• Title/Summary/Keyword: High-risk

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Emergence of Conjugative Multidrug-Resistant Pseudomonas aeruginosa (접합가능한다제내성녹농균의출현)

  • Miyoung Lee
    • Microbiology and Biotechnology Letters
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    • v.51 no.4
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    • pp.517-525
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    • 2023
  • The emergence and spread of multidrug-resistant Pseudomonas aeruginosa (MRPA) have become a serious problem worldwide. The involvement of metallo-β-lactamases (MBLs) in inducing carbapenem resistance is particularly acute. However, unlike other members of the Enterobacteriaceae genus, new clones of P. aeruginosa are constantly emerging and rapidly replacing previously prevalent dominant clones. Therefore, this study aimed to perform antimicrobial resistance gene analysis, integron gene cassette analysis using DNA sequencing, and plasmid transfer analysis by conjugation to investigate the antimicrobial resistance dynamics of 18 P. aeruginosa strains isolated from various medical samples at a general hospital in Busan from September 2017 to September 2019. All 18 strains showed extensively drug-resistant (XDR) phenotype and were resistant to most antibiotics, except colistin (100%) but were susceptible to aztreonam (22.2%) and ceftazidime (16.6%). Approximately 66.7% of the strains had Class 1 integrons showing various antimicrobial resistances. Notably, IMP-6 ST235 (66.7%), VIM-2 ST357 (16.7%), and IMP-1 ST446(16.7%) were identified. The identification of IMP-1-producing ST446, previously unreported in Korea, is noteworthy considering the emergence and prevalence of another MRPA high-risk clone.

Human Organic Anion Transporting Polypeptide 1B3 Applied as an MRI-Based Reporter Gene

  • Song-Ee Baek;Asad Ul-Haq;Dae Hee Kim;Hyoung Wook Choi;Myeong-Jin Kim;Hye Jin Choi;Honsoul Kim
    • Korean Journal of Radiology
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    • v.21 no.6
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    • pp.726-735
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    • 2020
  • Objective: Recent innovations in biology are boosting gene and cell therapy, but monitoring the response to these treatments is difficult. The purpose of this study was to find an MRI-reporter gene that can be used to monitor gene or cell therapy and that can be delivered without a viral vector, as viral vector delivery methods can result in long-term complications. Materials and Methods: CMV promoter-human organic anion transporting polypeptide 1B3 (CMV-hOATP1B3) cDNA or CMV-blank DNA (control) was transfected into HEK293 cells using Lipofectamine. OATP1B3 expression was confirmed by western blotting and confocal microscopy. In vitro cell phantoms were made using transfected HEK293 cells cultured in various concentrations of gadoxetic acid for 24 hours, and images of the phantoms were made with a 9.4T micro-MRI. In vivo xenograft tumors were made by implanting HEK293 cells transfected with CMV-hOATP1B3 (n = 4) or CMV-blank (n = 4) in 8-week-old male nude mice, and MRI was performed before and after intravenous injection of gadoxetic acid (1.2 µL/g). Results: Western blot and confocal microscopy after immunofluorescence staining revealed that only CMV-hOATP1B3-transfected HEK293 cells produced abundant OATP1B3, which localized at the cell membrane. OATP1B3 expression levels remained high through the 25th subculture cycle, but decreased substantially by the 50th subculture cycle. MRI of cell phantoms showed that only the CMV-hOATP1B3-transfected cells produced a significant contrast enhancement effect. In vivo MRI of xenograft tumors revealed that only CMV-hOATP1B3-transfected HEK293 tumors demonstrated a T1 contrast effect, which lasted for at least 5 hours. Conclusion: The human endogenous OATP1B3 gene can be non-virally delivered into cells to induce transient OATP1B3 expression, leading to gadoxetic acid-mediated enhancement on MRI. These results indicate that hOATP1B3 can serve as an MRI-reporter gene while minimizing the risk of long-term complications.

Visualization of Borderline Coronary Artery Lesions by CT Angiography and Coronary Artery Disease Reporting and Data System (관상동맥 질환 판독과 자료 체계와 CT 혈관조영술에서의 경계성 관상동맥 병변)

  • Hyewon Park;Yu-Whan Oh;Ki Yeol Lee;Hwan Seok Yong;Cherry Kim;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.297-307
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    • 2024
  • Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

Tree species migration to north and expansion in their habitat under future climate: an analysis of eight tree species Khyber Pakhtunkhwa, Pakistan

  • Muhammad Abdullah Durrani;Rohma Raza;Muhammad Shakil;Shakeel Sabir;Muhammad Danish
    • Journal of Ecology and Environment
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    • v.48 no.1
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    • pp.96-109
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    • 2024
  • Background: Khyber Pakhtunkhwa government initiated the Billion Tree Tsunami Afforestation Project including regeneration and afforestation approaches. An effort was made to assess the distribution characteristics of afforested species under present and future climatic scenarios using ecological niche modelling. For sustainable forest management, landscape ecology can play a significant role. A significant change in the potential distribution of tree species is expected globally with changing climate. Ecological niche modeling provides the valuable information about the current and future distribution of species that can play crucial role in deciding the potential sites for afforestation which can be used by government institutes for afforestation programs. In this context, the potential distribution of 8 tree species, Cedrus deodara, Dalbergia sissoo, Juglans regia, Pinus wallichiana, Eucalyptus camaldulensis, Senegalia modesta, Populus ciliata, and Vachellia nilotica was modeled. Results: Maxent species distribution model was used to predict current and future distribution of tree species using bioclimatic variables along with soil type and elevation. Future climate scenarios, shared socio-economic pathways (SSP)2-4.5 and SSP5-8.5 were considered for the years 2041-2060 and 2081-2100. The model predicted high risk of decreasing potential distribution under SSP2-4.5 and SSP5-8.5 climate change scenarios for years 2041-2060 and 2081-2100, respectively. Recent afforestation conservation sites of these 8 tree species do not fall within their predicted potential habitat for SSP2-4.5 and SSP5-8.5 climate scenarios. Conclusions: Each tree species responded independently in terms of its potential habitat to future climatic conditions. Cedrus deodara and P. ciliata are predicted to migrate to higher altitude towards north in present and future climate scenarios. Habitat of D. sissoo, P. wallichiana, J. regia, and V. nilotica is practiced to be declined in future climate scenarios. Eucalyptus camaldulensis is expected to be expanded its suitability area in future with eastward shift. Senegalia modesta habitat increased in the middle of the century but decreased afterwards in later half of the century. The changing and shifting forests create challenges for sustainable landscapes. Therefore, the study is an attempt to provide management tools for monitoring the climate change-driven shifting of forest landscapes.

Clustered Microcysts Detected on Breast US in Asymptomatic Women (무증상 여성의 유방초음파에서 발견된 군집 미세낭종)

  • Hyun Jin Kim;Jin Hwa Lee;Young Mi Park;Kyungjae Lim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.676-685
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    • 2023
  • Purpose To investigate the incidence, outcomes, and imaging characteristics of clustered microcysts detected on breast US in asymptomatic women, and suggest appropriate management guidelines. Materials and Methods We identified and reviewed the lesions recorded as "clustered microcysts" on breast US performed in asymptomatic women between August 2014 and December 2019. The final diagnosis was based on pathology and imaging follow-up results for at least 12 months. Results The incidence was 1.5% and 100 patients with 117 lesions were included. Among 117 lesions, 3 (2.6%), 2 (1.7%), and 112 (95.7%) were malignant, high-risk benign, and benign lesions, respectively. The malignant lesions included two cases of ductal carcinoma in situ and one invasive ductal carcinoma. Two of them were assessed as category 4, showing mammographic suspicious microcalcifications and internal vascularity on Doppler US. The remainder was a false negative case and showed echo pattern change on the 12-month follow-up US. Conclusion The incidence of clustered microcysts on breast US in asymptomatic women was 1.5% and malignancy rate was 2.6% (3 of 117). Knowledge of outcomes and imaging features of benign and malignant clustered microcysts may be helpful for radiologists, thereby aiding categorization and management recommendations.

Spectrum Analysis and Detection of Ships Based on Aerial Hyperspectral Remote Sensing Experiments (항공 초분광 원격탐사 실험 기반 선박 스펙트럼 분석 및 탐지)

  • Jae-Jin Park;Kyung-Ae Park;Tae-Sung Kim;Moonjin Lee
    • Journal of the Korean earth science society
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    • v.45 no.3
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    • pp.214-223
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    • 2024
  • The recent increase in maritime traffic and coastal leisure activities has led to a rise in various marine accidents. These incidents not only result in damage to human life and property but also pose a significant risk of marine pollution involving oil and hazardous and noxious substances (HNS) spills. Therefore, effective ship monitoring is crucial for preparing and for responding to marine accidents. This study conducted an aerial experiment utilizing hyperspectral remote sensing to develop a maritime ship monitoring system. Hyperspectral aerial measurements were carried out around Gungpyeong Port in the western coastal region of the Korean Peninsula, and spectral libraries were constructed for various ship decks. The spectral correlation similarity (SCS) technique was employed for ship detection, analyzing the spatial similarity distribution between hyperspectral images and ship spectra. As a result, 15 ships were detected in the hyperspectral images. The color of each ship's deck was classified based on the highest spectral similarity. The detected ships were verified by matching them with high-resolution digital mapping camera (DMC) images. This foundational study on the application of aerial hyperspectral sensors for maritime ship detection demonstrates their potential role in future remote sensing-based ship monitoring systems.

Approval status and characteristics of work-related musculoskeletal disorders among Korean workers in 2020

  • Eun-woo Cha;Sae-mi Jung;Il-ho Lee;Dae Hwan Kim;Eui Hyek Choi;In-ah Kim;Yong-kyu Kim;Kyung-joon Lee;Yang Won Kang;Ho-gil Kim;Young-ki Kim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.31.1-31.14
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    • 2022
  • Background: This study aimed to investigate the characteristics of work-related musculoskeletal disorders (WRMSDs) in occupational disease claims and identify patterns of WRMSDs for each body part by industry and occupation. Methods: This study analyzed the raw data of occupational disease claims for musculoskeletal disorders deliberated by the Occupational Disease Decision Committee of the Korea Workers' Compensation & Welfare Service in 2020. The data was classified into 6 body parts with the highest numbers of occupational disease cases by using the complete enumeration data on principal diagnoses and 4 types of subdiagnoses in the raw data. The characteristics and approval rates of WRMSDs by body part, industry and occupation were examined and summarized. Results: A total of 13,015 occupational disease cases for WRMSDs were classified, and lumbar spinal (back) diseases accounted for the largest proportion of claimed diseases, followed by shoulder, elbow, wrist, knee, and neck diseases in a descending order. The occupations with the highest and second highest numbers of occupational disease cases by body part were found to be automobile assemblers and production-related elementary workers for the neck, school meal service workers and cooks for the back, construction frame mold carpenters and school meal service workers for the shoulder, elementary workers in mining and food service workers for the elbow, food service workers and automobile parts assemblers for the wrist, and ship welders and school meal service workers for the knee. Conclusions: This study examined the characteristics and approval status of WRMSDs by body part and occupation. Based on the study results, management strategies for the prevention of WRMSDs should be established regarding occupations with a high risk of WRMSDs for each body part.

Predicting Helicobacter pylori infection from endoscopic features

  • Jun-young Seo;Ji Yong Ahn;Seonok Kim;Hee Kyong Na;Jeong Hoon Lee;Kee Wook Jung;Do Hoon Kim;Kee Don Choi;Ho June Song;Gin Hyug Lee;Hwoon-Yong Jung
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.439-447
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    • 2024
  • Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and 13C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.

The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention

  • Jiesuck Park;Jung-Kyu Han;Jeehoon Kang;In-Ho Chae;Sung Yun Lee;Young Jin Choi;Jay Young Rhew;Seung-Woon Rha;Eun-Seok Shin;Seong-Ill Woo;Han Cheol Lee;Kook-Jin Chun;DooIl Kim;Jin-Ok Jeong;Jang-Whan Bae;Han-Mo Yang;Kyung Woo Park;Hyun-Jae Kang;Bon-Kwon Koo;Hyo-Soo Kim
    • Korean Circulation Journal
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    • v.52 no.7
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    • pp.544-555
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    • 2022
  • Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

Programmed Follow-up and Quality Control of Treatment Techniques Enhance Chronic Thromboembolic Pulmonary Hypertension Management: Lessons From a Multidisciplinary Team

  • Taek Kyu Park;Sung-A Chang;Jeong Hoon Yang;Woochan Kwon;Min Yeong Kim;Young Seok Cho;Hye Yun Park;Dong Seop Jeong;Hojoong Kim;Duk kyung Kim
    • Korean Circulation Journal
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    • v.54 no.7
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    • pp.409-421
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    • 2024
  • Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.