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- 저자 : ( Dukhee Nho ) (검색결과 3 건)
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Lee, Hyojung,Nho, Dukhee,Chung, Hwan-Suck,Lee, Heekyung,Shin, Min-Kyu,Kim, Sung-Hoon,Bae, Hyunsu International Society of Nephrology 2010 Kidney international Vol.78 No.11
Nephrotoxicity limits the use of cisplatin, a widely used chemotherapeutic agent for treatment of various malignancies. Overall, CD4<SUP>+</SUP> T cells mediate cisplatin-induced renal injury; however, the CD4<SUP>+</SUP>CD25<SUP>+</SUP> regulatory T-cell subset (CD4<SUP>+</SUP>CD25<SUP>+</SUP> Treg) has broad suppressive effects on many different cell types. In this study, we determined whether CD4<SUP>+</SUP>CD25<SUP>+</SUP> Treg cells had protective effects against cisplatin-induced acute renal injury in nu/nu mice that lack mature T cells. In these mice, there was marked attenuation of the decreased survival, renal dysfunction and tubular injury, renal tumor necrosis factor-α, and interleukin-1β cytokine levels. Furthermore, renal macrophage accumulation was reduced in CD4<SUP>+</SUP>CD25<SUP>+</SUP> Treg cell-adoptive transferred nu/nu mice compared with control mice. Infusion of CD4<SUP>+</SUP>CD25<SUP>+</SUP>Treg cells into wild-type Balb/c mice reduced serum blood urea nitrogen and creatinine levels equivalent to those in nu/nu mice and extended their survival time after cisplatin injection. In contrast, depletion of CD4<SUP>+</SUP>CD25<SUP>+</SUP> Treg cells in wild-type mice exacerbated kidney injury after cisplatin administration. Transcription factor Foxp3-positive cells (Treg cells) were detected in the kidneys of nu/nu mice after cisplatin injection. Our results suggest that CD4<SUP>+</SUP>CD25<SUP>+</SUP> Treg cells directly affect cisplatin nephrotoxicity and their modulation represents an additional treatment strategy.
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Soo Jin Lee,Raeseok Lee,Sung-Yeon Cho,Dukhee Nho,Hye Lim Ahn,Dong-Gun Lee 대한내과학회 2024 The Korean Journal of Internal Medicine Vol.39 No.3
Antimicrobial stewardship programs (ASPs) can lower antibiotic use, decrease medical expenses, prevent the emergence of resistant bacteria, and enhance treatment for infectious diseases. This study summarizes the stepwise implementation and effects of ASPs in a single university-affiliated tertiary care hospital in Korea; it also presents future directions and challenges in resource-limited settings. At the study hospital, the core elements of the ASP such as leadership commitment, accountability, and operating system were established in 2000, then strengthened by the formation of the Antimicrobial Stewardship (AMS) Team in 2018. The actions of ASPs entail key components including a computerized restrictive antibiotic prescription system, prospective audit, post-prescription review through quantitative and qualitative intervention, and pharmacy-based interventions to optimize antibiotic usage. The AMS Team regularly tracked antibiotic use, the effects of interventions, and the resistance patterns of pathogens in the hospital. The reporting system was enhanced and standardized by participation in the Korea National Antimicrobial Use Analysis System, and educational efforts are ongoing. Stepwise implementation of the ASP and the efforts of the AMS Team have led to a substantial reduction in the overall consumption of antibiotics, particularly regarding injectables, and optimization of antibiotic use. Our experience highlights the importance of leadership, accountability, institution-specific interventions, and the AMS Team.
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( Seohee Oh ),( Yu-sun Sung ),( Mihee Jang ),( Yong-jin Kim ),( Hyun-wook Park ),( Dukhee Nho ),( Dong-gun Lee ),( Hyeon Woo Yim ),( Sung-yeon Cho ) 대한내과학회 2024 The Korean Journal of Internal Medicine Vol.39 No.3
Background/Aims: Since the coronavirus disease 2019 (COVID-19) outbreak, hospitals have implemented infection control measures to minimize the spread of the virus within facilities. This study aimed to investigate the impact of COVID-19 on the incidence of healthcare-associated infections (HCAIs) and common respiratory virus (cRV) infections in hematology units. Methods: This retrospective study included all patients hospitalized in Catholic Hematology Hospital between 2019 and 2020. Patients infected with vancomycin-resistant Enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Clostridium difficile infection (CDI), and cRV were analyzed. The incidence rate ratio (IRR) methods and interrupted time series analyses were performed to compare the incidence rates before and after the pandemic. Results: The incidence rates of CPE and VRE did not differ between the two periods. However, the incidence of CDI increased significantly (IRR: 1.41 [p = 0.002]) after the COVID-19 pandemic. The incidence of cRV infection decreased by 76% after the COVID-19 outbreak (IRR: 0.240 [p < 0.001]). The incidence of adenovirus, parainfluenza virus, and rhinovirus infection significantly decreased in the COVID-19 period (IRRs: 0.087 [p = 0.003], 0.031 [p < 0.001], and 0.149 [p < 0.001], respectively). Conclusions: The implementation of COVID-19 infection control measures reduced the incidence of cRV infection. However, CDI increased significantly and incidence rates of CPE and VRE remained unchanged in hematological patients after the pandemic. Infection control measures suitable for each type of HCAI, such as stringent hand washing for CDI and enough isolation capacities, should be implemented and maintained in future pandemics, especially in immunocompromised patients.
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