• Clinical Endoscopy
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• v.56 no.4
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• pp.391-408
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• 2023

With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

• Hip & pelvis
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• v.35 no.4
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• pp.228-232
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• 2023

Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.

• Journal of Animal Science and Technology
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• v.49 no.5
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• pp.621-632
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• 2007

The aim of this study was to isolate and characterize bacteriocin-producing bacteria from the intestine of duck to use as probiotics for livestock. A total of 416 strains were isolated from the small intestine and cecum of ducks and 13 isolates were finally selected after determinging inhibitory activity against pathogenic indicators by spot-on-lawn method. The selected strains were identified as Lactobacillus salivarius JWS 58, Lactobacillus plantarum JWS 1354, Pediococcus pentosaceus JWS 939, 7 strains of enterococci, and 3 strains of Escherichia coli. Lact. salivarius JWS 58, Ent. faecium JWS 833, and Ped. pentosaceus JWS 939 showed a strong inhibitory activity against Listeria monocytogenes. E. coli JWS 108 inhibited the growth of E. coli and Staphylococcus aureus. Lact. salivarius JWS 58 strain survived almost 50% in pH 2.5 phosphate buffer for 2 hr. Ped. pentosaceus JWS 939 and Lact. plantarum JWS 1354 showed strong amylolytic activity. These results suggest that a combination of bacteriocins or multispecies probiotics of the selected strains has a strong potential of alternative to antibiotics in livestock production.

• The Korean Journal of Physiology
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• v.23 no.1
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• pp.23-34
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• 1989

Gentamicin (GM) is a polybasic, aminoglycoside antibiotic used frequently for the treatment of serious gram-negative infections. The major limiting factors in the clinical use of GM as well as other aminoglycoside antibiotics are their nephrotoxicity and ototoxicity. The primary mechanism of cell injury in aminoglycoside toxicity appears to be the disruption of normal membrane function and the inhibition of $Na^{+}-K^{+}$ ATPase activity. There are both indirect and direct evidences which suggests that the effect of aminoglycoside antibiotics on $Na^{+}-K^{+}$ ATPase may explain, or contribute to, their toxicity. It has been shown that aminoglycoside reduce total ATPase activity (Kaku et al., 1973) and $Na^{+}-K^{+}$ ATPase activity (linuma et al., 1967) in the stria vascularis and spiral ligament of the guinea-pig cochlea. Lipsky and Lietman (1980) reported that aminoglycoside antibitoics inhibited the activity of $Na^{+}-K^{+}$ ATPase in microsomal fractions of the cortex and medulla of the guinea-pig kidney, isolated rat renal tubule and human erythrocyte ghosts. The present invstigation was undertaken to elucidate the mechanism of GM on human erythrocytes by examining its effect on $Na^{+}-K^{+}$ ATPase activity, actives sodium and potassium transport across red blood cell and $^{3}H-ouabain$ binding to red blood cell membranes. The results obtained are summarized as follows: 1) CM inhibited significantly both the activity of total ATPase and $Na^{+}-K^{+}$ ATPase at all concentrations tested. 2) GM inhibited active $^{22}Na$ efflux across red blood cell. When ouabain is present, the rate of $^{22}Na$ efflux was completely inhibited. When both GM and ouabain were added, the inhibitory effect of active $^{22}Na$ efflux was more pronounced. 3) Active $^{86}Rb$ influx was inhibited significantly by GM. In the presence of ouabain, the rate of $^{86}Rb$ influx is markedly inhibited. But $^{86}Rb$ influx is not appreciably altered by the presence of both GM and ouabain. 4) In the presence of GM, $^{3}H-ouabain$ binding to red blood cell membrane increased. From the above results, it may be concluded that the inhibition of active sodium and potassium transport across red blood cell by gentamicin appears to be due to the inhibition of $Na^{+}-K^{+}$ ATPase activity and an increase in ouabain binding to red blood cell membranes.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.38-43
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• 2013

Purpose: To evaluate the efficiency of arthroscopic treatment for infected total knee arthroplasty (TKA), and to investigate the factors affecting the outcomes. Materials and Methods: We analyzed 17 cases which underwent arthroscopic treatment to treat infection after TKA. After confirming infection by hematologic examination and analysis of joint fluid, we performed arthroscopic debridement, synovectomy and irrigation with normal saline mixed with antibiotics. Through routine examination after operation, we checked failure of treatment or recurrence of infection. If there is no recurrence until 2 years after the operation, we considered it as a success of treatment. Results: Of the 17 cases taken arthroscopic treatment, 13 cases were treated successfully with primary arthroscopic treatment only, but 4 cases had to undergo re-operation because of persistence or recurrence of infection. Analyzing the factors affecting the results, we found that symptom duration of the re-operation group is longer than the treated group after arthroscopy (p<0.05). Conclusion: Arthroscopic treatment can be effective when we performed appropriate selection of patients, careful and extensive arthroscopic irrigation and debridement, and suitable use of antibiotics. However, we have to do early arthroscopic surgery as soon as possible when infection after TKA is suspected.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.23-28
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• 2015

Purpose: The aim of this study was to investigate the clinical manifestations and laboratory characteristics of eosinophilic meningitis in Severance Children's Hospital. Methods: We examined 6,335 children under the age of 18 years old who had visited the tertiary hospital in Seoul, Korea, and had received cerebrospinal study results between January 2007 and July 2012. The medical records of the patients identified as eosinophilic meningitis were retrospectively reviewed. Results: Eosinophilic meningitis was diagnosed in 39 patients (0.6%). The mean age was 6 years (range 0-18 years) and the sex ratio was 1.3:1 (22 males and 17 females). The underlying diseases and past history were neurologic disease (n=36, 92%). Eosinophilic meningitis was diagnosed in thirty-five patients who had undergone postoperation neurosurgery (90%). The most common symptoms were fever (50%), headache (20%), vomiting (15%), seizure (10%), and dizziness (5%). The average duration for recovery was five days, and intravenous antibiotics or steroids were used. Conclusions: Manifestations of eosinophilic meningitis are similar to other types of meningitis. The most common cause of eosinophilic meningitis in children was neurosurgery. Eosinophilic meningitis should be considered for patients showing fever and headache after neurosurgery. Through careful investigation, use of improper antibiotics could be avoided.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.16-22
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• 2015

Purpose: The aim of this study was to identify the factors influencing the spontaneous decolonization period of vancomycin resistant enterococcus (VRE) species in pediatric patients. Methods: The medical records of patients presenting positive VRE cultures between January 2005 and November 2010 at a tertiary hospital in Seoul, Korea, were reviewed retrospectively. The subjects were divided into two groups according to the average number of days for decolonization (325 days). Clinical characteristics were compared between shorter VRE colonization patients (<325 days, n=41) and prolonged VRE colonization patients (>325 days, n=110). Results: There were 151 patients who had more than 1 year of follow up period or confirmed of VRE decolonization among patients who were identified with VRE. The average age at the time of initial VRE colonization was significantly younger in shorter decolonization group than in prolonged decolonization group (44.9 months vs 40.9 months, P =0.040). The prolonged decolonization group received more vancomycin treatments after VRE colonization in comparison with patients in shorter decolonization group (7.0% vs 27.2%, P =0.008). Conclusion: For the duration of VRE colonization, it was found that the initial age of acquiring VRE and use of antibiotics were important factors. Antibiotics should be used properly and precisely in order to treat infectious diseases and to control the colonization of antibiotic resistant bacteria.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.104-113
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• 2014

Purpose: We compared the clinical manifestations of patients with tsutsugamushi disease between children and adults. Methods: From January 2003 to December 2012, 768 patients diagnosed with tsutsugamushi disease were retrospectively reviewed, and the clinical characteristics, laboratory findings, and complications were compared between children and adults. Results: No patterns of annual increases in the number of patients were noted in both children and adults. The higher incidences occurred in October and November respectively. By gender, male outnumbered female in children, but the opposite trend was seen in adults. By residential area, the urban distribution of children was higher than that of adults. Rashes (P =0.001) and eschar (P =0.004) were more common in children, while myalgia was more common in adults. Children had a high prevalence of anemia (P =0.041), and low incidence rates of thrombocytopenia, abnormal liver and renal function. Children yielded better results in the duration of their hospital stay and the incidence of complications (P <0.001). A comparison of the therapeutic effects of doxycycline and macrolide antibiotics, which was performed only on the children, did not reveal any significant differences. Conclusion: Compared to adults, children had higher incidence rates of male patients and more often suffered from rashes and eschar. Children yielded better results in the laboratory findings and duration of the hospital stay and complications. Therefore, when children are suspected to have tsutsugamushi disease, especially during its peak occurrence period, detailed physical examination and serological test should be performed to ensure a prompt diagnosis, and the use of macrolide antibiotics, which have fewer side effects, is expected to yield the same therapeutic effects.

• Asian-Australasian Journal of Animal Sciences
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• v.19 no.1
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• pp.97-101
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• 2006

Certain amino acids are essential precursors of a variety of important biomolecules in addition to their major function as protein building blocks. ${\delta}$-Aminolevulinic acid (ALA) is synthesized from the condensed form of succinyl-CoA with glycine after decarboxylation catalyzed by ALA synthase. The objective of the study was to determine the effects of ALA supplementation on growth performance, behavioral characteristics and hematological/immune status in nursery pigs. A total of 144 pigs weaned at 21 d of age were allotted to three dietary treatments representing (-) control (w/o antibiotics; NC), (+) control (w/carbadox at 50 mg/kg; PC), and the treatment group with ALA supplementation (0.05%; TA). Each treatment had 6 pens (replicates) with 8 pigs per pen. Pigs were fed phase 1 (21.9% CP, 1.40% Lys) and 2 (20.6% CP, 1.15% Lys) experimental diets for 3 and 2 wks, respectively. Feed intake and weight gain were measured weekly during phase 1 and at the end of phase 2. At the end of phase 2, blood samples were taken and analyzed using an automated hematology analyzer. Skin color and activity of pigs (48 h) from all pens in each treatment were measured at the second week of phase 2. Growth performance was not affected (p>0.05) by the dietary supplementation of ALA during the 5 wk nursery period. Pigs in the TA (6.46) and PC (6.68) had a higher (p<0.05) number of red blood cells ($10^6cell/{\mu}L$) than pigs in the NC (6.15). Pigs in PC (12.16) had a higher (p<0.05) hemoglobin level (g/dL) than pigs in the NC group (11.29) and the TA group (11.47). Pigs in the TA and PC had darker (p<0.05) and less (p<0.05) yellow skin color than pigs in the NC. Pigs in the PC tended (p = 0.081) to be less active than pigs in the other groups. There were no differences in behavioral characteristics between the NC and the TA. The data suggest that ALA supplementation has no adverse effects on growth performance of nursery pigs. Moreover, ALA supplementation increased red blood cell counts which may be beneficial to pigs.

• Journal of Animal Science and Technology
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• v.59 no.8
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• pp.18.1-18.8
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• 2017

Background: In 2006, the European Union (EU) has decided to forbid use of antibiotics as growth promoters. Although many researches had been conducted about fiber source as alternatives of antibiotics, there are still lack of reports in the literature about the optimum level of sugar beet pulp supplementation, affecting growth performance and nutrient digestibility in weaning pigs. Therefore, different level of sugar beet pulp was added to diets to determine the effects of sugar beet pulp supplementation on growth performance, nutrient digestibility, fecal microflora, blood profile and incidence of diarrhea in weaning pigs. Methods: A total of 200 weaning pigs [$(Yorkshire{\times}Landrace){\times}Duroc$], averaging $9.01{\pm}1.389kg$ of initial body weight were, allotted to 5 treatments in a randomized complete block (RCB) design. Each treatment was composed of 4 replicates with 10 pigs per pen. The treatments were control treatment: Corn-SBM basal diet + ZnO (phase 1: 0.05%; phase 2; 0.03%) and four different levels of sugar beet pulp were supplemented in Corn-SBM basal diet (3, 6, 9 or 12%). Two phase feeding programs (phase 1: 1-2 weeks; phase 2: 3-5 weeks) were used for 5 week of growth trial. Results: In feeding trial, there were no significant differences in growth performance and incidence of diarrhea among treatments. The E.coli counts were not significantly different among dietary treatments but linear response was observed in Lactobacillus counts as sugar beet pulp supplementation increased (P < 0.05). In addition, IGF-1, IgA and IgG were not affected by dietary treatments. However, the BUN concentration was decreased when pigs were fed the treatments of diets with SBP compared to that of control treatment (P < 0.05). In nutrient digestibility, crude fiber and NDF digestibilities were improved as the sugar beet pulp increased (P < 0.05). However, digestibilities of crude ash, crude fat, crude fiber and nitrogen retention were not affected by dietary sugar beet pulp levels. Conclusion: This experiment demonstrated that sugar beet pulp can be supplemented in weaning pigs' diet instead of ZnO to prevent postweaning diarrhea without any detrimental effect on growth performance.