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Article ; Online: Changes in practice for mechanically ventilated patients: effect of the pain, agitation, and delirium guidelines.

Huh, Jin Won

2022 Volume 37, Issue 3, Page(s) 553–554

MeSH term(s)	Delirium/diagnosis ; Delirium/etiology ; Delirium/therapy ; Humans ; Pain ; Prospective Studies ; Republic of Korea ; Respiration, Artificial
Language	English
Publishing date	2022-04-28
Publishing country	Korea (South)
Document type	Editorial ; Comment
ZDB-ID	639023-7
ISSN	2005-6648 ; 1226-3303
ISSN (online)	2005-6648
ISSN	1226-3303
DOI	10.3904/kjim.2022.143
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Article ; Online: Contributed Session II: Immune cell speed changes over 5 orders of magnitude in response to inflammation in the retina.

Dholakia, Kosha / Huh, Jin Won / Schallek, Jesse

Journal of vision

2023 Volume 23, Issue 11, Page(s) 23

Abstract: Inflammation in vascularized tissues is mediated by circulating immune cells that are recruited to damaged tissue. Immune cells undergo dramatic changes in speed and motility indicating the severity and staging of inflammation. Here, we characterize the ... ...

Abstract	Inflammation in vascularized tissues is mediated by circulating immune cells that are recruited to damaged tissue. Immune cells undergo dramatic changes in speed and motility indicating the severity and staging of inflammation. Here, we characterize the spectrum of retinal leukocyte kinetics in response to an acute inflammatory stimulus using adaptive optics scanning light ophthalmoscopy (AOSLO) in living mice. C57BL/6J male mice were injected intravitreally with 1 µL lipopolysaccharide (LPS) and imaged at 6, 24 and 72 hours after LPS injection using phase contrast and fluorescence AOSLO. Speed of circulating leukocytes (n= 286 cells, 2 mice) was measured with 15kHz point-scan imaging using automated approach (Joseph et al. 2019). Rolling leukocytes (n=300 cells, 5 mice, 6 hrs after LPS) and extravasated cells (n=92 cells, 8 mice) were visualized with time-lapse imaging and manually tracked using ImageJ. Using our custom AOSLO, we observed leukocyte speeds spanning 5 orders of magnitude in the living retina. The fastest speeds were the circulating leukocytes (13,257.37 ± 7,086.41 µm/s). After LPS, leukocytes roll along the venular wall, where cell speed was 1000x slower (11.45 ± 7.45 µm/s.) When immune cells extravasated into the tissue, cell speed dropped further by 100x (0.3 ± 0.15 µm/s). Observed leukocyte speeds cluster around three distinct velocity bands that stratify the unique and purposeful behavior of these cells as they progress through the inflammatory cascade.
MeSH term(s)	Male ; Animals ; Mice ; Mice, Inbred C57BL ; Lipopolysaccharides/pharmacology ; Inflammation/diagnostic imaging ; Kinetics ; Retina/diagnostic imaging
Chemical Substances	Lipopolysaccharides
Language	English
Publishing date	2023-09-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2106064-2
ISSN	1534-7362 ; 1534-7362
ISSN (online)	1534-7362
ISSN	1534-7362
DOI	10.1167/jov.23.11.23
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Article: Age distribution and clinical results of critically ill patients above 65-year-old in an aging society: A retrospective cohort study.

Lee, Song I / Huh, Jin Won / Hong, Sang-Bum / Koh, Younsuck / Lim, Chae-Man

Tuberculosis and respiratory diseases

2024

Abstract: Background: Increasing age has been observed among patients admitted to the intensive care unit(ICU). Age traditionally considered a risk factor for ICU mortality. We investigated how the epidemiology and clinical outcomes of older ICU patients have ... ...

Abstract	Background: Increasing age has been observed among patients admitted to the intensive care unit(ICU). Age traditionally considered a risk factor for ICU mortality. We investigated how the epidemiology and clinical outcomes of older ICU patients have changed over a decade. Methods: We analyzed patients admitted to the ICU at a university hospital in Seoul, South Korea. We defined patients aged 65 and older as older patients. Changes in age groups and mortality risk factors over the study period were analyzed. Results: A total of 32,322 patients were enrolled who aged ≥ 65 years admitted to the ICUs between January 1, 2007, and December 31, 2017. Patients aged 65 years accounted for 35% and of these, the older(O: 65-74 yrs) comprised 19,630(66.5%), very older(VO: 75-84 yrs) group 8,573(29.1%), and very very older(VVO: 85 years) group 1,300(4.4 %). The mean age of ICU patients over the study period increased(71.9±5.6yrs in 2007 vs. 73.2±6.1yrs in 2017) and the proportions of the VO and VVO group both increased. Over the period, the proportion of female increased(37.9% in 2007 vs. 43.3% in 2017), and increased ICU admissions for medical reasons(39.7% in 2007 vs. 40.2% in 2017). In-hospital mortality declined across all older age groups, from 10.3% in 2007 to 7.6% in 2017. Hospital length of stay(LOS) decreased in all groups, but ICU LOS decreased only in the O and VO groups. Conclusion: The study indicates a changing demographic in ICUs with an increase in older patients, and suggests a need for customized ICU treatment strategies and resources.
Language	English
Publishing date	2024-02-29
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2161256-0
ISSN	1738-3536 ; 0378-0066
ISSN	1738-3536 ; 0378-0066
DOI	10.4046/trd.2023.0155
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Article: Predictors of Repeat Medical Emergency Team Activation in Deteriorating Ward Patients: A Retrospective Cohort Study.

Lee, Ju-Ry / Jung, Youn-Kyung / Hong, Sang-Bum / Huh, Jin Won

Journal of clinical medicine

2022 Volume 11, Issue 6

Abstract: Recurrent clinical deterioration and repeat medical emergency team (MET) activation are common and associated with high in-hospital mortality. This study assessed the predictors for repeat MET activation in deteriorating patients admitted to a general ... ...

Abstract	Recurrent clinical deterioration and repeat medical emergency team (MET) activation are common and associated with high in-hospital mortality. This study assessed the predictors for repeat MET activation in deteriorating patients admitted to a general ward. We retrospectively analyzed the data of 5512 consecutive deteriorating hospitalized adult patients who required MET activation in the general ward. The patients were divided into two groups according to repeat MET activation. Multivariate logistic regression analyses were used to identify the predictors for repeat MET activation. Hematological malignancies (odds ratio, 2.07; 95% confidence interval, 1.54-2.79) and chronic lung disease (1.49; 1.07-2.06) were associated with a high risk of repeat MET activation. Among the causes for MET activation, respiratory distress (1.76; 1.19-2.60) increased the risk of repeat MET activation. A low oxygen saturation-to-fraction of inspired oxygen ratio (0.97; 0.95-0.98), high-flow nasal cannula oxygenation (4.52; 3.56-5.74), airway suctioning (4.63; 3.59-5.98), noninvasive mechanical ventilation (1.52; 1.07-2.68), and vasopressor support (1.76; 1.22-2.54) at first MET activation increased the risk of repeat MET activation. The risk factors identified in this study may be useful to identify patients at risk of repeat MET activation at the first MET activation. This would allow the classification of high-risk patients and the application of aggressive interventions to improve outcomes.
Language	English
Publishing date	2022-03-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11061736
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Article ; Online: DnaJ-induced TLR7 mediates an increase in interferons through the TLR4-engaged AKT/NF-κB and JNK signaling pathways in macrophages.

Yu, Hyeonseung / Huh, Jin-Won / Bai, Fang / Ha, Un-Hwan

Microbial pathogenesis

2022 Volume 165, Page(s) 105465

Abstract: Toll-like receptor 7 (TLR7) signaling plays pivotal roles in innate immunity by sensing viral single-stranded RNA thereby triggering inflammatory signaling cascades and eliciting protective antiviral responses. In this study, we found that TLR7 ... ...

Abstract	Toll-like receptor 7 (TLR7) signaling plays pivotal roles in innate immunity by sensing viral single-stranded RNA thereby triggering inflammatory signaling cascades and eliciting protective antiviral responses. In this study, we found that TLR7 expression is highly induced in response to Pseudomonas aeruginosa (P. aeruginosa) infection in a dose- and time-dependent manner. P. aeruginosa-derived DnaJ, a homolog of HSP40, was identified as a related inducing agent for TLR7 expression, and expression of DnaJ was stimulated when host cells were infected with P. aeruginosa. Interestingly, DnaJ was not involved in mediating an increase in the expression levels of TLR3 and TLR8, other well-known antiviral receptors. The induction of TLR7 in response to DnaJ was mediated by the activation of the AKT (Thr308 and Ser473)/NF-κB and p38/JNK MAPKs signaling pathways, consequently transmitting related signals for the expression of interferons (IFNs). Of note, these antiviral responses were regulated, at least in part, by TLR4, which senses the presence of DnaJ and then promotes downstream activation of the AKT (Ser473)/NF-κB and JNK signaling cascades. Taken together, these results suggest that P. aeruginosa-derived DnaJ is sufficient to promote an increase in TLR7 expression in the TLR4-engaged AKT/NF-κB and JNK signaling pathways, thereby promoting an increased antiviral response through the elevated expression of IFNs.
MeSH term(s)	Antiviral Agents ; Interferons/metabolism ; MAP Kinase Signaling System ; Macrophages/metabolism ; NF-kappa B/metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; Pseudomonas aeruginosa/metabolism ; Toll-Like Receptor 4/genetics ; Toll-Like Receptor 4/metabolism ; Toll-Like Receptor 7/genetics ; Toll-Like Receptor 7/metabolism
Chemical Substances	Antiviral Agents ; NF-kappa B ; Toll-Like Receptor 4 ; Toll-Like Receptor 7 ; Interferons (9008-11-1) ; Proto-Oncogene Proteins c-akt (EC 2.7.11.1)
Language	English
Publishing date	2022-03-02
Publishing country	England
Document type	Journal Article
ZDB-ID	632772-2
ISSN	1096-1208 ; 0882-4010
ISSN (online)	1096-1208
ISSN	0882-4010
DOI	10.1016/j.micpath.2022.105465
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Article: Update on the Extracorporeal Life Support.

Huh, Jin-Won

Tuberculosis and respiratory diseases

2015 Volume 78, Issue 3, Page(s) 149–155

Abstract: Extracorporeal life support (ECLS) is a type of cardiopulmonary bypass. It is an artificial means of supplying oxygen and removing CO2 on behalf of damaged lungs while patients are recovering from underlying diseases. Recently, the use of ECLS is rapidly ...

Abstract	Extracorporeal life support (ECLS) is a type of cardiopulmonary bypass. It is an artificial means of supplying oxygen and removing CO2 on behalf of damaged lungs while patients are recovering from underlying diseases. Recently, the use of ECLS is rapidly increasing as this machine becomes smaller, less invasive and easier to use. In addition, the improvement of clinicians' technique and outcome is increasing their application to patients with acute respiratory distress. In this regard, the purpose of this review is to introduce the physiological principles, risk factors, and advantages of ECLS, clinical rationale for using ECLS, ventilatory strategy during ECLS, which are still causing different opinions, the weaning from ECLS, and the use of anticoagulant.
Language	English
Publishing date	2015-06-30
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2161256-0
ISSN	1738-3536 ; 0378-0066
ISSN	1738-3536 ; 0378-0066
DOI	10.4046/trd.2015.78.3.149
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Article: Gut microbiota alterations in critically Ill patients with carbapenem-resistant Enterobacteriaceae colonization: A clinical analysis.

Baek, Moon Seong / Kim, Seungil / Kim, Won-Young / Kweon, Mi-Na / Huh, Jin Won

Frontiers in microbiology

2023 Volume 14, Page(s) 1140402

Abstract: Background: Carbapenem-resistant Enterobacteriaceae (CRE) are an emerging concern for global health and are associated with high morbidity and mortality in critically ill patients. Risk factors for CRE acquisition include broad-spectrum antibiotic use ... ...

Abstract	Background: Carbapenem-resistant Enterobacteriaceae (CRE) are an emerging concern for global health and are associated with high morbidity and mortality in critically ill patients. Risk factors for CRE acquisition include broad-spectrum antibiotic use and microbiota dysbiosis in critically ill patients. Therefore, we evaluated the alteration of the intestinal microbiota associated with CRE colonization in critically ill patients. Methods: Fecal samples of 41 patients who were diagnosed with septic shock or respiratory failure were collected after their admission to the intensive care unit (ICU). The gut microbiota profile determined using 16S rRNA gene sequencing and quantitative measurement of fecal short-chain fatty acids were evaluated in CRE-positive ( Results: CRE carriers showed a significantly increased proportion of the phyla Proteobacteria and decreased numbers of the phyla Bacteroidetes as compared to the CRE non-carriers. Linear discriminant analysis (LDA) with linear discriminant effect size showed that the genera Conclusion: Critically ill patients with CRE have a distinctive gut microbiota composition and community structure, altered short-chain fatty acid production and changes in the metabolic pathways. Further studies are needed to determine whether amino acids supplementation improves microbiota dysbiosis in patients with CRE.
Language	English
Publishing date	2023-04-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2023.1140402
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Article ; Online: Pseudomonas aeruginosa

Kim, Dae-Kyum / Huh, Jin-Won / Yu, Hyeonseung / Lee, Yeji / Jin, Yongxin / Ha, Un-Hwan

International journal of molecular sciences

2023 Volume 24, Issue 21

Abstract: As members of pathogen-associated molecular patterns, bacterial heat shock proteins (HSPs) are widely recognized for their role in initiating innate immune responses. This study aimed to examine the impact of DnaJ, a homolog of HSP40 derived ... ...

Abstract	As members of pathogen-associated molecular patterns, bacterial heat shock proteins (HSPs) are widely recognized for their role in initiating innate immune responses. This study aimed to examine the impact of DnaJ, a homolog of HSP40 derived from
MeSH term(s)	Inflammasomes/metabolism ; Pseudomonas aeruginosa/metabolism ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; Signal Transduction ; Macrophages/metabolism ; NF-kappa B/metabolism ; Interleukin-1beta/metabolism
Chemical Substances	Inflammasomes ; NLR Family, Pyrin Domain-Containing 3 Protein ; NF-kappa B ; Interleukin-1beta
Language	English
Publishing date	2023-11-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms242115957
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Article ; Online: Prognosis of mechanically ventilated patients with COVID-19 after failure of high-flow nasal cannula: a retrospective cohort study.

Hyun, Dong-Gon / Lee, Su Yeon / Ahn, Jee Hwan / Hong, Sang-Bum / Lim, Chae-Man / Koh, Younsuck / Huh, Jin Won

Respiratory research

2024 Volume 25, Issue 1, Page(s) 109

Abstract: Background: There is an argument whether the delayed intubation aggravate the respiratory failure in Acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effect of high-flow nasal ... ...

Abstract	Background: There is an argument whether the delayed intubation aggravate the respiratory failure in Acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effect of high-flow nasal cannula (HFNC) failure before mechanical ventilation on clinical outcomes in mechanically ventilated patients with COVID-19. Methods: This retrospective cohort study included mechanically ventilated patients who were diagnosed with COVID-19 and admitted to the intensive care unit (ICU) between February 2020 and December 2021 at Asan Medical Center. The patients were divided into HFNC failure (HFNC-F) and mechanical ventilation (MV) groups according to the use of HFNC before MV. The primary outcome of this study was to compare the worst values of ventilator parameters from day 1 to day 3 after mechanical ventilation between the two groups. Results: Overall, 158 mechanically ventilated patients with COVID-19 were included in this study: 107 patients (67.7%) in the HFNC-F group and 51 (32.3%) in the MV group. The two groups had similar profiles of ventilator parameter from day 1 to day 3 after mechanical ventilation, except of dynamic compliance on day 3 (28.38 mL/cmH2O in MV vs. 30.67 mL/H2O in HFNC-F, p = 0.032). In addition, the HFNC-F group (5.6%) had a lower rate of ECMO at 28 days than the MV group (17.6%), even after adjustment (adjusted hazard ratio, 0.30; 95% confidence interval, 0.11-0.83; p = 0.045). Conclusions: Among mechanically ventilated COVID-19 patients, HFNC failure before mechanical ventilation was not associated with deterioration of respiratory failure.
MeSH term(s)	Humans ; Cannula ; Respiration, Artificial ; COVID-19/therapy ; Retrospective Studies ; Prognosis ; Respiratory Insufficiency/diagnosis ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-024-02671-y
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Article ; Online: Automatic adjustment of oxygen concentration during high-flow nasal cannula treatment using a targeted SpO2 feedback system.

Seo, Woo Jung / Kim, Eun Young / Seo, Ga Jin / Suh, Hee Jung / Huh, Jin Won / Hong, Sang-Bum / Koh, Younsuck / Lim, Chae-Man

Nursing in critical care

2024

Abstract: Aim: To test whether targeted SpO2 feedback (TSF), an automatic control system for fraction of inspired oxygen (FiO2), achieves more time in the optimal SpO2 range and/or reduces the frequency of manual adjustments to administered FiO2 compared with ... ...

Abstract	Aim: To test whether targeted SpO2 feedback (TSF), an automatic control system for fraction of inspired oxygen (FiO2), achieves more time in the optimal SpO2 range and/or reduces the frequency of manual adjustments to administered FiO2 compared with conventional manual titration in patients with hypoxia on high-flow nasal cannula (HFNC) therapy. Study design: Twenty-two patients were recruited from two hospitals. For each, two sessions of manual mode and two sessions of TSF were applied in a random order, each session lasting 2 h. The target SpO2 on TSF was 95%. Oxygen monitoring levels were classified into four SpO2 ranges: hypoxia (≤ 89%), borderline (90%-93%), optimal (94%-96%) and hyperoxia (≥ 97%). The two modes were compared based on the proportion of time spent in each SpO2 range and the number of manual FiO2 adjustments. Results: The proportion of time in the optimal SpO2 range was 20.5% under manual titration mode and 65.4% under TSF (p < .01). The proportions of time in the hypoxia range were 1.1% and 0.4%, respectively (p = .31), in the borderline range 4.7% and 3.5%, respectively (p = .54), and in the hyperoxia range 73.7% and 30.7%, respectively (p < .01). There were statistical differences only in the optimal and hyperoxia SpO2 ranges. During the 8 h, the frequency of manual FiO2 adjustment was 0.7 times for the manual mode and 0.2 times for TSF, showing no statistically significant difference (p = 0.076). Conclusion: Compared with manual titration, TSF achieved greater time of the optimal SpO2 and less time of hyperoxia during HFNC. The frequency of manual adjustments on TSF tended to be less than on manual titration mode. Relevance to clinical practice: Automatic closed-loop algorithm FiO2 monitoring systems can achieve better oxygen treatments than conventional monitoring and may reduce nurse workloads. In the era of pandemic respiratory diseases, this system can also facilitate contactless SpO2 monitoring during HFNC therapy.
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2011956-2
ISSN	1478-5153 ; 1362-1017
ISSN (online)	1478-5153
ISSN	1362-1017
DOI	10.1111/nicc.13033
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