• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.438-443
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• 2018

The emergence of biofilms have generated urgent alarm in clinical and medicine manufacturing fields engaged in the search for novel antimicrobials from ethno-medicinal plants. The National Institutes of Health (NIH) has estimated that 70% of all microbial infections in the world are associated with biofilms. In addition, the emergence of strains resistant to conventional antibiotics has become a serious threat to global public health. Therefore, finding alternative medicines is a major issue in the field of integrative medicine. In this study, four different herb extracts were screened for biofilm formation and the activities of Klebsiella pneumoniae. Of them, Scutellaria scordifolia Fisch. ex Schrank extracts had inhibitory effects on bacterial growth and biofilm formation. The Scutellaia scordifolia Fisch. ex Schrank extracts did not cause any cytotoxicity to L929 cells. The growth of K. pneumoniae was inhibited compared to other comparators in the experimental group containing Scutellaia scordifolia Fisch. ex Schrank. In a group of experiments with plant extracts, a maximum of 60 times the level of living bacteria was confirmed compared to the controls without the addition of the Scutellaia scordifolia Fisch. ex Schrank extracts. In a group of experiments with a significantly lower level of fluorescence extraction, differential interference contrast imaging showed that the number of K. pneumonae was reduced. These results suggest that extracts of this plant be applied as antimicrobial agents against K. pneumoniae, particularly in biofilm forms.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.3
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• pp.179-191
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• 2022

Carbapenem-resistant Enterobacteriaceae (CRE) poses an increasing public health threat and has limited treatment options with high associated mortality. Genotypes of carbapenemase that threaten public health (bla_KPC, bla_NDM, bla_IMP, and bla_VIM) and bla_OXA-48-like genes were detected by phenotypic and molecular diagnosis, and related gene distribution patterns were investigated. Phenotypic testing using the modified Hodge test confirmed positivity in all 41 strains examined, and carbapenemase inhibitory testing using meropenem+phenyl boronic acid or meropenem+EDTA confirmed positivity in 18 and 8 strains, respectively. Polymerase chain reaction revealed the presence of amplification products in 28 strains of bla_KPC, 25 strains of bla_NDM, 5 strains of bla_IMP, 1 strain of bla_VIM, and 13 bla_OXA-48-like strains. In addition, 7 strains of bla_KPC+bla_NDM, 1 strain of bla_KPC+bla_IMP, 1 strain of bla_NDM+bla_OXA-48-like, 1 strain of bla_NDM+bla_VIM, 4 strains of bla_KPC+bla_NDM+bla_IMP, and 4 strains of bla_KPC+bla_NDM+bla_OXA-48-like were identified. Melting curve analysis using real-time PCR was wholly consistent with PCR results. The study shows genetic identification of highly specific CRE by real-time PCR could be used to provide early diagnoses and infection control, improve surveillance, and prevent the transmission of CRE.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.207-212
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• 2001

Purpose: Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has not been studied yet until now in Korea. Methods: We performed the prospective study of 19 cases that had AST and ALT>50 IU/L respectively without evidence of hepatitis A, B, C, cytomegalovirus, and Ebstein-Barr virus infections amongst 143 patients with M. pneumoniae pneumonia who were admitted to the Department of Pediatrics, Seoul Red Cross Hospital from Jan. 1999 to Dec. 2000. Results: 1) Hepatitis occurred in 13.3% of Mycoplasma pneumoniae infection, especially in fall and winter times. The average age was 4.86 years and male to female ratio was 2.2:1. 2) Vomiting was developed in 21.1%, diarrhea in 36.8%, and hepatomegaly in 21.1%, respectively. And leukocytosis was noted in 21.1%, eosinophilia in 15.4%, anemia in 10.5%, and thrombocytosis in 5.3%, respectively. The average level of C-reactive protein was $6.34{\pm}4.82$ mg/dl. 3) There was no hyperbilirubinemia, but hypoalbuminemia was detected in 42.1%. The average serum levels of AST and ALT were $214.05{\pm}183.22$ IU/L and $284.16{\pm}286.84$ IU/L, respectively. 4) Chest radiology showed lobar or lobular consolidation in 73.7%, bronchial infiltration in 26.3%, and pleural effusion in 31.6%. 5) The average length of hospitalization was 7.9 days, and the average length of normalization of serum transaminases was 8.8 days. All patients recovered within 2 weeks completely. Conclusion: The prognosis of M. pneumoniae hepatitis is good. However, its incidence is not so low that liver function should be considerately checked in case of M. pneumoniae infection.

• Asian-Australasian Journal of Animal Sciences
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• v.30 no.9
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• pp.1340-1349
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• 2017

Objective: This study aimed to evaluate the microbiological and cellular milk profile for the diagnosis of subclinical mastitis in female buffaloes and to assess risk factors for predisposition of the disease. Methods: Analyses were carried out by standard plate count (SPC), identification of species and antibiotic resistance, somatic cell count (SCC), electrical electrical conductivity of milk (ECM), and lactoferrin content in milk. Teat cups were swabbed to evaluate risk factors, observing hyperkeratosis, milking vacuum pressure and cleanliness of the site. Hence, 30 female buffaloes were randomly selected (15 from a group in early lactation and 15 in late lactation). Results: The most common bacteria in the microbiological examination were Staphylococcus spp., Streptococcus spp. and Corynebacterium sp. In the antibiotic sensitivity test, 10 (58.82%) of the 17 antibiotics tested were sensitive to all isolates, and resistant bacteria were Streptococcus uberis, Streptococcus dysgalactiae, Streptococcus haemolyticus, and Escherichia coli. It was observed that positive samples in the microbiological examination showed total bacterial count between $9.10{\times}10^3$ to $6.94{\times}10^6$ colony forming units/mL, SCC between 42,000 to 4,320,000 cells/mL and ECM ranging from 1.85 to 7.40 mS/cm. It was also found that the teat cups had high microbial counts indicating poor hygiene, and even faults in the cleanliness of the animals' waiting room were observed. It is concluded that values of SCC above 537,000 cells/mL and ECM above 3.0 mS/mL are indications of mammary gland infection for this herd; however, the association of these values with a microbiological analysis is necessary to more accurately evaluate the health status of mammary glands with subclinical mastitis. Conclusion: Through phenotypic characterization of bacteria involved in the samples, the genera Staphylococcus spp., Streptococcus spp., and Corynebacterimum bovis were the most prevalent in this study. Faults in environment and equipment hygienization are factors that are directly associated with mastitis.

• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.149-155
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• 2012

Background: This study is to evaluate the effect of systemic corticosteroid on the clinical outcomes and the occurrence of complications in mechanical ventilated patients with severe community-acquired pneumonia (CAP). Methods: We retrospectively assessed the clinical outcomes and complications in patients with severe CAP admitted to ICU between March 1, 2003 and July 28, 2009. Outcomes were measured by hospital mortality after ICU admission, duration of mechanical ventilation (MV), ICU, and hospital stay. Complications such as ventilator associated pneumonia (VAP), catheter related-blood stream infection (CR-BSI), and upper gastrointestinal (UGI) bleeding during ICU stay were assessed. Results: Of the 93 patients, 36 patients received corticosteroids over 7 days while 57 patients did not receive corticosteroids. Age, underlying disease, APACHE II, PSI score, and use of vasopressor were not different between two groups. In-hospital mortality was 30.5% in the steroid group and 36.8% in the non-steroid group (p>0.05). The major complications such as VAP, CR-BSI and UGI bleeding was significantly higher in the steroid group than in the non-steroid group (19.4% vs. 7%, p<0.05). The use of steroids and the duration of ICU stay were significantly associated with the development of major complications during ones ICU stay (p<0.05). Conclusion: Systemic corticosteroid in patients with severe CAP requiring mechanical ventilation may have no beneficial effect on clinical outcomes like duration of ICU stay and in-hospital mortality but may contribute to the development of ICU acquired complications.

• IMMUNE NETWORK
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• v.3 no.3
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• pp.242-247
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• 2003

Background: Psoriasis is an inflammatory skin disorder that is characterized by a marked proliferation of keratinocytes, vascular dilation and leukocyte infiltration. Cytokines play important roles in the pathogenesis of inflammatory disorders. An overexpression of proinflammatory cytokines was characterized in psoriasis plaque. Among these cytokines, IL-$1{\beta}$ is major pro-inflammatory cytokine synthesized during the infection and inflammatory process. The IL-1 receptor antagonist (IL-1Ra) competes for the same IL-1 receptor for $IL-1{\alpha}$ and $-1{\beta}$, which prevents activation of the target cells. Three single nucleotide polymorphisms (SNPs) in the IL-$1{\beta}$ gene have been reported at position -31, -511 and +3954. Within the IL-1Ra gene (IL-1RN), there is a variable number of tandem repeats (VNTR) of an 86 bp length in intron 2. These polymorphisms related to cytokine production and associated with various diseases. Methods: We investigated the polymorphisms of IL-1B (promoter -511 and +3954) and IL-1RN on 114 psoriasis patients and 311 healthy normal controls in Korean. We performed PCR-RFLP on single nucleotide polymorphisms (SNPs) of IL-1B (promoter -511 and +3954) and fragment analysis on IL-1RN 86 bp VNTR polymorphism. Results: The frequency of IL-1B $-511^*1$ allele (patients vs. controls; 50.0% vs. 42.3%, RR=1.4) was significantly increased and IL-1B $-511^*2$ allele (patients vs. controls; 50.0% vs. 57.7%, RR=0.7) decreased in psoriasis patients compared to normal controls. We also analyzed the IL-1B -511 polymorphism according to patients' characters (age of onset, sex and family history). The IL-1B -511 alleles were significantly associated in patients with male and family history than health normal controls. There were no significant associations of IL-1B +3954 and IL-1RN polymorphisms with psoriasis patients. Conclusion: These results suggest that the polymorphism of IL-1B -511 could be genetic susceptibility to psoriasis in Koreans.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.207-216
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• 1988

Premature rupture of membrane is the most frequent cause of low birth weight infant delivery which increase the maternal and fetal morbidity and perinatal mortality. A retrospective case-control study was performed on 315 mothers who delivered low birth weight infants($\leq$2.5kg) with premature rupture of membrane and as control group 546 mothers who delivered normal birth weight infants(2.9-3.7kg) without premature rupture of membrane were chosen. The results obtained from this study were as follows: 1. The proportion of low birth weight infants due to premature rupture of membrane among all low birth weight infant deliveries was 14.5%, and this is equivalent to 1.1% among all deliveries. 2. The most significant maternal risk factor of low birth weight infant deliveries with premature rupture of membrane was infections on vagina, cervix and uterus during pregnancy. Compared with control, adjusted odds ratio was 7.61(95% confidence interval(CI) 1.88-30.88, p=0.004). Other significant maternal risk factors were the history of induced abortion, spontaneous abortion, and the experience of premature delivery. The risk ratios were 1.82, 2.07, 4.42, respectively. 3. Breech presentation did increase the risk of low birth weight infant delivery with premature rupture of membrane compared with control(Adjusted Odds ratio=2.66, 95% CI 1.35-5.26, p=0.005). 4. Mothers who had not taken antenatal care were having higher risk of low birth weight infant delivery with premature rupture of membrane against control(Adjusted odds ratio=1.73, 95% CI 1.19-2.53, p=0.004). These study results show that maternal factors such as the infection of genital organs during pregnancy, the history of induced abortion and breech presentation are significantly associated with the premature rupture of membrane in the low birth weight deliveries, and that most of these risk factors are controllable ones through proper antenatal cares.

• Asian-Australasian Journal of Animal Sciences
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• v.33 no.9
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• pp.1507-1519
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• 2020

Objective: The current research was aimed to profile the transcriptomic picture of the peripheral blood lymphocytes (PBLs) associated with immunity in Chinese Holsteins supplemented orally with coated folic acid during the periparturient period. Methods: The total of 123 perinatal cows were selected for this study and divided into three groups; group A (n = 41, 240 mg/500 kg cow/d), group B (n = 40, 120 mg/500 kg cow/d) and group C (n = 42, 0 mg/cow/d) based on the quantity of folic acid fed. Three samples of PBLs were selected from each folic acid treated group (high, low, and control) and RNA sequencing method was carried out for transcriptomic analysis. Results: The analysis revealed that a higher number of genes and pathways were regulated in response to high and low folic acid supplementation compared to the controls. We reported the novel pathways tumor necrosis factor (TNF) signaling, antigen processing and presentation, Staphylococcus aureus infection and nuclear factor (NF)-kappa B signaling pathways) and the key genes (e.g. C-X-C motif chemokine ligand 10, TNF receptor superfamily member 1A, cluster difference 4, major histocompatibility complex, class II, DQ beta, NF-kappa-B inhibitor alpha, and TNF superfamily 13) having great importance in immunity and anti-inflammation in the periparturient cows in response to coated folic acid treatment. Conclusion: Collectively, our study profiled first-time transcriptomic analysis of bovine lymphocytes and compared the involved cytokines, genes, and pathways between high vs control and low vs control. Our data suggest that the low folic acid supplementation (120 mg/500 kg) could be a good choice to boost appropriate immunity and anti-inflammation as well as might being applied to the health improvement of perinatal dairy cows.

• Journal of Preventive Medicine and Public Health
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• v.39 no.2
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• pp.135-140
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• 2006

Objectives : Polymorphisms of genes from glutathione Stransferases (GSTs) and N-acetyltransferase 2 (NAT2) have been associated with increased susceptibility to various cancers. Previous results showed that East Asians such as Koreans, Japanese and Chinese have a much higher frequency of the GSTM1 and GSTT1 null genotypes and NAT2 rapid acetylator type. Therefore, we investigated the association between the polymorphic types of GSTs (GSTM1, GSTT1, GSTP1) and NAT2 and the incidence of gastric cancer which is one of the most prevalent cancers among the East Asians. Methods : It was performed in a case-control study consisting of 238 healthy subjects and 108 cancer patients (54 distal and 54 proximal carcinomas). We also evaluated the association between GSTs and NAT2 and the risk factors for gastric cancer such as alcohol consumption, smoking, H. pylori infection, family history of gastric cancer, and tumor location. Results : In our study, the percentage of cases whose hometown was rural was higher than those of controls (odds ratio (OR) =2.88; 95% CI=1.72-4.76), and the frequency of the lower socio-economic status increased significantly in patients (OR=2.53; 95% CI=1.59-4.02). There was no significant difference in the GST polymorphic types between the cases and controls. However, NAT2 rapid or intermediate acetylator types were frequently detected in the cases with family history of gastric cancer (OR=1.92; 95% CI=1.79-26.0). Conclusions : These results suggest that the hometown and socio-economic status are important environmental factors for gastric carcinogenesis, and NAT2 polymorphic types could be associated with familial gastric carcinoma.