• Childhood Kidney Diseases
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• 제3권1호
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• pp.100-103
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• 1999

Focal Segmental Glomerulosclerosis(FSGS) is one of the underlying pathology of congenital and infantile nephrotic syndrome. There is no ultimate curative treatment except renal transplantation. We have experienced a case of infantile nephrotic syndrome In a 10 month old boy who presented with proteinuria and hematuria. His elder brother also suffered from nephrotic syndrome and died at the age of 18 months due to sepsis. We have diagnosed this patient with clinical manifestations, laboratory data and pathologic findings which was done by open renal biopsy. The patient expired 54 days after admission because or progressive uremia and sepsis.

• Journal of Microbiology
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• 제43권spc1호
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• pp.118-131
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• 2005

Vibrio vulnificus is an opportunistic pathogen of humans that has the capability of causing rare, yet devastating disease. The bacteria are naturally present in estuarine environments and frequently contaminate seafoods. Within days of consuming uncooked, contaminated seafood, predisposed individuals can succumb to sepsis. Additionally, in otherwise healthy people, V. vulnificus causes wound infection that can require amputation or lead to sepsis. These diseases share the characteristics that the bacteria multiply extremely rapidly in host tissues and cause extensive damage. Despite the analysis of virulence for over 20 years using a combination of animal and cell culture models, surprisingly little is known about the mechanisms by which V. vulnificus causes disease. This is in part because of differences observed using animal models that involve infection with bacteria versus injection of toxins. However, the increasing use of genetic analysis coupled with detailed animal models is revealing new insight into the pathogenesis of V. vulnificus disease.

• Biomolecules & Therapeutics
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• 제31권4호
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• pp.395-401
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• 2023

Innate immunity is a first line defence system in the body which is for sensing signals of danger such as pathogenic microbes or host-derived signals of cellular stress. Pattern recognition receptors (PRR's), which present in the cell memebrane, are suspect the infection through pathogen-associated molecular patterns (PAMP), and activate innate immunity with response to promote inflammation via inflammatory cells such as macrophages and neutrophils, and cytokines. Inflammasome are protein complexes which are part of innate immunity in inflammation to remove pathogens and repair damaged tissues. What is the important role of inflammation in disease? In this review, we are focused on the action mechanism of NLRP3 inflammasome in inflammatory diseases such as asthma, atopic dermatitis, and sepsis.

• Pediatric Infection and Vaccine
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• 제9권2호
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• pp.163-174
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• 2002

목 적: 본원 신생아실 및 신생아 중환자실에서 10년간 발생한 신생아 패혈증을 조사하여 환아들의 특징, 패혈증의 원인균 및 항생제 감수성의 변화를 파악하고 신생아 패혈증을 치료하는데 도움되고자 하였다. 방 법: 1989년부터 1998년까지의 10년간 본원 신생아실 및 신생아 중환자실에 입원하였던 환아 15,144명에 대해 의무기록을 확인하여 신생아 패혈증으로 진단된 환아를 선별하였다. 조사 기간을 1989년부터 1993년까지(전반기)와 1994년부터 1998 년까지(후반기)로 나누어 패혈증으로 진단된 환아 들의 임상적 특징, 균의 종류와 빈도, 항생제 감수성의 변화 양상을 관찰하였다. 결 과 : 신생아 패혈증은 총 15,144명 중 170명에서 진단되어 1.1%(전반기 91명, 1.2%, 후반기 79명 1.0%)이었으며, 186회(전반기 99회, 후반기 87회)에 걸쳐 200개의 균주(전반기 109균주, 후반기 91균주)가 분리동정 되었다. 평균 발병시기는 생후12.3일로 전반기 8.8일, 후반기 16.3일이었고, 조발형은 전반기 34.7%, 후반기 23.0%로 나타나 전반기에 더 빨리 발병하였다. 분리된 균주는 그람양성균 132회 (66.0%), 그람음성균 60회(30.0%), 진균 8회(4.0%)이었으며, Coagulase negative Staphylococcus(CNS)가 총 69회(34.5%)로 가장 많은 빈도를 나타내었고, Staphylococcus aureus(S. aureus) 36회(18.0%), Klebsiella pneumoniae(K. pneumoniae) 17회(8.5%), Enterococcus 12회(6.0%), Enterobacter cloacae(E. cloacae) 8회(4.0%), Escherichia coli(E. coli) 6회(3.0%), Pseudomonas aeruginosa(P. aeruginasa) 5회(2.5%) 등의 순이었다. 진균으로는 Candida parapsilosis, Candida albicans, Trichosporon pullulans 가 분리되었다. CNS, S. aureus 및 Acinetobacter baumannii(A. baumanii), Candida는 전반기에 비해 후반기에 더 많이 분리 동정되었으며, CNS 및 S. aureus의 methicillin 및 1세대 cephalosporin에 대한 항생제 감수성은 전반기에 비해 후반기에 감소하였고 aminoglycosides에 대한 감수성은 후반기에 증가하였으며, vancomycin 내성균은 분리되지 않았다. K. pneumoniae, Enterococcus, E. coli 및 P. aeruginosa는 전반기에 비해 후반기에 감소하였으며 K. pneumoniae는 1세대 cephalosporin에 대해 전, 후반기 모두 낮은 감수성을 보였고 tobramycin과 gentamicin에는 후반기에 감수성이 증가하였으며 amikacin, ceftriaxone, trimethoprim-sulfamethoxazole에는 전, 후반기 모두 높은 감수성을 보였다. Enterococcous는ampicillin, penicillin 및 1세대 cephalosporin에 대한 감수성이 후반기에 감소하였으나 vancomycin 내성균은 분리되지 않았다. 결 론 : 지난 10년간의 신생아 패혈증의 발생 빈도는 1.1%이었으며, CNS와 S. aureus가 신생아 패혈증의 주 원인균이었고, 일차 항생제에 대한 감수성은 전반기에 비해 후반기에 감소하였으나 vanco- mycin 내성균은 발견되지 않았다. 신생아 패혈증의 주요 원인균으로 알려진 group B Streptococcus는 발견되지 않았으며, K. pneumoniae에 의한 신생아 패혈증은 후반기에 더 많이 발생하였으나 항생제 감수성은 감소되지 않았다.

• Tuberculosis and Respiratory Diseases
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• 제42권6호
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• pp.871-877
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• 1995

연구배경: 중환자의 예후를 정량화하는 체점체계 중 APACHE III system은 중환자실 제 1병일 점수는 물론 일갱신 점수도 환자의 위험도를 갱신하는 것이 알려진 바 있어 패혈증 환자들에서 APACHE III score의 예후 지표로서의 가치를 알아 보고자 하였다. 방법: 48명의 패혈증 환자들에서 후향적으로 중환자실 제 1병일, 2병일 및 3병일의 APACHE III score를 조사하여 패혈증 생존자와 비생존자 간의 차이를 분석하였다. 결과: 패혈증 생존자는 비생존자에 비해 APACHE III system에 따른 중환자실 제 1병일 정수가 유의하게 낮았으며, 제 2일 및 제 3일의 점수도 각각의 전날 점수에 비해 유의하게 감소하였다. 폐혈증 비생존자의 경우 제 1병일 점수가 생존자에 비해 높았고, 제 2병일 및 제 3병일 점수 역시 각각의 전날 점수에 비해 증가하는 경향을 보였다. 결론: APACHE III system에 따른 제 1병일 점수 및 제 3병일까지의 점수의 일변동은 패혈증 환자의 예후를 반영하는 것으로 사려된다.

• Pediatric Infection and Vaccine
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• 제6권2호
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• pp.261-266
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• 1999

VRE 감염증은 항균제의 과다한 사용 후 출현하는 새로운 형태의 감염성 질환으로, 현재 심각한 임상 문제로 대두되고 있다. 최근 국내에서도 신경학적 장에나 당뇨병, 종양 등의 기저질환을 가진 성인 환자들에서 소수의 감염 예가 보고되고 있으나 소아기, 특히 신생아에서의 감염증은 잘 알려지지 않았다. 저자들은 생후 4일된 신생아에서 발생한 vancomycin 내성 E. faecalis 패혈증 l례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제42권1호
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• pp.107-110
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• 2009

자가 또는 이식혈관의 감염은 반복적인 파열 및 패혈증으로 인해 환자의 생명을 위협하는 심각한 질병이다. 대퇴동맥을 포함한 서혜부 감염이 생긴 경우 가장 성공적인 치료원칙은 감염된 조직의 광범위한 절제와 동맥재건술이다. 본원에서는 뇌동정맥루, 뇌출혈환자에서 대퇴동맥을 천자하여 시행한 혈관조영술후 패혈증을 동반한 감염된 가성동맥류가 발생하여 폐쇄공우회술을 이용하여 치험하였기에 보고하는 바이다.

• Journal of Microbiology and Biotechnology
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• 제29권11호
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• pp.1707-1716
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• 2019

The development of new antimicrobial agents is essential for the effective treatment of diseases such as sepsis. We previously developed a new short peptide, Pap12-6, using the 12 N-terminal residues of papiliocin, which showed potent and effective antimicrobial activity against multidrug-resistant Gram-negative bacteria. Here, we investigated the antimicrobial mechanism of Pap12-6 and a newly designed peptide, Pap12-7, in which the 12^th Trp residue of Pap12-6 was replaced with Val to develop a potent peptide with high bacterial selectivity and a different antibacterial mechanism. Both peptides showed high antimicrobial activity against Gram-negative bacteria, including multidrug-resistant Gram-negative bacteria. In addition, the two peptides showed similar anti-inflammatory activity against lipopolysaccharide-stimulated RAW 264.7 cells, but Pap12-7 showed very low toxicities against sheep red blood cells and mammalian cells compared to that showed by Pap12-6. A calcein dye leakage assay, membrane depolarization, and confocal microscopy observations revealed that the two peptides with one single amino acid change have different mechanisms of antibacterial action: Pap12-6 directly targets the bacterial cell membrane, whereas Pap12-7 appears to penetrate the bacterial cell membrane and exert its activities in the cell. The therapeutic efficacy of Pap12-7 was further examined in a mouse model of sepsis, which increased the survival rate of septic mice. For the first time, we showed that both peptides showed anti-septic activity by reducing the infiltration of neutrophils and the production of inflammatory factors. Overall, these results indicate Pap12-7 as a novel non-toxic peptide with potent antibacterial and anti-septic activities via penetrating the cell membrane.

• 대한간호학회지
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• 제42권5호
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• pp.719-729
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• 2012

Purpose: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. Methods: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. Results: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. Conclusion: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.291-296
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• 2013

Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.