The Antifungal Test: An Efficient Screening Tool for the Discovery of Microbial Metabolites with Respiratory Inhibitory Activity

Valuable natural compounds produced by a variety of microorganisms can be used as lead molecules for development of new agrochemicals. Furthermore, high-throughput in vitro screening systems with specific modes of action can increase the probability of discovery of new fungicides. In the current study, a rapid assay tested with various microbes was developed to determine the degree of respiratory inhibition of Saccharomyces cerevisiae in two different liquid media, YG (containing a fermentable carbon source) and NFYG (containing a non-fermentable carbon source). Based on this system, we screened 100 fungal isolates that were classified into basidiomycetes, to find microbial secondary metabolites that act as respiratory inhibitors. Consequently, of the 100 fungal species tested, the culture broth of an IUM04881 isolate inhibited growth of S. cerevisiae in NFYG medium, but not in YG medium. The result is comparable to that from treatment with kresoxim-methyl used as a control, suggesting that the culture broth of IUM04881 isolate might contain active compounds showing the inhibition activity for respiratory chain. Based on the assay developed in this study and spectroscopic analysis, we isolated and identified an antifungal compound (-)-oudemansin A from culture broth of IUM04881 that is identified as Oudemansiella venosolamellata. This is the first report that (-)-oudemansin A is identified from O. venosolamellata in Korea. Taken together, the development of this assay will accelerate efforts to find and identify natural respiratory inhibitors from various microbes.

Usage patterns of emergency medical services in Korea: analysis of patient flow / 中华医学杂志(英文版)

BACKGROUND@#This study used the National Emergency Department Information System (NEDIS) data to analyze the flow of emergency and critical emergency patients and to identify the patterns of emergency medical service usage in Korea.@*METHODS@#The relevance index (RI) and commitment index (CI) were calculated from the 2016 NEDIS data. In this study, the number of clusters was determined using NbClust, and cluster analysis was used to analyze the usage patterns of emergency and critical emergency patients.@*RESULTS@#The RI and CI were calculated using 8,389,766 cases of 214 districts. The results of the RI and CI suggested that there were 3 types of clusters among the emergency patients. In Cluster 1, 54 districts (25.2%) had low RI and high CI, and it was of outflow type. Cluster 2 was categorized as the influx-type in 58 districts (27.1%) irrespective of RI and low CI. Cluster 3 was categorized as the self-sufficient type found in 102 districts (47.7%), with high RI and high CI. The cluster analysis of the critical emergency patients was divided into 2 types. Cluster 1 was categorized as outflow type with high CI found in 129 districts (60.3%), while Cluster 2 was categorized as inflow type with low CI found in 85 districts (39.7%).@*CONCLUSIONS@#This study elucidates the regional status of usage patterns of emergency and critical emergency patients in Korea. This study might serve as a basis for the establishment and selection of emergency medical service areas and vulnerable emergency medical service areas.

Inflow and outflow type analysis of emergency department patients of the Honam region

OBJECTIVE: This study examined the inflow and outflow patterns of emergency department patients with si-gun-gu in the Gwangju, Jeonbuk, and Jeonnam areas. METHODS: Data from the Gwangju, Jeonbuk, and Jeonnam were extracted from the National Emergency Department Information System in 2016. The extracted data (on 42 areas in Gwangju, Jeonbuk, and Jeonnam) using the variables of the patient's address (zip code) and the emergency medical institution code (emergency medical institution address) were used to calculate the relevance index and commitment index. The calculated indices were classified into the regional types by applying NbClust and cluster analysis (K-means) of the R package. RESULTS: The relevance indices ranged from 12.5% to 90.4%, and the commitment indices ranged from 9.2% to 90.3%. The results of cluster analysis with the relevance indices and commitment indices revealed three types for 39 areas. In cluster 1, the relevance indices ranged from 43.5% to 61.6%, and the commitment indices ranged from 9.2% to 49.5%. Three out of the thirty-nine areas were classified as the inflow type. In cluster 2, the relevance indices ranged from 12.5% to 56.0% and the commitment indices ranged from 62.5% to 90.3%; 12 areas were classified as the outflow type. The areas in cluster 3 were classified as the self-sufficient type, with relevance indices ranging from 60.1% to 90.4% and commitment indices ranging from 59.0% to 89.7% for 24 areas. CONCLUSION: Three area types and 11 out of 12 areas classified as outflow types were found to be emergency medical vulnerable areas. The results of this study can be used to establish local emergency medical policies.

Analysis of Emergency Department Utilization Rate by Region, Emergency Medical Center, and Hospital Type

PURPOSE: Overcrowding in urban emergency departments (EDs) while a decline in rural EDs due to mismatch of supply and demand of emergency medical resources are still issues to date. Therefore, this study analyzed the current characteristics and reality of bed utilization in the EDs of Korea. METHODS: Real-time availability of bed information was obtained from the emergency medical resource information system. The data were extracted for 4 weeks every 3 months, from April 2014 to January 2015. We analyzed the emergency department utilization (EDU) rate of emergency medical centers and hospitals based in 16 provinces in Korea. RESULTS: A total of 14,889,750 data were included. The total EDU rate was 20.0% (9.1-43.9%). The EDU rate was 66.7% (40.0-95.0%) for regional emergency medical centers (REMC), 33.3% (15.0-63.3%) for local emergency medical centers (LEMC), 11.1% (0.0-30.0%) for local emergency medical agencies (LEMA). The EDU rate was 71.4.0% (50.0.0-96.7.0%) for tertiary general hospitals (TGH), 20.0% (10.0-36.8%) for general hospitals (GH), and 10.0% (0-20.0%) for hospital & medical centers (HMC). The REMC EDU rate was high in Seoul and Jeonbuk, and low in Jeonnam and Gyeongbuk. The LEMC utilization rate was high in Daegu and Jeonbuk. The LEMA utilization rate was high in Daegu and Ulsan. Moreover, despite the same ED type, the EDU rate of high degree hospitals was higher. CONCLUSION: The EDU rate differed by region, emergency medical center, and hospital type. We should consider investing in appropriate personnel and emergency medical resources in places with suboptimal EDU rate.

Preventive Effect of Korean Red Ginseng for Acute Respiratory Illness: A Randomized and Double-Blind Clinical Trial

Korean Red Ginseng (KRG) is a functional food and has been well known for keeping good health due to its anti-fatigue and immunomodulating activities. However, there is no data on Korean red ginseng for its preventive activity against acute respiratory illness (ARI). The study was conducted in a randomized, double-blinded, placebo-controlled trial in healthy volunteers (Clinical Trial Number: NCT01478009). Our primary efficacy end point was the number of ARI reported and secondary efficacy end point was severity of symptoms, number of symptoms, and duration of ARI. A total of 100 volunteers were enrolled in the study. Fewer subjects in the KRG group reported contracting at least 1 ARI than in the placebo group (12 [24.5%] vs 22 [44.9%], P = 0.034), the difference was statistically significant between the two groups. The symptom duration of the subjects who experienced the ARI, was similar between the two groups (KRG vs placebo; 5.2 +/- 2.3 vs 6.3 +/- 5.0, P = 0.475). The symptom scores were low tendency in KRG group (KRG vs placebo; 9.5 +/- 4.5 vs 17.6 +/- 23.1, P = 0.241). The study suggests that KRG may be effective in protecting subjects from contracting ARI, and may have the tendency to decrease the duration and scores of ARI symptoms.