The Impact of an Antimicrobial Stewardship Program on Days of Therapy in the Pediatric Center: An Interrupted Time-Series Analysis of a 19-Year Study

Kim Kyung-Ran,Park Hyo Jung,Baek Sun-Young,Choi Soo-Han,Lee Byung-Kee,Kim SooJin,Kim Jong Min,Kang Ji-Man,Kim Sun-Ja,Choi Sae Rom,Kim Dongsub,Choi Joon-sik,Yoon Yoonsun,Park Hwanhee,Kim Doo Ri,Shin Ar 대한의학회 2024 Journal of Korean medical science Vol.39 No.21

Background: We aimed to analyze the effects of an antimicrobial stewardship program (ASP) on the proportion of antimicrobial-resistant pathogens in bacteremia, antimicrobial use, and mortality in pediatric patients. Methods: A retrospective single-center study was performed on pediatric inpatients under 19 years old who received systemic antimicrobial treatment from 2001 to 2019. A pediatric infectious disease attending physician started ASP in January 2008. The study period was divided into the pre-intervention (2001–2008) and the post-intervention (2009–2019) periods. The amount of antimicrobial use was defined as days of therapy per 1,000 patientdays, and the differences were compared using delta slope (= changes in slopes) between the two study periods by an interrupted time-series analysis. The proportion of resistant pathogens and the 30-day overall mortality rate were analyzed by the χ2 . Results: The proportion of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia increased from 17% (39 of 235) in the pre-intervention period to 35% (189 of 533) in the post-intervention period (P < 0.001). The total amount of antimicrobial use significantly decreased after the introduction of ASP (delta slope value = −16.5; 95% confidence interval [CI], −30.6 to −2.3; P = 0.049). The 30-day overall mortality rate in patients with bacteremia did not increase, being 10% (55 of 564) in the pre-intervention and 10% (94 of 941) in the post-intervention period (P = 0.881). Conclusion: The introduction of ASP for pediatric patients reduced the delta slope of the total antimicrobial use without increasing the mortality rate despite an increased incidence of ESBL-producing gram-negative bacteremia.

Surface modification of polydimethylsiloxane (PDMS) induced proliferation and neural-like cells differentiation of umbilical cord blood-derived mesenchymal stem cells.

Kim, Sun-Jung,Lee, Jae Kyoo,Kim, Jin Won,Jung, Ji-Won,Seo, Kwangwon,Park, Sang-Bum,Roh, Kyung-Hwan,Lee, Sae-Rom,Hong, Yun Hwa,Kim, Sang Jeong,Lee, Yong-Soon,Kim, Sung June,Kang, Kyung-Sun Chapman and Hall ; Kluwer Academic Publishers 2008 Journal of materials science, Materials in medicin Vol.19 No.8

<P>Stem cell-based therapy has recently emerged for use in novel therapeutics for incurable diseases. For successful recovery from neurologic diseases, the most pivotal factor is differentiation and directed neuronal cell growth. In this study, we fabricated three different widths of a micro-pattern on polydimethylsiloxane (PDMS; 1, 2, and 4 microm). Surface modification of the PDMS was investigated for its capacity to manage proliferation and differentiation of neural-like cells from umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs). Among the micro-patterned PDMS fabrications, the 1 microm-patterned PDMS significantly increased cell proliferation and most of the cells differentiated into neuronal cells. In addition, the 1 microm-patterned PDMS induced an increase in cytosolic calcium, while the differentiated cells on the flat and 4 microm-patterned PDMS had no response. PDMS with a 1 microm pattern was also aligned to direct orientation within 10 degrees angles. Taken together, micro-patterned PDMS supported UCB-MSC proliferation and induced neural like-cell differentiation. Our data suggest that micro-patterned PDMS might be a guiding method for stem cell therapy that would improve its therapeutic action in neurological diseases.</P>

Neuroimaging Findings in Patients with COVID-19: A Systematic Review and Meta-Analysis

Kim Pyeong Hwa,Kim Minjae,Suh Chong Hyun,Chung Sae Rom,Park Ji Eun,Kim Soo Chin,Choi Young Jun,Lee Jeong Hyun,Kim Ho Sung,Baek Jung Hwan,Choi Choong Gon,Kim Sang Joon 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.11

Objective: Central nervous system involvement in coronavirus disease 2019 (COVID-19) has been increasingly reported. We performed a systematic review and meta-analysis to evaluate the incidence of radiologically demonstrated neurologic complications and detailed neuroimaging findings associated with COVID-19. Materials and Methods: A systematic literature search of MEDLINE/PubMed and EMBASE databases was performed up to September 17, 2020, and studies evaluating neuroimaging findings of COVID-19 using brain CT or MRI were included. Several cohort-based outcomes, including the proportion of patients with abnormal neuroimaging findings related to COVID-19 were evaluated. The proportion of patients showing specific neuroimaging findings was also assessed. Subgroup analyses were also conducted focusing on critically ill COVID-19 patients and results from studies that used MRI as the only imaging modality. Results: A total of 1394 COVID-19 patients who underwent neuroimaging from 17 studies were included; among them, 3.4% of the patients demonstrated COVID-19-related neuroimaging findings. Olfactory bulb abnormalities were the most commonly observed (23.1%). The predominant cerebral neuroimaging finding was white matter abnormality (17.6%), followed by acute/subacute ischemic infarction (16.0%), and encephalopathy (13.0%). Significantly more critically ill patients had COVID-19-related neuroimaging findings than other patients (9.1% vs. 1.6%; p = 0.029). The type of imaging modality used did not significantly affect the proportion of COVID-19-related neuroimaging findings. Conclusion: Abnormal neuroimaging findings were occasionally observed in COVID-19 patients. Olfactory bulb abnormalities were the most commonly observed finding. Critically ill patients showed abnormal neuroimaging findings more frequently than the other patient groups. White matter abnormalities, ischemic infarctions, and encephalopathies were the common cerebral neuroimaging findings.

2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology

Kim, Ji-hoon,Baek, Jung Hwan,Lim, Hyun Kyung,Ahn, Hye Shin,Baek, Seon Mi,Choi, Yoon Jung,Choi, Young Jun,Chung, Sae Rom,Ha, Eun Ju,Hahn, Soo Yeon,Jung, So Lyung,Kim, Dae Sik,Kim, Soo Jin,Kim, Yeo Koon The Korean Society of Radiology 2018 KOREAN JOURNAL OF RADIOLOGY Vol.19 No.4

<P>Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed recommendations for the optimal use of radiofrequency ablation for thyroid tumors in 2012. As new meaningful evidences have accumulated, KSThR decided to revise the guidelines. The revised guideline is based on a comprehensive analysis of the current literature and expert consensus.</P>

EVpedia: a community web portal for extracellular vesicles research.

Kim, Dae-Kyum,Lee, Jaewook,Kim, Sae Rom,Choi, Dong-Sic,Yoon, Yae Jin,Kim, Ji Hyun,Go, Gyeongyun,Nhung, Dinh,Hong, Kahye,Jang, Su Chul,Kim, Si-Hyun,Park, Kyong-Su,Kim, Oh Youn,Park, Hyun Taek,Seo, Ji H Oxford University Press 2015 Bioinformatics Vol.31 No.6

<P>Extracellular vesicles (EVs) are spherical bilayered proteolipids, harboring various bioactive molecules. Due to the complexity of the vesicular nomenclatures and components, online searches for EV-related publications and vesicular components are currently challenging.</P>

Metformin Enhances Leptin Sensitivity in Aged Rats

Kim, Sae-Rom,Park, So-Young,Kim, Jong-Yeon,Kim, Yong-Woon The Korean Society of Pharmacology 2006 The Korean Journal of Physiology & Pharmacology Vol.10 No.1

To evaluate whether metformin restores leptin sensitivity in aged rats with leptin resistance, we measured leptin sensitivity in aged (2 year old) and adult (5 month old) rats after 4 weeks of treatment with metformin (300 mg/kg/D, mixing in drinking water), by measuring food intake, body weight and visceral fat losing effects. Leptin ($15{\mu}g/D$) was administered by intracerobroventricular (i.c.v.) infusion through osmotic minipump for 1 week. Metformin treatment decreased body weight and daily food intake in both adult and aged rats compared with their control rats, however, these effects were more prominent in aged rats than in adult rats. Anorexic and fat losing responses following i.c.v. leptin were attenuated in aged rats compared to adult rats. However, these responses of aged rats to leptin were restored by metformin treatment. Moreover, serum concentration of leptin in aged rats was significantly decreased by combined treatment with metformin and leptin. These results suggest that metformin enhances leptin sensitivity in aged rat model, and that combination therapy with metformin and leptin would be helpful for treatment of aging-associated obesity.

Development and Validation of a Model Using Radiomics Features from an Apparent Diffusion Coefficient Map to Diagnose Local Tumor Recurrence in Patients Treated for Head and Neck Squamous Cell Carcinoma

Kim Minjae,Lee Jeong Hyun,Joo Leehi,Jeong Boryeong,Kim Seonok,Ham Sungwon,Yun Jihye,Kim NamKug,Chung Sae Rom,Choi Young Jun,Baek Jung Hwan,Lee Ji Ye,Kim Ji-Hoon 대한영상의학회 2022 Korean Journal of Radiology Vol.23 No.11

Objective: To develop and validate a model using radiomics features from apparent diffusion coefficient (ADC) map to diagnose local tumor recurrence in head and neck squamous cell carcinoma (HNSCC). Materials and Methods: This retrospective study included 285 patients (mean age ± standard deviation, 62 ± 12 years; 220 male, 77.2%), including 215 for training (n = 161) and internal validation (n = 54) and 70 others for external validation, with newly developed contrast-enhancing lesions at the primary cancer site on the surveillance MRI following definitive treatment of HNSCC between January 2014 and October 2019. Of the 215 and 70 patients, 127 and 34, respectively, had local tumor recurrence. Radiomics models using radiomics scores were created separately for T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI), and ADC maps using non-zero coefficients from the least absolute shrinkage and selection operator in the training set. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of each radiomics score and known clinical parameter (age, sex, and clinical stage) in the internal and external validation sets. Results: Five radiomics features from T2WI, six from CE-T1WI, and nine from ADC maps were selected and used to develop the respective radiomics models. The area under ROC curve (AUROC) of ADC radiomics score was 0.76 (95% confidence interval [CI], 0.62–0.89) and 0.77 (95% CI, 0.65–0.88) in the internal and external validation sets, respectively. These were significantly higher than the AUROC values of T2WI (0.53 [95% CI, 0.40–0.67], p = 0.006), CE-T1WI (0.53 [95% CI, 0.40– 0.67], p = 0.012), and clinical parameters (0.53 [95% CI, 0.39–0.67], p = 0.021) in the external validation set. Conclusion: The radiomics model using ADC maps exhibited higher diagnostic performance than those of the radiomics models using T2WI or CE-T1WI and clinical parameters in the diagnosis of local tumor recurrence in HNSCC following definitive treatment.

Metformin Enhances Leptin Sensitivity in Aged Rats

Sae Rom Kim,So-Young Park,Jong Yeon Kim,Yong Woon Kim 대한생리학회-대한약리학회 2006 The Korean Journal of Physiology & Pharmacology Vol.10 No.1

To evaluate whether metformin restores leptin sensitivity in aged rats with leptin resistance, we measured leptin sensitivity in aged (2 year old) and adult (5 month old) rats after 4 weeks of treatment with metformin (300 mg/kg/D, mixing in drinking water), by measuring food intake, body weight and visceral fat losing effects. Leptin (15μg/D) was administered by intracerobroventricular (i.c.v.) infusion through osmotic minipump for 1 week. Metformin treatment decreased body weight and daily food intake in both adult and aged rats compared with their control rats, however, these effects were more prominent in aged rats than in adult rats. Anorexic and fat losing responses following i.c.v. leptin were attenuated in aged rats compared to adult rats. However, these responses of aged rats to leptin were restored by metformin treatment. Moreover, serum concentration of leptin in aged rats was significantly decreased by combined treatment with metformin and leptin. These results suggest that metformin enhances leptin sensitivity in aged rat model, and that combination therapy with metformin and leptin would be helpful for treatment of aging-associated obesity.

Changes in Cytomegalovirus Seroprevalence in Korea for 21 Years: a Single Center Study

( Sae Rom Choi ),( Kyung-ran Kim ),( Dong Sub Kim ),( Ji-man Kang ),( Sun Ja Kim ),( Jong Min Kim ),( Soo-young Oh ),( Choel-in Kang ),( Doo Ryeon Chung ),( Kyong Ran Peck ),( Eun-suk Kang ),( Yae-jea 대한소아감염학회 2018 Pediatric Infection and Vaccine Vol.25 No.3

목적: 거대세포바이러스(Cytomegalovirus [CMV])는 정상 면역을 가진 사람에서는 대부분 불현성 감염이지만, 면역저하자 또는 태아의 선천 감염의 경우 위중한 합병증을 유발한다. 본 연구는 21년 동안의 시기 및 연령에 따른 CMV 항체 양성률을 조사하였다. 방법: 1995년 1월부터 2015년 12월까지 성균관대학교 의과대학, 삼성서울병원에서 CMV immunoglobulin G (IgG) 검사를 시행한 환자를 대상으로 하였다. 검사 결과는 성별, 연령별, 전국 지역별로 분석하였고, 두 시기에 따른 (1995-2005년; 1기, 2006-2015년; 2기) 항체 양성률의 변화를 분석하였다. 결과: 총 11,584명의 환자 중 CMV IgG 양성결과를 보인 총 환자는 10,900명 (94.1%)이었다. 전체 환자에서 두 시기에 따른 CMV 양성률의 차이는 없었다 (94.2% vs. 94.1%) (P=0.86). 10년 간격으로 비교를 했을 때 다른 연령군은 유의하지 않았으나 11-20세의 연령군의 CMV 양성률은 1기에 비해 2기에 더 낮았다 (P<0.001). 이 연령에 따른 항체 양성률 분석에서 31-40세 연령군의 항체 양성률 (97.4%)은 이보다 어린 연령군에 비하여 유의하게 높았으며 (P<0.001, odds ratio [OR]<1), 더 높은 연령군에 비하여 유의하게 낮았다 (P< 0.001, OR >1). 가임기 여성은 총 2,441명이었으며 (15-49세) 이 중 CMV IgG 양성률은 2,367 (97%)명이었다. 해당 연령군의 시기별 항체 양성률의 유의한 차이는 없었다. 가임기 여성 중 20-24세의 연령군은 해당 연령의 남자에 비하여 유의한 높은 항체 양성률을 보였다 (97.6% vs. 85.6%, OR, 6.78; 95% CI, 1.585-28.968; P=0.0028). 지역별 항체 양성률의 큰 차이는 보이지 않았다. 결론: 본 논문은 한국인의 전 연령의 CMV 항체 양성률 변화에 대한 조사를 시행한 최초 논문이며 전체적으로 약 94%의 높은 CMV 항체 양성률과 가임기 여성은 97%의 항체 양성률을 보이는 것으로 관찰되었다. 향후, 가임기 여성을 포함한 한국인의 CMV 항체 양성률의 변화 추세에 대한 모니터링과 국내 임산부에서의 CMV 감염에 대한 연구가 필요할 것으로 사료된다. Purpose: Cytomegalovirus (CMV) infection is mostly asymptomatic but can be detrimental to certain hosts. We investigated changes of CMV seroprevalence in Koreans before and after the year 2000. Methods: We reviewed laboratory values of patients who were tested for CMV immunoglobulin G (IgG) at Samsung Medical Center, Seoul, Korea, from January 1995 to December 2015. Changes in seroprevalence were analyzed by gender, age, region, and tested year period (period 1, 1995-2005 vs. period 2, 2006-2015). Results: Overall CMV seropositivity was 94.1% (10,900/11,584). There was no significant difference for CMV seropositivity among the two periods (94.2% vs. 94.1%) (P=0.862). CMV seropositivity in the 11 to 20-year age group in period 2 (78.8%) was significantly lower than that of period 1 (89.9%) (P=0.001). The seropositivity of individuals aged 31-40 years (97.4%) was significantly higher than that of younger age groups (P<0.001) and lower than that of older age groups (P<0.001). Of 2,441 females of reproductive age (from 15 to 49), CMV seropositivity was 97% (2,467/2,441). The seropositivity in women aged 20-24-years was higher than that of men in the same age group (97.6% vs. 85.6%, P=0.003). No significant difference was observed among different regions. Conclusions: Overall CMV seropositivity of Koreans was estimated to be 94% and the average seropositivity of reproductive women was 97%. Monitoring of the changes in seroprevalence including the reproductive age group is needed in the future.

Changes in Cytomegalovirus Seroprevalence in Korea for 21 Years: a Single Center Study

Choi, Sae Rom,Kim, Kyung-Ran,Kim, Dong Sub,Kang, Ji-Man,Kim, Sun Ja,Kim, Jong Min,Oh, Soo-young,Kang, Choel-In,Chung, Doo Ryeon,Peck, Kyong Ran,Kang, Eun-Suk,Kim, Yae-Jean The Korean Society of Pediatric Infectious Disease 2018 Pediatric Infection and Vaccine Vol.25 No.3

Purpose: Cytomegalovirus (CMV) infection is mostly asymptomatic but can be detrimental to certain hosts. We investigated changes of CMV seroprevalence in Koreans before and after the year 2000. Methods: We reviewed laboratory values of patients who were tested for CMV immunoglobulin G (IgG) at Samsung Medical Center, Seoul, Korea, from January 1995 to December 2015. Changes in seroprevalence were analyzed by gender, age, region, and tested year period (period 1, 1995-2005 vs. period 2, 2006-2015). Results: Overall CMV seropositivity was 94.1% (10,900/11,584). There was no significant difference for CMV seropositivity among the two periods (94.2% vs. 94.1%) (P=0.862). CMV seropositivity in the 11 to 20-year age group in period 2 (78.8%) was significantly lower than that of period 1 (89.9%) (P=0.001). The seropositivity of individuals aged 31-40 years (97.4%) was significantly higher than that of younger age groups (P<0.001) and lower than that of older age groups (P<0.001). Of 2,441 females of reproductive age (from 15 to 49), CMV seropositivity was 97% (2,467/2,441). The seropositivity in women aged 20-24-years was higher than that of men in the same age group (97.6% vs. 85.6%, P=0.003). No significant difference was observed among different regions. Conclusions: Overall CMV seropositivity of Koreans was estimated to be 94% and the average seropositivity of reproductive women was 97%. Monitoring of the changes in seroprevalence including the reproductive age group is needed in the future.