Objective: Agriculture is a hazardous industry. However, previous studies have focused on injuries to agricultural workers without comparison with injuries to nonagricultural workers. Therefore, we compared the clinical characteristics and outcomes of injuries reported at an emergency department (ED) between agricultural workers and nonagricultural workers. Methods: We established a prospective ED-based agricultural injury surveillance system at a tertiary university hospital. Adult patients visiting the ED for an injury were divided into farmer and non-farmer groups depending on their engagement with agriculture. Using an adjusted multivariate analysis and propensity score matching (age, sex, inhabitant, and insurance type), we compared the clinical characteristics and outcomes of injuries between the farmer and non-farmer groups. Results: In total, 38,556 injured adult patients (37,746 in the non-farmer group and 810 in the farmer group) were available for the unmatched sample analysis. The 1,620 matched subjects were equally classified after one-to-one nearest-neighbor propensity score matching. A multivariate logistic regression analysis of the unmatched sample revealed higher adjusted odds ratios (ORs) for intensive care unit admission (adjusted OR, 1.752; P=0.003) and overall surgery (adjusted OR, 1.870; P<0.001) in the farmer group. In contrast, univariate logistic regression analyses of the propensity score–matched sample found a higher OR in the farmer group only for overall surgery (OR, 1.786; P<0.001). Conclusion Injuries of agricultural workers had higher odds only of requiring surgery; differences in injury-related mortality between groups were not statistically significant in either the matched or unmatched sample analyses.

BACKGROUND: The rate of cognitive change and prognostic factor in Alzheimer's disease are important for clinical management, but little is known in Korea. We report a one year follow-up study of comprehensive evaluation including cognitive functions, behavioral and psychological symptoms of dementia (BPSD) and activity of daily living (ADL). METHODS: 43 patients with Alzheimer's disease were enrolled. All subjects received the Korean version of Mini-Mental State Examination (K-MMSE), the Severe Dementia Scale (SDS), the extended version of Korean Clinical Dementia Rating Scale (CDR) and Sum of Box (CDR-SB), the Barthel index of Activity of Daily Living (B-ADL), the Korean Instrumental Activity of Daily Living (K-IADL) and the Korean version of the Neuropsychiatric Inventory (K-NPI). We retested each scale after 1 year and evaluated the changes. RESULTS: The mean change rates of K-MMSE, SDS, CDR, CDR-SB and B-ADL scores were 2.0 +/- 3.2 (-7~8) mean +/- SD (range), 3.5 +/- 4.9 (-7~14), -0.4 +/- 0.7 (-2~1), -0.8 +/- 4.4 (-10~9) and 1.5 +/- 3.7 (-7~9). The change of K-MMSE and B-ADLscore according to CDR were significantly different. The annual rates of changes of scores on K-MMSE, B-ADL and CDR were largest in CDR 1 group (K-MMSE: 4.0 +/- 2.7, B-ADL: 3.4 +/- 2.8, CDR: -1 +/- 0.7). The change rate of SDS was largest in CDR 4 (7.2 +/- 4.3). There were not any significant factors that affected the change of K-MMSE, SDS, B-ADL or CDR. CONCLUSIONS: These results suggest that K-MMSE is sensitive to the early stage and SDS is sensitive to the later stage. The deterioration rate of cognitive function in Alzheimer's disease is large at middle stage.
Alzheimer Disease* ; Cognition ; Dementia ; Follow-Up Studies* ; Humans ; Korea ; Longitudinal Studies ; Prognosis

Myiasis is a relatively common infection of animals kept as pets, although only 1 case of canine myiasis has been described so far in the Republic of Korea. In the present study, we report an additional case of canine wound myiasis with identification of its causative agent, Lucilia sericata. An 8-year-old male Siberian husky dog was referred with anorexia, vomiting, and diarrhea to the Chungbuk National University Veterinary Medical Center, Cheongju-si (city), Chungcheongbuk-do (province), Korea in July 2013. Physical examination indicated the patient had a deep wound filled with a maggot swarm as a left gluteal lesion. A total of 216 maggots were removed by forceps, and the wounded area was sponged with gauzes and disinfected with 70% alcohol and a povidone-iodine solution. After daily care and suturing the wound, the patient was discharged at day 19 after admission. Recovered worms possessed morphological characteristics similar to those of L. sericata, namely, a sub-cylindrical body with 6–8 lobed anterior spiracles, round shaped with a button surrounded by a peritremal ring with no gaps, and similar distances between dorsal, median, and outer papillae of the 12th segment. Additionally, cox1 partial sequences (528 bp) obtained in the present study showed 100% identity with those of L. sericata (GenBank no. KT272854.1). L. sericata is indicated as a pathogen of myiasis infection not only in humans, but also in animals kept as pets in Korea.
Animals ; Anorexia ; Child ; Chungcheongbuk-do ; Diarrhea ; Dogs ; Humans ; Korea* ; Larva ; Male ; Myiasis* ; Physical Examination ; Povidone-Iodine ; Republic of Korea ; Surgical Instruments ; Vomiting ; Wounds and Injuries*

Aspidogastrid trematodes (Subclass Aspidogastrea) are a relatively small group with a characteristic adhesive disc and parasitize in a variety of cold-blooded hosts. Until now, only 2 species in the genus Cotylaspis, i.e., C. coreensis and C. sinensis, have been reported as the aspidogastrid trematode in the Republic of Korea (=Korea). In the present study, we intended to describe a species of aspidogastrids collected from the small intestine of the common carp, Cypri-nus carpio, in a faunistic point of view. Total 51 specimens were collected from a carp caught in Nakdong-gang (River) on May 2015. Some of them were prepared as the specimens for light microscopic observations, and some others were prepared for SEM. They were slightly elongated without head lobes, 2,432×840 μm in average size, and had characteristic adhesive discs with 4 rows and 46 alveoli in average. The ovary was reniform and was located in the posterior-upper part of the body. The single testis was larger than the ovary and was located below the ovary. The uterus was coiled containing numerous eggs and distributed in the posterior 2/3 of the body. The vitellaria were follicular, and distributed from the mid-level of testis to near the posterior end. The morphological characters with dimensions of our specimens were closely identical with those of Aspidogaster ijimai previously described. A new aspidogastrid is added among the Korean trematode fauna by the present study.
Adhesives ; Carps* ; Eggs ; Female ; Head ; Intestine, Small ; Korea* ; Ovary ; Ovum ; Republic of Korea ; Testis ; Uterus

Present study was performed to survey infection status of digenetic trematode metacercariae in 2 alien fish species, Micropterus salmoides (largemouth bass) and Lepomis macrochirus (bluegill), in 2 rivers draining Chungcheongbuk-do, Republic of Korea. A total of 107 largemouth bass and 244 bluegills were caught in Daecheong-ho (ho=lake) and Musim-cheon (a branch of Geum-gang), in Chungcheongbuk-do April–July 2015. Additionally, 68 native fish of 5 species, i.e., Zacco platypus, Hemibarbus longirostris, Carassius auratus, Pseudogobio esocinus and Puntungia herzi, were caught from the same water bodies. All of the fish collected were examined by artificial digestion method. The metacercariae of Centrocestus armatus, Clinostomum complanatum, Metagonimus sp. and Diplostomum spp. were detected from 4 out of 5 native fish species in Daecheong-ho. However, any metacercariae were not found from 87 M. salmoides and 177 L. macrochirus in Daecheong-ho. In Musim-cheon, metacercariae of Exorchis oviformis and Metacercaria hasegawai were detected from 78% Z. platypus and 34% L. macrochirus, but any metacercariae not found in M. salmoides. We report here that the 2 alien fish species were less infected with the metacercariae than the native ones. Surveys on the metacercariae in the alien fish species in geographically various rivers should be undertaken for better understanding on the role of alien fish species in the trematode infections in Republic of Korea.
Bass ; Chungcheongbuk-do ; Digestion ; Emigrants and Immigrants ; Goldfish ; Heterophyidae ; Humans ; Metacercariae ; Methods ; Perciformes ; Platypus ; Republic of Korea ; Rivers ; Trematode Infections ; Water

This study was undertaken to determine the complete mitochondrial DNA sequence and structure of the mitochondrial genome of Spirometra ranarum, and to compare it with those of S. erinaceieuropaei and S. decipiens. The aim of this study was to provide information of the species level taxonomy of Spirometra spp. using the mitochondrial genomes of 3 Spirometra tapeworms. The S. ranarum isolate originated from Myanmar. The mitochondrial genome sequence of S. ranarum was compared with that of S. erinaceieuropaei (GenBank no. KJ599680) and S. decipiens (Gen-Bank no. KJ599679). The complete mtDNA sequence of S. ranarum comprised 13,644 bp. The S. ranarum mt genome contained 36 genes comprising 12 protein-coding genes, 22 tRNAs and 2 rRNAs. The mt genome lacked the atp8 gene, as found for other cestodes. All genes in the S. ranarum mitochondrial genome are transcribed in the same direction and arranged in the same relative position with respect to gene loci as found for S. erinaceieuropaei and S. decipiens mt genomes. The overall nucleotide sequence divergence of 12 protein-coding genes between S. ranarum and S. decipiens differed by 1.5%, and 100% sequence similarity was found in the cox2 and nad6 genes, while the DNA sequence divergence of the cox1, nad1, and nad4 genes of S. ranarum and S. decipiens was 2.2%, 2.1%, and 2.6%, respectively.
Base Sequence ; Cestoda ; Classification ; DNA, Mitochondrial ; Genes, vif ; Genome ; Genome, Mitochondrial ; Myanmar ; RNA, Transfer ; Spirometra

Background: The corner pocket (CP) approach for supraclavicular block (SCB) prevents ulnar nerve (UN) sparing due to needle proximity to the lower trunk. Improved ultrasound resolution has suggested that the intertruncal (IT) approach is a suitable alternative method. We compared efficiency of these two approaches on the UN blockade. Methods: Sixty patients were randomized to undergo SCB using the ultrasound-guided CP or IT approach. For lower trunk blockade, 10 ml of local anesthetic agents (1 : 1 mixture of 0.75% ropivacaine and 1% lidocaine) were injected in the CP (CP approach) or between the lower and middle trunks (IT approach). Additional 15 ml was injected identically to block the middle and upper trunks in both groups. Sensory and motor blockade was evaluated after intervention. Results: Complete sensory blockade (75.9% [22/29] vs. 43.3% [13/30], P = 0.023) and complete motor blockade (82.8% [24/29] vs. 50.0% [15/30], P = 0.017) of the UN at 15 min after SCB were significantly more frequent in the IT than in the CP group. Sensory block onset time of the UN was significantly shorter in the IT compared to the CP group (15.0 [10.0; 15.0] min vs. 20.0 [15.0; 20.0] min; P = 0.012). Conclusions The IT approach provided a more rapid onset of UN blockade than the CP approach. These results suggest that the IT approach is a suitable alternative to the CP approach and can provide faster surgical readiness.

In the present study, we identified a Spirometra species of Myanmar origin (plerocercoid) by molecular analysis using mitochondrial cox1 and nad1 genes, as well as by morphological observations of an adult tapeworm. Spargana specimens were collected from a paddy-field in Taik Kyi Township Tarkwa Village, Yangon, Myanmar in December 2017. A total of 5 spargana were obtained from 20 frogs Hoplobatrachus rugulosus; syn: Rana rugulosa (Wiegmann, 1834) or R. tigrina (Steindachner, 1867). The plerocercoids were used for experimental infection of a dog. After 4 weeks of infection, an adult tapeworm was recovered from the intestine of the dog. Morphologically, the distinct features of Spirometra sp. (Myanmar origin) relative to S. erinaceieuropaei and S. decipiens include a uterine morphology comprising posterior uterine coils that larger than the terminal uterine ball and coiling of the uteri diagonally (swirling) rather than spirally. The cox1 sequences (1,566 bp) of the Myanmar-origin Spirometra species showed 97.9% similarity to a reference sequence of S. decipiens (GenBank no. KJ599679) and 90.5% similarity to a reference sequence of S. erinaceieuropaei (GenBank no. KJ599680). Phylogenetic tree topologies were identical and presented high confidence level of values for the 3 major branches of the 3 Spirometra species in cox1 and nad1 genes. These results indicated that Myanmar-origin Spirometra species coincided with those of S. ranarum and may be considered as a valid species.
Adult ; Animals ; Cestoda ; Dogs ; Genes, vif ; Humans ; Intestines ; Myanmar ; Ranidae ; Spirometra ; Trees ; Uterus

The present study was performed with morphological and molecular analysis (cox1 and nad1 mitochondrial genes) to identify the proglottids of spirometrid tapeworm found in the stool of an African lion, Panthera leo, in the Serengeti plain of Tanzania. A strand of tapeworm strobila, about 75 cm in length, was obtained in the stool of a male African lion in the Serengeti National Park (34° 50′ E, 02° 30′ S), Tanzania, in February 2012. The morphological features of the adult worm examined exhibited 3 uterine coils with a bow tie appearance and adopted a diagonal direction in the second turn. The posterior uterine coils are larger than terminal uterine ball and the feature of uteri are swirling rather than spirally coiling. The sequence difference between the Spirometra species (Tanzania origin) and S. erinaceieuropaei (GenBank no. KJ599680) was 9.4% while those of S. decipiens (GenBank no. KJ599679) differed by 2.1% in the cox1 and nad1 genes. Phylogenetic tree topologies generated using the 2 analytic methods were identical and presented high level of confidence values for the 3 major branches of the 3 Spirometra species in the cox1 gene. The morphological and molecular findings obtained in this study were nearly coincided with those of S. ranarum. Therefore, we can know for the first time that the African lion, Panthera leo, is to the definitive host of this tapeworm.
Adult ; Cestoda ; Humans ; Lions ; Male ; Panthera ; Parks, Recreational ; Spirometra ; Tanzania ; Trees ; Uterus

Cystic echinococcosis is a zoonotic parasitic disease caused by Echinococcus species. Tanzania is one of the endemic countries with cystic echinococcosis. This study focussed on identifying genotypes of Echinococcus spp. in Tanzania. We collected 7 cysts from cattle in Mwanza municipal (n=4) and Loliondo district (n=3). The cysts from Mwanza were all E. ortleppi and fertile. In contrast, the cysts from Loliondo were all E. granulosus sensu stricto and sterile. Two from the 4 cysts were a new haplotype of E. ortleppi (G5). These results can improve the preventive and control programs for humans and livestock in Tanzania. To our knowledge, this study is considered the first to identify the genotype and haplotype of Echinococcus spp. in Tanzania.