• Tuberculosis and Respiratory Diseases
• /
• v.55 no.3
• /
• pp.311-316
• /
• 2003

A 34-year-old man was admitted to our hospital due to fever and cough. He received the combination anti-cancer chemotherapy for testicular tumor, including bleomycin. The chest X-ray showed consolidation and ground glass opacity on the right upper lobe and subpleural areas of other lobes. This condition was initially misdiagnosed as a pneuomonia, but consolidation did not disappear after antibiotics treatment. We performed transbronchial lung biopsy and bleomycin induced pulmonary toxicity was confirmed. The bleomycin induced lung injury is the most common chemotherapeutically induced pulmonary disease. Bleomycin induced Bronchiolitis Obliterans Organizing Pneumonia(BOOP) is less common than interstitial pneumonitis and responds well to corticosteroid treatment.

• Restorative Dentistry and Endodontics
• /
• v.45 no.3
• /
• pp.26.1-26.18
• /
• 2020

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

• The Journal of the Korean Society for Microbiology
• /
• v.22 no.3
• /
• pp.275-282
• /
• 1987

Strains of bacteria resistant to beta-lactam antibiotics have been increasing in number and are becoming troublesome in clinical medicine. The in vitro antibacterial activity of augmentin, a combination drug consisting of two parts amoxycillin to one part clavulanic acid, a potent beta-lactamase inhibitor, and their minimum inhibitory concentrations were determined by an agar dilution technique against ampicillin-resistant clinical isolates in Korea. Of the 226 strains tested, 140 strains(62%) were resistant to ampicillin. Among the 140 ampicillin-resistant strains, all Salmonella spp. Proteus spp. the majority of S. aureus and Shigella spp. were sensitive to augmentin. Ps. aeruginosa remained 100% resistant and there has been a considerable decline in resistant strains in E. coli and K. pneumoniae although a significant percentage of strains showed intermediate sensitivity. The minimum inhibitory concentrations of augmentin were ranged in $8{\mu}g/ml$ to $32{\mu}g/ml$ in most bacteria and all S. aureus were inhibited by $8{\mu}g/ml$. In our microbiological studies we have shown that augmentin is active against ampicillin-resistant strains of Staphylococci and Gram-negative bacteria. In this hospital there would appear to be a significant number of strains of E. coli and K. pneumoniae showing intermediate resistance to augmentin. Most of these strains should be susceptible to augmentin given by mouth or by the intravenous route depending on the concentrations of both amoxycillin and clavulanic acid obtainable in the various tissues.

• Journal of Veterinary Science
• /
• v.22 no.2
• /
• pp.17.1-17.13
• /
• 2021

Background: Klebsiella spp. is an important conditional pathogen in humans and animals. However, due to the indiscriminate use of antibiotics, the incidence of antimicrobial resistance has increased. Objectives: The purpose of this study was to investigate antimicrobial resistance in strains of Klebsiella strains and the phylogenetic relatedness of extended-spectrum cephalosporin (ESC)-resistance among Klebsiella strains isolated from clinically ill companion animals. Methods: A total of 336 clinical specimens were collected from animal hospitals. Identification of Klebsiella species, determination of minimum inhibitory concentrations, detection of ESC resistance genes, polymerase chain reaction-based replicon typing of plasmids by conjugation, and multilocus sequence typing were performed. Results: Forty-three Klebsiella strains were isolated and, subsequently, 28 were identified as K. pneumoniae, 11 as K. oxytoca, and 4 as K. aerogenes. Eleven strains were isolated from feces, followed by 10 from ear, 7 from the nasal cavity, 6 from urine, 5 from genitals, and 4 from skin. Klebsiella isolates showed more than 40% resistance to penicillin, cephalosporin, fluoroquinolone, and aminoglycoside. ESCresistance genes, CTX-M groups (CTX-M-3, CTX-M-15, and CTX-M-65), and AmpC (CMY-2 and DHA-1) were most common in the K. pneumoniae strains. Some K. pneumoniae carrying CTX-M or AmpC were transferred via IncFII plasmids. Two sequence types, ST709 and ST307, from K. pneumoniae were most common. Conclusions: In conclusion, this is the first report on the prevalence, ESCresistance genotypes, and sequence types of Klebsiella strains isolated from clinically ill companion animals. The combination of infectious diseases and antimicrobial resistance by Klebsiella in companion animals suggest that, in clinical veterinary, antibiotic selection should be made carefully and in conjunction with the disease diagnosis.

• Korean Journal of Veterinary Service
• /
• v.42 no.1
• /
• pp.17-24
• /
• 2019

The aim of this study was to investigate the prevalence and characterization of plasmid-mediated quinolone resistance (PMQR) gene in 79 Enterobacteriaceae isolated from dogs and cats. Of 79 isolates, PMQR genes were found in 10 (12.7%) isolates, including aac(6')-lb-cr, qnrB, qnrS and qnrA detected alone or in combination in 8 (10.1%), 4 (5.1%), 2 (2.5%) and 1 (1.3%) isolates, respectively. Interestingly, two qnrS genes were detected in nalidixic acid and ciprofloxacin susceptible isolates. Extended-spectrum ${\beta}$-lactamase (ESBL) was detected in 90% (9 isolates) of PMQR positives isolates. Among ESBL genes, CTX-M, TEM and SHV were detected in 9, 8 and 3 isolates, respectively. Almost all PMQR genes were detected in co-existence with ESBL genes. All PMQR positives isolates were multidrug resistance (i.e. resistant to five or more antibiotics). qepA, OXA and CMY-2 genes were not found. The six transconjugants were obtained by conjugation experiment. The aac(6')-lb-cr, qnrB and qnrS were co-transferred with CTX-M, TEM and/or SHV, whereas qnrA was not observed among transconugants. This is the first report of the presence of aac(6')-lb-cr and qnrA gene among Enterobacteriaceae isolates from dogs in Korea. The prudent use of antimicrobials and continuous monitoring for companion animals are required.

• Asian-Australasian Journal of Animal Sciences
• /
• v.17 no.3
• /
• pp.394-400
• /
• 2004

To investigate the efficacy of alternatives to antibiotics, the present study was conducted to compare the effects of antibiotic, lactic acid, a blend of commercial essential oils (EOs) and EOs in combination with lactic acid on growth performance and the functional activity of the gut in broiler chickens. A total of 168 broiler chickens were given the basal diet supplemented with 10 ppm colistin (T1), 0.1% lactic acid (T2), 25 ppm EOs (T3), 25 ppm EOs+0.1% lactic acid (T4), 50 ppm EOs (T5) or 50 ppm EOs+0.1% lactic acid (T6) in the period 3 to 35 days of age. As a result, the broiler chickens assigned to T4 group throughout the experimental period had apparently (p<0.05) greater body weight and total gain than these assigned to T1, T2, T3 and T5 groups. However, there was no difference in growth performance among the birds fed the diets supplemented with antibiotic (T1), lactic acid (T2) and EOs (T3 and T5) alone. The weights of digestive organs and the number of lactobacilli and E. coli in the lower ileum were not affected by dietary treatments. Total trypsin activity was significantly (p<0.05) greater in T4 than T1, T2, T3 and T5 groups. Total and specific pancreatic $\alpha$-amylase activities were significantly (p<0.05) enhanced in the broiler chickens fed T4 diet compared with these fed T1, T2 and T3 diets. However, there were no differences in growth performance and digestive enzyme activities including pancreatic trypsin and $\alpha$-amylase between T4 and T6 groups fed the diets supplemented with either low or high EOs levels in combination of lactic acid. In conclusion, a blend of commercial EOs combined with lactic acid showed significant increases in digestive enzyme activities of the pancreas and intestinal mucosa, leading to increase in growth performance.

• Korean Journal of Plant Resources
• /
• v.28 no.1
• /
• pp.9-15
• /
• 2015

Methicillin-resistant Staphylococcus aureus (MRSA) has been emerging worldwide as one of the most important hospital and community pathogens. At the same time, because of the difficulty in developing chemical synthetic drugs and because of their side-effects, scientists are making more efforts to search for new drugs from plant resources to combat clinical multidrug-resistant microbial infections. Cinnamomum camphora (C. camphora) is a plant of family Lauraceae, and grown Jeju island in South Korea that are used as a drug to treat neurasthenia, epilepsy, cystitis, pyelonephritis, digitalis, cancer, and diabetes mellitus in folk remedies. In this study, antibacterial activites of 80% ethanol extract of C. camphora leaves (CCE) were investigated in combination with antibiotics against clinical isolates of MRSA. The results showed that CCE was determined with MIC and MBC values ranging from 156 to 313 and 313 to $625{\mu}g/ml$, oxacillin from 128 to 256 and 128 to $512{\mu}g/ml$, ampicillin from 4 to 64 and 8 to $128{\mu}g/ml$. The combination of CCE with oxacillin or/and ampicillin were synergistic effect against MRSA 1, 6, 7, 8, 10, 11, 12, 13, and 15/ MRSA 1, 2, 6, and 7.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.5
• /
• pp.537-545
• /
• 1994

Background: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with community-acquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of dying of severe community-acquired pneumonia. Methods: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. Results: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnca, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+) cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Seven patients death(70%) occured after admission within the first five days, and a mean duration of hospitaliztion was 11.2 days. Conclusion: As the results show most death occured within the first five days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.

• Journal of Yeungnam Medical Science
• /
• v.16 no.2
• /
• pp.347-356
• /
• 1999

Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI. we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt. mon and 1 per 2l.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA. 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for refractory ESI/TI before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.5
• /
• pp.1083-1093
• /
• 1997

Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.