BACKGROUND: Enteroviruses are known as major pathogen for aseptic meningitis. Although rapid diagnosis for enteroviruses is very essential to exclude bacterial infections in patients with meningitis, classical diagnostic method based on virus isolation is not practicable for timely treatment of patients due to its laborious and time-consuming procedure. Recently molecular methodologies as alternatives are routinely used for rapid and sensitive diagnosis for enteroviruses infections. METHODS: Reverse transcription (RT)-PCR ELISA kit for targeting 5'non-coding region (NCR) with highly conserved genetic identity among all genotypes of enteroviruses was introduced in this investigation. RT-PCR ELISA was evaluated about sensitivity and specificity through virus isolation using clinical specimens from patients suspected of enteroviral infections and enteroviral isolates comparing with conventional RT-PCR identifying them. RESULTS: The detection limit of the RT-PCR ELISA was up to 10-100 folds higher than virus isolation using cell culture and conventional RT-PCR. On comparison between above two methods, the detection rate of RT-PCR ELISA for clinical specimens from patients with aseptic meningitis was 7% higher than that of conventional RT-PCR targeting 5'NCR (P=0.016). CONCLUSIONS: Our results suggest that RT-PCR ELISA developed in this study could be an alternative diagnostic method for the detection of enteroviral genome with high sensitivity and specificity.
5' Untranslated Regions ; Adolescent ; Child ; Child, Preschool ; Enterovirus/genetics/*isolation & purification ; Enterovirus Infections/*diagnosis ; *Enzyme-Linked Immunosorbent Assay ; Humans ; Infant ; Meningitis, Aseptic/diagnosis ; RNA, Viral/analysis ; *Reverse Transcriptase Polymerase Chain Reaction ; Rotavirus/genetics ; Rotavirus Infections/diagnosis ; Sensitivity and Specificity

BACKGROUND: Emergencies in dentistry can be classified as medical and dental. Medical emergencies occur mainly during dental treatment in patients with a systemic disease. Dental emergency departments are largely divided into dental emergency rooms located in dental college hospitals and medical emergency rooms located in medical institutions. This study aimed to analyze the characteristics of and provide help to dental emergency patients in a dental hospital. METHODS: Overall, 1806 patients admitted to a dental emergency room at Yonsei University Dental Hospital for 1 year were included. The data collection period was from October 1, 2014 to September 30, 2015. An investigator reviewed medical records from the electronic medical record (EMR) system and radiographs. RESULTS: The patients were 1,070 men and 736 women. The sex ratio was 1.45:1. The commonest age group was of 0–9 years, including 451 (25.0%) patients, followed by 20–29 years, including 353 (19.5%) patients, and 30–39 years, including 277 (15.3%) patients. Of the 108 patients transferred to the Severance emergency department, 81 had trauma, 19 were in pain, 4 were bleeding, and 4 had other complaints. Among chief complaints, 1,079 patients (60.3%) had trauma, 564 (31.5%) had pain, and 75 (4.2%) had bleeding. Twenty-three cases (1.3%) were caused by temporomandibular disorder (TMD). CONCLUSION: Dentists should be able to adequately assess patients in a dental emergency room and treat trauma, pain, and bleeding.
Data Collection ; Dentistry ; Dentists ; Electronic Health Records ; Emergencies ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Male ; Medical Records ; Research Personnel ; Retrospective Studies ; Sex Ratio ; Temporomandibular Joint Disorders

Echovirus 6 (ECV6) is the prevalent serotype detected in aseptic meningitis cases in Korea. To analyze the genetic variation of ECV6 isolates recently circulating in Korea, we determined the partial sequence of the VP1 capsid gene from 22 Korean ECV6 isolates and performed pairwise analysis against 42 reference strains from the GenBank database using MegAlign. The 22 Korean ECV6 isolates formed 3 distinct genetic clusters: Kor-lineage I, II, and III. The Korean ECV6 strains showed significant genetic diversity with 14.8~22.8% nucleotide divergence among the 3 different lineages. These ECV6 Kor-lineages were demonstrated to belong to different genetic clusters using VP1 sequence-based phylogenetic analysis, implying that the recently circulating Korean ECV6 strains have potential antigenic variation.
Antigenic Variation ; Capsid ; Databases, Nucleic Acid ; Echovirus 6, Human ; Enterovirus B, Human ; Genetic Variation ; Korea ; Meningitis, Aseptic

PURPOSE: To clarify the difference between the bolus-tracking technique and a fixed scan delay protocol in the achievement of the optimal pancreatic phase of the pancreas with MDCT. MATERIALS AND METHODS: 526 patients underwent pancreatic and portal venous phase imaging of the pancreas using 16-channel MDCT. All the examinations were randomized into either scanning using a bolus-tracking technique with a scan delay of 20s after the aorta was enhanced > 100 HU (groups 1 and 2) or scanning with a scan delay of 38 s from the beginning of the injection (groups 3 and 4). A contrast material of 300 mgI/mL (groups 1 and 3) or 370 mgI/mL (groups 2 and 4) at an injection speed of 3 mL/sec was injected at 2 mL/kg body weight. The pancreatic CT attenuation values were compared. RESULTS: The scan delay times of the pancreatic phase in groups 1 and 2 were 38+/-3.8s and 37.4+/-3.4s, respectively. At the pancreatic phase, the pancreatic attenuation values of groups 1 and 2 were slightly higher than those of groups 3 and 4 (115.5+/-15.4 vs 111.7+/-15.1HU; p=0.093, 128.3+/-17.1 vs 119+/-17.1HU; p=0.003). There was no significant difference between groups at the portal venous phase. CONCLUSION: The use of a bolus-tracking technique in the optimal pancreatic phase of pancreatic CT does not significantly improve the pancreatic enhancement but does at higher iodine concentrations.
Aorta ; Body Weight ; Humans ; Iodine ; Pancreas*

OBJECTIVES: Using two stimuli, this study was designed to evaluate variations of P300 in relations to reaction time of pressing the button for target tones in patients with schizophrenia. METHODS: The auditory oddball paradigm was used for the patients (N=22) and normal controls (N=23). The two stimuli were composed of target (20%, 2000 Hz, 75 dB) tone and standard (80%, 1000 Hz, 75 dB) tone, with 2 sec inter-stimulus interval, 50 msec duration and 10 msec rise or fall time. In each subject, P300s were acquired for both fast reaction time (FRT) and slow reaction time (SRT) to target response. RESULTS: P300 amplitude in patients with schizophrenia was lower than controls across FRT and SRT (p<0.001), but P300 latency was not delayed (p>0.8). In this study, even though the reaction time for the button pressing task might be faster in patients with schizophrenia (p<0.1), the P300 to FRT in patients with schizophrenia was lower than the P300 to SRT in controls (p<0.01). CONCLUSION: These results suggest that the lower P300 in patients with schizophrenia might be due to cognitive dysfunction and the patient's performance in reaction time for pressing buttons, both independently. Thus, P300 as well as reaction time may be used to further explore a variety of domains of cognitive function.
Evoked Potentials* ; Humans ; Reaction Time* ; Schizophrenia*

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.
Ambulatory Care Facilities ; Evoked Potentials* ; Humans ; Noise ; Schizophrenia*

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.
Ambulatory Care Facilities ; Evoked Potentials* ; Humans ; Noise ; Schizophrenia*

PURPOSE: We sought to maximize the antitumor effect of an anticancer vaccine based on genetically modified endothelial cells by combining it with the platelet-derived growth factor receptor inhibitor imatinib. MATERIALS AND METHODS: Human umbilical vein endothelial cells (HUVECs) were infected with 10 MOI of Ad-CMV-mGMCSF to make anticancer vaccines. One million mouse bladder cancer cells (MBT-2) were subcutaneously inoculated in C3H mice. The experimental groups included the following: Group 1 (phosphate-buffered saline), Group 2 (anticancer vaccine and GM-CSF), Group 3 (imatinib), and Group 4 (anticancer vaccine, GM-CSF, and imatinib). Tumor growth and body weight were measured weekly. At 4 weeks, the tumors were immunostained with anti-CD31, and microvessel density (MVD) was measured. To evaluate the immunological mechanism of each treatment, flow cytometry analysis of activated CD4 and CD8 cells was performed. RESULTS: At 4 weeks, the mean body weight of each group, excluding the extracted tumor weight, was not significantly different. Since week 3, the mean tumor volume in Group 4 was the smallest among the treatment groups (p<0.05), and a synergistic suppressive effect on tumor volume was observed in Group 4. The MVD in Group 4 was the most suppressed among the treatment groups (p<0.05), and a synergistic anti-angiogenic effect was observed. Flow cytometry analysis revealed that activated CD4+ and CD8+ cells increased in Group 2 and decreased in Group 3 compared with the other groups. CONCLUSIONS: The combination of genetically modified endothelial cell vaccines and imatinib showed a synergistic antiangiogenic effect in bladder cancer.
Animals ; Benzamides ; Body Weight ; Endothelial Cells ; Flow Cytometry ; Granulocyte-Macrophage Colony-Stimulating Factor ; Human Umbilical Vein Endothelial Cells ; Immunotherapy ; Mice ; Mice, Inbred C3H ; Microvessels ; Piperazines ; Platelet-Derived Growth Factor ; Pyrimidines ; Receptors, Platelet-Derived Growth Factor ; Tumor Burden ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vaccines ; Imatinib Mesylate

PURPOSE: Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib and Sp vaccination in Korean pediatric HCT recipients. METHODS: Patients were prospectively enrolled at Samsung Medical Center during 2009-2011. ELISA tests to detect anti-PRP IgG antibody and antibodies to Sp serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were performed at the Center for Vaccine Evaluation and Study, Ewha Medical Research Institute. RESULTS: Ten patients (two allogeneic, eight autologous recipients) with median age 5.4 years (range 2.7-12.2 years) were enrolled. Before Hib vaccination, 60% of patients' anti-PRP IgG titers were below 0.15 microg/mL. After vaccination, 100% of patients' anti-PRP IgG titers increased above 0.15 microg/mL (cut-off value for detection) and 1.0 microg/mL (cut-off value for seroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) of IgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 microg/mL and at 5 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. In patients older than 5 years, pre-vaccination GMCs of IgG for four serotypes (4, 9V, 14, and 23F) were below 0.35 microg/mL and at 3 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. CONCLUSION: Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed good immune responses to protective levels after vaccination.
Academies and Institutes ; Antibodies ; Antibody Formation* ; Cell Transplantation* ; Enzyme-Linked Immunosorbent Assay ; Haemophilus influenzae type b* ; Humans ; Immunoglobulin G ; Prospective Studies ; Streptococcus pneumoniae* ; Transplants* ; Vaccination*

Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments’ regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.