Multiple Opportunistic Infections Related to Hypercortisolemia due to Adrenocortical Carcinoma: A Case Report / 감염과화학요법

Cushing's syndrome is characterized by excessive cortisol and immuno-suppression.We experienced a case of Cushing's syndrome caused by adrenocortical carcinoma that was complicated by multiple opportunistic infections. A 37-year-old woman with adrenocortical carcinoma (ACC) presented with decreased mental ability and high fever one week after undergoing chemotherapy. Her initial blood culture revealed methicillinresistant Staphylococcus aureus (MRSA) bacteremia accompanied by septic pneumonia. We admitted her to the intensive care unit and treated her for invasive pulmonary aspergillosis (IPA), Pneumocystis jirovecii pneumonia (PJP), candidemia, and Stenotrophomonas maltophilia pneumonia with broad-spectrum antibiotics and antifungal agents. Nevertheless, her clinical course worsened and she died. Herein, we report a case of Cushing's syndrome associated with cortisol-secreting ACC that presented with multiple opportunistic infections, including MRSA bacteremia, septic pneumonia, candidemia, PJP, and IPA, illuminating a relationship between hypercortisolemia and opportunistic infections.

Optimization of Fungal Enzyme Production by Trichoderma harzianum KUC1716 through Surfactant-Induced Morphological Changes

The morphological optimization of Trichoderma harzianum was carried out using several surfactants to achieve increased cellulase production. Addition of the surfactants to the culture medium successfully modified the fungal morphology from an aggregated form to a dispersed form. Optimization of the fungal morphology increased cellulase activity up to 177%. The morphologically optimized conditions enhanced the accessibility of the fungus to substrates and thus promoted cellulase production.

Five New Records of Soil-Derived Trichoderma in Korea: T. albolutescens, T. asperelloides, T. orientale, T. spirale, and T. tomentosum

Despite the huge worldwide diversity of Trichoderma (Hypocreaceae, Ascomycota), only about 22 species have been reported in Korea. Thus, between 2013 and 2015, soil-derived Trichoderma spp. were isolated to reveal the diversity of Korean Trichoderma. Phylogenetic analysis of translation elongation factor 1 alpha gene was used for identification. Among the soil-derived Trichoderma, Trichoderma albolutescens, T. asperelloides, T. orientale, T. spirale, and T. tomentosum have not been previously reported in Korea. Thus, we report the five Trichoderma species as new in Korea with morphological descriptions and images.

Wood Decay Fungi in South Korea: Polypores from Seoul

In Seoul, a majority of plant communities have undergone significant changes over the last few decades; however, how wood decay fungi have responded and adapted to the changes in vegetation remains unknown. Through an ongoing investigation of Korean indigenous fungi, ca. 300 specimens with poroid basidiocarp were collected in Seoul during 2008~2012. Morphological examination and molecular analysis using the internal transcribed spacer and nuclear large subunit ribosomal DNA region sequences helped identify 38 species belonging to 28 genera, 10 families, and 5 orders in this area. Among them, three polypores, Abundisporus pubertatis, Coriolopsis strumosa, and Perenniporia maackiae were found to be new to South Korea.

A Belt-type Biomedical Mobile Device / 대한의료정보학회지

OBJECTIVE: To investigate a belt-type, biomedical mobile device capable of measuring patients' biomedical signals and sending the biomedical data to a remote medical server. This device was designed to measure and record ECG and motion signals continuously for a moving subject and, on in the event of an emergent situation, to notify a remote doctor of the situation by transmitting data on the emergent situation to a remote server through a CDMA network. METHODS: The developed system is composed of three parts: biomedical signal acquisition, biomedical data recording, and data transmission. We conducted four types of experiment in order to evaluate the developed system's accuracy, reliability, operability, applicability to daily life, and SMS alarm function. First, we tested the accuracy of the R-R interval by comparing the signals measured via the developed system with those via a commercialized ECG system while the subjects were sitting, standing, lying or cycling. Second, we tested the reliability of the transmitted data to the remote server when two types of emergent events are generated in the developed system using a patient simulator, and measured the battery life to determine the system life. Third, we experimentally examined the accuracy of the corresponding data transmitted to the remote server via the CDMA network when two types of event are generated for each of seven types of action (sitting, standing, standing up from the seat, ordinary walking, fast walking, cycling, and running) during daily life. Lastly, we tested the SMS alarm function. RESULTS: The acquisition and comparison of the subjects' biomedical signals and motion signals confirmed the accuracy, reliability, operability and applicability of the developed system to daily life. The ability of the system to monitor the ECG signals and motion signals during daily life was also demonstrated. CONCLUSION: The system was demonstrated to be very applicable to subjects requiring continuous monitoring for chronic disease and health management. Therefore, the developed system is expected to play an important role in building ubiquitous healthcare systems in Korea in the near future.

A PDA-Based Wireless ECG Monitoring System for u-Healthcare / 대한의료정보학회지

OBJECTIVE: The purpose of this study is to design a portable ECG monitoring system, which integrates up-to-date PDA and RF communication technology, and to acquire the subject's biomedical signal without any constraint. METHODS: The developed system is composed of a transmitter and a receiver. The transmitter has a MCU (microcontroller), three-axial acceleration sensor, ECG amplifier and Zigbee communication controller. It has two types of transmission mode, which are total signal transmission mode and HR (heart rate)/SC (step count) transmission mode. The receiver has a MCU, Serial Communication IC, and Zigbee communication controller. It forwards the received data to PDA, where the data can be stored and displayed. RESULTS: In total signal transmission mode, it can send data 60 packets per second whose transmission speed corresponds to 300 ECG samples and 60 acceleration samples. In HR/SC transmission mode, it can calculate heart rate from ECG data with 216 samples per second and step count from acceleration data and send a packet every cardiac cycle. CONCLUSION: Using this device, a new method of remote monitoring both vital sign and activity is realized. A PDA-based wireless ECG system enables patients to be monitored during their daily living, without any constraints. Also, this method will reduce medical costs in the aged society.

Development Brief of Embedded Computing Technology for Mobile Wi reless Biotelemetry / 대한의료정보학회지

Embedded computing and wireless communication technology were used to develop a mobile biotelemetry system, featuring the functions of mobile measurement, wireless transmission, database archival, and internet retrieval of biomedical signals. Two PPCs (Pocket PC) with WLAN (wireless LAN) PC cards were used to simulate the communicating situation of biomedical signals between wireless sensors and a personal monitor. A PPC client program simulated the wireless sensors and a PPC server program simulated the personal medical monitor. Medical PDA was implemented by SBC (single board computer), LCD display, touch screen and Bluetooth module. Windows CE.net was ported as its operating system and the application program was developed using embedded Visual C++ 4. The measured transmission speed of ECG data was 2150 samples per second in the WLAN environment. For wireless internet connection, a Web-based server program was developed, able to display the biomedical signals of remote patients and be remotely monitored by medical doctors in a distant hospital. PDA data, which was archived at the server's database table, was transformed to an XML message and could be displayed on a Web browser as a signal graph. This system would be very useful for patients with chronic illness, especially in an emergent environment, and for containing medical cost in the aged society.