Journal of Yeungnam Medical Science

Chae Hoon Lee

23 Articles

Laboratory Medicine
Interpretation of Antimicrobial Susceptibility Test According to Resistance Mechanism of beta-lactam in Enterobacteriacae.: Chae Hoon Lee; Yeungnam Univ J Med. 2010;27(1):8-17. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.8

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Abstract PDF: It is important to select appropriate antimicrobials for the treatment of infection according to the results of antimicrobial susceptibility tests (ASTs), yet the clinical isolates are sometimes susceptible to antibiotics that are clinically ineffective or this is due to technical error of the ASTs. So, interpretive reading of ASTs is needed and especially for the beta-lactams for treating Enterobacteriacae. This review describes the interpretive reading of ASTs according to natural antimicrobial resistance and the mechanisms of mechanisms, with giving special attention to the antibiotics phenotypes for Enterobacteriacae. Further, as all the diffent tissues have a different antimicrobial concentration for identical antimicrobials, more information is needed on the antimicrobial tissue distribution for the appropriate treatment of infection. (ED note: I hope you send me the paper.)

Laboratory Medicine
Interpretation of Antibiotics Susceptibility Test According to Antimicrobial Concentration in Tissues: Chae Hoon Lee, Hee Soon Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S430-442. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S430

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Abstract PDF: Background
：It is important to select appropriate antimicrobials for the treatment of infection according to the results of antibiotic susceptibility test(AST). AST interprets as susceptible, resistant or intermediate on the base of breakpoints of Clinical and Laboratory Standard Institute(CLSI), but do not take into account the antimicrobial concentrations of variable tissues. As different tissues have different distributions of antimicrobials, it is necessary to interpret AST according to the tissue concentration. Thereby we intend to evaluate the usefulness of interpretation of antimicrobial susceptibility depending on tissue distribution of antimicrobials. Materials and Methods：Gram negative bacilli that isolated from clinical specimens in Yeungnam University Hospital from August to September, 2007 were evaluated retrospectively. The data of blood concentration and tissue distribution of antibiotics with variable administration route and dosage were collected and arranged in the forms of previous reported data and regarded as resistant if minimal inhibitory concentration (MIC) is higher than the expected concentration of each tissues.
Results
：Among the data reported as susceptible, aztreonam, imipenem and ciprofloxacin were relatively good relationship with AST. But, ampicillin, ticarcillin, cefazolin and cefotaxime of sputum or bronchial secretion were less effective with high MIC of organism. Gentamicin and amikacin also were shown as less effective in respiratory tissues and wound with high MIC of oganism.
Conclusion
：As different tissues have different antimicrobial concentrations for identical antimicrobial, more informations on antimicrobial tissue distribution is needed for appropriate treatment in infection. Reporting of MIC should be considered for selection of antimicrobials rather than AST with breakpoints. Therefore interpretation of AST considering tissue concentration is more helpful for prevention of major error and control of infection.

Laboratory Medicine
The Frequency and Distribution of Unexpected Antibodies at Yeungnam University Hospital : Recent Five Years Experience from January, 2002 to December, 2006: Hee Soon Cho, Chae Hoon Lee, Kyung Dong Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S449-455. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S449

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Abstract PDF: Background
：Unexpected antibodies can cause hemolytic transfusion reaction or decrease the survival of transfused red blood cells. Type and screen is recommended for efficient transfusion, so we perform antibody screening test for pre-transfusion test. In this study, we investigated the frequency and distribution of unexpected antibodies at Yeungnam University Hospital during recent 5 years.
Methods
：We analyzed the results of 28,944 antibody screening test that were performed for preparation of packed red cells from 2002 to 2006. Screening and identification of unexpected antibodies were carried out using a column agglutination method with the DiaMed ID system.
Results
：Unexpected antibodies were detected from 234 samples (0.84%) out of 28,944 samples. After exclusion of samples from same patients, 185 patients had unexpected antibodies. Identification of unexpected antibodies were performed from 108 patients. Antibody that was detected most frequently was anti-E (36.1%), followed by anti-C and anti-Le^a (6.5%), anti-c (4.6%), anti-D (3.7%), anti-Jk^b (3.0%), anti-Jk^a, anti-S, anti-Xg^a (1.9%), anti-e, anti-Fy^a, anti-M, anti-Js^a and anti-Lu^b (0.9%). 15 patients (13.9%) had autoantibodies and 20 cases (18.5%) could not be identified by LISS/Coombs method.
Conclusion
：The frequency of unexpected antibodies at our hospital was 0.84%, and the most identified unexpected antibodies were clinically significant. Therefore, antibody screening and identification tests are critical step in pre-transfusion test.

Laboratory Medicine
A Case of Swyer Syndrome: Soon Il Jung, Hee Soon Cho, Chae Hoon Lee, Kyung Dong Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S665-670. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S665

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Abstract PDF: 46,XY pure gonadal dysgenesis is a sex-reversal disorder, that is characterized by the presence of a female phenotype, with a normal to tall stature, primary amenorrhea and sexual infantilism. The internal genitalia are female with a uterus and vagina being present, however, there are bilateral dysgenetic gonads. In addition, neoplasia occurs in 20∼30% of patients who have gonadal dysgenesis and a Y chromosome. A 34 year old woman presented to our hospital with the chief complaint of primary amenorrhea. Physical examination revealed no secondary sexual characteristics and no somatic abnormality. Peripheral blood karyotype was 46,XY, and polymerase chain reaction (PCR) for the Sex determining Region Y (SRY) gene was positive. Sequencing analysis of the SRY gene revealed a single nucleotide polymorphism. A laparoscopic gonadectomy was performed to remove both gonads, and no tumor cells were observed. Estrogen replacement therapy was instituted.

Laboratory Medicine
Development of Rule-based Expert System for Interpretative Report with Health Screening Tests.: Chae Hoon Lee; Yeungnam Univ J Med. 2007;24(2):137-147. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.137

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Abstract PDF: BACKGROUND
Interpretative reporting is an important aspect of laboratory medicine. The large menu of laboratory tests available today makes it increasingly difficult for the non-specialist to order and interpret all laboratory tests. The aim of this study was to determine the usefulness of an expert system to interpret laboratory tests and help physicians order the appropriate tests. MATERIALS AND METHODS: In order to interpret laboratory tests, a rules-based expert system was developed. In this module, if-then rules were used to interpret the given test result patterns (e.g. urinalysis, anemia, hepatitis B virus, hypercholesterolemia, glucose, syphilis, and tumor markers) and select matching text elements. The system was used to evaluate 535 subjects who visited a health-check program. RESULTS: The overall abnormal rate was 50.5% in the expert system; 34% for cholesterol, 9.9% for urinalysis, 8.0% for anemia, 7.7% for thyroid function tests, 4.5% for tumor marker study, 4.7% for hepatitis virus antigen, 4.3% for serum glucose, and 1.1% for syphilis. CONCLUSION: These results indicate that the application of the expert system for the interpretation of laboratory tests may provide a useful method for the interpretation of reports. However more rules are needed for the application to in-patients.

Hematology
Acute Myeloid Leukemia with t(8;21)(q22;q22) (AML1/ETO) in a Patient with Marked Hypocellularity and Low Blasts Count.: Sung Ho Chun, Hee Soon Cho, Chae Hoon Lee, Kyung Dong Kim, Min Kyoung Kim, Myung Soo Hyun, Soon Il Jung; Yeungnam Univ J Med. 2007;24(1):85-90. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.85

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Abstract PDF: According to the World Health Organization (WHO) classification system, cases with t(8;21)(q22;q22) should be diagnosed as acute myeloid leukemia (AML) even with a blast count of less than 20 percent in blood or bone marrow. It is an uncommon manifestation, moreover hypocellularity is rarely observed in this subtype of leukemia. Here, we report a case of t(8;21) in a patient with marked hypocellularity of less than 5 percent and a blast count of less than 20 percent. This patient responded relatively well to chemotherapy. An allogeneic bone marrow transplantation was performed with good engraftment . This case suggests that hypocellular AML with a t(8;21) has as good a prognosis as hypercellular AML with t(8;21).

Laboratory Medicine
A Case of Constitutional Trisomy 8 Mosaicism.: Hee Soon Cho, Chae Hoon Lee, Kyoung Dong Kim, Eun Sil Lee; Yeungnam Univ J Med. 2005;22(2):241-246. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.241

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Abstract PDF

Constitutional trisomy 8 is a relatively rare aneuploidy; most identified cases are mosaic with a normal cell line. The phenotype is highly variable from apparently normal to severe disability. The proportion of abnormal cells is dramatically different between tissues and the severity of the phenotype is not directly related to the level of mosaicism. Therefore, it is very difficult to provide a definitive prognosis. We report here a case of constitutional trisomy 8 mosaicism with agenesis of the corpus callosum, congenital heart disease and micrognathia. The trisomy 8 cell line was not detected by prenatal cytogenetic study. This is the fourth reported case of constitutional trisomy 8 mosaicism in Korea.

Citations

Citations to this article as recorded by

A Case of Trisomy 8 Mosaicism in a Patient with Secondary Amnorreha without Abnormal Phenotype
Hye Sim Kang, Young Soo Son, Sung Yob Kim, Chul Min Park, Soon Sup Shim
Journal of Genetic Medicine.2011; 8(1): 67. CrossRef

Hematology
Two Cases of Vitamin B12 Deficiency Anemia Combined with Iron Deficiency Anemia.: Eun Hae Kim, Hee Soon Cho, Chae Hoon Lee, Kyung Dong Kim, Myung Soo Hyun; Yeungnam Univ J Med. 2003;20(2):206-211. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.206

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Abstract PDF: Simultaneous deficiency of Vitamin B12 and iron induces that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce hypochromic microcytic erythrocytes. We report two cases of Vitamin B12 deficiency anemia with low mean corpuscular volume (MCV) due to combined iron deficiency anemia with review of literature.

Cardiology and Cardiovascular Medicine
Change of Serum Levels of C-Reactive Protein After Coronary Angioplasty and Its Effects on Clinical Restenosis.: Jong Seon Park, Gu Ru Hong, Chae Hoon Lee, Dong Gu Shin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2001;18(2):215-225. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.215

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Abstract PDF: BACKGROUND
There are many evidences that inflammation is an important determinant of the development of atherosclerosis and one of the systemic markers of inflammation, C-reactive protein(CRP), is associated with extent of coronary artery disease and risk of coronary events. We assessed the time response of CRP response after coronary angioplasty and it's influence on the clinical restenosis in angina patients. MATERIALS AND METHODS: Patients included 36 angina patients undergoing single vessel angioplasty. Levels of CRP were measured before and 12, 24, 48, and 72 hours after angioplasty. Clinical restenosis was assessed at 6 months after procedure. RESULTS: Baseline CRP level was 0.30+/-0.01 mg/dL in stable and 0.46+/-0.28 mg/dL in unstable angina patients(p<0.05). After angioplasty, CRP level was increased with peak at 24 hour and persisted to 72 hours after angioplasty. At 24 hour after angioplasty, the magnitude of CRP change was 0.32+/-0.31 mg/dL in stable and 0.79+/-0.73 mg/dL in unstable angina patient(p<0.05). The change of CRP level was not associated with troponin-T after angioplasty. In unstable angina patients, clinical restenosis was developed in 8% of patients with low baseline CRP levels and in 50% of those with high baseline CRP levels more than 0.6 mg/dL(p<0.05). CONCLUSION: In unstable angina patients, inflammatory response is more increased than stable angina patients, and increased inflammatory response effects on the restenosis after coronary angioplasty.

Infectious Disease
Detection Rate of Extended-Spectrum beta-Lactamase Producers in Klebsiella pneumoniae and Escherichia coli Isolated at Yeungnam University Medical Center.: Chae Hoon Lee, Ho Chan Lee, Kyung Dong Kim, Tae Su Lee; Yeungnam Univ J Med. 1999;16(2):270-276. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.270

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Abstract PDF: BACKGROUND
Extended-spectrum beta-lactamases(ESBL) are enzymes that confer resistance to oxyimino-beta-lactams as well as to penicillins and cephalosporins. Strains of Klebsiella pneumoniae and Escherichia coli that produce ESBL have been increasingly prevalent in many countries. The purpose of this study was to investigate the ESBL production rate of K. pneumoniae and E. coli at the in Yeungnam University Medical Center. MATERIALS AND METHODS: Thirty-one isolates of K. pneumoniae and twenty-five isolates of E. coli were examined for ESBL by double disk synergy test, using 20/10microgram ticarcillin/clavulanic acid and 30microgram oxymino-beta-lactam(ceftazidime, ceftriaxone and aztreonam) disks. RESULTS: Fifty-two percent of K. pneumoniae and sixteen percent of E. coli isolates revealed double disk synersism. Majority of ESBL-producing strains(fifty-five percent) were isolated from patients in the intensive care unit. CONCLUSION: ESBL production of K. pneumoniae and E. coli were also common at the Yeungnam Univercity Medical Center and pose a serious problem for antimicrobial therapy.

Infectious Disease
Comparison of Three Third-generation Anti-HCV Enzyme Immunoassay Tests.: Hee Soon Cho, Jin Young Moon, Chae Hoon Lee, Kyung Dong Kim; Yeungnam Univ J Med. 1998;15(1):143-150. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.143

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Abstract PDF: The aim of this study was to evaluate domestic enzyme immunoassay(EIA) kit ?LG HCD 3.0?(LG) for the detection of antibody to hepatitis C virus(anti-HCV) in comparision with Axsym HCV version 3.0(Axsym), Cobas Core anti-HCV EIA(Cobas). Cobas kit shows better clear distinction between positive and negative by signal/cutoff ratio(S/C), but it also reveal relatively high false positive rate. The concordance rate of test results between LG and Axsym was 96.2%, between LG and Cobas was 95.5%, and total agreement between three EIA kit was 93.9%. LG were relative poor distinction between positive and negative results, but it could be applied clinically as a screening tool for hepatitis C in general population. The S/C of one false negative result by LG was 0.91, and false positive were less than 4.0, therefore we concluded it is necessary to confirm by immunoblotting assay when S/C were between 0.8 and 4.0.

Hematology
Surface Marker Analysis in Acute Leukemias.: Jin Young Moon, Chae Hoon Lee, Kyung Dong Kim, Chung Sook Kim; Yeungnam Univ J Med. 1997;14(2):359-369. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.359

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Abstract PDF: We studied the expression of the cell surface antigen associated with myeloid and lymphoid leukemias on bone marrow or peripheral blood blast cells from 153 leukemic patients including 61 cases of acute myelogenous leukemias(AML), 46 of acute lymphocytic leukemias(ALL) and 12 of acute leukemias. They were analyzed by direct or indirect immunofluorescence method for reactivity with the monoclonal antibodies to B cells(CD10, CD19, SmIg), T cells(CD2, CD5, CD7, CD3, CD4, CD8), myeloid antigen(CD13, CD14, CD33, CD61) and a nonspecific antigen, HLA-DR. Lymphoid associated markers detected on AML is CD7 32.8%, CD10 14.8%, CD5 13.1%, CD2 6.6% and CD19 1.6%. TdT was positive in 4.9% of AMLs. Hybrid leukemias were 8 cases out 61 AML cases and were mainly composed of monocytic lineage, M4 and M5a. Myeloid markers detected in ALL were CD13 2.2% and CD33 2.2%. In this study, immunologically classified ALLs were composed of 65.2% of CALLA (+) B precursor type, 10.9% of CALLA (-) B precursor pattern, 8.7% of T cell type, 2.2% of B cell type, 4.5% of mixed lymphoid lineage(B&T), 2.2% of undifferentiated leukemia, and 6.5% of hybrid leukemia. Twelve cases of acute leukemias ware finally diagnosed to be 5 cases of hybrid leukemia, 3 cases of B lineage, 3 case of T lineage and 1 case of mixed lymphoid(B&T) leukemia. In summary, we think the best method for typing acute leukemias is by using a combination of FAB classification and immunophenotying.

Gastroenterology and Hepatology
Subtypes of Hepatitis B Surface Antigen Among Chronic Liver Disease.: Hee Soon Cho, So Yeo Kim, Chae Hoon Lee, Kyung Dong Kim, Chung Sook Kim; Yeungnam Univ J Med. 1996;13(2):272-278. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.272

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Abstract PDF: Four subtypes of hepatitis B surface antigen are useful in the epidemiologic studies of the route of virus transmission and clinical significance of simultaneous occurance of hepatitis B surface antigen and antibody to hepatitis B surface antigen in the same serum as well as useful marker for population migration. The sera were obtained from 214 HBs Ag positive patients who are diagnosed as chronic liver disease and following up in the Yeungnam university hospital. The subtypes were determined by solid-phase sandwich EM using monoclonal antibodies. Among 214 specimens, the subtype adr was 93.9%, adw was 2.8%, ayr was 0.9%, ar was 0.9%, adwr was 1.4% and ayw was not detected. There were no correlation between subtype pattern and disease. In summary, the subtype adr was prominent in our study and the difference of subtype pattern by severity of disease was not significant. However, to determine the prognostic value of HBs Ag subtype and relationship between subtype and disease progression, long-term follow up will be needed.

Laboratory Medicine
Evaluation of Automated ESR Measuring system, SEDIsystem(TM).: Jung Ee Lee, Kyung Dong Kim, Chae Hoon Lee, Chung Sook Kim; Yeungnam Univ J Med. 1996;13(1):110-115. Published online June 30, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.1.110

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Abstract PDF

The ESR is one of the oldest laboratory test still in use. Although it lacks specificity in diagnosis, it can be effective for monitoring disease activity and following-up. The Westergren method is used for reference method, however coefficient of variation has been described 0.8% to 22.9% according to the literature. Since the ESR was invented in 1921, measurement technique has developed and automated measurement is introduced. We analyzed one hundred forty-three patient samples using SEDIsystem' automated ESR measuring system and compared with modified Westergren and Wintrobe methods. Comparison between SEDIsystem' and modified Westergren for ESR measurement yields the following regression equation; y = 0.863x - 1.69 (r=0.830), SEDIsystem'M and Wintrobe y'= 1.14x - 14.7 (r=0.789), rcspectively. We repeated measurement to evaluate reliability, results are not significant in statistically. In conclusion, SEDIsysten' automated ESR measurement correlated with modified Westergren and Wintro" ; methods, reveal reliable results after 4 hours and can report rapidly for large samples. Thus, these results indicate that SEDIsystenT"' automated ESR measurement may be useful tool for clinical practice.

Citations

Citations to this article as recorded by

Relaxation function and dynamic exponent for discrete growth models
Jin Min Kim, Jae Hwan Lee, In-mook Kim, Jin Yang, Youngki Lee
Physica A: Statistical Mechanics and its Applications.2000; 278(3-4): 304. CrossRef

Infectious Disease
Prevalence of HBV DNA in Packed Red Blood Cells.: Chae Hoon Lee, Chung Sook Kim, Dal Ho Song; Yeungnam Univ J Med. 1995;12(2):339-346. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.339

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Abstract PDF: Assays for HBsAg, HBV DNA, anti-HBc and anti-HBs of 285 units of packed red blood cells supplied by Taegu Red Cross Blood Center were performed to evaluate the correlation between the prevalence of HBV DNA and the serologic markers for hepatitis B virus. None of 285 plasma samples was positive for HBsAg, however, HBV DNA were detected by polymerase chain reaction in 2 samples which both presented only with anti-HBc positivity.. Of 204 samples tested for anti-HBs, 96 samples(47.1%) were positive and among 216 samples tested for anti-HBc, 80 samples(37.0%) were positive. Of 193 samples tested for both anti-HBs and anti-HBc, 80(41.1%) were all negative and 48(24.9%) were positive on both tests. Those samples which showed positivity only to anti-HBc were 25(13.0%). Considering the above results, transfusion-transmitted hepatitis B virus infection could be prevented by discarding anti-HBc positive blood, however, that may bring insufficient supply of donor bloods in the country like Korea where the prevalence of anti-HBc is high. Anti-HBc positive blood unequivocally positive for anti-HBs should be considered noninfectious for HBV and should be allowed to be transfused. It would reduce the amount of discarding donor blood as the routine blood donor screening tests presently used at Korea Red Cross Blood Center supplemented by anti-HBs and anti-HBc testing.

Cardiology and Cardiovascular Medicine
Diagnostic Efficiency of Lactate Dehydrogenase, Crreatine Kinase and Troponin T in Acute Myocardial Infarction.: Chae Hoon Lee, Kyung Dong Kim, Chung Sook Kim; Yeungnam Univ J Med. 1995;12(1):48-55. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.48

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Abstract PDF: The present study was designed to evaluate the efficiency of total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio, CK-MB and newly developed troponin T in acute myocardial infarction. The level of troponin T was 0.010.02 pg/L in 34 healthy person, but the peak vaule of acute myocardial infarction ranged in 4.7-24.2 pg/L. Total lactate dehydrogenase was peaked in 1 to 3 days after chest pain and then progressively decreased, but LD1/LD2 ratio was persistently higher than 1.0 for 10 days in most patients. Total creatine kinase and CK-MB were peaked in 1-2 days, and normalized in 3-4 days, so they, were useful in early diagnosis of acute myocardial infarction, but not for the late stages of acute myocardiz l infarction. Troponin T is early elevated and persistently high level for more than 10 days. Comparing with total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio and CK-MB, troponin-T test improves the efficiency of serodiagnostic method for the detection of ischemic myocardial damage.

Laboratory Medicine
Comparison study of AAS and ISE method in the lithium analysis of serum and urine.: Soo In Lee, Chae Hoon Lee, Kyung Dong Kim, Chung Sook Kim; Yeungnam Univ J Med. 1993;10(2):409-416. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.409

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Abstract PDF: In the method for lithium (Li) analysis, flame emission photometry and atomic absorption spectrophotometry (AAS) have been used most frequently. In addition, lithium can be analyzed by ion-selective electrode (ISE) or fluorscence polarization immunoassay. We evaluated the comparison between AAS method based on the principle of absorption of light at 670.8 nm by Li and ISE method based on the principle of voliage difference generated by Li in contact with lithium ionophore. We compared with those obtained by AAS (AA/AE Spectrophotometer 551, Instrumentation Laboratory Co.) and ISE (SYNCHRON EL-ISE, Beckman Co.) in the serum and urine of 6 pati,,:nts- and evaluated time-related changes of serum lithium concentration after dosing in both methods. The results are summarized-as follows: 1. In within-run precision study for lithium concentration, coefficient variations (CVs, %) ranged from 1.34 to 2.17 for AAS and from 0.34 to 0.85 for ISE method. In between-run precision study for lithium concentration, CVs ranged from 1.23 to 1.72 for AAS and from 0.61 to 1.38 for ISE method. 2. The correlation study between AAS and ISE method resulted in Y= 0.946X+ 0.137 (N = 32, r= 0. 933, X= AAS, Y= ISE) for serum lithium and Y= 1. 092X+ 0. 977 (N= 28, r= 0.943, X= AAS, Y= ISE) for urine lithium. 3. Time-related changes of serum lithium concentration in both AAS and ISE method resulted in peak serum levels about 2 hours after dosing and then rapidly decreased after the peak serum level and finally arrived at nearly initial levels about 9 hours after dosing. 4. The reference range of serum lithium was found as undetectable level for both AAS and ISE method and the reference range of urine lithium to the urine creatinine was 0 0.00014 mmol/mg(mean 0.00002 mmol/mg) for AAS method.

Laboratory Medicine
Results of secondary antibiotics susceptibility test for gram negative bacilli resistant to primary susceptibility test in Yeungnam University Hospital.: Chung Sook Kim, Kyung Dong Kim, Chae Hoon Lee; Yeungnam Univ J Med. 1993;10(1):28-36. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.28

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Abstract PDF: Major pathogenic Gramnegative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gramnegative bacilli, which had been isolated in Yeungnam Uni rersity Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicoi, ampicillin, eephaiothin,- geniamicitt, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofloxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms (53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime (37.1%), aztreonam (11. %), ciprofloxacine (7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gramnegative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.

Laboratory Medicine
Serum Angiotensin-Coverting Enzyme Levels in Coal Worker's Pneumoconiosis.: Kyung Dong Kim, Myung Sook Choi, Chae Hoon Lee, Chung Sook Kim, Eun Kyung Bae; Yeungnam Univ J Med. 1989;6(1):109-119. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.109

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Abstract PDF: We measured fasting Serum Angiotensin-Converting Enzyme (SACE) in 100 healthy controls and 75 coal worker's pneumoconiosis (CWP) patients by a commercial kits (ACEcolor®, Fujirio Inc., Japan) and evaluated this manual method. The linear range extends to an activity of 80U/L. Precision on a commercial control serum (ACE control-N®, Sigma Co.) with a mean value of 9.47U/L yielded a within-run and between-run CVs are 5.6% (N=15) and 6.9% (N=14) respectively. Save in 75 CWP was 20.3±5.7U/L (mean±s.d.); higher than in healthy controls (13.4±3.9U/L, P<0.01). No correlation was found between SACE, sex, and age. The results suggest that the measurement for SACE and follow-up SACE in coal workers may be a useful diagnostic tools for CWP.

Cardiology and Cardiovascular Medicine
Extra-LDH Isoenzyme(LD₆) in Myocardial Infarction with Serious Course: Two cases report.: Kyung Dong Kim, Myung Sook Choi, Chae Hoon Lee, Chang Ho Jeon, Chung Sook Kim, Young Jo Kim; Yeungnam Univ J Med. 1988;5(2):247-254. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.247

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Abstract PDF: Serum lactate dehydrogenase isoenzyme are separated 5 fractions (LD1-LD5) in normal serum by agarose electrophoresis. An unusual band on the cathodic side of LD5 isoenzyme has been found on lactate dehydrogenase electrophoresis is of serum, called LD6, and the presence of which signifies a poor prognosis for the patients of myocardial infarction. In recent, we have experienced LD6 in two patients with myocardial infarction. Cardiac arrest was noted within 24 hours after exhibition of LD6 extra band and they did not recover from their illness.

Hematology
A Case of Pure Red Cell Aplasia.: Myung Sook Choi, Chae Hoon Lee, Chang Ho Cheon, Kyung Dong Kim, Chung Sook Kim, Myung Soo Hyun; Yeungnam Univ J Med. 1988;5(2):239-246. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.239

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Abstract PDF: Pure red cell aplasia in uncommon disorder characterized by finding of anemia, absence of nucleated red blood cell in the marrow, absence of reticulocytes in the peripheral blood and normal peripheral platelet and leukocytes counts. We experienced one case of pure red cell aplasia associated with hemolytic anemia characterized by hemoglobinuria, reticulocytopenia, and erythroid hypoplasia of the bone marrow. The cause of the illness was not definitely identified, but we concluded that this patient had simultaneous occurrence of PRCA and hemolytic anemia following administration of diphenylhydantoin after craniotomy rather than virus or bacteria induced. The simultaneous occurrence of PRCA and hemolytic anemia in uncommon and the mechanism for diphenylhydantoin induced PRCA and hemolytic anemia is unclear.

Laboratory Medicine
Analysis of the Results of Blood Cultures, 1984~1987 at Yeungnam University Hospital.: Chung Sook Kim, Chae Hoon Lee, Myung Sook Choi, Chang Ho Cheon, Kyung Dong Kim; Yeungnam Univ J Med. 1988;5(1):49-60. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.49

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Abstract PDF: Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.

Laboratory Medicine
Diagnostic Significance of Cold Agglutinin and Antimycoplasma Antibody for Mycoplasma pneumoniae Infection.: Chung Sook Kim, Chae Hoon Lee, Chang Ho Jeon, Eun Kyung Bae, Seak il Hong; Yeungnam Univ J Med. 1987;4(1):97-103. Published online August 31, 1987; DOI: https://doi.org/10.12701/yujm.1987.4.1.97

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A study to evaluate the diagnostic significance of M. pneumoniae Infection by measurements of cold agglutinin and antimycoplasma antibody titers is performed with 191 pediatric patients who have visited Yeungnam University Hospital during the period through January to July, 1987. Forty eight of 191 cases made follow up tests feasible. The results obtained are as follows: 1. It is necessary to perform routine combined measurements of cold agglutinin and antimycoplasma antibody titers for the all pediatric pneumonia caser since a large proportion of pneumonia in children is caused by M. pneumonia. 2. For the diagnosis of M. pneumoniae Infection, measurements of cold agglutinin titer alone seems to be less significant than to check both cold agglutinin and antimycoplasma antibody titers. 3. The measurement of antimycoplasma antibody titer appeared to be more specific than cold agglutinin test in the diagnosis of M. pneumoniae Infection. 4. The present study urges the necessity of follow up study of cold agglutinin and antimycoplasma antibody titer for those who initially presented with normal titers in both tests, but are clinically suspected for M. pneumoniae Infection.

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Mycoplasma pneumoniae pneumonia in Korean children, from 1979 to 2006-a meta-analysis
Jin Woo Kim, Hyun Kyong Seo, Eun Gyong Yoo, Sung Jin Park, So Hwa Yoon, Hye Young Jung, Man Yong Han
Korean Journal of Pediatrics.2009; 52(3): 315. CrossRef

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