Streptomyces avermitilis genome includes 33 genes encoding monooxygenation-catalyzing cytochrome P450 enzymes. We investigated the structure of CYP107P2 and its interactions with terpenoid compounds. The recombinant CYP107P2 protein was expressed in Escherichia coli and the purified enzyme exhibited a typical P450 spectrum upon CO-binding in its reduced state. Type-I substrate-binding spectral titrations were observed with various terpenoid compounds, including α-pinene, β-pinene, α-terpinyl acetate, and (+)-3-carene. The calculated binding affinities (Kd) ranged from 15.9 to 50.8 µM. The X-ray crystal structure of CYP107P2 was determined at 1.99 Å resolution, with a well-conserved overall P450 folding conformation. The terpenoid com-pound docking models illustrated that the structural interaction between monoterpenes and CYP107P2, with the distance between heme and terpenes ranging from 3.4 to 5.4 Å, indicates potential substrate binding for P450 enzyme. This study suggests that CYP107P2 is a Streptomyces P450 enzyme capable of catalyzing terpenes as substrates, signifying noteworthy advancements in comprehending a novel P450 enzyme’s involvement in terpene reactions.

This study aims to identify the regional distribution in the prevalence of dental caries and related multidimensional factors among 12-year-old children in Korea. Data from the 2018 Child Oral Health Survey were used to calculate the average DMFT index of 12-year-old children in metropolitan cities, and a multi-level regression model was applied to explain the regional distribution of dental caries prevalence and related factors. Factors were divided into two levels by administrative structure. This study finds a significant regional difference in the prevalence of dental caries in 12-year-old Korean children across metropolitan cities. Multilevel analysis showed that districtlevel factors (average number of pit and fissure-sealed permanent teeth, dental treatment demand rate, preventive treatment rate, sex ratio, and number of dentists per 100,000 people) and metropolitan-level factors (intakes of cariogenic beverages and number of pediatric dental hospitals and clinics per 100,000 people) had a significant effect on dental caries prevalence (p < 0.05). Individual characteristics and local socio-environmental factors influence the prevalence of dental caries. Especially considering the strong dependence on preventive treatment and accessibility to dental care services, it is necessary to provide adequate preventive treatment and expand health care resources in high-risk areas of dental caries.

A 7-year-old spayed female English Cocker Spaniel dog presented with polyuria (PU), polydipsia (PD), intermittent vomiting, and weight loss. Physical examination revealed pale, tacky mucous membranes and severe emaciation. Hematological and biochemical examinations revealed moderate normocytic normochromic non-regenerative anemia and moderate azotemia. Abdominal ultrasonography demonstrated bilaterally small lumpy-bumpy kidneys with hyperechoic parenchyma as well as loss of renal corticomedullary junction. Based on clinical history and examinations, the dog was diagnosed with chronic kidney disease (CKD). The dog was treated with supportive care including fluid therapy, phosphate-binding agent, and histamine H2-receptor antagonist. Darbepoetin Alfa was administered to control renal secondary non-regenerative anemia. Prescribed diet with low-protein and low-phosphorus was fed to alleviate CKD signs. Further, dietary probiotics were supplemented. This case demonstrates that oral probiotic supplementation helped reduce blood urea-nitrogen (BUN) levels. This case indicates that dietary probiotics can be a potential alternative therapeutic agent for management of renal failure.
Anemia ; Animals ; Azotemia ; Child ; Darbepoetin alfa ; Diet ; Dietary Supplements* ; Dogs* ; Emaciation ; Female ; Fluid Therapy ; Histamine ; Humans ; Kidney ; Mucous Membrane ; Physical Examination ; Polydipsia ; Polyuria ; Probiotics* ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Ultrasonography ; Vomiting ; Weight Loss

BACKGROUND: In support of safe and appropriate utilization of blood products, the Korean Ministry of Health and Welfare and the Korean Society of Blood Transfusion developed transfusion guidelines in 2009. We evaluated the appropriateness of blood transfusions on the basis of these proposed guidelines. METHODS: We investigated the awareness of the 2009 proposed guidelines and the transfusion guidelines currently in use through a questionnaire administered to the physicians of a tertiary care hospital. We provided the 2009 proposed transfusion guidelines through summarized pop-ups for each blood product that appeared in the hospital information system whenever a physician ordered blood products, and promoted the guidelines by posting it on the bulletin board and the hospital information system for one month. Evaluation of the appropriateness of blood transfusion was conducted by reviewing the medical records of patients who were transfused within one month before and one month after the promotion. Further, we also examined the rates of blood wastage and return. RESULTS: Rates of appropriately transfused blood products changed from 29.4% to 33.1% for red blood cells, from 16.9% to 68.9% for platelets, and from 54.8% to 33.3% for fresh frozen plasma. The decreased appropriate transfusion rate of fresh frozen plasma might be due to the small number of transfusions performed during the short study period. The rates of blood wastage and return decreased from 1.77% to 1.21% and from 3.91% to 3.00%, respectively. CONCLUSIONS: Promotion of the new transfusion guidelines lowered the incidence of inappropriate transfusions. Continuous promotion and establishment of these guidelines after adjustments according to the status of each hospital are necessary.
Blood Platelets ; Blood Transfusion ; Erythrocytes ; Hospital Information Systems ; Humans ; Incidence ; Medical Records ; Plasma ; Surveys and Questionnaires ; Tertiary Healthcare

A 2-year-old intact female pomeranian dog presented dyspnea, labored breathing, cough, exercise intolerance, machinery heart murmur, and precordial thrill. A left-to-right patent ductus arteriosus (PDA) was diagnosed based on two-dimensional echocardiography, thoracic radiography, electrocardiography, and blood work. An angiography was performed to accurately evaluate the size and shape of the duct. An interventional approach for transcatheterial occlusion of the PDA was achieved using an Amplatz(R) Canine Duct Occluder (ACDO), which is a commercially available ductal occluding device. Due to the limited size of the dog's femoral artery, a device smaller [125% of minimal ductal diameter (MDD); recommended size: 150~200% of MDD] than recommended was mounted. After placement of the ACDO, precordial thrill and continuous heart murmur disappeared, and the patient was discharged the next day after stabilization with O2 supply. Upon follow up examination, dyspnea, labored breathing, cough, exercise intolerance, and cardiomegaly were improved with no complications after the procedure. The ACDO was well maintained in position. This case represents successful clinical application of the Amplatz(R) Canine Duct Occluder to achieve closure of a PDA using a slightly smaller device than the recommended size.
Angiography ; Animals ; Cardiomegaly ; Child, Preschool ; Cough ; Dogs* ; Ductus Arteriosus, Patent* ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Femoral Artery ; Follow-Up Studies ; Heart Murmurs ; Humans ; Radiography, Thoracic ; Respiration

A 61-year-old woman came to the hospital with dyspnea and pleural effusion on chest radiography. She underwent repeated thoracentesis, transbronchial lung biopsy, bronchoalveolar lavage, and thoracoscopic pleural biopsy with talc pleurodesis, but diagnosis of her was uncertain. Positron emission tomography showed multiple lymphadenopathies, so she underwent endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymph nodes. Here, we report a case of malignant pleural mesothelioma that was eventually diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. This is an unusual and first case in Korea.
Biopsy ; Bronchoalveolar Lavage ; Bronchoscopy ; Dyspnea ; Female ; Humans ; Korea ; Lung ; Lymph Nodes ; Mesothelioma ; Needles ; Pleural Effusion ; Pleurodesis ; Porphyrins ; Positron-Emission Tomography ; Talc ; Thorax

BACKGROUND: The detection of total anti-hepatitis A virus (anti-HAV) immunoglobulin (Ig) and IgM is important for diagnosing acute hepatitis A. Our laboratory introduced new commercial automated chemiluminescence immunoassays (CLIAs) for use in addition to pre-existing automated CLIA. We evaluated the rate of agreement in the detection of total anti-HAV Ig and IgM in serum samples between two automated CLIAs. METHODS: We analyzed 181 samples those were submitted for testing at Kangbuk Samsung Medical Center. We analyzed the rate of agreement between the ADVIA Centaur XP (Siemens, Germany) and the MODULAR ANALYTICS E170 (Roche, Switzerland) analyzers. We performed reverse transcription (RT)-PCR when there was a discrepancy between the results from the two analyzers. RESULTS: The agreement rates between the ADVIA Centaur XP and the MODULAR ANALYTICS E170 for total anti-HAV Ig and IgM were 97.2% and 98.9%, respectively. Discrepant results were obtained in seven cases; all were found to be HAV-negative based on RT-PCR analysis. CONCLUSIONS: The total anti-HAV Ig and IgM results obtained using the two automated analyzers were comparable. However, in cases of equivocal results tested by the ADVIA Centaur XP for anti-HAV IgM, retesting and follow-up testing of samples are recommended.
Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A virus ; Immunoassay ; Immunoglobulin M ; Immunoglobulins ; Luminescence ; Reverse Transcription ; Viruses

Background: Coronavirus disease 2019 (COVID-19) outbreaks occur in hospitals in many parts of the world. In hospital settings, the possibility of airborne transmission needs to be investigated thoroughly. Materials and Methods: There was a nosocomial outbreak of COVID-19 in a hematologic ward in a tertiary hospital, Seoul, Korea. We found 11 patients and guardians with COVID-19 through vigorous contact tracing and closed-circuit television monitoring. We found one patient who probably had acquired COVID-19 through airborne-transmission. We performed airflow investigation with simulation software, whole-genome sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: Of the nine individuals with COVID-19 who had been in the hematologic ward, six stayed in one multi-patient room (Room 36), and other three stayed in different rooms (Room 1, 34, 35). Guardian in room 35 was close contact to cases in room 36, and patient in room 34 used the shared bathroom for teeth brushing 40 minutes after index used.Airflow simulation revealed that air was spread from the bathroom to the adjacent room 1 while patient in room 1 did not used the shared bathroom. Airflow was associated with poor ventilation in shared bathroom due to dysfunctioning air-exhaust, grill on the door of shared bathroom and the unintended negative pressure of adjacent room. Conclusion Transmission of SARS-CoV-2 in the hematologic ward occurred rapidly in the multi-patient room and shared bathroom settings. In addition, there was a case of possible airborne transmission due to unexpected airflow.

Background: Coronavirus disease 2019 (COVID-19) outbreaks occur in hospitals in many parts of the world. In hospital settings, the possibility of airborne transmission needs to be investigated thoroughly. Materials and Methods: There was a nosocomial outbreak of COVID-19 in a hematologic ward in a tertiary hospital, Seoul, Korea. We found 11 patients and guardians with COVID-19 through vigorous contact tracing and closed-circuit television monitoring. We found one patient who probably had acquired COVID-19 through airborne-transmission. We performed airflow investigation with simulation software, whole-genome sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: Of the nine individuals with COVID-19 who had been in the hematologic ward, six stayed in one multi-patient room (Room 36), and other three stayed in different rooms (Room 1, 34, 35). Guardian in room 35 was close contact to cases in room 36, and patient in room 34 used the shared bathroom for teeth brushing 40 minutes after index used.Airflow simulation revealed that air was spread from the bathroom to the adjacent room 1 while patient in room 1 did not used the shared bathroom. Airflow was associated with poor ventilation in shared bathroom due to dysfunctioning air-exhaust, grill on the door of shared bathroom and the unintended negative pressure of adjacent room. Conclusion Transmission of SARS-CoV-2 in the hematologic ward occurred rapidly in the multi-patient room and shared bathroom settings. In addition, there was a case of possible airborne transmission due to unexpected airflow.

BACKGROUND: Mounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women. METHODS: Our study included 2276 Korean women who attended a single fertility center in 2016-2018. Women's exposure to air pollution was assessed using concentrations of particulate matter (PM RESULTS: The mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM CONCLUSIONS In a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women's fertility.
Adult ; Air Pollutants/adverse effects* ; Air Pollution/adverse effects* ; Environmental Exposure/adverse effects* ; Female ; Humans ; Infertility, Female/etiology* ; Ovarian Reserve/physiology* ; Republic of Korea