Publications by authors named "Hyungmin Lee"

22 Publications

  • Page 1 of 1

Status of antimicrobial stewardship programmes in Korean hospitals including small to medium-sized hospitals and the awareness and demands of physicians: a nationwide survey in 2020.

J Glob Antimicrob Resist 2021 Jun 18;26:180-187. Epub 2021 Jun 18.

Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam 13620, Gyeonggi-do, South Korea.

Objectives: This study aimed to identify the status of antimicrobial stewardship programmes (ASPs) in small to medium-sized Korean hospitals as well as the awareness and demands about ASPs of physicians.

Methods: A questionnaire was designed based on a questionnaire from a previous nationwide survey in 2018 targeting large hospitals in Korea and modified to reflect the results of in-depth interviews with non-infectious diseases (IDs) physicians at secondary care hospitals. The survey targeted all hospitals with ≥150 beds in South Korea and was performed in May-June 2020. Only one ASP-associated physician per hospital participated in the survey.

Results: The survey response rate was 31.9% (217/680). ID specialists comprised the majority of medical personnel participating in ASPs in tertiary care hospitals. Conversely, in secondary and primary care hospitals there was no predominant medical personnel for ASPs and the median full-time equivalent was 0 for all types of medical personnel. Tertiary care hospitals, more than secondary and primary care hospitals, tended to perform ASP activities more actively. 'Workforce for ASPs', 'Establishment of healthcare fees for ASPs' and 'Development of tools for ASPs' were the most important required support for ASP improvement.

Conclusion: The level of ASP establishment was more limited in primary care hospitals than in secondary and tertiary care hospitals in Korea. To improve ASPs in Korean hospitals, a supporting workforce and the establishment of a healthcare fee for ASPs appear to be necessary.
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http://dx.doi.org/10.1016/j.jgar.2021.06.001DOI Listing
June 2021

A Healthcare-Associated Outbreak of HCV Genotype 2a at a Clinic in Seoul.

Osong Public Health Res Perspect 2021 Feb;12(1):3-12

Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease and Prevention, Korea Disease Control and Prevention Agecy, Gwangju, Korea.

Objectives: An epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011-2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future.

Methods: A retrospective study of the outpatients and health care workers ( = 7,285) in the target outpatient clinic during 2011-2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1, 2006 and March 25, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016.

Results: The rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve ( < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster ( = 56) or 2 clusters ( = 25). This result indicated exposure to a high-association infection source.

Conclusion: Anti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011-2012) at an outpatients clinic in Seoul.
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http://dx.doi.org/10.24171/j.phrp.2021.12.1.02DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899231PMC
February 2021

Impact of national policy on hand hygiene promotion activities in hospitals in Korea.

Antimicrob Resist Infect Control 2020 09 23;9(1):157. Epub 2020 Sep 23.

Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongro-gu, Seoul,, 03080, Republic of Korea.

Background: After the Middle East respiratory syndrome coronavirus outbreak in Korea in 2015, the Government established a strategy for infection prevention to encourage infection control activities in hospitals. The new policy was announced in December 2015 and implemented in September 2016. The aim of this study is to evaluate how infection control activities improved within Korean hospitals after the change in government policy.

Methods: Three cross-sectional surveys using the WHO Hand Hygiene Self-Assessment Framework (HHSAF) were conducted in 2013, 2015, and 2017. Using a multivariable linear regression model, we analyzed the change in total HHSAF score according to survey year.

Results: A total of 32 hospitals participated in the survey in 2013, 52 in 2015, and 101 in 2017. The number of inpatient beds per infection control professionals decreased from 324 in 2013 to 303 in 2015 and 179 in 2017. Most hospitals were at intermediate or advanced levels of progress (90.6% in 2013, 86.6% in 2015, and 94.1% in 2017). In the multivariable linear regression model, total HHSAF score was significantly associated with hospital teaching status (β coefficient of major teaching hospital, 52.6; 95% confidence interval [CI], 8.9 to 96.4; P = 0.018), beds size (β coefficient of 100 beds increase, 5.1; 95% CI, 0.3 to 9.8; P = 0.038), and survey time (β coefficient of 2017 survey, 45.1; 95% CI, 19.3 to 70.9; P = 0.001).

Conclusions: After the new national policy was implemented, the number of infection control professionals increased, and hand hygiene promotion activities were strengthened across Korean hospitals.
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http://dx.doi.org/10.1186/s13756-020-00817-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509816PMC
September 2020

Characterization of Infections with Vancomycin-Intermediate Staphylococcus aureus (VISA) and Staphylococcus aureus with Reduced Vancomycin Susceptibility in South Korea.

Sci Rep 2019 04 17;9(1):6236. Epub 2019 Apr 17.

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.

The aim of the present study was to describe the characteristics of infections with Staphylococcus aureus with reduced vancomycin susceptibility (SARVS) including vancomycin-intermediate S. aureus (VISA) in South Korea, using data from the national sentinel surveillance system during 2014-2016. A total of 66 patients infected or colonized with SA-RVS were reported using the sentinel surveillance system. Among them, VISA was confirmed in 14 isolates (21.2%) and no vancomycin-resistant S. aureus (VRSA) was detected. Most of patients had any kind of indwelling devices (81.8%, 54/66) and underwent surgical procedures in the previous 6 months (84.8%, 56/66). Patients who admitted to an intensive care unit (ICU) in the previous 3 months were 68.2% (45/66). Furthermore, patients who used vancomycin or had MRSA in the previous 1 month were 54.5% (36/66) and 59.1% (39/66), respectively. Upon review of the medical records, 54.5% (36/66) of patients were classified as having SA-RVSassociated infection and 30-day mortality was 19.4% (7/36). Our findings revealed that there was no VRSA in South Korea. SA-RVS including VISA existed particularly in patients who had indwelling devices, history of surgical procedure, and history of ICU admission.
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http://dx.doi.org/10.1038/s41598-019-42307-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470132PMC
April 2019

Epidemiological, clinical, and microbiological characteristics of carbapenemase-producing Enterobacteriaceae bloodstream infection in the Republic of Korea.

Antimicrob Resist Infect Control 2019 5;8:48. Epub 2019 Mar 5.

Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401 Republic of Korea.

Background: Carbapenemase-producing Enterobacteriaceae (CPE) is an important pathogen in nosocomial infections; nevertheless, only a few studies regarding CPE infection and its epidemiological factors have been conducted in the Republic of Korea (ROK). We aimed to analyze the clinical, microbiological, and epidemiological characteristics of CPE bloodstream infections (BSIs) in the ROK.

Methods: This retrospective cohort study included data collected from the National Surveillance System from January 2015 to December 2016 based on the epidemiologic survey performed by an epidemiologist from the Korea Centers for Disease Control and Prevention. We selected patients with CPE BSI from the Korea National Institute of Health based on carbapenemase genotyping.

Results: In this study, 131 CPE BSIs were identified, and the proportion of CPE BSI among total CPE isolates was 7%. accounted for 69% of all CPE BSIs, and 66% of these produced carbapenemase. Among nine provinces in ROK, one province had NDM as the most common carbapenemase. CPE was susceptible to amikacin, tigecycline, and gentamicin (76, 41, and 39%, respectively). Of 29 patients tested for colistin sensitivity, one patient showed colistin resistance. The most common CPE BSI sources were pneumonia, primary bacteremia, and biliary tract infection. Multivariable analysis showed that adequate antibiotic use at CPE detection was significantly associated with decreased 30-day mortality.

Conclusions: CPE BSIs are prevalent in the ROK. Moreover, most CPE BSIs originated from hospital-acquired infection, demonstrating the need to improve hospital infection control strategies.
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http://dx.doi.org/10.1186/s13756-019-0497-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402157PMC
April 2020

Probable female to male sexual transmission of dengue virus infection.

Infect Dis (Lond) 2019 02 14;51(2):150-152. Epub 2018 Oct 14.

b Korea Centers for Disease Control and Prevention , Cheongju , Korea.

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http://dx.doi.org/10.1080/23744235.2018.1521004DOI Listing
February 2019

Morphology-Controlled Aluminum-Doped Zinc Oxide Nanofibers for Highly Sensitive NO Sensors with Full Recovery at Room Temperature.

Adv Sci (Weinh) 2018 Sep 23;5(9):1800816. Epub 2018 Jul 23.

School of Materials Science and Engineering KIST-UNIST Ulsan Center for Convergent Materials (KUUC) Ulsan National Institute of Science and Technology (UNIST) Ulsan 44919 Republic of Korea.

Room-temperature (RT) gas sensitivity of morphology-controlled free-standing hollow aluminum-doped zinc oxide (AZO) nanofibers for NO gas sensors is presented. The free-standing hollow nanofibers are fabricated using a polyvinylpyrrolidone fiber template electrospun on a copper electrode frame followed by radio-frequency sputtering of an AZO thin overlayer and heat treatment at 400 °C to burn off the polymer template. The thickness of the AZO layer is controlled by the deposition time. The gas sensor based on the hollow nanofibers demonstrates fully recoverable n-type RT sensing of low concentrations of NO (0.5 ppm). A gas sensor fabricated with AlO-filled AZO nanofibers exhibits no gas sensitivity below 75 °C. The gas sensitivity of a sensor is determined by the density of molecules above the minimum energy for adsorption, collision frequency of gas molecules with the surface, and available adsorption sites. Based on finite-difference time-domain simulations, the RT sensitivity of hollow nanofiber sensors is ascribed to the ten times higher collision frequency of NO molecules confined inside the fiber compared to the outer surface, as well as twice the surface area of hollow nanofibers compared to the filled ones. This approach might lead to the realization of RT sensitive gas sensors with 1D nanostructures.
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http://dx.doi.org/10.1002/advs.201800816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145242PMC
September 2018

Factors associated with severe neurologic complications in patients with either hand-foot-mouth disease or herpangina: A nationwide observational study in South Korea, 2009-2014.

PLoS One 2018 10;13(8):e0201726. Epub 2018 Aug 10.

Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea.

Background: In 2009, a nationwide sentinel surveillance for hand-foot-mouth disease (HFMD) and herpangina (HA) with neurologic complications was initiated in South Korea. We used this surveillance system to investigate the clinical characteristics of patients with either HFMD or HA with neurologic complications, with the aim of determining risk factors for severe neurologic complications.

Methods: A retrospective review of medical records was conducted on all cases of HFMD and HA with neurologic complications that were reported in the national system between April 1, 2009 and December 31, 2014. A severe case was defined as having HFMD or HA with encephalitis, polio-like syndrome, or cardiopulmonary failure, and less-severe cases were defined as having HFMD or HA with aseptic meningitis.

Results: A total of 138 cases (less-severe: 90/138, 65.2%; severe: 48/138, 24.8%) were included from 28 hospitals; 28 ineligible cases were excluded. Of 48 severe cases, 27 (56.2%) had encephalitis; 14 (29.2%) had polio-like syndrome; and seven (14.6%) had cardiopulmonary syndrome. The median patient age was 36 months (IQR: 18-60) and 63 (45.7%) patients were female. Most patients completely recovered, except for seven cases that were fatal or resulted in long-term symptoms (5.1%, 3 patients with neurologic sequelae and 4 deaths). In a multivariable logistic regression analysis, lethargy (OR = 4.67, 95% CI: 1.37-15.96, P = 0.014), female sex (OR = 3.51, 95% CI: 1.17-10.50, P = 0.025), and enterovirus A71 (OR = 3.55, 95% CI: 1.09-11.57, P = 0.035) were significantly associated with severe neurologic complications in HFMD and HA patients.

Conclusion: In patients with HFMD and HA, lethargy, female, and enterovirus A71 may predict severe neurologic complications.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201726PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086402PMC
February 2019

A case report and literature review on fabella syndrome after high tibial osteotomy.

Medicine (Baltimore) 2018 Jan;97(4):e9585

Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Korea.

Rationale: The fabella is a normal structure, but is occasionally reported to cause posterior knee pain. The aim of this study was to present fabella syndrome after high tibial osteotomy.

Patient Concerns: A 55-year-old female patient was admitted to the hospital due to about 1 year and 8 months of left knee pain. Sclerosis was observed in the anterior margin of the fabella in the preoperative magnetic resonance (MR) T2 image, and reactive bone marrow was found and was considered to be due to degeneration of the distal femur. Degenerative change (Kellgren and Lawrence-KL grade 2) of the left knee was observed, along with cartilage delamination corresponding to International Cartilage Repair Society (ICRS) grade 4 in the patellofemoral joint.

Diagnoses: We present the first reported case of fabella syndrome in Korea, after high tibial osteotomy due to degenerative arthritis and varus deformity, rather than artificial joint surgery.

Interventions: We excised the fabella from the patient's knee.

Outcomes: There was no evidence of recurrence during 5 months of postoperative follow-up. Posterolateral Corner including the fabella might have sustained increased tensile force causing symptoms due to compression of the fabella by the posterior joint of the posterior femoral condyle.

Lessons: We present the first reported case of fabella syndrome in Korea, after high tibial osteotomy due to degenerative arthritis and varus deformity, rather than artificial joint surgery. Collision syndrome caused by a fabella has previously been attributed to inconsistency of the joint surface due to excessive exercise and degenerative changes due to knee instability. We report this case since it appeared to involve collision syndrome due to mechanical change of an angular deformity.
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http://dx.doi.org/10.1097/MD.0000000000009585DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794358PMC
January 2018

Stability of cognitive development during the first five years of life in relation to heavy metal concentrations in umbilical cord blood: Mothers' and Children's Environmental Health (MOCEH) birth cohort study.

Sci Total Environ 2017 Dec 21;609:153-159. Epub 2017 Jul 21.

Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. Electronic address:

The objective of this study was to investigate stability of cognitive development during the first five years of life in relation to heavy metal concentrations in umbilical cord blood in Korean children. This research is part of the Mothers' and Children's Environmental Health (MOCEH) study, a multi-center prospective birth cohort study of pregnant women in Korea who were recruited from 2006 to 2010. We analyzed the complete follow-up data of children who were 5years-old in 2016. We measured lead, mercury, and cadmium levels in the umbilical cord blood of 251 children, and analyzed them, for whom neurodevelopmental data were available. We determined stability of cognitive development scores using three methods. First, we used partial correlation analyses to examine the stability of cognitive development at each measurement time. Second, we used Cramer's V to investigate the magnitude and direction of changes in cognitive development scores at each follow-up period among three groups (high, medium, and low scores). The results showed that cognitive development scores measured at the closest times had the strongest correlations, and the stability of cognitive development scores increased with age, from 6 to 60months. Groups at the extreme ends of cognitive development (high or low scores) had more stable scores, and this tendency was also stronger in infants >24months-old. The stability of cognitive development was unrelated to the umbilical cord level of heavy metals, based on analysis with Fisher's transformation. In conclusion, the present study showed that the cognitive development scores in a cohort of infants (6 to 60months-old) were stable.
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http://dx.doi.org/10.1016/j.scitotenv.2017.07.074DOI Listing
December 2017

Comparison of High, Intermediate, and Low Frequency Shock Wave Lithotripsy for Urinary Tract Stone Disease: Systematic Review and Network Meta-Analysis.

PLoS One 2016 7;11(7):e0158661. Epub 2016 Jul 7.

Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Objectives: To perform a systematic review and network meta-analysis of randomized controlled trials (RCTs) to determine the optimal shock wave lithotripsy (SWL) frequency range for treating urinary stones, i.e., high-frequency (100-120 waves/minute), intermediate-frequency (80-90 waves/minute), and low-frequency (60-70 waves/minute) lithotripsy.

Materials And Methods: Relevant RCTs were identified from electronic databases for meta-analysis of SWL success and complication rates. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Outcome variables are provided as odds ratios (ORs) with 95% confidence intervals (CIs).

Results: Thirteen articles were included in the qualitative and quantitative synthesis using pairwise and network meta-analyses. On pairwise meta-analyses, comparable inter-study heterogeneity was observed for the success rate. On network meta-analyses, the success rates of low- (OR 2.2; 95% CI 1.5-2.6) and intermediate-frequency SWL (OR 2.5; 95% CI 1.3-4.6) were higher than high-frequency SWL. Forest plots from the network meta-analysis showed no significant differences in the success rate between low-frequency SWL versus intermediate-frequency SWL (OR 0.87; 95% CI 0.51-1.7). There were no differences in complication rate across different SWL frequency ranges. By rank-probability testing, intermediate-frequency SWL was ranked highest for success rate, followed by low-frequency and high-frequency SWL. Low-frequency SWL was also ranked highest for low complication rate, with high- and intermediate-frequency SWL ranked lower.

Conclusions: Intermediate- and low-frequency SWL have better treatment outcomes than high-frequency SWL when considering both efficacy and complication.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158661PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936716PMC
July 2017

Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study.

J Korean Med Sci 2016 Apr 22;31(4):579-84. Epub 2016 Feb 22.

Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea .

We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers' and Children's Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants.
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http://dx.doi.org/10.3346/jkms.2016.31.4.579DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810341PMC
April 2016

The beneficial effect of alpha-blockers for ureteral stent-related discomfort: systematic review and network meta-analysis for alfuzosin versus tamsulosin versus placebo.

BMC Urol 2015 Jun 24;15:55. Epub 2015 Jun 24.

Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.

Background: This study was carried out a network meta-analysis of evidence from randomized controlled trials (RCTs) to evaluate stent-related discomfort in patients with alfuzosin or tamsulosin versus placebo.

Methods: Relevant RCTs were identified from electronic databases. The proceedings of appropriate meetings were also searched. Seven articles on the basis of RCTs were included in our meta-analysis. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Evaluation was performed with the Ureteric Stent Symptoms Questionnaire to assess the urinary symptom score (USS) and body pain score (BPS).

Results: One of the seven RCTs was at moderate risk of bias for all quality criteria; two studies had a high risk of bias. In the network meta-analysis, both alfuzosin (mean difference [MD];-4.85, 95 % confidence interval [CI];-8.53--1.33) and tamsulosin (MD;-8.84, 95 % CI;-13.08--4.31) showed lower scores compared with placebo; however, the difference in USS for alfuzosin versus tamsulosin was not significant (MD; 3.99, 95 % CI;-1.23-9.04). Alfuzosin (MD;-5.71, 95 % CI;-11.32--0.52) and tamsulosin (MD;-7.77, 95 % CI;-13.68--2.14) showed lower scores for BPS compared with placebo; however, the MD between alfuzosin and tamsulosin was not significant (MD; 2.12, 95 % CI;-4.62-8.72). In the rank-probability test, tamsulosin ranked highest for USS and BPS, and alfuzosin was second.

Conclusion: The alpha-blockers significantly decreased USS and BPS in comparison with placebo. Tamsulosin might be more effective than alfuzosin.
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http://dx.doi.org/10.1186/s12894-015-0050-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477492PMC
June 2015

A study on the relapse rate of tuberculosis and related factors in Korea using nationwide tuberculosis notification data.

Osong Public Health Res Perspect 2014 Dec 13;5(Suppl):S8-S17. Epub 2014 Nov 13.

Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea.

Objectives: From the perspective of public health, tuberculosis (TB) remains an important issue that threatens health. Korea is an intermediate burden country with a TB incidence of 97/100,000 individuals. Among many TB control measures, a relapse rate of TB is one indicator that can be used to indirectly assess the level of TB control in countries and in communities. Relapse TB has an approximately 12% yearly incidence in Korea. This study aims to estimate the relapse rate of TB and to investigate the associated factors by using nationwide TB notification data in Korea.

Methods: The nationwide TB notification data in 2005 was used with the exclusion criteria of duplicated reporting, foreign-born patients, outcome-died, and outcome-diagnosis changed. The data were double-checked as to whether they were reported again during 2006-2010 and the estimated relapse rate of TB. Associated factors were analyzed by multivariate logistic regression with the variables of age, sex, registration type, results of sputum smear test, medication, and outcome of treatment.

Results: Among 45,434 TB patients in 2005, 4,371 patients were again reported as TB patients from 2006 to 2010. Five hundred and sixty-four patients were reported more than twice and the cumulative number of relapses was 5,072 cases. The 5-year relapse rate was estimated as 9.62%. The relapse rate decreased yearly: 4.8% in 2006, 2.4% in 2007, 1.6% in 2008, 1.4% in 2009, and 1.0% in 2010. Age, sex, registration type, tuberculosis type, and medication were independently associated with a relapse of TB. In the multivariate logistic regression analysis, the following factors were related: male sex, 40-49 years old; registration type, relapse, treatment after failure, treatment after default, transfer in, and other, the sputum smear-positive pulmonary TB, and medications (including individuals taking 2-5 drugs).

Conclusion: This study has estimated a 5-year relapse rate of TB in Korea that is slightly lower than the rate of relapse TB in the annual reports. This study could be conducted and cross-checked with data from the National Health Insurance in the future.
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http://dx.doi.org/10.1016/j.phrp.2014.11.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301639PMC
December 2014

Meta-Analysis of the Relationship between CXCR4 Expression and Metastasis in Prostate Cancer.

World J Mens Health 2014 Dec 29;32(3):167-75. Epub 2014 Dec 29.

Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Purpose: Experimental studies have suggested that the stromal-derived factor-1 (SDF-1)/CXCR4 axis is associated with tumor aggressiveness and metastasis in several malignancies. We performed a meta-analysis to elucidate the relationship between CXCR4 expression and the clinicopathological features of prostate cancer.

Materials And Methods: Data were collected from studies comparing Gleason score, T stage, and the presence of metastasis with CXCR4 levels in human prostate cancer samples. The studies were pooled, and the odds ratio (OR) of CXCR4 expression for clinical and pathological variables was calculated.

Results: Five articles were eligible for the current meta-analysis. We found no relationship between CXCR4 expression and Gleason score (<7 vs. ≥7). The forest plot using the fixed-effects model indicated an OR of 1.585 (95% confidence interval [CI]: 0.793~3.171; p=0.193). Further, CXCR4 expression was not associated with the T stage (
Conclusions: Our meta-analysis showed that the higher CXCR4 protein expression in prostate cancer specimens is significantly associated with the presence of metastatic disease. This supports previous experimental data supporting the role played by the SDF-1/CXCR4 axis in metastasis.
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http://dx.doi.org/10.5534/wjmh.2014.32.3.167DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4298820PMC
December 2014

Changes in seroprevalence of hepatitis B surface antigen and epidemiologic characteristics in the Republic of Korea, 1998-2013.

Epidemiol Health 2015 23;37:e2015055. Epub 2015 Dec 23.

Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.

Objectives: This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people.

Methods: HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization.

Results: HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people.

Conclusions: While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.
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http://dx.doi.org/10.4178/epih/e2015055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835708PMC
August 2016

Regional distribution of hepatitis C virus infection in the Republic of Korea, 2007-2011.

Gut Liver 2014 Jul 23;8(4):428-32. Epub 2014 Apr 23.

Divisions of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea.

Background/aims: In Korea, hepatitis C is included as an infectious disease in a sentinel surveillance system. Recently, a large variation in hepatitis C incidence between different regions in Korea has been noticed. The current study verified the nationwide distribution of hepatitis C infection for effective prevention and management.

Methods: We counted the number of hepatitis C patients who visited a hospital per county using the National Health Insurance database from 2007 to 2011. The age-adjusted prevalence ratio was used, and the age adjustment method was used as an indirect standardization method. Disease mapping and spatial analysis were conducted using a geographic information system.

Results: The annual prevalence of diagnosed hepatitis C was approximately 0.12% to 0.13% in Korea. The age-adjusted prevalence ratios in Busan, Jeonnam, and Gyeongnam were high (1.75, 1.4, and 1.3, respectively). The three regions in the southern coastal area of the Korean Peninsula were identified as a high-prevalence cluster (Moran's index, 0.3636).

Conclusions: The present study showed that hepatitis C infection has very large regional variation, and there are several high-risk areas. Preventive measures focusing on these areas should be applied to block the transmission of hepatitis C and reduce the disease burden.
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http://dx.doi.org/10.5009/gnl.2014.8.4.428DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113042PMC
July 2014

Emerging Pathogens and Vehicles of Food- and Water-borne Disease Outbreaks in Korea, 2007-2012.

Osong Public Health Res Perspect 2014 Feb 10;5(1):34-9. Epub 2014 Jan 10.

Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea.

Objectives: Food- and water-borne disease outbreaks (FBDOs) are an important public health problem worldwide. This study investigated the trends in FBDOs in Korea and established emerging causal pathogens and causal vehicles.

Methods: We analyzed FBDOs in Korea by year, location, causal pathogens, and causal vehicles from 2007 to 2012. Information was collected from the FBDOs database in the Korean Centers for Disease Control and Prevention.

Results: During 2007-2012, a total of 1794 FBDOs and 48,897 patients were reported. After 2007, FBDOs and patient numbers steadily decreased over the next 2 years and then plateaued until 2011. However, in 2012, FBDOs increased slightly accompanied by a large increase in the number of affected patients. Our results highlight the emergence of norovirus and pathogenic Escherichia coli other than enterohemorrhagic E. coli (EHEC) in schools in 2012. We found that pickled vegetables is an emerging causal vehicle responsible for this problem.

Conclusion: On the basis of this study we recommend intensified inspections of pickled vegetable manufacturers and the strengthening of laboratory surveillance of relevant pathogens.
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http://dx.doi.org/10.1016/j.phrp.2013.12.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064638PMC
February 2014

Impact of surgical varicocele repair on pregnancy rate in subfertile men with clinical varicocele and impaired semen quality: a meta-analysis of randomized clinical trials.

Korean J Urol 2013 Oct 15;54(10):703-9. Epub 2013 Oct 15.

Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Purpose: To elucidate the impact of surgical varicocele repair on the pregnancy rate through new meta-analyses of randomized clinical trials that compared surgical varicocele repair and observation.

Materials And Methods: The PubMed and Embase online databases were searched for studies released before December 2012. References were manually reviewed, and two researchers independently extracted the data. To assess the quality of the studies, the Cochrane risk of bias as a quality assessment tool for randomized controlled trials was applied.

Results: Seven randomized clinical trials were included in our meta-analyses, all of which compared pregnancy outcomes between surgical varicocele repair and control. There were differences in enrollment criteria among the studies. Four studies included patients with clinical varicocele, but three studies enrolled patients with subclinical varicocele. Meanwhile, four trials enrolled patients with impaired semen quality only, but the other three trials did not. In a meta-analysis of all seven trials, a forest plot using the random-effects model showed an odds ratio (OR) of 1.90 (95% confidence interval [CI], 0.77 to 4.66; p=0.1621). However, for subanalysis of three studies that included patients with clinical varicocele and abnormal semen parameters, the fixed-effects pooled OR was significant (OR, 4.15; 95% CI, 2.31 to 7.45; p<0.001), favoring varicocelectomy.

Conclusions: Varicocelectomy for male subfertility is proven effective in men with clinical varicocele and impaired semen quality. Therefore, surgical repair should be offered as the first-line treatment of clinical varicocele in subfertile men.
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http://dx.doi.org/10.4111/kju.2013.54.10.703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806996PMC
October 2013

Trends in the incidence of scrub typhus: the fastest growing vector-borne disease in Korea.

Osong Public Health Res Perspect 2013 Jun 30;4(3):166-9. Epub 2013 Apr 30.

Department of Health, School of Public Health and Welfare, Sahmyook University, Seoul, Korea.

Scrub typhus, also called tsutsugamushi disease, is classified as a Group 3 disease in Korea according to the National Notifiable Diseases Surveillance Systems. It is an infectious disease transmitted to humans through the bite of mites that are infected with an intracellular parasite called Orientia tsutsugamushi (Family: Rickettsiaceae). This study aims to identify the demographic characteristics of the infected cases according to profession, region, gender, and onset period and provide a basic data for prevention and control of the disease in the infected patients. Between 2001 and 2010, 16,741 men (36.3%) and 29,373 women (63.7%) were reported to have been infected with scrub typhus, with men being 1.6 times less infected than women. When classified according to age, it was found that 4421 persons (9.6%) were under 40 years of age; 6601 (13.1%) in their 40s; 9714 (21.1%) in their 50s; 13,067 (28.3%) in 60s; 10,128 (22.0%) in their 70s; and 2723 (5.9%) aged 80 or more. The elderly (60 years or older) represented more than half of the infected cases. When the infections were classified according to region, it was found that the county residents had the major share of infection, with a total of 1583 infected cases (59.85).
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http://dx.doi.org/10.1016/j.phrp.2013.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3787531PMC
June 2013

A hybrid approach to gene ranking using gene relation networks derived from literature for the identification of disease gene markers.

Int J Data Min Bioinform 2012 ;6(3):239-54

Bio-Intelligence Mining Lab., College of IT Engineering, Kyungpook National University, 1370 Sankyuk-dong, Buk-gu, Daegu 702-701, Korea.

For the identification of gene markers involved in diseases, microarray expression profiles have been widely used to prioritize genes. In this paper, we propose a novel approach to gene ranking that employs gene relation network derived from literature along with microarray expression scores to calculate ranking statistics of individual genes. In particular, the gene relation network is constructed from literature by applying syntactic analysis and co-occurrence method in a hybrid manner. For evaluation, the proposed method was tested with publicly available prostate cancer data. The result shows that our method is superior to other existing approaches.
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http://dx.doi.org/10.1504/ijdmb.2012.049250DOI Listing
January 2013

A case of paraquat intoxication caused by intravenous injection.

Am J Emerg Med 2008 Sep;26(7):836.e3-4

Department of Emergency Medicine, Eulji University, Seoul, South Korea.

Paraquat intoxication is a fatal problem. Most paraquat intoxications happen through oral administration. We report a case of death after intravenous paraquat injection. There is little clinical data on parenteral paraquat exposure, and we describe this case and fatal progression. Toxic symptoms and severe organ function impairment developed soon after injection. Treatment with repeated activated charcoal hemoperfusion with pulse steroids, cyclophosphamide, and antioxidants was attempted. The patient died from multiple organ failure 3 days after intoxication. This case indicates that paraquat intoxication via intravenous injection, even in very small amounts, has an extremely poor prognosis.
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http://dx.doi.org/10.1016/j.ajem.2007.12.016DOI Listing
September 2008
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