Publications (11)13.24 Total impact
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Article: Delta neutrophil index: a promising diagnostic and prognostic marker for sepsis.
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ABSTRACT: Delta neutrophil index (DN) is the immature granulocyte fraction provided by a blood cell analyzer (ADVIA 2120; Siemens Healthcare Diagnostics, Deerfield, Ill), which is determined by subtracting the fraction of mature polymorphonuclear leukocytes from the sum of myeloperoxidase-reactive cells. The purpose of this study was to define the role of DN in differential diagnosis and prognosis prediction of patients with sepsis. Hospital records of 273 patients were retrospectively collected: 47 with systemic inflammatory response syndrome, 78 with sepsis, 51 with severe sepsis, and 97 control subjects. Delta neutrophil index and C-reactive protein data on the day of the first blood culture were compared among the groups, and 28-day mortality associated with sepsis was assessed. Median values of DN were 0.0% (interquartile range, 0.0%-0.0%) in the control group, 0.8% (0.0%-1.7%) in the systemic inflammatory response syndrome group, 3.4% (1.5%-5.3%) in the sepsis group, and 18.6% (9.3%-24.7%) in the severe sepsis group. Furthermore, there were significant differences among the groups. The receiver operating characteristic curves showed that DN was a better predictor of sepsis than C-reactive protein. The best cutoff value for DN for predicting sepsis was 2.7%. Delta neutrophil index was significantly higher in those who died than in the survivors (median [interquartile range], 11.5% [3.5%-25.0%] vs. 4.7% [2.2%-10.6%], P = 0.008) and was identified to be an independent predictor for 28-day mortality in patients with sepsis by Cox proportional hazards model. Delta neutrophil index may serve as a facile and useful marker for early diagnosis and prognostic assessment of patients with sepsis, as it is included in a routine complete blood count.Shock (Augusta, Ga.) 03/2012; 37(3):242-6. · 2.87 Impact Factor -
Article: Rapid identification of thrombocytopenia-associated multiple organ failure using red blood cell parameters and a volume/hemoglobin concentration cytogram.
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ABSTRACT: Thrombocytopenia-associated multiple organ failure (TAMOF) has a high mortality rate when not treated, and early detection of TAMOF is very important diagnostically and therapeutically. We describe herein our experience of early detection of TAMOF, using an automated hematology analyzer. From 498,390 inpatients, we selected 12 patients suspected of having peripheral schistocytosis, based on the results of red blood cell (RBC) parameters and a volume/hemoglobin concentration (V/HC) cytogram. We promptly evaluated whether the individual patients had clinical manifestations and laboratory findings were consistent with TAMOF. Plasma exchanges were then performed for each patient. All 12 patients had TAMOF. The mean values of RBC parameters were significantly higher in all of the patients than with the reference range, however, 3 patients had % RBC fragments within the reference range. The mean value of ADAMTS-13 activity was slightly lower in patients compared with the reference range. Of the 12 patients, remission was obtained in 9 patients (75%) within 4 to 5 weeks using plasma exchanges. Three patients died. An increased percentage of microcytic hyperchromic cells with anisocytosis and anisochromia indicated the presence of schistocytes, making it an excellent screening marker for TAMOF. Identification of TAMOF with RBC parameters and a V/HC cytogram is a facile and rapid method along with an automated hematology analyzer already in use for routine complete blood cell counting test.Yonsei medical journal 09/2011; 52(5):845-50. · 0.77 Impact Factor -
Article: Increase of ceftazidime- and fluoroquinolone-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter spp. in Korea: analysis of KONSAR study data from 2005 and 2007.
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ABSTRACT: Antimicrobial resistance monitoring could be a useful source of information for treating and controlling nosocomial infections. We analyzed antimicrobial resistance data generated by Korean Hospitals and by a commercial laboratory in 2005 and 2007. Susceptibility data for 2005 and 2007 were collected from 37 and 41 hospitals, respectively, and from one commercial laboratory. Intermediate susceptibility was not included in the calculation of resistance rates. Methicillin-resistant Staphylococcus aureus (MRSA) (64%), third-generation cephalosporin-resistant Klebsiella pneumoniae (29%), fluoroquinolone-resistant Escherichia coli (27%), Pseudomonas aeruginosa (33%), and Acinetobacter spp. (48%), and amikacin-resistant P. aeruginosa (19%) and Acinetobacter spp. (37%) were prevalent in hospitals in 2007. A gradual increase of vancomycin-resistant Enterococcus faecium and imipenem-resistant Acinetobacter spp. was observed. Higher incidences of thirdgeneration cephalosporin-resistant E. coli and K. pneumoniae and imipenemresistant P. aeruginosa were found in the commercial laboratory than in the hospitals. Methicillin-resistant S. aureus, third-generation cephalosporin- resistant K. pneumoniae, and fluoroquinolone-resistant E. coli, P. aeruginosa and Acinetobacter spp. remain prevalent in Korea, while the incidence of vancomycin-resistant E. faecium and imipenem-resistant Acinetobacter spp. has increased gradually. The higher prevalences of third-generation cephalosporinresistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa in the commercial laboratory are a new concern.Yonsei medical journal 11/2010; 51(6):901-11. · 0.77 Impact Factor -
Article: Prevalence and spread of integron-IS26 in imipenem-resistant Acinetobacter baumannii clinical isolates in South Korea.
International journal of antimicrobial agents 10/2009; 34(6):612-4. · 3.03 Impact Factor -
Article: Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis.
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ABSTRACT: This study investigated the relationship between calculated immature granulocyte (IG) counts and the severity of sepsis. Coagulation parameters, fibrinolytic indices, bacterial isolation rates in blood cultures, and mortality were observed in 237 patients with suspected sepsis. The difference in leukocyte subfractions (delta neutrophil index; DN) identified by a cytochemical myeloperoxidase reaction and by a nuclear lobularity assay was determined with a blood cell analyzer (ADVIA 120, Siemens, Inc.). DN was strongly correlated with manual IG counts (r = 0.75, p <0.05). Patients with high DN (>40%) averaged 40% lower in platelet count, 26% prolongation of prothrombin time (PT), and 35% diminution of antithrombin III (AT III) activity, vs those with low DN (5-20%). Overt disseminated intravascular coagulation was more prevalent as the DN increased, and reached a peak in patients with DN >40%. DN values were closely associated with PT (r = 0.35, p <0.05), AT III activity (r = -0.36, p <0.05), and platelet count (r = -0.27, p <0.05). Positive blood culture rate averaged 3.5-fold higher in patients with DN >40% vs the subgroup with low DN of 5-10%. The mortality rate of patients with DN >40% markedly exceeded the mortality rate of patients with DN of 5-10% (79% vs 15%, p <0.05). Thus, DN has implications for the severity of sepsis and may be valuable to assess the prognosis of patients with suspected sepsis.Annals of clinical and laboratory science 02/2008; 38(3):241-6. · 0.96 Impact Factor -
Article: [Mechanism of VanB Phenotype in Vancomycin-Resistant Enterococci carrying vanA gene.].
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ABSTRACT: Recently, vancomycin-resistant enterococci (VRE) with the vanA genotype that are susceptible to teicoplanin have been described in Japan, Taiwan, and Korea. The investigators suggested three point mutations in the putative sensor domain of vanS or impairment of accessory proteins VanY and VanZ as an explanation for the VanB phenotype-vanA genotype VRE. In this study, we analyzed Tn1546-like elements to determine the molecular mechanisms responsible for the impaired glycopeptide resistance of clinical VRE isolates with VanB phenotype-vanA genotype from Korea. From 2001 to 2004, 28 clinical isolates of Enterococcus faecium with VanB phenotypevanA genotype were collected from 8 different university hospitals in diverse geographic areas in Korea. For structural analysis of Tn1546-like elements, PCR amplifications for internal regions of Tn1546 were performed. The purified PCR products were directly sequenced with an ABI Prism 3100 DNA sequencer. The sequence data of the vanS regulatory gene revealed that none of the isolates had any point mutations in this gene. All 28 isolates had a complete or incomplete deletion of vanY gene. Of these, 13 strains represented a complete deletion of vanZ, and 2 strains showed the deletion of nucleotides near the end point of vanX. The mechanism of VanB phenotype-vanA genotype in VRE isolates from Korea is not point mutations of vanS but the rearrangements of vanX, vanY and vanZ.The Korean Journal of Laboratory Medicine 01/2007; 26(6):412-7. · 0.63 Impact Factor -
Article: [Production of Antibody against Helicobacter pylori HP0231.].
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ABSTRACT: Stool antigen detection kits for diagnosis of infection of Helicobacter pylori have been widely used for their convenience, but are mostly imported. Since Helicobacter pylori strains show a distinctive genetic diversity, it is important to find a protein that is a common antigen among various strains and shows a strong immunogenicity for the development of a stool antigen detection kit. HP0231 protein strongly reacts with the sera of patients suffering from gastritis and peptic ulcer. Therefore, HP0231 is an excellent candidate as a target gene for this study. Chromosomal DNA from H. pylori was isolated. HP0231 gene was amplified by PCR, cloned into pET28a(+) vector, and overexpressed using isopropyl-beta-D-thiogalactopyranoside in E. coli BL21 (DE3). HP0231 protein was purified by Ni-NTA affinity chromatography followed by electroelution after SDS-PAGE. Rabbits were immunized with the purified HP0231 protein for the production of antibodies. Rabbit anti-HP0231 antibody was partially purified and tested for the sensitivity and specificity using ELISA and Western Blot Analysis. The sequence of the cloned HP0231 gene was identical with the gene sequence from Genbank (AA216016). HP0231 gene was overexpressed and HP0231 protein was purified. Rabbit anti-HP0231 antibody produced after immunization with the purified HP0231 protein reacted with the purified HP0231 protein, cell extracts from cultured H. pylori, and stomach biopsy tissue from patients, but not with cell extracts from cultured E. coli used as a negative control. After 1 million fold dilution, rabbit anti-HP0231 antibody still reacted with 1 microg of HP0231 protein. Rabbit anti-HP0231 antibody was produced to detect HP0231 protein of H. pylori and will be tested for the development of a stool antigen detection kit for H. pylori.The Korean Journal of Laboratory Medicine 05/2006; 26(2):98-102. · 0.63 Impact Factor -
Article: [Emergence of CTX-M-12 and A Novel CTX-M Type Extended-Spectrum beta-Lactamaseproducing Klebsiella pneumoniae.].
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ABSTRACT: The aims of this study were to survey the nation-wide susceptibilities of Klebsiella pneumoniae isolates against ceftazidime and cefotaxime and to determine the prevalence of class A extended-spectrum beta-lactamases (ESBLs). During the period of February to July 2004, K. pneumoniae isolates intermediate or resistant to ceftazidime and/or cefotaxime were collected from 12 hospitals in Korea. Antimicrobial susceptibilities were determined by the disk diffusion and the agar dilution methods and ESBL-production was by double-disk synergy test. Ceftazidime or cefotaxime-resistance determinants of the ESBLproducers were transfered to Escherichia coli J53 by transconjugation. Searches for class A ESBL genes were performed by PCR amplication. Among 212 clinical K. pneumoniae isolates, 172 (81%) isolates showed positive results in double-disk synergy test; the most prevalent ESBL was SHV-12 (n=104). Genes encoding ESBLs including SHV-2 (n=6), SHV-2a (n=17), CTX-M-3 (n=18), CTX-M-9 (n=6), CTX-M-12 (n=1), CTX-M- 14 (n=27), CTX-M-15 (n=3), and a novel CTX-M-type beta-lactamases were also detected. It is concluded that diversity of ESBLs in K. pneumoniae isolates are increasing in Korea. CTX-M-12 has never been reported in Asia, and a novel CTX-M-type ESBL has emerged.The Korean Journal of Laboratory Medicine 03/2006; 26(1):21-6. · 0.63 Impact Factor -
Article: Pediatric hand injury induced by treadmill.
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ABSTRACT: Korea has recently seen an increase in pediatric hand injuries associated with treadmills. This study was conducted to identify the frequency, patterns, treatment and outcome of these injuries, in the hope of developing preventive programs. A retrospective review of the medical records of 25 children, all with treadmill-induced friction hand injuries, was conducted at the Hallym Burn Centre, Hangang Sacred Heart Hospital, Seoul, Korea, during the period of January 2002 to March 2004. The injuries constituted 1.4% of the total number of pediatric burn injury admissions. Male toddlers were affected more than female. The mean age of the children was 3.9+/-3.2 (3, 1-15) years old. Most injuries occurred in spring. Treadmill friction inflicted deep second or third degree burns, small in area (1.6+/-1.0% of TBSA). All lesions involved the hands and forearms, with 60% on the right. Most patients (64%) underwent surgical management 13+/-5 days after the injury. The volar surface of the hand was more affected than the dorsal side (27 versus 8). Treatment was mainly with full thickness skin graft (60%) and long-term surgical outcomes were excellent. Such injuries may be prevented by educating the public about the potential risks of the treadmill, and by the development of additional safety designs. Changes in management protocols and treatment policies would improve the provision of appropriate care.Burns 12/2005; 31(7):906-9. · 1.96 Impact Factor -
Article: Platelet activation in patients with diabetic retinopathy.
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ABSTRACT: To clarify the diabetic complications mediated by increased platelet activity, we undertook a study of the mean platelet component (MPC), as determined by an automated hematologic analyzer (ADVIA 120, Bayer). Prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen were also measured to investigate blood viscosity abnormalities. MPC was determined in 100 healthy controls and in 100 diabetic patients, the latter of which were subdivided into no diabetic retinopathy (DR) (n = 25), nonproliferative DR (n = 30), and proliferative DR (n = 45) groups. The mean MPC level was 26.9 g/dl in the control group and 22.5 g/dl in the diabetic patients (p < 0.05). PT and aPTT were similar for the diabetic patients and the controls; however, their corresponding fibrinogen levels were significantly different between the two groups(3.26 +/- 1.14 g/L vs. 4.21 +/- 2.35 g/L, p < 0.05). Our results suggest that platelet hyperfunction in diabetic patients may be implicated in the pathogenesis of diabetic retinopathy.Korean Journal of Ophthalmology 01/2004; 17(2):140-4. -
Article: Osteonecrosis of the hip in patients with aplastic anemia.
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ABSTRACT: The incidence and clinical and magnetic resonance imaging features of osteonecrosis of the hip were evaluated in patients with aplastic anemia. Two hundred and forty-one patients with aplastic anemia were examined using MR imaging of bone marrow during the five years from 1994 to 1998. Osteonecrosis of the hip was observed on MR imaging in nineteen (15 males and 4 females, mean age 35 yr) of the 241 patients. It was present in both hips in 14 patients, and there were five cases with unilateral occurrence, with a total of 33 involved hips. All except for five hips with associated bone marrow edema revealed increased fatty marrow conversion in the proximal femoral metaphysis. In nine patients, osteonecrosis was detected without any pain. Five patients already had osteonecrosis before any medication was administered. Twelve patients received antilymphocyte globulin, and seven patients received a low dose of steroids before the MR diagnosis of osteonecrosis. Osteonecrosis of the hip frequently develops in patients with aplastic anemia (7.9%), associated with fatty marrow conversion of the proximal femoral metaphysis.Journal of Korean Medical Science 01/2003; 17(6):806-10. · 0.99 Impact Factor
Top co-authors
Top Journals
Institutions
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2008
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Inha University
- Department of Laboratory Medicine
Seoul, Seoul, South Korea
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2006
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Konyang University
Taiden, Daejeon, South Korea
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