Journal of Yeungnam Medical Science

Hee Soon Cho

11 Articles

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.

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.

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.

A Case of Multiple Myeloma with AL Amyloidosis Successfully Treated with Autologous Stem Cell Transplantation: Ha-young Lee, Kyung Hee Lee, Min Kyoung Kim, Hee Soon Cho, Myung Soo Hyun; Yeungnam Univ J Med. 2007;24(2 Suppl):S676-682. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S676

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Abstract PDF: Myeloma is a disease of neoplastic B lymphocytes that synthesize abnormal amounts of immunoglobulin (Ig) or Ig fragments. Ten to twenty percent of myeloma patients are known to develop clinical evidence of amyloid-light chain(AL) amyloidosis. A high index of suspicion, however, is needed to make a diagnosis of amyloidosis. We report a case of multiple myeloma with AL amyloidosis successfully treated with autologous stem cell transplantation. In our case, the patient presented with longstanding abdominal discomfort and anterior chest pain. Chest X-ray showed several osteolytic changes on ribs. Endoscopic biopsy revealed massive amyloid deposits in the wall of stomach and rectum. Serum/urine protein electroporesis and bone marrow biopsy confirmed the diagnosis of multiple myeloma. At 18 months after high dose chemotherapy and autologous stem cell transplantation(ASCT), the patient maintained a complete response. In patients with multiple myeloma with AL amyloidosis, high dose chemotherapy and ASCT can be effective treatment strategy.

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).

A Case of Mercury Intoxication Associated with Pernicious Anemia.: Kyoung Ae Chang, Hyun Do Kim, Sun Jung Mun, Dong Hee Kim, Sung Ho Chun, Ha Young Lee, Dong Woon Bae, Hee Soon Cho, Kyung Hee Lee, Myung Soo Hyun; Yeungnam Univ J Med. 2006;23(1):103-107. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.103

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Abstract PDF: Pernicious anemia is the frequent cause of megaloblastic anemia, and it is the result of a vitamin B12 deficiency due to the decrease or absence of intrinsic factor (IF) because of gastric mucosa atrophy or autoimmune destruction of IF-producing parietal cells. With the existence of a severe gastric atrophy, there is a decreased in acid and IF production and a further change in vitamin B12 absorption. Mercury is ubiquitous in nature and exists in 3 forms, elemental mercury, inorganic salts and organic compounds. Organic forms, specifically methyl mercury, are the most toxic of the 3 classes of mercurials. Methyl mercury exerts its most devastating effect on the central nervous system by causing psychiatric disturbances, ataxia, visual loss, hearing loss, and neuropathy. We report a case of mercury intoxication associated with pernicious anemia. The 77 years old patient was referred to Yeungnam University Hospital for tongue pain, somatitis, headache and aggressive behavior. He had taken an unevaluated medicine for a long time. After clinical evaluation, this case was diagnosed as a pernicious anemia and the unevaluated medicine was made up of mercury. After the administration of D-penicillamine and intramuscular injection of BAL and cobalamine, clinical symptoms and aggressive behavior were improved as well as laboratory findings.

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.

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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

A Case of Congenital Factor VII Deficiency Presented with Subacute Subdural Hematoma.: Min Kyoung Kim, Sang Jun Shin, Kyung Ok Kim, Kyung Hee Lee, Myung Soo Hyun, Hee Soon Cho; Yeungnam Univ J Med. 2004;21(2):231-236. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.231

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Abstract PDF

A congenital factor VII deficiency is a rare disorder with an estimated incidence in the western contries of one in 500, 000. Because factor VII is important in initiation the coagulation cascade, a factor VII deficiency can result in significant bleeding with prolongation of the prothrombin time. We present a case of a factor VII deficiency with a subdural hematoma in an 18-year-old boy whose plasma activity of factor VII was < or =10%. Previously, he did not have any symptoms, such as hemarthrosis, easy bruising or bleeding after a minor trauma. He was administered fresh frozen plasma and a trephination was performed. His sister also had 51% lower level of factor VII.

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A forgotten or minimized head trauma, rather than a mild FVII deficiency, is the most likely cause of a subdural hematoma
A. Girolami, S. Ferrari, E. Cosi, A.M. Lombardi
Blood Cells, Molecules, and Diseases.2016; 60: 73. CrossRef
A case of intracranial hemorrhage in a neonate with congenital factor VII deficiency
Won Seok Lee, Young Sil Park
Korean Journal of Pediatrics.2010; 53(10): 913. CrossRef

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.

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.

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.

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