The Jinyang Lake is dammed up Nam River, and surrounded by Jinju city and four counties; Jinyang, Sanchong, Hadong, and Sachon in Kyongsang-Nam-Do, Korea. The area around this man-made lake have been known as an endemic focus of clonorchiasis in Korea. The present study was first aimed to know the distribution of freshwater mollusks including medically important snails, and larval trematodes shed from Parafossarulus manchouricus and Semisulcospira libertina. In addtion to above studies, water analyses in each snail habitat were carried out in order to figure out a part of their environmental factors. This malaco-ecological survey was done at the six areas around upper, middle and lower parts of the lake for 4 months, August-November, 1983. Total nine species of freshwater mollusks were collected throughout the study: 4 species of gastropods; Semisulcospira libertina, Cipangopaludina chinensis, Parafossarulus manchouricus and Radix auricularia, and 5 species of bivalves; Unio douglasiae, Anodonta woodiana, Lamprotula gottschei, Corbicula fluminea and Limnoperma lucustris. Out of nine species of freshwater mollusks, three species of gastropods; S. libertina, P. manchouricus and R. auricularia were medically important in terms of the transmission of digenetic trematodes to humans. P. manchouricus and R. auricularia were mainly collected from the shallow ponds and the irrigation channels with the muddy basin, but S. libertina and the bivalves were only collected from the stream of Nam river where the gravels and rocks were dominant. The levels of dissolved oxygen(D.O.) and biochemical oxygen demand (B.O.D.(5)) of the water specimens sampled from the study areas ranged from 6.0 to 9.6 ppm and from 0.4 to 1.6 ppm respectively. As a result, it is considered that water system around the Jinyang Lake might be relatively clean without any heavy pollution of aquatic microorganisms and organic materials during the period of this study. On the other hand, eight metalic constituents from the water samples were also assayed, and all metalic ions detected were remarkably low below the legal criteria. However, calcium ion in the water samples from the habitats of P. manchouricus was considerably higher than others. Infection rates of digenetic trematodes in the snails were 6.9 percent in P. manchouricus and 4.8 poercent in S. libertina, respectively. P. manchouricus snails harboring with the cercariae of Clonorchis sinensis were only 0.14 percent among the snails examined and other trematode cercariae except cercaria of C. sinensis were; furcocercus cercariae, cercaria of Loxogenes liberum type I and II. S. libertina snails parasitized with the cercariae of Metagonimus yokogawai were 1.5 percent out of the snails examined and no cercaria of Paragonimus westermani was found in S. libertina snails in the present study. Digenetic trematode cercariae other then M. yokogawai in S. libertina snails were: Cercaria yoshidae (B type), Cercaria cristata, Cercaria innominatum, Cercaria of Centrocestus formosanus and Cercaria nipponensis.
parasitology-helminth-trematoda ; Clonorchis sinensis ; Loxogenes liberum ; Metagonimus yokogawai ; Centrocestus formosanus ; Cercaria cristata ; Cercaria innominatum ; Cercaria nipponensis ; epidemiology ; Parafossarulus manchouricus ; Semisulcospira libertina ; Radix auricularia

BACKGROUND: Pusan is geographically far away from the indigenous area of malaria. It is the area where the tourists and foreigners travel through frequently because of the port. We investigated the situation in Pusan concerning malaria through the examination of malaria patients who contracted it recently. We found the ways to decrease erroneous diagnosis presuming malaria on the basis of these studies. METHODS: We retrospectively analyzed the medical records of 28 confirmed cases of malaria with the chief complaint of repeated high fever, who were admitted and treated in the Pusan Adventist Hospital and Pusan Samsun Hospital from June 1997 to August 2000. RESULTS: 25 cases were indigenous and 3 patients were imported cases contracted overseas. Peripheral blood smears revealed Plasmodium vivax in all indigenous cases, whereas 2 were P. falciparum and 1 case was P. vivax in the imported cases. Yeonchon-goon(9 cases) was the most prevalent area in the indigenous cases. Africa and Southeast Asia(3 cases) were the contracted areas in the imported cases. 27 cases were men and 1 case was a woman among the 28 cases, and the incidence was high peak in 8-10 month. Most of the patients(72.1%) were in the their 20's, and most of all had worked in the military bases near the demilitarized zone(DMZ). Thrombocytopenia and leukopenia were found more frequently by the laboratory findings. 23 of the cases(82%) were suspected to be malaria, before we confirmed it by peripheral blood smears. CONCLUSION: The number of patients with indigenous malaria from the other areas in Korea and patients with malaria from foreign countries will be expected to increase. Before we confirmed the malaria by peripheral blood smears, the cases suspected of malaria were 82.1%. This is a high diagnostic rate due to careful history taking and physical examination. The doctors decreased the rate of erroneous diagnosis of malaria and should be careful in the choice of the proper drugs.
Africa ; Busan* ; Diagnosis ; Emigrants and Immigrants ; Female ; Fever ; Humans ; Incidence ; Korea ; Leukopenia ; Malaria* ; Male ; Medical Records ; Military Facilities ; Physical Examination ; Plasmodium vivax ; Retrospective Studies ; Thrombocytopenia

BACKGROUND: C-reactive protein (CRP) levels are known to reflect chronic inflammatory processes of the cardiovascular system. In particular, it has been reported that high-sensitivity CRP (hs-CRP) may be a promising marker of development of atherosclerosis and cardiovascular disease. CRP may also have an active role in atherogenesis. METHODS: The relationship between hs-CRP and the classic cardiovascular risk factors was assessed in 186 subjects, aged 23-75 years, who entered the health-check program of Chung-Ang University Hospital. hs-CRP was measured by immunoturbidimetric assay. Quintiles of hs-CRP (quintile 1; < 0.7, quintile 2; 0.7-1.1, quintile 3; 1.2-1.9, quintile 4; 2.0-3.8, quintile 5; 3.9-15 mg/L), total cholesterol (TC)/high density lipoprotien-cholesterol (HDL-C) ratio, and relative risk (RR) estimates derived from quintiles of hs-CRP and TC/ HDL-C ratio, were used for the data analysis. RESULTS: Of the 186 subjects, 48 were hypertensive and 138 were normotensive. The serum hs-CPR values for the hypertensive subjects were 0.27+/-0.83 mg/L, compared to 0.12+/-0.23 mg/L for the normotensive subjects; this difference was not significant (P=0.0536) when tested on the arithmetic means, but highly significant (P=0.0091) when the geometric means were compared. The quitiles of hs-CRP were also significantly higher (P=0.0094) in the hypertensive subjects than in the normotensive subjects, when evaluated using Wilcoxon rank sum test. Of the 138 normotensive subjects, only 35 (25.4%) were in quintile 3 or over 3 and 18 (13.0%) in quintile 4 or 5, whereas the respective figures for the 48 hypertensive subjects were 21 (43.8%) and 15 (31.3%). Similarly, of the normotensive subjects, only 47 (34.1%) had RR estimates over 2 and 19 (13.8%) over 3, whereas the respective figures for the hypertentive subjects were 28 (58.3%) and 16 (33.3%). CONCLUSIONS: High-sensivity CRP may be useful in for the screening of the subjects who need preventive measures against cardiovascular diseases. The quintiles of hs-CRP, together with TC/HDL-C ratio, may be useful for the estimation of RR in subjects with low levels of hs-CRP.
Atherosclerosis ; C-Reactive Protein* ; Cardiovascular Diseases ; Cardiovascular System ; Cholesterol ; Humans ; Hypertension ; Mass Screening ; Risk Factors ; Statistics as Topic

The sensitivity and specificity of crude and affinity-purified antigens of Clonorchis sinensis obtained from the infected rabbits were studied. Stage-specific antigenic proteins from the eggs, metacercariae and adult worms were characterized by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and enzyme-linked immunosorbent assay (ELISA) The results were as follows: The antibody-binding antigen (ABA) purified from whole worm crude antigen (WWA) by CNBr-activated Sepharose 4B affinity chromatography made 4 specific bands against rabbit anti-sera on Ouchterlony gel diffusion plate, while WWA made 7 bands. Major WWA protein bands by SDS-PAGE were found at 16,300-18,500 and 28,000-29,000 daltons, while major ABA protein bands were at 18,000-21,000 and 29,000-31,000 daltons. The reactivity of ABA with rabbit anti-sera in ELISA was remarkably less sensitive than that of WWA. Molecular weights of egg antigen (EGA), metacercarial antigen (MEA) and adult worm antigen (WWA) of C. sinensis ranged from 15,000-200,000 daltons, 15,000-100,000 daltons and 11,000-80,000 daltons, respectively. Major WWA proteins consisted mainly of polypeptide bands of low molecular weight, less than 31,000 daltons, while those of EGA and MEA consisted of higher molecular weights than 30,000 daltons. The ELISA reactivities of WWA to rabbit anti-sera were remarkably greater than those of MEA. EGA showed negative reaction throughout the experiments. WWA showed higher optical density (O.D.) than 1.0, when reacted with rabbit anti-sera obtained at 4-6 weeks after the infection. In the rabbit anti-sera later than 12 weeks after the infection, the O.D. reacting with WWA showed a plateau without variation. MEA showed relatively low O.D. values (<0.6), when reacted with anti-sera from lightly infected groups throughout the experiments, although there were some weak positive cases (O.D.>0.6) in heavily infected groups. MEA reacted with rabbit anti-sera showed negative results on Ouchterlony gel diffusion plates. Summarizing the above results, it is suggested that the whole worm antigen prepared from the adult worms of C. sinensis is most highly antigenic. However, this antigen might reveal cross reactions with other trematodes such as Paragonimus westermani, therefore, purification of antigenic proteins from the crude antigen is essential to increase the sensitivity and specificity for the immunodiagnosis of clonorchiasis.
parasitology-helminth-trematoda ; Clonorchis sinensis ; clonorchiasis ; rabbit ; immunology ; diagnosis ; antigen

Mycophenolate mofetil (MMF) is an immunosuppressive agent used to treat severe lupus, including lupus nephritis. Common adverse effects of MMF include gastrointestinal and hematological manifestations; however, cardiac toxicity in association with MMF has not been reported. We present a 21-year-old woman with lupus nephritis who developed ventricular tachycardia 2 hours after an overdose of MMF (34 g). Ventricular bigeminy was documented 12 hours after the MMF overdose. Transthoracic echocardiography showed no evidence of structural heart disease. The ventricular arrhythmia was successfully treated with potassium replacement, hydration, and cholestyramine. This case suggests that an overdose of MMF can induce ventricular tachycardia, and electrocardiogram monitoring is critical to identify this rare cardiac complication of MMF.
Arrhythmias, Cardiac ; Cardiotoxicity ; Cholestyramine Resin ; Echocardiography ; Electrocardiography ; Female ; Heart Diseases ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Mycophenolic Acid ; Potassium ; Tachycardia, Ventricular ; Young Adult

Mycophenolate mofetil (MMF) is an immunosuppressive agent used to treat severe lupus, including lupus nephritis. Common adverse effects of MMF include gastrointestinal and hematological manifestations; however, cardiac toxicity in association with MMF has not been reported. We present a 21-year-old woman with lupus nephritis who developed ventricular tachycardia 2 hours after an overdose of MMF (34 g). Ventricular bigeminy was documented 12 hours after the MMF overdose. Transthoracic echocardiography showed no evidence of structural heart disease. The ventricular arrhythmia was successfully treated with potassium replacement, hydration, and cholestyramine. This case suggests that an overdose of MMF can induce ventricular tachycardia, and electrocardiogram monitoring is critical to identify this rare cardiac complication of MMF.

Skin burn injury from light cables is a rare complication of laparoscopic surgery. We report the case of a 57-year-old female who underwent laparoscopic-assisted right hemicolectomy under general anesthesia. During surgery, the anesthesiologist discovered that the tip of the light cable, with the light source powered on, penetrated the surgical drape and was positioned on the right forearm of the patient, where a bulla measuring 2.0× 2.5 cm in size and a second-degree burn were identified. All medical personnel participating in laparoscopic and arthroscopic procedures should always be aware that the light cable can cause burns to the patient. Additionally, after connecting the light cable to the scope, the light source should be activated. The light cable should not be placed around the patient or on the surgical drape while the light source is active. Immediately after completing the surgery, the power to the light source should be turned off, and the light cable should be placed in a safe place.

Patterns of brain-stem compression and secondary brain-stem evoked postentials were investigated to correlate with expanding mass volume and location in mass-induced supratentorial brain compression in cats in which the subjects were divided into four experimental group i.e., frontal, temporal, parietal, and occipital brain-compressed groups. Postmortem insepection of the brain-stem showed either unilateral or bilateral dorsal herniation of the brain in frontal and temporal brain-compressed groups and dorsolateral herniation in parietal and occipital brain-compressed groups, respectively. Microscopic examination revealed that the secondary brain-stem hemorrhages were mostly caused by venous bleeding secondary to venous congestion, the bleeding being more severe in occipital brain-compressed group. As the intracranial pressure was raised by expansion of a supratentorial balloon, the late components of the BSEP were suppressed first, followed by the suppression of the early components. In BSEP recording a significant change was observed in Vth wave with prolongation of latency and decrease in amplitude. This finding suggests that the midbrain is the most vulnerable to compression ischemia. In parietal group, the Vth wave started to be prolonged at 0.4ml of balloon expansion and totally disappeared at 1.8ml of expansion.
Animals ; Brain Stem* ; Brain* ; Cats ; Hemorrhage ; Hyperemia ; Intracranial Hypertension ; Intracranial Pressure ; Ischemia ; Mesencephalon ; Rabeprazole

We examined whether alterations in vascular endothelial function and early structural changes in atherosclerosis are associated with microvascular complications in patients with type 1 diabetes mellitus (DM). Flow-mediated dilation (FMD) of the brachial artery and carotid intima-media thickness (IMT) measurement were performed in 70 young adults (aged 19 to 35 yr), 48 with type 1 DM, and 22 normal controls. Patients with diabetes had a lower peak FMD response (7.8+/-3.9 vs. 11.1 +/-1.9%, p<0.001) and increased IMT (0.51+/-0.10 vs. 0.42+/-0.07 mm, p<0.001) compared with controls. Twenty (41.7%) of the patients had microvascular complications including neuropathy, nephropathy, or retinopathy. In these complicated diabetic patients, we found a lower FMD response (6.1+/-2.5 vs. 9.9+/-3.5%, p=0.001) compared with diabetics without microvascular complications. The presence of microvascular complications was also associated with older age and longer duration of the disease. However, no differences were observed in IMT, body size, blood pressure, HbA1c, C-reactive protein, low-density lipoprotein or high-density lipoprotein cholesterol levels between complicated and non-complicated patients. Endothelial dysfunction and early structural atherosclerotic changes are common manifestations in type 1 DM, and endothelial dysfunction is thought to be an early event in the atherosclerotic process and important in the pathogenesis of microvascular complications.
Adult ; Diabetes Mellitus, Type 1/*complications ; Diabetic Angiopathies/*etiology ; Endothelium, Vascular/*physiology ; Female ; Humans ; Male ; *Microcirculation ; Tunica Intima/pathology ; Tunica Media/pathology ; Vasodilation

OBJECTIVE: To compare the accuracy rates of non-guided vs. ultrasound-guided needle placement in four lower limb muscles (tibialis posterior, peroneus longus, and short and long heads of the biceps femoris). METHODS: Two electromyographers examined the four muscles in each of eight lower limbs from four fresh frozen cadavers. Each electromyographer injected an assigned dye into each targeted muscle in a lower limb twice (once without guidance, another under ultrasound guidance). Therefore, four injections were done in each muscle of one lower limb. All injections were performed by two electromyographers using 18 gauge 1.5 inch or 24 gauge 2.4 inch needles to place 0.5 mL of colored acryl solution into the target muscles. The third person was blinded to the injection technique and dissected the lower limbs and determined injection accuracy. RESULTS: A 71.9% accuracy rate was achieved by blind needle placement vs. 96.9% accuracy with ultrasound-guided needle placement (p=0.001). Blind needle placement accuracy ranged from 50% to 93.8%. CONCLUSION: Ultrasound guidance produced superior accuracy compared with that of blind needle placement in most muscles. Clinicians should consider ultrasound guidance to optimize needle placement in these muscles, particularly the tibialis posterior.
Cadaver* ; Electromyography ; Head ; Humans ; Lower Extremity ; Muscles ; Needles* ; Ultrasonography