Background/Aims: We investigated the risk of multidrug-resistant, gram-negative bacteria (MDRGNB) in hospitalized elderly patients from non-hospital long-term care facilities (LTCFs) and the antibiotic prescription pattern. Methods: All clinical cultures obtained within 48 hours of hospitalization from elderly patients of at least 55 years of age arriving at a 623-bed, public teaching hospital in Seoul, Republic of Korea from LTCFs between April 1, 2011 and April 1, 2012 were collected retrospectively. Results: During this period, 365 elderly persons from 13 LTCFs were hospitalized. This study enrolled 135 patients who had cultures performed. In this group, 27.4% harbored MDRGNB at hospitalization. The presence of MDRGNB during prior hospitalization was the only risk factor that predicted harboring it (p = 0.043, odds ratio = 5.00, confidence interval = 1.049-23.834). Combinations of antibiotics or carbapenems were used initially in 35.6% of the patients, and this did not affect the mortality rate in this population. Conclusions: Hospitalized elderly patients from non-hospital LTCFs need more attention. Judicious antibiotic selection is needed according to the risk factor of harboring MDRGNB for antibiotics stewardship.
A role of angiotensin-converting enzyme 2 (ACE2) in the coronavirus disease 2019 pandemic has been suggested, because it is the molecular receptor for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2). ACE2 is known to provide a protective effect for cardiac and vascular tissues, because it generally counteracts angiotensin II (Ang II) activity. ACE2 downregulation has been implicated in the pathogenesis of cardiovascular disease. ACE inhibitors and angiotensin receptor blockers may enhance ACE2 mRNA expression and enzyme activity. However, this has not been demonstrated in lung tissue. In the lungs, Ang II induces vasoconstriction to prevent ventilation perfusion mismatch, while also increasing vascular permeability (which can precipitate pulmonary edema). ACE2 is expressed in 0.67% of human lung cells, 80% of which are type 2 alveolar cells. Men (of all ethnicities) and Asian individuals have been shown to express higher levels of ACE2 than women and non-Asian individuals, respectively. However, there are no data from human studies indicating that high ACE2 expression increases the likelihood of SARS-CoV2 infection. In animal studies, an increase in Ang II caused by SARS-CoV2 or spike protein interactions, in turn due to ACE2 downregulation, has been identified as the key mechanism underlying lung injury. In human studies of SARS-CoV2 infection, ACE2 overexpression was shown to cause inflammatory apoptosis and a cytokine storm. The actions of ACE2 and Ang II in SARS-CoV2-infected vascular and lung tissues differ between animals and humans. ACE2 expression levels pre- and post-SARS-CoV2 infection should be differentiated.
․신진호 2) ․양금철 3) 1) 2) 공주대학교 대학원․ 3) 공주대학교 건설환경공학부 ABSTRACT This study suggested the planting model of Zelkova serrata communities in the areas with the warmth index of both 80~100 and 100~120°C․month. Warmth index was calculated with 449 weather points using inverse distance weighted interpolation method. The planting species were selected by correlation analysis between Z. serrata and each species of four or more frequency among the 36 relevé surveyed for this study. The result of this study is summarized as follows: Warmth index of Z. serrata communities was among 74~118°C․month. Results of the correlation analysis between Z. serrata and each species observed that the Z. serrata belongs to the tree layer with warmth index of 80~100 and 100~120°C․month. On the other hand, the species of Carpinus laxiflora, Quercus serrata, Prunus sargentii and Platycarya strobilacea appeared only in the tree layer with warmth index of 80~100°C․month. Z. serrata and Styrax japonica appeared in the subtree layer with the warmth index of 80~100 and 100~120°C․month, while Acer pseudosieboldianum, Lindera erythrocarpa, Acer mono, Quercus serrata, etc. appeared in the subtree layer with the warmth index of 80~100°C․month. Z. serrata, Ligustrum obtusifolium, Lindera obtusiloba, Callicarpa japonica and 공석준․신진호․양금철 78 Zanthoxylum schinifolium all appeared in the shrub layer with the warmth index of 80~100 and 100~ 120°C․month. Lindera erythrocarpa, Orixa japonica, Staphylea bumalda, Akebia quinata and Sorbus alnifolia appeared in the shrub layer with the warmth index of 80~100°C․month and Styrax japonica and Stephanandra incisa appeared in the shrub layer with the warmth index of 100~120°C․month.The numbers of each species planted in a 100m 2 area of the Z. serrata community were suggested as follows:five in tree layer, five in subtree layer and nine in shrub layer. The average area of canopy are suggested to be about 86m 2 for tree layer, 34m 2 for subtree layer and 34m 2 for shrub layer.
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