the teaching strategy. Students' learning significantly improved when students asked questions and the instructor answered the questions compared with the strategy of the instructor asking questions and students answering to the questions.

1996년 하계 및 추계에 전주지역에서 발생한 장티푸스 유행의 임상역학적 분석

안병이,오형태,이덕수,김세화,한동호,김영숙,김귀완,박미선 대한감염학회 1998 감염 Vol.30 No.1

목 적 : 본 연구는 1996년 8월부터 10월 사이에 전주지역에 집중 발생한 장티푸스 환자들에게 관찰된 비정형적이고 심한 임상양상 및 합병증을 분석하고, 분리균주들의 파지형을 분석하여 시험에 의해 감염원을 규명하는데 목적을 두었다. 방 법 : 장티푸스 232예의 의무기록지를 검토하여 임상양상과 합병증 종합하여 분석하였고, 분리된 Salmonella Typhi 균주들에 대하여 항균제 감수성 양상을 분석하였고, 심한 임상 양상을 보인 환자들로부터 분리된 50균주들의 혈청형 및 파지형 시험을 시행하였다. 결 과 : 전체 232명의 환자 들의 성별 분포는 여자가 2.4배 많았고, 연령별 분포는 10대와 20대가 157예(67.7%)로 주로 젊은 여성에 빈발하였다. 평균 입원 일수는 8일이었고, 평균 발열 기간은 약 5∼6일 이었다. 환자들에서 관찰된 합병증은 간염 155예(66.8%), 범혈구 감소증 47예(20%), 급성 췌장염 20예(8.6%), 비뇨기계 감염 13예(5.6%), 장출혈 12예(5.2%), 파종성 혈관내 응고 5예(2.1%), 뇌막염 4예(1.7%), 패형성 쇽 3예, 폐렴 2예, 심근 허혈 2예, 사산 1예, 태아 가사 1예 등이었다. 한 환자에서 여러 합병증이 병발한 경우가 많았고, 2예에서 간염, 췌장염, 감각 신경성 난청이 합병되었고 사망한 1예는 결핵성 폐렴이 동반된 환자였다. S. Typhi은 혈액에서 111주(86%), 대변에서 17주(13.2%), 소변에서 1주(0.8%)가 분리되었고, 모든 균주에서 ampicillin 포함한 110종 항균제 모두에 감수성을 보였으며, 특히 심한 비정형적 임상 증세를 보였던 환자에서 분리된 50주의 파지형은 모두 D1형으로 동일한 감염원에 의한 유행으로 추정되었다. 결 론 : 1996년 하계 및 추계에 전주 지역에서 집단 발생한 장티푸스 유행은 비정형적 임상 양상 및 다양한 합병증을 보였으며, 분리된 S. Typhi 50균주의 파지형은 모두 D1파지형으로 나타나 동일한 균주에 의한 집단 발생임을 추정할 수 있었다. Background : We experienced an outbreak of typhoid fever in Chunju area which manifested as severe symptoms and signs, and variable complications. To chracterize the epidemic and to identify a possible source of infection, the clinical findings of patients from the outbreak were analyzed, and the patterns of antimicrobial susceptibility and phage typing of Salmonella Typhi isolates were determined. Methods : We analyzed a total of 232 patients from the outbreak who admitted to Chunju Presbyterian Medical Center during 1996 August through October. The medical records of the patients were reviewed retrospectively. All isolates of S. Typhi from the outbreak were analyzed for serotyping, antibiogram, and phage typing. Phage typing were performed using Vi-phages for 50 strains isolated from the patients who showed atypical clinical manifestations and unusal complications. Results : The outbreak attacked mainly young female group. The complications observed were: 15 cases of hepatitis, 47 pancytopenia, 20 acute pancreatitis, 13 urinary tract infection, 12 intestinal hemorrhage, 5 disseminated intravascular coagulation, 4 meningitis, 3 septic shock, 2 sensorineural hearing loss, 2 myocardial ischemia, 2 pneumonia, 1 stillbirth, and 1 death. S. Typhi were isolated in 129 cases including 111 from blood, 17 stool and 1 urine. All isolates were susceptible to all antimicrobial agents tested. All 50 isolates from severe patients with unusal complications were identified as Salmonella, serogroup D1, serotype Typhi, phage type D1. Conclusions : We experienced an outbreak of typhoid fever associated with severe, atypical symptoms and unusual complications, caused by Salmonella, serogroup D1, serotype Typhi, phage type D1.

HIV Antiretroviral Resistance Mutations Among Antiretroviral Treatment-Naive and -Experienced Patients in South Korea

Kim, Min Hyung,Song, Je Eun,Ahn, Jin Young,Kim, Yong Chan,Oh, Dong Hyun,Choi, Heun,Ann, Hea Won,Kim, Jae Kyoung,Kim, Sun Bean,Jeong, Su Jin,Ku, Nam Su,Han, Sang Hoon,Song, Young Goo,Kim, June Myung,Ch Mary Ann Liebert 2013 AIDS research and human retroviruses Vol.29 No.12

굴곡성 기관지 내시경과 바스켓을 이용한 기관지 이물 제거 2예

김영철,윤보라,안전옥,백만순,나문준 중앙대학교 의과대학 의과학연구소 1999 中央醫大誌 Vol.24 No.1

저자들은 식사중 부주의로 흡인된 우측 중간 기관지 이물과 우상엽 기관지 내에 생긴 기관지 결석을 굴곡성 내시경과 바스켓을 이용하여 제가한 예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다 We have experienced two cases of foreign body in the tracheobronchial tree which removed by fiberoptic bronchoscopy with basket. Traditionally, rigid bronchoscopy has been the treatment for endobronchial foreign body in adults. Recent some reports have suggested that the fiberoptic bronchoscopy may be a valuable therapeutic option for adults. Of our case was aspirated bean in the right intermediate bronchus and the other one was broncholith in the orifice of the anterior segmental bronchus of the right upper lobar bronchus, Removal of this endobronchial foreign bodies would be accomplished by fiberoptic bronchoscope with basket successfully. They are didn't experience any complication and the complete resolution of pneumonia was followed after removal of foreign bodies.